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Suicide rates in the United States have been increasing, necessitating an understanding of demographic variations by ethnicity, age, sex and method to inform effective prevention strategies.
Objective
To dissect suicide rates in the US population from 2001 to 2023 by age, sex, ethnicity, and method.
Methods
This retrospective observational study utilized suicide data and population statistics from the CDC’s WISQARS database for the years 2001 (n = 30,418), 2018 (n = 48,132), 2020 (n = 45,721) and 2023 (n = 49,014). Cases were stratified by age, sex, ethnicity, and suicide method to assess trends and demographic differences.
Results
From 2001 to 2023, the overall US suicide rate rose from 10.7 to 14.6 per 100,000, with a temporary decrease in 2019 and 2020 (14.4 and 13.8, respectively). The primary driver of the increase was firearm-related suicides among White males, contributing 25.8% of the rise from 2001 to 2018 and 51.6% from 2020 to 2023. Decline between 2018 and 2020 was mainly due to reductions in firearm and drug-related suicides among White males, but firearm suicides surged again from 2020 to 2023. Additionally, firearm suicides among ethnic minorities, especially Black/African-American males, accounted for 14.0% of the increase during 2020–2023. Drug-related suicides also increased by 8.6% among White females aged 45 and older in the same period.
Conclusions
Firearm suicides are the leading factor in the changing suicide rates in the United States from 2001 to 2023, alongside rising drug-related suicides among White females. These trends highlight the necessity for targeted prevention efforts that consider demographic-specific factors and method accessibility.
Little is known about socioeconomic equity in access to healthcare among people with eating disorders in Australia. This study aims to measure the extent of inequity in eating disorder-related healthcare utilization, analyze trends, and explore the sources of inequalities using New South Wales (NSW) administrative linked health data for 2005 to 2020.
Methods
Socioeconomic inequities were measured using concentration index approach, and decomposition analysis was conducted to explain the factors accounting for inequality. Healthcare utilization included: public inpatient admissions, private inpatient admissions, visits to public mental health outpatient clinics and emergency department visits, with three different measures (probability of visit, total and conditional number of visits) for each outcome.
Results
Private hospital admissions due to eating disorders were concentrated among individuals from higher socioeconomic status (SES) from 2005 to 2020. There was no significant inequity in the probability of public hospital admissions for the same period. Public outpatient visits were utilized more by people from lower SES from 2008 to 2020. Emergency department visits were equitable, but more utilized by those from lower SES in 2020.
Conclusions
Public hospital and emergency department services were equitably used by people with eating disorders in NSW, but individuals from high SES were more likely to be admitted to private hospitals for eating disorder care. Use of public hospital outpatient services was higher for those from lower SES. These findings can assist policymakers in understanding the equity of the healthcare system and developing programs to improve fairness in eating disorder-related healthcare in NSW.
The aim of this study was to investigate the factors influencing urban–rural differences in depressive symptoms among old people in China and to measure the contribution of relevant influencing factors.
Design:
A cross-sectional research. The 2018 data from The Chinese Longitudinal Health Longevity Survey (CLHLS).
Setting:
Twenty-three provinces in China.
Participants:
From the 8th CLHLS, 11,245 elderly participants were selected who met the requirements of the study.
Measurements:
We established binary logistic regression models to explore the main influencing factors of their depressive symptoms and used Fairlie models to analyze the influencing factors of the differences in depressive symptoms between the urban and rural elderly and their contribution.
Results:
The percentage of depressive symptoms among Chinese older adults was 11.72%, and the results showed that rural older adults (12.41%) had higher rates of depressive symptoms than urban (10.13%). The Fairlie decomposition analysis revealed that 73.96% of the difference in depressive symptoms could be explained, which was primarily associated with differences in annual income (31.51%), education level (28.05%), sleep time ( − 25.67%), self-reported health (24.18%), instrumental activities of daily living dysfunction (20.73%), exercise (17.72%), living status ( − 8.31%), age ( − 3.84%), activities of daily living dysfunction ( − 3.29%), and social activity (2.44%).
Conclusions:
The prevalence of depressive symptoms was higher in rural than in urban older adults, which was primarily associated with differences in socioeconomic status, personal lifestyle, and health status factors between the urban and rural residents. If these factors were addressed, we could make targeted and precise intervention strategies to improve the mental health of high-risk elderly.
A number of reports have shown that workers with certain characteristics are disproportionately affected by the COVID-19 pandemic. Since these characteristics are associated with vulnerable workers, we hypothesise that the income distribution in the pandemic era will be polarised compared to the pre-pandemic period. This article compares the pre-COVID income distribution (February 2020) with the one that prevailed just after the hard lockdown (April 2020). Consistent with the hypothesis, the result shows evidence of polarisation. Disaggregating the analysis by worker characteristics, we find that the polarisation was stronger in vulnerable groups. Our decomposition result suggests that, apart from job losses, returns to gender and job characteristics explain the location and shape differences in the COVID-19 era income distribution. Although this analysis only looks at the short-term effect of the pandemic on income distribution, the result suggests that the structure of labour markets in developing countries is not conducive to a future of work where disruptions (or pandemics) may become more frequent.
The primary purpose of this study is to examine changes in socio-economic inequality in nutritional status (stunting and underweight) among children in Empowered Action Group (EAG) states.
Design:
The study is based on the most recent two wave’s cross-sectional data from the National Family Health Survey (NFHS) conducted in 2005–2006 (NFHS-3) and 2015–2016 (NFHS-4). The study used height-for-age (stunting) and weight-for-age (underweight) of children as anthropometric indicators.
Setting:
EAG states including Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh in India.
Participants:
The study includes a total of 11 858 (NFHS-3) and 92 630 (NFHS-4) children under 5 years of age.
Result:
The socio-economic inequality in stunting remained unchanged in all EAG states. At the same time, the inequality in underweight decreased during 2005–2016. On decomposing, the factors contributing to socio-economic inequality revealed that household wealth index, mother’s education and mother’s nutritional status were the largest contributors to stunting (47 %, 24 % and 8 %) and underweight (51 %, 21 % and 16 %), respectively, in 2015–2016.
Conclusion:
The study concluded the socio-economic inequality in underweight among children under 5 years of age increased over the years in EAG states in India. Altogether, household wealth index, mother’s education and mother’s nutritional status contributed to nearly 80 % to inequality in stunting and 90 % to inequality in underweight in 2015–2016. Hence, efforts should be made to minimise the socio-economic inequality in the nutritional status of children, particularly in EAG states in India.
This study contributes to a growing literature body of studies aimed at explaining socio-economic-related health inequality in non-communicable diseases (NCDs), with a focus on older people who are commonly affected by socio-economic gradient in later life. It identifies factors associated with self-reported NCDs and examines socio-economic-related health inequality in self-reported NCDs between rural and urban Vietnamese older people. This cross-sectional study utilised data from the Viet Nam Ageing Survey. A sample of 2,682 older people aged 60 and over (urban = 703, rural = 1,979) was analysed. Concentration indices were computed to measure socio-economic inequalities in self-reported NCDs. Concentration index decomposition analysis was performed to determine the relative contributions of the determinants to explaining those inequalities. Significant socio-economic inequalities in self-reported NCDs favouring the rich were found, in which the degree of inequality was more pronounced in urban areas than in their rural counterparts. Household wealth and social health insurance were the main drivers contributing to increased socio-economic inequalities in self-reported NCDs in urban and rural areas, respectively. Among disadvantaged groups, older people living alone, with lowest wealth and with social health insurance had highest probability of reporting at least one NCD for both areas. Public policies aimed at narrowing wealth gaps and expanding and improving principle roles of social health insurance should prioritise the most disadvantaged groups in order to achieve health equality.
To obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition.
Design:
Cross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition.
Setting:
Household surveys in Bangladesh from 1996 to 2014.
Participants:
Children under the age of 5 years.
Results:
A decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight.
Conclusions:
Our findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.
An alternative version of decomposition analysis, based on factor cost shares rather than input demand functions, is presented and applied to Greek agriculture. Decomposition analysis shows that most of the changes in factor cost shares during the period from 1973 to 1989 are attributed to technical change and factor substitution, while the role of the scale effect is small, except that of fertilizer. The decomposition analysis results are then used to analyze the implications of Greece's fertilizer and feed subsidy removal, which took place in 1990.
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