Introduction
Background
Suicide and intentional self-harm are serious but preventable public health problems. As part of the national effort to address suicide and self-harm in Australia, the Australian Institute of Health and Welfare set up the National Suicide and Self‑harm Monitoring System. This system will improve the quality, accessibility and timeliness of data on deaths by suicide, and on self-harming and suicidal behaviours. For more information on the system, see the AIHW Suicide and self-harm monitoring website.
There were 3,300 deaths by suicide in 2019, and more than 28,600 hospitalisations due to intentional self-harm in 2019–20 in Australia (AIHW 2021c). Males were 3 times more likely to take their lives than females, but females were more likely than males to be hospitalised for intentional self-harm.
Results from the 2018 ABDS indicate that suicide and self-inflicted injuries accounted for 2.8% of total burden (140,737 DALY) in 2018. It was the third leading cause of total burden in males, who suffered 3 times the amount of burden due to suicide as females. Almost all (99%) of this burden was due to fatal burden; that is, dying prematurely from suicide. Suicide was the second leading cause of fatal burden among males, responsible for 7.6% of total years of life lost. Suicide was the leading cause of fatal burden among males and females aged 15–44 (AIHW forthcoming 2021a).
The primary aim of this report is to update and extend data previously published on the burden due to suicide and self-inflicted injuries from the 2015 ABDS (AIHW 2019). Detailed estimates of the total, fatal and non-fatal burden of suicide and self‑inflicted injuries in 2019 are provided, as well as trends and analysis by selected population groups.
Burden of disease estimates for 2019 are not available for other diseases and injuries; hence, it was not possible to update the disease rankings and proportion of total burden due to suicide and self-inflicted injuries for the 2019 reference year. However, as these statistics are not expected to change much from year to year, they have been estimated using data from the 2018 ABDS.
What is burden of disease?
Burden of disease analysis measures the impact of disease and injury in a population by estimating the amount of DALY experienced by the population (AIHW 2019). This measure counts the combined years of healthy life lost due to living with disease or injury (‘years lived with disability’ or YLD) and dying prematurely from disease and injury (‘years of life lost’ or YLL) (AIHW 2019). One DALY represents 1 year of healthy life lost.
Rather than just counting deaths and disease prevalence, burden of disease analysis takes into account the age at death and the severity of disease to estimate the total health loss. The contribution of various modifiable risk factors to disease burden is also estimated (AIHW 2019).
Information on the burden of disease and injuries as well as the contribution of various risk factors to burden is important for monitoring population health and for providing an evidence base to inform health policy and service planning (AIHW 2019).
Burden estimates for suicide and self-inflicted injury
Fatal burden estimates (YLL) presented in this report were derived from the AIHW National Mortality Database (NMD). Non-fatal burden estimates (YLD) were derived from data sourced from the AIHW National Hospital Morbidity Database (NHMD) and the AIHW National Non-admitted Patient Emergency Department Care Database (NNAPEDCD) (see Technical notes for further information on the data sources and methods used).
Box 1: Key terms used in this report
attributable burden: The disease burden attributed to a particular risk factor. It is the reduction in fatal and non-fatal burden that would have occurred if exposure to the risk factor had been avoided (or, more precisely, had been at its theoretical minimum).
disability-adjusted life years (DALY): A measure (in years) of healthy life lost, either through premature death – defined as dying before the ideal life span (YLL) – or, equivalently, through living with ill health due to illness or injury (YLD). It is often used synonymously with ‘health loss’.
fatal burden: The burden from dying ‘prematurely’ as measured by years of life lost against an ideal life expectancy. Often used synonymously with YLL, and also referred to as ‘life lost’.
non-fatal burden: The burden from living with ill-health as measured by years lived with disability. It is often used synonymously with YLD.
risk factor: Any factor that represents a greater risk of a health condition or health event. Risk factors for suicide and self-inflicted harm include child abuse and neglect, alcohol use and illicit drug use. Intimate partner violence is also a risk factor for women aged 15 and over.