Suicide rates in China, 2004-2014: comparing data from two sample-based mortality surveillance systems

Area of Science:

• Public Health
• Epidemiology
• Demography

Background:

• China's declining suicide rate significantly impacts global trends.
• Previous suicide rate estimations in China may be inaccurate due to data bias.
• The Ministry of Health's Vital Registration (MOH-VR) system is biased towards more affluent populations.

Purpose of the Study:

• To compare suicide data from the MOH-VR system with the more representative Center for Disease Control and Prevention's Disease Surveillance Points (CDC-DSP) system.
• To update national and subnational suicide rates in China for the period 2004-2014.
• To assess the accuracy of different data sources for suicide surveillance in China.

Main Methods:

• Utilized negative binomial regression to compare suicide rates between CDC-DSP and MOH-VR data (2004-2014).
• Applied joinpoint regression analyses to examine suicide rate trends.
• Employed Kitagawa's decomposition method to analyze changes in crude suicide rates.

Main Results:

• Both systems showed a decrease in suicide rates, but CDC-DSP reported higher national (IRR=1.18) and rural (IRR=1.29) rates before 2013.
• Significant trend reversals in rural and urban suicide rates were identified by the CDC-DSP system in specific years.
• The MOH-VR system underestimated national and rural suicide rates compared to the CDC-DSP system.

Conclusions:

• The MOH-VR system provides biased and underestimated suicide rates for China.
• The CDC-DSP system offers more accurate suicide rate estimations and is recommended for future research.
• The CDC-DSP system is crucial for monitoring reversing suicide trends, particularly in more developed areas of China.