Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis

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cg.contributor.affiliationInternational Water Management Instituteen_US
cg.coverage.countrySri Lankaen_US
cg.coverage.iso3166-alpha2LKen_US
cg.coverage.regionSouthern Asiaen_US
cg.identifier.doihttps://doi.org/10.1186/s12889-016-3961-5en_US
cg.identifier.urlhttps://link.springer.com/content/pdf/10.1186%2Fs12889-016-3961-5.pdfen_US
cg.issn1471-2458en_US
cg.issue1en_US
cg.journalBMC Public Healthen_US
cg.volume17en_US
dc.contributor.authorKnipe, D.W.en_US
dc.contributor.authorPadmanathan, P.en_US
dc.contributor.authorMuthuwatta, Lal P.en_US
dc.date.accessioned2017-09-08T04:25:47Zen_US
dc.date.available2017-09-08T04:25:47Zen_US
dc.identifier.urihttps://hdl.handle.net/10568/83359en_US
dc.titleRegional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysisen_US
dcterms.abstractBackground: Between 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka’s 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period. Methods: We mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka’s suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman’s rank correlation and negative binomial models. Results: The rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = -0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = -0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively. Conclusions: The findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka’s suicide rate, but the impact of other factors cannot be ruled out.en_US
dcterms.accessRightsOpen Accessen_US
dcterms.available2017-02-14en_US
dcterms.bibliographicCitationKnipe, D. W.; Padmanathan, P.; Muthuwatta, Lal. 2017. Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis. Bmc Public Health, 14p. (Online first) doi: 10.1186/s12889-016-3961-5en_US
dcterms.extent14p. (Online first)en_US
dcterms.issued2017-12en_US
dcterms.languageenen_US
dcterms.publisherSpringeren_US
dcterms.subjectsocioeconomic environmenten_US
dcterms.subjectsocial behaviouren_US
dcterms.subjectsocial changeen_US
dcterms.subjectsocial phenomenaen_US
dcterms.subjectsuicideen_US
dcterms.subjectpesticidesen_US
dcterms.subjectpoisoningen_US
dcterms.subjecttemporal variationen_US
dcterms.subjectepidemiologyen_US
dcterms.typeJournal Articleen_US

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