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SUICIDE
The number of deaths in Australia attributed to suicide rose from 2,197 in 1988 to 2,723 in 1997, an increase of 24% over the 10 year period (table 9.3). In 1988, suicide accounted for about 12.8% of all deaths and ranked as the sixth leading cause of all deaths. In 1997, suicide ranked as the seventh leading cause of all deaths, but it ranked fourth in terms of the years of potential life lost before the age of 76 years.
Suicides, for statistical purposes, are defined as those deaths classified to 'suicide and self-inflicted injuries' by the Supplementary Classification of the Ninth Revision of the International Classification of Diseases. The actual number of suicides is thought to be higher than the number of registered suicides, because the true intention of some deaths is difficult to determine. When there is a doubt about the intention of death, suicides could be misclassified to other causes of death categories (i.e. natural cause, accident or undetermined whether accidentally or intentionally inflicted). The coroners may be reluctant to give a verdict of suicide because of the social stigma attached to suicides and the socioeconomic and emotional implications it could have on families of the victims. The extent of under-reporting of suicide is, however, difficult to assess accurately.
The age-standardised death rate for suicide rose from 13.4 deaths per 100,000 population in 1988 to 14.6 per 100,000 population in 1997, a 9% increase over the 10-year period. Between 1988 and 1996 the overall suicide death rate was relatively stable at 12 to 13 deaths per 100,000 population, but it then increased by 12% to 14.6 in 1997.
The trend in the overall death rate from suicide reflects the underlying trend in male suicide deaths, which generally account for over three-quarters of the total number of suicides each year.
Trends by age
The suicide death rate varied by age (table 9.4). Although age-specific suicide rates fluctuated from year to year, a strong age-related pattern can be identified for men. Suicide death rates commenced at a peak in young adulthood, followed by a decline, with a second peak registering at older ages. From the early 1990s, the suicide death rate for younger adult males has been higher than the second peak, which occurred for men aged 65 years and over. By comparison, women aged 65 years and over have a lower suicide death rate than women in any other age group.
9.3 DEATHS BY SUICIDE IN AUSTRALIA - 1988-97
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Suicides
| Age-standardised death rate per 100,000
population(a)
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| Males | Females | Total | Males | Females | Persons | Sex ratio
(male death rate/ female death rate) |
Year | no. | no. | no. | rate | rate | rate | ratio |
|
1988 | 1,730 | 467 | 2,197 | 21.5 | 5.6 | 13.4 | 3.8 |
1989 | 1,658 | 438 | 2,096 | 20.1 | 5.2 | 12.5 | 3.6 |
1990 | 1,735 | 426 | 2,161 | 20.7 | 4.9 | 12.7 | 4.0 |
1991 | 1,847 | 513 | 2,360 | 21.7 | 5.9 | 13.7 | 4.4 |
1992 | 1,820 | 474 | 2,294 | 21.1 | 5.3 | 13.1 | 3.6 |
1993 | 1,687 | 394 | 2,081 | 19.3 | 4.3 | 11.7 | 3.6 |
1994 | 1,830 | 428 | 2,258 | 20.7 | 4.7 | 12.6 | 4.8 |
1995 | 1,873 | 495 | 2,368 | 20.9 | 5.4 | 13.0 | 4.4 |
1996 | 1,931 | 462 | 2,393 | 21.3 | 4.9 | 13.0 | 3.9 |
1997 | 2,146 | 577 | 2,723 | 23.4 | 6.1 | 14.6 | 3.8 |
(a) Standardised death rates enable a comparison of death rates between populations with different age structures by relating them to a standard population, in this case all persons in the 1991 Australian population. They are expressed per 100,000 persons.
Source: Mortality data file.
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9.4 AGE-SPECIFIC SUICIDE RATES PER 100,000 POPULATION(a), By Sex - 1988-97
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| Age group (years)
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| 15-24 | 25-34 | 35-44 | 45-54 | 55-64 | 65+ | All ages(b) |
| rate | rate | rate | rate | rate | rate | rate |
MALES
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1988 | 27.9 | 28.3 | 26.0 | 24.4 | 23.8 | 31.9 | 21.0 |
1989 | 23.9 | 30.0 | 22.4 | 23.9 | 22.8 | 29.5 | 19.8 |
1990 | 27.0 | 29.1 | 25.4 | 21.4 | 24.8 | 28.2 | 20.4 |
1991 | 26.7 | 29.9 | 30.3 | 26.1 | 21.3 | 28.1 | 21.4 |
1992 | 27.0 | 30.4 | 24.9 | 25.8 | 23.1 | 28.4 | 20.9 |
1993 | 24.7 | 28.7 | 21.4 | 23.5 | 22.9 | 25.8 | 19.2 |
1994 | 27.0 | 29.2 | 26.1 | 24.7 | 23.1 | 26.6 | 20.6 |
1995 | 25.4 | 33.4 | 27.8 | 23.9 | 23.3 | 22.9 | 20.8 |
1996 | 25.7 | 32.5 | 29.4 | 22.7 | 23.4 | 25.9 | 21.2 |
1997 | 30.6 | 37.5 | 30.2 | 24.4 | 22.6 | 28.3 | 23.3 |
FEMALES
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1988 | 4.5 | 7.1 | 7.5 | 8.2 | 8.7 | 1.1 | 5.6 |
1989 | 3.4 | 6.9 | 6.7 | 7.1 | 8.5 | 1.1 | 5.2 |
1990 | 4.4 | 7.0 | 5.9 | 6.8 | 6.2 | 1.0 | 5.0 |
1991 | 6.3 | 7.4 | 7.4 | 7.8 | 10.0 | 0.9 | 5.9 |
1992 | 5.7 | 7.1 | 7.2 | 6.4 | 7.1 | 1.0 | 5.4 |
1993 | 4.1 | 5.5 | 6.0 | 7.1 | 5.0 | 0.8 | 4.4 |
1994 | 4.3 | 6.0 | 7.3 | 6.5 | 6.3 | 0.8 | 4.8 |
1995 | 6.4 | 7.0 | 7.5 | 8.1 | 6.6 | 0.8 | 5.5 |
1996 | 4.3 | 6.7 | 7.8 | 7.7 | 5.2 | 0.7 | 5.0 |
1997 | 7.1 | 8.0 | 8.5 | 8.2 | 7.2 | 0.9 | 6.2 |
PERSONS
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1988 | 16.4 | 17.8 | 16.9 | 16.6 | 16.3 | 18.4 | 13.3 |
1989 | 13.8 | 18.5 | 14.6 | 15.7 | 15.7 | 17.5 | 12.5 |
1990 | 15.9 | 18.1 | 15.7 | 14.3 | 15.5 | 16.7 | 12.7 |
1991 | 16.7 | 18.7 | 18.9 | 17.2 | 15.7 | 16.2 | 13.7 |
1992 | 16.5 | 18.7 | 16.1 | 16.3 | 15.1 | 16.5 | 13.1 |
1993 | 14.6 | 17.1 | 13.7 | 15.4 | 14.0 | 14.6 | 11.8 |
1994 | 15.9 | 17.6 | 16.7 | 15.8 | 14.7 | 14.8 | 12.6 |
1995 | 16.1 | 20.2 | 17.6 | 16.1 | 15.0 | 13.2 | 13.1 |
1996 | 15.2 | 19.6 | 18.6 | 15.3 | 14.4 | 14.2 | 13.1 |
1997 | 19.1 | 22.8 | 19.3 | 16.4 | 14.9 | 16.3 | 14.7 |
(a) Of the relevant age group.
(b) Including 10-14 year olds.
Source: Mortality data file.
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The overall suicide rates were relatively stable from 1988 until 1996, followed by a peak in 1997. For both males and females, there was an increase in the suicide rate among adolescents and young adults, but a fall in the suicide rate for people aged 55 years and over. In 1997, the suicide rate in each of the age groups under 45 was the highest during the 10-year period for both males and females.
The shift in suicide death rates from older to younger age groups has considerable implications for public health policy, as currently more than 50% of all suicides occur among people under 35 years of age, and this proportion is rising steadily. Although evident in both sexes, the rise in the suicide death rate among younger males was more marked than among females.
Pattern by gender
The suicide death rate among females was considerably lower than for males. Throughout the reference period, the death rate from suicide for males was 4 to 5 times the rate for females (table 9.4). This pattern was observed in every age group. Although the completed suicide rate is lower for females, suicide attempts are more common among females than males. Much of the difference in the death rate is attributed to the relative effectiveness of the methods of suicide employed by males and females.
Methods of suicide
In 1988, firearms were the most frequently reported method of suicide, accounting for nearly a quarter of all suicides (table 9.5) closely followed by hanging and strangulation. Poisoning by other gases and vapours (mainly carbon monoxide poisoning by car fumes), and poisoning by solid or liquid substances, each accounted for slightly less than one-fifth of all suicides. The method of suicide changed substantially during the 10-year period. The proportion of suicides due to firearms declined sharply, while that from hanging and strangulation increased. As a result, in 1997 the latter emerged as the most commonly reported method of suicide, accounting for over one-third of all suicides. The proportion of suicides by carbon monoxide poisoning also increased and accounted for almost one-quarter of all suicides, while poisoning by solid and liquid substances, and use of firearms, had both declined relatively, each accounting for approximately 12% of all suicides in 1997.
The method of suicide varied by sex. Males employed more violent and effective methods such as firearms and hanging. For females, in 1988 the most common method reported was poisoning by solid and liquid substances. In 1997, however, females had shown a tendency to greater use of methods such as hanging and carbon monoxide poisoning. The decrease in the proportion of suicide deaths among females due to poisoning by solid and liquid substances (from 40% to 27%) may be partly attributed to increased safety of prescription medications, and their restricted availability, together with improved resuscitation and life-saving techniques, rather than a substantial decline in suicide attempts using this method.
9.5 LEADING METHODS OF SUICIDE, By Sex - 1988 and 1997
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| 1988
| 1997
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| Males | Females | Persons | Males | Females | Persons |
| % | % | % | % | % | % |
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Poisoning by solid and liquid substances
| 12.2 | 40.0 | 18.1 | 8.9 | 27.2 | 12.7 |
Other gases and vapours (carbon monoxide)
| 20.7 | 14.5 | 19.4 | 24.2 | 18.7 | 23.1 |
Hanging and strangulation
| 24.5 | 19.5 | 23.4 | 37.8 | 30.3 | 36.2 |
| 28.3 | 6.9 | 23.7 | 14.4 | 3.6 | 12.2 |
Other unspecified methods
| 5.6 | 6.2 | 5.7 | 6.6 | 6.8 | 6.6 |
| 8.7 | 12.9 | 9.7 | 8.1 | 13.4 | 9.2 |
| 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 |
| no. | no. | no. | no. | no. | no. |
| 1,730 | 467 | 2,197 | 2,146 | 577 | 2,723 |
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Source: Mortality data file.
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