Comparison of years of life lost to 1,565 suicides versus 10,650 COVID-19 deaths in 2020 in Sweden: four times more years of life lost per suicide than per COVID-19 death

Keywords: Life expectancy, SARS-CoV-2, suicide, psychiatric disorders, burden of disease, public health

Abstract

Background: The burden of disease from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is large; however, suicide affects the population year after year. From a public health perspective, it is important to not neglect contributors to the total burden of disease. The aim of this paper is to compare years of life lost (YLL) to suicide with those lost to coronavirus disease 2019 (COVID-19).

Methods: A nationwide cohort study in 2020, in Sweden. YLL was measured as the sex- and age-specific remaining life expectancy at the time of the person’s death based on the death risks that pertained to the Swedish population in 2019. YLL to suicide was compared to YLL to COVID-19 and presented by sex and age groups. Suicide deaths in 2020 were estimated as the annual average of suicides in 2015–2019.

Results: Annual average of suicide was 1,565, whereof 1,076 (68.8%) men and 489 (31.2%) women. In 2020, 10,650 persons died of COVID-19, whereof 5,681 (53.3%) men and 4,969 (46.7%) women. Estimated total YLL to suicide and COVID-19 in 2020 was 53,237 and 90,116, respectively. The COVID-19 YLL to suicide YLL ratio in 2020 was 1.69 (90,116/53,237). Men accounted for 67.1% of suicide YLL and of 56.4% of COVID-19 YLL. Those 44 years or younger accounted for 60.3% of suicide YLL and 3.9% of COVID-19 YLL. Those 75 years and older accounted for 2.9% of suicide YLL and 60.9% of COVID-19 YLL. On average, each suicide generates 34 YLL (53,237/1,565), and each COVID-19 death generates 8.5 YLL (90,116/10,650).

Conclusions: YLL to suicide affects Sweden year after year, foremost attributable to the younger age groups, whereas YLL to COVID-19 is foremost attributable to the elderly. On average, each suicide generates four times more YLL than a COVID-19 death. Enormous efforts and resources have been put on tackling the pandemic, and without these, the burden would probably have been much larger. However, from a public health perspective, it is important to not neglect other contributors to the total burden of disease where national efforts also may have an impact.

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References


  1. Global Burden of Disease. Institute for Health Metrics and Evaluation (healthdata.org) Available from: https://www.healthdata.org/gbd/about [cited 17 February 2022].

  2. Global Health Estimates 2020: disease burden by cause, age, sex, by country and by region, 2000–2019. Geneva: World Health Organization; 2020. Available from: https://www.who.int/data/global-health-estimates [cited 23 October 2021].

  3. Ljung R, Peterson S, Hallqvist J, Heimerson I, Diderichsen F. Socioeconomic differences in the burden of disease in Sweden. Bull World Health Organ. 2005 Feb;83:92–9.

  4. Naghavi M, Global Burden of Disease Self-Harm Collaborators. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ. 2019 Feb 6;364:l94. doi: 10.1136/bmj.l94

  5. World Health Organization (WHO). The Global health observatory. Global health estimates: leading causes of death. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death;WHO methods and data sources for global burden of disease estimates 2000–2019. Available from: https://cdn.who.int/media/docs/default-source/gho-documents/global-health-estimates/ghe2019_daly-methods.pdf?sfvrsn=31b25009_7 [cited 24 October 2021].

  6. Coronavirus (COVID-19) dashboard. World Health Organization. Available from: https://covid19.who.int/ [cited 24 October 2021].

  7. Ludvigsson JF, Autio G, Almqvist C, Edstedt-Bonamy AK, Ljung R, Michaelsson K, et al. Registers of the Swedish total population and their use in medical research. Eur J Epidemiol. 2016 Feb;31:125–36. doi: 10.1007/s10654-016-0117-y

  8. Ljung R, Sundström A, Grünewald M, Backman C, Feltelius N, Gedeborg R, et al. The profile of the COvid-19 VACcination register SAFEty study in Sweden (CoVacSafe-SE). Ups J Med Sci. 2021 Dec 10;126. doi: 10.48101/ujms.v126.8136

  9. Brooke HL, Talbäck M, Hörnblad J, Johansson LA, Ludvigsson JF, Druid H, et al. The Swedish cause of death register. Eur J Epidemiol. 2017 Sep;32:765–73. doi: 10.1007/s10654-017-0316-1

  10. Ulfhamre P, Jansson A, Arneborn M, Ekdahl K. SmiNet-2: description of an internet-based surveillance system for communicable diseases in Sweden. Euro Surveill. 2006 May;11:15–16. doi: 10.2807/esm.11.05.00626-en

  11. Smith L. Life expectancy. In: Armitage P, Colton T, eds. Encyclopaedia of biostatistics. Chichester: John Wiley & Sons; 1998, pp. 2234–5.

  12. Statistics Sweden. Life table by sex and age. Year 1960–2020. Available from: https://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101I/LivslangdEttariga/ [cited 13 January 2022]

  13. Jokinen J, Talbäck M, Feychting M, Ahlbom A, Ljung R. Life expectancy after the first suicide attempt. Acta Psychiatr Scand. 2018 Apr;137:287–95. doi: 10.1111/acps.12842

  14. Björkenstam C, Johansson LA, Nordström P, Thiblin I, Fugelstad A, Hallqvist J, et al. Suicide or undetermined intent? A register-based study of signs of misclassification. Popul Health Metr. 2014 Apr 17;12:11. doi: 10.1186/1478-7954-12-11

  15. Murray CJL, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, et al. GBD 2010: design, definitions, and metrics. Lancet. 2012;380:2063–6. doi: 10.1016/S0140-6736(12)61899-6

  16. Fan CY, Fann JC, Yang MC, Lin TY, Chen HH, Liu JT, et al. Estimating global burden of COVID-19 with disability-adjusted life years and value of statistical life metrics. J Formos Med Assoc. 2021 May 31;120:S106–17. doi: 10.1016/j.jfma.2021.05.019

  17. Chan JKN, Wong CSM, Yung NCL, Chen EYH, Chang WC. Excess mortality and life-years lost in people with bipolar disorder: an 11-year population-based cohort study. Epidemiol Psychiatr Sci. 2021 May 28;30:e39. doi: 10.1017/S2045796021000305

  18. Ferenci T. Different approaches to quantify years of life lost from COVID-19. Eur J Epidemiol. 2021 Jun;36(6):589–597. doi: 10.1007/s10654-021-00774-0

Published
2022-05-11
How to Cite
Ljung R., Grünewald M., Sundström A., Thunander Sundbom L., & Zethelius B. (2022). Comparison of years of life lost to 1,565 suicides versus 10,650 COVID-19 deaths in 2020 in Sweden: four times more years of life lost per suicide than per COVID-19 death. Upsala Journal of Medical Sciences, 127(1). https://doi.org/10.48101/ujms.v127.8533