Nationwide impact of heat on suicide and homicide in Mexico and Brazil
摘要
Understanding how temperature, an environmental factor associated with suicide and homicide, may assist in identifying preventive approaches at the population level. However, significant gaps remain in understanding this association in tropical developing regions with high homicide and suicide burdens, where underlying socio-structural factors may critically modify temperature effects. By integrating 1,243,596 records extracted from two national mortality information systems and daily weather data between 2000 and 2019, the relationship between increased ambient mean temperature and the risk of suicide and homicide mortality was investigated using a time-stratified case-crossover design. Odds ratios and 95% confidence intervals (CIs) of temperature-associated mortality were estimated using the conditional logistic regression model combined with the distributed lag nonlinear model. Pooled estimates suggested each 1 °C increase in ambient mean temperature was associated with a 2.17% (95% CI 1.72–2.63%) and 1.80% (95% CI 1.33–2.27%) increase in homicide over lag 0–5 days in Brazil and Mexico, and the estimates for suicide were 2.78% (95% CI 2.18–3. 39%) and 3.75% (95% CI 3.05–4.46%), respectively. The association appeared stronger among males, mixed-race individuals in Brazil, during weekends, and in summer–autumn. Socioeconomic factors significantly modified the association between temperature and risks of suicide and homicide mortality. Throughout the study period, 10.19% of suicides and 9.43% of homicides in Brazil, along with 12.97% of suicides and 12.56% of homicides in Mexico, were associated with temperatures exceeding state-specific medians. Our findings emphasize the significance of heat adaptation strategies throughout almost the year to mitigate self-harm and interpersonal violence.