Yip Paul Siu Fai, Zheng Yan, Wong Clifford
HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, People's Republic of China
The School of Nursing, The Hong Kong Polytechnic University, Kowloon, People's Republic of China.
Inj Prev. 2022 Apr;28(2):117-124. doi: 10.1136/injuryprev-2021-044263. Epub 2021 Aug 16.
Suicide presents an ongoing public health challenge internationally. Nearly 800 000 people around the world lose their life to suicide every year, and many more attempt suicide.
A decomposition analysis was performed using global suicide mortality and population data from the Global Burden of Disease Study 2019.
Despite a significant decrease in age-specific suicide rate between 1990 and 2019 (-4.01; from 13.8% to 9.8% per 100 000), the overall numbers of suicide deaths increased by 19 897 (from 738 799 to 758 696) in the same time period. The reductions in age-specific suicide rates (-6.09; 152%) contributed to the overall reductions in suicide rates; however, this was offset by overtime changes in population age structure (2.08; -52%). The increase in suicide numbers was partly attributable to population growth (300 942; 1512.5%) and population age structure (189 512; 952.4%), which was attenuated by the significant reduction in overall suicide rates (-470 556; 2364.9%). The combined effect of these factors varied across the World Bank income level regions. For example, in the upper-middle-income level region, the effect of the reduction in age-specific suicide rates (-289 731; -1456.1%) exceeded the effect of population age structure (124 577; 626.1%) and population growth (83 855; 421.4%), resulting in its substantial decline in total suicide deaths (-81 298; -408.6%). However, in lower-middle income region, there was a notable increase in suicide death (72 550; 364.6%), which was related to the net gain of the reduction in age-specific suicide rates (-115 577; -580.9%) and negated by the increase in the number of suicide deaths due to population growth (152 093; 764.4%) and population age structure (36 034; 181.1%).
More support and resources should be deployed for suicide prevention to the low-income and middle-income regions in order to achieve the reduction goal. Moreover, suicide prevention among older adults is increasingly critical given the world's rapidly ageing populations in all income level regions.
自杀是一项持续存在的全球性公共卫生挑战。全球每年有近80万人死于自杀，还有更多人尝试自杀。
利用《2019年全球疾病负担研究》中的全球自杀死亡率和人口数据进行分解分析。
尽管1990年至2019年间特定年龄自杀率显著下降（-4.01；从每10万人中的13.8%降至9.8%），但同期自杀死亡总数增加了19897人（从738799人增至758696人）。特定年龄自杀率的下降（-6.09；152%）有助于总体自杀率的降低；然而，这被人口年龄结构的长期变化（2.08；-52%）所抵消。自杀人数的增加部分归因于人口增长（300942人；1512.5%）和人口年龄结构（189512人；952.4%），而总体自杀率的显著下降（-470556人；2364.9%）则减弱了这种影响。这些因素的综合影响在世界银行不同收入水平区域有所不同。例如，在中高收入水平区域，特定年龄自杀率下降的影响（-289731人；-1456.1%）超过了人口年龄结构（124577人；626.1%）和人口增长（83855人；421.4%）的影响，导致自杀死亡总数大幅下降（-81298人；-408.6%）。然而，在低收入区域，自杀死亡人数显著增加（72550人；364.6%），这与特定年龄自杀率下降的净效应（-115577人；-580.9%）有关，并被人口增长（152093人；764.4%）和人口年龄结构（36034人；181.1%）导致的自杀死亡人数增加所抵消。
应向低收入和中等收入地区投入更多支持和资源用于自杀预防，以实现降低自杀率的目标。此外，鉴于所有收入水平区域的全球人口迅速老龄化，老年人的自杀预防日益关键。
