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PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA years Crude rate of 1.3/100,000 (61% male) years Crude rate of 9.9/100,000 (77% male) 2004 Adolescent Suicide Rates in Canada 71% suffocations 18% firearms 4% poisonings 74% suffocations 12% firearms 7% poisonings
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1PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADAPUBLIC HEALTH AGENCY of CANADAAGENCE DE LA SANTÉ PUBLIQUE du CANADA
ADOLESCENT SUICIDE IN CANADA: TRENDS IN OCCURRENCE BETWEEN 1980 AND 2004.
Robin Skinner and Susan G. MackenzieHealth Surveillance and Epidemiology Division
Presented at the CPHA Annual ConferenceJune 1-4, 2008
2PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Obj
ectiv
e
M
etho
ds
Examine trends in suicides among 10-19-year-olds.
Discuss possible explanations.
Public Health Agency of Canada holdings of Statistics Canada mortality data for 1980-2004 were used in the study.
Implementation of ICD-10 in 2000 had no effect on the continuity of suicide data.
Suicide in Canada - 2004
1,200 deaths of Canadians 10-19 years• 30% motor vehicle • 20% suicides
2nd leading cause of death among adolescents.
3PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
10-1
4 ye
ars
Crude rate of 1.3/100,000 (61% male)
15-
19 y
ears
Crude rate of 9.9/100,000 (77% male)
2004 Adolescent Suicide Rates in Canada
• 71% suffocations
• 18% firearms
• 4% poisonings
• 74% suffocations
• 12% firearms
• 7% poisonings
4PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
2004 Rate Method Rate Method1.6/100,000 1.1/100,000
14.7/100,000 4.7/100,000
10-1
4 ye
ars
Males
15-
19 y
ears
2004 Adolescent Suicide Rates in Canada
Females
1. Suffocation
2. Firearms
3. Poisoning
1. Suffocation
2. Poisoning
3. Firearm
5PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
10
20
30
40
50
60
70
80
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
All injuries (incl. unint.,suicide, homicide, undetermined)Unintentional injuriesSuicides
Figure 1. Injury rates in Canada (per 100,000), males, 10-19 years
6PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Figure 2. Injury rates in Canada (per 100,000), females, 10-19 years
0
5
10
15
20
25
30
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
SuicidesUnintentional injuriesAll injuries (incl. unint.,suicide, homicide, undetermined)
7PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
5
10
15
20
25
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
15-19 years
10-14 years
Average annual percent change -1.27% (95% CI -1.83,-0.70)
Average annual percent change 0.05% (95% CI -1.60,1.73)
Figure 3. Suicide rates in Canada (per 100,000), all causes, males
8PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
1
2
3
4
5
6
7
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
15-19 years
10-14 years
Average annual percent change 2.10% (95% CI 1.28, 2.93)
Average annual percent change 4.80% (95% CI 2.45, 7.13)
Figure 4. Suicide rates in Canada (per 100,000), all causes, females
9PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Changes to firearm legislation (1980-2004)
1991 Bill C-17 1995 Bill C-68
Control access to firearms.(1993)
• 28 day waiting period for FAC
• Minimum age from 16 to 18
• Safer storage
•Firearms Act
•New licensing and registration system for all firearms.
1977-1991 No changes
10PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
Figure 5. Suicide rates in Canada (per 100,000), males, 10-14 years
Bill
C-1
7
Fire
arm
s A
ct
FirearmSuffocation
Poisoning
Suicide, Total
Pha
sing
in B
ill C
-17
11PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
5
10
15
20
25
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
Figure 6. Suicide rates in Canada (per 100,000), males, 15-19 years
Bill
C-1
7
Fire
arm
s A
ct
Pha
sing
in B
ill C
-17
FirearmSuffocation
Poisoning
Suicide, Total
12PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
0
0.5
1
1.5
2
2.5
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
Figure 7. Suicide rates in Canada (per 100,000), females, 10-14 years
Bill
C-1
7
Fire
arm
s A
ct
Pha
sing
in B
ill C
-17
FirearmSuffocation
Poisoning
Suicide, Total
13PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Figure 8. Suicide rates in Canada (per 100,000), females, 15-19 years
0
1
2
3
4
5
6
7
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
Bill
C-1
7
Fire
arm
s A
ct
Pha
sing
in B
ill C
-17
FirearmSuffocation
Poisoning
Suicide, Total
14PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Summary: 1980-2004 in Canada
Suicides by firearms and poisonings Suicides by suffocation
10-1
4 ye
ars
15
-19
year
s
Males
Suicide, Total NS Change
Suffocation NS Change
Poisoning NS Change
Firearm NS Change
Females
Suicide, Total +4.8%
Suffocation +9.0%
Poisoning -3.6%
Firearm NS Change
Males
Suicide, Total -1.3%
Suffocation +3.1%
Poisoning -4.0%
Firearm -6.2%
Females
Suicide, Total +2.1%
Suffocation +9.3%
Poisoning -5.2%
Firearm -5.9
15PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Common themes in the literature:
o Decrease in firearm suicides
o Increase in suffocation suicides
o Overall, little improvement in suicide rateso Varies by sex
o Possible replacement effect
Cheung AH, Dewa CS. Current trends in youth suicide and firearms regulations. Can J Public Health; 2005 Mar-Apr;96(2):131-5.
Pan SY et al. Adolescent injury deaths and hospitalization in Canada: Magnitude and temporal trends (1979-2003). J Adolesc Health; 2007 Jul (41)1: 84-92.
Bridge JA, Barbe RP, Brent DA. Recent trends in suicide among U.S. adolescent males, 1992-2001. Psychiatr Serv; May 2005 (56):522.
16PUBLIC HEALTH AGENCY of CANADA AGENCE DE LA SANTÉ PUBLIQUE du CANADA
Conclusiono Youth unintentional injury rates
o Suicide more difficult issueo Firearm legislation Firearm rates
Suffocation rate
o Differences in suicide rates between and among male and female adolescents
o Ongoing surveillance/further studyo 10-14 year old femaleso Suffocation method