Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study

Abstract Background Socio-economic status is associated with self-harm at the individual and area level. In Canada, there is limited evidence on the relationship between area-level markers of socio-economic status and self-harm. The objective of this study was to assess the impact of small area-leve...

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Main Authors: Li Liu, Nathaniel J. Pollock, Gisèle Contreras, Yuan Xu, Wendy Thompson
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-024-06316-8
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author Li Liu
Nathaniel J. Pollock
Gisèle Contreras
Yuan Xu
Wendy Thompson
author_facet Li Liu
Nathaniel J. Pollock
Gisèle Contreras
Yuan Xu
Wendy Thompson
author_sort Li Liu
collection DOAJ
description Abstract Background Socio-economic status is associated with self-harm at the individual and area level. In Canada, there is limited evidence on the relationship between area-level markers of socio-economic status and self-harm. The objective of this study was to assess the impact of small area-level material and social deprivation on rates of hospitalization due to self-harm. Methods Administrative data on hospitalizations from two databases in Canada (Discharge Abstract Database and Ontario Mental Health Reporting System) for the period April 1, 2015 to March 31, 2022, were analyzed. Rates of self-harm hospitalization and percentage of repeated admissions were estimated across quintiles of material and social deprivation. Rate ratios were computed to evaluate disparities. The rates were stratified by sex and age group; the percentage of repeated admissions were stratified by sex. Results In total, the study included 109,398 hospitalizations due to self-harm. Populations in more deprived areas had higher rates of self-harm hospitalizations than those in less deprived areas. The rate ratios for people who lived in the most deprived areas over the least deprived areas were 1.48 (95% CI: 1.38–1.58) and 1.71 (95% CI: 1.60–1.82) for material and social deprivation, separately. The largest disparity was among people aged 25–44 years for material and 45–64 years for social deprivation. Percentages of repeated self-harm hospitalizations were significantly higher in more deprived areas compared to less deprived areas for social deprivation, and among males but not females for material deprivation. Conclusions Both material and social deprivation were associated with self-harm hospitalization and repeated admissions; the disparity varied by subgroup and the deprivation components. This study demonstrated a need to consider interventions at the neighbourhood level and address both community and population-level conditions of social and material need.
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spelling doaj-art-d036fa15ef8847bbaec9364378c82b122025-08-20T02:49:17ZengBMCBMC Psychiatry1471-244X2024-11-0124111010.1186/s12888-024-06316-8Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological studyLi Liu0Nathaniel J. Pollock1Gisèle Contreras2Yuan Xu3Wendy Thompson4Centre for Surveillance and Applied Research, Public Health Agency of CanadaCentre for Surveillance and Applied Research, Public Health Agency of CanadaCentre for Surveillance and Applied Research, Public Health Agency of CanadaCentre for Surveillance and Applied Research, Public Health Agency of CanadaCentre for Surveillance and Applied Research, Public Health Agency of CanadaAbstract Background Socio-economic status is associated with self-harm at the individual and area level. In Canada, there is limited evidence on the relationship between area-level markers of socio-economic status and self-harm. The objective of this study was to assess the impact of small area-level material and social deprivation on rates of hospitalization due to self-harm. Methods Administrative data on hospitalizations from two databases in Canada (Discharge Abstract Database and Ontario Mental Health Reporting System) for the period April 1, 2015 to March 31, 2022, were analyzed. Rates of self-harm hospitalization and percentage of repeated admissions were estimated across quintiles of material and social deprivation. Rate ratios were computed to evaluate disparities. The rates were stratified by sex and age group; the percentage of repeated admissions were stratified by sex. Results In total, the study included 109,398 hospitalizations due to self-harm. Populations in more deprived areas had higher rates of self-harm hospitalizations than those in less deprived areas. The rate ratios for people who lived in the most deprived areas over the least deprived areas were 1.48 (95% CI: 1.38–1.58) and 1.71 (95% CI: 1.60–1.82) for material and social deprivation, separately. The largest disparity was among people aged 25–44 years for material and 45–64 years for social deprivation. Percentages of repeated self-harm hospitalizations were significantly higher in more deprived areas compared to less deprived areas for social deprivation, and among males but not females for material deprivation. Conclusions Both material and social deprivation were associated with self-harm hospitalization and repeated admissions; the disparity varied by subgroup and the deprivation components. This study demonstrated a need to consider interventions at the neighbourhood level and address both community and population-level conditions of social and material need.https://doi.org/10.1186/s12888-024-06316-8Self-harmSuicideHealth careSocial deprivationMaterial deprivationSocio-economic status
spellingShingle Li Liu
Nathaniel J. Pollock
Gisèle Contreras
Yuan Xu
Wendy Thompson
Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
BMC Psychiatry
Self-harm
Suicide
Health care
Social deprivation
Material deprivation
Socio-economic status
title Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
title_full Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
title_fullStr Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
title_full_unstemmed Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
title_short Self-harm hospitalizations and neighbourhood level material and social deprivation in Canada: an ecological study
title_sort self harm hospitalizations and neighbourhood level material and social deprivation in canada an ecological study
topic Self-harm
Suicide
Health care
Social deprivation
Material deprivation
Socio-economic status
url https://doi.org/10.1186/s12888-024-06316-8
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