User:Tzu-jan Entelechy/Suicide in Canada

Approximately 3,500 suicides take place in Canada annually, slightly below deaths due to cancers of the colon and breast, and suicide is the seventh-most common cause of death among Canadian males, and tenth-highest among both sexes combined. During the 2000s, Canada ranked 34th-highest overall among 107 nations' suicide rates, and 17th among 34 OECD countries. Rates of suicide in Canada have been fairly constant since the 1920s, averaging annually around twenty (males) and five (females) per 100,000 population, ranging from lows of 14 (males, 1944) and 4 (females, 1925, 1963) to peaks of 27 (males, 1977, 1982) and 10 (females, 1973).

Demographics and locations
Canada's incidence of suicide — deaths caused by intentional self-harm divided by total deaths from all causes — averaged over the period from 2000 to 2007 for both sexes, was highest in the northern territory of Nunavut, and highest across the country within the age group from 45 to 49 years.

Rate of suicide, all ages, average over 2000-2007, according to province or territory

Age-standardized mortality rate per 100,000 population

Source:

While Canadian males experience two periods over their lives when they are most likely to commit suicide — in their late forties, and past the ag e of ninety — for females there is a single peak, in their early fifties. The peak male rates are 53% above the average for all ages, while for females, the peak is 72% greater.

Rate of suicide, all Canadians, average over 2000-2007, according to age at death

Age-standardized mortality rate per 100,000 population

Source:

Among Canadians aged 15 to 24, suicide ranked second among the most common causes of death during 2003-2007, accounting for one-fifth of total mortality. In the 45 to 54 age group, its rank was fourth over these years, the cause of 6 per cent of all deaths.

Canada's regional rate of 71.0 in Nunavut is over double that for the highest-ranking country, Lithuania, with a national rate of 31.5.

With 86.5 suicides per 100,000 population in 2006, males' rates over the age of 74 in the Russian Federation exceed by threefold Canadian males' rate among the same age cohort, however Canada's Nunavut males of all ages exceeded the elderly Russian male rate by thirty per cent. During 2000-2007, there were between 13 and 25 male suicides recorded annually in the Nunavut territory, accounting for between 16% and 30% of total annual mortality.

A 2008 study of the health of 29,000 public school students in grades 7 to 12 in British Columbia found that cultural background, gender orientation, and health status played significant roles in suicide attempt behaviour: Some groups of youth were also at greater risk of suicide: these include Aboriginal youth (11% vs. 4% non-Aboriginal youth), lesbian, gay and bisexual youth (28% vs. 4% heterosexual youth), obese youth (10% vs. 4% healthy weight youth) and youth with a health condition or disability (16% vs. 4% of youth without a disability).

An internal study of suicide rates among Canadian Forces staff deployed over the period 1995 to 2008 found the rate for males in the Regular Forces to be approximately 20% lower than that among the general population of the same age. However, mortality analysis of 2,800 former Canadian Forces personnel revealed statistically significant, higher likelihoods of death by suicide, 46% higher for males and 32% higher for females, relative to the civilian population; released Canadian Forces males in the 16 to 24 age group showed the greatest deviations, with suicide rates more than two-fold in excess of their general population cohort.

Methods
During the 1980s and 1990s, firearms (or explosives) and hanging were the first- and second-most frequent means of suicide among Canadian males, followed by poisoning, gases, and jumping, and collectively, nine-tenths of suicides were committed via these five methods; poisoning was responsible for forty per cent of female suicides, followed by hanging (20%), gases and firearms (10% each). Analysis of coroners' reports has attributed overprescription practices, and deficiencies in patient screening and prevention by family physicians to recent Canadian suicide trends.

A study of 20,851 suicides in Quebec from 1990 to 2005 found that hanging, strangulation and suffocation were the principal causes of death (males, age-adjusted rate of 15.6 per 100,000; females, 3.6), followed by poisoning (males: 5.7; females: 2.9).

In 2009, 14 of 18 persons who jumped in front of oncoming subway trains in Toronto's mass transit system were killed by the direct impact, electrocution from the high voltage rail, or from entrapment underneath the cars. Although 1,200 suicide attempts or deaths have occurred in the Toronto subway from 1952 to 2010, with a peak of 54 suicide incidents in 1984, the current rate represents four per cent of Toronto's annual suicides. In 2010, the Toronto Transit Commission reported a total of 26 "suicide incidents" (attempts and deaths), and seven during the first five months of 2011.

Cultural and social aspects
Although early mortality statistics were not collected, during the middle of the twentieth century it was noted that among the Alaskan Inuit,

When a person was no longer able to produce, he had no right to expect continued support [...] This is not to imply a disrespect for the aged [...] It was rather the unnamed child, the child who was not regarded as a member of the society as yet, who was subject to abandonment [...] Only in the direst of circumstances would it have taken place.

During the same period, on Baffin Island, now part of Canada's Nunavut territory, elderly Inuit women, with the approval of her family, were in some cases "walled into a snowhut and left to die".

Two- to seven-fold differentials in suicide mortality rates among Canada's indigeneous communities, relative to the general population, exceed the two- to three-fold elevations reported among indigenous peoples in other countries of British colonisation, including Australia and the United States.

Rates of suicide among the Inuit of the eastern Arctic rose from around 40 per 100,000 population in 1984 to about 170 in 2002, and they no longer follow the tradition of suicide among the frail elderly, but have been speculated to relate to adverse childhood experiences involving emotional neglect and abuse, family violence and substance abuse, as well as social inequalities brought on by government intervention. During 1999-2003, the suicide rate among Nunavut males aged 15 to 19 was estimated to exceed 800 per 100,000 population, compared to around 14 for the general Canadian male population in that age group.

High concentrations of air pollutants, particularly nitrogen oxide during the winter months, have been associated with a twenty per cent rise in suicidal attempt presentations at a Vancouver hospital emergency department. Pathological gambling behaviour has been linked to a threefold increase in the likelihood of suicide attempts from a nationally representative sample. The same study found the overall incidence of attempted suicide to be 0.52% in 2002 from a survey of forty thousand individuals, with rates nine times higher among both persons aged 15 to 19 compared to those over age 55, and nine times higher among those who had suffered from major depression during the previous year; persons in the lowest income quintile were four times as likely to report suicide attempts than those in the top income bracket. Unattached Canadians between 45 and 59 years of age were in 2007 found to be 2.6 times more likely than their population share to fall within the low income category as defined by the low income cutoff measure, making them the most at-risk population group; they were followed by recent immigrants (2.0), lone parents and their children (1.9), and persons with work limitations (1.2).

During the period from 2002 to 2005, residents of health regions of Quebec that were in the lowest socioeconomic decile, as defined by average household income, unemployment rate and education, were statistically found to have 85% (males) and 51% (females) higher incidences of suicide mortality than Quebeckers in regions in the highest socioeconomic decile, and these differences have either persisted or worsened since 1990.

Government response
A survey of twenty-one advanced, industrialized nations during 2004 found that Canada was among ten lacking "countrywide integrated activities carried out by government bodies" to address the problem of suicide; Canada is in company with Belgium, the Netherlands, and Switzerland, while the eleven countries implementing national programs include Australia, France, the United Kingdom, and the United States. According to a former president of the Canadian Association for Suicide Prevention, Canada's federal government has failed to implement the 1995 United Nations guidelines for national suicide prevention strategies, the government has never formally acknowledged that "suicide is a national public health issue", and while Quebec, Alberta and Nova Scotia have provincial strategies, both Ontario and Saskatchewan lack them.

During 2005-2010, Canada's federal government allocated a total of $65 million to be administered by Health Canada and the Government of Nunavut for the National Aboriginal Youth Suicide Prevention Strategy (NAYSPS), and by 2010, two hundred community-based programs including mental health service providers, native elders and teachers had benefited from this initiative. . The federal government extended the NAYSPS in 2010 for an additional five years, and increased the budget to $75 million.

The National Strategy for Suicide Prevention Act, a private member's bill from New Democratic Party Member of Parliament Megan Leslie, received its first reading in 2010 in Canada's House of Commons. Harold Albrecht (Kitchener—Conestoga, CPC) introduced in September 2011 a private member's bill, known as the Federal Framework for Suicide Prevention Act, which directs the government to take responsibility for information and knowledge sharing related to suicide and suicide prevention in consultation with various government levels and civil society. In October 2011, a day-long debate in the House of Commons resulted in passage of an opposition motion, by a vote of 272 yeas against 3 nays, to "urge the government to work cooperatively with the provinces, territories, representative organizations from First Nations, Inuit, and Métis people, and other stakeholders to establish and fund a National Suicide Prevention Strategy".

Since the early 1970s, the Toronto Transit Commission's (TTC) policy was to suppress information concerning suicide jumpers in the Toronto subway, however data were publicly released following a request from journalists in 2009. As an interim measure, in June 2011, the TTC implemented a "Crisis Link" campaign, with posters exhorting persons contemplating suicide to press an autodial button on one of 141 designated payphones located on 69 stations' platforms to speak directly with a trained counsellor with the Distress Centres of Toronto. Platform screen doors have been already been built in underground mass transit systems in cities in Europe and Asia, however the first screen doors in Canadian metro stations are scheduled for Toronto in 2013.