#1ALCOHOL AND SUICIDES IN THE NENETS AUTONOMOUS OKRUG, RUSSIA Case from Krasnoe village Yury Sumarokov#2Saami Kalaallit Saami Inupiat Yup'ik Indigenous people in the Chukchi Kerek Russian Arctic 800 Veps Nenets Nonots Nganasan Enets Dolgan Evenk Finnic Evenk Ugric Uralic- Mansi Nenets Samodic Yukagiran Yukagiran Selkup Ket Evenk Turkic Khant Mongolic Altaic Selkup Tunguso-Manchurian Chukotko-Kamchatkan Chulym Ket (isolated) Nivkh (isolated) Kumandin Teleut Shor Tofa Soyot Tuba Chelkan Eskimoic Eskimo- Aleutian Aleutian Tuvinian- Telengit Todzhin Chukchi Chuyan Koryak Yukagir Alyutor Aleut Even Koryak Yukagir Itelmen Even Kamchadal Even Evenk Even Evenk Orok Nivkh Evenk Uichi Negidal Orochi Evonk Nanai Udege Taz Source: www.landofmaps.com 2#3Area studied Kanin peninsula Barents Sea Kolguev Island Bugrino Novaya Zemlya Pechorsky Sea Kara Sea Vaygach Island Nenets Autonomous Okrug Nel'min-Nos Andeg Iskateley Narian-Mar Indiga Viucheisky Khongurei Nes' Archangelsk Oblast Khorey-Ver Karataika Yamalo- Nenets Auton. Komi Republic Okrug 250 km Source: GRID-Arendal#4Social-economical situation in the area • Main industries: Oil and gas complex, including oil transport complex, reindeer husbandry, power generating, food industry, construction industry The highest average salary (1-st place in Russia). The highest per capita in Russia: about 110 000 USD Growing economy and investments, developing infrastructure 4#5Area studied - cluster of suicide Kanin peninsula Barents Sea Novaya Zemlya Kolguev Island Bugrino Pechorsky Sea Indiga Nenets Autonomous Okrug Nel'm Nos. A a Iskateley Narian-Mar KRASNOE Viucheisky Khongurei Nes' Archangelsk Oblast Khorey-Ver Kara Sea Vaygach Island Komi Republic N Source: GRID-Arendal 0 Karataika Yamalo- Nenets Auton. Okrug 5 250 km#6Krasnoe village • Established in 1956 • • - Population 1618 (adults – 1190, teenagers - 63, children - 365) in 2012 Ethnic structure - Nenets 56% (900), Russians and Komi - 44% Main occupation - reindeer herding - - Number of suicide deaths in 2002-2012 – 22 (all – Nenets) • Blood alcohol content positive (BAC+ suicides) - 100% 6 00#7What do we know about suicide in the Nenets? • • . Paper I. Sumarokov YA, Brenn T, Kudryavtsev AV, Nilssen O. Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics. Int J Circumpolar Health 2014;73:24308 Paper II. Sumarokov YA, Brenn T, Kudryavtsev AV, Nilssen O. Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets. Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study. BMC Psychiatry 2015;15:224 Paper III. Sumarokov YA, Brenn T, Kudryavtsev AV, Sidorenkov O, Nilssen O. Alcohol and suicides in the Nenets Autonomous Okrug and Arkhangelsk Oblast, Russia. Int J Circumpolar Health 2016;75:30965 7#8Structure HOW and WHEN they commit suicides? WHO commit suicides in the NAO? WHY people in the NAO commit suicide more often than those in the AO 8#9INTERNATIONAL JOURNAL OF CIRCUMPOLAR HEALTH ORIGINAL RESEARCH ARTICLE Paper | Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics Yury A. Sumarokov 1,2*, Tormod Brenn¹, Alexander V. Kudryavtsev 1,2 and Odd Nilssen¹ Suicide rates per 100,000 person years Among Nenets: 79.8 Highest (391) among 20-29 years of age Highest (106) among 30-39 years of age Among non-indigenous: 49.2 COACTION PUBLISHING#10Paper I results, cont. RR = suicide rate in Nenets suicide rate in non-indigenous Characteristic RR Residence Urban 3.1 Rural 1.1 Employment Employers and employees 2.4 Other 1.2 Education University/college 2.8 Secondary school 2.7 Incomplete school 3.4 Marital status Married 2.6 Single 2.1 Divorced 2.3#11Sumarokov et al. BMC Psychiatry (2015) 15:224 DOI 10.1186/s12888-015-0601-z Paper II Most in Spring RESEARCH ARTICLE BMC Psychiatry Open Access Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study Yury A. Sumarokov 1,2*, Tormod Brenn', Alexander V. Kudryavtsev 1,2 and Odd Nilssen¹ CrossMark NAO: Most on Barents Sea Kolguev Island Bugrino Indiga Viuchelsky Khongure NAO Nenets Autonomous Okrug Nol'min Nos Andeg Iskateley Kanan-Mar Kami Republic Khorey Ver Kara Sea Vaygach Fridays 69.3 % 86.2 % 86.5 % 74.9 % 20.9 % 4.7 % Russia Karataika. 8.1 % 0.4 % 6.5 % 3.0 % 5.4% 2.2 %#12INTERNATIONAL JOURNAL OF CIRCUMPOLAR HEALTH ORIGINAL RESEARCH ARTICLE Paper III Alcohol and suicide in the Nenets Autonomous Okrug and Arkhangelsk Oblast, Russia Yury A. Sumarokov 1,2*, Tormod Brenn¹, Alexander V. Kudryavtsev 1,2, TOLOX Oleg Sidorenkov¹ and Odd Nilssen &&tion PUBLISHING The White Sea Kolguev Island Kanin peninsula Barents Sea Nes Indiga Novaya Zemly NAO Viuchelsky Khongurel Nenets Autonomous Okrug Nel'min Nos Andeg Iskateley Narian-Mar Khorey-Ver Kara Sea Vaygach Karataika 2.02 % 2.14 %0 74.1 % 82.9% 2.54 % 2.56% 59.3% 46.6 % Archannalsk Kami Republic Among Nenets: 78.3 % 92.3 % Mezen Arkhangelsk Novodvinsk The Norther Dvina Arkhangelskaya oblast Kargapol The Republi of Komi#13Conclusions from the previous study 1. 2. Suicide rates in the NAO were substantially higher among the indigenous than the non- indigenous Nenets people, and were associated with different socio-demography Suicide methods and times differed from Russia at large 3. Alcohol may be an essential risk factor for suicide and even more important than in Arkhangelsk oblast#14WHAT WE CAN SUGGEST FOR SUICIDE PREVENTION IN KRASNOE VILLAGE? Level of Influence Existing risk factors National and regional Community Family Personality Conditional Historical trauma, forced relocation, and settlement. Socioeconomic inequality, lack of access to health services. Family history of suicide, intergenerational trauma, domestic violence Mental disorders, substance abuse, history of self-harm, acute stress, hopelessness, and isolation. Access to violent means of suicide, alcohol and drug intoxication Protective factors ? ? C. ? ? 2. ?#15Future research • . . • Is higher suicide rate in indigenous people due to the socio- economy? The role of biological and genetic factors What is the role of depression and history of attempted suicide? What about the subgroup of Nenets reindeer herders? Links to medical and psychological studies of indigenous peoples? WHAT ELSE?#16[email protected]