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Means of suicide

ENLACE BURDEN OF SUICIDE MEANS OF SUICIDE TECHNICAL NOTES ABOUT

 

In the Region of the Americas, suicide accounted for more than 97 thousand deaths (75 thousand in men and 22 thousand in women) in 2019. This number increased by 56% from 62 thousand in 2000. Suicide moved up from the 15th leading cause of premature mortality in 2000 (measured as years of life lost due to premature death) to the 10th leading cause.

Suicide is a serious public health problem in the Americas, that requires focused strategies and interventions that are timely, evidence-based and often low-cost. As indicated in LIVE LIFE: An implementation guide for suicide prevention in countries, knowledge of the most commonly used suicide means and methods is important to devise prevention strategies that have shown to be effective, such as restriction of access to means of suicide. For national responses to be effective, a comprehensive multisectoral suicide prevention strategy is needed. 

This visualization presents information on the means of suicides in countries of the Region of the Americas. It allows users to examine and identify the patterns, levels, and trends of the means of suicide by geographic area (region, subregion, and country), age, and sex.

In the Region of the Americas, the top most frequent means of suicide are i) hanging, strangulation, and suffocation, accounting for 48% of total suicide deaths; ii) firearms and handgun discharge which accounted for more than 30% of suicides, and iii) exposure to drugs, medicaments and biologicals (7%). These three means of suicide accounted for almost 80% of total suicide deaths in the region.

Unlike other means of suicide in the region, the proportion of suicide deaths by hanging, hanging, strangulation, and suffocation has increased by 45% from 33% in 2000 to 48% in 2020. The proportion of suicide deaths by firearms, handgun, rifle, and shotgun discharge decreased by 18% from 40% in 2000 to 33% in 2020. The proportion of suicide deaths by exposure to drugs, medications, and biologics remains constant in the latest two decades.

The pattern, levels, and frequency of means of suicide vary across subregions and countries of the Americas, where three typical patterns have been observed across countries:

  1. Countries where hanging, strangulation and suffocation is the most frequent mean of suicide.: Argentina, Brazil, Canada, Chile, Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Uruguay, and Venezuela.
  2. Countries where pesticide exposure is the most frequent mean of suicides: El Salvador, Guyana, Nicaragua, Saint Vincent and the Grenadines, and Suriname. 
  3. Countries where firearms and handgun is the most frequent mean of suicides: the United States of America. 

Data source

For exploring the means of suicide in countries of the Americas, the PAHO Mortality Database (MD) was used as the data source. The MD comprises all registered deaths by national vital registration and health statistics system with information on the underlying cause of death coded according to ICD-10, age, sex, country, and year from 1995 to 2021.

The data available on the PAHO MD have different levels of completeness, coverage, and quality of underlying causes of death. Data from Bolivia, Haiti, and Honduras were excluded because of the following reasons: i) available data for a few years; ii) data completeness and integrity is lower than 30%; and iii) low data quality on diagnosis and coding of the underlying cause of death. 

The data contained in the MD is periodically updated with new data provided by PAHO Member States and territories, however, the current version was updated as of November 2022.

Data included in this analysis

For this analysis, only registered deaths with underlying causes of death classified and coded as intentional self-harm (Suicide, ICD-10: X60-X84) were used from the Regional Mortality Database. 

For analysis and presentation purposes, the single cause categories under intentional self-harm (ICD-10 codes: X60-X84) were grouped in clusters of means of suicide. The clusters of means of suicide were built in a way that assures they are helpful for public health interventions:

Group of intentional self-injury Clusters of means of suicide with corresponding ICD-10 codes
Intentional self-poisoning by exposure to drugs, medicaments, and biological substances (ICD-10 codes: X60-X64)
by exposure to alcohol (X65)
by exposure to organic solvent, vapors and gasses, and chemicals (X66-X67, X69)
by exposure to pesticides (X68)
Intentional self-harm by hanging, strangulation, and suffocation (X70)
by drowning and submersion (X71)
by firearms, handguns, rifles, shotguns, and other firearms discharge (X72-X74)
by explosive materials, smoke, fire, steam, hot vapors, and hot objects (X75-X77)
by sharp objects (X78)
by blunt objects (X79)
by jumping from a high place or lying before moving objects (X80-X81)
by crashing of motor vehicles and other specified means (X82-X83)
by unspecified means (X84)

Detailed information about the intentional self-harm (suicide) category of cause of death is available in the WHO International Classification of Diseases, 10th Revision (ICD-10).

Registered deaths with unknown age and unknown sex were excluded from this analysis and visualization. 

Outcome measures

The number of deaths due to suicide and percentage of total deaths breakdown by specific cause category of intentional self-harm (suicide, coded at three characters of ICD-10 codes), country, sex, and year.  

Suggested citation

Means of Suicide in the Region of the Americas. ENLACE data portal. Pan American Health Organization (PAHO/WHO), 2023. [Internet] https://www.paho.org/en/enlace/means-suicide