Evaluation of the quality of cause of death statistics in rural China using verbal autopsies.

Death registration systems in rural China are in a developmental stage. The Disease Surveillance Points (DSP) system provides the only nationally representative information on causes of death. In this system, there are no standard procedures or instruments for ascertaining causes of death; hence available statistics require careful evaluation before use. Contact us for a copy […]

National Suicide Rates a Century After Durkheim: do we Know Enough to Estimate Error?

Durkheim’s nineteenth-century analysis of national suicide rates dismissed prior concerns about mortality data fidelity. Over the intervening century, evidence documenting various types of error in suicide data has only mounted & surprising levels of such error continue to be routinely uncovered. Yet the annual suicide rate remains the most widely used population-level suicide metric troday. […]

‘Hidden’ Suicides Amongst Deaths Certified as Undetermined Intent, Accident by Pesticide Poisoning and Accident by Suffocation in Taiwan

This study sought to identify cause-of-death categories in which suicides might be misclassified in Taiwan. Secular trends, 1971-2007, were plotted in gender- & method-specific rates of death classified as suicide, undetermined intent, & accident for the Taiwanese population aged 15 years & older & compared the gender, age, & marital status profiles in these 3 […]

Police Suicide: why are the Rates in Some Places so low? (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

The published literature on police suicide contains serious measurement problems that undermine understanding, including: unreliability of small samples, lack of statistical significance testing, comparison of different time periods, use of different data sources, use of different summary measures, comparison to inappropriate norms, & misclassification of suicides as accidents. The authors suggest solutions for these problem […]

Police Suicide and Small Departments: a Survey (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

The study presented in this chapter reviewed data from 89 sheriff & police departments in Illinois, Indiana, & Minnesota. Six questions arising from the results of the data were discussed. Nine suicides were reported in the 89 departments, representing 3,736 officers from 1980-1998. There was a 0.0004% yearly average difference between the police suicides & […]

Death by Their own Hands: Have we Failed to Protect our Protectors? (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

Twice as many peace officers reportedly die by suicide as are killed in the line of duty. Has suicide among law enforcement become an epidemic? If so, what is the cause? More important, what is the cure? Many obstacles interfere with research on law enforcement suicide, including the natural reticence of families & law enforcement […]

Using Civil law Occupational Death Procedures in Police Suicide Reporting (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

Both state & federal civil law require mandatory procedures in the event of occupational death. Any deviation from these procedures can result in civil monetary penalties & criminal charges. Statutory law & recent case law provide the legal foundation for development of mandatory police suicide reporting procedures. Using the occupational death reporting procedures outlined by […]


In this editorial, the author provides a general discussion of factors contributing to suicide rates around the world. There is also a brief discussion of prevention strategies. (32 refs.)

Suicide Deaths Concentrated in Beijing Universities

In this letter to the editor, the authors discuss suicide among students at Beijing University. Earlier in 2007, five suicides happened within a period of 8 days – the deaths coincided with official statements from the Ministry of Education on the relatively low rate of suicide among Chinese university students. The effect of the one-child […]

Measuring an Aspect of the Distribution of Mental Health: Suicide in Australia 1907-2003 Working Paper Series WP2006.9

The authors argue from welfare economics there is a legitimate economic justification for governments to be concerned with suicide. However, the purpose of this paper is to show the usefulness of employing an alternative measure of suicide – potential years of life lost – rather than a count of the number of suicides. It is […]

Achieving Standardised Reporting of Suicide in Australia: Rationale and Program for Change

Accurate statistics are vital for appropriately targeted prevention strategies & research, costing of suicide, & to combat associated stigma. Underreporting of Australian suicide rates probably grew from 2002-2006. Systemic reasons for undercounting include absence of a central authority for producing mortality data; inconsistent coronial process for determining intent; collection & coding methods that are problematic […]

The Psychological Autopsy and Determination of Child Suicides: a Survey of Medical Examiners

This study explored the decision-making processes of medical examiners in the determination of child suicide. 94 American medical examiners completed a survey regarding those factors considered when making a child suicide determination, sources of information used, & considerations in acccident versus suicide classifications. Well-known risk factors such as suicide notes were considered by virtually all […]

Appearances may Deceive: What’s Going on With Australian Suicide Statistics?

In this editorial, the authors discuss issues associated with Australian suicide statistics. Publication deadlines for reporting causes of death not yet finalised by the coroner & different methods employed by different jurisdictions may have disguised Australia’s true suicide rate. (11 refs.)

A Reassessment of Suicide Measurement: Some Comparative PYLL-Based Trends in Queensland, Australia, 1920-2005

This paper applies 2 different methods of measuring suicide data: the conventional age-standardized suicide (count) rate & the alternative rate, potential years of life lost. Both measures were applied to suicide data for Queensland, Australia since 1920. The measures were also applied to deaths due to circulatory diseases, cancers, & motor vehicle accidents. The two […]

A Comparison of Suicide and Undetermined Deaths in Cornwall Across National and Local Agencies

The reporting pathways & statistics between relevant stakeholders for reporting suicides & undetermined deaths in Cornwall were evaluated. The correlation of the numbers provided for suicides & open verdicts given by different national & regional agencies were checked. Results show the data transfer between the relevant agencies can be inaccurate. These inaccuracies not only prevent […]

Lies… Damned Lies… and Suicide Statistics!

In the absence of any measurable outome in psychiatry, suicide is now regarded as an outcome measure in Mental Health Services in the United Kingdom. The National Service Framework has set the reduction of the suicide rate by 20 per cent by 2010 as a national priority. This article examines how reliable suicide is as […]

Race/Ethnicity and Potential Suicide Misclassification: Window on a Minority Suicide Paradox?

This cross-sectional study uses multiple cause-of-death data from the American National Center for Health Statistics to assess whether race/ethnicity, psychiatric comorbidity documentation, & other decedent characteristics were associated with differential potential for suicide misclassification. Subjects were 105,946 white, black, & Hispanic residents, age 15 & older, who died between 2003-2005 & whose deaths were classified […]

Pure Elderly Suicide Rates Versus Combined Pure Elderly Suicide, Accidental and Undetermined Death Rates: Methodological Issues in Cross-National Studies

The relationship between pure elderly suicide rates & rates of accidental deaths & undetermined deaths in the elderly across different countries was examined using Spearman’s correlation coefficient. Complete data sets were available for 49 countries. There was no significant correlation between pure suicide rates & rates of accidental deaths & undetermined deaths in males, aged […]

Suicide Mortality in Italy From 1980 to 2002

This study updated age & sex suicide rates in Italy, evaluated the methods of suicide; considered the effect of underreporting on suicide rates; compared age-adjusted rates of suicide; & examined some possible causes for the misclassification of suicide. Temporal trends, from 1980-2002, were analyzed using joinpoint regression. Suicide rates decreased by 10.5 percent for men […]

A Review of Suicide Statistics in Australia (Injury Research and Statistics Series Number 49, Catalogue Number INJCAT 121)

This report investigated deaths occurring in 2004 using cases extracted from the National Coroners Information System as at early 2008. Comparisons were made using data added from the Australian Bureau of Statistics, including Underlying Causes of Death codes, & with aggregate data from the Australian Bureau of Statistics mortality data files. The comparisons indicated that […]

Analysis of the Swiss Death-Certificates 1877-1977

This presentation reviewed the epidemiology of suicide in Switzerland for the period 1877-1977. Information was provided on changes by age group and changes in methods. A noticeable fluctuation was delineated in the rates of non-Swiss populations, although this finding was provisional pending final official statistics.

Attempted Suicide in Egypt

This presentation discussed the epidemiology of attempted suicide in Cairo, Egypt. A crude suicide attempt rate for 1975 was calculated to be 38.5 per 100,000 population. A high percentage of suicides occurred in the age range 15-44 years. The accuracy of official government records was questioned.

Suicide Trends in Europe: a Study of the Decline in Suicide in England and Wales and the Increase Elsewhere

This presentation examined four hypotheses put forward to account for the changes in reported suicide rates in various European countries. The starting point for the study was a substantial fall (36%) in rates in England & Wales between 1961-1963 & 1972-1974. Three results from a comparative epidemiological study were discussed.