A Global Perspective on Suicidal Behaviors
September 19, 2014
Data from a World Health Organization study in the Western Pacific revealed that, with some exceptions, gender patterns of suicide and suicidal behavior were similar to those in North America and Europe. Variations in patterns of age and method provide some insight into how culture and context affect suicidal behavior.
As in the West, males died by suicide at a higher rate than females, while females were involved in non-fatal suicidal behaviors at a higher rate than males. One exception was Fiji where the difference in the suicide rates by sex was substantially less than in most countries involved in the study. The discrepancy was most likely due to the high suicide rate among women of Indian descent, a pattern that also exists in other countries and may reflect “the possible role of common interpersonal, social, and cultural risk factors” among women of Indian descent no matter where they live.
Differences in age patterns were also evident as “suicide cases were more often of a younger age in Pacific Island countries, which has been attributed to vast social and cultural changes, intergenerational conflict, unemployment, and lack of employment opportunities” as well as the increased access to drugs and alcohol.
The percentage of suicides associated with firearms was extremely low compared to the United States, with the highest being the Philippines where firearms were involved in 17.5 percent of suicides among men. Hanging was the most common means in all the countries studied. The use of carbon monoxide poisoning was relatively high in Australia, New Zealand, and Guam, where more residents have access to automobiles than in the Pacific Island countries. Overdoses of medication – especially drugs prescribed for mental disorders – were the most common method associated with non-fatal attempts in most countries, with the exception of the Philippines and Fiji, where pharmaceutical use is less common and the bulk of non-fatal attempts were associated with chemicals and poisons.
This summary based on: DeLeo, D., Milner, A., Fleischmann, A., Bertolote, J., Collings, S., Amadeo, S…. and Wang, X. (2013). The WHO START study: Suicidal behaviors across different areas of the world. Crisis 34(3): 156-163.
SPRC Commentary
This study reminds us that patterns of suicidal behavior differ based on culture and context. In the United States, for example, the patterns of suicide by age differ between the general population and American Indian/Alaska Native communities. This study also reminds us that access to lethal means is an important risk factor regardless of culture or context. For more information on these topics, we recommend these SPRC resources: