Advertisement

Suicide rates in China from 2002 to 2011: an update

  • Chong-Wen Wang
  • Cecilia L. W. Chan
  • Paul S. F. Yip
Original Paper

Abstract

Purposes

The aims of this study were: (1) to present the time trend of suicide rate among people aged 15 or above in China over the period 2002–2011 and (2) to examine the current profile of completed suicides during 2009–2011.

Methods

Data on suicide rate in 2002–2011 were provided by the Chinese Ministry of Health (MOH). The trends of region-, gender-, and age-specific suicide rates were examined using Poisson regression models. The mean number of completed suicides for each cohort during 2009–2011 was calculated and a mean national suicide rate was estimated.

Findings

The overall suicide rate decreased significantly over the past decade, but rates in young males and rural older adults did not reduce and in fact increased among older adults in both urban and rural areas towards the end of the study period. For 2009–2011, 44 % of all suicides occurred among those aged 65 or above and 79 % among rural residents. The estimated mean national suicide rate was 9.8 per 100,000 and was slightly higher for males than females.

Conclusion

The benefits of economic growth, such as higher employment and more educational opportunities for the rural population in particular, may have contributed to the reduced suicide rate in China. However, the recent rapid changes in socioeconomic conditions could have increased stress levels and resulted in more suicides, especially among the elderly. Despite the significant reduction reported here, the latest figures suggest the declining trend is reversing. It will be important to continue monitoring the situation and to examine how urbanization and economic changes affect the well-being of 1.3 billion Chinese.

Keywords

Suicide rate Mortality Time trend Male-to-female ratio China 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Varnik P (2012) Suicide in the world. Int J Environ Res Public Health 9(3):760–771PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Phillips MR, Liu H, Zhang Y (1999) Suicide and social change in China. Cul Med Psychiatry 23(1):25–50CrossRefGoogle Scholar
  3. 3.
    Phillips MR, Li X, Zhang Y (2002) Suicide rates in China, 1995–99. Lancet 359(9309):835–840PubMedCrossRefGoogle Scholar
  4. 4.
    He ZX, Lester D (2002) Sex ratio in Chinese suicide. Percept Motor Skills 95(2):620PubMedCrossRefGoogle Scholar
  5. 5.
    Ji J, Kleinman A, Becker AE (2001) Suicide in contemporary China: a review of China’s distinctive suicide demographics in their sociocultural context. Harv Rev Psychiatry 9(1):1–12PubMedCrossRefGoogle Scholar
  6. 6.
    Qin P, Mortensen PB (2001) Specific characteristics of suicide in China. Acta Psychiatr Scand 103(2):117–121PubMedCrossRefGoogle Scholar
  7. 7.
    Yip PS, Callanan C, Yuen HP (2000) Urban/rural and gender differentials in suicide rates: east and west. J Affect Disord 57(1–3):99–106PubMedCrossRefGoogle Scholar
  8. 8.
    Yang GH, Phillips MR, Zhou MG, Wang LJ, Zhang YP et al (2005) Understanding the unique characteristics of suicide in China: national psychological autopsy study. Biomed Environ Sci 18(6):379–389PubMedGoogle Scholar
  9. 9.
    Durkheim E (1952) Suicide: a study in sociology (initially published in 1897). Routledge and Kegan Paul Ltd, LondonGoogle Scholar
  10. 10.
    Perkins DH (2012) Rapid growth and changing economic structure: the expenditure side story and its implications for China. China Econ Rev 23(3):501–511CrossRefGoogle Scholar
  11. 11.
    Barboza D (2010) China passes Japan as second-largest economy. The New York TimesGoogle Scholar
  12. 12.
    Stack S (1993) The effect of modernization on suicide in Finland, 1800–1985. Soc Perspect 36(2):137–148CrossRefGoogle Scholar
  13. 13.
    Stack S (2000) Suicide: a 15-year review of the sociological literature part II: modernization and social integration perspectives. Suicide Life Threat Behav 30(2):163–176PubMedGoogle Scholar
  14. 14.
    Steen DM, Mayer P (2004) Modernization and the male–female suicide ratio in India 1967–1997: divergence or convergence? Suicide Life Threat Behav 34(2):147–159PubMedCrossRefGoogle Scholar
  15. 15.
    Lester BY (2001) Learnings from Durkheim and beyond: the economy and suicide. Suicide Life Threat Behav 31(1):15–31PubMedCrossRefGoogle Scholar
  16. 16.
    Stack S (2000) Suicide: a 15-year review of the sociological literature. Part I: cultural and economic factors. Suicide Life Threat Behav 30(2):145–162PubMedGoogle Scholar
  17. 17.
    Zhang J, Ma J, Jia C, Sun J, Guo X et al (2010) Economic growth and suicide rate changes: a case in China from 1982 to 2005. Eur Psychiatry 25(3):159–163PubMedCrossRefGoogle Scholar
  18. 18.
    Ying YH, Chang K (2009) A study of suicide and socioeconomic factors. Suicide Life Threat Behav 39(2):214–226PubMedCrossRefGoogle Scholar
  19. 19.
    Otsu A, Araki S, Sakai R, Yokoyama K, Scott Voorhees A (2004) Effects of urbanization, economic development, migration of workers on suicide mortality in Japan. Soc Sci Med 58(6):1137–1146PubMedCrossRefGoogle Scholar
  20. 20.
    Chang SS, Gunnell D, Sterne JA, Lu TH, Cheng AT (2009) Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Soc Sci Med 68(7):1322–1331PubMedCrossRefGoogle Scholar
  21. 21.
    Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M (2011) Effects of the 2008 recession on health: a first look at European data. Lancet 378(9786):124–125PubMedCrossRefGoogle Scholar
  22. 22.
    Reeves A, Stuckler D, McKee M, Gunnell D, Chang SS et al (2012) Increase in state suicide rates in the USA during economic recession. Lancet 380(9856):1813–1814PubMedCrossRefGoogle Scholar
  23. 23.
    Chang SS, Stuckler D, Yip P, Gunnell D (2013) Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ 17(347):f5239. doi: 10.1136/bmj.f5239 CrossRefGoogle Scholar
  24. 24.
    Moniruzzaman S, Andersson R (2008) Economic development as a determinant of injury mortality—a longitudinal approach. Soc Sci Med 66(8):1699–1708PubMedCrossRefGoogle Scholar
  25. 25.
    Blasco-Fontecilla H, Perez-Rodriquez MM, Garcia-Nieto R, Fernandez-Navarro P, Galfalvy H et al (2012) Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study. BMJ Open 2(3). pii: e000785Google Scholar
  26. 26.
    Yip PS, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social changes. Soc Psychiatry Psychiatr Epidemiol 40(10):792–798PubMedCrossRefGoogle Scholar
  27. 27.
    Yang G, Hu J, Rao KQ, Ma J, Rao C et al (2005) Mortality registration and surveillance in China: history, current situation and challenges. Popul Health Metr 3(1):3PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    McCullagh P, Nelder JA (1989) Generalized linear models (2nd). Chapman and Hall, LondonCrossRefGoogle Scholar
  29. 29.
    National Bureau of Statistics of China (2008) China’s Fifth National Census Results. http://www.stats.gov.cn/tjsj/pcsj/rkpc/dwcrkpc/. Accessed 21 Sept 2013
  30. 30.
    National Bureau of Statistics of China (2012) China statistical yearbook 2011. China Statistics Press, BeijingGoogle Scholar
  31. 31.
    Sun J, Guo X, Zhang J, Jia C, Xu A (2013) Suicide rates in Shandong, China, 1991–2010: rapid decrease in rural rates and steady increase in male–female ratio. J Affect Disord 146(3):361–368PubMedCrossRefGoogle Scholar
  32. 32.
    Chen YY, Wu KC, Yousuf S, Yip PS (2012) Suicide in Asia: opportunities and challenges. Epidemiol Rev 34(1):129–144PubMedCrossRefGoogle Scholar
  33. 33.
    Titelman D, Oskarsson H, Wahlbeck K, Nordentoft M, Mehlum L et al (2013) Suicide mortality trends in the Nordic countries 1980–2009. Nord J Psychiatry (epub ahead of print)Google Scholar
  34. 34.
    Salmerón D, Cirera L, Ballesta M, Navarro-Mateu F (2013) Time trends and geographical variations in mortality due to suicide and causes of undetermined intent in Spain, 1991–2008. J Public Health 35(2):237–245CrossRefGoogle Scholar
  35. 35.
    Knight J (2013) The economic causes and consequences of social instability in China. China Econ Rev 25:17–26CrossRefGoogle Scholar
  36. 36.
    Minzner C (2006) Social instability in China, causes, consequences, and implications. http://csis.org/files/media/csis/events/061205_mizner_abstract.pdf. Accessed 29 April 2013
  37. 37.
    Rockett IR, Hobbs G, De Leo D, Stack S, Frost JL et al (2010) Suicide and unintentional poisoning mortality trends in the United States, 1987–2006: two unrelated phenomena? BMC Public Health 10:705PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Li X, Xiao Z, Xiao S (2009) Suicide among the elderly in mainland China. Psychogeriatrics 9(2):62–66PubMedCrossRefGoogle Scholar
  39. 39.
    He ZX, Lester D (2001) Elderly suicide in China. Psychol Rep 89(3):675–676PubMedCrossRefGoogle Scholar
  40. 40.
    Conwell Y, Duberstein PR, Caine ED (2002) Risk factors for suicide in later life. Biol Psychiatry 52(3):193–204PubMedCrossRefGoogle Scholar
  41. 41.
    O’Connell H, Chin AV, Cunningham C, Lawlor BA (2004) Recent developments: suicide in older people. BMJ 329(7471):895–899PubMedCentralPubMedCrossRefGoogle Scholar
  42. 42.
    Conwell Y, Van Orden K, Caine ED (2011) Suicide in older adults. Psychiatr Clin N Am 34(2):451–468CrossRefGoogle Scholar
  43. 43.
    Phillips MR, Yang G, Zhang Y, Wang L, Ji H et al (2002) Risk factor for suicide in China: a national case–control psychological autopsy study. Lancet 360(9347):1728–1736PubMedCrossRefGoogle Scholar
  44. 44.
    Cheng AT (1995) Mental illness and suicide. A case-control study in east Taiwan. Arch Gen Psychiatry 52(7):594–603PubMedCrossRefGoogle Scholar
  45. 45.
    Phillips MR, Cheng HG (2012) The changing global face of suicide. Lancet 379(9834):2318–2319PubMedCrossRefGoogle Scholar
  46. 46.
    Sutherland D, Yao S (2011) Income inequality in China over 30 years of reforms. Camb J Reg Econ Soc 4(1):91–105CrossRefGoogle Scholar
  47. 47.
    Parmet S, Lynm C, Glass RM (2004) JAMA patient page. Suicide in older persons. JAMA 291(9):1158PubMedCrossRefGoogle Scholar
  48. 48.
    Wanta BT, Schlotthauer AE, Guse CE, Hargarten SW (2009) The burden of suicide in Wisconsin’s older adult population. WMJ 108(2):87–93PubMedGoogle Scholar
  49. 49.
    Chen W, Liu J (2009). Future population trends in China: 2005–2050. http://monash.edu.au/policy/ftp/workpapr/g-191.pdf. Accessed 30 Sept 2013
  50. 50.
    Abas M, Crawford MJ (1999) A national target for reducing suicide. Suicide in older people must be reduced. BMJ 318(7177):191PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    Pritchard C (1996) Suicide in the People’s Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 93(5):362–367PubMedCrossRefGoogle Scholar
  52. 52.
    He ZX, Lester D (1997) The gender difference in Chinese suicide rates. Arch Suicide Res 3(2):81–89Google Scholar
  53. 53.
    Shiang J, Barron S, Xiao SY, Blinn R, Tam WCC (1998) Suicide and gender in the People’s Republic of China, Taiwan, Hong Kong, and Chinese in the US. Transcult Psychiatry 35(2):235–251CrossRefGoogle Scholar
  54. 54.
    Zhang J, Jiang C, Jia S, Wieczorek WF (2002) An overview of suicide research in China. Arch Suicide Res 6(2):167–184PubMedCentralPubMedCrossRefGoogle Scholar
  55. 55.
    Canetto SS (2008) Women and suicidal behavior: a cultural analysis. Am J Orthopsychiatry 78(2):259–266PubMedCrossRefGoogle Scholar
  56. 56.
    Weiyuan C (2009) Women and suicide in rural China. Bull World Health Org 87(12):888–889PubMedCrossRefGoogle Scholar
  57. 57.
    Burnett J (2010) Women’s employment rights in China: creating harmony for women in the workforce. Ind J Global Legal Stud 17(2):289–318CrossRefGoogle Scholar
  58. 58.
    Cantor CH (2000) Suicide in the western world. In: Hawton K, van Heeringen K (eds) The international handbook of suicide and attempted suicide. John Wiley & Sons, Chichester, pp 9–28Google Scholar
  59. 59.
    Gunnell D, Lopatatzidis A, Dorling D, Wehner H, Southall H et al (1999) Suicide and unemployment in young people—analysis of trends in England and Wales, 1921–1995. Br J Psychiatry 175:263–270PubMedCrossRefGoogle Scholar
  60. 60.
    Gunnell D, Middleton N, Whitley E, Dorling D, Frankel S (2003) Why are suicide rates rising in young men but falling in the elderly?—a time-series analysis of trends in England and Wales 1950–1998. Soc Sci Med 57(4):595–611PubMedCrossRefGoogle Scholar
  61. 61.
    Wu P, Li LP, Jin J, Yuan XH, Liu X et al (2012) Need for mental health services and service use among high school students in China. Psychiatr Ser 63(10):1026–1031CrossRefGoogle Scholar
  62. 62.
    Zhang J, Jia CX (2011) Suicidal intent among young suicides in rural China. Arch Suicide Res 15(2):127–139PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Cash SJ, Bridge JA (2009) Epidemiology of youth suicide and suicidal behavior. Curr Opin Pediatr 21(5):613–619PubMedCentralPubMedCrossRefGoogle Scholar
  64. 64.
    World Health Organization (2013). Counting the dead in China. http://www.who.int/bulletin/volumes/84/3/news30306/en/index.html. Accessed 03 July 2013
  65. 65.
    Chinese CDC (2010) Chinese DSP system mortality data 2005. Jun Shi Yi Xue Chu Ban She, BeijingGoogle Scholar
  66. 66.
    Chinese CDC (2010) Chinese DSP system mortality data 2006. Jun Shi Yi Xue Chu Ban She, BeijingGoogle Scholar
  67. 67.
    Chinese CDC (2010) Chinese DSP system mortality data 2007. People’s Medical Publishing House, BeijingGoogle Scholar
  68. 68.
    Chinese CDC (2010) Chinese DSP system mortality data 2008. People’s Medical Publishing House, BeijingGoogle Scholar
  69. 69.
    Chinese CDC (2011) Chinese DSP system mortality data 2009 report (unpublished report). Chinese CDCGoogle Scholar
  70. 70.
    Tian M, Zhang X (2011) The impact of the global economic slowdown on enterprises and employees in China. J Asian Public Policy 4(1):76–102CrossRefGoogle Scholar
  71. 71.
    Fernquist RM (2003) Perceived income inequality and suicide rates in Central/Eastern European countries and Western countries, 1990–1993. Death Stud 27(1):63–80PubMedCrossRefGoogle Scholar
  72. 72.
    Stubbs B (2010) A replication of a cross-national study of the relationship between elderly suicide rates and urbanization. Psychogeriatrics 30:1–10Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Chong-Wen Wang
    • 1
  • Cecilia L. W. Chan
    • 2
  • Paul S. F. Yip
    • 3
  1. 1.Centre on Behavioral HealthThe University of Hong KongHong KongChina
  2. 2.Department of Social Work and Social AdministrationThe University of Hong KongHong KongChina
  3. 3.Centre for Suicide Research and PreventionThe University of Hong KongHong KongChina

Personalised recommendations