CGHR.ORG/SUICIDE Twitter: CGHR_org 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) [email protected]
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 - PowerPoint PPT Presentation
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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)
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Risk of suicide is high among Indians
Cumulative risk of suicide (%)
Country Male Female
India (2010) 1.7 1.0
US (2004-07) 1.6 0.5
Canada (2004-07) 1.2 0.4
UK (2004-07) 0.5 0.2
CGHR.ORG/SUICIDETwitter: CGHR_org
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Risk of suicide is higher in rural and southern India
Region
Male Female
Rural 2.05 1.08
Urban 0.81 0.60
South India 3.51 1.76
Rest of India 1.16 0.70
Total 1.69 0.96
Percentage probability of death of a 15 year old person before
reaching 80 years
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Risk of suicide deaths for men and women aged 15 years and above
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Estimated suicide deaths by different regions
Region
Rural 95.1 (31.5) 57.8 (20.4)
Urban 19.7 (14.4) 14.3 (12.0)
South India 50.6 (52.9) 29.5 (32.2)
Rest of India 64.2 (18.7) 42.6 (13.3)
Total 114.8 (26.3) 72.1 (17.5)
Male Female
Estimated suicide deaths x1000 (age standardised suicide death rate per 100,000)
CGHR.ORG/SUICIDETwitter: CGHR_org
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17 of 1000 men will die of suicide
10 of 1000 women will die of suicide
Risk of death from Suicide
For Indians aged 15 years, the risk of dying before age 80 in the absence of other diseases:
Source: Dikshit et al, Lancet 2012CGHR.ORG/SUICIDETwitter: CGHR_org
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Suicide death rates for selected states- aged 15 years or older
CGHR.ORG/SUICIDETwitter: CGHR_org
0
10
20
30
40
50
60
70
Kerala AndhraPradesh
Delhi Bihar &Jharkhand
India
Ag
e st
and
ard
ised
su
icid
e d
eath
rat
e p
er 1
00,0
00
Men Women
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Method of suicide among Indian men – aged 15 years or older
CGHR.ORG/SUICIDETwitter: CGHR_org
Poisoning (T=60.2, ASR=13.8)
Other (T=8.8, ASR=2.0)
Drowning (T=4, ASR=0.8)
Burns (T=5, ASR=1.1)
Hanging (T=37, ASR=8.3)
49%
8%4%
4%
35%
T = estimated suicide deaths in 1000,
ASR = age standardised suicide death rate per 100,000
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Method of suicide among Indian women – aged 15 years or older
CGHR.ORG/SUICIDETwitter: CGHR_org
Poisoning (T=31.5, ASR=7.9)
Other (T=5, ASR=1.2)
Drowning (T=5.4, ASR=1.3)
Burns (T=13.4, ASR=3.3)
Hanging (T=17,ASR=4.2)
44%
7%8%
15%
26%
T = estimated suicide deaths in 1000,ASR = age standardised suicide death rate per 100,000
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Significant risk factors for suicide -Men aged 15 to 69 years
Education
Secondary or higher 1•43 (1•1 - 1•8)
Primary or middle 1•60 (1•4 - 1•9)
Below primary 1•00 --
Region
Southern 2•68 (2•3 - 3•1)
Rest of India 1•00 --
Alcohol use
Yes 1•84 (1•6 - 2•2)
No 1•00 --
Residence
Rural 1•45 (1•1 - 1•9)
Urban 1•00 --
Odds ratio (suicide vs.
other deaths) (99% CI)
CGHR.ORG/SUICIDETwitter: CGHR_org
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Significant risk factors for suicide - Women aged 15 to 69 years
Education
Secondary or higher 1•90 (1•4 - 2•6)
Primary or middle 1•43 (1•1 - 1•8)
Below primary 1•00 --
Region
Southern 2•96 (2•4 - 3•6)
Rest of India 1•00 --
Marital Status
Widower/divorced/separated 0•64 (0•4 - 0•9)
Never married 0•92 (0•7 - 1•2)
Married/ remarried 1•00 --
Odds ratio (suicide vs.
other deaths) (99% CI)
CGHR.ORG/SUICIDETwitter: CGHR_org
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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
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Million Death Study CollaboratorsIndian Academic Partners (in alphabetical order): 1. Department of Community Medicine Gujarat Medical College, Ahmedabad: DV Bala, P Seth, KN Trivedi 2. Department of Community Medicine Kolkatta Medical College, Kolkatta: SK Roy 3. Department of Community Medicine Regional Institute of Medical Sciences, Imphal: L Usharani 4. Department of Community Medicine S.C.B. Medical College Cuttack, Orissa: B Mohapatra 5. Department of Community Medicine SMS Medical College Jaipur: AK Bharadwaj, R Gupta 6. Epidemiological Research Center, Chennai: V Gajalakshmi, CV Kanimozhi 7. Gandhi Medical College, Bhopal: RP Dikshit, S Sorangi 8. Healis-Seskarhia Institute of Public Health, Navi Mumbai: PC Gupta, MS Pednekar, S Sreevidya 9. Apollo Institute of Medical Sciences & Research, Hyderabad: P Bhatia 10. St. John’s Academy of Health Sciences, Bangalore: A Kurpad, P Mony, M Vaz, S Srinivasan, A Shet, AS Shet, D
Xavier, S Rathi 11. King George Medical College, Lucknow: S Awasthi 12. Najafgarh Rural Health Training Centre Ministry of Health Government of India, New Delhi: N Dhingra, J Sudhir,
I Rawat (until 2007) 13. Regional Medical Research Center, ICMR Institute, Bhubaneshwar: AS Karketta, SK Dar 14. School of Preventative Oncology, Patna: DN Sinha 15. School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh: N Kaur, R
Kumar, JS Thakur 16. Tata Memorial Cancer Hospital, Mumbai: RA Badwe, R Dikshit, M Mallath Lead Partners: 1. Office of the Registrar-General India, RK Puram, New Delhi India: C Chandramouli (Registrar General of India [RGI]), RC Sethi, B Mishra, S Jain (until 2008), DK Dey (until 2009), AK Saxena, MS Thapa, N Kumar, JK Banthia and DK Sikri (former RGIs) 2. Million Death Study Coordinating, Centre for Global Health Research (CGHR), Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Dalla Lana School of Public Health, University of Toronto, Canada: P Jha (Principal Investigator), R Jotkar, R Kamadod, S Rao-Seshadri, P Rodriguez, P Sati, J Sudhir, C Ramasundarahettige, W Suraweera Affiliated Partners: 1. Indian Council of Medical Research, New Delhi India: VM Katoch (Director General or DG from 2008), NK
Ganguly (DG to 2008), L Kant, B Bhattacharya, B Shah, DK Shukla 2. World Health Organisation, Geneva and SEARO Office, New Delhi: T Boerma, A Fric, S Habayeb (former WHO
Representative-India), S Khanum, CD Mathers, DN Sinha, N Singh, P Singh (Deputy Regional Director) 3. Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, England: N Bhala, J