title: An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia.
abstract: BACKGROUND
  This study investigates the associations between railway suicide and neighborhood social, economic, and physical determinants using postcode-level data. It also examines whether the associations are influenced by having high concentration of high-risk individuals in a neighborhood area.
  
  
  METHODS
  Railway suicide cases from Victoria, Australia for the period of 2001-2012, their age, sex, year of death, usual residential address and suicide location were obtained from the National Coronial Information System. Univariate negative binomial regression models were used to estimate the association between railway suicide and neighborhood-level social, economic and physical factors. Variables which were significant in these univariate models were then assessed in a multivariate model, controlling for age and sex of the deceased and other known confounders.
  
  
  RESULTS
  Findings from the multivariate analysis indicate that an elevated rate of railway suicide was strongly associated with neighborhood exposure of higher number of railway stations (IRR=1.30 95% CI=1.16-1.46). Other significant neighborhood risk factors included patronage volume (IRR=1.06, 95% CI=1.02-1.11) and train frequency (IRR=1.02, 95% CI=1.01-1.04). An increased number of video surveillance systems at railway stations and carparks was significantly associated with a modest reduction in railway suicide risk (IRR=0.93, 95% CI=0.88-0.98). These associations were independent of concentration of high-risk individuals.
  
  
  CONCLUSIONS
  Railway suicide may be under-reported in Australia.
  
  
  CONCLUSIONS
  Interventions to prevent railway suicide should target vulnerable individuals residing in areas characterized by high station density, patronage volume and train frequency.
authors.affiliation: Monash Injury Research Institute, Monash University, Victoria, Australia. Electronic address: tiffany.too@monash.edu.
authors.forename: Lay San
authors.initials: LS
authors.lastname: Too
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Spittal
authors.affiliation: Monash Injury Research Institute, Monash University, Victoria, Australia.
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bugeja
authors.affiliation: Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Milner
authors.affiliation: Melbourne School of Design, The University of Melbourne, Victoria, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Stevenson
authors.affiliation: Harvard Injury Control Research Center, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Roderick
authors.initials: R
authors.lastname: McClure
mesh_terms: D000328:Adult; D001108:Architecture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011890:Railroads / Q000706:statistics & numerical data*; D012042:Registries; D012111:Residence Characteristics / Q000145:classification* / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Neighborhood; Railway; Socio-environment; Suicide