TY - JOUR
T1 - Investigation of the marked and long-standing spatial inhomogeneity of the Hungarian suicide rate
T2 - A spatial regression approach
AU - Balint, Lajos
AU - Dome, Peter
AU - Daroczi, Gergely
AU - Gonda, Xenia
AU - Rihmer, Zoltan
PY - 2014/2
Y1 - 2014/2
N2 - Background In the last century Hungary had astonishingly high suicide rates characterized by marked regional within-country inequalities, a spatial pattern which has been quite stable over time. Aims To explain the above phenomenon at the level of micro-regions (n=175) in the period between 2005 and 2011. Methods Our dependent variable was the age and gender standardized mortality ratio (SMR) for suicide while explanatory variables were factors which are supposed to influence suicide risk, such as measures of religious and political integration, travel time accessibility of psychiatric services, alcohol consumption, unemployment and disability pensionery. When applying the ordinary least squared regression model, the residuals were found to be spatially autocorrelated, which indicates the violation of the assumption on the independence of error terms and - accordingly - the necessity of application of a spatial autoregressive (SAR) model to handle this problem. According to our calculations the SARlag model was a better way (versus the SARerr model) of addressing the problem of spatial autocorrelation, furthermore its substantive meaning is more convenient. Results SMR was significantly associated with the "political integration" variable in a negative and with "lack of religious integration" and "disability pensionery" variables in a positive manner. Associations were not significant for the remaining explanatory variables. Limitations Several important psychiatric variables were not available at the level of micro-regions. We conducted our analysis on aggregate data. Conclusion Our results may draw attention to the relevance and abiding validity of the classic Durkheimian suicide risk factors - such as lack of social integration - apropos of the spatial pattern of Hungarian suicides.
AB - Background In the last century Hungary had astonishingly high suicide rates characterized by marked regional within-country inequalities, a spatial pattern which has been quite stable over time. Aims To explain the above phenomenon at the level of micro-regions (n=175) in the period between 2005 and 2011. Methods Our dependent variable was the age and gender standardized mortality ratio (SMR) for suicide while explanatory variables were factors which are supposed to influence suicide risk, such as measures of religious and political integration, travel time accessibility of psychiatric services, alcohol consumption, unemployment and disability pensionery. When applying the ordinary least squared regression model, the residuals were found to be spatially autocorrelated, which indicates the violation of the assumption on the independence of error terms and - accordingly - the necessity of application of a spatial autoregressive (SAR) model to handle this problem. According to our calculations the SARlag model was a better way (versus the SARerr model) of addressing the problem of spatial autocorrelation, furthermore its substantive meaning is more convenient. Results SMR was significantly associated with the "political integration" variable in a negative and with "lack of religious integration" and "disability pensionery" variables in a positive manner. Associations were not significant for the remaining explanatory variables. Limitations Several important psychiatric variables were not available at the level of micro-regions. We conducted our analysis on aggregate data. Conclusion Our results may draw attention to the relevance and abiding validity of the classic Durkheimian suicide risk factors - such as lack of social integration - apropos of the spatial pattern of Hungarian suicides.
KW - Alcoholism
KW - Durkheim
KW - Hungary
KW - Religion
KW - Suicide
KW - Unemployment
UR - http://www.scopus.com/inward/record.url?scp=84891847127&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2013.10.047
DO - 10.1016/j.jad.2013.10.047
M3 - Article
C2 - 24238954
AN - SCOPUS:84891847127
SN - 0165-0327
VL - 155
SP - 180
EP - 185
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1
ER -