7.3.5. Intentional injuries
Intentional injuries (suicide and homicide, assault, other
violence) account for 27% of fatal injuries but only for 7.4% of all medically
treated cases (See Table 7.1).
Suicide and self harm
represent a serious public health problem. as they are one of are the main
causes of injury mortality in the EU27 (24% of all cases, almost 61 000 people
a year – see Figure 7.2
) In Europe suicide rates vary
from about 2 per 100 000 people in Cyprus to 35 per 100 000 in Lithuania (Figure 7.15.A).
Figure 7.15.a. Suicide and self harm in the EU27
than women commit suicide in the European Union (Figure 7.15.b. Suicide and intentional self-harm by
gender in the EU27 whereas more women commit more suicide attempts (Figure
Figure 7.15.b. Suicide and intentional
self-harm by gender in the EU27
majority of researchers and professionals involved in suicide prevention agree
that suicide is associated with a complex array of factors such as:
previous suicide attempt
to means of suicide.
has shown that more than 90% of people who commit suicide had depression or
another diagnosable mental or substance abuse disorder. Some risk factors vary
with age, gender and ethnic group. Risk factors may change over time, while
some factors frequently occur in combination.
risk factors also vary in their degree of effect and no one single factor has
been found to be a sufficient cause of suicide (Guo and Harstall, 2004).
seen, in modern societies there is still a lack of awareness of suicide as a
major health problem. At the same time, there is also still a taboo to discuss
the issue in an open manner.
data on suicide attempts and self harms are not adequately documented. Hospital
discharge data only deliver a rough picture, and no details on the background
and risk factors of suicide attempts and self-harm.
Figure 7.16. Hospital deaths and
discharges due to suicide and suicide attempts by sex, selected EUGLOREH
situation might be changed as the European Injury Database will also contain in
the future details on self harm injuries of hospital treated patients.
sure, tackling the problem of suicide and self harm requires a comprehensive
multisectoral approach involving different scientific disciplines.
Interpersonal violence: Homicide, assault
Interpersonal violence (IPV) is defined as "the
intentional use of physical force or power, threatened or actual, against another
person, or against a group or community, that either results in or has a high
likelihood of resulting in injury, death, psychological harm, maldevelopment,
or deprivation“. The definition used by the World Health Organization
associates intentionality to the committing of the act itself, irrespective of
the outcome it produces. Interpersonal violence related mortality includes
deaths due to homicide, sexual assault, neglect and abandonment, and other
forms of maltreatment
For all age groups taken together, interpersonal violence
accounts for 2% of fatal injuries in the EU27 and in particular for 5% in the
1-4 age group. Again, differences between countries in the European Union
indicate a high potential for improvement and confirm the nature of
preventability of violence (Figure 7.17).
many other health problems in the EU, violence is not distributed evenly among
sex or age groups. More men than women
are victims of violence (Figure
7.17. Homicide, assault by sex selected
Figure 7.17. Homicide, assault by sex
selected EUGLOREH countries
The above-mentioned mortality figures almost certainly
underestimate the true burden of violence. In all parts of the world deaths
represent the ‘‘tip of the iceberg’’ as far as violence is concerned. Physical
and sexual assaults occur daily, though precise national and international
estimates of each are lacking. Not all assaults result in injuries severe
enough to require medical attention and – even among those that do result in
serious injuries – surveillance systems for reporting and compiling these
injuries are in many countries either lacking or are still being developed (WHO, 2002).
Again, hospital discharge data only give a rough picture
of the circumstances of non-fatal injuries due to homicide, assault and other
The currently developed European Injury Database will in
future deliver information on injuries due to violence of hospital treated
The WHO World Report on Violence and Health provides an
excellent introduction into the global perspective of the problem of violence