Monday, 15 September 2014

Suicide notes

From a recent report titled 'Preventing suicide: A global imperative', authored by the World Health Organization:
These numbers are from 172 WHO Member States with populations of 300,000 or more. These estimates represent the best estimates of WHO, computed using standard categories, definitions and methods to ensure cross-country comparability, and may not be the same as official national estimates. The estimates are rounded to the appropriate number of significant figures.

Compare them to what they were in 2000 with the map below.

Exactly 50 of the 172 countries saw an increase in suicide rate per 100,000 people between 2000 and 2012. Of them, the top 10 were South Korea, Bolivia, Suriname, Angola, Turkmenistan, Montenegro, Burundi, Cyprus, Malawi and Equatorial Guinea.

The WHO concedes that the numbers reported here may not be the same as national estimates, which means the efficacy and/or methodology of federal methods to register cases of suicide could vary from country to country. The report maps this variation out. As you can see, almost all of Africa has unreliable data; Middle East countries with autocratic governments and western South American nations have vital registration systems in place; and, surprisingly, most of South East Asia has only sample registration of data - at least probably because of logistical issues in heavily populated India and China.

From the report, again:
There are several important caveats that need to be considered when evaluating these suicide mortality data. Of the WHO 172 Member States for which estimates were made, only 60 have good-quality vital registration data that can be used directly to estimate suicide rates. The estimated suicide rates in the other 112 Member States (which account for about 71% of global suicides) are necessarily based on modelling methods. As might be expected, good quality vital registration systems are much more likely to be available in high-income countries. The 39 high-income countries with good vital registration data account for 95% of all estimated suicides in high-income countries, but the 21 LMICs [low- and middle-income countries] with good vital registration data account for only 8% of all estimated suicides in LMICs.
For India-specific data, there is a report from 2012 from the office of the Registrar General of India, which estimates that 134,600 killed themselves in that year - a value that a study in The Lancet pegs at 187,000. Either way: an image from this study shows which states have the highest suicide rates (ASR = age-standardized suicide death rate per 100,000 people) by gender.

While 75% of the world's suicides occur in LMICs, most of India's suicides seem to be happening in the better-off southern states.