Comparing rates and patterns of male suicide and ''hidden suicide'' between nations and over time

Abstract

Rates and age patterns of suicide differ between nations and population groups. The accuracy of data provided by national statistics offices has been questioned. This paper (1) compares recent high quality data regarding suicide rates in larger countries, and (2) explores differences between countries in proportions of male deaths coded as ''undetermined''. Data were obtained from the WHO Mortality Database regarding deaths in ten larger nations in 2015, coded (using ICD-10) as due to suicide, Event of Undetermined Intent (EUI), ill-defined or unknown cause (R99), or accidental poisoning or drowning. Numbers in 5-year age groups were recorded and rates calculated using population figures. Male suicide rates per 100,000 in the ten nations were found to vary between 8.40 (Mexico) and 37.52 (Korea). Most Western nations had bimodal male age patterns, US and Japan trimodal, and Korea's was upward-sloping. Male EUI rates varied: those in Mexico and Japan progressively increased across the age-range. The UK's male R99 cross-age rate was nearly zero; the other 9 countries had high rates, largely with exponential rises in late life. England & Wales publish combined suicide and EUI rates as their ''official'' suicide figures. Other countries, too, have been shown to code many suicides as ''undetermined deaths''. Partly this could be because of lack of resources to adequately investigate deaths. Accuracy of data would be improved by increased use of verbal autopsies. Comparisons of male age patterns of suicide, examining associations between period effects and sociocultural differences, could help identify reversible causative factors.