The global suicide rate has declined by nearly a third since 1990, a new report finds, despite high rates and increases in suicide rates in multiple countries, including the United States.

Using data from the Global Burden of Disease Study of 2016, University of Washington professor and study author Mohsen Naghavi estimated suicide rates by age, sex, location and country development status between 1990 and 2016 for 195 countries and territories. He found that, while the total number of deaths by suicide increased globally in that time period, the age-adjusted suicide mortality rate decreased by 32.7 percent, from 16.6 deaths per 100,000 in 1990 to 11.2 deaths per 100,000 in 2016. There were 817,000 deaths globally from suicide in 2016, according to the report, published Wednesday in The BMJ, a peer-reviewed medical journal.

"Suicide deaths were in the leading 10 causes of death across eastern Europe, central Europe, high-income Asia Pacific, Australasia and high-income North America," according to the report. "Whether the decline in suicide mortality is due to suicide prevention activities, or whether it reflects general improvements in population health, warrants further research."

But the decline in the global suicide rate draws attention away from countries that have high suicide rates and experienced statistically significant increases in their rates between 1990 and 2016. According to the report, Zimbabwe, Jamaica, Paraguay and Belize all experienced statistically significant increases in their mortality rates from suicide over the time period, and Lesotho (at 39 deaths per 100,000), Lithuania (31), Russia (30.6) and Zimbabwe (27.8) had the highest suicide mortality rates among countries with populations greater than 1 million. Further, suicide rates in the U.S., at 14.0 per 100,000 in 2017, increased by a third since 1999, according to the Centers for Disease Control and Prevention, especially among its rural communities.

Meanwhile, deaths from suicide in China and India – the countries with the highest populations – accounted for 44.2 percent of global suicide deaths in 2016. Both countries experienced significant decreases of 64.1 and 15.2 percent, respectively.

"Much of the global estimated decline is owing to the large decrease in suicide mortality in China during the study period, and the lower but still important decrease in India," the study says. "Moreover, although the decrease in suicide mortality has been substantial during the period 1990 to 2016, if current trends continue, only 3 percent of 118 countries will attain the Sustainable Development Goals target to reduce suicide mortality buy one third between 2015 and 2030."

Despite the decline pointing toward progress in recent decades, suicide remains a global and preventable public health concern, the report says. Suicide accounts for about 800,000 related deaths annually, according to the World Health Organization.

Men, younger adults and older adults reportedly have higher rates of suicide than women and middle-aged adults. The rate of suicide among women only exceeded men for the 15 to 19 age group, the study found, though the gap "narrowed between 1990 and 2016 to almost parity in 2016."

Overall, suicide deaths are under-reported. Despite reclassifying some death codes to account for misclassification and under-reporting, the researchers admitted that their study could be affected by sociocultural factors, causing results to show lower suicide rates in countries with religious and cultural sanctions against the practice.