The counterintuitive case of suicide and population density

Blueberry farm in winter

Suicide often raises one question more than any other: why? The answers are often varied, but that hasn’t stopped epidemiologists, psychiatrists, and other experts from trying to find some common threads. They may include anything from mental health to financial condition to gun ownership. Population density plays a role, too, though not the one you might suspect.

Sociologists in the 1930s speculated that the mayhem of the modern city drove people to take their own lives. On the surface, it sounds logical. Cities can be large, impersonal places. It’s easy to imagine a single person becoming lost in a swarm of millions with no safety net of friends or family to prevent him or her from falling into deep despair. Yet research seems to have proven that theory wrong. Many studies have discovered that people in rural areas—not cities—seem to have higher rates of suicide.

In Japan, a nation with a culture steeped in ritual suicide, suicide rates for men living in cities dropped between 1970 and 1990. Over roughly the same period, rates increased in rural areas. Suicide rates among Japan’s rural elderly are much higher than its urban elderly, too. Similar trends show up on the other side of the globe. In England and Wales, more people between the ages of 15 and 44 living in rural areas took their lives compared to those in cities. Many studies in the United States have discovered the same.

Suicide is also a significant problem in the Australian outback, where rates are two, even three times higher among men than their metropolitan analogs. At fault may be the consolidation of farms that took place in the latter half of the 20th century, leaving young men in the country with fewer employment opportunities. Combine that with easy access to firearms and pesticides (a very common method of suicide in agricultural areas around the world), and you have a recipe for disaster. Indeed, between 1964 and 1988, suicide rates for 15 to 19 year old boys living in the outback increased nearly fivefold, and the use of firearms in the act also increased fivefold.

Access to firearms is a recurring theme in the literature on suicide. Experts think easy access to firearms is partly behind the high rates observed in the countryside. Part of the problem is the lethal reliability of guns—an attempt with a gun is often more successful than other methods. Guns and suicidal tendencies are such a lethal combination that more people in the United States people kill themselves with guns than any other method.

Blaming guns would be a convenient way to wrap up this story, but the reality is that they are merely a means—albeit a very effective means—of committing suicide. Rather, there are deeper issues behind high rural suicides rates, most of which revolve around how mental health issues are handled. Mental health disorders are one of the main factors that lead people to suicide—as much as 70 percent of cases involve someone with a mental illness. Rural ideologies of self-reliance and hard work can lead to stigma against people with mental illness and discourage them from seeking help. Furthermore, the vastness of rural areas often means mental health services are few and far between. Even simple isolation is also a factor. Long distances mean fewer social bonds that could help pull someone back from the brink, especially for elderly people that have a hard time getting around.

That’s not to say the picture is hopeless. Education focused on reducing the stigma of mental illness can go a long way, especially considering that the majority of suicides occur among people with mental illness. Traveling counselors, crisis lines, and even educating clergy about risk factors can help. Though some of these proposed solutions are speculative—rural suicide is still greatly understudied—many are based on proven models from urban areas. The barrier, as always, is money. Providing services to rural areas is notoriously expensive, and in this age of budget cutting, social programs like these are often first in line for the axe.

Sources:

Dudley M, Waters B, Kelk N, & Howard J (1992). Youth suicide in New South Wales: urban-rural trends. The Medical journal of Australia, 156 (2), 83-8 PMID: 1736082

Hirsch, J. (2006). A Review of the Literature on Rural Suicide Crisis: The Journal of Crisis Intervention and Suicide Prevention, 27 (4), 189-199 DOI: 10.1027/0227-5910.27.4.189

Strong K., Trickett P., Titulaer I., & Bhatia K. (1998). Health in rural and remote Australia: the first report of the Australian Institute of Health and Welfare on rural health Report Other: 9780642247827

Photo by rkramer62.

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  1. I’m glad you brought attention to the myriad of factors that complicate this issue–that there is no one cause that determines suicide rates within a population, no more than there is no one cause that determines whether an individual commits suicide. And, to go back to Durkheim, the “problem” of suicide within a population is a social one, so one must look for social causes, further complicating an investigation into what can explain “why?”

    What made you think about this? I hope you expand on the idea that population density effects (or, perhaps more precisely, correlates with) suicide rates in particular ways. There’s a lot to get into here.

    1. I actually stumbled on it when searching for articles on another topic. Google does funny things sometimes, I guess. It jumped out at me as an intriguing topic, and sure enough, it was.

  2. This is true in China where endemic poverty, almost all-female heads of household and wretched living conditions prevail. China has the highest number female suicides worldwide, 3:1 female to male. Men are off in cities with paramours and jobs, infrequent visitors to children and home.
    see my blog
    http://UnderstandingChina.wordpress.com

    PBS has a 4 part series on China with one part focused on women. Their figures may be more up to date than mine.

    From The Tech (online) The Chinese government tallies that female suicide is responsible for 18 of every 100,000 deaths, a rate five times higher than other countries.

  3. It’s interesting to note that in England, homicide rates have plummeted since the 15th century or so. (see _Homicide_, Daly and Wilson). And, of course, this was happening as people were less likely to live in small communities and were being herded into larger cities. On a Durkheimian analysis this should have driven the rate of violence up. But exactly the opposite happened.

  4. This is very interesting, and of course, for those of us trying to serve rural area populations in accessing mental health it is very big issue. I compared rate of suicide rankings for all states (derived from American Foundation for Suicide Prevention 2010 data – rate is per 100,000 of population), and ranking of states by population density (2011 data). Not a perfect match of years, but certainly obvious trends: Notably – top 3 suicide rate rankings go to the three lowest population density states- Montana #3, Wyoming #1, and Alaska #2. Beyond that is the fact that the top 10 suicide rate rankings all fall within the 14 lowest population density states! Yes, mental services are largely underrepresented in rural areas.