Burden of suicide presented as one of the leading causes of death: uncover facts or misrepresent statistics?

Abstract

BackgroundSuicide is a relatively rare incident. Nevertheless, parts of the literature on intentional self-harm behaviour state that suicide is one of the leading causes of death. We aimed to assess the evidence behind the statement that suicide is a leading cause of death across all ages, with reference to the methods of ranking causes of death.MethodsTwo sets of data were used: For the European Union (EU) we used cause specific mortality statistics from the European Statistical Office (Eurostat) for the data-year 2014, and globally and for the WHO European Region we used data from Global Health Estimates (GHE) 2015. We used different sets of rules to select mutually exclusive leading underlying causes of mortality for Europe (EU28). We also present lists with estimates of leading causes of death globally, and for the WHO European Region based on the GHE 2015.ResultsIn 2014, 1.2% of all reported deaths in the Europe Union (EU28) were due to suicide, and 1.4% globally (2015) according to the WHO estimates. In Europe, suicide was ranked as number 11 and 15 in the two different ranking lists we used, and according to GHE-2015, suicide was ranked as the 17th leading cause globally, and number 14 in the WHO European Region. Looking at the differences by sex, suicide for males was ranked as the ninth and the tenth leading cause of death in two ranking lists for the European Union. For females, suicide was number 13 in the first and 23 in the second list, respectively.ConclusionsDifferent cause lists and rules for ranking produce different leading causes of mortality. The quality of data can also affect the ranking. Our rankings suggested that suicide was not among the ten leading causes of death in Europe or globally. To ensure that ranking causes of death is not driven by political motives and funding considerations, standard methods and official tabulation lists should be used. The rankings do not necessarily present the causes of mortality of greatest public health importance.

Suicide among people treated for drug use disorders: a Danish national record-linkage study

“…Patients who had been in treatment for a DUD with past psychiatric care had a more than 13 times higher risk of committing suicide compared with gender or age-matched individuals with no history of treatment for substance use disorders and psychiatric care in the general population. However, the high relative elevation must be considered in light of the low base-rate of completed suicide, and it must be remembered that among the individuals that we tracked for up to ten years, less than 1% took their own lives (compare also [32]).…”

Production Losses Attributable to Suicide Deaths in European Union

“…The cross-country study using WHO European mortality data shows that the quality of suicide statistics varies notably between countries while the reasons for this variability are numerous [49] making the magnitude of the gures' uncertainty di cult to assess. All and all, until now the ambiguous quality of suicides statistics appears to be an unsolved problem [50] and I was not able to address it in a reasonable way. Finally, the analysis only accounts for the cost borne in formal economies and does not include the burden experienced in terms of household activities undone or unregistered production lost because of suicides.…”

Suicidal Ideations and Attempts Among Adolescents in Kampala Urban Settlements in Uganda: A Case Study of Adolescents Receiving Care From the Uganda Youth Development Link

“…Suicide is a major public health concern (Luxton et al, 2012 ) and one of the leading causes of death among adolescents ages 15–19 years (Hottes et al, 2015 ; Gjertsen et al, 2019 ; WHO, 2020a ). There is also an increasing recognition that suicidal ideation is a major public health concern in sub-Saharan Africa (SSA) (Page and West, 2011 ; Quarshie et al, 2020 ).…”