An approach to suicide among adolescents and youth in Brazil

Ribeiro, José Mendes; Moreira, Marcelo Rasga

doi:10.1590/1413-81232018239.17192018

Brasil

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ARTICLES • Ciênc. saúde colet. 23 (9) • Sept 2018 • https://doi.org/10.1590/1413-81232018239.17192018 linkcopy

An approach to suicide among adolescents and youth in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This essay article examines suicide among young people in Brazil on the basis of Durkheim’s classical approaches as revisited in current discussions of social integration networks. It presents arguments regarding the behaviour of suicide mortality rates in the light of classical public health assumptions as to social causality in processes of health and illness. The mortality rates, updated in line with international statistics, review of data in Brazilian studies and recent series for Brazil, reveal suicide “aptitudes” by age, sex and social group. The linear and non-linear nature of the trends are treated in the context of pathways in complex social systems. Current data were prospected in the Ministry of Health’sNational Mortality Information System and World Health Organisation databases. In this policy analysis study, a conceptual outline was built up from classical theory updated to the present-day context, analysis of data relevant to the study object and observation of target groups for comprehensive, inclusive policies. The results of this analysis reveal that adolescents and young people are highly liable to growing, sustained, high-impact vulnerability to suicide.

Durkheim; Suicide; Youth

Countries	HDI	CM	CM	CM	CM
Countries	2015	2000	2005	2010	2015
Australia	0.939	13.40	11.90	12.10	11.80
Germany	0.926	14.60	13.60	13.50	13.40
Denmark	0.925	15.50	14.70	11.70	12.30
Holland	0.924	9.70	9.80	9.80	11.90
Eire	0.923	12.50	11.50	11.60	11.70
Canada	0.920	12.40	12.60	12.70	12.30
United States	0.920	10.80	11.70	13.00	14.30
Sweden	0.913	15.10	15.70	14.60	15.40
Japan	0.903	24.40	24.70	24.30	19.70
France	0.897	20.20	19.20	18.40	16.90
Belgium	0.896	22.60	20.50	20.30	20.50
Italy	0.887	7.50	7.20	7.00	7.90
Chile	0.847	10,80	10,30	12,00	9,90
Portugal	0.843	7.40	10.90	13.50	13.70
Hungary	0.836	32.40	26.30	25.50	21.60
Argentina	0.827	13.30	12.20	12.90	14.20
Russian Federation	0.804	38.70	33.60	25.70	20.10
Uruguay	0.795	16.30	14.90	16.40	17.00
Turkey	0.767	13.40	11.50	10.50	8.70
Mexico	0.762	3.40	4.00	4.20	5.00
Brazil	0.754	5.20	5.90	5.90	6.30
China	0.738	11.00	9.90	9.80	10.00
Jamaica	0.730	0.20	1.90	0.50	1.40
Botswana	0.698	11.50	11.20	10.20	9.70
Indonesia	0.689	3.10	3.20	3.10	2.90
South Africa	0.666	10.10	9.70	10.10	10.70
Namibia	0.640	10.00	9.10	8.70	7.70
India	0.624	17.80	17.50	17.10	15.70

Sex	Age group	2000	2005	2010	2015
Total	Total (all ages)	12,22	11,61	11,23	10,73
Male		15,55	14,67	14,16	13,61
Female		8,84	8,51	8,26	7,80
Male	0-28 days	0,00	0,00	0,00	0,00
	1-59 months	0,00	0,00	0,00	0,00
	5-14 years	1,23	1,14	1,1	1,10
	15-29 years	17,12	15,6	14,84	14,06
	30-49 years	20,91	18,87	17,62	16,54
	50-59 years	25,98	23,47	21,72	19,74
	60-69 years	30,53	27,44	25,65	23,80
	70+ years	47,11	44,47	41,89	40,98
Female	0-28 days	0,00	0,00	0,00	0,00
	1-59 months	0,00	0,00	0,00	0,00
	5-14 years	1,13	1,07	1	0,92
	15-29 years	13,00	12,15	11,46	10,34
	30-49 years	9,47	8,81	8,21	7,65
	50-59 years	10,62	9,89	9,81	9,36
	60-69 years	14,50	13,57	13,32	12,92
	70+ years	22,25	21,33	20,48	19,74

Year ^reference	Scope Findings	Results
1976-2001¹⁷	Campinas (SP)	Fall in annual rates for age 15 to 34 years; rates do not rise with lower socioeconomic position
1980-2000²⁰	Brazil	Increase of 21% in crude rate since 1980; greater risk for men and over-65 year age group; substantial increase among 15-24 year olds
1998-2002¹²	Brazil	Sustained increase in crude rates per 100,000 and spatial “contagion effect” for neighbouring areas
2002-2013²¹	Brazil	Hospital admission rates per 100,000 fell from 4.4 to 3.3 for 10-19 year olds and from 7.4 to 5.6 for 20-29 year olds; the overall rate declined
2004-2014²²	Brazil	Overall rate increased, with more marked increases for 10-19 year olds; rate for 20-29 year olds increased since 2010
2005 23	Pelotas (RS)	Prevalence of suicidal ideas at 14.1% among 11-15 year olds, associated with female sex, legal or illegal drugs and depression
2007-2008²⁴	Pelotas (RS)	Risk of suicide 8.6% among 18-24 year olds and more significant among victims of sexual abuse
2007-2008²⁵	Pelotas (RS)	Risk of suicide 8.6% among 18-24 year olds, associated with violence, drug abuse and risky sexual behaviour
2009¹⁶	Presidente Prudente, Assis e Ourinhos (SP)	Among 12-20 year olds, risk of suicidal ideas and attempts greater for non-heterosexuals, particularly bisexuals or “others”
2010¹⁵	States	Suicide related to high income and not correlated to homicide; major differences among states
2014¹³	24 state capitals and DF	In emergency and casualty departments, 0-9 year olds accounted for 2.9% of self-inflicted injury cases and 10-19 year olds, 18.8%

Year	Age group / Sex	Mortality from self-inflicted injuries				Overall mortality
Year		10 a 14	15 a 19	20 a 29	Total (a)	10 a 14	15 a 19	20 a 29	Total (b)
1996	Male	0,75	5,32	10,28	6,89	52,25	164,13	299,05	684,46
	Female	0,58	2,23	2,26	1,77	31,86	56,53	85,94	472,83
	Total	0,66	3,78	6,22	4,29	42,16	110,36	191,09	577,18
1997	Male	0,57	4,66	9,96	6,98	48,95	168,26	295,74	671,49
	Female	0,61	2,12	1,98	1,76	29,02	53,54	80,72	461,82
	Total	0,59	3,39	5,92	4,33	39,08	110,93	186,82	565,20
1998	Male	0,53	4,85	9,61	6,93	44,60	169,02	292,74	681,12
	Female	0,51	2,17	2,39	1,78	29,60	54,10	80,92	471,82
	Total	3,35	9,78	5,45	4,32	37,17	111,57	185,44	575,03
1999	Male	0,51	4,65	9,35	6,56	43,48	167,62	285,43	677,35
	Female	0,40	1,62	1,82	1,48	27,36	50,96	76,14	469,20
	Total	0,45	3,13	5,54	3,98	35,50	109,30	179,41	571,84
2000	Male	0,47	3,80	8,79	6,46	43,53	165,51	277,24	660,63
	Female	0,49	2,04	2,06	1,60	28,84	48,55	71,51	456,50
	Total	0,48	2,93	5,39	3,99	36,27	107,35	173,46	556,97
2001	Male	0,61	5,23	10,07	7,28	43,72	165,87	274,83	661,33
	Female	0,61	2,49	2,04	1,78	26,56	47,66	69,28	456,49
	Total	0,61	3,87	6,02	4,49	35,24	107,08	171,14	557,32
2002	Male	0,59	4,74	9,80	7,01	41,77	169,96	286,25	664,72
	Female	0,61	2,24	2,36	1,91	27,75	45,98	70,05	463,21
	Total	0,60	3,50	6,05	4,42	34,85	108,30	177,18	562,40
2003	Male	0,59	4,75	10,14	7,19	40,25	162,06	283,10	669,37
	Female	0,50	2,28	2,42	1,79	25,38	46,18	69,09	466,23
	Total	0,55	3,52	6,25	4,44	32,90	104,42	175,13	566,23
2004	Male	0,48	4,60	10,09	7,16	39,22	157,12	275,49	673,43
	Female	0,65	2,15	2,26	1,88	24,91	44,51	67,87	472,43
	Total	0,56	3,38	6,14	4,48	32,15	101,10	170,74	571,37
2005	Male	0,53	4,27	9,90	7,44	37,81	152,70	259,57	642,22
	Female	0,58	2,13	2,26	1,93	23,98	41,27	65,76	453,48
	Total	0,55	3,21	6,04	4,64	30,98	97,26	161,78	546,40
2006	Male	0,60	4,42	10,18	7,43	36,57	150,27	259,52	645,80
	Female	0,63	1,96	2,19	1,90	24,47	40,71	65,27	461,31
	Total	0,61	3,20	6,15	4,63	30,59	95,75	161,51	552,13
2007	Male	0,77	4,79	9,79	7,52	41,34	169,97	246,86	647,66
	Female	0,62	2,10	2,36	1,94	26,77	45,52	61,88	461,83
	Total	0,69	3,46	6,07	4,68	34,18	108,53	154,21	553,15
2008	Male	0,58	5,02	10,60	7,92	41,80	174,17	254,31	664,75
	Female	0,58	2,41	2,13	2,02	27,98	47,01	62,18	474,08
	Total	0,58	3,73	6,37	4,92	35,01	111,46	158,21	567,76
2009	Male	0,64	5,04	10,31	7,97	41,84	173,14	259,33	671,15
	Female	0,64	1,66	2,24	1,92	27,76	47,71	65,82	483,82
	Total	0,64	3,37	6,28	4,90	34,92	111,33	162,65	575,83
2010	Male	0,62	5,08	10,56	7,90	40,03	174,66	265,34	695,21
	Female	0,56	2,02	2,35	2,13	26,38	47,44	65,19	500,40
	Total	0,59	3,56	6,43	4,95	33,32	111,52	164,77	595,80
2011	Male	0,67	4,96	11,01	8,24	39,14	180,40	258,27	706,50
	Female	0,54	2,35	2,46	2,13	24,56	48,93	64,20	513,79
	Total	0,61	3,66	6,71	5,12	31,97	115,16	160,76	608,16
2012	Male	0,87	5,48	10,55	8,49	40,40	196,43	262,58	706,10
	Female	0,47	2,31	2,21	2,28	24,73	48,62	61,83	515,12
	Total	0,67	3,91	6,36	5,32	32,70	123,07	161,72	608,64
2013	Male	0,80	2,78	11,28	8,36	38,93	198,81	255,43	691,25
	Female	0,58	1,05	2,41	2,19	24,07	49,01	61,34	514,47
	Total	0,69	1,92	6,83	5,24	31,64	125,09	159,14	601,82
2014	Male	0,92	2,77	11,16	8,41	38,58	208,86	263,16	692,82
	Female	0,74	1,12	2,37	2,18	23,64	46,56	61,75	518,83
	Total	0,83	1,95	6,75	5,25	31,26	129,02	163,25	604,77
2015	Male	0,87	3,00	10,82	8,70	35,35	200,69	255,82	702,41
	Female	0,66	1,21	2,42	2,32	22,31	45,98	59,99	535,66
	Total	0,77	2,11	6,61	5,47	28,96	124,60	158,70	618,00

Age group	White	Black	Yellow	Pardo	Indigenous	Unknown	Total
0 to 4 years	0.00	0.00	0.00	0.00	0.00	0.00	0.00
5 to 9 years	0.02	0.00	0.00	0.01	0.00	414.94	0.02
10 to14 years	0.33	0.61	1.24	0.63	11.60	937.50	0.59
15 to19 years	3.04	2.53	1.13	3.57	33.94	9,345.79	3.56
20 to29 years	6.16	5.52	1.24	6.20	20.94	4,586.37	6.43
30 to 39 years	6.59	4.77	2.99	6.50	17.23	6,494.33	6.74
40 to 49 years	7.90	4.59	1.14	6.83	5.22	9,469.70	7.41
50 to 59 years	8.21	3.41	1.98	4.75	1.85	12,984.05	6.73
60 to 69 years	7.47	2.76	2.63	4.91	2.77	13,145.54	6.33
70 to 79 years	8.84	3.74	5.34	6.45	0.00	21,014.49	7.92
Total	5.32	3.54	1.78	4.29	11.37	6,552.66	4.95

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[TFN1001] Obs.: HDI estimates for 2015.