Canada Has Sixth-Highest Suicide Rate in Americas, Says First Study of Its Kind

A new study shows that Canada had the sixth-highest suicide rate in 2019 out of the 33 countries examined in North, Central, and South America. (OLIVIER DOULIERY/AFP via Getty Images)

A new study ranks Canada as having the sixth-highest suicide mortality rate in 2019, out of 33 countries in North, Central, and South America.

Conducted by the Centre for Addiction and Mental Health (CAMH) and published on Feb. 23 in The Lancet Regional Health, the study is the first of its kind to examine the impact of specific contextual factors associated with national suicide rates in the Americas, according to CAMH.

The study looked at suicide rates from 2000–2019 using a cross-sectional ecological study.

In 2019, there were over 97,000 suicides in the region of the Americas, with a suicide mortality rate of 9.0 per 100,000 population, says the study. Among males, the rate was 14.2 per 100,000, and among females it was 4.1 per 100,000.

By sub-region, the suicide mortality rate varied considerably. North America had the highest rate of suicide, at 14.1 per 100,000 population, the study found. The Andean region in South America had the lowest rate, at 3.9 per 100,000 population, which the study attributed to “notable sociocultural differences between regions.”

Between countries, there were also significant differences in the suicide rate. The rate in Barbados ranged from 0.3 per 100,000 population, while Guyana had a rate of up to 65 per 100,000 population, according to the study.

The suicide mortality rates differed significantly between males and females, which the study called a “culture-bound phenomenon, meaning that cultural expectations about gender and suicide strongly determine both its existence and magnitude.”

“As such, it is also likely that the contextual factors associated with suicide will be different for males and females,” it states.

The study, which considered health data from the World Health Organization Global Health Estimates, found that the suicide mortality rate in the Americas has been increasing, while it decreased in all other studied regions. This highlights “an urgent need for more enhanced and targeted suicide prevention efforts,” it said.

Even between regions within a country, the study found differences in the suicide rate.

“Prevention efforts must not only target vulnerable populations, but also target the contextual factors contributing to the suicide mortality burden in a given country. In fact, population-level approaches to suicide prevention have been called for,” says the study.

The study also considered what factors influence the suicide rate, and concluded that eight population-level factors play a role in the number of people taking their own lives. These include intravenous drug use, alcohol use, “education inequality,” the number of doctors available per population, population density, health-care spending, homicide rate, and unemployment rate.

Education inequality was defined as unequal distribution of academic resources.

The study found that the mean suicide rate among males decreased as health expenditure per capita increased, and if the proportion of the country with a moderate population density increased. However, as the death rate due to homicide, prevalence of intravenous drugs, alcohol use, and unemployment rates went up, so too did male death rates from suicide.

For females, the number of medical doctors per 10,000 population reduced the suicide rate, as did moderate increases in population density. When education inequality and unemployment rates increased, so did the number of female suicides.

“The contextual factors that significantly impacted the suicide mortality rate among males and females were largely different,” states the study. “Sex should be considered when adapting and testing suicide risk reduction interventions, and when developing national suicide prevention strategies.”

Study author and CAMH scientist Dr. Shannon Lange said the study can help governments create more effective national suicide prevention strategies.

“Our findings highlight the vital importance of considering gender differences when developing, adapting and testing suicide risk reduction initiatives. Gender norms and expectations are likely to influence suicide risk factors so it can’t be a one-size fits all approach,” Lange said in a news release.

“Our results indicate that multi-sectoral measures targeting health and social well-being should be emphasized.”

Overall, the study found that there are some significant differences in the factors associated with male and female suicide rates.