Saturday, May 04, 2013

On Suicide Statistics

This post is because the news about increases in the US suicide rates among certain age groups which have traditionally not been the focus of those who research suicide.  But it is ultimately going to be about another aspect of suicide.

First, it is pretty clear (from earlier studies) that bad economic times increase suicide rates.  The current or recent economic slump,  combined with various types of belt-tightening initiatives in many states and the general austerity policies are probably the reason for this:

More Americans now die of suicide than from car accidents, according to the Centers for Disease Control and Prevention, a disturbing statistic that some experts say points to the true depths of the US economic crisis.

From 1999 to 2010, the suicide rate among US citizens between the ages of 35 to 64 soared by about 30 per cent, to 17.6 deaths per 100,000 people, a jump from 13.7.

In 2010, there were 33,687 deaths from motor vehicle crashes and 38,364 suicides.

Although suicide has been traditionally viewed as a problem among the youth and elderly, the recent study, published in Friday’s issue of its Morbidity and Mortality Weekly Report, shows a marked rise in the number of suicides among middle-aged men and women.

The suicide rate for men aged 35–64 years jumped 27.3 per cent, from 21.5 to 27.3 per 100,000, while the rate for women increased 31.5 per cent, from 6.2 to 8.1.

Among the male population, the greatest increases were among those aged 50–54 years and 55–59 years, (49.4 per cent, from 20.6 to 30.7, and 47.8 per cent, from 20.3 to 30.0 respectively). Among females, suicide rates tended to increase with age. The largest percentage increase in suicide rate was observed among women aged 60–64 years (59.7 per cent, from 4.4 to 7.0).

Men were more likely to take their own lives than women. The suicide rate for middle-aged men was 27.3 deaths per 100,000, while for women it was 8.1 deaths per 100,000.
Bad economic times cause many of us tightrope walkers to fall.  If nobody grabs us in time or if someone is busily cutting away the safety net below, we will fall.  That's how it goes.

Translated into less poetic terms,  the loss of a job can mean not only the loss of money for food and heating and other necessities of life but also the loss of self-esteem, the loss of seeing oneself as a worthwhile person and not just as someone taking up oxygen.

This problem is particularly acute when politicians find nothing as fascinating as how best to unravel the safety nets people depend in old age and when the health insurance which would make seeing a mental health care professional becomes one of those luxuries the unemployed simply cannot afford.

But more permanent effects are also at work behind those statistics.  Men, on average, commit more suicides than women do, and several researchers believe that this may be a consequence of the definitions of masculinity which make asking for help or relying for support a sissy thing to do.

Likewise, our self-esteem is more likely to suffer if we have staked our value on one aspect only.  Thus, women are more likely to commit suicides if they live in cultures where the way women's value is defined is through married motherhood alone.  Under such circumstances anything going wrong inside the family has drastic effects, and having children outside the marriage can be so stigmatizing as to make suicide the only exit one can imagine.

Men, on the other hand, are more likely to commit suicides if they live in individualistic cultures which define their value by how good a job they can hold, by the size of their bank account and by their ability to never, ever ask for help.

Or so I think, based on quite limited research.  Other factors also matter in understanding why men are more likely to commit suicide in most countries* than women:  Differences in alcoholism and in access to firearms.

Men are more likely to use firearms and women poisons.  The former act quickly and have high fatality rates, the latter are slow-acting and offer time for someone to intervene.  Alcohol consumption has been found to correlate with the rate of suicides in some countries such as Russia where men are more likely to drink than women.

Certain types of Men's Rights Activists argue that the higher rate of male suicides should be taken into account when judging whether women or men are more oppressed.  I have never understood the thesis behind this argument, though it must somehow be based on the assumption that men kill themselves because the traditional culture is so harsh on them or on some odd type of essentialism about whether it's better to be born male or female (in which case one should also address the fact that men don't have to menstruate or to give birth and so on, but none of that is about feminism).

But if it is the rigid way masculinity has been traditionally defined, feminism should be the answer, given that feminism wants to make gender roles less rigid and to expand the allowed spheres of activity for both sexes.  This, however, is not the explanation ever offered.  Rather, it is the exact reverse:  Because being dominant in the society is so bad for men, women should stop whining and accept their more comfortable roles.

Given this background, I was a little shocked when I found** recent (2010) statistics (pdf) on the US suicide rates (expressed per 100,000 individuals in the relevant group):

The rate for white males (men and boys) is, indeed, a very high 22.6.  The rate for white females (women and girls) is only about a fourth of that at 5.9.

But here's what I was also shocked about:  The rate for black males was 8.7 and for black females 1.8.

The overall*** rate for Latinos in the US was 5.3, the rate for Native Americans 11.0 and the rate for Pacific Islanders/Asians 6.2.

Thus, while there clearly is a gender difference in the suicide rates among the white and black segments of the population, there is very large ethnic or racial difference, too.  The rate for black men is only about a third of the rate for white men, for example, and the rate for black women is also about a third of the rate for white women.

How to interpret this?  If we used the MRA mold to turn out an explanation we probably would have to argue that the higher suicide among white men is the price they pay for being dominant in the society?  That, in turn, could be used to insist that the other racial groups should be pleased with not having to share any of that.

I think that is utter rot,  and so is the original MRA argument about women and men. What's right is to fix the high suicide rate of white men, as well as to lower the rates of suicides for all at-risk groups, and the real solutions are found in those safety nets or support.

Human beings are herd animals.  We should all talk to the steer next to us, we should learn that asking for help in dire situations is a sign of strength, not a sign of weakness, that the help received that way can one day be returned (but not if you are no longer around), that mental health care professionals are intended to serve us in our times of need, that all individuals have many aspects of value, that nobody should put all their dreams into one basket and on and on.  Community, in short.  That's one of its major functions.

Let's return to the initial news about the economic depression and increased suicide rates among certain groups of Americans.  We failed these individuals as a community.  Economists failed them.  The government failed them.  The financial and housing markets failed them.  But their deaths should be counted in the overall costs of the depression and its aftermath.
*China is the main exception to this.  Women in rural China have a very high rate of suicide, usually carried out by taking weed killers.  I have not been able to find out if those weed killers act quickly or if there are no good treatments to stop their effect.  Given that one reason for the higher male completion rate of suicide has to do with the rapid and often-fatal aspect of guns,  looking into that question seemed worthwhile.

The mention of suicide completion rates links to the so-called gender paradox in suicide:  Women attempt suicide at least as often as men but succeed in it less often.  Why that is the case is unclear, but the slower action of poisons, women's preferred weapon, may be part of the explanation.  It is also possible that poison suicides are more often classified as, say, accidental overdoses than suicides.  Finally, women may be more likely to attempt parasuicide than men.

**As far as I can tell, this data set seems legit.  But you should be aware of the fact that I didn't spend a lot of time checking it.

***I was unable to find this information separately by sex.