Self-harm Mortality Research Articles

Production losses attributable to suicide mortality in the European Union in 2015

Abstract Background Suicides are an important public health problem with multidimensional consequences for the whole society. One of the under-researched areas of suicide consequences are production losses associated with these deaths. The aim of this study was to estimate the production losses (indirect costs) of suicide deaths in 28 European Union states (EU-28) in 2015. Methods The study applied the top-down approach, societal perspective and human capital method to sex- and age-specific data on suicide mortality at working age. The WHO Mortality Database was used to identify the number of deaths (3-year average) in each country while the Eurostat's labour and economic indicators were used to proxy the value economic output lost. Results The production losses attributable to suicide deaths in EU-28 in 2015 were €8.81 billion. The per capita indirect costs of these deaths were €17.28 for the whole EU-28 population; Ireland experienced the highest per capita burden (€50.38), while the average costs were the lowest in Cyprus (€3.84). The losses constituted an economic burden of 0.06% of EU-28's GDP; this share ranged from 0.016% (Cyprus) to 0.149% (Latvia). Most of the losses were due to men's deaths and the proportion of losses associated with male mortality ranged from 70.9% (Sweden) to 91.4% (Poland). The results of sensitivity analysis exhibit large variation of losses; the highest costs were estimated with no adjustment for lower employment rates among those committing suicide (36.9% to 238.9% higher than in base scenario) while the lowest costs resulted from the scenario of adjustment for minimum productivity (-47.6% to -65.7% lower than in base scenario). Conclusions The production losses caused by suicide deaths are a substantial burden for European economies. Therefore, the use of cost-effective actions aimed at limiting self-harm mortality might be beneficial not only in terms of health gains but could also contribute to limiting indirect costs. Key messages Production losses attributable to suicide deaths are 0.06% of EU’s GDP, ranging from 0.02% of GDP in Cyprus to 0.15% of GDP in Latvia. Indirect costs of men’s deaths dominate in all the countries and this can be explained by both higher suicide rates and longer economic activity than among women in Europe.

The mortality rate from self-harm in Iran

BackgroundSelf-harm–related death is one of the most unfortunate, tragic, and regrettable types of death owing to injuries with a variety of socio-economic and cultural causes. The study aimed to determine the trend in the mortality of self-harm by sex and age at national and provincial levels in Iran over a period of 26 years. MethodsThe Iran Death Registration System (DRS), cemetery databanks in Tehran and Esfahan, and the national population and housing censuses of Iran were used for this study. Using a growth model, the population was estimated in the age groups. Incompleteness, misalignment, and misclassification in the DRS were all considered and addressed accordingly. We used a spatio-temporal and Gaussian process regression model to estimate mortality rates in children and adults. ResultsOver the study period, 67,670 deaths were estimated owing to self-harm across the country. The overall age-standardized mortality rate decreased from 4.32 per 100,000 (95% unit interface (UI): 3.25–5.75) to 2.78 (2.15–3.59) per 100,000 between 1990 and 2015, a reduction of approximately 35.65%. The M/F ratio was 2.03:1 with an annual percent change of −2.38% and −1.37% for women and men, respectively. The annual self-harm mortality rate was higher among individuals aged 15–24 years, as well as it was more in men during the study period. ConclusionMortality from self-harm has declined over the study period in Iran. Higher rates in men and in population aged 15–24 years, with considerable variation by province, were the distinguishing features of self-harm. Iran needs to improve monitoring through a comprehensive multisectoral strategy; and most importantly, provide timely, effective and low-cost preventive interventions.

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

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.

Gendered risk factors associated with self-harm mortality among youth in South Africa, 2006 - 2014.

Despite efforts to reduce self-harm mortality, death rates remain high, with almost 12% of all youth deaths in South Africa (SA) attributed to this cause. There are gendered differences in causes of death among youth, but little is known about the sex-specific risk factors. To identify the levels and sex-specific determinants of self-harm mortality among youth in SA. This was a cross-sectional study of SA death notification forms from 2006 to 2014. Descriptive and analytical statistical techniques were used, including cause-specific mortality rates, proportional mortality ratios and logistic regression models. A total of 1 122 youth (15 - 24 years of age) deaths due to self-harm causes were reported over the study period, during which rates of self-harm mortality increased. More deaths of males (n=818) than females (n=304) were reported. Almost 60% of deaths (p<0.05) were of 20 - 24-year-olds, and 46.4% (p<0.05) of those who died had a secondary education. Almost 10% of females (p<0.05) were pregnant at the time of death. Hanging was the most common type of self-harm mortality among males (79.2%) and females (49.3%). While 11.0% (n=90) of self-harm deaths of males were due to poisoning, more females used this method (39.8%, n=121). The probability of self-harm mortality for males increased according to certain provinces of residence. For females the odds were higher for those who were pregnant (odds ratio (OR) 1.3; p<0.05) and non-South African (OR 1.7; p<0.05) and had secondary education (OR 1.4; p<0.05). The study showed gender differentials in the determinants of self-harm mortality among youth in SA. For this reason, uniform approaches to awareness campaigns need to be altered to address the specific needs of youth. While males have higher rates than females, the prevalence of self-harm mortality in pregnant females is of concern and needs to be addressed specifically, as it relates not only to suicidal ideation and behaviour but also to youth sexual and reproductive health programmes in the country.