Citation

Kposowa AJ. J. Community Psychol. 2009; 37(1): 73-87.

Copyright

(Copyright © 2009, John Wiley and Sons)

DOI

10.1002/jcop.20271

PMID

unavailable

Abstract

Previous studies have found that primary care resources are associated with various health outcomes. The primary purpose of the study was to test for associations between psychiatrist availability, social disintegration and suicide rates. Data utilized were from the 2002 Area Resource File on U.S. counties (N=3080). Suicide rates were averaged over 6 years covering 1990 through 1995. Poisson and Negative binomial regression models were used to assess the association of psychiatrist availability and suicide rate ratios. Availability of psychiatrists was significantly related to suicide. Counties with greater availability of psychiatrists per 10,000 experienced a 0.12% reduction in their suicide rates (β=−0.0012, incidence density ratio [IDR]=0.9988, 95% CI=0.9984–0.9992). Divorce strongly elevated suicide rates (β=0.0724, IDR=1.0751, 95% CI=1.0664–.0858). Counties with a high percentage of men 65 years or older had significantly high suicide rates. An increase in the White population between 1980 and 1990 was also associated with a significant increase in suicide. Increases in psychiatrists reduced suicide rates, but the association was small. Psychiatrist availability may also partially reduce the effects of social disintegration at the county level. Primary care was not associated with suicide once other variables, including hospital beds were taken into account. Results provide evidence to suggest that greater mental health promotion might reduce area inequalities in suicide rates. © 2008 Wiley Periodicals, Inc.