The effect of altitude and climate on the suicide rates in Turkey
Introduction
Suicide is one of the most important public health problems. According to the estimation of World Health Organization, approximately 804000 people died of suicide worldwide in 2012, and an annual global age-standardized suicide rate was calculated as 11.4 per 100000 population.1
The association between suicide and several factors such as psychiatric diseases and psychological characteristics [mood disorders (major depressive episode and dysthymia), anxiety disorders (panic disorder, agoraphobia, post-traumatic stress disorder, generalized anxiety disorder, specific phobia, social phobia) and alcohol or drug abuse and dependence, the loss of a loved one, etc.],2., 3., 4., 5. somatic illness, cultural (honor, religion, political factors and cultural attitudes, etc.), socioeconomic (economic problems, poor financial status, insufficient social support, low gross domestic product per capita, unemployment, etc.), familial (divorce, familial conflicts, infertility and fertility, inequalities, etc.), occupational (employment and problems at work) and individual (gender, age, region, country) risk factors were well-defined in the previous studies.5,6
In the literature, strong positive correlation between high altitudes and suicide rates was recorded. It was reported that depression and suicide rates increase in high altitude due to hypoxia. Additionally, depression, panic disorder and anxiety disorders are associated with high altitudes and they are important risk factors of suicides.7., 8., 9.
Also it was reported in many studies that there was a positive or negative correlation between suicide rates and several components of climatic effect such as high temperature or temperature alteration,10., 11., 12., 13., 14., 15., 16., 17., 18., 19., 20., 21. sunshine,10,11,14,16,18., 19., 20., 22., 23.,22,23 cloudiness,10,11 rainfalls,10,11,18,19 etc.
In this study, we aimed to investigate correlation between suicide rates and altitudes of all cities in Turkey and between suicide rates and climate factors including Rainfall Activity Index, Winter Mean Temperatures, Summer Mean Temperatures and Temperature Difference between January and July were previously defined by several authors in broad series in Turkey.
Section snippets
Material and methods
In this study, the data were extracted for “suicide number for each years and each city” and “population number for each years and each city” between 2006 and 2015 years from web pages of the Turkish Statistical Institute (TURKSTAT) of the Republic of Turkey.24 Crude suicide rates for per 100000 population for each years and each of 81 cities in Turkey were calculated and mean suicide rates was found for 10 years.
After mean altitudes were calculated for every city on the basis of city altitude
Results
In Turkey, 29865 suicidal deaths occurred in 10 years period between 2006 and 2015. Of them, 21020 (70.4%) were males and 8845 (29.6%) were females. Mean suicidal death rates for 10 years were calculated as 5.6 (per 100000 population) in males, 2.4 (per 100000 population) in females and 4.0 (per 100000 population) totally. When we investigated the changes of suicide rates annually, it was seen that it increased 1.1 per 100000 population in males, decreased 0.6 per 100000 population in females
Discussion
In Turkey, the suicide rates (per 100000 population) were reported as 3.5 in 1996 and 4.8 in 2005 for males, 2.2 in 1996 and 2.7 in 2005 for females and 2.9 in 1996 and 3.8 in 2005 for total population in previous decade.5 In the present study, it was found that these rates increased from 4.8 to 5.9 in males, decreased from 2.8 to 2.2 in females and increased from 3.8 to 4.1 in total population between 2006 and 2015. Also, 70.4% of the suicides was males whilst this rate was 61.1% in previous
Conclusion
Suicides, one of the most serious actions against human life, are associated with multiple risk factors. High altitude and climatic factors including high temperature, cloudiness, more sunshine and low rainfalls were defined as some of these risk factors in the literature. In this study, we found that high altitude above 1500 m, winter median temperature lower than −10 °C and hard temperature changes above 25 °C between winter and summer of settlements were important factors that affected on
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