title: Suicide rates and trends in São Paulo, Brazil, according to gender, age and demographic aspects: a joinpoint regression analysis.
abstract: OBJECTIVE
  To evaluate suicide rates and trends in São Paulo by sex, age-strata, and methods.
  
  
  METHODS
  Data was collected from State registry from 1996 to 2009. Population was estimated using the National Census. We utilized joinpoint regression analysis to explore temporal trends. We also evaluated marital status, ethnicity, birthplace and methods for suicide.
  
  
  RESULTS
  In the period analyzed, 6,002 suicides were accrued with a rate of 4.6 per 100,000 (7.5 in men and 2.0 in women); the male-to-female ratio was around 3.7. Trends for men presented a significant decline of 5.3% per year from 1996 to 2002, and a significant increase of 2.5% from 2002 onwards. Women did not present significant changes. For men, the elderly (> 65 years) had a significant reduction of 2.3% per year, while younger men (25-44 years) presented a significant increase of 8.6% from 2004 onwards. Women did not present significant trend changes according to age. Leading suicide methods were hanging and poisoning for men and women, respectively. Other analyses showed an increased suicide risk ratio for singles and foreigners.
  
  
  CONCLUSIONS
  Specific epidemiological trends for suicide in the city of São Paulo that warrant further investigation were identified. High-risk groups - such as immigrants - could benefit from targeted strategies of suicide prevention.
authors: Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors: Daniel H
authors: DH
authors: Bando
authors: André R
authors: AR
authors: Brunoni
authors: Tiótrefis G
authors: TG
authors: Fernandes
authors: Isabela M
authors: IM
authors: Benseñor
authors: Paulo A
authors: PA
authors: Lotufo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013405:Suicide / Q000145:classification / Q000706:statistics & numerical data / Q000639:trends*; D014505:Urban Population; D055815:Young Adult