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The COVID-19 Impact on Accidental Deaths and Suicide Incidence in India- A Comparative Study (1967-2022)

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20 May 2023

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26 May 2023

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Abstract
Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men. COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide. This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.
Keywords: 
Subject: Public Health and Healthcare  -   Public Health and Health Services

1. Background:

Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies [1]. LMICs (low- and middle-income countries) account for 77% of global suicides most commonly by ingestion of pesticide (20% of global suicides) in rural agricultural areas in low- and middle-income countries; hanging and firearms [2]. Suicide is serious public health issue in India which can be prevented by low-cost interventions [3]. In 2016 the suicidal death rate in India per lakh population was 16.5, whereas the global average in 2016 was 10.5 per 100 000 [4]. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men [5].
COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways [6]. The COVID-19 distress is no more a PHEIC (public health emergency of international concern) as declared by WHO (World Health Organization) International Health Regulations (2005) (IHR) Emergency Committee 15th meeting, held on Thursday 4 May 2023 [7]. The global researcher community is yet calculating and analyzing the devastating impact of this pandemic on various aspect of life. Undoubtedly the situations have provoked mental health issues globally. Numerous factors originating due to the pandemic situation like fear, anxiety, reduced access-utilization of routine health services, forced social distancing, lockdowns, loss of job, hiked treatment costs, social boycott of infected individuals, an increase of domestic violence could deteriorate the physical, mental, economical and social health of an individual [8]. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide [9]. Several Studies have reported that COVID-19 pandemic is associated with increased stress, depression, insomnia, and narcotics abuse [10]. Research on exploring association/impact of the pandemic with suicide and accident are abundant in developed countries, where there is narrow gap in different samples. In countries like India where there are extreme rich and extreme poor individuals such studies will provide a better insight about the impact of pandemic situation on such explorations [11]. Of course limited public data availability and lack of funds to eminent poor researchers of countries like India for carrying out field survey of situation might interfere with the output of such studies on the COVID-19 impact on suicide and accidental death in developing countries. One study done by, Pirikis et al. found that the suicidal death has not increased in twenty two high-income countries, whereas in LMICs, COVID-19 attributed as a prominent cause of suicidal death [12]. The impact of the pandemic on suicide and accidental death could be country- exclusive depending on individual country specific factors like the prevalence of physical, mental, economical and social co morbidities, and the country specific public health actions imposed by governments to contain the pandemic. Some studies found gender variation in suicide rates with a high rate for males, whereas some have reported mental health worsening related to the pandemic is higher in females [13,14,15].
The COVID-19 pandemic has had deleterious effects on the food system, economy and social life globally as well as it has disrupted transportation across the world [16]. Globally governments imposed travel restrictions (closed borders, restricted flights, and lockdowns) which may have reduced the risk of collisions and accidental deaths [17]. Two major waves of the COVID-19 pandemic distressed the world in 2020 and 2021, leading to the death of about 06 million (real count may be more) people worldwide by 2021end [18]. The first confirmed case of COVID-19 in India, was from southern state Kerala on 30th January 2020 [19], India imposed nationwide lockdown and stopped flights, Railways and roadways from 25thMarch disrupting several routine services except for essential services like food, health, etc [20,21,22,23]. The lockdown increased fear and feeling of isolation, which was more aggravated by the loss of relatives, and social stigma [24]. Added to this lockdown caused loss of employment, financial crisis, uncertain future to students who could not attend schools and colleges [25]. Females became more exposed to domestic violence at home while older ones feel neglected leading to depression [26].
This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. This study may help policy and decision makers in devising appropriate programs for reducing the future pandemic or any similar disaster responses to minimize harm. This study also aims to create awareness among health professionals and readers in general by doing comparative study of suicidal deaths and accidents during the pre-COVID-19 and COVID-19 periods.

2. Aim and Objective

The aim of this study is to compare the accidental and suicidal deaths, (incidence, prevalence, rate, numbers, percentage, gender, etc.) in the pandemic (COVID-19 period) with non-pandemic periods (pre-COVID-19 period), in India. The key objective is to assess the COVID-19 impact on accidental and suicidal mortality in terms of epidemiological indicators like rate, proportions, etc.

Methodology

This is an observational, comparative and retrospective study for analyzing the COVID-19 impact on suicide and accidental death count in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. We define 1st January 1967 to 31st December 2019 as the pre-pandemic period and 1st January 2020 to 31st December 2021 as the pandemic period (based on identification of first COVID-19 confirmed case in India). Of course two similar periods is also compared to avoid bias i.e. 2018-2019 is compared to 2020-2021. A larger period is studied to know the longer trends in suicide and accidental death count in India.

Study setting and data

The annual suicide and accidental death counts by gender for India were obtained from NCRB (NATIONAL CRIME RECORDS BUREAU), Government of India [27]. The cause of death is investigated by the Indian Police department of 36 states and union territories of India as required by established law. The nature of death is usually based on the certified medical and autopsy reports. The population estimate by gender was obtained from World Bank, Population data [28]. Table 1 presents the data collected during the study period.

Statistical analysis

We calculated the suicide and accidental death rates for each year during the study period by dividing the number of suicide and accidental death by the population exposed (considering whole population exposed). Then incidence rate per lakh population is calculated for each year during the pandemic era by utilizing the data.
The data was collected from NCRB records. The same period was also taken to address any bias due to seasonal factors as well as the whole data collected was also analyzed to present the previous background. The data is presented as tables, graph, etc. with appropriate statistical analysis. The incidence rate ratio (IRR) is calculated as the ratio of incidence of suicide and accidental death out of total deaths during the study period and two period separately (NOT AVAILABLE IN PREPRINT). Table 2 presents the statistical analysis of the data collected during the study period.

3. Results

Suicidal deaths - accidental deaths – 2018-2019-2020-2021

Table 3-A shows that during the pre-COVID-19 era of this study, 1106567 suicidal and accidental deaths were reported, of which 83298 (75.27 %) were accidental deaths and 273639 (24.73 %) were suicidal death. During the COVID-19 epoch of this study, 1089012 suicidal and accidental deaths were reported of which 771927 (70.88 %) were accidental and 317085 (29.12 %) were suicidal.
This research study revealed that out of two study period the accidental death were reduced by 4.39 % during the COVID-19 epoch of this study whereas the suicidal death increased by 4.39% during the COVID-19 epoch. This study also revealed that the total suicidal and accidental deaths reduced during COVID-19 epoch by 1.59%.
Table 3-B shows that out of total 1604855 accidental death during above study period 832928 (51.90%) accidental deaths were reported during the pre-COVID-19 era of this study, whereas 771927 (48.10 %) were reported during COVID-19 epoch. During the pre-COVID-19 epoch of this study, 273639 (46.32%) suicidal deaths whereas 317085 (53.68%) were reported during the COVID-19 epoch out of total 590724 suicide during above study period.
This research study revealed that out of individual category of total suicide and accidental death, the accidental death were reduced by 3.80 % during the COVID-19 epoch of this study whereas the suicidal death increased by 7.35% during the COVID-19 epoch.

Mean Suicidal deaths vs. accidental deaths – 1967-2021

The whole study period i.e. from 1967 to 2021 mean comparison of two periods is presented in Table 3-C and D. The mean accidental death and suicides increased to a great extent during the COVID period as compared to pre- COVID period of study. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.
To reduce the bias a similar previous period of pre- COVID period is compared in Table3-A and B.
Test of independence is not applied here between cause of death during pre-COVID-19 and COVID-19 era as this is not a sample survey, instead the whole population is taken into account for this study.

Gender-Wise Yearly variation in suicides and accidental death

Table 1,Table 2, Table 4 and Figure 1 and Figure 2 presents the Gender-Wise Yearly variation in suicides and accidental death during the study period.
A monthly data of suicides will provide a better insight in suicides and accidental deaths during the COVID period, particularly to assess the impact of the lockdown period on, the number of accidental and Suicidal deaths. The data is not available to us but we are trying to get data from an accredited source.

Gender Variation- accidental deaths

Tables 1, 2, 4-A and Figure 1 shows that during the total pre-COVID-19 period (1967-2019), there were 12149833 [95% C.I. - 198716.8 -259767.4] total accidental deaths, out of which 8905209 were male[95% C.I. - 142066 -193979.6], and 3220020 female[95% C.I. - 55866.3 -65643.9], whereas, for the COVID-19 period, there were total 771927 accidental deaths [95% C.I. - 238997.2- 532929.8] out of which 625556 were males[95% C.I. -168270.3 -457285.7], and 146281 were females[95% C.I. -71037.6 -75243.4]. This study revealed that compared to immediate previous i.e. 2018-2019 pre-pandemic era a decrease in percentage and annual incidence of accidental deaths is observed in both the genders with male preponderance during the COVID-19 period (2020-2021) of the study.

Male

Table 1, 2, 4-A and Figure 1 shows that for the pre-COVID period 2018-2019, accidental deaths percentage among males out of total accidental deaths (411824-421104) were 80.4%-80.8% respectively for 2018-2019 whereas for the COVID period 2020-2021(374397-397530), accidental deaths among males as a percentage of total accidental deaths was 80.5%-81.5% respectively for 2018-2019. The accidental deaths among males percentage increased slight in comparison to females in COVID-19 era but actual count and incidence decreased.

Female

Table 1, 2, 4-A and Figure 1 shows that for the pre-COVID period 2018-2019, accidental deaths percentage among females out of total accidental deaths (411824-421104) were 19.6%-19.2% respectively for 2018-2019 whereas for the COVID period 2020-2021(374397-397530), accidental deaths among females as a percentage of total accidental deaths was 19.5%-18.4% respectively for 2018-2019. The accidental deaths among females percentage decreased slight in comparison to males in COVID-19 era but actual count and incidence decreased.

Gender Variation- Suicide

Table 1, 2, 4-B and Figure 2 shows that during the total pre-COVID-19 period (1967-2019), there were 4464299 [95% C.I. - 74052.4- 94411.8] total suicide deaths, out of which 2797739 were male[95% C.I. - 45719.6 -59855.4], and 1666479 female[95% C.I. - 28207.7- 34678.3], whereas, for the COVID-19 period, there were total 317085 suicide deaths [95% C.I. - 88779.1 -228305.9] out of which 227511 were males[95% C.I. -47384.6 -180126.4], and 89524 were females[95% C.I. -41407.6- 48116.4]. This study revealed that compared to immediate previous i.e. 2018-2019 pre-pandemic era, an increase in percentage and annual incidence of suicide deaths is observed in both the genders with male preponderance during the COVID-19 period (2020-2021) of the study.

Male

Table 1, 2, 4-B and Figure 2 shows that for the pre-COVID period 2018-2019, suicide deaths percentage among males out of total suicide deaths (134516-139123) were 68.5%-70.2% respectively for 2018-2019 whereas for the COVID period 2020-2021(153052-164033), suicide deaths among males as a percentage of total suicide deaths was 70.9%-72.5% respectively for 2018-2019. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased.

Female

Table 1, 2, 4-B and Figure 2 shows that for the pre-COVID period 2018-2019, suicide deaths percentage among females out of total suicide deaths (134516-139123) were 31.5%-29.8% respectively for 2018-2019 whereas for the COVID period 2020-2021(153052-164033), suicide deaths among females as a percentage of total suicide deaths was 29.1%-27.4% respectively for 2018-2019. This study revealed that the suicide deaths among females percentage increased in COVID-19 era and actual count and incidence also increased.
Table 1, 2, 3 and 4 shows that during this 55 year observational retrospective study between 1st January 1967 and 31st December 2021, 1, 29, 21,760 accidental deaths occurred of which 71.0% were male and 28.6% were female and 47, 81,384 people committed suicide in India, of which 61.9% were male and 38.1% were female. The annual average accidental death and suicide incidence (including both gender) during 55 years of the study is 24.6 and 9.1 per 100,000 respectively. This study revealed that males had a significantly higher mean annual incidence of accidental deaths of 32.7 per 100,000 compared to female of 13.4 per 100,000. Furthermore males had a significantly higher mean annual incidence of suicidal deaths of 10.5 per 100,000 compared to female of 06.8 per 100,000. Furthermore mean male and female suicide percent out of total suicides during whole period of study is 61.9% and 38.1%, whereas for accidental deaths it is 71.0 and 28.6 respectively.
The statistical analysis of suicide in India from 1st January-1967 to 31st December 2021 showed a substantial variation with annual suicide numbers ranging from 38217 to 164033 [Min, Max],( Obs, Mean, Std. Dev., [95% Conf. Interval], Std. Err., Total, - 55,86934.3, 38879.9, 76423.5 -97444.9, 5242.6, 4781384,) respectively.
The statistical analysis of accidental deaths in India from 1st January-1967 to 31st December 2021 showed a substantial variation with annual accidental deaths ranging from 105601 to 451757, [Min, Max],( Obs, Mean, Std. Dev., [95% Conf. Interval], Std. Err., Total, - 55, 234941.1, 112658.5, 204485.2 -265397, 15190.9, 12921760,) respectively.
Gender-wise statistical analysis is presented in Table 2-A-B-C-D. The lowest suicides were recorded in 1979 in all 55 years, whereas the highest suicides were recorded in 2021 of the COVID-19 era. In the accidental death category lowest count were recorded in 1971 in all 55 years, whereas the highest count were recorded in 2014 of the pre-COVID-19 era. During the whole study period, the highest suicides incidence/lakh population were observed in males during the COVID-19 era 2021 while in 1999 highest suicides incidence/lakh population were observed in females.
Table 4 presents the gender-wise annual suicide and accidental death counts with annual incidence rates in different years at the country level. The annual increase/decrease in suicide and accidental death can be seen in this table.
Over the entire pandemic period, this study found an overall increase in annual suicide rates of males compared to female population. The increase in suicide rate is significant among males.

4. Discussion

Suicide and accidents are significant preventable public health problem especially in LMICs like India due to several factors like population density, illiteracy and a multitude of socio-economic as well as political-administrative issues [29]. Majority of these can be prevented with specific, timely, research-based low-cost interventions. A comprehensive multisectoral co-ordination for suicide and accident prevention is needed to reduce the mortality. Suicides are absolutely preventable cause of death by creating awareness in individual, community and national levels [30]. The prevention of accidents and suicide can be addressed by creating awareness in the societies to openly discuss it. A novel robust but flexible national suicide and accident prevention framework needs to be drafted for countrywide implementation in order to improve the data and situation.
Globally, the data of suicides and accidents availability and quality is poor [31,32]. This problem of poor-quality data is likely due to under-reporting and lack of proper classification. Improved surveillance and monitoring is needed for making accident and suicide prevention strategies. Faulty registration of accidental death and suicide in hospital- register and nationally-representative surveys may occur like COVID-19 death registration [33]. Furthermore a large percentage of mortality is not medically certified in India; hence the mortality counts may represent only the iceberg of deaths from accidents and suicides [34].
Risk assessment should be done at national level. Several research found well established link between suicide, accidental death and psychiatric illness (mostly depression and substance use dependency) [35,36]. Furthermore situations of crisis like COVID-19 leading to a breakdown in the normal ability to deal with life stresses, like financial crisis, fear, conflict, violence, abuse, discrimination, sense of isolation, relationship break-up, and illness can increase the vulnerability for suicides and accidental death [37].
The National Mental Health Act AND accident prevention strategy- NOT AVAILABLE IN PREPRINT

Limitations and strength

There are several studies done on the title mentioned research question but this study is very unique study as we have also explored the pandemic impact on accidents together with suicide (considering the fact that the COVID-19 led mental issues may have increased the accidents due to poor concentration while driving etc). One of the major limitations is the data which is obtained solely from the NCRB in our study. In India there is lack of any accredited other public health agencies, to collect and report these data. The NCRB is dependent on the 36 states and union territories for this data which lacks robust data collection systems hence prone to error due to utilizing methods like paper- recording and document transfer of data. Hence there could be data quality issues. Despite this limitation, the data utilized for this study is the most accredited available data and most of the studies have utilized this data source. The data we utilized was yearly aggregated data hence we were cannot explore finer variation in less time intervals (e.g. days or weeks) or age standardized variations like age or cause of accident and suicide. Furthermore, the study can only adjust for seasonality (by comparing equal annual periods), but the geographical-temporal trends could not be calculated specific to pandemic periods or pre- COVID-19 era. This is the first study in our knowledge analyzing the accidental death and suicide together in India in the context of the COVID-19 in the whole population, and by gender.

5. Conclusion

COVID-19 is having an indirect impact on accidental death and suicide, positive impact on accidental death while negative impact on suicide. The present quantitative data study on the accidental and suicidal deaths in both genders is intended to present a brief answer to the title mentioned query. The accident rate decreased while the suicide rates significantly increased in males of India during the COVID-19 pandemic, whereas in females the suicide rates increased slightly with significant decrease in accident rate. Epidemiological studies with better data input and more analysis is needed to better understand and control the drivers of accident and suicide with more exploration related to gender and other differences like existing co-morbidities. Future version of this research will try to explore these differential impacts of the COVID-19 pandemic in different states and union territories of India.

Prevention and control of suicides (accident already reduced hence not emphasized here)

Suicides are largely preventable. Measures should be taken at national, state/UTs and individual levels to reduce suicide and suicide attempts. WHO’s approach and recommendation for suicide prevention is given below which is based on evidence-based interventions [38]:
  • Stop the access to instrument of suicide (e.g. firearms, pesticides, certain medications);
  • Improve the media for appropriate-responsible reporting of suicide events;
  • Encourage socio-emotional life skills;
  • Early identification, assessment, management and follow up of individuals with suicidal behaviours.,
These interventions need situation analysis with multisectoral collaboration, financing, awareness raising, surveillance and monitoring, capacity building, and evaluation. Suicide prevention require multisectoral coordination with collaboration among individuals of society, including the health and other sectors like agriculture, business, education, politics, labour, justice, law, defence, and the media. These efforts need to be comprehensive and integrated as individual approach for an issue as complex as suicide is not sufficient.

Recommendations for reducing suicides in distress like COVID-19 (accident already reduced)

  • A national robust, flexible and scientifically-technically sound, multisectoral primordial preventive strategy is needed to mitigate the suicidal morbidity and mortality.
  • Creating mass awareness by government bodies, national/local media, NGO-social organizations, health care facilities-providers, and increasing budgetary allocation for mental health.
  • More investment on research and analysis to better understand the COVID-19 impact on suicides in different regions.
  • Financial stability programs to decreased suicide in times of poverty.
  • Promoting BCC through online portals with community approach.

Ethical Issues

None, Not applicable. This study has not involved any human or animals in real or for experiments. The submitted work does not contain any identifiable patient/participant information.

Sources of Funding

None

Author Contributions

Project proposal, data collection, compilation and analysis; Drafting project report; Writing final project report and proofreading – by author and co-author.

Funding

The author declares that no funds are taken from any individual or agency-institution for this study.

Acknowledgments

I am thankful to Advocate Anupama my wife and daughters Aathmika-Atheeva for cooperation.

Conflicts of Interest

There are no conflicts of interest.

Abbreviations

COVID-19- Coronavirus Disease 2019; UTs- union territories; World Health Organization (WHO); LMICs (lower-middle-income countries); GoI (Government of India)

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Figure 1. Gender-wise comparison of annual accidental death in India from 1st January-1967 to 31st December 2021.
Figure 1. Gender-wise comparison of annual accidental death in India from 1st January-1967 to 31st December 2021.
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Figure 2. Gender-wise comparison of annual suicide in India from 1st January-1967 to 31st December 2021.
Figure 2. Gender-wise comparison of annual suicide in India from 1st January-1967 to 31st December 2021.
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Table 1. Gender-wise suicide and accidental death in India from 1967 to 2021*.
Table 1. Gender-wise suicide and accidental death in India from 1967 to 2021*.
Year Accidental Deaths-Male Accidental Deaths-Female Accidental Deaths-Bisexual Total -Accidental Deaths Suicides-Male Suicides-Female Suicides-Bisexual Suicides-Total
1967 79131 47631 N/A** 126762 22637 16192 N/A 38829
1968 79159 47073 N/A 126232 24464 16224 N/A 40688
1969 82105 48650 N/A 130755 25947 17686 N/A 43633
1970 89210 50542 N/A 139752 28846 19582 N/A 48428
1971 68344 37257 N/A 105601 26326 17349 N/A 43675
1972 69838 36346 N/A 106184 26923 16678 N/A 43601
1973 69613 36741 N/A 130654 25231 15576 N/A 40807
1974 73580 37044 N/A 110624 27791 18217 N/A 46008
1975 74987 38029 N/A 113016 26074 16816 N/A 42890
1976 73098 38513 N/A 111611 24042 17373 N/A 41415
1977 76013 41325 N/A 117338 23453 16265 N/A 39718
1978 78352 40242 N/A 118594 24137 16070 N/A 40207
1979 72448 36539 N/A 108987 22980 15237 N/A 38217
1980 76293 40619 N/A 116912 24188 17475 N/A 41663
1981 82328 39893 N/A 122221 23864 16381 N/A 40245
1982 82977 43016 N/A 125993 26520 18212 N/A 44732
1983 85577 42999 N/A 128576 27260 19319 N/A 46579
1984 90636 43992 N/A 134628 29296 21275 N/A 50571
1985 93568 46089 N/A 139657 30460 22351 N/A 52811
1986 98480 48543 N/A 147023 31271 23086 N/A 54357
1987 103727 48587 N/A 152314 34292 24276 N/A 58568
1988 110235 53287 N/A 163522 37755 26515 N/A 64270
1989 114953 54113 N/A 169066 40212 28532 N/A 68744
1990 117932 56469 N/A 174401 43451 30460 N/A 73911
1991 129142 58861 N/A 188003 46324 32126 N/A 78450
1992 133977 60933 N/A 194910 47481 32668 N/A 80149
1993 130499 61858 N/A 192357 49851 34393 N/A 84244
1994 132241 58194 N/A 190435 52752 36443 N/A 89195
1995 157219 65268 N/A 222487 52357 36821 N/A 89178
1996 156106 63988 N/A 220094 51206 37035 N/A 88241
1997 164876 69027 N/A 233903 56281 39548 N/A 95829
1998 185520 72889 N/A 258409 61686 43027 N/A 104713
1999 193652 78266 N/A 271918 65488 45099 N/A 110587
2000 186324 69559 N/A 255883 66032 42561 N/A 108593
2001 196129 74890 N/A 271019 66314 42192 N/A 108506
2002 194850 65272 N/A 260122 69332 41085 N/A 110417
2003 197285 62340 N/A 259625 70221 40630 N/A 110851
2004 210190 67073 N/A 277263 72651 41046 N/A 113697
2005 224806 69369 N/A 294175 72916 40998 N/A 113914
2006 241210 73494 N/A 314704 75702 42410 N/A 118112
2007 262918 77876 N/A 340794 79295 43342 N/A 122637
2008 263809 78500 N/A 342309 80544 44473 N/A 125017
2009 276333 80688 N/A 357021 81471 45680 N/A 127151
2010 298262 86387 N/A 384649 87180 47419 N/A 134599
2011 302420 88464 N/A 390884 87839 47746 N/A 135585
2012 306061 88921 N/A 394982 88453 46992 N/A 135445
2013 312670 87847 N/A 400517 90543 44256 N/A 134799
2014 354573 97078 106 451757 89129 42521 16 131666
2015 328241 85169 47 413457 91528 42088 7 133623
2016 333804 84372 45 418221 88997 41997 14 131008
2017 318316 78234 34 396584 89019 40852 16 129887
2018 330925 80864 35 411824 92114 42391 11 134516
2019 340267 80800 37 421104 97613 41493 17 139123
2020 301405 72975 17 374397 108532 44498 22 153052
2021 324151 73306 33 397530 118979 45026 28 164033
Total 9530765 3366301 354 12921760 3025250 1756003 131 4781384
*Source of data – NCRB, Government of India- Available at - https://ncrb.gov.in/en/ADSI-2021 ** N/A – Not Available.
Table 2. Statistical analysis of the data collected during the study period.
Table 2. Statistical analysis of the data collected during the study period.
A-Gender-wise statistical analysis of suicide and accidental death in India from 1st January-1967 to 31st December 2021
Variable Obs Mean Std. Dev. [95% Conf. Interval] Std. Err. Total Min Max
Accidental Deaths-Male 55 173286.6 96397.1 147226.9 -199346.4 12998.2 9530765 68344 354573
Accidental Deaths-Female 55 61205.5 17561.7 56457.9 -65953.1 2368.0 3366301 36346 97078
Accidental Deaths-Bisexual 8 44.3 26.5 22.1 -66.4 9.4 354 17 106
Total -Accidental Deaths 55 234941.1 112658.5 204485.2 -265397 15190.9 12921760 105601 451757
Suicides-Male 55 55004.6 27692.1 47518.3 -62490.7 3734.0 3025250 22637 118979
Suicides-Female 55 31927.3 11789.9 28740.1- 35114.6 1589.8 1756003 15237 47746
Suicides-Bisexual 8 16.4 6.4 10.9 -21.8 2.3 131 7 28
Suicides-Total 55 86934.3 38879.9 76423.5 -97444.9 5242.6 4781384 38217 164033
B-Gender-wise statistical analysis of suicide and accidental death in India during pre-COVID-19 period from 1st January 1967 to 31st December 2019
Variable Obs Mean Std. Dev. [95% Conf. Interval] Std. Err. Total Min Max
Accidental Deaths-Male 53 168022.8 94171.1 142066 -193979.6 12935.4 8905209 68344 354573
Accidental Deaths-Female 53 60755.1 17736.6 55866.3 -65643.9 2436.3 3220020 36346 97078
Accidental Deaths-Bisexual 6 50.7 27.6 21.7 -79.7 11.3 304 34 106
Total -Accidental Deaths 53 229242.1 110745.8 198716.8 -259767.4 15212.1 12149833 105601 451757
Suicides-Male 53 52787.5 25642.4 45719.6 -59855.4 3522.3 2797739 22637 97613
Suicides-Female 53 31443 11737.6 28207.7- 34678.3 1612.3 1666479 15237 47746
Suicides-Bisexual 6 13.5 3.8 9.5- 17.5 1.6 81 7 17
Suicides-Total 53 84232.1 36931.9 74052.4- 94411.8 5072.9 4464299 38217 139123
C-Gender-wise statistical analysis of suicide and accidental death in India during COVID-19 period from 1st January 2020 to 31st December 2021
Variable Obs Mean Std. Dev. [95% Conf. Interval] Std. Err. Total Min Max
Accidental Deaths-Male 2 312778 16083.9 168270.3 -457285.7 11373 625556 301405 324151
Accidental Deaths-Female 2 73140.5 234.1 71037.6 -75243.4 165.5 146281 72975 73306
Accidental Deaths-Bisexual 2 25 11.3 -76.6- 126.6 8 50 17 33
Total -Accidental Deaths 2 385963.5 16357.5 238997.2- 532929.8 11566.5 771927 374397 397530
Suicides-Male 2 113755.5 7387.1 47384.6 -180126.4 5223.5 227511 108532 118979
Suicides-Female 2 44762 373.4 41407.6- 48116.4 264 89524 44498 45026
Suicides-Bisexual 2 25 4.2 -13.1- 63.1 3 50 22 28
Suicides-Total 2 158542.5 7764.7 88779.1 -228305.9 5490.5 317085 153052 164033
D-Gender-wise statistical analysis of suicide and accidental death in India during Pre-COVID-19 period from 1st January 2018 to 31st December 2019 – NOT AVAILABLE IN PREPRINT
Table 3. Cause of death during COVID-19 and pre-COVID-19 periods.
Table 3. Cause of death during COVID-19 and pre-COVID-19 periods.
Table 3A: Cause of death during COVID and pre-COVID periods Manner of death (same period percent of accidents and deaths) Pre-COVID period 2018-2019 COVID period 2020-2021 Total 2018-2021
Total Accidental Death 832928(75.27%) 771927(70.88%) 1604855
Total Suicide 273639(24.73%) 317085(29.12%) 590724
Total 1106567(100%) 1089012(100%) 2195579
Table 3B: Cause of death during COVID and pre-COVID periods Manner of death(Two study period percent of accidents and deaths) Pre-COVID period 2018-2019 COVID period 2020-2021 Total 2018-2021
Total Accidental Death 832928 (51.90%) 771927(48.10%) 1604855(100%)
Total Suicide 273639(46.32%) 317085(53.68%) 590724(100%)
Total 1106567 1089012 2195579
Table 3C: Cause of death during COVID and pre-COVID periods Manner of death (Two study period percent of accidents and deaths) Mean Pre-COVID period 1967-2019 Mean COVID period 2020-2021 Mean Total 1967-2021
Mean Accidental Death 229242.1(37.26%) 385964(62.74%) 615206.1(100%)
Mean Suicide 84232.06(34.70%) 158543(65.30%) 242775.1(100%)
Mean Total 313474.2 544507 857981.2
Table 3D: Cause of death during COVID and pre-COVID periods Manner of death (same period percent of accidents and deaths) Mean Pre-COVID period 1967-2019 Mean COVID period 2020-2021 Mean Total 1967-2021
Mean Accidental Death 229242.1(73.13%) 385964(70.88%) 615206.1
Mean Suicide 84232.06(26.87%) 158543(29.12%) 242775.1
Mean Total 313474.2(100%) 544507(100%) 857981.2
Table 4A-. Gender-wise comparison of accidental death in India from 1st January-1967 to 31st December 2021.
Table 4A-. Gender-wise comparison of accidental death in India from 1st January-1967 to 31st December 2021.
Year Accidental Deaths-Male Population male Male-Annual Incidence per 100000 Accidental Deaths-Female Population female Female-Annual Incidence per 100000 Total -Accidental Deaths Male-% of Total Female-%of total Accidental Deaths-Bisexual*
Y-1967 79131 269770979 29.3 47631 252216091 18.9 126762 62.4 37.6 N/A**
Y-1968 79159 275736482 28.7 47073 257695427 18.3 126232 62.7 37.3 N/A
Y-1969 82105 281934206 29.1 48650 263380464 18.5 130755 62.8 37.2 N/A
Y-1970 89210 288292405 30.9 50542 269208897 18.8 139752 63.8 36.2 N/A
Y-1971 68344 294818942 23.2 37257 275180236 13.5 105601 64.7 35.3 N/A
Y-1972 69838 301529376 23.2 36346 281308597 12.9 106184 65.8 34.2 N/A
Y-1973 69613 308465459 22.6 36741 287642024 12.8 130654 53.3 28.1 N/A
Y-1974 73580 315584063 23.3 37044 294137889 12.6 110624 66.5 33.5 N/A
Y-1975 74987 322800952 23.2 38029 300723268 12.6 113016 66.4 33.6 N/A
Y-1976 73098 330077580 22.1 38513 307373867 12.5 111611 65.5 34.5 N/A
Y-1977 76013 337496325 22.5 41325 314189303 13.2 117338 64.8 35.2 N/A
Y-1978 78352 345069608 22.7 40242 321198151 12.5 118594 66.1 33.9 N/A
Y-1979 72448 352826329 20.5 36539 328422054 11.1 108987 66.5 33.5 N/A
Y-1980 76293 360875327 21.1 40619 335953058 12.1 116912 65.3 34.7 N/A
Y-1981 82328 369149846 22.3 39893 343719452 11.6 122221 67.4 32.6 N/A
Y-1982 82977 377542519 22.0 43016 351626946 12.2 125993 65.9 34.1 N/A
Y-1983 85577 386102269 22.2 42999 359724278 12.0 128576 66.6 33.4 N/A
Y-1984 90636 394865497 23.0 43992 368029660 12.0 134628 67.3 32.7 N/A
Y-1985 93568 403766421 23.2 46089 376475662 12.2 139657 67.0 33.0 N/A
Y-1986 98480 412811682 23.9 48543 385067312 12.6 147023 67.0 33.0 N/A
Y-1987 103727 421960524 24.6 48587 393755601 12.3 152314 68.1 31.9 N/A
Y-1988 110235 431194389 25.6 53287 402535292 13.2 163522 67.4 32.6 N/A
Y-1989 114953 440551295 26.1 54113 411461378 13.2 169066 68.0 32.0 N/A
Y-1990 117932 449984059 26.2 56469 420468106 13.4 174401 67.6 32.4 N/A
Y-1991 129142 459463492 28.1 58861 429478264 13.7 188003 68.7 31.3 N/A
Y-1992 133977 469046096 28.6 60933 438527953 13.9 194910 68.7 31.3 N/A
Y-1993 130499 478735976 27.3 61858 447615320 13.8 192357 67.8 32.2 N/A
Y-1994 132241 488535405 27.1 58194 456726553 12.7 190435 69.4 30.6 N/A
Y-1995 157219 498432465 31.5 65268 465846665 14.0 222487 70.7 29.3 N/A
Y-1996 156106 508349160 30.7 63988 474932057 13.5 220094 70.9 29.1 N/A
Y-1997 164876 518303618 31.8 69027 484031612 14.3 233903 70.5 29.5 N/A
Y-1998 185520 528287413 35.1 72889 493147162 14.8 258409 71.8 28.2 N/A
Y-1999 193652 538244360 36.0 78266 502255693 15.6 271918 71.2 28.8 N/A
Y-2000 186324 548223581 34.0 69559 511410095 13.6 255883 72.8 27.2 N/A
Y-2001 196129 558291332 35.1 74890 520679574 14.4 271019 72.4 27.6 N/A
Y-2002 194850 568334873 34.3 65272 529978166 12.3 260122 74.9 25.1 N/A
Y-2003 197285 578236241 34.1 62340 539178882 11.6 259625 76.0 24.0 N/A
Y-2004 210190 587990365 35.7 67073 548274218 12.2 277263 75.8 24.2 N/A
Y-2005 224806 597477666 37.6 69369 557161047 12.5 294175 76.4 23.6 N/A
Y-2006 241210 606611392 39.8 73494 565762395 13.0 314704 76.6 23.4 N/A
Y-2007 262918 615506279 42.7 77876 574185530 13.6 340794 77.1 22.9 N/A
Y-2008 263809 624242020 42.3 78500 582492785 13.5 342309 77.1 22.9 N/A
Y-2009 276333 632892402 43.7 80688 590747758 13.7 357021 77.4 22.6 N/A
Y-2010 298262 641566029 46.5 86387 599047591 14.4 384649 77.5 22.5 N/A
Y-2011 302420 650244390 46.5 88464 607376801 14.6 390884 77.4 22.6 N/A
Y-2012 306061 658839435 46.5 88921 615647779 14.4 394982 77.5 22.5 N/A
Y-2013 312670 667322883 46.9 87847 623809180 14.1 400517 78.1 21.9 N/A
Y-2014 354573 675549357 52.5 97078 631697152 15.4 451757 78.5 21.5 106
Y-2015 328241 683543213 48.0 85169 639323292 13.3 413457 79.4 20.6 47
Y-2016 333804 691623419 48.3 84372 647012921 13.0 418221 79.8 20.2 45
Y-2017 318316 699587889 45.5 78234 654607791 12.0 396584 80.3 19.7 34
Y-2018 330925 707149230 46.8 80864 661854076 12.2 411824 80.4 19.6 35
Y-2019 340267 714325057 47.6 80800 668786993 12.1 421104 80.8 19.2 37
Y-2020 301405 720997448 41.8 72975 675389679 10.8 374397 80.5 19.5 17
Y-2021 324151 726503429 44.6 73306 681060412 10.8 397530 81.5 18.4 33
Mean 173286.6 493012045 32.7 61205.5 460355243.8 13.4 234941.091 71.0 28.6 44.3
*Due to less available data further analysis of this category is not done but it is included in total count. ** N/A – Not Available
Table 4B-. Gender-wise comparison of suicide in India from 1st January-1967 to 31st December 2021.
Table 4B-. Gender-wise comparison of suicide in India from 1st January-1967 to 31st December 2021.
Year No. of Suicides-Male Population of male Male-Annual Incidence of suicide in male per 100000 No. of Suicides-Female Population of female Female-Annual Incidence of suicide in female per 100000 Total No. of Suicides- Male-% of Total suicide Female-%of total suicide Suicides-Bisexual*
Y-1967 22637 269770979 8.4 16192 252216091 6.4 38829 58.3 41.7 N/A**
Y-1968 24464 275736482 8.9 16224 257695427 6.3 40688 60.1 39.9 N/A
Y-1969 25947 281934206 9.2 17686 263380464 6.7 43633 59.5 40.5 N/A
Y-1970 28846 288292405 10.0 19582 269208897 7.3 48428 59.6 40.4 N/A
Y-1971 26326 294818942 8.9 17349 275180236 6.3 43675 60.3 39.7 N/A
Y-1972 26923 301529376 8.9 16678 281308597 5.9 43601 61.7 38.3 N/A
Y-1973 25231 308465459 8.2 15576 287642024 5.4 40807 61.8 38.2 N/A
Y-1974 27791 315584063 8.8 18217 294137889 6.2 46008 60.4 39.6 N/A
Y-1975 26074 322800952 8.1 16816 300723268 5.6 42890 60.8 39.2 N/A
Y-1976 24042 330077580 7.3 17373 307373867 5.7 41415 58.1 41.9 N/A
Y-1977 23453 337496325 6.9 16265 314189303 5.2 39718 59.0 41.0 N/A
Y-1978 24137 345069608 7.0 16070 321198151 5.0 40207 60.0 40.0 N/A
Y-1979 22980 352826329 6.5 15237 328422054 4.6 38217 60.1 39.9 N/A
Y-1980 24188 360875327 6.7 17475 335953058 5.2 41663 58.1 41.9 N/A
Y-1981 23864 369149846 6.5 16381 343719452 4.8 40245 59.3 40.7 N/A
Y-1982 26520 377542519 7.0 18212 351626946 5.2 44732 59.3 40.7 N/A
Y-1983 27260 386102269 7.1 19319 359724278 5.4 46579 58.5 41.5 N/A
Y-1984 29296 394865497 7.4 21275 368029660 5.8 50571 57.9 42.1 N/A
Y-1985 30460 403766421 7.5 22351 376475662 5.9 52811 57.7 42.3 N/A
Y-1986 31271 412811682 7.6 23086 385067312 6.0 54357 57.5 42.5 N/A
Y-1987 34292 421960524 8.1 24276 393755601 6.2 58568 58.6 41.4 N/A
Y-1988 37755 431194389 8.8 26515 402535292 6.6 64270 58.7 41.3 N/A
Y-1989 40212 440551295 9.1 28532 411461378 6.9 68744 58.5 41.5 N/A
Y-1990 43451 449984059 9.7 30460 420468106 7.2 73911 58.8 41.2 N/A
Y-1991 46324 459463492 10.1 32126 429478264 7.5 78450 59.0 41.0 N/A
Y-1992 47481 469046096 10.1 32668 438527953 7.4 80149 59.2 40.8 N/A
Y-1993 49851 478735976 10.4 34393 447615320 7.7 84244 59.2 40.8 N/A
Y-1994 52752 488535405 10.8 36443 456726553 8.0 89195 59.1 40.9 N/A
Y-1995 52357 498432465 10.5 36821 465846665 7.9 89178 58.7 41.3 N/A
Y-1996 51206 508349160 10.1 37035 474932057 7.8 88241 58.0 42.0 N/A
Y-1997 56281 518303618 10.9 39548 484031612 8.2 95829 58.7 41.3 N/A
Y-1998 61686 528287413 11.7 43027 493147162 8.7 104713 58.9 41.1 N/A
Y-1999 65488 538244360 12.2 45099 502255693 9.0 110587 59.2 40.8 N/A
Y-2000 66032 548223581 12.0 42561 511410095 8.3 108593 60.8 39.2 N/A
Y-2001 66314 558291332 11.9 42192 520679574 8.1 108506 61.1 38.9 N/A
Y-2002 69332 568334873 12.2 41085 529978166 7.8 110417 62.8 37.2 N/A
Y-2003 70221 578236241 12.1 40630 539178882 7.5 110851 63.3 36.7 N/A
Y-2004 72651 587990365 12.4 41046 548274218 7.5 113697 63.9 36.1 N/A
Y-2005 72916 597477666 12.2 40998 557161047 7.4 113914 64.0 36.0 N/A
Y-2006 75702 606611392 12.5 42410 565762395 7.5 118112 64.1 35.9 N/A
Y-2007 79295 615506279 12.9 43342 574185530 7.5 122637 64.7 35.3 N/A
Y-2008 80544 624242020 12.9 44473 582492785 7.6 125017 64.4 35.6 N/A
Y-2009 81471 632892402 12.9 45680 590747758 7.7 127151 64.1 35.9 N/A
Y-2010 87180 641566029 13.6 47419 599047591 7.9 134599 64.8 35.2 N/A
Y-2011 87839 650244390 13.5 47746 607376801 7.9 135585 64.8 35.2 N/A
Y-2012 88453 658839435 13.4 46992 615647779 7.6 135445 65.3 34.7 N/A
Y-2013 90543 667322883 13.6 44256 623809180 7.1 134799 67.2 32.8 N/A
Y-2014 89129 675549357 13.2 42521 631697152 6.7 131666 67.7 32.3 16
Y-2015 91528 683543213 13.4 42088 639323292 6.6 133623 68.5 31.5 7
Y-2016 88997 691623419 12.9 41997 647012921 6.5 131008 67.9 32.1 14
Y-2017 89019 699587889 12.7 40852 654607791 6.2 129887 68.5 31.5 16
Y-2018 92114 707149230 13.0 42391 661854076 6.4 134516 68.5 31.5 11
Y-2019 97613 714325057 13.7 41493 668786993 6.2 139123 70.2 29.8 17
Y-2020 108532 720997448 15.1 44498 675389679 6.6 153052 70.9 29.1 22
Y-2021 118979 726503429 16.4 45026 681060412 6.6 164033 72.5 27.4 28
Mean 55004.545 493012045 10.5 31927.3 460355243.8 6.8 86934.3 61.9 38.1 16.4
*Due to less available data further analysis of this category is not done but it is included in total count. ** N/A – Not Available.
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