Date of Award

January 2017

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Robert M. Rohrbaugh

Abstract

CLUSTERING OF SUICIDE IN BRAZILIAN INDIGENOUS CHILDREN AND YOUTH: IMPLICATIONS FOR INTERVENTIONS.

Thomas Lazzarini, Crhistinne Gonçalves, Julio Croda, Albert Ko, Walter Benites, Liliane da Silva, Kristen McLean, Jason Andrews, Daniel Henrique Tsuha, and Robert Rohrbaugh. Department of Psychiatry, Yale University, School of Medicine, New Haven, CT.

Abstract: The purpose of this study was to conduct a retrospective cohort study as well as a qualitative study to better understand the current context of suicide among the indigenous population living on the reservations surrounding Dourados, Brazil. Critical questions included: What are the most important suicide risk factors? Which communities have the highest rates? What differences exist between higher-risk and lower-risk communities? The Brazilian National Mortality Database (SIM), the Special Indigenous Information System (SIASI), as well as the national census (IBGE) were utilized to estimate an overall suicide rate of 73·4 per 100,000 population per year in the reservation communities. The peak risk for males is during adolescence (15-19) and the peak risk for females is during late childhood (10-14). There was strong evidence for the clustering of suicides by time and geography as well as within extended families among this population. A comparison between two neighboring communities with a 5-fold difference in suicide rate demonstrated that the community with a higher suicide rate suffers from greater poverty and structural barriers to health care. Interventions must focus on children and youth living within the household of suicide victims as well as structural interventions to improve economic opportunities and access to healthcare in highly affected communities.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/12/2019

Share

COinS