4.1 Article

Suicide mortality among older adults in Brazil between 2000 and 2019-estimates from the Global Burden of Disease Study 2019

Journal

Publisher

SOC BRASILEIRA MEDICINA TROPICAL
DOI: 10.1590/0037-8682-0322-2021

Keywords

Suicide; Epidemiology; Public health; Aged

Funding

  1. Bill & Melinda Gates Foundation
  2. Brazilian Ministry of Health [25000192049/2014-14]

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Older adults in Brazil are at higher risk of suicide, particularly men. The declining trend in suicide mortality is more significant globally compared to Brazil and other countries. There are significant differences in suicide rates among states in Brazil, indicating potential factors such as data quality, socio-cultural, and historical aspects.
Introduction: Older adults present a higher risk of suicide, and Brazil is experiencing a fast population aging. To understand the impact of demographic transition, we compared Brazilian suicide mortality rates (MR) among adults (50+ years) with global rates, those from one high-income country, and those from one middle-income country. Looking for regional disparities, the MR was analyzed among older adults (60+ years) by Brazilian states. Methods: This was an ecological study based on estimates from the Global Burden of Disease Study, from 2000 to 2019. Age-standardized MR and age-specific MR per 100,000 inhabitants were described, with 95% uncertainty intervals (UI). Results: During the period, the annual estimates and the declining trend in mortality were higher in the world than in the studied countries. In 2019, global age-standardized MR was 9.39 (95% UI 8.48-10.29), compared to 5.68 (95% UI 5.40-6.19), 6.01 (95% UI 5.107.04), and 6.63 (95% UI 6.43-6.95) in Brazil, Mexico, and England, respectively. In Brazil, despite a significant decline in national rates, stability was observed in 15 states. An increase in aging was only found for men, who presented 3-4 times higher MR than women. The states' rates presented large differences: in 2019, the rates among men aged 60-64 years varied from 7.24 (95% UI 5.31; 9.85) to 26.32 (95% UI 20.21; 34.50). Conclusions: The smaller decline in suicide mortality among older Brazilian adults, the increasing risk with aging, and the higher mortality among men indicate the need for specific prevention policies. The variation within states suggests differences in the data quality or in socio-cultural and historical aspects, which requires further investigation.

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