Citation

Snowdon J. J. Suicidol. (Taipei) 2022; 17(4): 330-336.

Copyright

(Copyright © 2022, Taiwanese Society of Suicidology, Publisher Airiti)

DOI

10.30126/JoS.202212_17(4).0010

PMID

unavailable

Abstract

This article focuses on the accuracy of suicide statistics in 14 jurisdictions in East and South-East Asia. Inaccuracies most commonly occur when (1) registration of a country's deaths (whatever the cause) is markedly incomplete, and (2) there is mis-recording or mis-coding of the cause of death (c.o.d.), sometimes despite almost complete registration. The World Health Organization (WHO) criticizes those certifying death who assign inexact ICD (International Classification of Diseases) codes such as 'old age', which cannot clearly indicate the underlying c.o.d. WHO refers to these as 'unusable' or 'garbage' codes. Two examples are 'Ill-defined and unknown cause' (ICD-10 code R99) and 'event of undetermined intent' (EUI, coded Y10-Y34); significant numbers of suicides have, to an extent that varies between nations, been assigned one of these codes. Suicides coded in this way, along with others mis-coded as accidental or to other codes have been called 'hidden suicides'. The quality of mortality statistics in 5 of the above 14 nations, and of one third of WHO's member states (mostly high income), has been rated as high, though commonly with caveats regarding earlier years. Lower income nations that lack resources to attempt collection of data regarding all deaths may use randomized household surveys. Where countries report low death registration rates and/or unacceptable garbage code rates, WHO publishes estimated suicide rates, based on the mortality data supplied by member states to the WHO Mortality Database. Rates of suicide, R99, EUI and accidental death vary considerably. It is recommended that all such rates be published at the same time as the suicide rates, and that WHO make ICD-11 mortality rates easily accessible online (as they were before October 2019). Well-resourced nations should be encouraged to help fund collection and analysis of suicide and hidden suicide data in under-resourced nations.

Language: zh

Keywords

East Asia; misclassification; mortality rates; South-East Asia; suicide rates; undetermined deaths