João Werner Falk

Epidemiological aspects of suicide in Rio Grande do Sul, Brazil

OBJECTIVE To describe epidemiological aspects of suicide mortality in a 10-year time series. METHODS Suicide deaths reported in the state of Rio Grande do Sul (RS), Brazil, were put together as historical time series based on data from the Ministry of Health Mortality Reporting System for the period 1980 to 1999. Suicides were grouped according to the WHO criteria and analyzed using standard demographic variables. RESULTS Suicide rates (proportional mortality and mortality rates) in RS during the study period were the highest in Brazil. The standardized rates grew from around 9 per 100,000 in the 1980s to 11 per 100,000 in 1999. This increase in mortality was attributed mainly to male mortality rates that grew from 14 per 100,000 to the current 20 per 100,000. The male:female ratio increased from 3 to 5. The highest ratios were seen among the elderly although this ratio has been increasing in young adults as well. Widows, widowers and farmers/fishers had the highest mortality rates. CONCLUSIONS The study highlights suicide as a collective health problem in RS and shows aspects that could contribute to preventive action.

Suicide rates in the State of Rio Grande do Sul, Brazil: association with socioeconomic, cultural, and agricultural factors

Rio Grande do Sul State has the highest suicide rates in Brazil. Previous studies have suggested a possible role of agricultural activities, especially tobacco farming, where pesticide use is intensive. An ecological study was designed to assess associations between age-adjusted suicide rates based on death certificates and socioeconomic and agricultural factors. Suicide rates in males and females were inversely associated with schooling level and directly associated with divorce/marital separation. Rates for men were higher in areas where traditional Protestant religious were more prevalent, and rates for women were lower in areas with a higher proportion of single-inhabitant households. Multivariate analyses showed no associations between increased suicide rates and any of the agricultural variables. These results confirm the role of socioeconomic determinants of suicide, but do not support the hypothesis of a specific role of agricultural practices.