title: Suicide and self-inflicted injury hospitalizations in Canada (1979 to 2014/15).
abstract: BACKGROUND
  The purpose of this paper is to describe the trends and patterns of self-inflicted injuries, available from Canadian administrative data between 1979 and 2014/15, in order to inform and improve suicide prevention efforts.
  
  
  METHODS
  Suicide mortality and hospital separation data were retrieved from the Public Health Agency of Canada (PHAC) holdings of Statistics Canada's Canadian Vital Statistics: Death Database (CVS:D) (1979 to 2012); Canadian Socio-Economic Information Management System (CANSIM 2011, 2012); the Hospital Morbidity Database (HMDB) (1994/95 to 2010/11); and the Discharge Abstract Database (2011/12 to 2014/15). Mortality and hospitalization counts and rates were reported by sex, 5-year age groups and method.
  
  
  RESULTS
  The Canadian suicide rate (males and females combined, all ages, age-sex standardized rate) has decreased from 14.4/100 000 (n = 3355) in 1979 to 10.4/100 000 (n = 3926) in 2012, with an annual percent change (APC) of -1.2% (95% CI: -1.3 to -1.0). However, this trend was not observed in both sexes: female suicide rates stabilized around 1990, while male rates continued declining over time-yet males still accounted for 75.7% of all suicides in 2012. Suffocation (hanging and strangulation) was the primary method of suicide (46.9%) among Canadians of all ages in 2012, followed by poisoning at 23.3%. In the 2014/15 fiscal year, there were 13 438 hospitalizations in Canada (excluding Quebec) associated with self-inflicted injuries-over 3 times the number of suicides. Over time females have displayed consistently higher rates of hospitalization for self-inflicted injury than males, with 63% of the total. Poisoning was reported as the most frequent means of self-inflicted harm in the fiscal year 2014/15, at 86% of all hospitalizations.
  
  
  CONCLUSIONS
  Suicides and self-inflicted injuries continue to be a serious - but preventable - public health problem that requires ongoing surveillance.
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Skinner
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: McFaull
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Draca
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Frechette
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Kaur
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Pearson
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: W
authors.initials: W
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002648:Child; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000453:epidemiology*; D016728:Self-Injurious Behavior / Q000150:complications / Q000453:epidemiology*; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Canada; intentional injuries; self-harm; self-inflicted injuries; suicide; suicide attempts; trends