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Demographic and epidemiological decomposition analysis of global changes in suicide rates and numbers over the period 1990–2019
  1. Paul Siu Fai Yip1,
  2. Yan Zheng2,
  3. Clifford Wong3
  1. 1HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, People's Republic of China
  2. 2The School of Nursing, The Hong Kong Polytechnic University, Kowloon, People's Republic of China
  3. 3Social Work and Social Administration, The University of Hong Kong, Hong Kong, People's Republic of China
  1. Correspondence to Dr Paul Siu Fai Yip, HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, People's Republic of China; sfpyip{at}hku.hk

Abstract

Background Suicide presents an ongoing public health challenge internationally. Nearly 800 000 people around the world lose their life to suicide every year, and many more attempt suicide.

Methods A decomposition analysis was performed using global suicide mortality and population data from the Global Burden of Disease Study 2019.

Results Despite a significant decrease in age-specific suicide rate between 1990 and 2019 (-4.01; from 13.8% to 9.8% per 100 000), the overall numbers of suicide deaths increased by 19 897 (from 738 799 to 758 696) in the same time period. The reductions in age-specific suicide rates (−6.09; 152%) contributed to the overall reductions in suicide rates; however, this was offset by overtime changes in population age structure (2.08; −52%). The increase in suicide numbers was partly attributable to population growth (300 942; 1512.5%) and population age structure (189 512; 952.4%), which was attenuated by the significant reduction in overall suicide rates (−470 556; 2364.9%). The combined effect of these factors varied across the World Bank income level regions. For example, in the upper-middle-income level region, the effect of the reduction in age-specific suicide rates (−289 731; −1456.1%) exceeded the effect of population age structure (124 577; 626.1%) and population growth (83 855; 421.4%), resulting in its substantial decline in total suicide deaths (−81 298; −408.6%). However, in lower-middle income region, there was a notable increase in suicide death (72 550; 364.6%), which was related to the net gain of the reduction in age-specific suicide rates (-115 577; -580.9%) and negated by the increase in the number of suicide deaths due to population growth (152 093; 764.4%) and population age structure (36 034; 181.1%).

Conclusion More support and resources should be deployed for suicide prevention to the low-income and middle-income regions in order to achieve the reduction goal. Moreover, suicide prevention among older adults is increasingly critical given the world’s rapidly ageing populations in all income level regions.

  • public health
  • suicide/self-harm
  • epidemiology
  • policy analysis

Data availability statement

Data are available in a public, open-access repository. The data in the study are open to the public.

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Data availability statement

Data are available in a public, open-access repository. The data in the study are open to the public.

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Footnotes

  • Contributors PSFY has contributed to the conceptualisation, analysis and writing of the paper. YZ has contributed to the analysis and writing of the paper. CW has contributed to the analysis of the paper.

  • Funding This study was funded by Humanities and Social Sciences Prestigious Fellowship (for Yip).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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