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Column: Casualty Report
The World Health Organization conducted an extensive investigation into global suicide statistics in 2012 and estimated that, worldwide, there were 804,000 recorded suicide deaths, 75 percent of which occurred in low- or middle-income countries.1 Moreover, many suicides are not recorded, either because of stigma or because the country has a poor record-keeping infrastructure.2
The countries with the highest incidence of suicide were: Guyana (1), South Korea (2), Sri Lanka (3), Lithuania (4), Suriname (5). Other notable countries include: India (11), Russia, (14), Japan (17)
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The U.S. stood at number 50. Syria and Saudi Arabia were last on the list, but Syria's suicide statistics have likely changed since 2012, since war, especially civil war and political unrest, often lead to a higher incidence of suicide in a particular country. These same factors also make proper record-keeping difficult. Recent statistics indicate that Syria's overall life expectancy has decreased from 75 to 69 for men and from 80 to 75 for women in just three years' time. It is unclear how much of that decrease is due to suicide.3
Sri Lanka (3) was ravaged by a 25-year civil war (1983–2009) that left the nation with a poor infrastructure and economy. But its overall suicide rate has decreased since 1995, when it ranked number one in the world. This is largely due to stringent pesticide bans. In Sri Lanka, as in many other countries with a large agrarian population, pesticide ingestion is the most common means of self-harm and suicide.4
Nepal was also ravaged by a lengthy civil war (1996–2006) that left it with a poor health system and infrastructure. The country ranks third in the rate of suicide by women (30.1 per 100,000) but 17th for men. The disparity is likely related to poor health care for women and children, as well as to domestic violence against women, as indicated by police records.5
South Korea (2) stood out as the only wealthy country among the top five in suicide rate, but a closer look at the data shows that many of the suicides were committed by defectors from North Korea. A factor in their suicides may be the discovery that the Soviet-era training in medicine or engineering that they received in the North was inadequate for South Korea's modern, industrialized economy, leaving them poor and able to get only low-level jobs.6
Several countries that were part of the Soviet bloc had high suicide rates, particularly among men. Lithuania (4) in particular saw a rate of 51 suicides per 100,000 men in 2012. The rates were even higher in the late 1990s, the transitional years after the country declared its independence in 1995. Although they decreased somewhat by 2012, Lithuania still ranked second in male suicides. Some attribute this to remnants of the Soviet indoctrination on their mental health.7
Northern Ireland has also had a wave of suicides traceable to conflict, but unlike many other countries, it has seen suicides double during peacetime. Because Northern Ireland's government and infrastructure stayed relatively intact, unusual for war-torn countries, sociologists have been able to study the phenomenon of peacetime suicide and how trauma is perpetuated through generations. Many of the suicides in Northern Ireland are of young men in their twenties, too young to have lived during the most brutal times of conflict, which ended in 1998. The rate among men is 25.2 suicides per 100,000, and there is also a high incidence of post-traumatic stress disorder.8
Guyana (1) and Suriname (5) have the highest suicide numbers in the world, with Guyana having the highest average number of suicides at 44.2 per 100,000 people. Likely contributing factors are poverty, alcohol abuse, access to pesticides, and cultural associations of mental illness with witchcraft. Notably, there are fewer than ten practicing psychologists in the country, and because of the stigma of mental illness, few efforts have been made to address the problem. Suriname has similar contributing factors.9
According to the American Foundation for Suicide Prevention, the suicide rate in the United States is about 13 per 100,000 individuals, or 117 per day.
Women attempt suicide three times more often than men, but men are four times more likely than women to die from suicide.
Among youth, the ratio of suicide attempts to deaths is 25:1.
The same ratio for the elderly is 4:1. In 2014, the highest rate of suicide was among people aged 85 or older, followed by those between 45 and 64. The latter is the only age group that is seeing an increase in suicides.
Racially, the highest rate was among whites (14.7 out of 100,000)*, followed by American Indians (10.9 out of 100,000) and Alaskan Natives. Lower suicide rates were found among Hispanics, Asian and Pacific Islanders, and Blacks.10
Mortality among middle-aged white, non-Hispanic men and women has increased substantially, to the point that the U.S. overall mortality rate has increased by half a percent per year since 1998. Other wealthy countries have seen a decrease in overall mortality rates each year. The causes of death in this age group include suicide, drug and alcohol poisoning, and chronic liver disease and cirrhosis. Furthermore, mortality was not higher for this group when they were younger, indicating that this is a problem peculiar to middle-aged Americans.11
Explaining the Trends
Native Americans, the Inuit, and aboriginal peoples in Australia and Canada have a significantly higher incidence of suicide than other groups. While it is difficult to assess the causes, the situation in Greenland may offer insight. Greenland is undergoing a transition from rural farm communities to industrial cities, and many rural towns are being abandoned. This transition has led young men to feel disconnected from their past, which is very much tied to the land, and despondent concerning their future.
In tight-knit communities such as the rural towns in Greenland, "suicide contagion"—when the incidence of suicide spreads within a community or social network—may be a factor. Recent research on adolescents shows that teens who knew that a friend attempted suicide were twice as likely to attempt suicide themselves. If the friend died from suicide, the likelihood of attempting it increased even more.12
Suicide contagion does not just occur among teens. The American Foundation for Suicide Prevention recommends that journalists reporting on suicide not sensationalize the suicide and not provide details as to how the person killed himself. Copycat suicides are of concern in the months immediately following a well-known celebrity's death. The textbook example of this is the highly publicized death of Marilyn Monroe in August 1962; the following month saw a 12 percent increase in the number of suicides.13
Consumerism & Poverty
Articles that address the causes of suicide in our culture often look at the economy. There is a correlation between economic downturn and a higher incidence of both suicide and drug and alcohol abuse. Suicide is also often seen as the solution in cases where a person cannot afford medications or medical treatment. Japan has one of the highest suicide rates among wealthy countries, with more than 25,000 suicides in 2014. One study showed a correlation between the number of suicides in Japan and the beginning and end of the fiscal year.14
An increase in suicides during an economic downturn, particularly in wealthy countries, points to a larger problem. Many people believe that money will provide happiness or satisfaction, and media reports often blame suicides on the economy. The U.S. recently saw an increase in suicide among middle-aged women, with the rate jumping from 6.0 to 9.8 for every 100,000 women between 45 and 64.15 Several articles attribute this to economic factors, including alleged salary disparities between men and women, but they do not provide actual evidence that this is the reason for this recent increase.16
The line between suicide and personal neglect can be a hazy one. In Japan, there are an inordinate number of men who die a lonely death each year. The Ministry of Health, Labour and Welfare reported 3,700 "unaccompanied deaths," or kodokushi, in 2013, but many think the number is ten times higher. Such men have no outside interactions and rarely socialize. They are often found dead in their beds surrounded by filth and usually have stopped eating or taking care of themselves.17
Studies have shown that loneliness can cause changes in the immune system, placing lonely people at higher risk for heart attacks and cancer. Additionally, feelings of isolation and loneliness correlate with incidences of suicide.18 Another phenomenon in Japan, called hikikomori, often leads to suicide or the eventual lonely death. This is when young people—again, typically men—refuse to come out of their rooms or their home for months on end because they are afraid to integrate with society. Once their parents are no longer there to care for them, they often die from suicide or self-neglect.19 •
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