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Abstract
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Abstract/Background: Taiwan and Australia are similar in population size. Both publish mortality statistics of high quality. Comparing suicide data between an East Asian country and an Englishspeaking Western nation may help identify factors that affect suicide rates.
METHODS: Mortality statistics were available on-line from Taiwan's Ministry of Health and Welfare and the Australian Bureau of Statistics regarding suicides and 'hidden suicides' from 2009 to 2022. Comparisons were made between rates, age patterns, and other data concerning suicides, ill-defined deaths (coded R99), event of undetermined intent (EUI) deaths, accidental poisoning and drowning deaths in the two jurisdictions. Age patterns of suicide in 2017-2020 were graphed.
RESULTS: Recent suicide rates, especially of females, have been higher in Taiwan (16.0 per 100,000 in 2017-2022) than Australia (13.3 in 2019). Comparisons of mortality rates take account of revisions of Australian data during 3 years following first publication. The respective male to female ratios are 2:1 and 3:1. Hanging is the commonest method of suicide in both jurisdictions, with charcoal burning next most common in Taiwan. Drug poisoning (accidental and suicides) deaths are commoner in Australia, drowning deaths (accidental and suicide) in Taiwan. Sociocultural changes that affect security, relationships and self-esteem can lead to unbearable distress and suicide. Such factors may account for continuously high suicide rates in late life in Taiwan. EUI deaths are relatively low, especially in Australia. Most R99 deaths are not suicides. Nevertheless, evidence suggests that some EUI, R99 and accidental deaths were hidden suicides.
CONCLUSIONS: Mortality data from Australia confirm that under-investigation can result in under-recognition of suicides that have been coded as accidental, EUI or R99 deaths. It is recommended that psychological or verbal autopsy be used if manner of death is doubtful, or where there appears to have been insufficient use of available investigatory resources.
Language: en |