Suicide Around the World – What Causes Suicide?

Suicide Around the World – What Causes Suicide?

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Suicide rates have increased around the world at alarming rates. So what causes suicide? Is it genetically or ethnically-based? Or is suicide a cultural and sociological disease? Religion, media influence, globalization, social and cultural feelings of support and membership are probably among the crucial factors.

Suicide rates have increased around the world at alarming rates. Statistics from the World Health Organization (WHO) and the Center for Disease and Control (CDC): 1 & 2

  • 1 million people die of suicide every year
  • Suicide rates have increased by 60%
  • By 2020, 1 person will die of suicide every 20 seconds
  • By 2020, 1 person will attempt suicide every 1-2 seconds
  • Most suicide attempts are by the elderly but more youths are successful
  • Youth suicide is increasing at the fastest rate and suicide now ranks among the three leading causes of death for those 15-44
  • Males are 4 times as likely to die from suicide than females, but females attempt suicide 3 times more than males
  • In Eastern Europe, the rates of suicide for men and women are the same
  • Most deaths from suicide occur in Eastern Europe
  • The second highest rates of suicide occur in the island countries of Cuba, Japan and Mauritus
  • China and India report the most deaths but this number is due to their large population size
  • The lowest rates of suicide are in the Eastern Mediterranean and Islamic countries
  • Some of WHO’s numbers are skewed by the fact that Africa has not reported suicide rates, Asia rarely does and the Eastern Mediterranean, Western Pacific and Latin American countries do so irregularly

So what causes suicide? Is it genetically or ethnically-based? Or is suicide a cultural and sociological disease? Does culture and a country’s social practices determine susceptibility to suicide?

Alcohol and drug use make up the biggest risk factor for all age groups of people. Alcohol and drug use are linked to depression, impaired judgment and skewed thinking.

After substance abuse and depression, what commonalities can be found in suicides around the world?

One study, done by researchers Marusic and Farmer, suggests that genetic vulnerability could be a factor. The researchers point out that residents of Hungary and Finland have very different cultural and political practices but share a common genetic origin and a high rate of suicide. 3

On the other hand, a number of studies have looked at the genetically similar countries: Denmark, Norway and Sweden. Although members of these countries share ethnic backgrounds, Norway has a remarkably lower rate of suicide than either Denmark or Sweden. 4

Pharmaceutical companies are eager to fund research that will result in physiological cures for suicide and genetic research is the first step along that route.

What is not considered however, is the fact that genes and behavior don’t make up a one-way street. Our diet, environment, well-being and actions affect both the expression and evolution of our genes. 5 

Social Solidarity Evidence

Emile Durkheim proposed that suicide rates increase during times of change and crisis because our social bonds, cohesion, and integration are disrupted. 4

A great deal of evidence exists to support the idea that our social environment and practices greatly affect suicide rates.

The World Health Organization recognizes that depression and other mood disorders are linked to suicide and that alcohol and drug use play a large role too, but WHO expounds that “suicide results from many complex factors and is more likely to occur during periods of socioeconomic, family and individual crisis (e.g. loss of a loved one, unemployment, sexual orientation, difficulties with developing one’s identity, disassociation from one’s community or other social/belief group, and honour.” 6

In terms of prevention, WHO says that factors that seem to lessen the incidence of suicide include “high self-esteem and social “connectedness,” especially with family and friends, having social support and being in a stable relationship, and religious or spiritual commitment.” 6

Professor Michael Kearl concurs. He points out that Norway’s low suicide rates may be related to its strong and supportive family environments, that suicide rates fall during war time (we bond as a country then), that one study found that U.S. suicides increased by 360 people for every 1% rise in unemployment and that 30% of youth suicides were of homosexuals struggling with their identity in homophobic communities. 6

Indeed, the words of one youth struggling with his sexual identity illustrate his alienation when looking at couples together in a park. “There’s no belonging. So you’re an outcast. These people looked like they knew where they belonged. There was no place for me to feel comfortable with anyone or anything.” 4

Thomas Joiner, author of Why People Die of Suicide, believes that a lack of “belongingness” is a huge factor in suicide. He points out that suicide is common in the elderly (who lose social ties,) adolescents (who are struggling with developing identity,) and retirees (who suddenly cannot define themselves by a life-long career.) 7

Joiner also believes that residents of the former Soviet Union (countries with the highest rates of suicide in the world) have been cast out of their national identity and social group. 7

The case for the link between suicide and lack of social solidarity can be illustrated by looking at studies of immigrants, religion, media effects and the country of Norway.

Immigrants

The World Health Organization (WHO) and the International Association for Suicide Prevention (IASP) have teamed up to study the causes of suicide and promote its prevention all over the globe.

IASP says that increasing globalization, ease of travel and civil wars have spawned a great number of immigrants worldwide. 8 Being separated from one’s country and ending up where you are considered an “alien” increases the risk of suicide.

IASP is working to implement interventions that address the “specific cultural and religious attitudes” and “family and social structures” of different migrant groups, as well as teaching them coping skills and encouraging them to socialize. 8

An interesting study was done in 2004 on the suicide rates of Russian immigrants in Estonia. 9

Before WWII, the country of Estonia stood apart from its neighbor Russia. After its incorporation into the Soviet Union, Russian immigrants made up 30% of the population in Estonia, where they enjoyed a privileged status.

The researchers studied the rates of suicide among the Russian immigrants, Estonians and Russians at home before and after the dissolution of the Soviet Union.

Originally, Russians that emigrated to Estonia did not have to acculturate. After Estonia became independent, the Russian population has to study Estonian as the official language, apply for citizenship and adapt themselves to a very different social stratum.

The study found that the Russian immigrants experienced suicide rates that were 13.3% higher than native Russians and 22.1% higher than native Estonians.

Another at-risk group is the indigenous or aboriginal youths in Australia, Canada, New Zealand and the U.S. As westernization destroys aboriginal culture and forces them to join the majority of society, suicide rates rise significantly.

Colonization changes their lives drastically, disrupting family and social ties, changing the way they work and live, and results in a lack of secure cultural identity. 8

The North Dakota Adolescent Suicide Prevention Project was able to reduce suicide rates in 10-19 year-old indigenous youth by 47% over 4 years. The project worked to promote community involvement, recognize at-risk youth, and provided mentoring programs to affect the acculturation, guidance and inclusion of the youths. 8

Religion

Religion plays a large role in susceptibility to suicide. It’s not only that some religions strictly forbid or condemn the act as an unpardonable sin (although this plays a part), but the very fact of being part of a group with common beliefs and practices strengthens one’s social ties and personal identity.

In a review of the WHO’s international statistics for suicide, researchers have taken note of the suicide rates by religion. 10

Muslim countries (which strictly forbid suicide) have rates as low as 0.1%; countries that are Hindu have 9.6% suicide rates. Christian countries rank about 11.2%, Buddhist countries 17.9% and Atheists’ top the charts at 25.6%.

In a study titled “Religious Affiliation, Atheism and Suicide,” researchers studied suicide rates to determine if religious involvement lowered the number of suicides. 11

  • The researchers found that participants who did not have a religious affiliation had significantly more suicide attempts over their lifetime.
  • They also found that those same people were less likely to be married, have children or have much regular contact with their families.
  • The subjects without ties to religion reported fewer reasons for living and had fewer objections to the idea of suicide.
  • The unaffiliated participants were also more likely to be impulsive, aggressive and have abused substances in the past (characteristics tied to increased suicide incidence.)

The researchers concluded that religious affiliation provided more social ties and integration, less suicidal behavior (even in the depressed,) greater moral objection to taking their own lives and lower aggression levels.

Media

The media has a huge impact on cultural beliefs and practices. The WHO, IAPS and a host of other agencies are working to combat this effect.

The American Foundation for Suicide Prevention (AFSP)has worked with many agencies to develop media recommendations for responsible reporting on the subject of suicide. 12

Research from these agencies has found that “graphic, sensationalized or romanticized descriptions of suicide deaths in the news media can contribute to suicide contagion, popularly referred to as “copycat” suicides.” 12

AFSP tracks media coverage of suicides and attempts to watchdog the industry. The agency points out that in many circumstances, the media misrepresents the suicide case: attributing it to a single event such as a divorce of job loss, instead of educating the public about underlying factors that contribute to suicide. 12

Instead, the agency believes that the media can use stories to truly educate people on the warning signs and realities of suicide and its successful prevention and treatment. 12

World Health Organization’s Dr. Sarceno agrees. “We would urge that the media show sensitivity in its reporting on these tragic and frequently avoidable deaths. The media can play a major role in reducing stigma and discrimination associated with suicidal behaviors and mental disorders.” 6

In 1986, a study reviewed nationally-televised stories of suicide and the co-occurring teen suicide rates from 1973 to 1979. Teen suicides increased by 7% in the week following 38 broadcast suicide stories. 4

In Hong Kong, suicide is most often accomplished with poison. Media reports of a new way to take one’s life, charcoal burning, caused a large increase in suicide attempts even in those who had no history of such actions. 8

Suicide prevention experts worked to persuade the media to report the suicides more responsibly, access to charcoal was reduced in supermarkets and lodging owners were trained to recognize at-risk people that might be renting a room for the purpose of charcoal burning. The efforts greatly slowed the rate of the suicide attempts. 8

Although Norway has low rates of suicide and strong social cohesion, the “Werther effect” is starting to affect its country’s youth.

Werther was a character in a novel written by Johann Wolfgang von Goethe over 200 years ago. In Die Leiden des jungen Werthers (The Sorrows of Young Werther,) the broken-hearted character dresses in a blue coat, yellow vest and boots, opens a book on his desk and shoots himself.

The image was so vivid for so many young boys that followed in his footsteps; the book was banned from many countries.

Norwegian youth has been affected in the same way. In 1990, researchers found that suicide rates were rising. Bjerke et al. proposed that the increased availability of drugs and guns weren’t the only reason youth suicides were rising but spoke of a “cultural availability”—a Werther effect and spread of suicidal ideation. 13

A more recent study released by the Norwegian Social Research Association (NOVA) studied youth suicides for a decade. The researchers concluded that psychological problems for Norway’s young are only growing worse. 13

Professor Lars WichstrÃm, of the Norwegian University of Science and Technology, believes that substance abuse subsequent family conflicts are part of the problem. 14

He also believes that weight and dissatisfaction with one’s appearance, common themes in western cultures and on TV, increase pressure on Norway’s youth. 14

Norway

Although Norway has enjoyed some of the lowest suicide rates compared to its European neighbors in the past, the rate at which suicides are climbing is alarming.

Any change, good or bad, will disrupt social cohesion. In the way that one can startle a band of butterflies, suicide is a symptom of change. Butterflies make choices, reorganize themselves and settle back down to business.

The advent of the Internet, urbanization, global communication and the Werther Effect are causing casualties as Norwegians go through the same motions of reorganization.

For a long time, Norway’s geography and industry helped preserve its cultural identity and protect it from the negative influence of the rest of the world. As Nils Retterstøl put it, Norway was more “an outpost of Europe.” 15

Today, Norway has the advantage of research to combat the rise of suicide that is plaguing its citizens.

More than 40 years of investigations have looked at Norway’s strengths when it comes to suicide and identified what the most protective characteristics are.

In Suicide: A European Perspective, Nils Retterstøl identifies how well Norway fits neatly into Durkheim’s social theory of suicide, by reviewing the many studies conducted from the 1960’s to 1993. 15

He tells us how Erik Allardt evaluated Norway versus four of its neighbors on social qualifiers such as contentment and satisfaction, and degree of cohesion within a group, family and national origin. Norway scored very high on all qualifiers.

Retterstøl talks about Raoul Norrol’s research for his book, The Moral Order, in which Norrol proposes that close family groups and smaller communities provide strong adherence to norms, protecting citizens from undesirable behavior.

Norrol looked at 12 countries and judged them on 12 parameters that he judged to affect those norms and behavior. He rated Norway number 1 on all 12 and named it the “model country” for others to follow.

Retterstøl believed that Norway’s relative isolation preserved its cultural traditions and strong social identity and cohesion. Norway has been noted for its strong family ties, positive child upbringing, rural traditions, ties to nature, strong religious affiliation and a commitment to community and working for the common good.

But unfortunately we must emphasize that this romanticism of Norway belongs to a bygone era. Norway are on an equal footing with all of its neighbors, and even if Norway lack the EU membership, they are deeply connected to the rest of the world in many ways. Religiosity declines, and Professor Richard Dawkins, a scientist and an atheist, often refers to Norway as an atheist country. Secularization and globalization has taken over and Norway is in the middle of the global culture. The costs of such a process of change within a few decades, maybe just a kind of existential agony and inner turmoil that becomes visible in suicide statistics.

Last comment

Conformity, stability, and a kind of conservatism seem to be preventive factors in relation to suicide, but at the same time these factors might prevent development and change. Great changes are taking humanity forward, giving us new ways to live and wider perspectives, and our pool of information is increasing at a tremendous speed. Much information creates unstable systems that have potential for growth and change, but the cost is thus a kind of existential anxiety that might be associated with suicide. People’s basic fear of change and conservative forces are always working to preserve a kind of status quo (Latin expression for unaltered state).

Sources

1)Befrienders Staff Writer (2009). Suicide statistics. Befrienders [online]. Retrieved from http://www.befrienders.org/info/index.asp?PageURL=statistics.php

2)Bertolote, Jose Manoel and Fleischmann, Alexandra (2002) A Global Perspective in the Epidemiology of Suicide. Suicidologi [online]. Retrieved from http://www.med.uio.no/iasp/files/papers/Bertolote.pdf

3)Savitz, JB, Cupido CL, Ramesar, RS (2006, May 9). Trends in Suicidology: Personality as an Endophenotype for Molecular Genetic Investigations. PLOS Medicine[online]. Retrieved from http://www.plosmedicine.org/article/info:doi%2F10.1371%2Fjournal.pmed.0030107

4) Kearl, Michael C. (2004) Kearl’s Guide to the Sociology of Death: Suicide. Trinity University [online]. Retrieved from http://www.trinity.edu/~MKearl/death-su.html

5)Bondy, B, Buettner, A and Zill, P. (2006, February 7) Genetics of Suicide. Molecular Psychiatry [online]. Retrieved from http://www.nature.com/mp/journal/v11/n4/full/4001803a.html

6)WHO Staff (2004) Suicide huge but preventable public health problem, says WHO. World Health Organization [online]. Retrieved fromhttp://www.who.int/mediacentre/news/releases/2004/pr61/en/index.html

7) Joiner, Thomas E. (2005) Why People die by Suicide. The President and Fellow of Harvard University.

8) Religious Tolerance Staff (2009)Suicide: Worldwide efforts to prevent suicide. Religious Tolerance [online]. Retrieved from http://www.religioustolerance.org/sui_world1.htm

9) Värnik, Airi, Kõlves,Kairi and Wasserman,Danuta (2004, September 14). Suicide among Russians in Estonia: database study before and after independence. BMJ [online]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC544990/

10) Bertolote, Jose Manoel and Fleischmann, Alexandra (2002) A Global Perspective in the Epidemiology of Suicide

11) Dervic, Kanita, Oquendo, Maria, Grunebaum, Michael, Ellis, Steve, Burke, Ainsely and Mann, J. (2004, December) Religious Affiliation, Aetheism and Suicide. American Journal of Psychiatry [online]. Retrieved from http://www.adherents.com/misc/religion_suicide.html

12) American Foundation for Suicide Prevention Staff Writer (2009) Reporting on Suicide. American Foundation for Suicide Prevention [online]. Retrieved from http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_id=0523D365-A314-431E-A925C03E13E762B1

13) Rossow, Ingeborg (1993, May) Trends and Variations in Suicide in Norway. SIFA Rapport [online]. Retrieved from http://www.sirus.no/files/news/346/5-93.PDF

14) African Press Staff (2007, February 6). Norway: Suicide attempt rising among youngsters. African Press [online]. Retrieved from http://africanpress.wordpress.com/2007/02/06/norway-suicide-attempt-rising-among-youngsters/

15)Retterstøl, Nils (1993) Suicide: A European Perspective. University Press, Cambridge [online]. Retrieved fromhttp://books.google.com/books?id=JCCHtVitcKwC&printsec=frontcover&dq=suicide+a+european+perspective&ei=pjQiS5mWMqawywS34rSoCw&cd=1#v=onepage&q=&f=false

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