Spatial patterning and correlates of self-harm in Manchester, England

被引:16
作者
Lin, Chien-Yu [1 ,2 ]
Bickley, Harriet [3 ,4 ]
Clements, Caroline [3 ,4 ]
Webb, Roger T. [3 ,4 ,5 ]
Gunnell, David [6 ,7 ,8 ]
Hsu, Chia-Yueh [9 ,11 ,12 ]
Chang, Shu-Sen [1 ,12 ]
Kapur, Nav [3 ,4 ,5 ,10 ]
机构
[1] Natl Taiwan Univ, Coll Publ Hlth, Inst Hlth Behav & Community Sci, Taipei, Taiwan
[2] Waseda Univ, Grad Sch Sport Sci, Tokorozawa, Saitama, Japan
[3] Univ Manchester, Ctr Mental Hlth & Safety, Div Psychol & Mental Hlth, Manchester, Lancs, England
[4] Manchester Acad Hlth Sci Ctr MAHSC, Manchester, Lancs, England
[5] Natl Inst Hlth Res, Greater Manchester Patient Safety Translat Res Ct, Manchester, Lancs, England
[6] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England
[7] Univ Hosp Bristol NHS Fdn Trust, Biomed Res Ctr, Natl Inst Hlth Res, Bristol, Avon, England
[8] Univ Bristol, Bristol, Avon, England
[9] Taipei Med Univ, Wan Fang Hosp, Dept Psychiat, Taipei, Taiwan
[10] Greater Manchester Mental Hlth NHS Fdn Trust, Manchester, Lancs, England
[11] Taipei Med Univ, Coll Med, Sch Med, Dept Psychiat, Taipei, Taiwan
[12] Taipei Med Univ, Wan Fang Hosp, Psychiat Res Ctr, Taipei, Taiwan
关键词
Deprivation; self-harm; social fragmentation; socioeconomic characteristics; spatial analysis; SMALL AREAS; SUICIDE; PARASUICIDE; MULTICENTER; DENSITY; LEVEL; RATES; URBAN;
D O I
10.1017/S2045796019000696
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Aims. To investigate the spatial distribution of self-harm incidence rates, their socioeconomic correlates and sex/age differences using data on self-harm presentations to emergency departments from The Manchester Self-Harm Project (2003-2013). Methods. Smoothed standardised incidence ratios for index self-harm episodes (n = 14 771) and their associations with area-level socioeconomic factors across 258 small areas (median population size = 1470) in the City of Manchester municipality were estimated using Bayesian hierarchical models. Results. Higher numbers and rates of self-harm were found in the north, east and far southern zones of the city, in contrast to below average rates in the city centre and the inner city zone to the south of the centre. Males and females aged 10-24, 25-44 and 45-64 years showed similar geographical patterning of self-harm. In contrast, there was no clear pattern in the group aged 65 years and older. Fully adjusted analyses showed a positive association of self-harm rates with the percentage of the unemployed population, households privately renting, population with limiting long-term illness and lone-parent households, and a negative association with the percentage of ethnicity other than White British and travel distance to the nearest hospital emergency department. The area-level characteristics investigated explained a large proportion ( four-fifths) of the variability in area self-harm rates. Most associations were restricted to those aged under 65 years and some associations (e.g. with unemployment) were present only in the youngest age group. Conclusions. The findings have implications for allocating prevention and intervention resources targeted at high-risk groups in high incidence areas. Targets for area-based interventions might include tackling the causes and consequences of joblessness, better treatment of long-term illness and consideration of the accessibility of health services.
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收藏
页数:10
相关论文
共 42 条
[31]   Spatial patterning, correlates, and inequality in suicide across 432 neighborhoods in Taipei City, Taiwan [J].
Lin, Chien-Yu ;
Hsu, Chia-Yueh ;
Gunnell, David ;
Chen, Ying-Yeh ;
Chang, Shu-Sen .
SOCIAL SCIENCE & MEDICINE, 2019, 222 :20-34
[32]  
Manchester City Council, 2008, IND DEPR 2017
[33]  
Manchester City Council, 2007, HOUS NEEDS ASS FIN R
[34]   Suicide risk in small areas in England and Wales, 1991-1993 [J].
Middleton, N ;
Whitley, E ;
Frankel, S ;
Dorling, D ;
Sterne, J ;
Gunnell, D .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2004, 39 (01) :45-52
[35]   Ethnic density and deliberate self harm; a small area study in south east London [J].
Neeleman, J ;
Wilson-Jones, C ;
Wessely, S .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2001, 55 (02) :85-90
[36]   Characteristics of small areas with high rates of hospital-treated self-harm: deprived, fragmented and urban or just close to hospital? A national registry study [J].
O'Farrell, I. B. ;
Corcoran, P. ;
Perry, I. J. .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2015, 69 (02) :162-167
[37]  
Office for National Statistics, 2019, LOW LAYER SUP OUTP A
[38]   Spatial patterning of self-harm rates within urban areas [J].
Polling, Catherine ;
Bakolis, Ioannis ;
Hotopf, Matthew ;
Hatch, Stephani L. .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2019, 54 (01) :69-79
[39]  
Spiegelhalter D., 2003, WINBUGS USER MANUAL
[40]   Bayesian measures of model complexity and fit [J].
Spiegelhalter, DJ ;
Best, NG ;
Carlin, BR ;
van der Linde, A .
JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES B-STATISTICAL METHODOLOGY, 2002, 64 :583-616