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Nearly half of Australia’s suicides potentially avoidable


Morgan Liotta


5/11/2021 2:50:40 PM

More than 145,000 years of healthy life was lost in Australia in 2019 due to suicide and self-harm, but four key factors could reduce that figure.

Man looking at sunset
In 2019, suicide and self-inflicted injuries represented around 3% of the total burden of disease and injury in Australia.

Almost half (48%) of the estimated burden of suicide and self-harm in Australia can be attributed to potentially modifiable risk factors, the latest report from the Australian Institute of Health and Welfare (AIHW) has revealed.
 
The report, which builds on data from the 2018 Australian Burden of Disease Study, provides updated estimates of the total, fatal and non-fatal burden of suicide and self-inflicted injuries and illness in Australia across 2019, which is measured using Disability-Adjusted Life Years (DALY).
 
Of the 145,703 years of healthy life lost due to suicide and self-inflicted injuries in 2019, 99% were due to premature death, referred to in the report as ‘fatal burden’. This represents a rate of 5.7 DALY per 1000 population − around 3% of the total burden of disease and injury in Australia.
 
During 2019, there were 3318 deaths by suicide in Australia and 3139 in 2020. In 2019–20, there were more than 28,600 hospital admissions due to intentional self-harm.
 
The four potentially modifiable risk factors identified as being associated with suicide are:

  • child abuse and neglect during childhood among people aged five and over
  • alcohol use among people aged 15 and over
  • illicit drug use among people aged 15 and over
  • intimate partner violence among females aged 15 and over.
In 2019, child abuse and neglect during childhood was the leading risk factor contributing to the burden of suicide and self-inflicted injuries in both males and females − linked with 33% of the total suicide burden in females and 24% in males.
 
According to the report, alcohol use was the second leading risk factor for males aged 15 years and over, responsible for 17% of the burden due to suicide and self-inflicted injuries.
 
Meanwhile, for females aged 15 years and over, intimate partner violence reportedly contributed to almost 20% of the burden.
 
By comparing key population groups, including age and gender, the AIHW paper further highlighted the particular toll of mental health on men and young people.
 
Males accounted for around three-quarters of the total burden of suicide and self-inflicted injuries (109,144 DALY) at a rate of 8.7 per 1000 population − an estimated 4% of total burden among males.
 
For females, rates were significantly lower, with suicide and self-inflicted injuries responsible for 36,558 DALY, at a rate of 2.9 per 1000 − an estimated 1.5% of total burden among this cohort.
 
In age groups, the proportion of total burden due to suicide and self-inflicted injuries was highest among those aged 25–34 (25%), followed by those aged 15–24 and 35–44 (both 21%).
 
On average, males and females lost 42 years of life due to dying from suicide in 2019, placing it among the top five causes with the highest average years of life lost each year.
 
Although this rate is comparable to years lost to road transport injuries (43 years) and drug use disorders (41 years), it is significantly higher than other leading causes of death, including:
 
  • coronary heart disease (12 years)
  • dementia (seven years)
  • lung cancer (17 years).
In addition to population groups, the report compares rates according to areas where people live.
 
The highest rates of DALY burden from suicide and self-harm were among people living in remote and very remote areas, at 2.3 times higher than in major cities, generally increasing with remoteness.
 
Total burden rates were highest in remote areas (11.5 DALY per 1000 population) and very remote areas (11.4 DALY per 1000), with similar patterns noted for both fatal and non-fatal burden.
 
Both males and females living in the most disadvantaged socioeconomic areas also had twice as high age-standardised rates of total, fatal and non-fatal burden of suicide and self-inflicted injuries as those in the least disadvantaged socioeconomic areas.  
 
The rate of burden in the lowest socioeconomic, most disadvantaged areas was 7.9 DALY per 1000 population, compared to that of the highest, least disadvantaged areas at 3.9 DALY per 1000.
 
With DALY burden varying across states and territories, the Northern Territory continues to have the highest rates, with both total and fatal burden due to suicide and self‑inflicted injuries 1.6 times as high as the national rates.
 
After adjusting for population increase and ageing, the AIHW found that total burden rates in 2019 were highest in the Northern Territory at 9.2 DALY per 1000 population. Rates were lowest in Victoria at 4.9 DALY per 1000.
 
The Northern Territory also had the highest age-standardised rate for fatal burden of years of life lost (9.1 per 1000) and Victoria the lowest at 4.8 years per 1000.
 
AIHW spokesperson Richard Juckes said the report is a reminder of the continuing efforts needed in the space of mental health and suicide prevention.
 
‘Behind the numbers presented in this report, are people who have died due to suicide or experienced self-harm,’ he said.
 
‘This report has been funded through the National Suicide and Self-harm Monitoring System and is part of the AIHW’s ongoing contribution to the national effort to prevent suicide and self-harm in Australia.
 
‘It’s important we build our understanding of suicide and self-harm to inform policy development that will save lives.’
 
The full report is available on the AIHW website.
 
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