Suicide mortality among older adults in Brazil between 2000 and 2019 - estimates from the Global Burden of Disease Study 2019

Abstract

Introduction: Older adults present a higher risk of suicide, and Brazil is experiencing a fast population aging. To understand the impact of demographic transition, we compared Brazilian suicide mortality rates (MR) among adults (50+ years) with global rates, those from one high-income country, and those from one middle-income country. Looking for regional disparities, the MR was analyzed among older adults (60+ years) by Brazilian states. Methods: This was an ecological study based on estimates from the Global Burden of Disease Study, from 2000 to 2019. Age-standardized MR and age-specific MR per 100,000 inhabitants were described, with 95% uncertainty intervals (UI). Results: During the period, the annual estimates and the declining trend in mortality were higher in the world than in the studied countries. In 2019, global age-standardized MR was 9.39 (95% UI 8.48-10.29), compared to 5.68 (95% UI 5.40-6.19), 6.01 (95% UI 5.10-7.04), and 6.63 (95% UI 6.43-6.95) in Brazil, Mexico, and England, respectively. In Brazil, despite a significant decline in national rates, stability was observed in 15 states. An increase in aging was only found for men, who presented 3-4 times higher MR than women. The states' rates presented large differences: in 2019, the rates among men aged 60-64 years varied from 7.24 (95% UI 5.31; 9.85) to 26.32 (95% UI 20.21; 34.50). Conclusions: The smaller decline in suicide mortality among older Brazilian adults, the increasing risk with aging, and the higher mortality among men indicate the need for specific prevention policies. The variation within states suggests differences in the data quality or in socio-cultural and historical aspects, which requires further investigation.

Excess suicides in Brazil during the first 2 years of the COVID-19 pandemic: Gender, regional and age group inequalities

“…However, significant excess suicides among women from the Northeast region were observed, regardless of pandemic year, as well as among women in the Southeast region, mainly in July-October 2021 of the second pandemic year. As may be expected, there was excess suicide in the older age group (Chen et al, 2023;Pires et al, 2022;Ryu et al, 2022), mainly in the Northeast, confirming previous predictions during the first 10 months of the pandemic in Brazil (J. D.Y. Orellana & de Souza, 2022).…”

“…Women aged 30 to 59 years were probably the most impacted by excess suicides in the Brazilian pandemic setting. It would be reasonable to expect this in the elderly, usually the age group at greatest suicide risk, in Brazil and throughout Latin America (Dávila-Cervantes, 2022; Pires et al, 2022). The consequences of caregiver death for children, for example, can be devastating with long-term impacts (Hillis et al, 2022).…”

Excess suicides in Brazil: Inequalities according to age groups and regions during the COVID-19 pandemic

“…It is worth noting that although the national results of this study do not point to a significant increase in suicides in the elderly, in the period 2000 to 2019, the trend in the country was toward a decrease in mortality rates for those aged 70 years or over (Pires et al, 2022). Therefore, our results indicate that the COVID-19 pandemic, in addition to having severely affected the population in terms of specific mortality from the disease (Bastos et al, 2021), may have contributed, at least, to the interruption of the downward trend toward suicide in the elderly.…”

“…These matters also may have contributed to the decrease in the number of suicides in those aged 10 to 29 years. In Brazil, there was important politicization in regards to confronting the epidemic, which required strong pressure from society for economic and social support measures to be implemented, both by the federal government (Pires et al, 2022) and by the state government. Prior to the pandemic, one Brazilian study pointed out that conditional cash transfer programs can decrease suicide by mitigating part of the effect of poverty on its incidence (Alves et al, 2019).…”