title: The World Health Organization (WHO) dataset for guiding suicide prevention policies: A 3-decade French national survey.
abstract: BACKGROUND
  Public health policies aim to prevent suicide in the general population. Assessing their effectiveness is required to further guide public health policies. The present article focuses on the French paradox. The French health care system was classified as the best in the world according the World Health Organization (WHO). However, suicide rates in France remain high compared to other European countries. The aim of the present article was to analyze (i) the evolution of suicide Age-Standardized Death (ASDRs) in France during the last three decades and the associations with socio-economic parameters and (ii) to understand which populations may specifically benefit from further targeted suicide prevention policies.
  
  
  METHODS
  The database of the World Health Organization (WHO), freely available, was explored in April 2015. ASDRs were calculated each year by ratio between the number of deaths by suicide and the total population (per 100,000 inhabitants). Number of deaths by gender and age were also analyzed.
  
  
  RESULTS
  Overall, ASDR suicide has decreased since 1987 in France (-32.8% between 1987 and 2010). However, France kept the same rank (10/26) when compared to other European countries between 1987 and 2010. The relative burden of suicide in all-causes mortality increased during the same period (+28.2%) while the total number of deaths by suicide increased only slightly (+3.9%). More specifically, the number of deaths by suicide increased substantially in [35-54] years old (+40%) and 75+ years old (+27%) males, and in [35-54] (+41%) years old females. Between 2000 and 2010, suicide rates significantly decreased when yearly mean income increased, and when general and psychiatric care beds decreased.
  
  
  CONCLUSIONS
  Although ASDR suicide has decreased in France since 1987, this decline is quite modest when considering its universal access to care, the prevention of depression and suicide public policies. Suicide prevention public policies should focus on evaluation and improvement of prevention and care in the [35-54] years old population, and in the males aged 75+.
authors.affiliation: Université Paris Est-Créteil, Pôle de psychiatrie des hôpitaux universitaires H Mondor, INSERM U955, Eq Psychiatrie Translationnelle, DHU Pe-Psy, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France. Electronic address: guillaume.fond@gmail.com.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Fond
authors.affiliation: Department of Psychiatry, La Conception University Hospital, Marseille, France; Aix-Marseille University, Public Health, Chronic Diseases and Quality of Life, Research Unit, Marseille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Zendjidjian
authors.affiliation: EA3279, Self-perceived Health Assessment Research Unit, School of Medicine, Université de la Méditerranée, 27 bd Jean Moulin, Marseille Cedex 05 F-13385, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Boucekine
authors.affiliation: Université Paris Est-Créteil, Pôle de psychiatrie des hôpitaux universitaires H Mondor, INSERM U955, Eq Psychiatrie Translationnelle, DHU Pe-Psy, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Lore
authors.initials: L
authors.lastname: Brunel
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France; CHU Clermont Ferrand, Clermont-Ferrand, France.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: Service hospitalo-universitaire de psychiatrie, Hôpital Sainte-Marguerite, Marseille, France; Service hospitalo-universitaire de psychiatrie, Hôpital Sainte-Marguerite, Marseille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000368:Aged; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D006291:Health Policy / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012737:Sex Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014944:World Health Organization; D000092864:Suicide Prevention
keywords: Age; Death rate; Gender; Mortality; Suicide; World Health Organization