Tendência temporal da mortalidade geral por suicídio no Estado do Ceará/Brasil, 2000 A 2015

Abstract

Suicide is characterized as a behavior in which an individual carries out self-harm in order to produce damage to himself and comprises ideations, attempts and consummation, being considered a public health problem.This study analyzes the magnitude and temporal trend of the mortality by suicide in the State of Ceará in the period from 2000 to 2015. It is an ecological study of the temporal series type, through the mortality data by suicide obtained from the National Mortality Information System - DATASUS/MS. Population data were obtained from the National Census of Population (2000 and 2010) and population estimates for the intercensary years (2001-2009 and 2011-2015). The economic and social indicators were obtained through the "Atlas Brasil", the health indicators through "Saúde Mental em dados" and the climatic indicators through Funceme. The general suicide mortality coefficient (CBMS) and by year (2000-2015) was used as the independent variable. Statistical analyzes were performed using SPSS® software (version 20), Joinpoint Regression Program® (version 4.4.2) and ArcGIS Desktop®. Data were stratified by sex, race/color, age group, marital status, MRS (Health Macro-region) residence. For the analysis of the temporal trend, the Annual Percentage Change (APC) and the Average Annual Percentage Change (AAPC) were estimated and tested in each segment with 95% CI. Spearman's correlation was used to evaluate the relationship between the outcome and the economic, social, health and climatic indicators. There is a trend of CBMS growth in Ceará between 2000-2015 (AAPC = 3.8, p <0.05). The trend of growth occurred in both sexes (male AAPC = 3.9, p <0.05 and female AAPC = 3.8, p<0.05) in brown race (AAPC = 3.2, p<0.05), in the age edges (youth (AAPC = 3.6, p <0.05) and the elderly (AAPC = 2.6, p <0.05)), in people living without stable union(judicially separated AAPC= 3.0, p <0.05 and/or single AAPC=3.0, p<0.05), in the state countryside residents (AAPC=2.9, p<0.05), especially in the MRS Fortaleza (AAPC = 5.3, p <0.05) and Sobral (AAPC = 2.9, p <0.05). There is an inverse correlation of the CBMS with the Gini indicators (r = -0.63, p = 0.01); ratio between the richest 10% and the poorest 40% (r = -0.63, p = 0.01; Theil (r= -0,63, p= 0,01). There is a direct correlation with the coverage of CAPS / 100 thousand inhabitants (r = 0.63, p = 0.01); per capita income of the population (r = 0.63, p = 0.01) and HDI (r = 0.63, p = 0.01). Climatic variations were not related to the increase of the CBMS (p = 0.56). Despite the improvement in economic, social and mental health conditions, these did not affect the suicide rates in the state of Ceará.