Worldwide suicide mortality trends (2000-2019): A joinpoint regression analysis

Abstract

Background: Studies exploring suicide mortality on a global scale are sparse, and most evaluations were limited to certain populations.

Aim: To assess global, regional and national trends of suicide mortality.

Methods: Suicide mortality data for the period 2000-2019 were obtained from the mortality database of the World Health Organization and the Global Burden of Disease Study. Age-standardized rates (ASRs; expressed per 100000) were presented. To assess trends of suicide mortality, joinpoint regression analysis was used: The average annual percent change (AAPC) with the corresponding 95% confidence interval (95%CI) was calculated.

Results: A total of 759028 (523883 male and 235145 female) suicide deaths were reported worldwide in 2019. The global ASR of mortality of suicide was 9.0/100000 population in both sexes (12.6 in males vs 5.4 in females). In both sexes, the highest rates were found in the region of Africa (ASR = 11.2), while the lowest rates were reported in Eastern Mediterranean (ASR = 6.4). Globally, from 2000 to 2019, ASRs of mortality of suicide had a decreasing tendency in both sexes together [AAPC = -2.4% per year; 95%CI: (-2.6)-(-2.3)]. The region of the Americas experienced a significant increase in suicide mortality over 2000-2019 unlike other regions that had a declining trend. Out of all 133 countries with a decline in suicide mortality, Barbados (AAPC = -10.0%), Grenada (AAPC = -8.5%), Serbia (AAPC = -7.6%), and Venezuela (AAPC = -6.2%) showed the most marked reduction in mortality rates. Out of all 26 countries with a rise in suicide mortality, Lesotho (AAPC = +6.0%), Cyprus (AAPC = +5.1%), Paraguay (AAPC = +3.0%), Saudi Arabia (AAPC = +2.8%), Brunei (AAPC = +2.6%), Greece (AAPC = +2.6%), Georgia (AAPC = +2.1%), and Mexico (AAPC = +2.0%), are among those with the highest increase in mortality.

Conclusion: Decreasing trends in suicide mortality were observed in most countries across the world. Unfortunately, the mortality of suicide showed an increasing trend in a number of populations. Further research should explore the reasons for these unfavorable trends, in order to consider and recommend more efforts for suicide prevention in these countries.

Keywords: Average annual percent change; Joinpoint analysis; Mortality; Suicide rates; Trends.

Figure 1

Global suicide deaths, 2000-2019. Source: World Health Organization[6] and Global Burden of Disease estimates[7].

Figure 2

Number of suicide (global and by World Health Organization regions), by sex, 2019. Source: World Health Organization[6] and Global Burden of Disease estimates[7].

Figure 3

Age-standardized suicide mortality rates (global and by World Health Organization regions), by sex, 2019. Source: World Health Organization[6] and Global Burden of Disease estimates[7].

Figure 4

Suicide mortality, by countries, 2019. ¹Country with the highest rates; ²Country with the lowest rate. A: Men; B: Women. Source: World Health Organization[6] and Global Burden of Disease estimates[7].

Figure 5

Joinpoint regression analysis of global suicide mortality. ¹Indicates that the Annual Percent Change is significantly different from zero at the alpha = 0.05 level. Final selected model: 2 joinpoints. A: Both sexes, 2019: 2 joinpoints; B: By sex, 2019: Men: 2 joinpoints vs women: 2 joinpoints. APC: Annual percent change. Source: World Health Organization[6] and Global Burden of Disease estimates[7].

Figure 6

Suicide mortality trends (World Health Organization regions), 2000-2019; a joinpoint analysis. ¹Statistically significant trend. A: In males; B: In females. APC: Annual percent change. Source: World Health Organization[6] and Global Burden of Disease estimates[7].