中国城乡2002-2018年自杀死亡率发展趋势的Joinpoint回归分析

Joinpoint regression analysis of suicide mortality rate trends among urban and rural in China from 2002 to 2018

目的:本研究通过Joinpoint回归方法分析2002年至2018年中国城乡居民自杀死亡率变化趋势,为中国自杀预防策略制定提供参考依据。方法:自《中国卫生统计年鉴》中提取2002年至2018年中国城乡居民自杀死亡率数据,利用Joinpoint回归模型分析中国城乡居民标化自杀死亡率变化趋势;计算年度变化百分比(APC)及平均年度变化百分比(AAPC),并进行短期预测。结果:2002-2018年,中国城乡居民自杀死亡均呈现下降趋势,城市居民标化自杀死亡率下降幅度(AAPC=-8.2%,P<0.01)大于农村(AAPC=-6.4%,P<0.001);城市、农村女性标化自杀死亡率下降幅度(城市:AAPC=-9.3%,P<0.01;农村:AAPC=-7.8%,P<0.001)均大于男性居民(城市:AAPC=-6.8%,P<0.01;农村:AAPC=-6.0%,P<0.001);2008年、2007年分别为城市男性与女性标化自杀死亡率变化节点,2007年、2006年分别为农村男性与女性标化自杀死亡率变化节点。结论:2002-2018年中国城乡居民标化自杀死亡率明显降低,男性居民成为自杀防控重点人群,农村仍然是自杀防控重点区域。

Objective:To analyze the trends of suicide mortality rate among urban and rural residents in China from 2002 to 2018 by Joinpoint regression,so as to provide references for the formulation of suicide prevention strategies.Methods:The data of suicide mortality rate from 2002 to 2018 based on the China Health Statistics Yearbook were collected.The Joinpoint regression model was used to analyze the trend of age-adjusted suicide mortality rate among urban and rural residents in China.The annual percentage change(APC) and the average annual percentage change(AAPC) were calculated,and the age-adjusted suicide mortality rates of short-term were predicted.Results:From 2002 to 2018,the suicide mortality rate of urban and rural residents in China showed downward trends.The age-adjusted suicide mortality rate of urban residents(AAPC=-8.2%,P<0.01) was higher than that of rural residents(AAPC=-6.4%,P<0.001).The decrease of age-adjusted suicide mortality rates among the women of urban and rural(urban areas:AAPC=-9.3%,P<0.01;rural areas:AAPC=-7.8%,P<0.001) were larger than male residents(urban areas:AAPC=-6.8%,P<0.01;rural area:AAPC=-6.0%,P<0.001).The years of 2008 and 2007 were the change Joinpoints of age-adjusted suicide mortality rates of males and females of the urban.The years of 2007 and 2006 respectively were the change Joinpoints of age-adjusted suicide mortality rates of males and females of the rural.Conclusion:From 2002 to 2018,the age-adjusted suicide mortality rates among urban and rural residents in China decreased significantly.Male residents and rural areas should be concerned about in suicide prevention.