This population-based time-series study assessed suicide mortality trends across the Region of the Americas from 2015 to 2021. It used WHO Global Health Estimates for 33 countries and PAHO death records on suicide method for 20 countries. Joinpoint regression estimated trends against the 2·67% yearly fall needed for a one-third cut by 2030. The regional rate rose 1·05% a year (95% CI 0·85–1·26), driven by males, while the female rate stayed stable. Only 10 countries (30·3%) were falling fast enough; the share of suicides by hanging rose as firearms and poisoning fell. Method data were proportions, not method-specific rates, and came mostly from countries with better death registration.
Why it is interesting: The Americas was the only WHO region with rising suicide rates to 2019; this study extends the series to 2021. Comparing each country with the one-third target separates those meeting it from those getting worse.
Abstract — the authors' own words, CC BY
Background
The suicide mortality rate is a key global indicator for monitoring progress toward improved mental health and well-being under the Sustainable Development Goals, and the World Health Organization Comprehensive Mental Health Action Plan has set an explicit suicide-specific target of reducing the age-standardized suicide mortality rate by one-third by 2030 (with a baseline year of 2015). This study assessed temporal trends in suicide mortality and suicide methods in the Region of the Americas using average annual percent change (AAPC) for the period 2015-2021. Methods
Age-standardized and age group-specific suicide mortality rates (per 100,000 population) for the region, subregions, and by country for 2000-2021, and proportion of suicides by method by country, overall and by sex for 2015-2021, were obtained from the World Health Organization Global Health Estimates and the Pan American Health Organization Regional Mortality Database, respectively. In this population-based time-series analysis, AAPC was estimated using joinpoint regression analyses. The AAPCs for suicide mortality rates between 2015 and 2021 were compared with the compound annual reduction required to achieve a one-third reduction by 2030 (-2·67%). Findings
The regional age-standardized suicide mortality rate increased by 1·05% (95% CI: 0·85%, 1·26%; p ≤ 0·0001) annually on average between 2015 and 2021, driven by males (AAPC: 0·99%, 95% CI: 0·81%, 1·17%; p ≤ 0·0001), as the rate among females remained relatively stable during this period (AAPC: 0·02%, 95% CI: -1·38%, 1·45%; p = 0·97). Only 10 countries (30·3%; out of 33) showed significant declines exceeding the 2·67% annual reduction needed to achieve the one-third reduction target by 2030. Across countries, the distribution of recorded suicide methods shifted over time, with increases in the proportion of suicides involving hanging and decreases in the proportions involving firearms and poisoning. Interpretation
Suicide mortality in the region is rising, and the target of a one-third reduction by 2030 is unlikely to be met regionally; however, progress varies considerably across countries, with 10 (30·3%) making substantial progress toward the target. Urgent, coordinated action is needed in the countries with high and increasing suicide mortality rates, combining evidence-based means restriction strategies with broader upstream interventions that address social, economic and health-system determinants of suicide risk. Funding
None.
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