Sunday, November 25, 2018

Suicide Rates are Declining Globally, But Not in the U.S.

This week's Economist has a very nice summary of the global trends in suicide (or "intentional self-harm" as it is known in the International Classification of Diseases). In the world as a whole, the rates are declining, but the United States is bucking that trend.
Globally, the rate has fallen by 38% from its peak in 1994. As a result, over 4m lives have been saved—more than four times as many people as were killed in combat over the period. The decline has happened at different rates and different times in different parts of the world. In the West, it started long ago: in Britain, for instance, the male rate peaked at around 30 per 100,000 a year in 1905, and again at the same level in 1934, during the Great Depression; among women it peaked at 12 in 1964. In most of the West, it has been flat or falling for the past two decades.

America is the big exception. Until the turn of the century the rate there dropped along with those in other rich countries. But since then, it has risen by 18% to 12.8—well above China’s current rate of seven. The declines in those other big countries, however, far outweigh the rise in America.
There are a couple of important reasons for the global decline--urbanization and women's liberation. Although in most societies men (especially older men) tend to have the highest suicide rates, in China and India (the world's two most populous countries), the burden of suicide was often on women trapped in a relationship and family that was not of their choosing. Indeed, a few years ago I blogged about the fact that urbanization in China seemed to be lowering their suicide rate.

The graph below, based on data from the University of Washington's Institute for Health Metrics and Evaluation, compares the recent trends among several countries, and you can the U.S. pattern is different from the global pattern:



In the U.S., we have two important things that contribute to the rise, and I've blogged about both in the past: (1) the "sea of despair" that has taken root especially among white working class Americans; and (2) the availability of guns. Both of these are within the purview of public policy, and the lack of legislative initiatives on these underlying contributors to suicide almost certainly explains the rise in the rate of suicides in the U.S.

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