Global Health Estimates
Global Health Estimates
WHO/MSD/MER/19.3
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Acknowledgements 06
Introduction 07
Data sources 08
Global epidemiology of suicide 09 Regional epidemiology of suicide 13 Changes in suicide rates over time 15
Data quality 16
Conclusions 16
References 17
Annex 18
Contents
Acknowledgements
Conceptualization and guidance
Dévora Kestel (WHO), Mark van Ommeren (WHO) Project coordination and editing
Alexandra Fleischmann (WHO), Aiysha Malik (WHO), Alison Brunier (WHO)
Global Health Estimates and maps
Colin Mathers (WHO), Gretchen A. Stevens (WHO), Jessica Ho (WHO), Wahyu Retno Mahanani (WHO), Doris Ma Fat (WHO), Dan Hogan (WHO),
Elise Paul (WHO ), Florence Rusciano (WHO),
Zoe Brillantes (WHO)
Introduction
Suicide is a serious global public health issue.
It is among the top twenty leading causes of death worldwide, with more deaths due to suicide than to malaria, breast cancer, or war and homicide. Close to 800 000 people die by suicide every year.
The reduction of suicide mortality has been
prioritized by the World Health Organization (WHO) as a global target and included as an indicator in the United Nations Sustainable Development Goals (SDGs) under target 3.4 (see Box 1), the WHO 13th General Programme of Work 2019-2023
1and the WHO Mental Health Action Plan 2013-2030.
2A comprehensive and coordinated response to suicide prevention is critical to ensure that the tragedy of suicide does not continue to cost lives and affect many millions of people through the loss of loved ones or suicide attempts.
The timely registration and regular monitoring of suicide form the backbone of effective national suicide prevention strategies (WHO, 2014). In order to identify specific groups at risk for suicide, it is important for countries to use disaggregated rates by sex, age, and method.
Doing so provides essential information for understanding the scope of the problem so that interventions can be tailored to meet the needs of specific populations and to adjust to trends.
UN SDG Target 3.4 By 2030, reduce by one third premature mortality from
non-communicable diseases through prevention and treatment and
promote mental health and well-being Indicator 3.4.2.
Suicide mortality rate Box 1.
1
See: https://apps.who.int/iris/bitstream/handle/10665/324775/WHO-PRP-18.1-eng.pdf (accessed 23 August 2019).
2
See: https://www.who.int/mental_health/publications/action_plan/en (accessed 23 August 2019).
This booklet presents the most recent available suicide mortality data from the WHO Global Health Estimates for the year 2016 and trend from 2000.
3To facilitate comparisons across countries, rates are age-standardized according to the WHO World Standard Population
4which assumes one standard age distribution of the population in all countries.
Data are presented at the global and regional level, by age and sex, as well as over time.
Country-specific estimates are provided in the Annex. Estimates are calculated using mortality data reported by countries to the WHO Mortality Database
5as the key input data. Full details of the methods and data sources used as well as the data and analyses can be found on the WHO Global Health Estimates website.
6Data sources
Global epidemiology of suicide
The global age-standardized suicide rate was 10.5 per 100 000 population for 2016. Rates varied between countries from less than 5 deaths by suicide per 100 000, to over 30 per 100 000 (Figure 1).
Figure 1. Age-standardized suicide rates (per 100 000 population), both sexes, 2016
The global age-standardized suicide rate was higher in males (13.7 per 100 000) than in females (7.5 per 100 000) (Figures 2 and 3). While for females, the highest rates in countries were above 30 per 100 000 (Figure 2), for males they were above 45 per 100 000 (Figure 3).
Figure 2. Age-standardized suicide rates (per 100 000 population), females, 2016
0 850 1,700 3,400Kilometers
Suicide rate (per 100 000 population)
<5.0 5.0–9.9 10.0–14.9
≥15.0
Data not available Not applicable
0 850 1,700 3,400Kilometers
Suicide rates (per 100 000 population)
<5.0 5.0–9.9 10.0–14.9
≥15.0
Data not available Not applicable
Figure 3. Age-standardized suicide rates (per 100 000 population), males, 2016
Figure 4. Male:female ratio of age-standardized suicide rates, 2016
Globally, the age-standardized suicide rate was 1.8 times higher in males than in females. Male:female (M:F) suicide ratios greater than 1 indicate that suicide rates are higher in males than in females. While the M:F ratio is close to 3 in high-income countries (i.e. the rates are three times higher in males), the ratio was more equal in low- and middle-income countries. The only countries where the suicide rate was estimated to be higher in females than in males were Bangladesh, China, Lesotho, Morocco, and Myanmar (Figure 4).
0 850 1,700 3,400Kilometers
Suicide rate (per 100 000 population)
<5.0 5.0–9.9 10.0–14.9
=15.0
Data not available Not applicable
0 850 1,700 3,400Kilometers
Male:Female ratio
<1.0 1.0–1.9 2.0–2.9 3.0–3.9
≥4.0
Data not available Not applicable
Figure 5. Global suicides, by age and country income level* (thousands), 2016
Globally, the majority of deaths by suicide occurred in low-and-middle-income countries (79%), where most of the world's population lives (84%) (Figure 5). Regarding age, more than half (52.1%) of global suicides occurred before the age of 45 years. Most adolescents who died by suicide (90%) were from low- and middle-income countries where nearly 90% of the world’s adolescents live.
* World Bank income groups, 2017
Age groups (years)
Figure 6. Top three causes of death, ages 15-29 years, 2016
Suicide was the second leading cause of death in young people aged 15-29 years for both sexes, after road
injury (Figure 6). More deaths were due to suicide in this age group than to interpersonal violence. For females
and males, respectively, suicide was the second and third leading cause of death in this age group.
Figure 7. Top three causes of death, ages 15-19 years, 2016
Suicide was the third leading cause of death in 15-19-year-olds for both sexes, with the number of deaths
relatively similar between males and females in this age group. Suicide was the second leading cause of
death in 15-19-year-old girls (after maternal conditions) and the third leading cause of death in males (after
road injury and interpersonal violence) in this age group (Figure 7).
Figure 8. Age-standardized suicide rates (per 100 000 population) by WHO region, 2016
Regional epidemiology of suicide
Differences in age-standardized suicide rates can be seen across WHO regions (Figure 8). Suicide rates in the African (12.0 per 100 000), European (12.9 per 100 000), and South-East Asia (13.4 per 100 000) regions were higher than the global average (10.5 per 100 000) in 2016. The lowest suicide rate was in the Eastern Mediterranean region (4.3 per 100 000).
The South-East Asia Region had a much higher female age-standardized suicide rate (11.5 per 100 000)
compared to the global female average (7.5 per 100 000). In males, the regions of Africa (16.6 per 100 000), the
Americas (14.5 per 100 000), South-East Asia (15.4 per 100,000), and especially Europe (21.2 per 100,000), all
had suicide rates which were higher than the global male average (13.7 per 100 000).
While most of the world’s suicides occurred in low-and-middle-income countries (79%), high-income countries had the highest age-standardized suicide rate (11.5 per 100 000). Lower-middle-income countries had a slightly lower rate (11.4 per 100 000), and low-income and upper-middle-income countries had lower rates (10.8 per 100 000 and 9.0 per 100 000 respectively). Females in lower-middle-income countries had the highest suicide rate (9.1 per 100 000) compared to females in other income level groupings. Males in high-income countries had the highest rate (17.2 per 100 000) as compared to males in other income level groupings (Figure 9).
Figure 9. Age-standardized suicide rates (per 100 000 population) by income level*, 2016
* World Bank income groups, 2017
Changes in suicide rates over time
In the six years between 2010 and 2016, the global age-standardized suicide rate decreased by 9.8%, with decreases ranging from 19.6% in the Western Pacific Region to 4.2% in the South-East Asia Region.
The only increase in age-standardized suicide rates was in the Region of the Americas with an increase of 6.0% in the same time-period (Figure 10).
Figure 10. Age-standardized suicide rates (per 100 000 population)
over time by WHO region, both sexes
Data quality Conclusions
Of the 183 WHO Member States for which estimates were made for the year 2016, close to 80 had good- quality vital registration data. Modelling methods were required to generate estimates for the majority of remaining countries, which were mostly low-and middle-income.
As the majority of suicides are estimated to occur in low- and middle-income countries, good quality vital registration data are urgently needed in these settings. Improving the surveillance of suicide is important in order to inform planning and evaluation in countries, and to accurately assess progress towards global suicide mortality targets.
The suicide mortality data presented in this
booklet underscore the imperative that urgent action is needed to prevent suicide. Suicide is a global public health issue. All ages, sexes, and regions of the world are affected. Each item of data here represents a life that has been lost to suicide; each loss is one too many.
Overall, the global age-standardized suicide rate
is somewhat in decline, but this is not observed
in all countries around the world. Should the
decline continue at its current rate, global targets
to reduce suicide mortality will not be met. Lives
will be lost, while suicides are preventable. Further
action and strengthening of ongoing efforts in the
implementation of key effective suicide prevention
interventions (i.e. restricting access to means of
suicide, interaction with the media for responsible
reporting, training young people in their life skills,
and early identification, management and follow-up)
as described in the LIVE LIFE strategy (WHO, 2018)
are crucially needed, to save lives lost to this serious
public health issue.
References
World Health Organization (2018). Global Health Estimates 2016: Deaths by cause, age, sex, by country and by region, 2000-2016. World Health Organization, Geneva.
World Health Organization (2018). National suicide prevention strategies: progress, examples and indicators. World Health Organization, Geneva.
World Health Organization (2014). Preventing suicide:
a global imperative. World Health Organization,
Geneva.
WHO African Region
Country Data
quality
1WHO
Region Income
Group
2Sex Number of suicides, all ages, 2016
Crude suicide rates, all ages (per 100 000), 2016
Age-standardized suicide rates, all ages (per 100 000), 2016
Algeria 4 AFR UMI
both sexes 1299 3.2 3.3
females 339 1.7 1.8
males 960 4.7 4.9
Angola 4 AFR LMI
both sexes 1347 4.7 8.9
females 362 2.5 4.6
males 984 7.0 14.0
Benin 4 AFR LI
both sexes 1077 9.9 15.7
females 324 5.9 9.6
males 754 13.9 22.6
Botswana 4 AFR UMI
both sexes 209 9.3 11.5
females 51 4.5 5.7
males 158 14.2 18.3
Burkina Faso 4 AFR LI
both sexes 1442 7.7 14.8
females 498 5.3 9.1
males 944 10.2 22.4
Burundi 4 AFR LI
both sexes 956 9.1 15.0
females 262 4.9 7.7
males 694 13.4 23.1
Cabo Verde 3 AFR LMI
both sexes 61 11.3 15.1
females 16 6.1 7.7
males 44 16.5 24.1
Cameroon 4 AFR LMI
both sexes 2867 12.2 19.5
females 864 7.4 12.5
males 2003 17.1 26.9
Annex
1