Estimating patterns in the under-reporting of suicide deaths in India: comparison of administrative data and Global Burden of Disease Study estimates, 2005-2015
Estimating patterns in the under-reporting of suicide deaths in India: comparison of administrative data and Global Burden of Disease Study estimates, 2005-2015
复制标题
DOI：
10.1136/jech-2020-215260
复制
发表时间：
2021-06-01
影响因子：
6.3
通讯作者：
Dandona, Rakhi
中科院分区：
文献类型：
--
作者：
Arya, Vikas;Page, Andrew;Dandona, Rakhi
背景 有人建议，负责报告印度自杀情况的国家犯罪记录局 (NCRB) 根据地理和人口因素不同地低估了自杀情况。我们通过将 NCRB 数据中记录的自杀人数与全球疾病负担 (GBD) 倡议最近对印度自杀人数的估计进行比较，评估了潜在漏报的程度。方法 按性别、年龄和州计算两个数据源的年龄标准化自杀率，并比较相应阶层的 NCRB 与 GBD 估计值的比率，以确定 NCRB 报告中的相对漏报情况。结果 与 NCRB 报告相比，GBD 研究报告 2005 年至 2015 年间，自杀死亡人数增加了 802 684 例（男性 333 558 例，女性自杀 469 126 例）。男性每年平均漏报率为 27%（范围 21%-31%），女性平均漏报率为 50%（范围每年 47%-54%)。与中年组相比，年轻组（15-29 岁）和老年组（≥ 60 岁）的漏报情况更为明显。与社会人口指数（SDI）中等和高的印度邦相比，社会人口指数（SDI）较低的印度邦的漏查率普遍较高。结论 NCRB 数据低估了印度的自杀情况，且按性别、年龄和地理区域存在差异，这可能是由于社会耻辱和法律后果导致缺乏社区层面的自杀报告。虽然最近自杀非刑事化预计将改善社区一级对自杀的报告，但应制定自杀预防政策，优先解决自杀和自杀行为带来的社会耻辱，特别是在女性中。
Background It has been proposed that the National Crime Records Bureau (NCRB), which reports suicides in India, differentially underenumerates suicides by geographic and demographic factors. We assessed the extent of potential underenumeration by comparing suicides recorded in NCRB data with recent estimates of Indian suicides developed by the Global Burden of Disease (GBD) initiative. Methods Age-standardised suicide rates were calculated for both data sources by sex, age and state, and rate ratios of NCRB to GBD estimates by corresponding strata were compared to ascertain the relative under-reporting in the NCRB report. Results The GBD Study reported an additional 802 684 deaths by suicide (333 558 male and 469 126 female suicide deaths) compared with the NCRB report between 2005 and 2015. Among males, the average under-reporting was 27% (range 21%-31%) per year, and among females, the average under-reporting was 50% (range 47%-54%) per year. Under-reporting was more evident among younger (15-29 years) and older age groups (>= 60 years) compared with middle age groups. Indian states belonging to low Socio-Demographic Index (SDI) generally had greater underenumeration compared with middle and high-SDI states. Conclusion NCRB data under-report suicides in India, and differentially by sex, age and geographic area, possibly because of lack of community-level reporting of suicides due to social stigma and legal consequences. While the recent decriminalisation of suicide is expected to improve community-level reporting of suicides, suicide prevention policies should be developed, with a priority to address social stigma attached with suicide and suicidal behaviour, especially among females.