The Monetary Value of Human Lives Lost to Suicide in the African Continent: Beating the African War Drums

Assessing the societal value of health lost to alcohol use in India compared to excise taxes on alcohol sales

INTRODUCTION

We retrospectively studied the societal value of lost health due to alcohol use and compared it with excise taxes on alcohol sales for India in 2019.

METHODS

We estimated the overall alcohol-attributable disease burden using disability-adjusted life-years (DALY) for India and its 30 states for all causes with alcohol use as a risk factor from the GBD 2019 Study. The societal value of lost health was calculated using value of life-year (VLY) approach by multiplying region-specific factors from 'Global Health 2035', 2019-2020 GDP per capita and DALYs. We acquired the national and state-level (top 10 states) alcohol sales excise taxes from the Reserve Bank of India. Net losses were assessed by subtracting the revenue collected from excise taxes from VLY. All values are in Indian rupees (INR).

RESULTS

The societal value of health lost due to alcohol use in India was 6.2 (95% uncertainty interval 4.8, 7.8) trillion INR in 2019. The absolute state-level values varied from 7.3 (4.7, 10.4) billion INR in Mizoram to 1.1 (0.8, 1.4) trillion INR in Maharashtra. The per capita values ranged from 950.2 (642.9, 1285.3) INR for Bihar to 61,332 (39,273.7, 87,288.5) INR for Mizoram. Nationally, excise tax collection from alcohol sales was 1.8 trillion INR depicting a net loss of 4.4 (3.1, 6.0) trillion. Maharashtra had the largest absolute and per capita net loss.

DISCUSSION AND CONCLUSIONS

These are novel estimates depicting the net losses due to alcohol use in India with direct policy implications to disincentivise sales and adequately raise taxes.

Economic burden of suicides and suicide attempts in low- and middle-income countries: a systematic review of costing studies

INTRODUCTION

Suicide is a major public health concern in low- and middle-income countries (LMICs) due to its substantial psychological, social, and economic impact. There is little synthesized evidence to estimate the economic burden of suicide and suicide attempts in such economies. The present systematic literature review aims to examine existing evidence on the cost of illness (COI) in the case of suicides and suicide attempts and assess their quality.

METHODS

A systematic review was carried out using electronic databases, such as Medline, EMBASE, EconLit, PsycINFO, and CINAHL using keywords like 'suicide and suicide attempts,' 'cost of illness,' and economic burden." The quality assessment of studies was conducted along with the per-person cost estimation to understand the variation of methods followed across the studies.

RESULT

14 studies qualified for final data extraction and synthesis out of 4,164 studies. The studies showed heterogeneity across objectives, settings, and methods, with cost estimates reflecting a wide range of costings per person in suicide and suicide attempts.

CONCLUSION

It is challenging to determine and compare the economic estimates of suicide. Intensive research is warranted with standardized cost assessment techniques and wider perspectives to understand the true economic burden of suicide.

REGISTRATION

PROSPERO Registration No- CRD42022294080.

Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study

Background

India has the highest number of suicide deaths in the world. Suicide prevention requires policy attention and resource allocation. Evidence of economic losses due to disease burden can influence such allocations. We assessed the economic burden and its distribution across states and demographic groups in India.

Methods

We used the human capital approach in this retrospective cross-sectional analysis to assess the economic burden of suicide in India for the year 2019 for 28 Indian states and 3 union territories (UTs). We calculated the monetary value for the years of life lost disaggregated by states, age groups, and sexes. For sensitivity, we present a library of estimates using different discount rates, life expectancy thresholds, and estimates specific to the populations that can participate in the workforce.

Findings

The national economic burden of suicide was US$ 16,749,079,455 (95% Uncertainty Interval: 11,913,034,910-22,404,233,468). The top three states, Karnataka, Tamil Nadu, and Maharashtra, contributed to 44.82% of the total burden in India. The age group 20-34 years had the largest suicide burden and contributed to 53.05% of the overall national economic burden (US$ 8,885,436,385 [6,493,912,818-11,694,138,884]). Twenty states and UTs had a greater economic burden for females than males.

Interpretation

The current analysis ascertains a high economic burden of suicide among the Indian youth and females, necessitating concerted multisectoral efforts and immediate investments.

Funding

None.