Suicide has drawn much attention from both the scientific community and the public. Examining the impact of socio-environmental factors on suicide is essential in developing suicide prevention strategies and interventions, because it will provide health authorities with important information for their decision-making. However, previous studies did not examine the impact of socio-environmental factors on suicide using a spatial analysis approach. The purpose of this study was to identify the patterns of suicide and to examine how socio-environmental factors impact on suicide over time and space at the Local Governmental Area (LGA) level in Queensland. The suicide data between 1999 and 2003 were collected from the Australian Bureau of Statistics (ABS). Socio-environmental variables at the LGA level included climate (rainfall, maximum and minimum temperature), Socioeconomic Indexes for Areas (SEIFA) and demographic variables (proportion of Indigenous population, unemployment rate, proportion of population with low income and low education level). Climate data were obtained from Australian Bureau of Meteorology. SEIFA and demographic variables were acquired from ABS. A series of statistical and geographical information system (GIS) approaches were applied in the analysis. This study included two stages. The first stage used average annual data to view the spatial pattern of suicide and to examine the association between socio-environmental factors and suicide over space. The second stage examined the spatiotemporal pattern of suicide and assessed the socio-environmental determinants of suicide, using more detailed seasonal data. In this research, 2,445 suicide cases were included, with 1,957 males (80.0%) and 488 females (20.0%). In the first stage, we examined the spatial pattern and the determinants of suicide using 5-year aggregated data. Spearman correlations were used to assess associations between variables. Then a Poisson regression model was applied in the multivariable analysis, as the occurrence of suicide is a small probability event and this model fitted the data quite well. Suicide mortality varied across LGAs and was associated with a range of socio-environmental factors. The multivariable analysis showed that maximum temperature was significantly and positively associated with male suicide (relative risk [RR] = 1.03, 95% CI: 1.00 to 1.07). Higher proportion of Indigenous population was accompanied with more suicide in male population (male: RR = 1.02, 95% CI: 1.01 to 1.03). There was a positive association between unemployment rate and suicide in both genders (male: RR = 1.04, 95% CI: 1.02 to 1.06; female: RR = 1.07, 95% CI: 1.00 to 1.16). No significant association was observed for rainfall, minimum temperature, SEIFA, proportion of population with low individual income and low educational attainment. In the second stage of this study, we undertook a preliminary spatiotemporal analysis of suicide using seasonal data. Firstly, we assessed the interrelations between variables. Secondly, a generalised estimating equations (GEE) model was used to examine the socio-environmental impact on suicide over time and space, as this model is well suited to analyze repeated longitudinal data (e.g., seasonal suicide mortality in a certain LGA) and it fitted the data better than other models (e.g., Poisson model). The suicide pattern varied with season and LGA. The north of Queensland had the highest suicide mortality rate in all the seasons, while there was no suicide case occurred in the southwest. Northwest had consistently higher suicide mortality in spring, autumn and winter. In other areas, suicide mortality varied between seasons. This analysis showed that maximum temperature was positively associated with suicide among male population (RR = 1.24, 95% CI: 1.04 to 1.47) and total population (RR = 1.15, 95% CI: 1.00 to 1.32). Higher proportion of Indigenous population was accompanied with more suicide among total population (RR = 1.16, 95% CI: 1.13 to 1.19) and by gender (male: RR = 1.07, 95% CI: 1.01 to 1.13; female: RR = 1.23, 95% CI: 1.03 to 1.48). Unemployment rate was positively associated with total (RR = 1.40, 95% CI: 1.24 to 1.59) and female (RR=1.09, 95% CI: 1.01 to 1.18) suicide. There was also a positive association between proportion of population with low individual income and suicide in total (RR = 1.28, 95% CI: 1.10 to 1.48) and male (RR = 1.45, 95% CI: 1.23 to 1.72) population. Rainfall was only positively associated with suicide in total population (RR = 1.11, 95% CI: 1.04 to 1.19). There was no significant association for rainfall, minimum temperature, SEIFA, proportion of population with low educational attainment. The second stage is the extension of the first stage. Different spatial scales of dataset were used between the two stages (i.e., mean yearly data in the first stage, and seasonal data in the second stage), but the results are generally consistent with each other. Compared with other studies, this research explored the variety of the impact of a wide range of socio-environmental factors on suicide in different geographical units. Maximum temperature, proportion of Indigenous population, unemployment rate and proportion of population with low individual income were among the major determinants of suicide in Queensland. However, the influence from other factors (e.g. socio-culture background, alcohol and drug use) influencing suicide cannot be ignored. An in-depth understanding of these factors is vital in planning and implementing suicide prevention strategies. Five recommendations for future research are derived from this study: (1) It is vital to acquire detailed personal information on each suicide case and relevant information among the population in assessing the key socio-environmental determinants of suicide; (2) Bayesian model could be applied to compare mortality rates and their socio-environmental determinants across LGAs in future research; (3) In the LGAs with warm weather, high proportion of Indigenous population and/or unemployment rate, concerted efforts need to be made to control and prevent suicide and other mental health problems; (4) The current surveillance, forecasting and early warning system needs to be strengthened, to trace the climate and socioeconomic change over time and space and its impact on population health; (5) It is necessary to evaluate and improve the facilities of mental health care, psychological consultation, suicide prevention and control programs; especially in the areas with low socio-economic status, high unemployment rate, extreme weather events and natural disasters.

Les études théoriques en épidémiologie utilisent principalement des équations différentielles pour étudier (voire tenter de prévoir) les processus infectieux liés aux maladies contagieuses, souvent sous des hypothèses peu réalistes (ex: des populations spatialement homogènes). Cependant ces modèles ne sont pas bien adaptés pour étudier les processus épidémiologiques à différentes échelles et ils ne sont pas efficaces pour prédire correctement les épidémies. De tels modèles devraient notamment être liés à la structure sociale et spatiale des populations. Dans cette thèse, nous proposons un ensemble de nouveaux modèles dans lesquels différents niveaux de spatialité (par exemple la structure locale de la population, en particulier la dynamique de groupe, la distribution spatiale des individus dans l'environnement, le rôle des personnes résistantes, etc.) sont pris en compte pour expliquer et prédire la façon dont des maladies transmissibles se développent et se répandent à différentes échelles, même à l'échelle de grandes populations. La manière dont les modèles que nous avons développé sont paramétrés leur permet en outre d'être reliés entre eux pour bien décrire en même temps le processus épidémiologique à grande échelle (population d'une grande ville, pays ...) mais avec précision dans des zones de surface limitée (immeubles de bureaux, des écoles). Nous sommes d'abord parvenus à inclure la notion de groupes dans des systèmes d'équations différentielles de modèles SIR (susceptibles, infectés, résistants) par une réécriture des dynamiques de population s'inspirant des réactions enzymatiques avec inhibition non compétitive : les groupes (une forme de complexe) se forment avec des compositions différentes en individus S, I et R, et les individus R se comportent ici comme des inhibiteurs non compétitifs. Nous avons ensuite couplé de tels modèles SIR avec la dynamique globale des groupes simulée par des algorithmes stochastiques dans un espace homogène, ou avec les dynamiques de groupe émergentes obtenues dans des systèmes multi-agents. Comme nos modèles fournissent de l'information bien détaillée à différentes échelles (c'est-à-dire une résolution microscopique en temps, en espace et en population), nous pouvons proposer une analyse de criticité des processus épidémiologiques. Nous pensons en effet que les maladies dans un environnement social et spatial donné présentent des signatures caractéristiques et que de telles mesures pourraient permettre l'identification des facteurs qui modifient leur dynamique.Nous visons ainsi à extraire l'essence des systèmes épidémiologiques réels en utilisant différents modèles mathématique et numériques. Comme nos modèles peuvent prendre en compte les comportements individuels et les dynamiques de population, ils sont en mesure d'utiliser des informations provenant du BigData, collectée par les technologies des réseaux mobiles et sociaux. Un objectif à long terme de ce travail est d'utiliser de tels modèles comme de nouveaux outils pour réduire les épidémies en guidant les rythmes et organisation humaines, par exemple en proposant de nouvelles architectures et en changeant les comportements pour limiter les propagations épidémiques. / Theoretical studies in epidemiology mainly use differential equations, often under unrealistic assumptions (e.g. spatially homogeneous populations), to study the development and spreading of contagious diseases. Such models are not, however, well adapted understanding epidemiological processes at different scales, nor are they efficient for correctly predicting epidemics. Yet, such models should be closely related to the social and spatial structure of populations. In the present thesis, we propose a series of new models in which different levels of spatiality (e.g. local structure of population, in particular group dynamics, spatial distribution of individuals in the environment, role of resistant people, etc) are taken into account, to explain and predict how communicable diseases develop and spread at different scales, even at the scale of large populations. Furthermore, the manner in which our models are parametrised allow them to be connected together so as to describe the epidemiological process at a large scale (population of a big town, country ...) and with accuracy in limited areas (office buildings, schools) at the same time.We first succeed in including the notion of groups in SIR (Susceptible, Infected, Recovered) differential equation systems by a rewriting of the SIR dynamics in the form of an enzymatic reaction in which group-complexes of different composition in S, I and R individuals form and where R people behave as non-competitive inhibitors. Then, global group dynamics simulated by stochastic algorithms in a homogeneous space, as well emerging ones obtained in multi-agent systems, are coupled to such SIR epidemic models. As our group-based models provide fine-grain information (i.e. microscopical resolution of time, space and population) we propose an analysis of criticality of epidemiological processes. We think that diseases in a given social and spatial environment present characteristic signatures and that such measurements could allow the identification of the factors that modify their dynamics.We aim here to extract the essence of real epidemiological systems by using various methods based on different computer-oriented approaches. As our models can take into account individual behaviours and group dynamics, they are able to use big-data information yielded from smart-phone technologies and social networks. As a long term objective derived from the present work, one can expect good predictions in the development of epidemics, but also a tool to reduce epidemics by guiding new environmental architectures and by changing human health-related behaviours.