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The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation

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Title: The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation
Authors: Esteban Ortiz-Prado, Juan S. Izquierdo-Condoy, Raul Fernandez-Naranjo, Jorge Vásconez-González, Sebastián Encalada, Johanna Mosquera, Simone Cordovez, Nicole Camino, Daniela Montenegro-Salazar, Ginés Viscor, Ana María Diaz, Clara Paz
Source: BJPsych Open
Articles publicats en revistes (Biologia Cel·lular, Fisiologia i Immunologia)
Dipòsit Digital de la UB
instname
BJPsych Open, Vol 10 (2024)
Publisher Information: Royal College of Psychiatrists, 2024.
Publication Year: 2024
Subject Terms: Psychiatry, Paper, Suicide, Equador, Influència de l'altitud, high altitude, depression, public health, RC435-571, Ecuador, Suïcidi, Influence of altitude
Description: Background The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood. Aims This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m. Method We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60–X84). Results A total of 11 280 cases of suicide were reported during 2011–2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000). Conclusions Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 2056-4724
DOI: 10.1192/bjo.2024.736
Access URL: https://pubmed.ncbi.nlm.nih.gov/39313761
https://hdl.handle.net/2445/216672
https://doaj.org/article/7444d28cc81c4adbafef24b1b6f194aa
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Accession Number: edsair.doi.dedup.....0c8311867c8a4d92d4a9525b6369fef3
Database: OpenAIRE
Description
Abstract:Background The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood. Aims This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m. Method We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60–X84). Results A total of 11 280 cases of suicide were reported during 2011–2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000). Conclusions Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.
ISSN:20564724
DOI:10.1192/bjo.2024.736