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Fertility, economic development, and suicides among women in India

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Indian states at greater levels of economic development report more suicides. This relation appears stronger among women relative to men. We test the hypothesis, suggested in the literature, that conflict between rapid economic growth and inadequate female autonomy (approximated using total fertility rate) varies positively with female suicides.

Methods

We used state-level data on female suicides for all 35 Indian states and union territories, from 2001 to 2011, from the National Crime Records Bureau. We specified, as our outcome, age-adjusted female suicides per 100,000 population per state-year. We retrieved data on key covariates, namely, gross state domestic product (GSDP) per capita, total fertility rate (TFR), and other control variables from multiple national surveys and publicly available data sources. We examined whether and to what extent age-adjusted female suicides (per 100,000 population) correspond with total fertility rate (lower TFR indicates greater female autonomy and vice versa) within the context of greater economic development (GSDP per capita). Linear longitudinal mixed effect regressions controlled for state-specific random intercepts, son preference (male:female sex ratio at birth), literacy gap (percentage difference between literate males and females), access to health systems (institutional deliveries), female to male employment ratio, and linear time trends.

Results

At constant levels of GSDP per capita, a one unit decline in TFR corresponds with 0.27 fewer female suicides per 100,000 population (P value = 0.008). Sensitivity tests indicate that this relation does not hold for male age-adjusted suicides (per 100,000 population).

Conclusion

Our findings, if replicated, indicate that at constant levels of economic development, lower TFR (indicating greater female autonomy) may reduce suicide risk among women.

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Data availability

The state-level datasets are available from the corresponding author. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

Code availability

The statistical code is available upon request from the corresponding author.

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Funding

This work was supported by the National Institute of Allergy and Infectious Diseases [Grant Number 1R03AI135322-01].

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Authors and Affiliations

  1. Program in Public Health, University of California, 653 E. Peltason Drive, Irvine, CA, 92617, USA

    Parvati Singh, Abhery Das & Tim Bruckner

  2. College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA

    Jenesca William

  3. Center for Population, Inequality, and Policy (CPIP), University of California, Irvine, USA

    Tim Bruckner

Authors
  1. Parvati Singh
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  2. Abhery Das
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  4. Tim Bruckner
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Contributions

PS developed the research concept and managed data collection and analysis. JW assisted with data collection. PS wrote the first draft of the manuscript. PS, TB, and AD edited the manuscript. TB managed, supervised the research project, and provided funding resources.

Corresponding author

Correspondence to Parvati Singh.

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Conflict of interest

The authors of this paper do not report any conflicts of interest.

Ethical approval

The University of California, Irvine, institutional review board deemed this study exempt owing to the use of publicly available, de-identified data.

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Singh, P., Das, A., William, J. et al. Fertility, economic development, and suicides among women in India. Soc Psychiatry Psychiatr Epidemiol 56, 1751–1759 (2021). https://doi.org/10.1007/s00127-021-02054-4

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  • DOI: https://doi.org/10.1007/s00127-021-02054-4

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