An analysis of unnatural deaths between 1990 and 1994 in A-Lein, Taiwan

This is an analysis of all unnatural deaths (ICD-9, E47-E55) that occurred between 1990 and 1994 in A-Lein, Taiwan. Unnatural deaths for this period totalled 134, or 89.66 per 100,000 per year. The crude accidental mortality rate (E47-E53) and road traffic accident (RTA) mortality rate (E54 is many times larger than in other industrialized countries: 2.1-5.1 times and 2.4-7.7 times, respectively. These figures are even higher for males. The reported suicide rate in A-Lein is approximately equal to that in the UK, but less than other industrialized countries. The actual suicide mortality rate in A-Lein as computed in this survey was 1.8 times higher than reported, which was 2.4 times that of Taiwan as a whole and 2.1 times Great Britain; 30.9 per cent of male and 75 per cent of female unnatural deaths excluding RTAs were suicides (ICD-9 E48-E55). RTA deaths were 3.2 times higher among males than among females (P < 0.05) and 26.8 per cent were associated with alcohol consumption. Only 21.4 per cent of killed motorcyclists wore helmets and only 8.3 per cent of killed car drivers used seat belts. Unnatural deaths excluding RTAs were mostly among people of low socio-economic status aged 50-60 years with less than a college education. Of these, 75 per cent occurred at home or at work. The most common cause of non-traffic unnatural death excluding RTAs was suicide, and the second most common was drowning. In conclusion, it was found that high unnatural death rates in A-Lein are related to low socio-economic level, sex (males), drinking, inadequate safety protection while working and driving, and inadequate law enforcement.