Ian Richard Hildreth Rockett

Covert suicide among elderly Japanese females: Questioning unintensional drownings

A hypothesis is generated that despite high reported rates, suicide among elderly Japanese females is substantially underestimated due to misclassification of drowning suicides (ICD-9 E954) as unintentional drownings (ICD-9 E910). Data are adapted from 1979-1981 age-, sex- and cause-specific mortality tabulations for Japan, the United States, Australia, France, New Zealand, Norway, Sweden and the United Kingdom. Between ages 55 and 74 years, unintentional drowning rates for males and females in Japan begin to diverge sharply from those of comparison countries. By ages 75 and older, the rate for Japanese females is 13.5 per 100,000, which exceeds comparison rates by 7- to 15-fold. Although drowning suicide rates in this population are also high, its ratio of drowning suicides to unintentional drownings declines precipitously beyond ages 35-44. Excess drowning suicide underestimation among Japanese females is suggested by the absence of a similar change among the males and evidence of both a lack of drowning witnesses and sex differentials in life expectancy, living arrangements and suicide methods. A preliminary test of the drowning suicide hypothesis is proposed which incorporates psychological autopsies.

Injuries and the Australian mortality mosaic: a comparison with the United Kingdom and New Zealand

With reference to comparative data for New Zealand and the United Kingdom, the contribution of injuries to the Australian mortality mosaic is examined against the background of the three leading causes of death; namely, heart disease, cancer and cerebrovascular disease. The data are primarily adapted from 1980 age-, sex- and cause-specific mortality tabulations published by the World Health Organization. A core concept is premature mortality, which is operationalised as an age-adjusted rate of potential years of life lost between ages one and 65. Injuries universally rank first as a cause of male premature mortality, and are second to cancer in the female case. The 15-24 age group is the predominant source of these injury losses. Irrespective of sex, Australian and New Zealand premature injury mortality rates are similar, and are almost double the British rates. Three-quarters of the rate variation between Australia and the United Kingdom are accounted for by two causes of death; motor vehicle traffic accidents and suicide.

Adolescent risk-takers: a trauma center study of suicide attempters and drivers

Adolescence is a developmental stage characterized by excessive risk-taking behavior that produces adverse health effects, typically in the form of injury. At issue is whether adolescent suicide attempters and injured adolescent motor vehicle drivers constitute a common risk group and are differentiated by the response of the emergency medical care system and by case disposition. Data originated in the medical records of a Rhode Island (USA) trauma center. The two study groups were not distinguished by religious preference, socioeconomic status or timing of the injury incident, but differed significantly by gender, race, emergency vehicle use, hospital admission rates, and seasonal injury patterns. Alcohol and drug involve ment was examined, but serious data deficiencies were noted.