Disparities in suicide mortality trends between United States of America and 25 European countries: retrospective analysis of WHO mortality database (original) (raw)
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BMJ, 2019
Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
Suicide mortality in the European Union
The European Journal of Public Health, 2003
on behalf of the EUROSAVE Working Group * Background: There are an estimated one million completed suicides per year worldwide. As a response to increasing concern about suicide within Europe, the EUROSAVE (European Review of Suicide and Violence Epidemiology) study was undertaken to examine recent trends in the epidemiology of suicide and self-inflicted injury mortality in the European Union (EU). Methods: Suicide and self-inflicted injury mortality data for the 15 EU countries for the years 1984-1998 were obtained from the World Health Organisation (WHO), the European Statistical Office of the European Commission (EUROSTAT) and national statistical agencies. Data were also obtained for a second group of deaths classified as 'undetermined' or 'other violence'. Age-standardized mortality rates were calculated and examined for trends over time. Results: Finland had the highest suicide rate, while Greece had the lowest for the latest available year (1997). Age-standardized suicide rates tended to be lowest in the Mediterranean countries. Significant downward linear time trends in suicide mortality were observed in most countries, although rates varied markedly between countries. Both Ireland and Spain displayed significant upward linear trends in suicide mortality. Portugal had the highest rate of undetermined deaths both in 1984 and 1998 while Greece had the lowest in both 1984 and 1997. Five countries (including Ireland and Spain) showed significant downward trends in deaths due to undetermined causes whereas Belgium and Germany showed borderline significant upward linear trends in deaths due to undetermined causes. Conclusions: Although suicide rates in most countries seem to be decreasing, the validity of the data is uncertain. Misclassification may contribute to the geographical and temporal variation in suicide rates in some EU countries but it does not explain the phenomenon. More detailed research comparing suicide-recording procedures and practices across the EU is required. In the absence of adequate EU wide data on suicide epidemiology, effective prevention of this distressing phenomenon is likely to remain elusive.
Global Suicide: the problem of health systems
International Archives of Medicine, 2015
It is estimated that over 800 000 people die by suicide and that there are many suicide attempts for each death. Young people are among those most affected. The numbers differ between countries, but it is the low-and middle-income countries that bear most of the global suicide burden, with an estimated 75% of all suicides occurring in these countries. The importance of each risk factor and the way it is classified will depend on each context. These factors can contribute to suicidal behaviours directly but can also contribute indirectly by influencing individual susceptibility to mental disorders. From the analysis of the rate of suicide, the numbers of suicide preventions successful with the number of hospitalizations and hospitalized for attempted suicide, it becomes possible to determine a path in order to create social change in three important factors to be followed to be fulfilled: knowledge (scientific and practical), public support (political will) and a social strategy, showing up as a national response to achieve the goals of suicide prevention.
Suicide mortality trends in the Nordic countries 1980 – 2009
2013
Background and aim: The Nordic countries provide a suitable setting for comparing trends in suicide mortality. The aim of this report is to compare suicide trends by age, gender, region and methods in Denmark, Finland, Iceland, Norway and Sweden 1980 – 2009. Methods: Suicide statistics 1980 – 2009 were analyzed for men and women aged 15 years and above and the age group 15 – 24 years. Regional suicide rates in 2009 were presented in maps. Results: The suicide rates across the Nordic countries declined from 25 – 50 per 100,000 in 1980 to 20 – 36 in 2009 for men and from 9 – 26 in 1980 to 8 – 11 in 2009 for women. The rates in Finland were consistently higher than those of the other countries. A significant increase of suicides in young women in Finland and Norway and a lack of a decline among young women in Sweden were noted. The male – female ratio of suicide converged to approximately 3:1 across the region during the study period. Rural areas in Finland, Norway and Sweden saw the highest suicide rates, whereas the rates in the capital regions of Denmark, Norway and Sweden were lower than the respective national rates. Conclusions: We hold that the overall decline of suicide rates in the Nordic countries reflects the socio-economic development and stability of the region, including the well-functioning healthcare. The increasing rates in Finland and Norway and the unchanged rate in Sweden of suicide in young women are an alarming trend break that calls for continued monitoring.
Suicide in Europe: an on-going public health concern
Socijalna psihijatrija, 2017
Every 40 seconds, somewhere in the world someone dies by suicide, with certain groups such as youth and men being most at risk. Research abounds as to the risks and protective factors, but there is still a huge gap in our knowledge as to what leads one person to act on suicidal ideation and another to refrain. Risks factors vary by country, culture, gender and class, and represent a complex and potentially synergistic interplay between biological, psychological, social, environmental and personal factors. These will be discussed in this paper. Many prevention programmes have been established, but no one intervention stands out. At a minimum, country-wide efforts raising awareness of suicide and deliberate self-harm, highlighting risk and protective factors and identifying and treating mental health problems early, particularly in youth, are essential. Targeted methods include public education and media campaigns, providing training for front-line staff in early recognition and, in the case of primary care clinicians, appropriate referrals for treatment of mental illness, generating policies on restricting easy access to lethal means or substances such as alcohol which disinhibit behaviour and reducing the stigma of, and promoting, help-seeking. These efforts should go some way towards slowing what might otherwise become a self-destructive epidemic. We all have a role to play. / Svakih 40 sekundi negdje na svijetu netko počini samoubojstvo pri čemu su određene skupine, poput mladih i muškaraca pod većim rizikom. Istraživanja ukazuju na brojne kako rizične, tako i zaštitne čimbenike, ali i dalje postoji veliki nedostatak u znanju što neku osobu vodi da djeluje prema svojim suicidalnim idejama, a drugu da se suzdrži od počinjenja suicida. Rizični čimbenici variraju ovisno o državi, kulturi, spolu, klasi i predstavljaju kompleksno, potencijalno sinergističko međudjelovanje bioloških, psiholoških, društvenih, okolišnih i osobnih činitelja o čemu raspravlja ovaj članak. Utemeljeni su mnogi preventivni programi, ali ni jedna intervencija se posebno ne ističe svojom većom učinkovitošću. Potreban minimum treba uključivati: napore na nacionalnoj razini u podizanju svjesnosti o suicidu i namjernom samoozljeđivanju, ukazivanje na rizične i zaštitne čimbenike, rano identificiranje i tretman problema duševnog zdravlja, osobito u mladih. Ciljane metode prevencije uključuju: javnu edukaciju i medijske kampanje, provođenje edukacije i treninga stručnjaka prve linije u ranom prepoznavanju, u slučaju primarne zdravstvene skrbi adekvatno upućivanje na liječenje mentalnih poremećaja, stvaranje politike restriktivnog pristupa smrtonosnim sredstvima ili supstancijama poput alkohola koji dezinhibira ponašanje, reduciranje stigme i promoviranje traženja pomoći. Sve bi ove aktivnosti trebalo smanjiti ono što bi u suprotnom moglo postati epidemija autodestruktivnog ponašanja. Svi mi u ovome imamo svoju ulogu.