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Background: Suicide by road vehicle collision in Australia is under-explored with mixed findings. We aimed to address this research gap by examining time trends, different types of vehicle collision, and individual characteristics related to vehicle-collision suicide. Method: We retrospectively analyzed deaths by suicide between 1st January 2001 and 31st December 2017 in Australia, using coronial records from the National Coronial Information System. The travel mode used and collision counterpart were retrieved from records of death by vehicle-collision suicide using all available information. We conducted negative binomial regression analysis to examine annual changes in suicide rate by vehicle collision on a public road (N = 640) and other methods of suicide (N = 41,890), and logistic regression analysis to examine individual characteristics associated with the likelihood of dying by suicide via road vehicle collision. Results: Overall, the national suicide rate involving road vehicle collision significantly increased, while the rate by other methods significantly decreased. Drivers accounted for 61% of suicide events by vehicle collision, of which 72% were single-vehicle collisions (commonly involving a tree). For multiple-vehicle collision suicide events, 82% involved collision with a truck. Pedestrians accounted for more than one-third of suicide events, of which 58% involved collision with a truck and 23% involved collision with a car/van. Individuals who were male (odds ratio 1.15; 95% CI 0.88–1.50), aged <25 years old (odds ratio 5.27; 95% CI 3.05–9.10), non-Indigenous (odds ratio 3.36; 95% CI 1.71–6.62), and born overseas (odds ratio 1.40; 95% CI 1.10–1.79) were more likely to die by vehicle-collision suicide than by other methods of suicide. Conclusions: This study provides a better understanding of road vehicle collision suicide in Australia and informs future research directions on topic. Our findings can be used to inform suicide prevention initiatives to reduce vehicle-collision suicide deaths. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The aim of this study was to highlight the differences in injury rates between populations through a descriptive epidemiological study of population-level trends in injury mortality for the high-income countries of Australia, Canada and the United States. METHODS: Mortality data were available for the US from 2000 to 2014, and for Canada and Australia from 2000 to 2012. Injury causes were defined using the International Classification of Diseases, Tenth Revision external cause codes, and were grouped into major causes. Rates were direct-method age-adjusted using the US 2000 projected population as the standard age distribution. RESULTS: US motor vehicle injury mortality rates declined from 2000 to 2014 but remained markedly higher than those of Australia or Canada. In all three countries, fall injury mortality rates increased from 2000 to 2014. US homicide mortality rates declined, but remained higher than those of Australia and Canada. While the US had the lowest suicide rate in 2000, it increased by 24% during 2000-2014, and by 2012 was about 14% higher than that in Australia and Canada. The poisoning mortality rate in the US increased dramatically from 2000 to 2014. CONCLUSION: Results show marked differences and striking similarities in injury mortality between the countries and within countries over time. The observed trends differed by injury cause category. The substantial differences in injury rates between similarly resourced populations raises important questions about the role of societal-level factors as underlying causes of the differential distribution of injury in our communities. KEY WORDS: Injury prevention; suicide; global injury; homicide; falls; poisonings; motor vehicle injury; population level change OBJECTIFS : Souligner les ecarts dans les taux de traumatismes des populations au moyen d'une etude epidemiologique descriptive des tendances populationnelles de la mortalite imputable aux traumatismes dans les pays a revenu eleve que sont l'Australie, le Canada et les Etats-Unis. METHODE : Les donnees sur la mortalite etaient disponibles pour les EtatsUnis de 2000 a 2014 et pour le Canada et l'Australie de 2000 a 2012. Les causes de traumatismes ont ete definies selon les codes de causes externes de la Classification internationale des maladies, 10e revision, et ont ete regroupees en causes majeures. Les taux ont ete ajustes selon l'age par la methode directe en utilisant comme structure par age standard la population projetee en 2000 aux Etats-Unis. RESULTATS : Les taux de mortalite par accidents de vehicules a moteur aux Etats-Unis ont baisse de 2000 a 2014, mais ils sont restes nettement superieurs a ceux de l'Australie ou du Canada. Dans les trois pays, les taux de mortalite par chutes accidentelles ont augmente de 2000 a 2014. Les taux de mortalite par homicides aux Etats-Unis ont baisse, mais ils sont restes plus eleves que ceux de l'Australie et du Canada. Les Etats-Unis affichaient le plus bas taux de suicide en 2000, mais ce taux a augmente de 24% entre 2000 et 2014; en 2012, il etait superieur d'environ 14% a ceux de l'Australie et du Canada. Le taux de mortalite par intoxication aux Etats-Unis a grimpe de facon spectaculaire entre 2000 et 2014. CONCLUSION : Les resultats indiquent des differences marquees et des similitudes frappantes dans la mortalite imputable aux traumatismes d'un pays a l'autre et dans chaque pays au fil du temps. Les tendances observees differaient selon la categorie de causes de traumatismes. Les ecarts considerables dans les taux de traumatismes de ces populations, qui disposent de ressources semblables, soulevent d'importantes questions sur le role des facteurs societaux comme causes sous-jacentes de la repartition differentielle des traumatismes dans nos communautes. MOTS CLES : prevention des traumatismes; suicide; traumatismes dans le monde; homicide; chutes accidentelles; intoxications; accidents de vehicules a moteur; changements populationnels Can J Public Health 2017;108(2):e185-e191 doi: 10.17269/CJPH.108.5695, Epidemiology is the study of the distribution and determinants of health conditions in human populations. (1) Implicit in the definition of epidemiology is that a principal activity of epidemiologists is [...]

Availability of ICD-10 cause of death codes in the National Coroners Information System (NCIS) strengthens its value as a public health surveillance tool. This study quantified the completeness of external cause ICD-10 codes in the NCIS for Victorian deaths (as assigned by the Australian Bureau of Statistics (ABS) in the yearly Cause of Death data). It also examined the concordance between external cause ICD-10 codes contained in the NCIS and a re-code of the same deaths conducted by an independent coder. Of 7,400 NCIS external cause deaths included in this study, 961 (13.0%) did not contain an ABS assigned ICD-10 code and 225 (3.0%) contained only a natural cause code. Where an ABS assigned external cause ICD-10 code was present (n=6,214), 4,397 (70.8%) matched exactly with the independently assigned ICD-10 code. Coding disparity primarily related to differences in assignment of intent and specificity. However, in a small number of deaths (n=49, 0.8%) there was coding disparity for both intent and external cause category. NCIS users should be aware of the limitations of relying only on ICD-10 codes contained within the NCIS for deaths prior to 2007 and consider using these in combination with the other NCIS data fields and code sets to ensure optimum case identification.