CITIES, HEALTH AND WELL-BEING NOVEMBER 2011 Urban Age Conference - PowerPoint PPT Presentation

CITIES, HEALTH AND WELL-BEING NOVEMBER 2011

Urban Age Conference – Cities Health and Well-being 17 November 2011 Social Isolation and Suicide Paul S.F. YIP Department of Social Work and Social Administration HKJC Centre for Suicide Research and Prevention The University of Hong Kong

資料來源 : 世界衛生組織 : http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

Hong Kong Hong Kong Source: Google Maps

Statistics • Suicide rate is about 13.5 per 100,000 with about 970 people died each year out of 7 million. • In comparing to Australia, 12. 0; USA: 11.0 UK : 8.0 per 100,000 • Cost: HK$1.6 billions in potential economic lost • And another HK$100 million in the medical cost for the deliberate self harm,

Hong Kong 40.0 Suicide rate (per 100,000) 30.0 20.0 10.0 0.0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Below 15 15 - 24 25 - 39 40 - 59 60 or above

Ten Leading Causes of Death Rank 1981 Rank 1991 Rank 2001 Diseases of the circulatory 1 1 Neoplasm 1 Neoplasm system Diseases of the circulatory Diseases of the circulatory 2 Neoplasm 2 2 system system Diseases of the respiratory Diseases of the respiratory Diseases of the respiratory 3 3 3 system system system Injury & poisoning (excludes Diseases of the genitourinary Diseases of the genitourinary 4 4 4 suicide) system system Symptoms, signs & ill-defined Diseases of the digestive Diseases of the digestive 5 5 5 conditions system system Diseases of the digestive Infectious & parasitic 6 Suicide death 6 6 system diseases Diseases of the genitourinary Injury & poisoning (excludes Infectious and parasitic 7 7 7 system suicide) diseases Infectious & parasitic Diseases of blood & blood- 8 Suicide death 8 8 diseases forming organs Symptoms, signs & ill- Injury & poisoning (excludes 9 Suicide death 9 9 defined conditions suicide) Endocrine nutritional & Certain conditions originating Diseases of the nervous 10 10 metabolic diseases & 10 in the prenatal period system and sense organs immunity disorders

Ten Leading Causes of YLL, HKSAR, 1981, 1991 and 2001 Rank 1981 Rank 1991 Rank 2001 1 Neoplasm 1 Neoplasm 1 Neoplasm Diseases of the Diseases of the circulatory Diseases of the 2 2 2 circulatory system system circulatory system Diseases of the Diseases of the respiratory Diseases of the 3 3 3 respiratory system system respiratory system Injury and poisoning Injury and poisoning 4 Suicide 4 4 (excludes suicide) (excludes suicide) Certain conditions Injury and poisoning 5 Suicide 5 originating in the 5 (excludes suicide) perinatal period Diseases of the Diseases of the digestive Diseases of the 6 6 6 digestive system system digestive system Diseases of the Diseases of the Diseases of the 7 7 7 genitourinary system genitourinary system genitourinary system Certain conditions Infectious and parasitic 8 Suicide 8 originating in the perinatal 8 diseases period Infectious and parasitic Infectious and parasitic Diseases of blood and 9 9 9 diseases diseases blood-forming organs Diseases of the nervous 10 Congenital anomalies 10 Congenital anomalies 10 system and sense organs

Suicidal Risk/protective factors for the Older adults (>=60) in HK (Yip et al., 2004) • Current Psychiatric Illness • Recent negative life events: Loss of significant others, loss of health in themselves or significant other • Past attempts • Chronic Physical Illnesses: Cancer, AIDS, chronic pain, constipation • Lack of social support

Risk and protective factors of suicide for 20-59 1.Presence of psychiatric disorder (OR=28.67; p<0.001) 2.Past suicidal attempt (OR=24.78; p<0.01) 3.Indebtedness (OR=10.08; p<0.01) 4.Unemployment (OR=8.65; p<0.01) 5.Never married (OR=7.29; p<0.01) 6.Social support (OR=0.27; p<0.001) Ref (Liu, Yip et al 2006;Chen et al., 2006)

Youth Suicides (< 24) • Suicide deaths, aged 24 or below, – Family disputes (43.5%) – Financial difficulties (35.8%) – Relationship problems (31.6%) – School-related issues (29.5%) – Mental health (28.4%) – Work-related issues (16.8%) – Substance use problems (11.6%) – Physical health (2.1%) – Abuse (1.1%)

Distribution of Hong Kong suicide by 18 districts 2008 North 2009 Yuen Long Tai Po Tuen Mun Tsuen Wan Shatin Sai Kung 2010 Kwai Sham Tsing Shui Po Wong Kwun Yau Tai Sin Tong Tsim Mong Central & Western Wan Eastern Chai Islands Southern Hong Kong map source: Department of Geography, The University of Hong Kong Suicide data source: HKJC Centre for Suicide Research & Prevention, The University of Hong Kong

SMR and suicide rates in 2008 – 2010* for aged 15+ SMR Suicide rate (per 100,000) District of residence 15 – 24 25 – 59 60+ 15+ 15 – 24 25 – 59 60+ 15+ Central and Western 0.2 0.9 0.7 0.8 1.2 12.1 19.3 12.2 Wan Chai 0.8 0.6 0.5 0.6 6.6 8.9 13.1 9.6 Eastern 1.2 1.0 1.2 1.1 9.5 14.3 31.4 17.5 Southern 0.5 0.9 0.7 0.8 4.0 12.1 18.8 12.3 Yau Tsim Mong 0.0 1.0 0.5 0.8 0.0 14.0 13.7 12.3 Sham Shui Po 0.9 1.2 1.0 1.1 7.4 16.3 26.9 17.6 Kowloon City 0.9 1.0 1.3 1.1 7.3 13.9 34.2 17.6 Wong Tai Sin 1.1 1.3 1.3 1.3 8.4 17.9 35.6 20.8 Kwun Tong 1.5 1.1 1.0 1.1 11.9 15.0 27.2 17.5 Kwai Tsing 0.9 1.1 1.2 1.1 7.1 15.3 33.1 17.7 Tsuen Wan 0.4 0.9 0.8 0.8 3.1 12.9 21.4 13.2 Tuen Mun 1.1 1.1 1.2 1.1 8.4 15.8 32.4 17.0 Yuen Long 1.0 1.2 0.9 1.0 8.0 16.2 24.4 15.8 North 1.1 0.9 0.9 0.9 8.4 13.2 25.6 14.3 Tai Po 1.3 0.9 1.2 1.0 10.4 13.1 31.4 15.4 Shatin 1.2 0.9 0.9 0.9 9.6 12.9 25.7 14.7 Sai Kung 1.2 0.7 0.9 0.8 9.4 10.1 23.2 11.8 Islands 0.7 0.6 1.0 0.7 5.4 8.1 26.0 10.5 Overall 7.8 14.0 27.1 15.6 * Provisional figures (registration death date up to 31 st July 2011)

Dsitrict profiles to highlight • Wong Tai Sin • Kwun Tong • Tuen Mun • Sham Shui Po • Kwai Tsing

Regional profiles summary Wong Sham Kwun Tuen Kwai Tai Shui Overall Tong Mun Tsing Sin Po Average household 3.0 2.9 2.9 2.8 3.0 2.9 size (2010) Median monthly household income 15,000 14,000 16,000 14,000 14,500 18,000 (HKD) (2010) Unemployment rate 6.2 6.4 6.6 6.3 7.0 5.4 (%) (2009) Median age (2010) 43 42 39 42 40 40 Elderly population 88,600 122,800 63,300 75,400 93,400 1,169,300 (60+) (2010) Students studying full-time as percentage of 17.4 18.3 18.1 18.1 18.1 18.1 population in district (2010) Dependency ratio 388 404 258 412 342 339 (2010) Source: Population and Household Statistics Analysed by District Council District 2010, Census & Statistics Department, HKSAR

Source: Census & Statistics Department, HKSAR Unemployment rate (%) 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 7.0 Central and Western Wan Chai 2009 Unemployment rate (%) Eastern Southern Unemployment rate (%) Yau Tsim Mong Sham Shui Po Kowloon City Wong Tai Sin Kwun Tong Kwai Tsing Tsuen Wan Tuen Mun 2007-2010 average suicide rate Yuen Long North Tai Po Sha Tin Sai Kung Islands Overall 8.0 10.0 12.0 14.0 16.0 18.0 20.0 2007-2010 average suicide rate (per 100,000)

Median monthly household income Source: Census & Statistics Department, HKSAR 10,000 15,000 20,000 25,000 30,000 2009 Median Monthly Household Income (HKD) Central & Western Wan Chai Median monthly household income Eastern Southern Yau Tsim Mong Sham Shui Po Kowloon City Wong Tai Sin Kwun Tong Kwai Tsing Tsuen Wan 2007-2010 average suicide rate Tuen Mun Yuen Long North Tai Po Sha Tin Sai Kung Islands Overall 8.0 10.0 12.0 14.0 16.0 18.0 20.0 2007-2010 average suicide rate (per 100,000)

Source: Census & Statistics Department, HKSAR Population by marital statis (Aged 15+) 2009 Population Aged 15 and over by Marital Status 10000 15000 20000 25000 30000 35000 40000 45000 5000 Widowed population 0 Central & Western Wan Chai Eastern Southern Yau Tsim Mong Divorced / Separated population Sham Shui Po Kowloon City Wong Tai Sin Kwun Tong Kwai Tsing Tsuen Wan Tuen Mun 2007-2010 average suicide rate Yuen Long North Tai Po Sha Tin Sai Kung Islands 8.0 10.0 12.0 14.0 16.0 18.0 20.0 2007-2010 average suicide rate (per 100,000)

Correlations between regional suicide rates and social isolation indicators in Hong Kong 18 districts, 2009 Median Monthly Divorced / Unemployment Elderly Widowed Household Separated Rate (%) Population Population Income Population Overall 0.436 0.482* – 0.532* 0.511* 0.452 suicide rate (0.071) (0.043) (0.023) (0.030) (0.060) Aged 15 – 24 0.457 0.494* – 0.325 0.525* 0.536* suicide rate (0.057) (0.037) (0.188) (0.025) (0.022) Aged 25 – 59 0.622** 0.655** – 0.699** 0.709** 0.673** suicide rate (0.006) (0.003) (0.001) (0.001) (0.002) Aged 60+ 0.532* 0.493* – 0.518* 0.529* 0.449 suicide rate (0.023) (0.038) (0.027) (0.024) (0.062) Pearson Correlation ( p -value) * p < 0.05 ** p < 0.01

Deliberate self harm (2004-2008) DSH Incidence in Kwai Tsing 2004-2008 / 0 1,500 3,000 6,000 Meters

Social Isolation Indicators • Unemployed • Elderly people • Less household income • Divorced / separated, widowed • Single parents families • Recent immigrants • Ethnic Minorities • Living alone