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Suicide rates in Zhejiang Province, China, from 2006 to 2016: a population-based study
  1. Fangrong Fei1,
  2. Huixin Liu2,
  3. Sequoia I Leuba3,
  4. Yichong Li4,
  5. Ruying Hu1,
  6. Min Yu1,
  7. Jin Pan1,
  8. Jieming Zhong1
  1. 1 Department of Non- communicable Disease control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
  2. 2 Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing, China
  3. 3 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  4. 4 Department for clinical research and epidemiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
  1. Correspondence to Dr Jieming Zhong, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, China; cdcjmz{at}


Background We investigated the current temporal trends of suicide in Zhejiang, China, from 2006 to 2016 to determine possible health disparities in order to establish priorities for intervention.

Methods We collected mortality surveillance data from 2006 to 2016 from the Zhejiang Chronic Disease Surveillance Information and Management System from the Zhejiang Provincial Centre for Disease Control and Prevention. We estimated region-specific and gender-specific suicide rates using joinpoint regression analyses to determine the average annual percentage change (AAPC) and its 95% CI.

Results The crude suicide rate declined from 9.64 per 100 000 people in 2006 to 4.86 per 100 000 in 2016, and the age-adjusted suicide rate decreased from 9.74 per 100 000 in 2006 to 4.14 per 100 000 in 2016. During 2006–2013, rural males had the highest suicide rate, followed by rural females, urban males, and urban females, while after 2013, urban males suicide rates surpassed rural female suicide rates, and became the second highest suicide rate subgroup. The rate of suicide declined in all region-specific and/or gender-specific subgroups except among urban males between 20 and 34 years of age. Their age-adjusted suicide rate AAPC greatly increased to 28.39 starting in 2013 compared with an AAPC of −13.47 from 2006 to 2013.

Conclusions The suicide rate among young urban males has been alarmingly increasing since 2013, and thus, researchers must develop targeted effective strategies to mitigate this escalating loss of life.

  • suicide
  • epidemiology
  • public health

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  • FF and HL are joint first authors.

  • FF and HL contributed equally.

  • Contributors F-FR and L-HX conceived, designed and organised the study. Z-JM, H-RY and YM coordinated and monitored the study. F-FR and PJ collected data. F-FR, L-HX and L-YC did the analysis. F-FR, L-HX and SIL wrote the first manuscript draft and all authors contributed to the subsequent drafts and approved the final version.

  • Funding This study was supported by National Natural Science Foundation of China (NSFC No. 81602939 and No. 81201063) and Medicine and Health Care in Zhejiang Province Science and Technology Plan (grant No. 2019KY355).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the ethics committee of Zhejiang Provincial Centre for Disease Control and Prevention.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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