public health agency of canada agence de la santÉ publique du canada 1 public health agency of...

1PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADAPUBLIC HEALTH AGENCY of CANADAAGENCE DE LA SANTÉ PUBLIQUE du CANADA

ADOLESCENT SUICIDE IN CANADA: TRENDS IN OCCURRENCE BETWEEN 1980 AND 2004.

Robin Skinner and Susan G. MackenzieHealth Surveillance and Epidemiology Division

Presented at the CPHA Annual ConferenceJune 1-4, 2008

2PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA

Obj

ectiv

e

M

etho

ds

Examine trends in suicides among 10-19-year-olds.

Discuss possible explanations.

Public Health Agency of Canada holdings of Statistics Canada mortality data for 1980-2004 were used in the study.

Implementation of ICD-10 in 2000 had no effect on the continuity of suicide data.

Suicide in Canada - 2004

1,200 deaths of Canadians 10-19 years• 30% motor vehicle • 20% suicides

2nd leading cause of death among adolescents.


10-1

4 ye

ars

Crude rate of 1.3/100,000 (61% male)

15-

19 y

ears

Crude rate of 9.9/100,000 (77% male)

2004 Adolescent Suicide Rates in Canada

• 71% suffocations

• 18% firearms

• 4% poisonings

• 74% suffocations

• 12% firearms

• 7% poisonings


2004 Rate Method Rate Method1.6/100,000 1.1/100,000

14.7/100,000 4.7/100,000

10-1

4 ye

ars

Males

15-

19 y

ears

2004 Adolescent Suicide Rates in Canada

Females

1. Suffocation

2. Firearms

3. Poisoning

1. Suffocation

2. Poisoning

3. Firearm


0

10

20

30

40

50

60

70

80

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

All injuries (incl. unint.,suicide, homicide, undetermined)Unintentional injuriesSuicides

Figure 1. Injury rates in Canada (per 100,000), males, 10-19 years


Figure 2. Injury rates in Canada (per 100,000), females, 10-19 years

0

5

10

15

20

25

30

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

SuicidesUnintentional injuriesAll injuries (incl. unint.,suicide, homicide, undetermined)


0

5

10

15

20

25

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

15-19 years

10-14 years

Average annual percent change -1.27% (95% CI -1.83,-0.70)

Average annual percent change 0.05% (95% CI -1.60,1.73)

Figure 3. Suicide rates in Canada (per 100,000), all causes, males


0

1

2

3

4

5

6

7

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

15-19 years

10-14 years

Average annual percent change 2.10% (95% CI 1.28, 2.93)

Average annual percent change 4.80% (95% CI 2.45, 7.13)

Figure 4. Suicide rates in Canada (per 100,000), all causes, females


Changes to firearm legislation (1980-2004)

1991 Bill C-17 1995 Bill C-68

Control access to firearms.(1993)

• 28 day waiting period for FAC

• Minimum age from 16 to 18

• Safer storage

•Firearms Act

•New licensing and registration system for all firearms.

1977-1991 No changes


0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

Figure 5. Suicide rates in Canada (per 100,000), males, 10-14 years

Bill

C-1

7

Fire

arm

s A

ct

FirearmSuffocation

Poisoning

Suicide, Total

Pha

sing

in B

ill C

-17


0

5

10

15

20

25

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

Figure 6. Suicide rates in Canada (per 100,000), males, 15-19 years

Bill

C-1

7

Fire

arm

s A

ct

Pha

sing

in B

ill C

-17

FirearmSuffocation

Poisoning

Suicide, Total


0

0.5

1

1.5

2

2.5

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

Figure 7. Suicide rates in Canada (per 100,000), females, 10-14 years

Bill

C-1

7

Fire

arm

s A

ct

Pha

sing

in B

ill C

-17

FirearmSuffocation

Poisoning

Suicide, Total


Figure 8. Suicide rates in Canada (per 100,000), females, 15-19 years

0

1

2

3

4

5

6

7

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

Bill

C-1

7

Fire

arm

s A

ct

Pha

sing

in B

ill C

-17

FirearmSuffocation

Poisoning

Suicide, Total


Summary: 1980-2004 in Canada

Suicides by firearms and poisonings Suicides by suffocation

10-1

4 ye

ars

15

-19

year

s

Males

Suicide, Total NS Change

Suffocation NS Change

Poisoning NS Change

Firearm NS Change

Females

Suicide, Total +4.8%

Suffocation +9.0%

Poisoning -3.6%

Firearm NS Change

Males

Suicide, Total -1.3%

Suffocation +3.1%

Poisoning -4.0%

Firearm -6.2%

Females

Suicide, Total +2.1%

Suffocation +9.3%

Poisoning -5.2%

Firearm -5.9


Common themes in the literature:

o Decrease in firearm suicides

o Increase in suffocation suicides

o Overall, little improvement in suicide rateso Varies by sex

o Possible replacement effect

Cheung AH, Dewa CS. Current trends in youth suicide and firearms regulations. Can J Public Health; 2005 Mar-Apr;96(2):131-5.

Pan SY et al. Adolescent injury deaths and hospitalization in Canada: Magnitude and temporal trends (1979-2003). J Adolesc Health; 2007 Jul (41)1: 84-92.

Bridge JA, Barbe RP, Brent DA. Recent trends in suicide among U.S. adolescent males, 1992-2001. Psychiatr Serv; May 2005 (56):522.


Conclusiono Youth unintentional injury rates

o Suicide more difficult issueo Firearm legislation Firearm rates

Suffocation rate

o Differences in suicide rates between and among male and female adolescents

o Ongoing surveillance/further studyo 10-14 year old femaleso Suffocation method

public health agency of canada agence de la santÉ publique du canada 1 public health agency of...

Documents