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id	title	slug	type	status	content	archieml	archieml_update_statistics	published_at	updated_at	gdocSuccessorId	authors	excerpt	created_at_in_wordpress	updated_at_in_wordpress	featured_image	formattingOptions	markdown	wpApiSnapshot
5554	Suicides	suicide	page	publish	<!-- wp:html --> <!-- formatting-options toc:false bodyClassName:topic-page --> <!-- /wp:html --> <!-- wp:owid/sticky-nav --> <!-- wp:navigation-link {"label":"Introduction","url":"#introduction","kind":"custom","isTopLevelLink":false} /--> <!-- wp:navigation-link {"label":"Key Insights","type":"internal","url":"#key-insights-on-suicide","kind":"custom","isTopLevelLink":false} /--> <!-- wp:navigation-link {"label":"Charts","type":"internal","url":"#interactive-charts-on-suicides","kind":"custom","isTopLevelLink":false} /--> <!-- wp:navigation-link {"label":"Endnotes","url":"#endnotes","kind":"custom","isTopLevelLink":false} /--> <!-- wp:navigation-link {"label":"Cite This Work","url":"#citation","kind":"custom","isTopLevelLink":false} /--> <!-- wp:navigation-link {"label":"Reuse This Work","url":"#licence","kind":"custom","isTopLevelLink":false} /--> <!-- /wp:owid/sticky-nav --> <!-- wp:columns {"className":"front-matter"} --> <div class="wp-block-columns front-matter" id="introduction"><!-- wp:column --> <div class="wp-block-column"><!-- wp:paragraph --> <p>Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as </strong><a href="https://findahelpline.com/"><strong>findahelpline.com</strong></a><strong>.</strong></p> <!-- /wp:paragraph --></div> <!-- /wp:column --> <!-- wp:column --> <div class="wp-block-column"><!-- wp:group {"className":"related-topics"} --> <div class="wp-block-group related-topics"><!-- wp:paragraph --> <p>Related topics</p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li><a href="https://ourworldindata.org/causes-of-death">Causes of death</a></li><li><a href="https://ourworldindata.org/mental-health" data-type="URL" data-id="https://ourworldindata.org/mental-health">Mental health</a></li></ul> <!-- /wp:list --></div> <!-- /wp:group --></div> <!-- /wp:column --></div> <!-- /wp:columns --> <!-- wp:owid/key-insights-slider {"title":"Key insights on Suicide data \u0026amp; research","slug":"key-insights-on-suicide"} --> <!-- wp:owid/key-insight {"title":"Suicide rates vary around the world","slug":"-strong-suicide-rates-vary-around-the-world-strong-"} --> <!-- wp:paragraph --> <p>Suicide rates vary widely between countries. The map shows this.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href="https://doi.org/10.1136/bmj.l94">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. <a href="https://doi.org/10.1186/s12916-020-01525-w">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. <a href="https://doi.org/10.1016/S0140-6736(18)32203-7">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. <a href="https://doi.org/10.1016/j.socscimed.2010.11.008">https://doi.org/10.1016/j.socscimed.2010.11.008</a><br>Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789</a><br>World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a><br>World Health Organization. (2019). <em>Suicide worldwide in 2019: Global Health Estimates</em>.<a href="https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf"> https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf</a> {/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- /wp:owid/key-insight --> <!-- wp:owid/key-insight {"title":"Suicide rates have declined in many countries","slug":"suicide-rates-have-declined-in-many-countries"} --> <!-- wp:paragraph --> <p>In many countries, suicide rates have declined substantially. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots.<br>Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611–624.<a href="https://doi.org/10.1176/appi.ajp.2020.20060864"> https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646–659. <a href="https://doi.org/10.1016/S2215-0366(16)30030-X">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This tells us that suicide is preventable. But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href="https://pubmed.ncbi.nlm.nih.gov/32208755/">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href="https://pubmed.ncbi.nlm.nih.gov/32208764/">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by Värnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. <a href="https://doi.org/10.1136/injuryprev-2011-040070">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152–160.</li><li>Puigdefàbregas Serra, A., Freitas Ramírez, A., Gispert Magarolas, R., Castellà Garcia, J., Vidal Gutiérrez, C., Medallo Muñiz, J., Subirana Domènech, M., & Martínez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13–19. <a href="https://doi.org/10.1016/j.remle.2017.02.001">https://doi.org/10.1016/j.remle.2017.02.001</a></li><li>Tøllefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., Østevold, G., & Ekeberg, Ø. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. <a href="https://doi.org/10.1136/bmjopen-2015-009120">https://doi.org/10.1136/bmjopen-2015-009120</a>{/ref}</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- /wp:owid/key-insight --> <!-- wp:owid/key-insight {"title":"Deaths by suicide are under-reported in many countries","slug":"-strong-deaths-by-suicide-are-under-reported-in-many-countries-strong-"} --> <!-- wp:paragraph --> <p>In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general – not just suicides – are not well-recorded in many countries. You can see this in the chart.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>It shows that in some cases, not all deaths are registered in a country’s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789<br></a>Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. <a href="https://doi.org/10.1136/injuryprev-2011-040070">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href="https://pubmed.ncbi.nlm.nih.gov/32208755/">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href="https://pubmed.ncbi.nlm.nih.gov/32208764/">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref} For these reasons, suicides may be misclassified, especially as deaths due to "events of undetermined intent", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789</a>{/ref} </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. <a href="https://doi.org/10.1101/2021.08.12.21261978">https://doi.org/10.1101/2021.08.12.21261978</a> <a href="https://github.com/akarlinsky/death_registration">https://github.com/akarlinsky/death_registration</a> {/ref}</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>The total number of expected deaths per year is an average of estimates from three data sources – the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study. </li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ. </li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>The level of death registration may also vary widely across different regions <em>within</em> these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a>{/ref}</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- /wp:owid/key-insight --> <!-- wp:owid/key-insight {"title":"Suicides are more common among men","slug":"suicide-deaths-are-more-common-among-men"} --> <!-- wp:paragraph --> <p>Across countries, the estimates show that suicide rates are much higher among men than women.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- /wp:owid/key-insight --> <!-- wp:owid/key-insight {"title":"Mental illnesses are a major risk factor for suicide","slug":"mental-illnesses-are-a-major-risk-factor-for-suicide"} --> <!-- wp:paragraph --> <p>There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Importantly, the chart also shows that the vast majority of people – with or without a mental illness – did not die by suicide. Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611–624. <a href="https://doi.org/10.1176/appi.ajp.2020.20060864">https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646–659. <a href="https://doi.org/10.1016/S2215-0366(16)30030-X">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. <a href="https://doi.org/10.1001/archgenpsychiatry.2011.113">https://doi.org/10.1001/archgenpsychiatry.2011.113</a>{/ref} Since the study was published, the cumulative risk of suicide may have changed.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:image {"id":57555,"sizeSlug":"large","linkDestination":"none"} --> <figure class="wp-block-image size-large"><img src="https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png" alt="" class="wp-image-57555"/></figure> <!-- /wp:image --> <!-- /wp:owid/key-insight --> <!-- wp:owid/key-insight {"title":"Suicide rates may vary with age","slug":"suicide-rates-rise-with-age"} --> <!-- wp:paragraph --> <p>In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>That suicide rates can be much higher among older people may sound surprising, because suicide is a leading <a href="https://ourworldindata.org/causes-of-death">cause of death</a> in young people. But it is because deaths due to <em>other</em> causes tend to rise with age at a much faster rate than deaths by suicide.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age–mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. <a href="https://link.springer.com/content/pdf/10.2307/2061656.pdf">https://link.springer.com/content/pdf/10.2307/2061656.pdf<br></a>Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109–2134. <a href="https://doi.org/10.1215/00703370-10286336">https://doi.org/10.1215/00703370-10286336</a>{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. <em>Journal of Affective Disorders</em>, <em>295</em>, 587–593. <a href="https://doi.org/10.1016/j.jad.2021.08.084">https://doi.org/10.1016/j.jad.2021.08.084</a><br>Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986–2015): A tale of two countries. <em>Social Science & Medicine</em>, <em>235</em>, 112385. <a href="https://doi.org/10.1016/j.socscimed.2019.112385">https://doi.org/10.1016/j.socscimed.2019.112385</a><br>Martínez-Alés, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. <em>Molecular Psychiatry</em>, <em>26</em>(7), 3374–3382. <a href="https://doi.org/10.1038/s41380-021-01078-1">https://doi.org/10.1038/s41380-021-01078-1</a><br>Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. <em>Asia Pacific Journal of Public Health</em>, <em>23</em>(4), 581–587. <a href="https://doi.org/10.1177/1010539509348242">https://doi.org/10.1177/1010539509348242</a><br>Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., & Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983–2012. <em>International Journal for Equity in Health</em>, <em>15</em>(1), 107. <a href="https://doi.org/10.1186/s12939-016-0400-2">https://doi.org/10.1186/s12939-016-0400-2</a>{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href="https://doi.org/10.1136/bmj.l94">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. <a href="https://doi.org/10.1186/s12916-020-01525-w">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. <a href="https://doi.org/10.1016/S0140-6736(18)32203-7">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. <a href="https://doi.org/10.1016/j.socscimed.2010.11.008">https://doi.org/10.1016/j.socscimed.2010.11.008</a> {/ref}</p> <!-- /wp:paragraph --> <!-- wp:owid/technical-text --> <!-- wp:heading {"level":5} --> <h5>What you should know about this data</h5> <!-- /wp:heading --> <!-- wp:list --> <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul> <!-- /wp:list --> <!-- /wp:owid/technical-text --> <!-- wp:html --> <iframe src="/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- /wp:owid/key-insight --> <!-- /wp:owid/key-insights-slider --> <!-- wp:owid/all-charts {"className":"wp-block-full-content-width"} /-->	{ "id": "wp-5554", "slug": "suicide", "content": { "toc": [], "body": [ { "left": [ { "type": "text", "value": [ { "text": "Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as ", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "url": "https://findahelpline.com/", "children": [ { "children": [ { "text": "findahelpline.com", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "spanType": "span-link" }, { "children": [ { "text": ".", "spanType": "span-simple-text" } ], "spanType": "span-bold" } ], "parseErrors": [] } ], "type": "sticky-right", "right": [ { "type": "text", "value": [ { "text": "Related topics", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "url": "https://ourworldindata.org/causes-of-death", "children": [ { "text": "Causes of death", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] }, { "type": "text", "value": [ { "url": "https://ourworldindata.org/mental-health", "children": [ { "text": "Mental health", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Suicide rates vary widely between countries. The map shows this.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. 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Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1186/s12916-020-01525-w", "children": [ { "text": "https://doi.org/10.1186/s12916-020-01525-w", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S0140-6736(18)32203-7", "children": [ { "text": "https://doi.org/10.1016/S0140-6736(18)32203-7", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608\u2013616. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/j.socscimed.2010.11.008", "children": [ { "text": "https://doi.org/10.1016/j.socscimed.2010.11.008", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1080/17441692.2020.1801789", "children": [ { "text": "https://doi.org/10.1080/17441692.2020.1801789", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "World Health Organization. (2019). ", "spanType": "span-simple-text" }, { "children": [ { "text": "Suicide worldwide in 2019: Global Health Estimates", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ".", "spanType": "span-simple-text" }, { "url": "https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf", "children": [ { "text": " https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " {/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA ", "type": "chart", "parseErrors": [] }, { "type": "text", "value": [ { "text": "In many countries, suicide rates have declined substantially.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "text": "Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. ", "spanType": "span-simple-text" }, { "children": [ { "text": "American Journal of Psychiatry", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "178", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(7), 611\u2013624.", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1176/appi.ajp.2020.20060864", "children": [ { "text": " https://doi.org/10.1176/appi.ajp.2020.20060864", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet Psychiatry", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "3", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(7), 646\u2013659. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S2215-0366(16)30030-X", "children": [ { "text": "https://doi.org/10.1016/S2215-0366(16)30030-X", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This tells us that suicide is preventable.\u00a0But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. ", "spanType": "span-simple-text" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32208755/", "children": [ { "text": "https://pubmed.ncbi.nlm.nih.gov/32208755/", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Crisis: The Journal of Crisis Intervention and Suicide Prevention", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "41", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(S1), S72. ", "spanType": "span-simple-text" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32208764/", "children": [ { "text": "https://pubmed.ncbi.nlm.nih.gov/32208764/", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by V\u00e4rnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1136/injuryprev-2011-040070", "children": [ { "text": "https://doi.org/10.1136/injuryprev-2011-040070", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152\u2013160.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Puigdef\u00e0bregas Serra, A., Freitas Ram\u00edrez, A., Gispert Magarolas, R., Castell\u00e0 Garcia, J., Vidal Guti\u00e9rrez, C., Medallo Mu\u00f1iz, J., Subirana Dom\u00e8nech, M., & Mart\u00ednez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13\u201319. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/j.remle.2017.02.001", "children": [ { "text": "https://doi.org/10.1016/j.remle.2017.02.001", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "T\u00f8llefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., \u00d8stevold, G., & Ekeberg, \u00d8. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1136/bmjopen-2015-009120", "children": [ { "text": "https://doi.org/10.1136/bmjopen-2015-009120", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA ", "type": "chart", "parseErrors": [] }, { "type": "text", "value": [ { "text": "In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general \u2013 not just suicides \u2013 are not well-recorded in many countries. You can see this in the chart.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "It shows that in some cases, not all deaths are registered in a country\u2019s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1080/17441692.2020.1801789", "children": [ { "text": "https://doi.org/10.1080/17441692.2020.1801789", "spanType": "span-simple-text" }, { "spanType": "span-newline" } ], "spanType": "span-link" }, { "text": "V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1136/injuryprev-2011-040070", "children": [ { "text": "https://doi.org/10.1136/injuryprev-2011-040070", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. ", "spanType": "span-simple-text" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32208755/", "children": [ { "text": "https://pubmed.ncbi.nlm.nih.gov/32208755/", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Crisis: The Journal of Crisis Intervention and Suicide Prevention", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "41", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(S1), S72. ", "spanType": "span-simple-text" }, { "url": "https://pubmed.ncbi.nlm.nih.gov/32208764/", "children": [ { "text": "https://pubmed.ncbi.nlm.nih.gov/32208764/", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} For these reasons, suicides may be misclassified, especially as deaths due to \"events of undetermined intent\", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1080/17441692.2020.1801789", "children": [ { "text": "https://doi.org/10.1080/17441692.2020.1801789", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1101/2021.08.12.21261978", "children": [ { "text": "https://doi.org/10.1101/2021.08.12.21261978", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "url": "https://github.com/akarlinsky/death_registration", "children": [ { "text": "https://github.com/akarlinsky/death_registration", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " {/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "The total number of expected deaths per year is an average of estimates from three data sources \u2013\u00a0the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "The level of death registration may also vary widely across different regions ", "spanType": "span-simple-text" }, { "children": [ { "text": "within", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR ", "type": "chart", "parseErrors": [] }, { "type": "text", "value": [ { "text": "Across countries, the estimates show that suicide rates are much higher among men than women.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log", "type": "chart", "parseErrors": [] }, { "type": "text", "value": [ { "text": "There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S2215-0366(14)70240-8", "children": [ { "text": "https://doi.org/10.1016/S2215-0366(14)70240-8", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Importantly, the chart also shows that the vast majority of people \u2013 with or without a mental illness \u2013\u00a0did not die by suicide.\u00a0Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. ", "spanType": "span-simple-text" }, { "children": [ { "text": "American Journal of Psychiatry", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "178", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(7), 611\u2013624. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1176/appi.ajp.2020.20060864", "children": [ { "text": "https://doi.org/10.1176/appi.ajp.2020.20060864", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet Psychiatry", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "3", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(7), 646\u2013659. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S2215-0366(16)30030-X", "children": [ { "text": "https://doi.org/10.1016/S2215-0366(16)30030-X", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1001/archgenpsychiatry.2011.113", "children": [ { "text": "https://doi.org/10.1001/archgenpsychiatry.2011.113", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} Since the study was published, the cumulative risk of suicide may have changed.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "alt": "", "size": "wide", "type": "image", "filename": "suicide-lifetime-risk-by-mental-illnessv2.png", "parseErrors": [] }, { "type": "text", "value": [ { "text": "In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "That suicide rates can be much higher among older people may sound surprising, because suicide is a leading ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/causes-of-death", "children": [ { "text": "cause of death", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " in young people. But it is because deaths due to ", "spanType": "span-simple-text" }, { "children": [ { "text": "other", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " causes tend to rise with age at a much faster rate than deaths by suicide.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age\u2013mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. ", "spanType": "span-simple-text" }, { "url": "https://link.springer.com/content/pdf/10.2307/2061656.pdf", "children": [ { "text": "https://link.springer.com/content/pdf/10.2307/2061656.pdf", "spanType": "span-simple-text" }, { "spanType": "span-newline" } ], "spanType": "span-link" }, { "text": "Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109\u20132134. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1215/00703370-10286336", "children": [ { "text": "https://doi.org/10.1215/00703370-10286336", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Journal of Affective Disorders", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "295", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", 587\u2013593. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/j.jad.2021.08.084", "children": [ { "text": "https://doi.org/10.1016/j.jad.2021.08.084", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986\u20132015): A tale of two countries. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Social Science & Medicine", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "235", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", 112385. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/j.socscimed.2019.112385", "children": [ { "text": "https://doi.org/10.1016/j.socscimed.2019.112385", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Mart\u00ednez-Al\u00e9s, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Molecular Psychiatry", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "26", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(7), 3374\u20133382. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1038/s41380-021-01078-1", "children": [ { "text": "https://doi.org/10.1038/s41380-021-01078-1", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. 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", "spanType": "span-simple-text" }, { "children": [ { "text": "International Journal for Equity in Health", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "15", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(1), 107. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1186/s12939-016-0400-2", "children": [ { "text": "https://doi.org/10.1186/s12939-016-0400-2", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. 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T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/S0140-6736(18)32203-7", "children": [ { "text": "https://doi.org/10.1016/S0140-6736(18)32203-7", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "spanType": "span-newline" }, { "text": "Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608\u2013616. ", "spanType": "span-simple-text" }, { "url": "https://doi.org/10.1016/j.socscimed.2010.11.008", "children": [ { "text": "https://doi.org/10.1016/j.socscimed.2010.11.008", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " {/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "What you should know about this data", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "type": "list", "items": [ { "type": "text", "value": [ { "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. 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", "spanType": "span-simple-text" }, { "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "children": [ { "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.", "spanType": "span-simple-text" } ], "parseErrors": [] } ], "parseErrors": [] }, { "url": "/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT", "type": "chart", "parseErrors": [] } ], "type": "article", "title": "Suicides", "authors": [ "Saloni Dattani", "Lucas Rod\u00e9s-Guirao", "Hannah Ritchie", "Max Roser", "Esteban Ortiz-Ospina" ], "excerpt": "Suicide rates can be reduced with greater understanding and support for people at risk.", 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But research shows that its rates can be reduced with greater understanding and support. To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced. On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time. If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as [findahelpline.com](https://findahelpline.com/). Related topics * [Causes of death](https://ourworldindata.org/causes-of-death) * [Mental health](https://ourworldindata.org/mental-health) Suicide rates vary widely between countries. The map shows this. For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people. Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people. The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8) Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. [https://doi.org/10.1136/bmj.l94](https://doi.org/10.1136/bmj.l94) Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. [https://doi.org/10.1186/s12916-020-01525-w](https://doi.org/10.1186/s12916-020-01525-w) Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. [https://doi.org/10.1016/S0140-6736(18)32203-7](https://doi.org/10.1016/S0140-6736(18)32203-7) Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. [https://doi.org/10.1016/j.socscimed.2010.11.008](https://doi.org/10.1016/j.socscimed.2010.11.008) Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789](https://doi.org/10.1080/17441692.2020.1801789) World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1) World Health Organization. (2019). _Suicide worldwide in 2019: Global Health Estimates_.[ https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf](https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf) {/ref} ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA "/> In many countries, suicide rates have declined substantially. You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France. These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots. Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. _American Journal of Psychiatry_, _178_(7), 611–624.[ https://doi.org/10.1176/appi.ajp.2020.20060864](https://doi.org/10.1176/appi.ajp.2020.20060864) Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. _The Lancet Psychiatry_, _3_(7), 646–659. [https://doi.org/10.1016/S2215-0366(16)30030-X](https://doi.org/10.1016/S2215-0366(16)30030-X){/ref} This tells us that suicide is preventable. But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. [https://pubmed.ncbi.nlm.nih.gov/32208755/](https://pubmed.ncbi.nlm.nih.gov/32208755/) Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. _Crisis: The Journal of Crisis Intervention and Suicide Prevention_, _41_(S1), S72. [https://pubmed.ncbi.nlm.nih.gov/32208764/](https://pubmed.ncbi.nlm.nih.gov/32208764/){/ref} ## What you should know about this data * It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by Värnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. [https://doi.org/10.1136/injuryprev-2011-040070](https://doi.org/10.1136/injuryprev-2011-040070){/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152–160. * Puigdefàbregas Serra, A., Freitas Ramírez, A., Gispert Magarolas, R., Castellà Garcia, J., Vidal Gutiérrez, C., Medallo Muñiz, J., Subirana Domènech, M., & Martínez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13–19. [https://doi.org/10.1016/j.remle.2017.02.001](https://doi.org/10.1016/j.remle.2017.02.001) * Tøllefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., Østevold, G., & Ekeberg, Ø. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. [https://doi.org/10.1136/bmjopen-2015-009120](https://doi.org/10.1136/bmjopen-2015-009120){/ref} * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. <Chart url="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA "/> In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general – not just suicides – are not well-recorded in many countries. You can see this in the chart. It shows that in some cases, not all deaths are registered in a country’s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all. Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies. Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789 ](https://doi.org/10.1080/17441692.2020.1801789)Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. [https://doi.org/10.1136/injuryprev-2011-040070](https://doi.org/10.1136/injuryprev-2011-040070){/ref} This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. [https://pubmed.ncbi.nlm.nih.gov/32208755/](https://pubmed.ncbi.nlm.nih.gov/32208755/) Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. _Crisis: The Journal of Crisis Intervention and Suicide Prevention_, _41_(S1), S72. [https://pubmed.ncbi.nlm.nih.gov/32208764/](https://pubmed.ncbi.nlm.nih.gov/32208764/){/ref} For these reasons, suicides may be misclassified, especially as deaths due to "events of undetermined intent", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789](https://doi.org/10.1080/17441692.2020.1801789){/ref} To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} ## What you should know about this data * This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. [https://doi.org/10.1101/2021.08.12.21261978](https://doi.org/10.1101/2021.08.12.21261978)[https://github.com/akarlinsky/death_registration](https://github.com/akarlinsky/death_registration) {/ref} * The total number of expected deaths per year is an average of estimates from three data sources – the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study. * For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ. * The level of death registration may also vary widely across different regions _within_ these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1){/ref} <Chart url="https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR "/> Across countries, the estimates show that suicide rates are much higher among men than women. This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women. But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference. ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log"/> There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8){/ref} A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide. The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51. Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness. Importantly, the chart also shows that the vast majority of people – with or without a mental illness – did not die by suicide. Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. _American Journal of Psychiatry_, _178_(7), 611–624. [https://doi.org/10.1176/appi.ajp.2020.20060864](https://doi.org/10.1176/appi.ajp.2020.20060864) Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. _The Lancet Psychiatry_, _3_(7), 646–659. [https://doi.org/10.1016/S2215-0366(16)30030-X](https://doi.org/10.1016/S2215-0366(16)30030-X){/ref} ## What you should know about this data * This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. [https://doi.org/10.1001/archgenpsychiatry.2011.113](https://doi.org/10.1001/archgenpsychiatry.2011.113){/ref} Since the study was published, the cumulative risk of suicide may have changed. * The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses. <Image filename="suicide-lifetime-risk-by-mental-illnessv2.png" alt=""/> In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups. However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups. That suicide rates can be much higher among older people may sound surprising, because suicide is a leading [cause of death](https://ourworldindata.org/causes-of-death) in young people. But it is because deaths due to _other_ causes tend to rise with age at a much faster rate than deaths by suicide. The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan. However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age–mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. [https://link.springer.com/content/pdf/10.2307/2061656.pdf ](https://link.springer.com/content/pdf/10.2307/2061656.pdf)Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109–2134. [https://doi.org/10.1215/00703370-10286336](https://doi.org/10.1215/00703370-10286336){/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. _Journal of Affective Disorders_, _295_, 587–593. [https://doi.org/10.1016/j.jad.2021.08.084](https://doi.org/10.1016/j.jad.2021.08.084) Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986–2015): A tale of two countries. _Social Science & Medicine_, _235_, 112385. [https://doi.org/10.1016/j.socscimed.2019.112385](https://doi.org/10.1016/j.socscimed.2019.112385) Martínez-Alés, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. _Molecular Psychiatry_, _26_(7), 3374–3382. [https://doi.org/10.1038/s41380-021-01078-1](https://doi.org/10.1038/s41380-021-01078-1) Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. _Asia Pacific Journal of Public Health_, _23_(4), 581–587. [https://doi.org/10.1177/1010539509348242](https://doi.org/10.1177/1010539509348242) Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., & Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983–2012. _International Journal for Equity in Health_, _15_(1), 107. [https://doi.org/10.1186/s12939-016-0400-2](https://doi.org/10.1186/s12939-016-0400-2){/ref} Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8) Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. [https://doi.org/10.1136/bmj.l94](https://doi.org/10.1136/bmj.l94) Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. [https://doi.org/10.1186/s12916-020-01525-w](https://doi.org/10.1186/s12916-020-01525-w) Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. [https://doi.org/10.1016/S0140-6736(18)32203-7](https://doi.org/10.1016/S0140-6736(18)32203-7) Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. [https://doi.org/10.1016/j.socscimed.2010.11.008](https://doi.org/10.1016/j.socscimed.2010.11.008) {/ref} ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT"/>	{ "id": 5554, "date": "2023-04-02T22:00:00", "guid": { "rendered": "http://ourworldindata.org/?page_id=5554" }, "link": "https://owid.cloud/suicide", "meta": { "owid_publication_context_meta_field": [], "owid_key_performance_indicators_meta_field": { "raw": "760,000 die from suicide per year.\n\n59% are younger than 50 years old.", "rendered": "<p><strong>760,000 die</strong> from suicide per year.</p>\n<p>59% are younger than 50 years old.</p>\n" } }, "slug": "suicide", "tags": [], "type": "page", "title": { "rendered": "Suicides" }, "_links": { "self": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/5554" } ], "about": [ { "href": "https://owid.cloud/wp-json/wp/v2/types/page" } ], "author": [ { "href": "https://owid.cloud/wp-json/wp/v2/users/47", "embeddable": true } ], "curies": [ { "href": "https://api.w.org/{rel}", "name": "wp", "templated": true } ], "replies": [ { "href": "https://owid.cloud/wp-json/wp/v2/comments?post=5554", "embeddable": true } ], "wp:term": [ { "href": "https://owid.cloud/wp-json/wp/v2/categories?post=5554", "taxonomy": "category", "embeddable": true }, { "href": "https://owid.cloud/wp-json/wp/v2/tags?post=5554", "taxonomy": "post_tag", "embeddable": true } ], "collection": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages" } ], "wp:attachment": [ { "href": "https://owid.cloud/wp-json/wp/v2/media?parent=5554" } ], "version-history": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/5554/revisions", "count": 29 } ], "wp:featuredmedia": [ { "href": "https://owid.cloud/wp-json/wp/v2/media/55879", "embeddable": true } ], "predecessor-version": [ { "id": 57556, "href": "https://owid.cloud/wp-json/wp/v2/pages/5554/revisions/57556" } ] }, "author": 47, "parent": 0, "status": "publish", "content": { "rendered": "\n<!-- formatting-options toc:false bodyClassName:topic-page -->\n\n\n\t<div class=\"sticky-nav-contents\">\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#introduction\"><span class=\"wp-block-navigation-item__label\">Introduction</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#key-insights-on-suicide\"><span class=\"wp-block-navigation-item__label\">Key Insights</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#interactive-charts-on-suicides\"><span class=\"wp-block-navigation-item__label\">Charts</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#endnotes\"><span class=\"wp-block-navigation-item__label\">Endnotes</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#citation\"><span class=\"wp-block-navigation-item__label\">Cite This Work</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\" href=\"#licence\"><span class=\"wp-block-navigation-item__label\">Reuse This Work</span></a></li>\n</div>\n\n\n<div class=\"wp-block-columns front-matter\" id=\"introduction\">\n<div class=\"wp-block-column\">\n<p>Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support.</p>\n\n\n\n<p>To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced.</p>\n\n\n\n<p>On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time.</p>\n\n\n\n<p><strong>If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as </strong><a href=\"https://findahelpline.com/\"><strong>findahelpline.com</strong></a><strong>.</strong></p>\n</div>\n\n\n\n<div class=\"wp-block-column\">\n<div class=\"wp-container-65e6e2815cea5 wp-block-group related-topics\">\n<p>Related topics</p>\n\n\n\n<ul><li><a href=\"https://ourworldindata.org/causes-of-death\">Causes of death</a></li><li><a href=\"https://ourworldindata.org/mental-health\" data-type=\"URL\" data-id=\"https://ourworldindata.org/mental-health\">Mental health</a></li></ul>\n</div>\n</div>\n</div>\n\n\n\t<block type=\"key-insights\">\n\t\t<title>Key insights on Suicide data & research</title>\n <slug>key-insights-on-suicide</slug>\n <insights>\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates vary around the world</title>\n <slug>-strong-suicide-rates-vary-around-the-world-strong-</slug>\n <content>\n\n<p>Suicide rates vary widely between countries. The map shows this.</p>\n\n\n\n<p>For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people. </p>\n\n\n\n<p>Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people.</p>\n\n\n\n<p>The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href=\"https://doi.org/10.1136/bmj.l94\">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. <a href=\"https://doi.org/10.1186/s12916-020-01525-w\">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. <a href=\"https://doi.org/10.1016/S0140-6736(18)32203-7\">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608\u2013616. <a href=\"https://doi.org/10.1016/j.socscimed.2010.11.008\">https://doi.org/10.1016/j.socscimed.2010.11.008</a><br>Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789</a><br>World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a><br>World Health Organization. (2019). <em>Suicide worldwide in 2019: Global Health Estimates</em>.<a href=\"https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf\"> https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf</a> {/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for ‘intentional self-harm’ in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country’s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to “events of undetermined intent”, accidents, homicides, or unknown causes. To account for this, the WHO’s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates have declined in many countries</title>\n <slug>suicide-rates-have-declined-in-many-countries</slug>\n <content>\n\n<p>In many countries, suicide rates have declined substantially. </p>\n\n\n\n<p>You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.</p>\n\n\n\n<p>These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots.<br>Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611\u2013624.<a href=\"https://doi.org/10.1176/appi.ajp.2020.20060864\"> https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646\u2013659. <a href=\"https://doi.org/10.1016/S2215-0366(16)30030-X\">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p>\n\n\n\n<p>This tells us that suicide is preventable. But many countries don’t take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208755/\">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208764/\">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>It’s possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by V\u00e4rnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. <a href=\"https://doi.org/10.1136/injuryprev-2011-040070\">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152\u2013160.</li><li>Puigdef\u00e0bregas Serra, A., Freitas Ram\u00edrez, A., Gispert Magarolas, R., Castell\u00e0 Garcia, J., Vidal Guti\u00e9rrez, C., Medallo Mu\u00f1iz, J., Subirana Dom\u00e8nech, M., & Mart\u00ednez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13\u201319. <a href=\"https://doi.org/10.1016/j.remle.2017.02.001\">https://doi.org/10.1016/j.remle.2017.02.001</a></li><li>T\u00f8llefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., \u00d8stevold, G., & Ekeberg, \u00d8. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. <a href=\"https://doi.org/10.1136/bmjopen-2015-009120\">https://doi.org/10.1136/bmjopen-2015-009120</a>{/ref}</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for ‘intentional self-harm’ in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country’s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to “events of undetermined intent”, accidents, homicides, or unknown causes. To account for this, the WHO’s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Deaths by suicide are under-reported in many countries</title>\n <slug>-strong-deaths-by-suicide-are-under-reported-in-many-countries-strong-</slug>\n <content>\n\n<p>In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general \u2013 not just suicides \u2013 are not well-recorded in many countries. You can see this in the chart.</p>\n\n\n\n<p>It shows that in some cases, not all deaths are registered in a country\u2019s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.</p>\n\n\n\n<p>Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.</p>\n\n\n\n<p>Researchers typically define suicides as deaths which were classified as deaths caused by ‘intentional self-harm’ in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country’s particular legal definition.</p>\n\n\n\n<p>Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789<br></a>V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. <a href=\"https://doi.org/10.1136/injuryprev-2011-040070\">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref}</p>\n\n\n\n<p>This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208755/\">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208764/\">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref} For these reasons, suicides may be misclassified, especially as deaths due to “events of undetermined intent”, accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789</a>{/ref} </p>\n\n\n\n<p>To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. <a href=\"https://doi.org/10.1101/2021.08.12.21261978\">https://doi.org/10.1101/2021.08.12.21261978</a> <a href=\"https://github.com/akarlinsky/death_registration\">https://github.com/akarlinsky/death_registration</a> {/ref}</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The total number of expected deaths per year is an average of estimates from three data sources \u2013 the UN’s World Population Prospects, WHO’s Global Health Estimates and IHME’s Global Burden of Disease study. </li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ. </li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The level of death registration may also vary widely across different regions <em>within</em> these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a>{/ref}</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicides are more common among men</title>\n <slug>suicide-deaths-are-more-common-among-men</slug>\n <content>\n\n<p>Across countries, the estimates show that suicide rates are much higher among men than women.</p>\n\n\n\n<p>This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). </p>\n\n\n\n<p>Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.</p>\n\n\n\n<p>But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for ‘intentional self-harm’ in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country’s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to “events of undetermined intent”, accidents, homicides, or unknown causes. To account for this, the WHO’s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Mental illnesses are a major risk factor for suicide</title>\n <slug>mental-illnesses-are-a-major-risk-factor-for-suicide</slug>\n <content>\n\n<p>There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a>{/ref}</p>\n\n\n\n<p>A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.</p>\n\n\n\n<p>The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.</p>\n\n\n\n<p>Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.</p>\n\n\n\n<p>Importantly, the chart also shows that the vast majority of people \u2013 with or without a mental illness \u2013 did not die by suicide. Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611\u2013624. <a href=\"https://doi.org/10.1176/appi.ajp.2020.20060864\">https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646\u2013659. <a href=\"https://doi.org/10.1016/S2215-0366(16)30030-X\">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. <a href=\"https://doi.org/10.1001/archgenpsychiatry.2011.113\">https://doi.org/10.1001/archgenpsychiatry.2011.113</a>{/ref} Since the study was published, the cumulative risk of suicide may have changed.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.</li></ul>\n\n\n\t</div>\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"651\" height=\"550\" src=\"https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png\" alt=\"\" class=\"wp-image-57555\" srcset=\"https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png 651w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-400x338.png 400w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-150x127.png 150w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-768x649.png 768w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-1536x1297.png 1536w\" sizes=\"(max-width: 651px) 100vw, 651px\" /></figure>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates may vary with age</title>\n <slug>suicide-rates-rise-with-age</slug>\n <content>\n\n<p>In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.</p>\n\n\n\n<p>However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.</p>\n\n\n\n<p>That suicide rates can be much higher among older people may sound surprising, because suicide is a leading <a href=\"https://ourworldindata.org/causes-of-death\">cause of death</a> in young people. But it is because deaths due to <em>other</em> causes tend to rise with age at a much faster rate than deaths by suicide.</p>\n\n\n\n<p>The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.</p>\n\n\n\n<p>However, the rates of deaths from suicides, accidents, and other ‘external causes’ tend to rise steeply from childhood until adulthood.{ref}The shape of this age\u2013mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. <a href=\"https://link.springer.com/content/pdf/10.2307/2061656.pdf\">https://link.springer.com/content/pdf/10.2307/2061656.pdf<br></a>Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109\u20132134. <a href=\"https://doi.org/10.1215/00703370-10286336\">https://doi.org/10.1215/00703370-10286336</a>{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. <em>Journal of Affective Disorders</em>, <em>295</em>, 587\u2013593. <a href=\"https://doi.org/10.1016/j.jad.2021.08.084\">https://doi.org/10.1016/j.jad.2021.08.084</a><br>Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986\u20132015): A tale of two countries. <em>Social Science & Medicine</em>, <em>235</em>, 112385. <a href=\"https://doi.org/10.1016/j.socscimed.2019.112385\">https://doi.org/10.1016/j.socscimed.2019.112385</a><br>Mart\u00ednez-Al\u00e9s, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. <em>Molecular Psychiatry</em>, <em>26</em>(7), 3374\u20133382. <a href=\"https://doi.org/10.1038/s41380-021-01078-1\">https://doi.org/10.1038/s41380-021-01078-1</a><br>Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. <em>Asia Pacific Journal of Public Health</em>, <em>23</em>(4), 581\u2013587. <a href=\"https://doi.org/10.1177/1010539509348242\">https://doi.org/10.1177/1010539509348242</a><br>Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., & Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983\u20132012. <em>International Journal for Equity in Health</em>, <em>15</em>(1), 107. <a href=\"https://doi.org/10.1186/s12939-016-0400-2\">https://doi.org/10.1186/s12939-016-0400-2</a>{/ref}</p>\n\n\n\n<p>Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href=\"https://doi.org/10.1136/bmj.l94\">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. <a href=\"https://doi.org/10.1186/s12916-020-01525-w\">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. <a href=\"https://doi.org/10.1016/S0140-6736(18)32203-7\">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608\u2013616. <a href=\"https://doi.org/10.1016/j.socscimed.2010.11.008\">https://doi.org/10.1016/j.socscimed.2010.11.008</a> {/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for ‘intentional self-harm’ in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country’s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to “events of undetermined intent”, accidents, homicides, or unknown causes. To account for this, the WHO’s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n</insights>\n\t</block>\n\n\t<block type=\"all-charts\"></block>", "protected": false }, "excerpt": { "rendered": "Suicide rates can be reduced with greater understanding and support for people at risk.", "protected": false }, "date_gmt": "2023-04-02T21:00:00", "modified": "2023-06-21T21:16:36", "template": "", "categories": [ 44, 46, 233 ], "menu_order": 319, "ping_status": "closed", "authors_name": [ "Saloni Dattani", "Lucas Rod\u00e9s-Guirao", "Hannah Ritchie", "Max Roser", "Esteban Ortiz-Ospina" ], "modified_gmt": "2023-06-21T20:16:36", "comment_status": "open", "featured_media": 55879, "featured_media_paths": { "thumbnail": "/app/uploads/2023/02/suicide-topic-page-featured-image-150x79.png", "medium_large": "/app/uploads/2023/02/suicide-topic-page-featured-image-768x403.png" } }

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<div class="wp-block-columns front-matter" id="introduction"> <div class="wp-block-column"> Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support.   To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced.   On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time.   If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as <a href="https://findahelpline.com/">findahelpline.com</a>. </div>   <div class="wp-block-column"> <div class="wp-block-group related-topics"> Related topics   <ul><li><a href="https://ourworldindata.org/causes-of-death">Causes of death</a></li><li><a href="https://ourworldindata.org/mental-health" data-type="URL" data-id="https://ourworldindata.org/mental-health">Mental health</a></li></ul> </div> </div> </div>     Suicide rates vary widely between countries. The map shows this.   For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people.    Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people.   The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a> Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href="https://doi.org/10.1136/bmj.l94">https://doi.org/10.1136/bmj.l94</a> Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. <a href="https://doi.org/10.1186/s12916-020-01525-w">https://doi.org/10.1186/s12916-020-01525-w</a> Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. <a href="https://doi.org/10.1016/S0140-6736(18)32203-7">https://doi.org/10.1016/S0140-6736(18)32203-7</a> Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. <a href="https://doi.org/10.1016/j.socscimed.2010.11.008">https://doi.org/10.1016/j.socscimed.2010.11.008</a> Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789</a> World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a> World Health Organization. (2019). Suicide worldwide in 2019: Global Health Estimates.<a href="https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf"> https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf</a> {/ref}    <h5>What you should know about this data</h5>   <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul>     <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>     <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>    <iframe src="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe>     In many countries, suicide rates have declined substantially.    You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.   These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots. Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. American Journal of Psychiatry, 178(7), 611–624.<a href="https://doi.org/10.1176/appi.ajp.2020.20060864"> https://doi.org/10.1176/appi.ajp.2020.20060864</a> Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry, 3(7), 646–659. <a href="https://doi.org/10.1016/S2215-0366(16)30030-X">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}   This tells us that suicide is preventable. But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href="https://pubmed.ncbi.nlm.nih.gov/32208755/">https://pubmed.ncbi.nlm.nih.gov/32208755/</a> Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S72. <a href="https://pubmed.ncbi.nlm.nih.gov/32208764/">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref}    <h5>What you should know about this data</h5>   <ul><li>It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by Värnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. <a href="https://doi.org/10.1136/injuryprev-2011-040070">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152–160.</li><li>Puigdefàbregas Serra, A., Freitas Ramírez, A., Gispert Magarolas, R., Castellà Garcia, J., Vidal Gutiérrez, C., Medallo Muñiz, J., Subirana Domènech, M., & Martínez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13–19. <a href="https://doi.org/10.1016/j.remle.2017.02.001">https://doi.org/10.1016/j.remle.2017.02.001</a></li><li>Tøllefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., Østevold, G., & Ekeberg, Ø. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. <a href="https://doi.org/10.1136/bmjopen-2015-009120">https://doi.org/10.1136/bmjopen-2015-009120</a>{/ref}</li></ul>     <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul>     <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>    <iframe src="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe>     In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general – not just suicides – are not well-recorded in many countries. You can see this in the chart.   It shows that in some cases, not all deaths are registered in a country’s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.   Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.   Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.   Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789 </a>Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. <a href="https://doi.org/10.1136/injuryprev-2011-040070">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref}   This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href="https://pubmed.ncbi.nlm.nih.gov/32208755/">https://pubmed.ncbi.nlm.nih.gov/32208755/</a> Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S72. <a href="https://pubmed.ncbi.nlm.nih.gov/32208764/">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref} For these reasons, suicides may be misclassified, especially as deaths due to "events of undetermined intent", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. <a href="https://doi.org/10.1080/17441692.2020.1801789">https://doi.org/10.1080/17441692.2020.1801789</a>{/ref}    To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref}    <h5>What you should know about this data</h5>   <ul><li>This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. <a href="https://doi.org/10.1101/2021.08.12.21261978">https://doi.org/10.1101/2021.08.12.21261978</a> <a href="https://github.com/akarlinsky/death_registration">https://github.com/akarlinsky/death_registration</a> {/ref}</li></ul>     <ul><li>The total number of expected deaths per year is an average of estimates from three data sources – the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study. </li></ul>     <ul><li>For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ. </li></ul>     <ul><li>The level of death registration may also vary widely across different regions within these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1</a>{/ref}</li></ul>    <iframe src="https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR " loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe>     Across countries, the estimates show that suicide rates are much higher among men than women.   This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis).   Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.   But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.    <h5>What you should know about this data</h5>   <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul>     <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>     <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>    <iframe src="https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe>     There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a>{/ref}   A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.   The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.   Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.   Importantly, the chart also shows that the vast majority of people – with or without a mental illness – did not die by suicide. Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. American Journal of Psychiatry, 178(7), 611–624. <a href="https://doi.org/10.1176/appi.ajp.2020.20060864">https://doi.org/10.1176/appi.ajp.2020.20060864</a> Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry, 3(7), 646–659. <a href="https://doi.org/10.1016/S2215-0366(16)30030-X">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}    <h5>What you should know about this data</h5>   <ul><li>This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. <a href="https://doi.org/10.1001/archgenpsychiatry.2011.113">https://doi.org/10.1001/archgenpsychiatry.2011.113</a>{/ref} Since the study was published, the cumulative risk of suicide may have changed.</li></ul>     <ul><li>The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.</li></ul>    <figure class="wp-block-image size-large"><img src="https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png" alt="" class="wp-image-57555"/></figure>     In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.   However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.   That suicide rates can be much higher among older people may sound surprising, because suicide is a leading <a href="https://ourworldindata.org/causes-of-death">cause of death</a> in young people. But it is because deaths due to other causes tend to rise with age at a much faster rate than deaths by suicide.   The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.   However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age–mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. <a href="https://link.springer.com/content/pdf/10.2307/2061656.pdf">https://link.springer.com/content/pdf/10.2307/2061656.pdf </a>Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109–2134. <a href="https://doi.org/10.1215/00703370-10286336">https://doi.org/10.1215/00703370-10286336</a>{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. Journal of Affective Disorders, 295, 587–593. <a href="https://doi.org/10.1016/j.jad.2021.08.084">https://doi.org/10.1016/j.jad.2021.08.084</a> Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986–2015): A tale of two countries. Social Science & Medicine, 235, 112385. <a href="https://doi.org/10.1016/j.socscimed.2019.112385">https://doi.org/10.1016/j.socscimed.2019.112385</a> Martínez-Alés, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. Molecular Psychiatry, 26(7), 3374–3382. <a href="https://doi.org/10.1038/s41380-021-01078-1">https://doi.org/10.1038/s41380-021-01078-1</a> Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. Asia Pacific Journal of Public Health, 23(4), 581–587. <a href="https://doi.org/10.1177/1010539509348242">https://doi.org/10.1177/1010539509348242</a> Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., & Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983–2012. International Journal for Equity in Health, 15(1), 107. <a href="https://doi.org/10.1186/s12939-016-0400-2">https://doi.org/10.1186/s12939-016-0400-2</a>{/ref}   Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. <a href="https://doi.org/10.1016/S2215-0366(14)70240-8">https://doi.org/10.1016/S2215-0366(14)70240-8</a> Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href="https://doi.org/10.1136/bmj.l94">https://doi.org/10.1136/bmj.l94</a> Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. <a href="https://doi.org/10.1186/s12916-020-01525-w">https://doi.org/10.1186/s12916-020-01525-w</a> Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. <a href="https://doi.org/10.1016/S0140-6736(18)32203-7">https://doi.org/10.1016/S0140-6736(18)32203-7</a> Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. <a href="https://doi.org/10.1016/j.socscimed.2010.11.008">https://doi.org/10.1016/j.socscimed.2010.11.008</a> {/ref}    <h5>What you should know about this data</h5>   <ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.</li></ul>     <ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>     <ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href="https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>    <iframe src="/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe>

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                        "text": "Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1186/s12916-020-01525-w",
                        "children": [
                            {
                                "text": "https://doi.org/10.1186/s12916-020-01525-w",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1016/S0140-6736(18)32203-7",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/S0140-6736(18)32203-7",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608\u2013616. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1016/j.socscimed.2010.11.008",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/j.socscimed.2010.11.008",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1080/17441692.2020.1801789",
                        "children": [
                            {
                                "text": "https://doi.org/10.1080/17441692.2020.1801789",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1",
                        "children": [
                            {
                                "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "World Health Organization. (2019). ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Suicide worldwide in 2019: Global Health Estimates",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ".",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf",
                        "children": [
                            {
                                "text": " https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf",
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                            }
                        ],
                        "spanType": "span-link"
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                    {
                        "text": " {/ref}",
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                "text": [
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                        "text": "What you should know about this data",
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                                "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.",
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                                "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.",
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                            {
                                "text": "Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
                                "children": [
                                    {
                                        "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": "{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.",
                                "spanType": "span-simple-text"
                            }
                        ],
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                ],
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            {
                "url": "https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA ",
                "type": "chart",
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                "type": "text",
                "value": [
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                        "text": "In many countries, suicide rates have declined substantially.\u00a0",
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                "type": "text",
                "value": [
                    {
                        "text": "You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.",
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                "type": "text",
                "value": [
                    {
                        "text": "These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots.",
                        "spanType": "span-simple-text"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "American Journal of Psychiatry",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
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                    {
                        "children": [
                            {
                                "text": "178",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(7), 611\u2013624.",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1176/appi.ajp.2020.20060864",
                        "children": [
                            {
                                "text": " https://doi.org/10.1176/appi.ajp.2020.20060864",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "The Lancet Psychiatry",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
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                    {
                        "children": [
                            {
                                "text": "3",
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                    },
                    {
                        "text": "(7), 646\u2013659. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1016/S2215-0366(16)30030-X",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/S2215-0366(16)30030-X",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref}",
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                "type": "text",
                "value": [
                    {
                        "text": "This tells us that suicide is preventable.\u00a0But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://pubmed.ncbi.nlm.nih.gov/32208755/",
                        "children": [
                            {
                                "text": "https://pubmed.ncbi.nlm.nih.gov/32208755/",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Crisis: The Journal of Crisis Intervention and Suicide Prevention",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
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                        "children": [
                            {
                                "text": "41",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(S1), S72. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://pubmed.ncbi.nlm.nih.gov/32208764/",
                        "children": [
                            {
                                "text": "https://pubmed.ncbi.nlm.nih.gov/32208764/",
                                "spanType": "span-simple-text"
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                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref}",
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            {
                "text": [
                    {
                        "text": "What you should know about this data",
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                            {
                                "text": "It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by V\u00e4rnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://doi.org/10.1136/injuryprev-2011-040070",
                                "children": [
                                    {
                                        "text": "https://doi.org/10.1136/injuryprev-2011-040070",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": "{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152\u2013160.",
                                "spanType": "span-simple-text"
                            }
                        ],
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                        "type": "text",
                        "value": [
                            {
                                "text": "Puigdef\u00e0bregas Serra, A., Freitas Ram\u00edrez, A., Gispert Magarolas, R., Castell\u00e0 Garcia, J., Vidal Guti\u00e9rrez, C., Medallo Mu\u00f1iz, J., Subirana Dom\u00e8nech, M., & Mart\u00ednez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13\u201319. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://doi.org/10.1016/j.remle.2017.02.001",
                                "children": [
                                    {
                                        "text": "https://doi.org/10.1016/j.remle.2017.02.001",
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                            {
                                "text": "T\u00f8llefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., \u00d8stevold, G., & Ekeberg, \u00d8. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. ",
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                            },
                            {
                                "url": "https://doi.org/10.1136/bmjopen-2015-009120",
                                "children": [
                                    {
                                        "text": "https://doi.org/10.1136/bmjopen-2015-009120",
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                            },
                            {
                                "text": "{/ref}",
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                                "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.",
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                                "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.",
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                "url": "https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA ",
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                        "text": "In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general \u2013 not just suicides \u2013 are not well-recorded in many countries. You can see this in the chart.",
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                "value": [
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                        "text": "It shows that in some cases, not all deaths are registered in a country\u2019s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.",
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                        "text": "Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.",
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                        "text": "Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.",
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                "value": [
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                        "text": "Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1080/17441692.2020.1801789",
                        "children": [
                            {
                                "text": "https://doi.org/10.1080/17441692.2020.1801789",
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                        "text": "V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1136/injuryprev-2011-040070",
                        "children": [
                            {
                                "text": "https://doi.org/10.1136/injuryprev-2011-040070",
                                "spanType": "span-simple-text"
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                        "text": "{/ref}",
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                        "text": "This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://pubmed.ncbi.nlm.nih.gov/32208755/",
                        "children": [
                            {
                                "text": "https://pubmed.ncbi.nlm.nih.gov/32208755/",
                                "spanType": "span-simple-text"
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                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Crisis: The Journal of Crisis Intervention and Suicide Prevention",
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                        "text": ", ",
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                        "children": [
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                                "text": "41",
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                    {
                        "text": "(S1), S72. ",
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                    {
                        "url": "https://pubmed.ncbi.nlm.nih.gov/32208764/",
                        "children": [
                            {
                                "text": "https://pubmed.ncbi.nlm.nih.gov/32208764/",
                                "spanType": "span-simple-text"
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                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref} For these reasons, suicides may be misclassified, especially as deaths due to \"events of undetermined intent\", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1080/17441692.2020.1801789",
                        "children": [
                            {
                                "text": "https://doi.org/10.1080/17441692.2020.1801789",
                                "spanType": "span-simple-text"
                            }
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                    },
                    {
                        "text": "{/ref}\u00a0",
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                "value": [
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                        "text": "To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
                        "children": [
                            {
                                "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
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                        "text": "{/ref}",
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                "text": [
                    {
                        "text": "What you should know about this data",
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                        "value": [
                            {
                                "text": "This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://doi.org/10.1101/2021.08.12.21261978",
                                "children": [
                                    {
                                        "text": "https://doi.org/10.1101/2021.08.12.21261978",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "url": "https://github.com/akarlinsky/death_registration",
                                "children": [
                                    {
                                        "text": "https://github.com/akarlinsky/death_registration",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " {/ref}",
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                                "text": "The total number of expected deaths per year is an average of estimates from three data sources \u2013\u00a0the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study.\u00a0",
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                                "text": "For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ.\u00a0",
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                                "text": "The level of death registration may also vary widely across different regions ",
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                            {
                                "children": [
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                                        "text": "within",
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                            {
                                "text": " these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1",
                                "children": [
                                    {
                                        "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1",
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                                "text": "{/ref}",
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                "url": "https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR ",
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                        "text": "Across countries, the estimates show that suicide rates are much higher among men than women.",
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                "value": [
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                        "text": "This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). ",
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                ],
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                "type": "text",
                "value": [
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                        "text": "Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.",
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                "type": "text",
                "value": [
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                        "text": "But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.",
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                "text": [
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                        "text": "What you should know about this data",
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                                "text": "Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition.",
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                                "text": "In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to \"events of undetermined intent\", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.",
                                "spanType": "span-simple-text"
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                        ],
                        "parseErrors": []
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                        "value": [
                            {
                                "text": "Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
                                "children": [
                                    {
                                        "text": "https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5",
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                            },
                            {
                                "text": "{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.",
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                "url": "https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log",
                "type": "chart",
                "parseErrors": []
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            {
                "type": "text",
                "value": [
                    {
                        "text": "There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1016/S2215-0366(14)70240-8",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/S2215-0366(14)70240-8",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref}",
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            {
                "type": "text",
                "value": [
                    {
                        "text": "A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.",
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                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.",
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            {
                "type": "text",
                "value": [
                    {
                        "text": "Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.",
                        "spanType": "span-simple-text"
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                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "Importantly, the chart also shows that the vast majority of people \u2013 with or without a mental illness \u2013\u00a0did not die by suicide.\u00a0Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "American Journal of Psychiatry",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
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                    {
                        "children": [
                            {
                                "text": "178",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(7), 611\u2013624. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1176/appi.ajp.2020.20060864",
                        "children": [
                            {
                                "text": "https://doi.org/10.1176/appi.ajp.2020.20060864",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "The Lancet Psychiatry",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
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                    {
                        "children": [
                            {
                                "text": "3",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(7), 646\u2013659. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1016/S2215-0366(16)30030-X",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/S2215-0366(16)30030-X",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref}",
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                ],
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            {
                "text": [
                    {
                        "text": "What you should know about this data",
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                    }
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                "type": "heading",
                "level": 2,
                "parseErrors": []
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            {
                "type": "list",
                "items": [
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://doi.org/10.1001/archgenpsychiatry.2011.113",
                                "children": [
                                    {
                                        "text": "https://doi.org/10.1001/archgenpsychiatry.2011.113",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": "{/ref} Since the study was published, the cumulative risk of suicide may have changed.",
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                            }
                        ],
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                "parseErrors": []
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                        "value": [
                            {
                                "text": "The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.",
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                "alt": "",
                "size": "wide",
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                "type": "text",
                "value": [
                    {
                        "text": "In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.",
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                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.",
                        "spanType": "span-simple-text"
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                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "That suicide rates can be much higher among older people may sound surprising, because suicide is a leading ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://ourworldindata.org/causes-of-death",
                        "children": [
                            {
                                "text": "cause of death",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " in young people. But it is because deaths due to ",
                        "spanType": "span-simple-text"
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                    {
                        "children": [
                            {
                                "text": "other",
                                "spanType": "span-simple-text"
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                    {
                        "text": " causes tend to rise with age at a much faster rate than deaths by suicide.",
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                "parseErrors": []
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            {
                "type": "text",
                "value": [
                    {
                        "text": "The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.",
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            {
                "type": "text",
                "value": [
                    {
                        "text": "However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age\u2013mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://link.springer.com/content/pdf/10.2307/2061656.pdf",
                        "children": [
                            {
                                "text": "https://link.springer.com/content/pdf/10.2307/2061656.pdf",
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                            },
                            {
                                "spanType": "span-newline"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109\u20132134. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1215/00703370-10286336",
                        "children": [
                            {
                                "text": "https://doi.org/10.1215/00703370-10286336",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Journal of Affective Disorders",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-italic"
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                    {
                        "text": ", ",
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                        "children": [
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                                "text": "295",
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                    {
                        "text": ", 587\u2013593. ",
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                    {
                        "url": "https://doi.org/10.1016/j.jad.2021.08.084",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/j.jad.2021.08.084",
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                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986\u20132015): A tale of two countries. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Social Science & Medicine",
                                "spanType": "span-simple-text"
                            }
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                    {
                        "text": ", ",
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                    {
                        "children": [
                            {
                                "text": "235",
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                            }
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                        "spanType": "span-italic"
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                    {
                        "text": ", 112385. ",
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                    },
                    {
                        "url": "https://doi.org/10.1016/j.socscimed.2019.112385",
                        "children": [
                            {
                                "text": "https://doi.org/10.1016/j.socscimed.2019.112385",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Mart\u00ednez-Al\u00e9s, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Molecular Psychiatry",
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                        "text": ", ",
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                        "children": [
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                                "text": "26",
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                        "spanType": "span-italic"
                    },
                    {
                        "text": "(7), 3374\u20133382. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1038/s41380-021-01078-1",
                        "children": [
                            {
                                "text": "https://doi.org/10.1038/s41380-021-01078-1",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Asia Pacific Journal of Public Health",
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                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
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                    },
                    {
                        "children": [
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2024-03-05 09:19:03

1VfZnfnJWL-t3XTwwvVogsYJTHKp-6GXoFji0UOkNmsc

[
    "Saloni Dattani",
    "Lucas Rod\u00e9s-Guirao",
    "Hannah Ritchie",
    "Max Roser",
    "Esteban Ortiz-Ospina"
]

Suicide rates can be reduced with greater understanding and support for people at risk.

2019-10-27 16:29:36

2023-06-21 20:16:36

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Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support. To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced. On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time. **If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as **[**findahelpline.com**](https://findahelpline.com/)**.** Related topics * [Causes of death](https://ourworldindata.org/causes-of-death) * [Mental health](https://ourworldindata.org/mental-health) Suicide rates vary widely between countries. The map shows this. For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people. Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people. The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8) Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. [https://doi.org/10.1136/bmj.l94](https://doi.org/10.1136/bmj.l94) Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. [https://doi.org/10.1186/s12916-020-01525-w](https://doi.org/10.1186/s12916-020-01525-w) Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. [https://doi.org/10.1016/S0140-6736(18)32203-7](https://doi.org/10.1016/S0140-6736(18)32203-7) Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. [https://doi.org/10.1016/j.socscimed.2010.11.008](https://doi.org/10.1016/j.socscimed.2010.11.008) Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789](https://doi.org/10.1080/17441692.2020.1801789) World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1) World Health Organization. (2019). _Suicide worldwide in 2019: Global Health Estimates_.[ https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf](https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf) {/ref} ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA "/> In many countries, suicide rates have declined substantially. You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France. These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots. Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. _American Journal of Psychiatry_, _178_(7), 611–624.[ https://doi.org/10.1176/appi.ajp.2020.20060864](https://doi.org/10.1176/appi.ajp.2020.20060864) Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. _The Lancet Psychiatry_, _3_(7), 646–659. [https://doi.org/10.1016/S2215-0366(16)30030-X](https://doi.org/10.1016/S2215-0366(16)30030-X){/ref} This tells us that suicide is preventable. But many countries don't take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. [https://pubmed.ncbi.nlm.nih.gov/32208755/](https://pubmed.ncbi.nlm.nih.gov/32208755/) Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. _Crisis: The Journal of Crisis Intervention and Suicide Prevention_, _41_(S1), S72. [https://pubmed.ncbi.nlm.nih.gov/32208764/](https://pubmed.ncbi.nlm.nih.gov/32208764/){/ref} ## What you should know about this data * It's possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by Värnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. [https://doi.org/10.1136/injuryprev-2011-040070](https://doi.org/10.1136/injuryprev-2011-040070){/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., & Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152–160. * Puigdefàbregas Serra, A., Freitas Ramírez, A., Gispert Magarolas, R., Castellà Garcia, J., Vidal Gutiérrez, C., Medallo Muñiz, J., Subirana Domènech, M., & Martínez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13–19. [https://doi.org/10.1016/j.remle.2017.02.001](https://doi.org/10.1016/j.remle.2017.02.001) * Tøllefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., Østevold, G., & Ekeberg, Ø. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. [https://doi.org/10.1136/bmjopen-2015-009120](https://doi.org/10.1136/bmjopen-2015-009120){/ref} * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. <Chart url="https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&stackMode=relative&country=ESP~ITA~NOR~AUT~LUX~FIN~FRA "/> In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general – not just suicides – are not well-recorded in many countries. You can see this in the chart. It shows that in some cases, not all deaths are registered in a country’s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all. Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies. Researchers typically define suicides as deaths which were classified as deaths caused by 'intentional self-harm' in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789 ](https://doi.org/10.1080/17441692.2020.1801789)Värnik, P., Sisask, M., Värnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., & Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321–325. [https://doi.org/10.1136/injuryprev-2011-040070](https://doi.org/10.1136/injuryprev-2011-040070){/ref} This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., & Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. [https://pubmed.ncbi.nlm.nih.gov/32208755/](https://pubmed.ncbi.nlm.nih.gov/32208755/) Rezaeian, M., & Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. _Crisis: The Journal of Crisis Intervention and Suicide Prevention_, _41_(S1), S72. [https://pubmed.ncbi.nlm.nih.gov/32208764/](https://pubmed.ncbi.nlm.nih.gov/32208764/){/ref} For these reasons, suicides may be misclassified, especially as deaths due to "events of undetermined intent", accidents, homicides or unknown causes.{ref}Snowdon, J., & Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894–1901. [https://doi.org/10.1080/17441692.2020.1801789](https://doi.org/10.1080/17441692.2020.1801789){/ref} To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} ## What you should know about this data * This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. [https://doi.org/10.1101/2021.08.12.21261978](https://doi.org/10.1101/2021.08.12.21261978)[https://github.com/akarlinsky/death_registration](https://github.com/akarlinsky/death_registration) {/ref} * The total number of expected deaths per year is an average of estimates from three data sources – the UN's World Population Prospects, WHO's Global Health Estimates and IHME's Global Burden of Disease study. * For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ. * The level of death registration may also vary widely across different regions _within_ these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&ua=1){/ref} <Chart url="https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR "/> Across countries, the estimates show that suicide rates are much higher among men than women. This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women. But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference. ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&yScale=log"/> There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8){/ref} A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide. The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51. Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness. Importantly, the chart also shows that the vast majority of people – with or without a mental illness – did not die by suicide. Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. _American Journal of Psychiatry_, _178_(7), 611–624. [https://doi.org/10.1176/appi.ajp.2020.20060864](https://doi.org/10.1176/appi.ajp.2020.20060864) Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. _The Lancet Psychiatry_, _3_(7), 646–659. [https://doi.org/10.1016/S2215-0366(16)30030-X](https://doi.org/10.1016/S2215-0366(16)30030-X){/ref} ## What you should know about this data * This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. [https://doi.org/10.1001/archgenpsychiatry.2011.113](https://doi.org/10.1001/archgenpsychiatry.2011.113){/ref} Since the study was published, the cumulative risk of suicide may have changed. * The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses. <Image filename="suicide-lifetime-risk-by-mental-illnessv2.png" alt=""/> In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups. However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups. That suicide rates can be much higher among older people may sound surprising, because suicide is a leading [cause of death](https://ourworldindata.org/causes-of-death) in young people. But it is because deaths due to _other_ causes tend to rise with age at a much faster rate than deaths by suicide. The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan. However, the rates of deaths from suicides, accidents, and other 'external causes' tend to rise steeply from childhood until adulthood.{ref}The shape of this age–mortality curve is often described by the Gompertz function. Olshansky, S. J., & Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. [https://link.springer.com/content/pdf/10.2307/2061656.pdf ](https://link.springer.com/content/pdf/10.2307/2061656.pdf)Lleras-Muney, A., & Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109–2134. [https://doi.org/10.1215/00703370-10286336](https://doi.org/10.1215/00703370-10286336){/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., & Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. _Journal of Affective Disorders_, _295_, 587–593. [https://doi.org/10.1016/j.jad.2021.08.084](https://doi.org/10.1016/j.jad.2021.08.084) Kino, S., Jang, S., Gero, K., Kato, S., & Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986–2015): A tale of two countries. _Social Science & Medicine_, _235_, 112385. [https://doi.org/10.1016/j.socscimed.2019.112385](https://doi.org/10.1016/j.socscimed.2019.112385) Martínez-Alés, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., & Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. _Molecular Psychiatry_, _26_(7), 3374–3382. [https://doi.org/10.1038/s41380-021-01078-1](https://doi.org/10.1038/s41380-021-01078-1) Odagiri, Y., Uchida, H., & Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. _Asia Pacific Journal of Public Health_, _23_(4), 581–587. [https://doi.org/10.1177/1010539509348242](https://doi.org/10.1177/1010539509348242) Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., & Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983–2012. _International Journal for Equity in Health_, _15_(1), 107. [https://doi.org/10.1186/s12939-016-0400-2](https://doi.org/10.1186/s12939-016-0400-2){/ref} Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2–3. [https://doi.org/10.1016/S2215-0366(14)70240-8](https://doi.org/10.1016/S2215-0366(14)70240-8) Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. [https://doi.org/10.1136/bmj.l94](https://doi.org/10.1136/bmj.l94) Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., & Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all ‘garbage’ codes equally problematic? BMC Medicine, 18(1), 55. [https://doi.org/10.1186/s12916-020-01525-w](https://doi.org/10.1186/s12916-020-01525-w) Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., … Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736–1788. [https://doi.org/10.1016/S0140-6736(18)32203-7](https://doi.org/10.1016/S0140-6736(18)32203-7) Li, Z., Page, A., Martin, G., & Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science & Medicine, 72(4), 608–616. [https://doi.org/10.1016/j.socscimed.2010.11.008](https://doi.org/10.1016/j.socscimed.2010.11.008) {/ref} ## What you should know about this data * Suicide estimates come from death certificate data, using deaths that were classified under death codes for 'intentional self-harm' in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country's particular legal definition. * In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to "events of undetermined intent", accidents, homicides, or unknown causes. To account for this, the WHO's Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide. * Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. [https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5](https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5){/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline. <Chart url="/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&country=USA~JPN~KOR~PRT"/>

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        "rendered": "\n<!-- formatting-options toc:false bodyClassName:topic-page -->\n\n\n\t<div class=\"sticky-nav-contents\">\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#introduction\"><span class=\"wp-block-navigation-item__label\">Introduction</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#key-insights-on-suicide\"><span class=\"wp-block-navigation-item__label\">Key Insights</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#interactive-charts-on-suicides\"><span class=\"wp-block-navigation-item__label\">Charts</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#endnotes\"><span class=\"wp-block-navigation-item__label\">Endnotes</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#citation\"><span class=\"wp-block-navigation-item__label\">Cite This Work</span></a></li>\n\n<li class=\" wp-block-navigation-item wp-block-navigation-link\"><a class=\"wp-block-navigation-item__content\"  href=\"#licence\"><span class=\"wp-block-navigation-item__label\">Reuse This Work</span></a></li>\n</div>\n\n\n<div class=\"wp-block-columns front-matter\" id=\"introduction\">\n<div class=\"wp-block-column\">\n<p>Every death from suicide is a tragedy. But research shows that its rates can be reduced with greater understanding and support.</p>\n\n\n\n<p>To do this, suicide should be recognised as a public health problem, and people should know that it can be prevented and its rates can be reduced.</p>\n\n\n\n<p>On this page we show data on the prevalence of suicide across the world, its risk factors, and how these trends are changing over time.</p>\n\n\n\n<p><strong>If you are dealing with suicidal thoughts you can receive immediate help by visiting resources such as </strong><a href=\"https://findahelpline.com/\"><strong>findahelpline.com</strong></a><strong>.</strong></p>\n</div>\n\n\n\n<div class=\"wp-block-column\">\n<div class=\"wp-container-65e6e2815cea5 wp-block-group related-topics\">\n<p>Related topics</p>\n\n\n\n<ul><li><a href=\"https://ourworldindata.org/causes-of-death\">Causes of death</a></li><li><a href=\"https://ourworldindata.org/mental-health\" data-type=\"URL\" data-id=\"https://ourworldindata.org/mental-health\">Mental health</a></li></ul>\n</div>\n</div>\n</div>\n\n\n\t<block type=\"key-insights\">\n\t\t<title>Key insights on Suicide data &amp; research</title>\n        <slug>key-insights-on-suicide</slug>\n        <insights>\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates vary around the world</title>\n        <slug>-strong-suicide-rates-vary-around-the-world-strong-</slug>\n        <content>\n\n<p>Suicide rates vary widely between countries. The map shows this.</p>\n\n\n\n<p>For some countries in Southern Africa and Eastern Europe, the estimated rates of suicide are high, with over 15 annual deaths per 100,000 people.&nbsp;</p>\n\n\n\n<p>Meanwhile for other countries in Europe, South America and Asia, the estimated rates of suicide are lower, with under 10 annual deaths per 100,000 people.</p>\n\n\n\n<p>The wide range in suicide rates around the world is likely the result of many factors. This includes differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and other factors.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href=\"https://doi.org/10.1136/bmj.l94\">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., &amp; Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. <a href=\"https://doi.org/10.1186/s12916-020-01525-w\">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. <a href=\"https://doi.org/10.1016/S0140-6736(18)32203-7\">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., &amp; Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science &amp; Medicine, 72(4), 608\u2013616. <a href=\"https://doi.org/10.1016/j.socscimed.2010.11.008\">https://doi.org/10.1016/j.socscimed.2010.11.008</a><br>Snowdon, J., &amp; Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789</a><br>World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&amp;ua=1\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&amp;ua=1</a><br>World Health Organization. (2019). <em>Suicide worldwide in 2019: Global Health Estimates</em>.<a href=\"https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf\"> https://apps.who.int/iris/bitstream/handle/10665/341728/9789240026643-eng.pdf</a> {/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for &#8216;intentional self-harm&#8217; in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country&#8217;s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to &#8220;events of undetermined intent&#8221;, accidents, homicides, or unknown causes. To account for this, the WHO&#8217;s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-suicides-gho?country=FIN~AUT~NOR~FRA~LUX~ESP~ITA \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates have declined in many countries</title>\n        <slug>suicide-rates-have-declined-in-many-countries</slug>\n        <content>\n\n<p>In many countries, suicide rates have declined substantially.&nbsp;</p>\n\n\n\n<p>You can see this in the chart, which shows the change since the year 2000. It shows estimates for countries in Europe that surpass an indicator for data quality on suicides. These include Spain, Italy, Norway, Austria, Luxembourg, Finland and France.</p>\n\n\n\n<p>These large declines in suicide rates have been partly driven by greater awareness and help for people at risk, improvements in mental health treatment, and restrictions on some of the methods of suicide.{ref}Restrictions on the means of suicide are often used in preventative strategy. This may include regulation on pesticides, medication and poisons, restrictions on gun access, and barriers at railways, buildings, bridges and other hotspots.<br>Mann, J. J., Michel, C. A., &amp; Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611\u2013624.<a href=\"https://doi.org/10.1176/appi.ajp.2020.20060864\"> https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., &amp; Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646\u2013659. <a href=\"https://doi.org/10.1016/S2215-0366(16)30030-X\">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p>\n\n\n\n<p>This tells us that suicide is preventable.&nbsp;But many countries don&#8217;t take enough action to drive down its rates. Suicide may not be tackled effectively, or may not even be seen as a public health concern.{ref}Osafo, J., Asante, K. O., &amp; Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208755/\">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., &amp; Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208764/\">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>It&#8217;s possible to get an indicator of data quality on suicides by looking at the ratio of unexpected deaths to suicides. If there is a lower ratio of unexpected deaths to suicides, this implies that a higher proportion of unexpected deaths were classified as suicides, which is an indicator of better data quality. In the chart we show a selection of countries in Europe where suicide rates have declined and which had a low ratio of unexpected deaths to suicides, as identified by V\u00e4rnik and colleagues (2012), which implies that they had higher quality data on suicides. This included Spain, Italy, Norway, Austria, Luxembourg, Finland and France.{ref}V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., &amp; Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. <a href=\"https://doi.org/10.1136/injuryprev-2011-040070\">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref} Several of these countries also have very high rates of validation by coroner reports, and/or have autopsies performed for almost all unexpected or injury deaths.{ref}Gatov, E., Kurdyak, P., Sinyor, M., Holder, L., &amp; Schaffer, A. (2018). Comparison of vital statistics definitions of suicide against a coroner reference standard: A population-based linkage study. The Canadian Journal of Psychiatry, 63(3), 152\u2013160.</li><li>Puigdef\u00e0bregas Serra, A., Freitas Ram\u00edrez, A., Gispert Magarolas, R., Castell\u00e0 Garcia, J., Vidal Guti\u00e9rrez, C., Medallo Mu\u00f1iz, J., Subirana Dom\u00e8nech, M., &amp; Mart\u00ednez Alcazar, H. (2017). Deaths with medicolegal intervention and its impact on the cause-of-death statistics in Catalonia, Spain. Spanish Journal of Legal Medicine, 43(1), 13\u201319. <a href=\"https://doi.org/10.1016/j.remle.2017.02.001\">https://doi.org/10.1016/j.remle.2017.02.001</a></li><li>T\u00f8llefsen, I. M., Helweg-Larsen, K., Thiblin, I., Hem, E., Kastrup, M. C., Nyberg, U., Rogde, S., Zahl, P.-H., \u00d8stevold, G., &amp; Ekeberg, \u00d8. (2015). Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open, 5(11), e009120. <a href=\"https://doi.org/10.1136/bmjopen-2015-009120\">https://doi.org/10.1136/bmjopen-2015-009120</a>{/ref}</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for &#8216;intentional self-harm&#8217; in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country&#8217;s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to &#8220;events of undetermined intent&#8221;, accidents, homicides, or unknown causes. To account for this, the WHO&#8217;s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/death-rate-from-suicides-gho?tab=chart&amp;stackMode=relative&amp;country=ESP~ITA~NOR~AUT~LUX~FIN~FRA \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Deaths by suicide are under-reported in many countries</title>\n        <slug>-strong-deaths-by-suicide-are-under-reported-in-many-countries-strong-</slug>\n        <content>\n\n<p>In many countries, suicides are under-reported for a number of reasons. A major reason is that deaths in general \u2013 not just suicides \u2013 are not well-recorded in many countries. You can see this in the chart.</p>\n\n\n\n<p>It shows that in some cases, not all deaths are registered in a country\u2019s central vital registration system. In many countries, especially in Africa and South Asia, a low share of deaths are registered in such systems at all.</p>\n\n\n\n<p>Where vital registration systems are underdeveloped, statisticians have to estimate the number of deaths and their causes from partial data and particular studies.</p>\n\n\n\n<p>Researchers typically define suicides as deaths which were classified as deaths caused by &#8216;intentional self-harm&#8217; in the International Classification for Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country&#8217;s particular legal definition.</p>\n\n\n\n<p>Self-harm deaths tend to be under-recorded, even among countries that have a large share of deaths registered.{ref}Snowdon, J., &amp; Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789<br></a>V\u00e4rnik, P., Sisask, M., V\u00e4rnik, A., Arensman, E., Van Audenhove, C., van der Feltz-Cornelis, C. M., &amp; Hegerl, U. (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: Developing the 2-20 benchmark. Injury Prevention, 18(5), 321\u2013325. <a href=\"https://doi.org/10.1136/injuryprev-2011-040070\">https://doi.org/10.1136/injuryprev-2011-040070</a>{/ref}</p>\n\n\n\n<p>This is partly because, in many countries, suicide is highly stigmatised. In some countries, suicides and suicide attempts can be a criminal offence.{ref}Osafo, J., Asante, K. O., &amp; Akotia, C. S. (2020). Suicide prevention in the African region. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(S1), S53. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208755/\">https://pubmed.ncbi.nlm.nih.gov/32208755/</a><br>Rezaeian, M., &amp; Khan, M. M. (2020). Suicide prevention in the Eastern Mediterranean region. <em>Crisis: The Journal of Crisis Intervention and Suicide Prevention</em>, <em>41</em>(S1), S72. <a href=\"https://pubmed.ncbi.nlm.nih.gov/32208764/\">https://pubmed.ncbi.nlm.nih.gov/32208764/</a>{/ref} For these reasons, suicides may be misclassified, especially as deaths due to &#8220;events of undetermined intent&#8221;, accidents, homicides or unknown causes.{ref}Snowdon, J., &amp; Choi, N. G. (2020). Undercounting of suicides: Where suicide data lie hidden. Global Public Health, 15(12), 1894\u20131901. <a href=\"https://doi.org/10.1080/17441692.2020.1801789\">https://doi.org/10.1080/17441692.2020.1801789</a>{/ref}&nbsp;</p>\n\n\n\n<p>To account for this, the WHO and IHME reclassify a proportion of deaths reported with those causes as suicides. This is done according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide, but they may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>This comes from the International Completeness of Death Registration dataset, developed by Ariel Karlinsky.{ref}Karlinsky, A. (2021). International Completeness of Death Registration 2015-2019 [Preprint]. Public and Global Health. <a href=\"https://doi.org/10.1101/2021.08.12.21261978\">https://doi.org/10.1101/2021.08.12.21261978</a> <a href=\"https://github.com/akarlinsky/death_registration\">https://github.com/akarlinsky/death_registration</a> {/ref}</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The total number of expected deaths per year is an average of estimates from three data sources \u2013&nbsp;the UN&#8217;s World Population Prospects, WHO&#8217;s Global Health Estimates and IHME&#8217;s Global Burden of Disease study.&nbsp;</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>For many countries, their estimates are very similar. However, for others, where vital registration systems are lacking or not functional, they tend to differ.&nbsp;</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The level of death registration may also vary widely across different regions <em>within</em> these countries.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&amp;ua=1\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5&amp;ua=1</a>{/ref}</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-deaths-registered?country=ZMB~LBY~BLR \" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicides are more common among men</title>\n        <slug>suicide-deaths-are-more-common-among-men</slug>\n        <content>\n\n<p>Across countries, the estimates show that suicide rates are much higher among men than women.</p>\n\n\n\n<p>This is shown in the scatterplot, which compares estimates of suicide rates among women (on the horizontal axis) to the rates among men (on the vertical axis). </p>\n\n\n\n<p>Almost all countries are located above the gray diagonal line, which means that the suicide rate was higher among men than women.</p>\n\n\n\n<p>But the size of the gender disparity varies widely between countries. Some countries lie close to the line, meaning they have a smaller gender disparity. Other countries lie far away and have a large gender difference.</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for &#8216;intentional self-harm&#8217; in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country&#8217;s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to &#8220;events of undetermined intent&#8221;, accidents, homicides, or unknown causes. To account for this, the WHO&#8217;s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"https://ourworldindata.org/grapher/male-vs-female-suicide-who?xScale=log&amp;yScale=log\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Mental illnesses are a major risk factor for suicide</title>\n        <slug>mental-illnesses-are-a-major-risk-factor-for-suicide</slug>\n        <content>\n\n<p>There are many risk factors for suicide, including bullying, financial distress, and trauma.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a>{/ref}</p>\n\n\n\n<p>A large risk factor is mental illness, especially if it is not treated. On average, people who are diagnosed with a mental illness tend to have a higher risk of suicide.</p>\n\n\n\n<p>The chart shows estimates of the risk of suicide from a nationwide study in Denmark, using data from the entire population aged between 15 and 51.</p>\n\n\n\n<p>Around 2.1% of women and 4.3% of men who were diagnosed with a mental illness died by suicide, versus 0.3% of women and 0.7% of men without a mental illness.</p>\n\n\n\n<p>Importantly, the chart also shows that the vast majority of people \u2013 with or without a mental illness \u2013&nbsp;did not die by suicide.&nbsp;Even among those diagnosed with a mental illness, the risk of suicide can be reduced substantially with treatment.{ref}Mann, J. J., Michel, C. A., &amp; Auerbach, R. P. (2021). Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. <em>American Journal of Psychiatry</em>, <em>178</em>(7), 611\u2013624. <a href=\"https://doi.org/10.1176/appi.ajp.2020.20060864\">https://doi.org/10.1176/appi.ajp.2020.20060864</a><br>Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., H\u00f6schl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., S\u00e1iz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., &amp; Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. <em>The Lancet Psychiatry</em>, <em>3</em>(7), 646\u2013659. <a href=\"https://doi.org/10.1016/S2215-0366(16)30030-X\">https://doi.org/10.1016/S2215-0366(16)30030-X</a>{/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>This study uses data from the entire population of Denmark until the end of 2006.{ref}Nordentoft, M. (2011). Absolute Risk of Suicide After First Hospital Contact in Mental Disorder. Archives of General Psychiatry, 68(10), 1058. <a href=\"https://doi.org/10.1001/archgenpsychiatry.2011.113\">https://doi.org/10.1001/archgenpsychiatry.2011.113</a>{/ref} Since the study was published, the cumulative risk of suicide may have changed.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>The data included all diagnoses made in in-patient psychiatric hospitals and, from 1995 onwards, all out-patient clinics. The large sample size allows for precise estimates of the risks of suicide and how they relate to clinical diagnoses.</li></ul>\n\n\n\t</div>\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"651\" height=\"550\" src=\"https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png\" alt=\"\" class=\"wp-image-57555\" srcset=\"https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-651x550.png 651w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-400x338.png 400w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-150x127.png 150w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-768x649.png 768w, https://owid.cloud/app/uploads/2023/06/suicide-lifetime-risk-by-mental-illnessv2-1536x1297.png 1536w\" sizes=\"(max-width: 651px) 100vw, 651px\" /></figure>\n\n</content>\n\t</block>\n\n\t<block type=\"key-insight\">\n\t\t<title is-hidden=\"0\">Suicide rates may vary with age</title>\n        <slug>suicide-rates-rise-with-age</slug>\n        <content>\n\n<p>In some countries, such as the United States and Japan, you can see that suicide rates tend to be similar across age groups.</p>\n\n\n\n<p>However, in some other countries, such as South Korea and Portugal, you can see that suicide rates tend to be higher among older age groups.</p>\n\n\n\n<p>That suicide rates can be much higher among older people may sound surprising, because suicide is a leading <a href=\"https://ourworldindata.org/causes-of-death\">cause of death</a> in young people. But it is because deaths due to <em>other</em> causes tend to rise with age at a much faster rate than deaths by suicide.</p>\n\n\n\n<p>The rates of death from other causes such as cardiovascular disease, cancers, dementia, and respiratory diseases, rise steeply with age throughout the lifespan.</p>\n\n\n\n<p>However, the rates of deaths from suicides, accidents, and other &#8216;external causes&#8217; tend to rise steeply from childhood until adulthood.{ref}The shape of this age\u2013mortality curve is often described by the Gompertz function. Olshansky, S. J., &amp; Carnes, B. A. (1997). Ever since Gompertz. Demography, 34(1), 1-15. <a href=\"https://link.springer.com/content/pdf/10.2307/2061656.pdf\">https://link.springer.com/content/pdf/10.2307/2061656.pdf<br></a>Lleras-Muney, A., &amp; Moreau, F. (2022). A Unified Model of Cohort Mortality. Demography, 59(6), 2109\u20132134. <a href=\"https://doi.org/10.1215/00703370-10286336\">https://doi.org/10.1215/00703370-10286336</a>{/ref} After this, some countries show a continued rise in suicides with age, while others do not.{ref}Chen, Y.-Y., Yang, C.-T., Pinkney, E., &amp; Yip, P. S. F. (2021). The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. <em>Journal of Affective Disorders</em>, <em>295</em>, 587\u2013593. <a href=\"https://doi.org/10.1016/j.jad.2021.08.084\">https://doi.org/10.1016/j.jad.2021.08.084</a><br>Kino, S., Jang, S., Gero, K., Kato, S., &amp; Kawachi, I. (2019). Age, period, cohort trends of suicide in Japan and Korea (1986\u20132015): A tale of two countries. <em>Social Science &amp; Medicine</em>, <em>235</em>, 112385. <a href=\"https://doi.org/10.1016/j.socscimed.2019.112385\">https://doi.org/10.1016/j.socscimed.2019.112385</a><br>Mart\u00ednez-Al\u00e9s, G., Pamplin, J. R., Rutherford, C., Gimbrone, C., Kandula, S., Olfson, M., Gould, M. S., Shaman, J., &amp; Keyes, K. M. (2021). Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: Moderation by sex, race, and firearm involvement. <em>Molecular Psychiatry</em>, <em>26</em>(7), 3374\u20133382. <a href=\"https://doi.org/10.1038/s41380-021-01078-1\">https://doi.org/10.1038/s41380-021-01078-1</a><br>Odagiri, Y., Uchida, H., &amp; Nakano, M. (2011). Gender Differences in Age, Period, and Birth-Cohort Effects on the Suicide Mortality Rate in Japan, 1985-2006. <em>Asia Pacific Journal of Public Health</em>, <em>23</em>(4), 581\u2013587. <a href=\"https://doi.org/10.1177/1010539509348242\">https://doi.org/10.1177/1010539509348242</a><br>Wang, Z., Yu, C., Wang, J., Bao, J., Gao, X., &amp; Xiang, H. (2016). Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983\u20132012. <em>International Journal for Equity in Health</em>, <em>15</em>(1), 107. <a href=\"https://doi.org/10.1186/s12939-016-0400-2\">https://doi.org/10.1186/s12939-016-0400-2</a>{/ref}</p>\n\n\n\n<p>Differences between countries are likely to result from many factors, just as there are differences in the overall rates of suicide around the world. For example, they may result from differences in underlying mental health and treatment, personal and financial stress, restrictions on the means of suicide, recognition and awareness of suicide, and from changes over generations.{ref}Hawton, K. (2014). Suicide prevention: A complex global challenge. The Lancet Psychiatry, 1(1), 2\u20133. <a href=\"https://doi.org/10.1016/S2215-0366(14)70240-8\">https://doi.org/10.1016/S2215-0366(14)70240-8</a><br>Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. BMJ, l94. <a href=\"https://doi.org/10.1136/bmj.l94\">https://doi.org/10.1136/bmj.l94</a><br>Naghavi, M., Richards, N., Chowdhury, H., Eynstone-Hinkins, J., Franca, E., Hegnauer, M., Khosravi, A., Moran, L., Mikkelsen, L., &amp; Lopez, A. D. (2020). Improving the quality of cause of death data for public health policy: Are all \u2018garbage\u2019 codes equally problematic? BMC Medicine, 18(1), 55. <a href=\"https://doi.org/10.1186/s12916-020-01525-w\">https://doi.org/10.1186/s12916-020-01525-w</a><br>Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, H. T., Abebe, M., Abebe, Z., Abejie, A. N., Abera, S. F., Abil, O. Z., Abraha, H. N., \u2026 Murray, C. J. L. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1736\u20131788. <a href=\"https://doi.org/10.1016/S0140-6736(18)32203-7\">https://doi.org/10.1016/S0140-6736(18)32203-7</a><br>Li, Z., Page, A., Martin, G., &amp; Taylor, R. (2011). Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Social Science &amp; Medicine, 72(4), 608\u2013616. <a href=\"https://doi.org/10.1016/j.socscimed.2010.11.008\">https://doi.org/10.1016/j.socscimed.2010.11.008</a> {/ref}</p>\n\n\n\t<div class=\"wp-block-owid-technical-text\">\n\t\t\n\n<h5>What you should know about this data</h5>\n\n\n\n<ul><li>Suicide estimates come from death certificate data, using deaths that were classified under death codes for &#8216;intentional self-harm&#8217; in the International Classification of Diseases (ICD). This includes people who had self-harmed but had not intended to die, and they may not be considered suicides by the country&#8217;s particular legal definition.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>In many countries, deaths due to self-harm are highly underreported due to social stigma, cultural and legal concerns. Instead, these deaths are often misclassified in reported data, especially as deaths due to &#8220;events of undetermined intent&#8221;, accidents, homicides, or unknown causes. To account for this, the WHO&#8217;s Global Health Observatory reclassifies a proportion of deaths reported with those causes as suicides, according to the fraction that are estimated to be deaths by suicide. As a result, data on suicide rates represent a better estimate of how many people die from suicide.</li></ul>\n\n\n\n<p></p>\n\n\n\n<ul><li>Suicides may still be underestimated after this adjustment, especially if they are misclassified as other types of deaths.{ref}World Health Organization. (2020). WHO methods and data sources for country-level causes of death 2000-2019. <a href=\"https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5\">https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_cod_methods.pdf?sfvrsn=37bcfacc_5</a>{/ref} This can also be why some countries appear to have rising suicide rates, if the rates of misclassification decline.</li></ul>\n\n\n\t</div>\n\n\n<iframe src=\"/grapher/suicide-rates-by-age-detailed-who?uniformYAxis=0&amp;country=USA~JPN~KOR~PRT\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n</content>\n\t</block>\n</insights>\n\t</block>\n\n\t<block type=\"all-charts\"></block>",
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        "rendered": "Suicide rates can be reduced with greater understanding and support for people at risk.",
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