Area socioeconomic inequality and suicide mortality: contrasting common measures using National Violent Death Reporting System and linked administrative data.
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| Název: | Area socioeconomic inequality and suicide mortality: contrasting common measures using National Violent Death Reporting System and linked administrative data. |
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| Autoři: | Kalesnikava VA; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.; Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, MI 48104, United States., Kahsay E; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States., Zhong C; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States., Spring E; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States., Bagge C; Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI 48109, United States., Burgard S; Population Studies Center, University of Michigan Institute for Social Research, Ann Arbor, MI 48104, United States.; Department of Sociology, University of Michigan, Ann Arbor, MI 48109, United States., Mezuk B; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.; Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, MI 48104, United States., Clarke PJ; Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.; Social Environment and Health Program, Survey Research Center, University of Michigan Institute for Social Research, Ann Arbor, MI 48104, United States. |
| Zdroj: | American journal of epidemiology [Am J Epidemiol] 2025 Dec 02; Vol. 194 (12), pp. 3472-3482. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 7910653 Publication Model: Print Cited Medium: Internet ISSN: 1476-6256 (Electronic) Linking ISSN: 00029262 NLM ISO Abbreviation: Am J Epidemiol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Cary, NC : Oxford University Press Original Publication: Baltimore, School of Hygiene and Public Health of Johns Hopkins Univ. |
| Výrazy ze slovníku MeSH: | Suicide*/statistics & numerical data , Socioeconomic Factors*, Humans ; Male ; Female ; United States/epidemiology ; Middle Aged ; Adult ; Bayes Theorem ; Aged ; Young Adult ; Adolescent ; Poverty/statistics & numerical data |
| Abstrakt: | Area economic inequality may underlie social disparities in suicide mortality (SM). Differences in measuring inequality contribute to variability across empirical evidence. We contrasted common income measures-absolute poverty, Gini inequality index, Index of Concentration at the Extremes (ICE)-and examined their associations with age- and sex-standardized SM across 1381 US counties. We used the 2006-2019 National Violent Death Reporting System linked to 2006-2010 administrative data on socioeconomic factors and a Bayesian spatial multilevel approach. Compared to affluent areas, poorer areas had the highest relative risk (RR) of SM (ICE RR, 1.24; 95% credible interval [CI], 1.17-1.31; absolute poverty RR, 1.33; 95% CI, 1.25-1.41). Gini inequality was not linearly associated with SM. Cross-classifying Gini × ICE showed that the highest-risk areas had concentrated poverty (ICE) but varying Gini inequality. These high-risk, poverty-segregated areas were more often medically underserved, had lower population density, and high unemployment. African American or Indigenous suicide decedents frequently resided in high inequality areas, while older, White decedents with military backgrounds more often resided in lower Gini areas. The choice of inequality measure can lead to varied conclusions about social disparities in SM. A comparative approach offers more nuanced understanding of underlying socioeconomic marginalization. (© The Author(s) 2025. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Grant Information: | R01 MH128198 United States MH NIMH NIH HHS; R01MH128198-03S1 National Institute of Mental Health (; R01-MH128198 National Institute of Mental Health ( |
| Contributed Indexing: | Keywords: Bayesian spatial models; United States; comparative measures; geographic variations; social disparities in suicide |
| Entry Date(s): | Date Created: 20250202 Date Completed: 20251202 Latest Revision: 20251202 |
| Update Code: | 20251203 |
| DOI: | 10.1093/aje/kwaf021 |
| PMID: | 39894765 |
| Databáze: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstrakt: | Area economic inequality may underlie social disparities in suicide mortality (SM). Differences in measuring inequality contribute to variability across empirical evidence. We contrasted common income measures-absolute poverty, Gini inequality index, Index of Concentration at the Extremes (ICE)-and examined their associations with age- and sex-standardized SM across 1381 US counties. We used the 2006-2019 National Violent Death Reporting System linked to 2006-2010 administrative data on socioeconomic factors and a Bayesian spatial multilevel approach. Compared to affluent areas, poorer areas had the highest relative risk (RR) of SM (ICE RR, 1.24; 95% credible interval [CI], 1.17-1.31; absolute poverty RR, 1.33; 95% CI, 1.25-1.41). Gini inequality was not linearly associated with SM. Cross-classifying Gini × ICE showed that the highest-risk areas had concentrated poverty (ICE) but varying Gini inequality. These high-risk, poverty-segregated areas were more often medically underserved, had lower population density, and high unemployment. African American or Indigenous suicide decedents frequently resided in high inequality areas, while older, White decedents with military backgrounds more often resided in lower Gini areas. The choice of inequality measure can lead to varied conclusions about social disparities in SM. A comparative approach offers more nuanced understanding of underlying socioeconomic marginalization.<br /> (© The Author(s) 2025. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
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| ISSN: | 1476-6256 |
| DOI: | 10.1093/aje/kwaf021 |