Research reportUrban/rural and gender differentials in suicide rates: East and West
Introduction
Suicide is a very complex phenomenon. Any patterns observed in the past or in the West might not be valid at present or applicable to other non-western countries. There are many differences in suicide rates between East and West. For example, the male to female suicide ratio is higher in western than eastern countries (Yip, 1998a); elderly suicide rates in Asian countries are three times higher than the average while in western countries the elderly suicide rate is higher than the average, but by a much smaller factor (Chi et al., 1997, Yip et al., 1998a). The bi-modal seasonal pattern for female suicides was not found in Hong Kong, Taiwan, Australia and New Zealand (Ho et al., 1997, Yip et al., 1998b, Hakko et al., 1998). Many existing studies of the incidence of suicide in western societies suggest that the suicide rate is higher in urban regions (Garrison, 1992, Pearson, 1993, Cantor and Coory, 1993). In this paper we attempt to test two hypotheses as in Pritchard’s (1996a): (i) the male to female suicide ratio is larger than one; (ii) urban suicide rates are higher than rural rates. We will explore the gender, urban and rural differentials in Beijing (China) and Australia and to highlight the difference between East and West. Also discussed are factors which are common to both places and the extent to which differences in ratios and rates are explained by the cultural differences.
In Australia, 36% of the population live outside the capital cities and about half of that figure can be classified as living in rural areas. Urban and rural populations aged 15 or over in 1996 were 11,872,500 and 2,524,700 respectively. In contrast, 70% of the population of China lives in rural areas. The GDP in rural areas is only one third compared to that of urban areas (China Statistical Yearbook, 1996). In the administrative territory of Beijing (China), where the data for the current paper were sourced, urban and rural populations aged 15 or over in 1996 were 6,042,600 and 2,585,500 respectively. As the capital city surrounded by a number of rural counties Beijing provides an interesting comparison with Australia’s largely urbanised population.
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Data and methods
For the purpose of this study, deaths coded in the range E950-E959 of ICD-9 (World Health Organization, 1978) were classified as suicides. For Australia, suicide data for the period of 1991–1996 were made available by the Australian Bureau of Statistics. The ascertainment of death due to unnatural causes is made through the Coroner’s court in Australia and judicial inquiries establish where deaths are due to suicide. In Beijing, all deaths are reported to the Public Security Office for
Age–gender specific rates
Age–gender specific rates for Australia and Beijing for the study period 1991–1996 were given in Fig. 1, Fig. 2. Suicide rates for both genders in Australia and Beijing were quite stable for the six year period. The average suicide rates (aged 15 or over) for Australian males and females were 26.6 and 6.5 per 100,000 respectively for the period. The male to female ratio was 4.1. The corresponding figures for Beijing were 8.9 and 9.4 per 100,000 with the ratio 0.95. In Australia, males of age 75
Discussion
Consistent with international comparisons (Yip, 1997, Pritchard, 1996b, Yip, 1998b, Pritchard, 1992a) and despite some changes in recent decades, the propensity for Australian men to kill themselves continues unabated. Pritchard, 1992a, Pritchard, 1992b has shown that the gap between male and female rates has widened. In Australia gender was a major factor in the incidence of suicide and the rural/urban differential played a role but was less important. In Beijing rural populations suicided
Conclusion
In examining the urban and rural differentials between Beijing and Australia we reject the two hypotheses. We have shown that male to female rate in Beijing is less than one which is unique in world. Also, suicide rates in urban regions are not necessarily larger than their rural counterparts even in a western country like Australia.
Differences in socio-economic conditions in urban and rural settings can explain some of the discrepancies between Australia and Beijing. Gender differentials
Acknowledgments
The authors would like to thank the details comments from the two referees; Australian Bureau of Statistics and the Division of Statistics of the Ministry of Health of People’s Republic of China for supplying the relevant data and Doris Chong in preparing the data. The work is supported by a CRCG and a RGC grant.
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