PROPOSAL FOR “GLOBAL HEALTH POLICY FRAMEWORK”

DESIGNED TO MITIGATE SUICIDE

Emine Meral Inelmen, Marialuisa Gazerro,Erol Inelmen, Giuseppe Sergi

ADDRESS FOR CORRESPONDENCE:

Emine Meral Inelmen MD.

Clinica Geriatrica - Ospedale Giustinianeo (2° piano)

via Giustiniani 2, 35100, Padova, ITALY

Telephone number: 0039 049-8218493

Fax number: 0039 (0)49-8211218

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1. Introduction

This work starts with the premise that suicide (S) rates are at the increase. According to the World Health Organization“Suicide is the single greatest cause of violent death around the globe” (World Health Organization Suicide Prevention, 2004)(1). The common factor in S. seems to be an unbearable suffering. The suicidal person is sad, lonely, disaffected, hopeless and helpless, feels that life is futile, and S. becomes the only solution to abolish the suffering. S., thus, becomes an escape.

Harmful use of alcohol is considerable in countries with different levels of development. The association of alcohol dependence with suicidal behaviour is well established although complex. On the basis of epidemiological and clinical evidence, alcohol dependence is known to increase the risk for suicidal ideation, S. attempts and complete S. According to the World Health Organization (WHO 2004) (1), there is an increased harm among young people and women worldwide.

2. Background

Death can be seen as a world of silence and peace, calm and darkness, which are not present in our modern society.Hence, S. seems to be a complex outcome of multiple, inter-related factors, although some individuals commit S. without any identifiable reason.Thus, specific reasons for S. are as diverse as the individuals who commit it. In other words, S. is a complicated and difficult phenomenon to understand, with many contributing factors.

Severe alcohol-related life impairment, alcohol dependence, is observed at some time during their lives in about 10%of men and 3-5% of women (2). The scientific literature confirms that individuals with alcoholism have higher risk for attempted and completed S. compared to persons without alcoholism; thus, S. is a cause of death for substantial percentage of individuals with alcoholism (3).

Alcohol abuse or dependence is a worldwide flagellum, because it leads to disruptions in interpersonal relationships, employment, financial, and legal difficulties, car accidents, and other stressful events that may increase risk of S. behaviour (4). The data collected by Bilban and Skibin, 2004 show that a number of S. victims had alcohol problems (men 37.4%, women 11.6%) (5).

3. Methodology

In order to better understand the problem of S, we present a global view of the S. phenomenon in the world, by focusing on the geographical differences using “thematic mapping”. To highlight the predictors of S -particularly the factor alcoholism in relation with S.-, we investigate the association between alcohol consumption and S. rates in the world, and to put a glance on the future prospective.

The paper goes on with the discussion of the results from the available data the find evidence on the relation between alcohol use and S. considering different characteristics –climate, religion, abundance, etc- of the regions in the world.This paper part of a larger project on public polices which include also other aspects of life: nutrition, shelter, transportation, education.

4. Conclusion

As described in the previous sections, the identification of risk factors for suicidal behaviour requires a public health priority. Our findings show that alcohol abuse substantially influences S. rates.Nevertheless many different factors –such as age, gender, psychiatric and medical disorders, unemployment, divorce, social isolation, widowhood, past history ofattempt S.- determinate S. rates in a certain country.

We thereforeclaimthat more effort be directed to prevention of alcohol abuse. Public health education (awareness of the advantages of a healthy lifestyle without alcohol), is an important step towards lowering the S. rate.A global health policy is required to effectively mitigate S. Global statistical analysis can provide the arguments for a health policy framework to deal with S.

Furthermorewe argue that alcohol is too cheap, too available, and too acceptable in many countries. A suitable policy to restrictive access to alcohol is toincrease alcohol prices.This measurewould fight against the culture of alcohol drinking of our societies.Future studies are necessary to determinate which strategies may best reduce suicidal behaviour in alcohol abuse.

References

(1) C:\Documents and Settings\user001\Desktop\WHO Global Status Report on Alcohol 2004.mht(2) Sher L. Alcohol and suicide: neurobiological and clinical aspects. Scientific World Journal 2006; 6: 700-6.

(3) Sher L. Alcohol use and suicide rates. Medical Hypotheses 2005;65:1010-1012.

(4) Conner KR, and Duberstein PR. Predisposing and precipitating factors for suicide among alcoholics: empirical review and conceptual integration. Alcohol Clin Exp Res 2004; 28(5 Suppl): 6S-17S.

(5) Bilban M, and Skibin L. Presence of alcohol in suicide victims. Forsenic Science International 2005;147S: S9-S12.

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Epidemiologia del suicidio nella popolazione anziana