Intersection of race/skin color and sex in intentional self-inflicted injury rates among Brazilian people (2014-2023)

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Abstract
Suicidal and self-injurious behaviors are major public health issues, disproportionately affecting youth. While global suicide rates declined, Brazil has seen a significant rise over recent decades. Considering the persistent social inequality in Brazil, especially among Black/Mixed-race women, an intersectional approach is essential to understanding how the combination of social identities impacts health. This study analyzes reported intentional self-inflicted injury rates among Brazilian people (18-30 years) from 2014 to 2023, according to race/skin color, sex, and their intersection. Data were obtained from official public records (Brazilian Information System for Notifiable Diseases). Intentional self-inflicted injury rates were estimated nationally and by macroregion, for the population aged 18 to 30 years, according to race/skin color, sex, and their intersection. Brazilian national intentional self-inflicted injury rates increased 638% (24.2 to 178.5/100,000), with regional increases up to 969%. Females had higher rates than males, and Mixed-race individuals showed the steepest rise (890%). Intersectional analysis revealed that White females had the highest rates, but Mixed-race females experienced the most significant increase (914%). Regional variations were notable, Mixed-race females led in the North, Northeast and Central-West, while White females dominated the South and Southeast. Intentional self-inflicted injury rates surged among Brazilian people (18-30 years), particularly White/Mixed-race women and Mixed-race individuals, with substantial regional variation. Intersectional and contextual factors (healthcare access, gender, and socioeconomic) are likely contributors. These findings suggest combined effects of racial and gender inequities, policy responses must address intersectional vulnerabilities.

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