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Divorce Lowers Risk of Suicide for Women in India and China

Divorce Lowers Risk of Suicide for Women in India and China
Women cross a street in front of the Jawaharlal Nehru Stadium in New Delhi. Photographer: Brian Sokol/Bloomberg

Suicide rates in India are lower among divorced and widowed women and higher among those with more education, according to a new study that has found parallels to trends in China.

Suicide takes nearly as many young women’s lives in India as complications from pregnancy and childbirth, according to a study led by Vikram Patel at the London School of Hygiene and Tropical Medicine and published today in the Lancet journal. The study used data collected by the Registrar General of India for deaths between 2001 and 2003 and extrapolated those findings to estimate suicide figures for 2010.

The World Health Organization estimates there are almost 900,000 suicides worldwide every year, with India and China accounting for 49 percent in 2004, the latest available figure. Lower risk for divorced women has also been reported in China and may reflect changing perceptions of what is “an acceptable way of life” as women become more educated, Patel said.

As in China, suicide is more prevalent among young women than young men, a trend that is reversed in developed countries.

“What’s interesting is how similar these findings are between China and India and how different these two Asian countries are from the developed world,” Patel said in an interview. In India, suicide trends may reflect “the clash between education and the traditional value system.”

India Data

Past studies have pointed to social difficulties, marital conflict, domestic violence and depression as the leading causes of suicide among women in India, Patel said.

For the overall population, the Registrar General found that about 3 percent of surveyed deaths in people ages 15 and older were attributed to suicide. That translates to about 187,000 suicide deaths in India in 2010. Suicide is the second-leading cause of death of young people in India, the authors said in the paper.

The Registrar’s survey is the first to systematically obtain information on the causes of deaths in India, Patel said. As suicide is a crime in India, the only other available data from the National Crime Records Bureau probably reflects underreporting.

In China, studies showed that mental illness didn’t afflict about a third of people who committed suicide and two-thirds of people who attempted suicide, which contrasts with findings in high-income countries where suicidal behavior is almost always associated with mental illness, Michael Phillips of Emory University and Hui Cheng of Shanghai Mental Health Centre wrote in a commentary accompanying the Lancet publication. Low socioeconomic status and divorce are also risk factors for suicide in developed countries, they said.

National Differences

“These cross-national and cross-regional differences have major implications for prevention,” Phillips and Cheng said.

In India, poisoning, mostly from pesticides used in agriculture, was the leading method of suicide in both men and women, Patel said. Restricting access to these pesticides and improving the availability of mental health services are possible approaches for prevention, he said.

The study was funded by the U.S. National Institutes of Health, the University of Toronto and the Wellcome Trust.

Suicide rates for young men between aged 19 to 30 are falling in England, Australia, China and the U.S., according to a review of past studies led by Alexandra Pitman at University College London, also published in the Lancet today. These national trends mask shifting suicide rates by geographic region, socio-economic status and ethnic origin, they said.

Rural Deaths

In England and Australia, suicide rates are rising among young men in rural areas and falling in urban areas. Among ethnic groups, those with the highest suicide rates are white men in South Africa, first-generation Eastern European and Caribbean immigrants to England and Wales, and indigenous populations of Norway, Australia, New Zealand, Canada and the U.S.

Factors that may affect rates of suicide in young men include unemployment, social deprivation, and media reports of suicide, Pitman said in the paper.

“This review underlines the importance of the development of regionally and nationally tailored approaches to reducing suicide,” she said.

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