Injury and suicide in people aged 60 years and over in China: an analysis of nationwide data

Abstracts Background Of China's population of 1·37 billion, 16.1% are elderly people (aged 60 years or over), and of those over 65 years, 16·4% live alone. Most studies agree that with urbanization has come a decline in the suicide rate, except in elderly people. This study aims to examine the morbidity and mortality associated with injury and suicide among elderly people in China. Methods Injury data for elderly people (aged 60 and over) in China (according to the International Classification of Diseases tenth revision [ICD-10] for injury data) from 2006 to 2015 were obtained from the annual reports of the Chinese National Health and Family Planning Commission published by the government of China and the Peking Union Medical College. These reports compiled the causes of death of residents from all 31 provinces. The institutional review board of National Yang-Ming University approved this study. Findings From 2006 to 2015, the likelihood of death due to injury in elderly people in China increased with age in those over 65 years old. On average, mean rates of death due to injury were higher in rural areas (53·95 [SD 3·49] per 100 000 population) than in urban areas (35·71 [2·67] per 100 000), and were higher in males (58·91 [14·36] per 100 000) than in females (30·29 [5·30] per 100 000). Mortality rates due to injury in those aged 65–70 years, 70–75 years, 75–80 years, and 80 years and over were 1·6, 2·2, 3·3, and 5·8 times that of the general population. Furthermore, mortality rates secondary to accidental falls for those aged 80–85 and 85 years and over were 11·45 and 39·05 times that of the general population, respectively. In 2015, suicide rates in people aged 60–85 were 9·7–41·09 per 100 000 in urban areas. In rural areas, the suicide rate was 65·60 per 100 000 in people aged 85 and over. On average, mortality from suicide in Chinese people aged 65–85 was 2·75–7·08 times that of the general population. Interpretation Morbidity and mortality due to suicide and injury in elderly people in China continues to rise. As the Chinese population ages, the problem is set to worsen. Policies to reduce injury and prevent suicide in elderly people in China are needed urgently. Funding This study was supported by the ROC Ministry of Science and Technology Grant (number MOST 105-2511-S-010-002-MY2 ).