Centre for Surveillance and Applied Research (Liu, Capaldi, Orpana, Tonmyr), Public Health Agency of Canada; School of Epidemiology and Public Health (Orpana), University of Ottawa, Ottawa, Ont.; Luskin School of Public Affairs (Kaplan), University of California, Los Angeles, Calif.; Department of Sociology and Anthropology (Tonmyr), Carleton University, Ottawa, Ont.
CMAJ. 2021 Mar 8;193(10):E331-E338. doi: 10.1503/cmaj.202378.
Ongoing surveillance of the means of suicide is necessary for effective prevention. We examined how mortality rates owing to different means of suicide changed in Canada from 1981 to 2018.
We obtained data from 1981 to 2018 on suicide deaths of individuals aged 10 years and older, from the Canadian Vital Statistics Death Database. We used joinpoint regression analysis to examine changes over time in the suicide mortality rate for the 3 most common means of suicide.
The age-standardized suicide mortality rate declined in earlier decades for both sexes, but did not significantly change in recent decades for either sex. The age-standardized rate of suicide by suffocation increased from 1993 for females (2.1% per year) and from 1996 for males (0.4% per year). The age-standardized rate of suicide by poisoning decreased for females (2.2% per year) and males (2.1% per year) from 1981 to 2018. The age-standardized rate of suicide by firearm decreased from 1981 to 2008 (7.4% per year) but did not significantly change there-after for females; for males, it decreased 2.1% per year from 1981 to 1993 and 5.7% per year from 1993 to 2007, but did not significantly change thereafter.
For both sexes, the rate of suicide by poisoning is decreasing, the rate of suicide by suffocation is increasing, and the rate of suicide by firearm has not significantly changed in the last decade. Given the high proportion of suicide deaths by suffocation, its increasing rate and the difficulty of restricting the means of suffocation, other approaches to suicide prevention are needed.
持续监测自杀手段对于有效预防自杀至关重要。我们研究了 1981 年至 2018 年加拿大不同自杀手段导致的死亡率变化情况。
我们从加拿大生命统计死亡数据库获取了 1981 年至 2018 年 10 岁及以上人群自杀死亡的数据。我们使用 joinpoint 回归分析，研究了三种最常见自杀手段的自杀死亡率随时间的变化情况。
在过去几十年中，两性的标准化自杀死亡率都呈下降趋势，但在最近几十年中，两性的标准化自杀死亡率均未发生显著变化。女性通过窒息自杀的标准化死亡率从 1993 年开始上升（每年 2.1%），男性从 1996 年开始上升（每年 0.4%）。女性（每年 2.2%）和男性（每年 2.1%）通过中毒自杀的标准化死亡率从 1981 年下降到 2018 年。女性通过枪支自杀的标准化死亡率从 1981 年到 2008 年下降（每年 7.4%），但此后并未显著变化；男性从 1981 年到 1993 年每年下降 2.1%，从 1993 年到 2007 年每年下降 5.7%，此后未再显著变化。
在过去几十年中，两性通过中毒自杀的比率呈下降趋势，通过窒息自杀的比率呈上升趋势，通过枪支自杀的比率在过去十年中未发生显著变化。鉴于窒息自杀的死亡比例较高，其上升速度以及限制窒息手段的难度，需要采取其他自杀预防方法。
