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Age-adjusted suicide rate drops by a third globally
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Between 1990 and 2016, the total number of deaths from suicide increased by 6.7% globally; however, the age-standardized mortality rate for suicide dropped by 32.7%, according to a systematic analysis of the Global Burden of Disease Study 2016.
Despite the decline in age-adjusted suicide-related mortality, suicide remains a major contributor to mortality worldwide and varies across locations, sexes and age groups, analysis results showed.
“Given the focus on preventing suicide internationally and by specific countries, an accounting of levels and trends of suicide mortality, including analyses by region, country, age, and sex is necessary to inform suicide prevention efforts,” Mohsen Naghavi, MD, PhD, MPH, from the Institute for Health Metrics and Evaluation at the University of Washington, wrote on behalf of the Global Burden of Disease Self-Harm Collaborators.
Using estimates from the Global Burden of Disease Study 2016, Naghavi and colleagues described patterns of suicide mortality globally, regionally and for 195 countries and territories between 1990 and 2016. In this systematic analysis, they compared crude and age-standardized rates of suicide mortality and years of life lost across regions and countries, and by age, sex and sociodemographic measures.
Over the 27-year period, analysis revealed that there were 817,000 (95% uncertainty interval [UI], 762,000-884,000) deaths globally from suicide in 2016, which comprised 1.49% (95% UI, 1.39-1.61) of the total deaths that year. Although the global number of deaths from suicide rose by 6.7% (95% UI, 0.4-15.6), the age-standardized mortality rate from suicide declined by 32.7% (95% UI, 27.2-36.6) from 16.6 deaths per 100,000 in 1990 to 11.2 in 2016.
In 2016, 34.6 (95 % UI, 32.4-37.4) million years of life lost resulted from suicide and the global age-standardized rate of years of life lost was estimated at 458.4 (95% UI, 438.5-506.1) per 100,000 person-years, according to the results.
Naghavi and colleagues found that suicide was the leading cause of age-standardized years of life lost in the high-income Asia Pacific region and was among the top 10 leading causes in Eastern, Central and Western Europe, Central Asia, Australasia, Southern Latin America and high-income North America.
They also observed a greater decline in the global suicide mortality rate for women (49%; 95% UI, 42.6-54.6) than men (23.8%; 95% UI,15.6-32.7) from 1990 to 2016; however, the global age-standardized mortality rate was higher for men (15.6 deaths per 100,000; 95% UI, 13.7-17.2) than for women (7; 95% UI, 6.5-7.4).
Globally, the suicide rate was higher for men than for women across regions, countries and age groups, excluding the 15 to 19 age group. For both men and women and across all regions, the rates of suicide mortality were highest for the oldest age groups, according to the data. In addition, the ratio of age-standardized mortality rates for women compared with men were highest in countries with a low sociodemographic index; this varied in some countries.
“Accurate and timely data on suicide mortality are necessary to inform suicide prevention interventions, and to monitor the impact of interventions,” Heather Orpana, PhD, research scientist at the Public Health Agency of Canada, told Healio Psychiatry.
“A continued focus on improving suicide mortality data, especially in countries without high quality vital registration systems, will advance our understanding,” she continued. “Given the variability in rates and patterns of suicide mortality presented in the study, suicide prevention efforts need to be sensitive to local contexts.” – by Savannah Demko
Disclosures: Naghavi and Orpana report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
Perspective
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Jonathan B. Singer, PhD, LCSW
I find it interesting that the age-adjusted suicide and nonsuicide deaths decreased by basically the same amount (32% and 30% respectively). The authors rightly point to the significant contribution that China and India have on mortality rates. Both of those countries had a significant decline in suicide deaths among young women over the 26-year period of the study. Why?
The authors point to restricted access to lethal means (ie, pesticides) in China and India. While means restriction is certainly one of the most important suicide prevention efforts, I hope that the decrease in age-adjusted mortality overall suggests that women are not only living, but are finding their lives worth living. One of the unintended consequences of female infanticide during China’s one-child era is that there are fewer women in China than men, which make women more valued in Chinese society. A silver lining on a very dark cloud.
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