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Public Health Report

Suicide and suicide attempts in Norway

Every year, 500-600 suicides are registered in Norway. Two out of three who commit suicide are men. Many bereaved people are affected by suicide every year.

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Main points

  • About 500 - 600 people commit suicide every year in Norway. Two out of three are men.
  • The number of suicides per 100,000 inhabitants has been constant in 15 years.
  • The median age of suicide is 47 years, which means that half are older and half are younger than 47 years.
  • Between 5,000 and 6,000 bereaved family members and close friends are affected by suicide every year.
  • The incidence of suicide in Norway is similar to Europe, North America and Australia.

About suicide, suicide attempts and self-harm

Suicide is the result of a self-inflicted injury with the intent to end life.

Suicide attempts and self-harm are usually different scenarios.

  • In the case of suicide attempts, there is an intention to die, although the intention may vary in strength.
  • Self-harm is not necessarily associated with a desire to die but is linked to a desire to self-inflict physical pain, to change an intense negative thought, a bad feeling or a difficult relationship (Øverland, 2006).

 

Data source and glossary

Suicide statistics are extracted from the Cause of Death Registry. Deaths are coded as suicides in the registry if suicide/ probable suicide was reported on the death certificate or the post-mortem report.

There is some uncertainty about suicide rates. Some suicides are categorised incorrectly as accidents, and there is a grey zone between accidents and suicide. Lack of information about the reported cause of death in the Cause of Death Registry can also disguise some suicides.

In the case of suicide attempts and self-harm, there are no national figures for incidence and trends over time.

Suicide rate

In order to compare the suicide rate over time, or between different populations, we must account for changes in the population. Therefore, we use the suicide rate for comparisons, which is the number of suicides per 100,000 inhabitants.

In addition, a correction is often made to account for different age distributions in the groups to be compared (age adjustment).

Median age

This age divides the group into two equal parts, meaning that there are as many people younger than this age as people who are older.

Suicide in Norway - Status and trends

In 2016, there were 617 suicides registered in Norway, 421 men and 196 women. Two out of three were men.

By comparison in 2015, 590 suicides were registered, 400 men and 190 women.

Trends over time

From 1970 to 1990, the risk of suicide doubled for both sexes, before a sharp decline from 1988 to 1993. By 2016, the rate was 12.0 per 100 000 inhabitants. This is 25 per cent lower than in 1990 when the rate was at 16.4 per 100,000 inhabitants, see figure 1.

A major reason for the change is a reduction in the number of suicides among men. For women, the decline continued until 1993 and since then, the rate has been relatively constant. For men, the decline continued to 2002 before levelling off. The gender difference has become smaller; at the beginning of the period there were almost three times as many suicides among men as in women, while the ratio is now approaching 2:1, see Figure 1.

Suicide FHR figure 1.jpg

Figure 1. Number of suicides per 100,000 inhabitants. Men, women and both sexes combined for the period 1970-2016. Not age-standardised population. Source: Cause of Death Registry. See Norhealth for figures and rates. 

For women, suicide rates for 2015 and 2016 were slightly higher than in recent years, but no more than could be expected with random fluctuations. There will always be some fluctuations in the number of suicides (and thus the suicide rate) from year to year.

Suicide methods have changed over time. Among men, hanging and suffocation are the most common methods. The use of firearms has declined over the last 20 years. Among women, poisoning is as common as hanging and suffocation.

Suicide in different age groups

The median age of suicide was 47 years in 2016 (NIPH, 2017).

The suicide rate is higher for men than for women in all age groups when we exclude the youngest age group, see Figure 2.

  • Suicide rates are very low for the youngest group (0-14 years).
  • In the 20-75 year age group, there are about 20 suicides among men per 100,000 inhabitants per year, while the rate for women is between 5 and 10 suicides per 100,000 inhabitants.
  • Among the oldest, the number per 100,000 inhabitants is significantly higher among men than among women.
Suicide FHR figure 2.jpg

Figure 2. Number of suicides per 100,000 inhabitants for men and women in different age groups, based on suicide rates for 2012-2016. Source: Cause of Death Registry, Norwegian Institute of Public Health.

County differences

For the last decade combined, Eastern Norway, excluding Oslo and Akershus, had the highest suicide rate and Western Norway, particularly Sogn og Fjordane, had the lowest.

Many counties have a low population and there are so few suicides that the random annual fluctuations appear to be large. A few deaths in a county can result in a large statistical difference. This makes the uncertainty range around the suicide rate in each county high and it can be difficult to say whether a county actually has higher or lower suicide rates than the rest of the country. In the Norhealth statistics bank, figures for the counties are shown per 100,000 inhabitants in five-year periods in the age-standardised population.

International differences

From 1969-2000, there were major differences in the incidence of suicide between the Nordic countries. Today, the incidence is similar in Norway, Sweden and Denmark (around 11 per 100,000 inhabitants), but Finland still has a significantly higher incidence than the other Nordic countries (almost 20 per 100,000).

The incidence of suicide in Norway resembles the rest of Europe, North America and Australia. In Europe, the average suicide rate was 11.7 per 100,000 for both sexes in the years 2006-2014 (European Commission, 2017). This is very close to the figures for Norway. However, there are even greater gender differences in the rest of Europe than in Norway. Compared with Norway, the figures are lower for women and higher for men. If using Eurostat, please note that the figures may differ from those in the Norwegian statistical banks because the statistics may be adjusted according to different age groups in the population.

In Eastern Europe, Russia, China, Japan and other countries in Asia with reliable statistics, the figures are higher than in Norway; 20-30 suicides per 100,000 inhabitants per year (Varnik, 2012). In these areas, suicide rates in most countries are higher among men than among women.

Consequences for the bereaved

Suicide has significant consequences for close family and friends, and for society as a whole. If we estimate that there are 10 bereaved people per suicide, 5000-6000 people are affected by suicide in Norway every year.

Several studies found higher rates of post-traumatic stress reactions, prolonged grief, depression, anxiety and suicidal thoughts and / or suicide attempts among the bereaved after suicide (Dyregrov, 2003; Groot, 2006; Pfeffer, 1997). Corresponding mental and physical problems have been seen among the bereaved after other sudden deaths (Li, 2003). However, those who are bereaved by suicide report higher levels of feelings of rejection, shame, stigma and the need to conceal what has happened (Sveen, 2008).

About the article:

Reference: Folkehelseinstituttet, http://www.fhi.no/artikler/?id=110540

References

Dyregrov, K., Nordanger, D., & Dyregrov, A. (2003). Predictors of psychosocial distress after suicide, SIDS and accidents. Death Studies, 27(2), 143-165.

European Commission. (2017) Suicide death rate, by age group. [database]. Eurostat; European Commission. Extracted 11th December 2017.

Groot, M. H., Keijser, J., & Neeleman, J. (2006). Grief shortly after suicide and natural death: a comparative study among spouses and first-degree relatives. Suicide and Life-Threatening Behavior, 36(4), 418-431.

Li, J., Precht, D. H., Mortensen, P. B., & Olsen, J. (2003). Mortality in parents after death of a child in Denmark: a nationwide follow-up study. Lancet, 361(9355), 363-367.

NIPH. (2017) Cause of Death Registry [database]. Extracted 12th December 2017.

Pfeffer, C. R., Martins, P., Mann, J., Sunkenberg, M., Ice, A., Damore, J. P., Jr., et al. (1997). Child survivors of suicide: psychosocial characteristics. J Am Acad Child Adolesc Psychiatry, 36(1), 65-74.

Sveen, C. A., & Walby, F. A. (2008). Suicide survivors' mental health and grief reactions: a systematic review of controlled studies. Suicide and Life-Threatening Behavior, 38(1), 13-29.

Varnik, P. (2012). Suicide in the world. Int J Environ Res Public Health, 9(3), 760-771.

Øverland, S. (2006). Selvskading: en praktisk tilnærming. Bergen: Fagbokforl.

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