© 2003 by European Journal of Public Health
Health Determinants |
Suicide mortality in the European Union
Christopher Birt1, Unni Bille-Brahe2, Madelena Cabecadas3, Parveen Chishti4, Paul Corcoran5, Rodney Elgie6, Kees van Heeringen7, Lars-Gunnar Horte8, Alberto G. Marchi9, Aini Ostamo, Eleni Petridou11, Ellinor S. Renberg12, David H. Stone13, Johannes Wiik14 and Eileen Williamson51 University of Birmingham, Collaboration for Public Health in Europe, UK 2 Centre for Suicidological Research, WHO Collaborating Centre for Prevention of Suicide, Denmark 3 Rua Prof Mark Athias, Lisbon, Portugal 4 PEACH Unit, Department of Child Health, University of Glasgow, Yorkhill Hospital, Glasgow 5 National Suicide Research Foundation, Cork, Ireland 6 GAMIAN-Europe, UK 7 University Hospital, Unit for Suicide Research, Gent, Belgium 8 Department of Public Health Services, Stockholm, Sweden 9 IRCCS Burlo Garofolo, Trieste, Italy 10 National Public Health Institute, Helsinki, Finland 11 University of Athens, School of Medicine, Athens, Greece 12 University Hospital, Umea, Sweden 13 PEACH Unit, Department of Child Health, University of Glasgow, Yorkhill Hospital, Glasgow, UK 14 National Institute of Public Health, Oslo, Norway
Background: There are an estimated one million completed suicides per year worldwide. As a response to increasing concern about suicide within Europe, the EUROSAVE (European Review of Suicide and Violence Epidemiology) study was undertaken to examine recent trends in the epidemiology of suicide and self-inflicted injury mortality in the European Union (EU). Methods: Suicide and self-inflicted injury mortality data for the 15 EU countries for the years 1984–1998 were obtained from the World Health Organisation (WHO), the European Statistical Office of the European Commission (EUROSTAT) and national statistical agencies. Data were also obtained for a second group of deaths classified as ‘undetermined’ or ‘other violence’. Age-standardized mortality rates were calculated and examined for trends over time. Results: Finland had the highest suicide rate, while Greece had the lowest for the latest available year (1997). Age-standardized suicide rates tended to be lowest in the Mediterranean countries. Significant downward linear time trends in suicide mortality were observed in most countries, although rates varied markedly between countries. Both Ireland and Spain displayed significant upward linear trends in suicide mortality. Portugal had the highest rate of undetermined deaths both in 1984 and 1998 while Greece had the lowest in both 1984 and 1997. Five countries (including Ireland and Spain) showed significant downward trends in deaths due to undetermined causes whereas Belgium and Germany showed borderline significant upward linear trends in deaths due to undetermined causes. Conclusions: Although suicide rates in most countries seem to be decreasing, the validity of the data is uncertain. Misclassification may contribute to the geographical and temporal variation in suicide rates in some EU countries but it does not explain the phenomenon. More detailed research comparing suicide-recording procedures and practices across the EU is required. In the absence of adequate EU wide data on suicide epidemiology, effective prevention of this distressing phenomenon is likely to remain elusive.
Keywords: epidemiology; mortality; suicide; trends
Received 24 May 2002. Accepted 25 September 2002.
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