Attributable risk of suicide for populations in Australia

Piumee Bandara; Andrew Page; Lennart Reifels; Karolina Krysinska; Karl Andriessen; Marisa Schlichthorst; Anna Flego; Long Khanh-Dao Le; Cathrine Mihalopoulos; Jane Pirkis

doi:10.3389/fpsyt.2023.1285542

Attributable risk of suicide for populations in Australia

Front Psychiatry. 2024 Jan 8:14:1285542. doi: 10.3389/fpsyt.2023.1285542. eCollection 2023.

Authors

Affiliations

¹ Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
² Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
³ Health Economics Group, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
⁴ Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia.

Abstract

Objective: Each year approximately 3,000 Australians die by suicide. We estimated the population attributable risk for identified target populations to provide evidence on how much of the overall burden of suicide in the Australian population is experienced by each of them.

Methods: We identified 17 demographic and clinical target populations at risk of suicide and calculated the population attributable fraction (PAF) using a single or pooled suicide risk and the proportional representation of each target population within Australia.

Results: Large PAF estimates were found for men (52%, 95% confidence interval (CI) 51%-53%), people bereaved by suicide (35%, 95% CI 14%-64%), people with a mental health or behavioural condition (33%, 95%CI 17%-48%), people with a chronic physical condition (27%, 95%CI 18%-35%), adults aged 25-64 years (13%, 95%CI 12%-14%), LGB populations (9%, 95%CI 6%-13%), offenders (9%, 95%CI 8%-10%), and people employed in blue collar occupations (8%, 95%CI 4%-12%).

Limitations: The PAF is limited by assumptions, namely, that risk factors are independent, and that the relationship between risk factors and outcomes are unidirectional and constant through time.

Conclusions and implications for public health: Considerable reductions in the overall suicide rate in Australia may occur if risk factors are addressed in identified populations with large PAF estimates. These estimates should be considered as an adjunct to other important inputs into suicide prevention policy priorities.

Keywords: Australia; population attributable fraction; population attributable risk; suicide; suicide prevention.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was conducted in the context of the LIFEWAYS Project, which is funded by the Australian Government Department of Health. The funder had no role in the study design, data collection, analysis and interpretation of the data, writing and decision to submit the article for publication. JP is supported by NHMRC Investigator and Partnership Project Grants (1173126, 1191874). KA is supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (1157796) and an Early Career Researcher Grant of The University of Melbourne (ECR1202020). LL was supported by the Alfred Deakin Postdoctoral Research Fellowship 2021–2022.