title: Socio-environmental drivers and suicide in Australia: Bayesian spatial analysis.
abstract: BACKGROUND
  The impact of socio-environmental factors on suicide has been examined in many studies. Few of them, however, have explored these associations from a spatial perspective, especially in assessing the association between meteorological factors and suicide. This study examined the association of meteorological and socio-demographic factors with suicide across small areas over different time periods.
  
  
  METHODS
  Suicide, population and socio-demographic data (e.g., population of Aboriginal and Torres Strait Islanders (ATSI), and unemployment rate (UNE) at the Local Government Area (LGA) level were obtained from the Australian Bureau of Statistics for the period of 1986 to 2005. Information on meteorological factors (rainfall, temperature and humidity) was supplied by Australian Bureau of Meteorology. A Bayesian Conditional Autoregressive (CAR) Model was applied to explore the association of socio-demographic and meteorological factors with suicide across LGAs.
  
  
  RESULTS
  In Model I (socio-demographic factors), proportion of ATSI and UNE were positively associated with suicide from 1996 to 2000 (Relative Risk (RR)ATSI = 1.0107, 95% Credible Interval (CI): 1.0062-1.0151; RRUNE = 1.0187, 95% CI: 1.0060-1.0315), and from 2001 to 2005 (RRATSI = 1.0126, 95% CI: 1.0076-1.0176; RRUNE = 1.0198, 95% CI: 1.0041-1.0354). Socio-Economic Index for Area (SEIFA) and IND, however, had negative associations with suicide between 1986 and 1990 (RRSEIFA = 0.9983, 95% CI: 0.9971-0.9995; RRATSI = 0.9914, 95% CI: 0.9848-0.9980). Model II (meteorological factors): a 1°C higher yearly mean temperature across LGAs increased the suicide rate by an average by 2.27% (95% CI: 0.73%, 3.82%) in 1996-2000, and 3.24% (95% CI: 1.26%, 5.21%) in 2001-2005. The associations between socio-demographic factors and suicide in Model III (socio-demographic and meteorological factors) were similar to those in Model I; but, there is no substantive association between climate and suicide in Model III.
  
  
  CONCLUSIONS
  Proportion of Aboriginal and Torres Strait Islanders, unemployment and temperature appeared to be statistically associated with of suicide incidence across LGAs among all selected variables, especially in recent years. The results indicated that socio-demographic factors played more important roles than meteorological factors in the spatial pattern of suicide incidence.
authors.affiliation: School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China. chestertsee@outlook.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Qi
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
authors.forename: Kerrie
authors.initials: K
authors.lastname: Mengersen
authors.forename: Shilu
authors.initials: S
authors.lastname: Tong
mesh_terms: D001315:Australia; D001499:Bayes Theorem; D002980:Climate; D005260:Female; D006358:Hot Temperature; D006801:Humans; D015994:Incidence; D009111:Local Government; D008297:Male; D008685:Meteorological Concepts; D012307:Risk Factors; D013405:Suicide / Q000208:ethnology / Q000706:statistics & numerical data; D013696:Temperature; D013997:Time Factors; D014478:Unemployment