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SUICIDE MORTALITY IN INDIA. Vikram Patel, Chinthanie Ramasundarahettige, Lakshmi Vijayakumar, JS Thakur, Vendhan Gajalakshmi, Gopalkrishnan Gururaj, Wilson Suraweera, and Prabhat Jha, for the Million Death Study Collaborators, and in partnership with
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SUICIDE MORTALITY IN INDIA Vikram Patel, Chinthanie Ramasundarahettige, Lakshmi Vijayakumar, JS Thakur, Vendhan Gajalakshmi, Gopalkrishnan Gururaj, Wilson Suraweera, and Prabhat Jha, for the Million Death Study Collaborators, and in partnership with Centre for Global Health Research (Toronto, Canada) Prabhat.jha@utoronto.ca
Key findings About 0.2 million deaths at ages 15 years and older in 2010 were due to suicide. 54% of female and 40% of male suicides occurred at ages 15-29 years. A 15 year old south Indian male had a 3.5% risk of dying from suicide before reaching 80 years, in the absence of the other causes. About half of suicide deaths were due to poisoning. Age standardised suicide death rates at ages 15 years and older were two fold higher in rural areas than urban areas. Suicide death rates vary markedly between states. CGHR.ORG/SUICIDETwitter: CGHR_org
What’s new about this research? • Previous suicide estimates have used the National Crime Records Bureau numbers, which are based on police reports • These data could under-report suicide, as attempted suicide is a crime in India • The Million Death Study provides direct suicide estimates by age, gender, area and method of suicide from a nationally representative sample. CGHR.ORG/SUICIDETwitter: CGHR_org
Crude suicide death rate based on NCRB data CGHR.ORG/SUICIDETwitter: CGHR_org Year
How was the study done? • Nationally representative sample (Sample Registration System) • 6,671 of these small areas randomly chosen from all parts of India (each with about 1000 people per area) CGHR.ORG/SUICIDETwitter: CGHR_org
How was the study done? 800 Registrar General of India field workers interviewed 122 thousand families of people who had died in 2001-2003 Written reports each coded independently by at least two physicians to attribute a probable cause of death (i.e., suicide) Calculated proportion of all suicide deaths by age, gender, and area within the study CGHR.ORG/SUICIDETwitter: CGHR_org
How was the study done? Combined with national 2010 UN totals of deaths, and 2007-2009 state-specific SRS death rates Produced national and state estimates of rates and number of suicide deaths for 2010 CGHR.ORG/SUICIDETwitter: CGHR_org
Age specific suicide death rates in India and in high-income countries - Men Age standardised suicide death rate at ages 15 years or older (99%CI) India 26.3 (24.5, 28.0) High income 21.8 (21.6, 22.0)
Age specific suicide death rates in India and in high-income countries - Women Age standardised suicide death rate at ages 15 years or older (99%CI) India 17.6 (16.1, 19.0) High income 6.8 (6.7, 6.9)
Risk of suicide is high among Indians CGHR.ORG/SUICIDETwitter: CGHR_org
Risk of suicide deaths for men and women aged 15 years and above
Estimated suicide deaths by different regions CGHR.ORG/SUICIDETwitter: CGHR_org
Risk of death from Suicide For Indians aged 15 years, the risk of dying before age 80 in the absence of other diseases: 17 of 1000 men will die of suicide 10 of 1000 women will die of suicide CGHR.ORG/SUICIDETwitter: CGHR_org Source: Dikshit et al, Lancet 2012
Suicide death rates for selected states- aged 15 years or older CGHR.ORG/SUICIDETwitter: CGHR_org
Method of suicide among Indian men – aged 15 years or older Drowning (T=4, ASR=0.8) Other (T=8.8, ASR=2.0) Burns (T=5, ASR=1.1) 8% 4% 4% Poisoning (T=60.2, ASR=13.8) 49% 35% Hanging (T=37, ASR=8.3) T = estimated suicide deaths in 1000, ASR = age standardised suicide death rate per 100,000 CGHR.ORG/SUICIDETwitter: CGHR_org
Method of suicide among Indian women – aged 15 years or older Other (T=5, ASR=1.2) Poisoning (T=31.5, ASR=7.9) Drowning (T=5.4, ASR=1.3) 7% 8% Burns (T=13.4, ASR=3.3) 15% 44% 26% Hanging (T=17,ASR=4.2) T = estimated suicide deaths in 1000, ASR = age standardised suicide death rate per 100,000 CGHR.ORG/SUICIDETwitter: CGHR_org
Significant risk factors for suicide -Men aged 15 to 69 years CGHR.ORG/SUICIDETwitter: CGHR_org
Significant risk factors for suicide - Women aged 15 to 69 years CGHR.ORG/SUICIDETwitter: CGHR_org
CONCLUSIONS • Large proportion of suicide deaths occur between the ages of15 to 29 years. • Many suicide death might be prevented by: - restricting access to pesticides - providing community or support services - providing easy access to services for mental illness associated with suicide - reducing binge alcohol drinking through higher taxation on alcohol CGHR.ORG/SUICIDETwitter: CGHR_org