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Yiing-Jenq Chou, Nicole Huang, Response, International Journal of Epidemiology, Volume 33, Issue 6, December 2004, Pages 1409–1410, https://doi.org/10.1093/ije/dyh236
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We agree with Dr Lu1 that more research, not limited to individual-level studies, is required to assess the impacts of earthquake on suicide. The role of the physical and social environment should not be overlooked.2–4 Ecological and multilevel studies can help contribute to this line of research. Individual and ecological studies are different analyses, but of equal importance.
Dr Lu's assertion1 that we ‘explicitly stated that our individual-level study was better than previous ecological disaster studies’5 is not entirely correct. The actual statement in our Discussion section was that ‘the accuracy of our study is relatively higher than that of some previous ecological disaster studies’ because previous disaster studies on suicides seldom differentiate victims from non-victims at the individual level, and incorporate relatively comprehensive socio-economic and health status information on each member of the study population due to lack of individual-level data.5 We, by no means, claim that our study is better than all previous ecological disaster studies. We believe there is always more than one ‘correct’ way to address one question. No one design is better than the other.
