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. 2023 Apr 13;18(4):e0284224.
doi: 10.1371/journal.pone.0284224. eCollection 2023.

The influence of the age-period-cohort effects on male suicide in Brazil from 1980 to 2019

Weverton Thiago da Silva Rodrigues  1 , Taynãna César Simões  2 , Carinne Magnago  3 , Eder Samuel Oliveira Dantas  4 , Raphael Mendonça Guimarães  5 , Jordana Cristina de Jesus  1 , Sandra Michelle Bessa de Andrade Fernandes  6 , Karina Cardoso Meira  6
Affiliations

The influence of the age-period-cohort effects on male suicide in Brazil from 1980 to 2019

Weverton Thiago da Silva Rodrigues et al. PLoS One. .

Abstract

Suicide is a complex and multi-determined phenomenon. Higher rates are observed in men and are related to multiple risk factors, including mental disorders, financial crises, unemployment, and easy access to highly lethal means of perpetration, such as firearms. We studied the effects of age, period, and cohort (APC) on total and firearm-related suicides in men in Brazil and its major regions from 1980 to 2019. Death records were extracted from the Brazilian Ministry of Health's Mortality Information System. Estimable functions were used to estimate APC models, through the Epi library of the R statistical program, version 4.2.1. During the study period, Brazil had an average rate of 10.22 deaths per 100,000 men. Among regions, rates ranged from 8.62 (Northeast) to 16.93 (South). The same profile was observed in suicides by firearms. After estimating the APC models, we observed a temporal trend of increasing total suicides for Brazil and regions, except for the South region, where the trend was stationary. The trend was downward for firearm suicides for all locations. A positive gradient was observed in the mortality rate with advancing age for total suicides; and peak incidence between 20-29 years, with subsequent stabilization, for suicides perpetrated by firearms. There was a reduction in the risk of death for suicides perpetrated by firearms in relation to the reference period (1995-1999) for all locations, except in the North region, where the effect was not significant. The younger generations from the 1960s onwards had a higher risk of death from total suicide and a lower risk for those perpetrated by firearms in relation to the reference cohort (1950-1954). We observed a reduction in the mortality trend for suicides perpetrated by firearms, a reduction in the risk of death in the 2000s and for men born after 1960. Our results suggest reducing the risk of death from suicide by firearms in Brazil and regions. However, there is an upward trend in mortality from total suicides in the study period (1980-2019) and for younger cohorts.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Total Suicide mortality rates per 100,000 men in Brazil, according to age group, period, and cohort, from 1980 to 2019.
Fig 2
Fig 2. Total Suicide mortality rates per 100,000 men in in major Brazilian regions according to age, period, and cohort, from 1980 to 2019.
Fig 3
Fig 3. Suicide by firearms mortality rates per 100,000 men in Brazil, according to age group, period, and cohort, from 1980 to 2019.
Fig 4
Fig 4. Suicide by firearms mortality rates per 100,000 men in in major Brazilian regions according to age, period, and cohort, from 1980 to 2019.
Fig 5
Fig 5. Age, period, and cohort effects estimated by estimable functions for total and firearm-related suicides, in Brazil, from 1980 to 2019.
Fig 6
Fig 6. Mortality rates by age group, per 100,000 men, adjusted for period and cohort effect, for total suicide by firearms, from 1980 to 2019, Brazil and its major regions.
Fig 7
Fig 7. Risk of death (relative risk) by period, adjusted for age and cohort effect, for total suicide and suicide by firearms, from 1980 to 2019, Brazil and major regions.
Fig 8
Fig 8. Risk of death (relative risk) by cohort, adjusted for age and period effect, for total suicide and suicide by firearms, from 1980 to 2019, Brazil and major regions.
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