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Behavioural risk factor burden for suicide and self-inflicted injuries

The National Suicide and Self-harm Monitoring Project provided funding for the AIHW to produce a report on The health impact of suicide and self-inflicted injuries in Australia, 2019. The report estimates the combined impact of people dying prematurely from suicide and the direct health impacts on individuals living with injury due to self-harm. Note that the estimates do not take into consideration the potential mental health issues associated with self-harm or the effects suicide and self-harm can have on people’s families, friends and communities. Through detailed data visualisations the report presents time series data for the Australian population by age, sex and key population groups. The contribution of various modifiable risk factors to disease burden is also estimated.

Data on risk factors associated with suicide and self-inflicted injuries from the Australian Burden of Disease Study 2022 are included below. The full report is available here.

According to the AIHW’s Australian Burden of Disease Study 2022, suicide and self-inflicted injuries was the second leading cause of premature death from injury or disease, accounting for an estimated 6% of the total years of life lost in Australia (AIHW, 2022). Moreover, suicide and self-inflicted injuries is the leading cause of premature death in men aged 15–49 years. See Burden of disease for further information.

What is burden of disease?

Burden of disease analysis measures the impact of living with illness and injury and dying prematurely. The method uses the summary measure ‘disability-adjusted life years (or DALY) to measure the years of healthy life lost by combining premature death (years of life lost; YLL) with years lived with disability (YLD). For further information including a more comprehensive explanation of the methodology and data sources used, see Australian Burden of Disease Study: methods and supplementary material 2022. 

The burden of suicide and self-inflicted injuries due to behavioural risk factors, known as attributable burden, has also been estimated in the Australian Burden of Disease Study. These estimates reflect the amount of burden that could have been avoided if all people in Australia were not exposed to the risk factor.

In 2022, ‘suicide and self-inflicted injuries’ was the second leading cause of fatal burden among all people, with an estimated 159,200 total YLL. Approximately 121,200 YLL were lost to suicide and self-inflicted injuries among men and 38,000 YLL among women. In 2022, suicide and self-inflicted injuries were also the second leading cause of fatal burden among men and the ninth leading cause of fatal burden among women (down from eighth in 2018).

The interactive data visualisation shows the leading causes for years of life lost (YLL) based on leading causes of mortality in Australia. Sex (females, males, persons) and data year can be selected for viewing. Highlighted in purple indicates YLL due to suicide and self-inflicted injuries.

The visualisation directly below shows the average YLL per individual deceased person separately for each of the study years (2003, 2011 and 2018). The causes of death shown in this visualisation are the top 20 leading contributors to years of life lost initially identified according to total YLL. The causes of death included are not necessarily among the top 20 leading causes according to average YLL.

In 2018, an average of 42.2 years were lost to ‘suicide and self-inflicted injuries’ among males, and 41.6 years were lost to ‘suicide and self-inflicted injuries’ among females. 

The interactive data visualisation shows average years of life lost (YLL). The causes of death shown in this visualisation are the top 20 leading contributors to years of life lost initially identified according to total YLL. Sex (females, males, persons) and data year can be selected for viewing. Highlighted in purple indicates YLL due to suicide and self-inflicted injuries.

'Child abuse and neglect’ during childhood was:

  • consistently the leading behavioural risk factor contributing to the years of healthy life lost due to suicide and self-inflicted injuries in both men and women since 2003 and has increased at each time point.
  • associated with 32% of the years of healthy life lost due to ‘suicide and self-inflicted injuries’ in men (about 25,700 DALYs) and 43% of the years of healthy life lost due to ‘suicide and self-inflicted injuries’ in women (about 12,000 DALYs) in 2019 with the vast majority of these years of healthy life lost due to premature death.

Until 2018, among men, the second and third leading risk factors contributing to the years of healthy life lost due to suicide and self-inflicted injuries were ‘alcohol use’ and ‘illicit drug use’ across all years of the Australian Burden of Disease Study. Since 2018, ‘illicit drug use’ became the second leading risk factor contributing to the years of healthy life lost due to suicide and self-inflicted injuries among men followed by ‘alcohol use’. In 2019 this trend continued:

  • ‘Illicit drug use’ was responsible for 23% (about 18,600 DALYs) of the years of healthy life lost to ‘suicide and self-inflicted injuries’ among men.
  • ‘Alcohol use’ was responsible for 22% of the years of healthy life lost due to ‘suicide and self-inflicted’ injuries in men (about 18,100 DALYs)

For women, the second greatest contributor to the years of healthy life lost due to ‘suicide and self-inflicted injuries’ was ‘intimate partner violence’ (estimated in women only) which was consistent over all study years. The third leading contributor of healthy life lost due to suicide and self-inflicted injuries among women has remained ‘illicit drug use’ since 2018. In 2019:

  • ‘Intimate partner violence’ contributed 25% of the years of healthy life lost due to suicide and self-inflicted injuries in women (about 7,000 DALYs).
  • ‘Illicit drug use’ contributed to 11% of the years of healthy life lost to suicide and self-inflicted injuries (about 3,100 DALYs) among women.

The interactive data visualisation shows the burden (based on frequency) of suicide and self-inflicted injuries attributable to selected risk factors and categorised by age (from 5 years old to over 85). Selection for sex (females and males), data year (2003, 2011, 2015, 2018 and 2019) and attributable DALY, YLD and YLL are available for viewing.

In 2019, ‘child abuse and neglect’ during childhood was the greatest contributor to the years of healthy life lost due to suicide and self-inflicted injuries in both men and women in all age groups. The exception to this are women aged 85 years and over where ‘intimate partner violence’ was the highest contributor. The majority of the ‘child abuse and neglect’ burden was experienced among people aged 15–44 years. In females, the number of DALYs was similar across these age groups (about 2,000–2,900 DALYs). The highest among men was between ages 25–34 years (7,000 DALYs).

Similarly, most of the years of healthy life lost due to suicide and self-inflicted injuries attributable to ‘alcohol use’ or ‘illicit drug use’ was experienced in ages 15–54 years. Both risk factors were highest among both men and women aged 15–34 years.

The years of healthy life lost due to suicide and self-inflicted injuries in women that were attributable to ‘intimate partner violence’ was highest among women aged 35–44 years.

References

Australian Institute of Health and Welfare 2022. Australian Burden of Disease Study 2022. Cat. no. BOD 37. Canberra: AIHW.

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