Journal article
Global, regional, and national burden of suicide, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
The Lancet. Public health, Vol.10(3), pp.e189-e202
03/01/2025
DOI: 10.1016/S2468-2667(25)00006-4
PMCID: PMC11876099
PMID: 39986290
Abstract
Background: Deaths from suicide are a tragic yet preventable cause of mortality. Quantifying the burden of suicide to understand its geographical distribution, temporal trends, and variation by age and sex is an essential step in suicide prevention. We aimed to present a comprehensive set of global, regional, and national estimates of suicide burden. Methods: We produced estimates of the number of deaths and age-standardised mortality rates of suicide globally, regionally, and for 204 countries and territories from 1990 to 2021, and disaggregated these results by age and sex. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 estimates of deaths attributable to suicide were broken down into two comprehensive categories: those by firearms and those by other specified means. For this analysis, we also produced estimates of mean age at the time of death from suicide, incidence of suicide attempts compared with deaths, and age-standardised rates of suicide by firearm. We acquired data from vital registration, verbal autopsy, and mortality surveillance that included 23 782 study-location-years of data from GBD 2021. Point estimates were calculated from the average of 1000 randomly selected possible values of deaths from suicide by age, sex, and geographical location. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles from a 1000-draw distribution. Findings: Globally, 746 000 deaths (95% UI 692 000-800 000) from suicide occurred in 2021, including 519 000 deaths (485 000-556 000) among males and 227 000 (200 000-255 000) among females. The age-standardised mortality rate has declined over time, from 14·9 deaths (12·8-15·7) per 100 000 population in 1990 to 9·0 (8·3-9·6) per 100 000 in 2021. Regionally, mortality rates due to suicide were highest in eastern Europe (19·2 [17·5-20·8] per 100 000), southern sub-Saharan Africa (16·1 [14·0-18·3] per 100 000), and central sub-Saharan Africa (14·4 [11·0-19·1] per 100 000). The mean age at which individuals died from suicide progressively increased during the study period. For males, the mean age at death by suicide in 1990 was 43·0 years (38·0-45·8), increasing to 47·0 years (43·5-50·6) in 2021. For females, it was 41·9 years (30·9-46·7) in 1990 and 46·9 years (41·2-52·8) in 2021. The incidence of suicide attempts requiring medical care was consistently higher at the regional level for females than for males. The number of deaths by suicide using firearms was higher for males than for females, and substantially varied by country and region. The countries with the highest age-standardised rate of suicides attributable to firearms in 2021 were the USA, Uruguay, and Venezuela. Interpretation: Deaths from suicide remain variable by age and sex and across geographical locations, although population mortality rates have continued to improve globally since the 1990s. This study presents, for the first time in GBD, a quantification of the mean age at the time of suicide death, alongside comprehensive estimates of the burden of suicide throughout the world. These analyses will help guide future approaches to reduce suicide mortality that consider a public health framework for prevention. Funding: Bill & Melinda Gates Foundation.
Details
- Title: Subtitle
- Global, regional, and national burden of suicide, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
- Creators
- Nicole Davis Weaver - University of WashingtonGregory J. Bertolacci - University of WashingtonEmily Rosenblad - University of WashingtonSama Ghoba - University of WashingtonMatthew Cunningham - University of WashingtonKevin S. Ikuta - University of WashingtonMadeline E. Moberg - University of WashingtonVincent Mougin - University of WashingtonChieh Han - University of WashingtonEve E. Wool - University of WashingtonYohannes Habtegiorgis Abate - Institute for Health Metrics and EvaluationHabeeb Omoponle Adewuyi - University of JohannesburgQorinah Estiningtyas Sakilah Adnani - Padjadjaran UniversityLeticia Akua Adzigbli - University of Health and Allied SciencesAanuoluwapo Adeyimika Afolabi - Memphis Center For Reproductive HealthSuneth Buddhika Agampodi - International Vaccine InstituteBright Opoku Ahinkorah - University of Technology SydneyAqeel Ahmad - Shaqra UniversityDanish Ahmad - Public Health Foundation of IndiaAyman Ahmed - University of BaselSajjad Ahmad - American University of BeirutHaroon Ahmed - COMSATS University IslamabadHanadi Al Hamad - Hamad Medical CorporationYazan Al-Ajlouni - New York Medical CollegeRasmieh Mustafa Al-Amer - Western Sydney UniversityMohammed Albashtawy - Al al-Bayt UniversityWafa A. Aldhaleei - Mayo ClinicSyed Shujait Ali - University of SwatWaad Ali - Sultan Qaboos UniversityMahmoud A. Alomari - Jordan University of Science and TechnologyMohammed A. Alsabri - Drexel UniversityNelson Alvis-Guzman - Institute for Health Metrics and EvaluationYaser Mohammed Al-Worafi - University of Science and Technology of FujairahAlireza Amindarolzarbi - Johns Hopkins UniversitySohrab Amiri - Baqiyatallah University of Medical SciencesTudorel Andrei - Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, RomaniaSaeid Anvari - Guilan University of Medical SciencesJalal Arabloo - Iran University of Medical SciencesDemelash Areda - Ottawa UniversityAnton A. Artamonov - Institute for Health Metrics and EvaluationTahira Ashraf - Pioneer (Japan)Seyyed Shamsadin Athari - Zanjan University of Medical SciencesMaha Moh d.Wahbi Atout - Philadelphia UniversityAhmed Y. Azzam - October 6 UniversityAshish D. Badiye - Central Forensic Science LaboratoryNayereh Baghcheghi - Department of Nursing, Saveh University of Medical Sciences, Saveh, IranSaeed Bahramian - School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMaciej Banach - Institute for Health Metrics and EvaluationSuzanne Lyn Barker-Collo - University of AucklandTill Winfried Bärnighausen - Institute for Health Metrics and EvaluationAmadou Barrow - University of FloridaAzadeh Bashiri - Shiraz UniversityHameed Akande Bashiru - Obafemi Awolowo UniversityMohammad Mahdi Bastan - Tehran University of Medical SciencesKavita Batra - University of Nevada, Las VegasRavi Batra - University of Nevada, Las VegasMohsen Bayati - Shiraz University of Medical SciencesCorina Benjet - Instituto Nacional de Psiquiatría Ramón de la Fuente MuñizHabib Benzian - New York UniversityPaola Bertuccio - University of PaviaAkshaya Srikanth Bhagavathula - North Dakota State UniversityPriyadarshini Bhattacharjee - Cambridge University Hospitals NHS Foundation TrustCorey B. Bills - University of California, San FranciscoSri Harsha Boppana - Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United StatesGuilherme Borges - Instituto Nacional de Psiquiatría Ramón de la Fuente MuñizHamed Borhany - Internal Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, IranYasser Bustanji - University of SharjahFlorentino Luciano Caetano dos Santos - Harvard UniversityGiulio Castelpietra - University of UdineArthur Caye - University of Rio Grande and Rio Grande Community CollegeMuthia Cenderadewi - University of MataramRama Mohan Chandika - Jazan UniversityEeshwar K. Chandrasekar - University of RochesterPeriklis Charalampous - Erasmus MCYifan Chen - University of JinanRitesh Chimoriya - Concord Clinical School, Sydney, NSW, AustraliaHitesh Chopra - Chitkara UniversitySonali Gajanan Choudhari - Department of Community Medicine, Jawaharlal Nehru Medical College, Wardha, IndiaDinh Toi Chu - Faculty of Applied Sciences, VNU International School (VNUIS), Hanoi, Viet NamIsaac Sunday Chukwu - Federal Medical CentreMuhammad Chutiyami - University of Technology SydneyRichard G. Cowden - University of the Free StateBerihun Assefa Dachew - University of GondarOmid Dadras - Research Center for Child Psychiatry, University of Turku, Turku, FinlandXiaochen Dai - University of WashingtonKoustuv Dalal - Örebro UniversityLalit Dandona - Public Health Foundation of IndiaRakhi Dandona - Public Health Foundation of IndiaSamuel Demissie Darcho - Haramaya UniversityReza Darvishi Cheshmeh Soltani - Arak UniversityClaudio Alberto Dávila-Cervantes - Facultad Latinoamericana de Ciencias MéxicoAlejandro de la Torre-Luque - Universidad Complutense de MadridShayom Debopadhaya - Albany Medical CollegeLouisa Degenhardt - UNSW SydneyIvan Delgado-Enciso - BienestarEmina Dervišević - University of SarajevoMichael J. Diaz - University of FloridaDeepa Dongarwar - The University of Texas Health Science Center at HoustonOjas Prakashbhai Doshi - South Plainfield, NJ, United StatesHaneil Larson Dsouza - Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, Mangalore, IndiaDavid C Schwebel - University of Iowa, Research AdministrationGBD 2021 Suicide Collaborators
- Resource Type
- Journal article
- Publication Details
- The Lancet. Public health, Vol.10(3), pp.e189-e202
- DOI
- 10.1016/S2468-2667(25)00006-4
- PMID
- 39986290
- PMCID
- PMC11876099
- NLM abbreviation
- Lancet Public Health
- ISSN
- 2468-2667
- eISSN
- 2468-2667
- Grant note
- Bill and Melinda Gates Foundation (http://data.elsevier.com/vocabulary/SciValFunders/100000865) OPP1176062 / Bill and Melinda Gates Foundation (http://data.elsevier.com/vocabulary/SciValFunders/100000865)
- Language
- English
- Date published
- 03/01/2025
- Academic Unit
- Research Administration; Psychological and Brain Sciences
- Record Identifier
- 9985017451702771
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