Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework

Wang, Zhenkun; Wang, Jinyao; Bao, Junzhe; Gao, Xudong; Yu, Chuanhua; Xiang, Hao

doi:10.3390/ijerph13080784

Cited by 23 publications

(18 citation statements)

References 54 publications

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“…Females in Hubei used to be in disadvantaged positions and had higher self-harm burdens than males, similar to the national situation in China [ 7 , 18 ]. Nonetheless, our results revealed that females experienced a bigger reduction in self-harm burdens than males from 1990 to 2015 in Hubei, consistent with the national results in China [ 3 , 23 , 24 ]. Since 2010, self-harm burdens have begun to shift from females to males.…”

Section: Discussionsupporting

confidence: 89%

Sharply Reduced but Still Heavy Self-Harm Burdens in Hubei Province, China, 1990–2015

Pan

Zhang

Tang

et al. 2018

IJERPH

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The aims of this study were to describe fatal and non-fatal self-harm burdens, as well as burdens from the main preventable risk factors, and to investigate the different suicide methods in Hubei province in central China utilizing data from both Global Burden of Disease Study 2015 and Hubei Disease Surveillance Points system. All self-harm burdens including mortality, years of life lost (YLLs), prevalence, years lived with disability (YLDs), and disability adjusted life-years (DALYs) consistently demonstrated downward trends in Hubei from 1990 to 2015, with a bigger decline gap observed among females and narrower decreasing amplitudes among the elderly. Hubei experienced much higher age-standardized rates for self-harm mortality (22.0 per 100,000), YLLs (560.1 per 100,000) and DALYs (563.9 per 100,000) than the national (9.0, 292.3 and 295.0 per 100,000 respectively) and global levels (11.5, 453.3 and 457.9 per 100,000 respectively) in 2015. Self-harm burdens have begun shifting from females to males and the elderly suffered more self-harm burdens than other age groups. Alcohol use accounted for 20.9% of all self-harm DALYs for males, whereas intimate partner violence accounted for 24.4% of all self-harm DALYs for females. Poisoning, mainly pesticide self-poisoning, was still the most common method of suicide. Effective interventions by multi-sectoral collaboration are urgently needed to reduce the alarmingly heavy self-harm burdens in Hubei.

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Section: Discussionsupporting

confidence: 89%

Sharply Reduced but Still Heavy Self-Harm Burdens in Hubei Province, China, 1990–2015

Pan

Zhang

Tang

et al. 2018

IJERPH

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“…China and Taiwan have also seen marked reductions in suicide rates from pesticide poisoning; 36–38 however, these reductions may have been more associated with urbanization and reduction in the agricultural work force than pesticide regulation. 36 , 39 , 40 …”

Section: Discussionmentioning

confidence: 99%

Bans of WHO Class I Pesticides in Bangladesh—suicide prevention without hampering agricultural output

Chowdhury

Dewan

Verma

et al. 2017

International Journal of Epidemiology

110

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BackgroundPesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production.MethodsWe obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014.ResultsMortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output.ConclusionsStrengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs.

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“…Primarily, this is a consequence of a substantially higher rate of fatal suicide attempts among men. Except for China, where more females than males die due to suicide [ 24 ], this is a ubiquitous tendency. On average, the global male to female suicide-related death ratio is 3.5:1.…”

Section: Discussionmentioning

confidence: 99%

Burden of suicide in Poland in 2012: how could it be measured and how big is it?

Orlewska

2017

Eur J Health Econ

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ObjectivesThe aim of our study was to estimate the health-related and economic burden of suicide in Poland in 2012 and to demonstrate the effects of using different assumptions on the disease burden estimation.MethodsYears of life lost (YLL) were calculated by multiplying the number of deaths by the remaining life expectancy. Local expected YLL (LEYLL) and standard expected YLL (SEYLL) were computed using Polish life expectancy tables and WHO standards, respectively. In the base case analysis LEYLL and SEYLL were computed with 3.5 and 0% discount rates, respectively, and no age-weighting. Premature mortality costs were calculated using a human capital approach, with discounting at 5%, and are reported in Polish zloty (PLN) (1 euro = 4.3 PLN). The impact of applying different assumptions on base-case estimates was tested in sensitivity analyses.ResultsThe total LEYLLs and SEYLLs due to suicide were 109,338 and 279,425, respectively, with 88% attributable to male deaths. The cost of male premature mortality (2,808,854,532 PLN) was substantially higher than for females (177,852,804 PLN). Discounting and age-weighting have a large effect on the base case estimates of LEYLLs. The greatest impact on the estimates of suicide-related premature mortality costs was due to the value of the discount rate.ConclusionsOur findings provide quantitative evidence on the burden of suicide. In our opinion each of the demonstrated methods brings something valuable to the evaluation of the impact of suicide on a given population, but LEYLLs and premature mortality costs estimated according to national guidelines have the potential to be useful for local public health policymakers.

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Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework

Cited by 23 publications

References 54 publications

Sharply Reduced but Still Heavy Self-Harm Burdens in Hubei Province, China, 1990–2015

Sharply Reduced but Still Heavy Self-Harm Burdens in Hubei Province, China, 1990–2015

Bans of WHO Class I Pesticides in Bangladesh—suicide prevention without hampering agricultural output

Burden of suicide in Poland in 2012: how could it be measured and how big is it?

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