Guide to the Suicidology of Death

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Guide to the Suicidology of Death

In 1999, for the first time, the Surgeon General issued a Call To Action To Prevent Suicide, defining it as a "public health hazard." In public interviews he noted how in 1998 for every two homicides in the U.S. there were three suicides. Since 1952, the incidence for adolescents and young adults has nearly tripled, and 90% of these cases were due to guns. Each day 86 Americans take their own lives and another 1,500 attempt to do so.

Two years later, President Bush's new Surgeon General, Dr. David Satcher, repeated the alarm and unveiled a national blueprint to challenge "a preventable problem.

No one really knows why people commit suicide and perhaps the person least aware is the victim at the moment of the decision. An estimated 2.9% of the adult population attempts suicide. In efforts to explain this 8th-leading cause of death (third for Americans 15-24), scientists have located the cause of self-destructive behavior both within and without the individual. Physiologists, for instance, have found those with low serotonin.

The very field of sociology was in part founded on the discovery that suicide rates are as much a sociological phenomenon as they are psychological. Around the turn of the century, French sociologist Emile Durkheim found that single people were more likely to be victims than married individuals, Protestants more likely than Catholics, urban residents more likely than rural folks. Arguing that suicide was related to the nature of the bonds between self and society, Durkheim argued that either excessive or deficient levels of integration and regulation lead to four "ideal types" of suicide:

egoistic: perhaps the most prevalent form in the United States, is the result of too little social integration, such as the suicide of a retired elderly widower; altruistic: the consequence of excessive integration, such as deaths of a Japanese kamikaze pilot during World War II or the self-sacrifice of an Indian suttee, where a widow throws herself upon her husband's funeral pyre; anomic: results from too little regulation or the shattering of one ties with society, such as with divorce or unemployment;

Across the United States there is a four-fold difference in rates, ranging from New Mexico (19.8 suicides per 100,000 population) and Montana (19.3) to New York (6.6) and Massachusetts (6.7). Among the major predictors: 1998 divorce rates (r=.75), the percent of the population having no religious affiliation (r=.41), 1995 fatal accident rates (.59), and the percent of the state comprised of Catholics (r=-.40).

Turning to international rates, consider the following table from The Statistical Abstract of the United States 1982-83, where rates are broken down by age and sex:

	MALE RATES (per 100K)				FEMALE RATES (per 100K)
COUNTRY	15-24	25-44	45-64	65+	15-24	25-44	45-64	65+	TOTAL
Austria	28.8	40.0	58.1	77.2	6.7	12.7	21.8	31.1	35.5
Switzerland	31.0	39.2	50.6	59.4	13.2	16.3	24.3	22.2	32.5
Denmark	16.3	51.4	71.2	67.7	7.7	25.5	41.1	32.4	29.9
W.Germany	19.09.0	30.1	40.8	60.4	5.6	12.1	22.0	26.6	27.8
Sweden	16.9	35.3	39.4	42.7	5.8	13.6	19.6	13.2	27.7
France	14.0	25.5	36.2	62.3	5.2	9.1	14.9	21.3	22.9
Japan	16.6	26.8	32.9	51.3	8.2	11.9	16.3	44.4	21.4
Poland	19.5	31.8	34.9	24.7	4.3	4.6	6.3	5.8	19.3
USA	20.0	24.0	25.3	38.0	4.7	8.9	10.5	7.4	18.9
Canada	27.8	30.3	30.2	28.6	5.7	10.1	12.8	8.7	17.2
Australia	17.6	23.1	23.1	25.3	4.5	8.1	8.6	7.9	15.2
Norway	20.4	19.2	30.3	25.0	3.3	8.0	13.0	7.5	14.2
Netherlands	6.2	13.4	20.7	27.8	2.7	9.8	17.7	18.0	10.8
Israel	10.8	9.4	12.9	23.4	1.2	4.3	6.6	15.9	9.6
UK	6.4	14.1	16.6	19.3	3.0	6.0	11.4	12.3	9.1
Ireland	6.2	11.1	12.1	4.3	2.5	4.8	8.4	3.6	6.6

In this sample of basically European countries, observe in the right-most column that there is a five-fold difference in suicide rates between Austria and Ireland. For all age categories, male rates exceed female rates. In eleven of our sixteen countries male rates are highest in old age, while such is the case for females in only seven.

Any analyses of such data must be taken with extreme caution. Undoubtedly there are national differences in the reporting and classification of deaths as suicide and these differences, in turn, probably vary by the sex and age of the deceased. In the United States, for example, suicides of older individuals are more frequently recorded as being due to "natural causes" than is the case for other age groups. With this qualification in mind, let's see what stories might be revealed in this data. First, let us divide female rates by males for each age category. Observe, for instance, that young Austrian women commit suicide at a rate that is 23% that of young Austrian males and that this ratio nearly doubles among Austrians 65 years of age and older:

NATIONAL RATIOS BY AGE OF FEMALE/MALE SUICIDE RATES

COUNTRY	15-24	25-44	45-64	65+
Austria	.23	.32	.38	.40
Switzerland	.43	.42	.48	.37
Denmark	.47	.36	.58	.48
W. Germany	.29	.40	.54	.44
Sweden	.34	.39	.50	.31
France	.37	.36	.41	.34
Japan	.49	.44	.50	.87
Poland	.22	.14	.18	.23
USA	.23	.37	.42	.19
Canada	.21	.33	.42	.30
Australia	.26	.35	.37	.31
Norway	.16	.42	.43	.30
Netherlands	.43	.73	.86	.65
Israel	.11	.46	.51	.68
UK	.47	.43	.69	.64
Ireland	.40	.43	.69	.84

RATIO OF SUICIDE RATES FOR AGE CATEGORY DIVIDED BY RATE FOR THOSE 65 AND OLDER FOR MEN AND WOMEN BY COUNTRY

	MALE STD. RATESES			FEMALE STD. RATES
COUNTRY	15-24	25-44	45-64	15-24	25-44	45-64
Austria	.37	.52	.75	.22	.41	.70
Switzerland	.52	.66	.85	.59	.73	1.09
Denmark	.24	.76	1.05	.24	.79	<1.27
W.Germany	.3131	.50	.68	.21	.45	.83
Sweden	.40	.83	.92	.44	1.03	1.48
France	.22	.41	.58	.24	.43	.70
Japan	.32	.52	.64	.18	.27	.37
Poland	.79	1.29	1.41	.74	.79	1.09
USA	.53	.63	.67	.64	1.20	1.42
Canada	.97	1.06	1.06	.66	1.16	1.47
Australia	.70	.91	.91	.57	1.03	1.09
Norway	.82	.77	1.21	.44	1.07	1.73
Netherlands	.22	.48	.74	.15	.54	.98
Israel	.46	.40	.55	.07	.27	.42
UK	.33	.73	.86	.24	.48	.93
Ireland	1.44	2.58	2.81	.69	1.33	2.33

In what countries would you find the challenges of midlife to be considerably greater than those of early adulthood and old age--if you are a male? a female?

According to the U.S. Department of Health and Human Services ("Suicide Among Older Persons, United States, 1980-92MMWR [Jan. 12, 1996]), age-specific rates of Americans suicides have consistently been highest among older personss. Though accounting for 13% of the populations, older Americans commit nearly one-fifth of all suicides. Though the overall suicide rate for persons 65 and older had been declining from the 1940s through the 1980s, it increased in the late 1980s before once again declining throughout the 1990s. Why the suicide rate of elderly black Americans is but a fraction of that of their white counterparts has intrigued workers. According to a 2002 study by Joan Cook and her colleagues (in the August special suicide issue of The American Journal of Geriatric Psychiatry), the answer may lie in the strong religious faith and social support of African Americans.

In the United States, in the wake of stories of the right-to-die, Jack Kevorkian, and suicide pacts of elderly couples, the morality of the terminally ill to take their own lives has become a matter of considerable discourse. Since 1977, the National Opinion Research Center has included the following question in its General Social Surveys: "Do you think a person has the right to end his or her own life if this person has an incurable disease?" In 1994, 61% of American adults agreed with this statement compared to 38% seventeen years earlier.

This chart is worth considering in light of the actual suicide rates of these groups::
AGE-ADJUSTED SUICIDE RATES (PER 100,000)
BY RACE AND SEX IN 1991

	MALEE	FEMALE
WHITES	19.9	4.8
BLACKS	12.5	1.9

Source: U.S. Department of Health and Human Services. 1993. Monthly Vital Statistics, vol. 42(2), Tables 10-11 (Aug. 31):38-41.

In Norway, the suicide rate is approximately one-third that of Denmark and Sweden even though all three countries are very similar ethnically, culturally, and geographically. In Suicide in Different Cultures, Faberow argues the lower Norwegian rate is due to its more supportive family environments and childrearing practices.
Studies in the early 1980s, for instance, found that the number of suicides in the U.S. increased by 360 a year for each one percent rise in unemployment.
Suicides, as well as homicides, plummeted in the country during World War II.
Being homosexual in a homophobic community can be lethal. A 1989 study for the Department of Health and Human Services estimated that 30 percent of youth suicides are committed by gay and lesbian young people.
A 1986 study by David P. Phillips and Lundie Carstensen found that between 1973 and 1979 teen-age suicides increased by about 7 percent in the seven days following 38 nationally-televised stories of suicide.

http://www.trinity.edu/~mkearl/death-su.html

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