Abstract
In the context of rapid ageing, understanding the time-trend of elderly suicide (ES) could inform China’s efforts on suicide prevention. We examined time-trends in Chinese ES rates (ESRs) from 1987 to 2014, a period of profound social changes. Suicide rates by residence (rural/urban), gender, and 5-year age-group (65+) in 1987–2014 were provided by the Chinese Ministry of Health. Time-trends were analyzed with joinpoint analysis. The time-trend of national ESRs was downward (average annual percent change [AAPC] = −3.7, P < 0.001): 76.6/100000 in 1987 and 30.2/100000 in 2014. However, the time-trend of corresponding percentages of ESs among the total suicides was monotonically increasing (AAPC = 3.4, P < 0.001): 16.9% in 1987 to 41.2% in 2014. The time-trends in ESRs of both rural and urban men and women were decreasing, but only the rural trends were significant (P < 0.001). Rural-urban and male-female differences in ESRs were decreasing over time (slope = −4.2 and −3.0, P ≤ 0.006), but the rural-urban and male-female ESR differences in 2014 remained large (16.3/100000 and 9.8/100000, P < 0.001). While national ESRs decreased significantly during the past three decades, the current ESR remains high in China. Further, the age-pattern of Chinese suicide is transitioning to elderly predominance. ES, particularly rural ES, should be a public health priority in China.
Highlights
In the context of rapid ageing, understanding the time-trend of elderly suicide (ES) could inform China’s efforts on suicide prevention
Time-trend studies found that the changing patterns of suicide in China varied considerably between residences, genders, age-groups and even geographic regions[3,4,5,6,7]; the drop in suicide rates was more dramatic among younger age-groups, young rural women, but was less pronounced in older age-groups, and even, in 2009–11, it was predicted that Chinese elderly suicide rates (ESRs), especially rural ES rates (ESRs), were likely to go up again[5,8,9]
We primarily focused on time-trends of actual annual ESRs, percentages of ES deaths and residence/gender differences in crude ESRs, because standardized ESRs might be insufficient to reflect the true level of older adults (OAs)’ potential needs for suicide prevention
Summary
In the context of rapid ageing, understanding the time-trend of elderly suicide (ES) could inform China’s efforts on suicide prevention. Time-trend studies found that the changing patterns of suicide in China varied considerably between residences (rural/urban), genders, age-groups and even geographic regions[3,4,5,6,7]; the drop in suicide rates was more dramatic among younger age-groups, young rural women, but was less pronounced in older age-groups, and even, in 2009–11, it was predicted that Chinese elderly suicide rates (ESRs), especially rural ESRs, were likely to go up again[5,8,9]. Considering the very high ESRs relative to other age-groups and the unprecedented population aging in China, elderly suicide (ES) prevention should be given greater priority for reducing Chinese suicides. Detailed information on the changing epidemiology of ES in the context of China’s significant macro-social changes might serve to inform the development of current and long-term national suicide prevention strategies
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