| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 100 === Background: Suicide rose dramatically in Taiwan in the last decade, especially among elders. However, many studies conducted the relationship in the young people or all of the population. This study was to determine whether there are statistically significant geographical clusters of suicide among those aged above 65 years and whether these persist through time.
Method: Data from suicide (ICD-9 code from 950-959) among elders were obtained in the Death Certification data file from 1999 to 2007. The Time-Spatial Scan Statistic (SaTScan) in combination with GIS software was used to identify potential time-spatial clusters of suicide for each of the 359 Taiwanese districts, and Poisson regression was used to evaluate risk differences. Then, all of the data among the time-spatial clusters was analyzed using multileved logistic regression to adjust factors for different nested-level between elders and districts.
Result: Two significant (p < 0.001) elders suicide time-spatial clusters were identified in southern (RR=1.226) and northern (RR=1.661) regions in Taiwan between 2003 and 2006. As shown in the results, the individual variables including elders who were male, younger (aged 65-74 year), divorced, and in the summertime were strongly associated with suicide in the sounthern cluster (n=103766). But, there were only seasonality of suicide in the northern cluster (n=11674), especially in spring and summer.
Conclusion: The findings of the present study provide evidence for the existence of two time-spatial clusters, and show the geographic variations in risk. And this study also revealed that indivial character of elders including sex, age and marriage has impact on suicide and also demonstrate seasonality of suicide in the areas of time-spatial clusters. The public health interventions necessarily alleviate the social and personal problems among the elderly. And suicide prevention strategies could focus on unique local patterns.
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