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The Gender Ratio of Chinese Suicide Rates: An Explanation in Confucianism

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Abstract

The gender (male to female) ratio of the Chinese suicide rates is different from those found in the rest of the world. None of the other societies with known suicide data has had female suicide rates higher than those for the males. While we investigate the factors that contribute to the relatively high suicide rates for Chinese women, we also need to ask what makes the relatively low suicide rates for Chinese men. In this study we try to examine some social and cultural variables in rural Chinese youths in order to identify the factors that account for the relatively low rate for men and relatively high rate for women. In rural China, 392 suicides (both men and women) aged 14–35 years consecutively sampled from 16 counties of three provinces were studied with 416 community living controls of the same age range and from the same locations. Case–control psychological autopsy method was used for the data collection. It is found that believing in Confucianism and being married are both protecting the rural young men from suicide, while the two same variables are either risk or non-protecting factors for the Chinese rural young women’s suicide. In rural China, social structure and culture may play an even more important role determining a society’s suicide rates as well as the gender ratios. Thus, suicide prevention may need to include culture specific measures.

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References

  • Bauman, Z. (1976). Toward a critical sociology. London: Routledge Kegan Paul.

    Google Scholar 

  • Callanan, V. J., & Davis, M. S. (2011). Gender and suicide method: Do women avoid facial disfiguration? Sex Roles, 65, 867–879. doi:10.1007/s11199-011-0043-0.

    Article  Google Scholar 

  • Callanan, V., & Davis, M. (2012). Gender differences in suicide methods. Social Psychiatry and Psychiatric Epidemiology, 47, 857–869. doi:10.1007/s00127-011-0393-5.

    Article  PubMed  Google Scholar 

  • Canetto, S. S., & Sakinofsky, I. (1998). The gender paradox in suicide. Suicide and Life-threatening Behavior, 28, 1–23. doi:10.1111/j.1943-278X.1998.tb00622.x.

    PubMed  Google Scholar 

  • Conner, K. R., Beautrais, A. L., Brent, D. A., Conwell, Y., Phillips, M. R., & Schneider, B. (2011). The next generation of psychological autopsy studies. Suicide and Life-threatening Behavior, 41, 594–613. doi:10.1111/j.1943-278X.2011.00057.x.

    Article  PubMed  Google Scholar 

  • de Bary, W. T. (1988). East Asian civilizations: A dialogue in five stages. Boston: Harvard University Press.

    Google Scholar 

  • Dervic, K., Grunebaum, M. F., Burke, A. K., Mann, J. J., & Oquendo, M. A. (2006). Protective factors against suicidal behavior in depressed adults reporting childhood abuse. Journal of Nervous and Mental Disorders, 194, 971–974. doi:10.1097/01.nmd.0000243764.56192.9c.

    Article  Google Scholar 

  • Durkheim, E. (1951). Suicide: A study in sociology. New York: Free Press. (Original work published in 1897).

  • Elman, B. A. (2005). On their own terms: Science in China, 1550–1900. Cambridge: Harvard University Press.

    Google Scholar 

  • Eskin, M. (2004). The effects of religious versus secular education on suicide ideation and suicidal attitudes in adolescents in Turkey. Social Psychiatry and Psychiatric Epidemiology, 39, 536–542. doi:10.1007/s00127-004-0769-x.

    Article  PubMed  Google Scholar 

  • Eskin, M., Ertekin, K., Dereboy, C., & Demirkiran, F. (2007). Risk factors for and protective factors against adolescent suicidal behavior in Turkey. Crisis, 28, 131–139. doi:10.1027/0227-5910.28.3.131.

    Article  PubMed  Google Scholar 

  • Fingarette, H. (1972). Confucious-the secular as sacred. New York: Harper Torchbooks.

    Google Scholar 

  • Girard, C. (1993). Age, gender, and suicide: A cross-national analysis. American Sociological Review, 58, 553–574. doi:10.2307/2096076.

    Article  Google Scholar 

  • Hawton, K. (2000). Sex and suicide: Gender differences in suicidal behaviour. The British Journal of Psychiatry, 177, 484–485. doi:10.1192/bjp.177.6.484.

    Article  PubMed  Google Scholar 

  • Hee Ahn, M., Park, S., Ha, K., Choi, S. H., & Hong, J. P. (2012). Gender ratio comparisons of the suicide rates and methods in Korea, Japan, Australia, and the United States. Journal of Affective Disorders, 142, 161–165. doi:10.1016/j.jad.2012.05.008.

    Article  PubMed  Google Scholar 

  • Hsu, F. L. K. (1998). Confucianism in comparative context. In W. H. Slote & G. A. De Vos (Eds.), Confucianism and the family (pp. 537–571). Albany: State University of New York Press.

    Google Scholar 

  • Hwang, K.-K. (1999). Filial piety and loyalty: Two types of social identification in Confucianism. Asian Journal of Social Psychology, 2, 163–183. doi:10.1111/1467-839x.00031.

    Article  Google Scholar 

  • Ikels, C. (2004). Introduction. In C. Ikels (Ed.), Filial piety: Practice and discourse in contemporary East Asia (pp. 1–15). Stanford: Stanford University Press.

    Google Scholar 

  • Jacka, T. (1997). Women’s work in rural China: Change and continuity in an era of reform. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • King, A. Y. C., & Bond, M. H. (1985). The Confucian paradigm of man: A sociological view. In W. S. Tseng & D. Y. H. Wu (Eds.), Chinese culture and mental health (pp. 29–45). Orlando: Academic.

    Chapter  Google Scholar 

  • Kraemer, H. C., Measelle, J. R., Ablow, J. C., Essex, M. J., Boyce, W. T., & Kupfer, D. J. (2003). A new approach to integrating data from multiple informants in psychiatric assessment and research: Mixing and matching contexts and perspectives. American Journal of Psychiatry, 160, 1566–1577. doi:10.1176/appi.ajp.160.9.1566.

    Article  PubMed  Google Scholar 

  • Li, Y., Li, Y., & Cao, J. (2012). Factors associated with suicidal behaviors in mainland China: A meta-analysis. BMC Public Health, 12, 524–530. doi:10.1186/1471-2458-12-524.

    Article  PubMed Central  PubMed  Google Scholar 

  • Malone, K. M., Oquendo, M. A., Haas, G. L., Ellis, S. P., Li, S., & Mann, J. J. (2000). Protective factors against suicidal acts in major depression: Reasons for living. American Journal of Psychiatry, 157, 1084–1088. doi:10.1176/appi.ajp.157.7.1084.

    Article  PubMed  Google Scholar 

  • Marty, M. A., Segal, D. L., & Coolidge, F. L. (2010). Relationships among dispositional coping strategies, suicidal ideation, and protective factors against suicide in older adults. Aging and Mental Health, 14, 1015–1023. doi:10.1080/13607863.2010.501068.

    Article  PubMed  Google Scholar 

  • Möller-Leimkühler, A. M. (2003). The gender gap in suicide and premature death or: Why are men so vulnerable? European Archives of Psychiatry and Clinical Neuroscience, 253, 1–8. doi:10.1007/s00406-003-0397-6.

    Article  PubMed  Google Scholar 

  • Neeleman, J., Wessely, S., & Lewis, G. (1998). Suicide acceptability in African and White Americans: The role of religion. Journal of Nervous and Mental Disease, 186, 12–16. doi:10.1097/00005053-199801000-00003.

    Article  PubMed  Google Scholar 

  • Oquendo, M. A., Dragatsi, D., Harkavy-Friedman, J., Dervic, K., Currier, D., Burke, A. K., . . . Mann, J. J. (2005). Protective factors against suicidal behavior in Latinos. Journal of Nervous and Mental Disorders, 193, 438–443. doi:10.1097/01.nmd.0000168262.06163.31.

    Google Scholar 

  • Payne, S., Swami, V., & Stanistreet, D. L. (2008). The social construction of gender and its influence on suicide: A review of the literature. Journal of Men’s Health, 5, 23–35. doi:10.1016/j.jomh.2007.11.002.

    Article  Google Scholar 

  • Phillips, M. R., Li, X., & Zhang, Y. (2002). Suicide rates in China, 1995–99. The Lancet, 359, 835–840. doi:10.1016/S0140-6736(02)07954-0.

    Article  Google Scholar 

  • Rich, C., Ricketts, J., Fowler, R., & Young, D. (1988). Some differences between men and women who commit suicide. American Journal of Psychiatry, 145, 718–722.

    PubMed  Google Scholar 

  • Rofel, L. (1999). Other modernities: Gendered yearnings in china after socialism. Berkeley: University of California Press.

    Book  Google Scholar 

  • Schrijvers, D. (2012). The gender paradox in suicidal behavior and its impact on the suicidal process. Journal of Affective Disorders, 138, 19–26. doi:10.1016/j.jad.2011.03.050.

    Article  PubMed  Google Scholar 

  • Slote, W. H. (1998). Psychocultural dynamics within the Confucian family. In W. H. Slote & G. A. De Vos (Eds.), Confucianism and the family (pp. 37–51). Albany: State University of New York Press.

    Google Scholar 

  • Solomon, R. H. (1971). Mao’s revolution and the Chinese political culture. Berkeley: University of California Press.

    Google Scholar 

  • Stack, S. (1983). The effect of religious commitment on suicide: A cross-national analysis. Journal of Health and Social Behavior, 24, 362–374. doi:10.2307/2136402.

    Article  PubMed  Google Scholar 

  • Stack, S. (1998). Gender, marriage, and suicide acceptability: A comparative analysis. Sex Roles, 38, 501–520. doi:10.1023/a:1018770124576.

    Article  Google Scholar 

  • Stack, S. (2000). Suicide: A 15-year review of the sociological literature, part II: Modernization and social integration. Suicide and Life-threatening Behavior, 30, 163–176. doi:10.1111/j.1943-278X.2000.tb01074.x.

    PubMed  Google Scholar 

  • Stack, S., & Kposowa, A. J. (2011). Religion and suicide acceptability: A cross-national analysis. Journal for the Scientific Study of Religion, 50, 289–306. doi:10.1111/j.1468-5906.2011.01568.x.

    Article  PubMed  Google Scholar 

  • Steffensmeier, R. H. (1984). Suicide and the contemporary woman: Are male and female suicide rates converging? Sex Roles, 10, 613–631. doi:10.1007/bf00287269.

    Article  Google Scholar 

  • Streng, F. (1985). Understanding religious life (3rd ed.). Belmont: Wadsworth.

    Google Scholar 

  • Taiwan Government. (2003). Taiwan yearbook 2003. Retrieved from http://www.stat.gov.tw/bs2/2002YearBook.pdf.

  • Tu, W., Hejtmanek, M., & Wachman, A. (Eds.). (1992). The Confucian world observed: A contemporary discussion of Confucian humanism in East Asia. Honolulu: University of Hawaii Press.

    Google Scholar 

  • Värnik, A., Kõlves, K., van der Feltz-Cornelis, C. M., Marusic, A., Oskarsson, H., Palmer, A., . . . Hegerl, U. (2008). Suicide methods in Europe: A gender-specific analysis of countries participating in the “European Alliance Against Depression”. Journal of Epidemiology and Community Health, 62, 545–551. doi:10.1136/jech.2007.065391.

    Google Scholar 

  • Vijayakumar, L., John, S., Pirkis, J., & Whiteford, H. (2005). Suicide in developing countries (2): Risk factors. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 26, 112–119. doi:10.1027/0227-5910.26.3.112.

    Article  Google Scholar 

  • Wang, S., Li, Y., Chi, G., Xiao, S., Ozanne-Smith, J., Stevenson, M., et al. (2008). Injury-related fatalities in China: An under-recognised public-health problem. The Lancet, 372, 1765–1773. doi:10.1016/S0140-6736(08)61367-7.

    Article  Google Scholar 

  • Webster, R. F., Ferrada-Noli, M., & Skolbekken, J.-A. (2003). Questions of culture, age and gender in the epidemiology of suicide. Scandinavian Journal of Psychology, 44, 373–381. doi:10.1111/1467-9450.00357.

    Article  Google Scholar 

  • WHO, W. H. O. (2009). Suicide Prevention (SUPRE). Retrieved from http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/.

  • Yang, C. K. (1959). Chinese communist society: The family and the village. Boston: MIT Press.

    Google Scholar 

  • Zhang, J. (2000). Gender differences in athletic performance and their implications in gender ratios of suicide: A comparison between the USA and China. Omega: Journal of Death and Dying, 41, 117–123. doi:10.2190/K1K2-MUW6-9YGG-PVBK.

    Google Scholar 

  • Zhang, J. (2010). Marriage and suicide among Chinese rural young women. Social Forces, 89, 311–326. doi:10.1353/sof.2010.0065.

    Article  Google Scholar 

  • Zhang, J., & Lester, D. (2008). Psychological tensions found in suicide notes: A test for the strain theory of suicide. Archives of Suicide Research, 12, 67–73. doi:10.1080/13811110701800962.

    Article  PubMed  Google Scholar 

  • Zhang, J., Wieczorek, W. F., Jiang, C., Zhou, L., Jia, S., Sun, Y., . . . Conwell, Y. (2002). Studying suicide with psychological autopsy: Social and cultural feasibilities of the methodology in China. Suicide and Life-threatening Behavior, 32, 370–379. doi:10.1521/suli.32.4.370.22342.

  • Zhang, J., Conwell, Y., Zhou, L., & Jiang, C. (2004). Culture, risk factors and suicide in rural China: A psychological autopsy case control study. Acta Psychiatrica Scandinavica, 110, 430–437. doi:10.1111/j.1600-0447.2004.00388.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zhang, J., Dong, N., Delprino, R., & Zhou, L. (2009). Psychological strains found from in-depth interviews with 105 Chinese rural youth suicides. Archives of Suicide Research, 13, 185–194. doi:10.1080/13811110902835155.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zhang, J., Wieczorek, W. F., Conwell, Y., Tu, X. M., Wu, B. Y. W., Xiao, S., et al. (2010). Characteristics of young rural Chinese suicides: A psychological autopsy study. Psychological Medicine, 40, 581–589. doi:10.1017/S0033291709990808.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zhang, J., Jing, J., Wu, X., Sun, W., & Wang, C. (2011a). A sociological analysis of the decline in the suicide rate in China. Social Sciences in China, 2011, 97–113.

    Google Scholar 

  • Zhang, J., Li, N., Tu, X.-M., Xiao, S., & Jia, C. (2011b). Risk factors for rural young suicide in China: A case–control study. Journal of Affective Disorders, 129, 244–251. doi:10.1016/j.jad.2010.09.008.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zhang, J., Wieczorek, W. F., Conwell, Y., & Tu, X. M. (2011c). Psychological strains and youth suicide in rural China. Social Science & Medicine, 72, 2003–2010. doi:10.1016/j.socscimed.2011.03.048.

    Article  Google Scholar 

  • Zhang, J., Tan, J., & Lester, D. (2013). Psychological strains found in the suicides of 72 celebrities. Journal of Affective Disorders, 149, 230–234. doi:10.1016/j.jad.2013.01.031.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, China

    Jie Zhang

  2. Department of Sociology, State University of New York Buffalo State, 1300 Elmwood Avenue, Buffalo, NY, 14222, USA

    Jie Zhang

Authors
  1. Jie Zhang
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Correspondence to Jie Zhang.

Additional information

The research was supported by the United States National Institute of Mental Health (NIMH): R01 MH068560.

Appendix

Appendix

Chinese Version of the Instruments Measuring the Confucian Values

Respondents (informants) were asked to indicate how strongly the target person agreed or disagreed on a five-point Likert scale with the following statements:

Confucianism for men

  1. (1)

    Filial piety to parents

    他赞同“孝顺父母”对一个人来讲是很重要的事情吗?

  2. (2)

    Closeness to parents

    他赞同“父母在不远游”(父母活着的时候,子女不应出远门)吗?

  3. (3)

    Body and hairs are given by parents and no hurt should be brought to them

    他赞同“身体发肤,受之父母”(身体是父母给的,不应该自我伤残)吗?

  4. (4)

    Not die earlier than parents

    他赞同“白发人不送黑发人”(年轻人不可以在父母之前死掉)吗?

  5. (5)

    Being harmonious with family and friends

    他赞同“家庭和睦,邻里相让”吗?

  6. (6)

    Self-discipline

    他赞同“克己复礼”(约束自己,使每件事情符合礼节)吗?

  7. (7)

    Endurance

    他赞同“小不忍则乱大谋”(小事不忍耐,就会坏了大事情)吗?

Confucianism for women

  1. (1)

    Women should stay at home

    她赞同“女人应在家干活不应外出工作”吗?

  2. (2)

    Caring her husband and kids

    她赞同女人应该“相夫教子” (侍候丈夫、教育孩子)吗?

  3. (3)

    Bearing a son

    她赞同“生儿子”比生女儿更重要吗?

  4. (4)

    Keeping marriage without divorce

    她赞同“守寡”(为了保持贞节不再婚)吗?

  5. (5)

    Three Obediences

    她赞同妇女应“三从四德”(凡事服从男人)吗?

  6. (6)

    No social activities

    她赞同“妇女应该持家,而不应该参加社会活动(抛头露面)”吗?

  7. (7)

    Women working at home only

    她赞同“女主内男主外”吗?

  8. (8)

    Woman is less important than man

    她赞同总体上讲“男人比女人更重要”吗?

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Zhang, J. The Gender Ratio of Chinese Suicide Rates: An Explanation in Confucianism. Sex Roles 70, 146–154 (2014). https://doi.org/10.1007/s11199-013-0333-9

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