U.S. should look to China, India for suicide prevention

[TW: This piece contains discussion of suicide.]

In the wake of celebrity suicides such as those of Kate Spade and Anthony Bourdain, suicide has become a topic often discussed in the media, typically viewed with a kind of morbid curiosity. Not only do these deaths reveal a tragic fact about a life of fame, but they also expose how the suicide epidemic has proliferated across the United States.

Since 2000, suicide rates have increased by 18 percent, mostly targeting white, middle-aged, poorly educated men. However, while rates in America have increased, rates in the rest of the world have dropped. According to the Institute for Health Metrics and Evaluation, the world suicide rate has decreased by 29 percent since 2000, an optimistic statistic that will hopefully continue (The Economist, “Why suicide is falling around the world, and how to bring it down more,” 11.24.2018). In China and India, overall social change has led to the betterment of people’s mental well-being, indicating that perhaps America should learn from these other countries and move toward this kind of global adaptation.

Around the world, men tend to have higher suicide rates than women, and older people have higher rates than young people. However, in China and India, young women have been disproportionately prone to suicide. As part of the Global Burden of Diseases, Injuries and Risk Factor Study 2016, 30 public health doctors and researchers evaluated data to study suicide rates of both men and women in India and concluded that the prevalence of suicide in young women (15–30 years old) was likely because Indian women below 30 have to cope with major life changes and social pressures after they get married. Many of these young women live with their in-laws and acutely experience the oppression of a patriarchal system. However, after the age of 30, suicide rates drop for women.

One of the psychiatrists involved in the research, Dr. Lakshmi Vijavkumar, suggested that the drop occurred due to women shifting their focus onto their children. Another researcher, Rakhi Dandona, who works with the Public Health Foundation of India, provided a similar claim, stating “It is believed that educated women expect more from their lives and hence have deeper dissatisfaction when they were thwarted from achieving their goals, such as higher education and career advancement” (National Public Radio, “Suicide By Women Is A Major Public Health Concern in India,” 09.25.2018). Harvard psychiatrist Vikram Patel offered another explanation: “[Many suicides in India] are related to the lack of agency for young people to choose their own romantic partners.” He cited an example of a family threatening to tell the police that their daughter has been abducted if they disapproved of her partner (The Economist, “Suicide is declining almost everywhere,” 11.24.2018).

A similar situation exists in China, the only country in the world in which the rate of female suicide is higher than the male rate. One reason is unique cultural circumstances such as the one-child policy—which has since changed to a twochild policy as of January 2016—that put pressure on women to give birth to a male child. If they failed, women, particularly those in rural China, were often mistreated or harassed (Indian Journal of Psychiatry, “Suicide in Women,” 07.2015). In addition, women in rural communities often face financial struggles as well as a stricter adherence to traditions. Women marry much earlier and oftentimes must live with their in-laws and obey their rules. According to one popular saying, a married woman is like “poured-out water”; she is given away by her birth family and never able to return (The Telegraph, “Young Chinese women are committing suicide at a terrifying rate here’s why,” 10.20.2016).

Fortunately, these trends have started to change. China’s suicide rate has declined more rapidly than that of any other country and has now fallen even lower than that of the United States and only slightly above that of the United Kingdom. Interestingly, rural women have served as the biggest contributor to this change. Such a dramatic decline coincides with an increase in Chinese people leaving rural areas to seek employment in urban areas. Despite the sweatshop stereotypes that many Westerners may entertain when imagining factory work in China, such work tends to be an improvement from working in the countryside. Factory conditions can be harsh and certain areas could use improvements, but they are still much better than the labor-intensive conditions and extreme poverty prevalent in rural areas. This move provides women in particular the opportunity to improve their social and economic conditions.

For many young women in countries like China and India, urbanization gives women more choice in terms of whom they marry and with whom they live due to less strict traditions. Leaving rural civilization also helps in a different way—people have less access to methods of killing themselves, typically committed with agricultural pesticides in the countryside (Foundation for Economic Education, “The Remarkable Fall in China’s Suicide Rate,” 05.18.2018).

In America, which has experienced more urbanization than countries like China and India, the government can still do its part to reduce suicide rates. One of the most significant initiatives would be limiting the availability of methods that people use to commit suicide. Fifty percent of all Americans who commit suicide do so by using a gun, and America has approximately double the overall suicide rate of the United Kingdom, which enforces strict gun control (The Economist, “Why suicide is falling around the world, and how to bring it down more,” 11.24.2018). Governments could also ease economic and social problems by introducing labor-market policies of retraining unemployed workers and altering the current health-care system. Spending on health-care services can help many people who use suicide as a means to escape the pain they fear may befall them, particularly as they become older.

Globalization has quite literally saved the lives of many people, particularly young women, providing the opportunity for freedom and mobility. China and India, alongside many other countries in the world whose suicide rates have fallen, give hope for other countries that suffer from this worldwide epidemic. America, therefore, should take the opportunity to learn from these places and move toward a position of progress that is in line with the global reduction of suicide.

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