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Suicide The Leading Cause Of Death Among Young Adults In China (pp 813, 835)

March 06, 2002

A study in this week's issue of THE LANCET describes the incidence of suicide among people living in China, highlighting that it is the most common cause of death in young adults, three times more frequent in rural areas than urban environments, and 25% more common in women than men.

A wide range of suicide rates are reported for China because official mortality data are based on an unrepresentative sample and because different reports adjust crude rates in different ways. Michael Phillips and colleagues from Beijing Hui Long Guan Hospital, China, aimed to present accurate information about suicide, based on conservative estimates of suicide rates in different population groups in China.

Suicide rates by sex, 5-year age-group, and region (reported in mortality data for 1995-99 by the Chinese Ministry of Health) were adjusted according to an estimated rate of unreported deaths and projected to the corresponding population. The investigators estimated an average annual suicide rate of 23 per 100 000 and a total of 287 000 suicide deaths per year.

Suicide accounted for 3.6% of all deaths in China and was the fifth most important cause of death among the whole population. Suicide was the leading cause of death among people aged 15-34 years, accounting for around 19% of all deaths. In this age-group, it was the leading cause of death for rural and urban women, and the second most important cause of death (after motor-vehicle accidents) for rural and urban men. In rural women aged 15-34 years, suicides accounted for almost a third of all deaths, and the rate of death by suicide was more than seven times greater than from medical complications during pregnancy and childbirth. The overall suicide rate in women was 25% higher than in men, mainly because of the large number of suicides in young rural women. Rural rates were three times higher than urban rates-a difference that remained true for both sexes, for all age-groups, and over time.

In an accompanying Commentary (p 813), Rachel Jenkins from the Institute of Psychiatry, London, UK, concludes: "The study by Phillips and colleagues is important, not so much for its rather more conservative estimate of China's suicide rate, as for its being a key step along the path to encouraging China, and other countries, to have a complete vital registration system. Also, it highlights suicide as a leading cause of death among the young and a major cause of death in all age-groups, and the need to acknowledge and address suicide as a serious public-health problem."

Lancet