Suicides in Hong Kong and Australia

Although the suicide rate for both Hong Kong and Australia was about 12 per 100,000 in 1994, the age- and gender-specific rates, methods of suicide, and time trends vary greatly for these two places. This paper explores the possible social, economic, and cultural background to explain this discrepancy. We used the official suicide death statistics of Hong Kong and Australia for the period 1984-1994. We calculated age-standardized suicide rates in order to take into account the differences in the age composition between the two countries and years. We employed a log-linear (Poisson) model to detect the age- and gender-specific trends, and to determine whether there were specific age or gender groups whose suicide behavior had changed significantly between 1984 and 1994. Hong Kong experienced a slight increase in suicide rate for both genders in the years 1984-1994, whereas Australia experienced a cubic trend for both genders during the same period and a rise in suicide rate in recent years. The suicide rate in Hong Kong increased with age, with a sharp increase (nearly four times the average) among the group aged 75 or over. A relatively low gender ratio (male:female) was also observed in Hong Kong, whereas in Australia there was not much difference in suicide rates among all age groups, though the suicide rate of the group aged 75 or over was 1.2 times the average. The gender ratio in Australia was higher, and the male suicide rate was four times higher than that of females. The Hong Kong suicide rate in females was twice that of Australia, whereas the Hong Kong male suicide rate was about half that of Australia. Jumping and hanging were the most common methods of suicide in Hong Kong, accounting for more than 80% of all suicide deaths. Poisoning (including gas poisoning) was the most common method used in Australia, with firearms being more common among young males. Australia had a higher years of potential life lost (YPLL) than Hong Kong because of the higher suicide rate among young males (aged 15-24). The high suicide rate among the elderly in Hong Kong raises the possibility that medical and social support to the elderly could be enhanced. The high female suicide rate in Hong Kong could be related to workload, responsibility, and expectations. The high suicide rate in Australia among males aged 15-24 was disturbing. Availability of the suicide methods is certainly one explanation for the difference in suicide methods used in Hong Kong and Australia.