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Suicide of Older People in Rural China

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Suicide of Older People in Rural China Suicide of Older People in Rural China Shanshan Wei Institute for Population and Development Studies Xi'an Jiaotong University (China) Yanping Zhang Institute for Population and Development Studies Xi'an Jiaotong University (China) Jesús J. Sánchez-Barricarte, Ph. D. Carlos III University of Madrid (Spain) [email protected] 1 Abstract With the extension of life expectancy, the number and proportion of older population is increasing rapidly. And the suicide of older people in rural China has attracted widespread attention. Based on the literature on the suicide of older people in rural China, it is found that the annual average suicide rate is relatively high, and that the general trend has been increasing since the 1980s but that the tendency has declined after 2000. Besides, the suicide rate of rural older people increases with age and the incidence of suicide ideation also makes up a higher percentage. The ways of suicide mainly include drinking pesticides, hanging and drowning. Suicide among older people is mainly attributed to the decline in offspring number in the context of family old age support, fierce social competition, loss of filial piety and suffering of illness. Furthermore, many issues are reflected by the suicide of rural older people such as the imbalance of intergenerational relations in rural areas, the destruction of the traditional family system caused by gender imbalance and challenges to the traditional family old age support. Therefore, to cope with the suicide of rural older people, it is necessary to alleviate rural poverty and to perfect the rural social security system. Keywords: older people, suicide, ways of suicide, loss of filial piety, social security 2 1- INTRODUCTION With the development of social economy, there has been a progressive increase in the proportion of older people in China every year and the rate of aging is gradually accelerating. As is indicated by the population census in 2010, there are more than 177 million people aged 60 and over, accounting for 13.26% of the total population. By the end of 2015, the population of old people aged 60 and over has reached 222 million with the proportion of 16.1%. The projection of the United Nations in 2015 has shown that the proportion of older people in China will continue to grow and reach 27.55% in 2050 (UN, 2015). Issues such as the health of older people and the social security have aroused extensive attention. However, few researches are carried out from the perspective of the suicide of rural older people. The suicide behavior has gradually entered the public eyeshot (Sun et al., 2013), especially the suicide of older people, since Chinese government published the data on suicide rate in 1989 (Li et al., 2009). The suicide of older people is a relatively serious issue in rural China. Compared with that in urban areas, the suicide rate of rural older people is four times higher (Phillips et al., 2002b) and the average rural suicidal population from 1987 to 2010 is 5.5 times that of urban areas with the maximum of 11 times in 2001 and the minimum of 1.4 times in 2005 (Huang and Liu, 2013). The average suicide number per year is 303,047 in rural China and 28.72 of every 100,000 rural people die by suicide (Sun Yefang Fiscal Science Foundation, 2010), among which the rate of older people aged over 60 is the highest (Wang, 2011) and the suicide rate of older people over 65 years old is 5-7 times higher than the average suicide rate in rural areas (WHO, 2009). There are many factors accounting for the suicide of older people in rural China. Early researches paid much attention to the mental and psychological illness of individuals and hold the view that older people committing suicide all exhibit symptoms such as mental disorder and depression, etc. to different extent (Xu et al., 2000; Phillips et al., 2004; Yang et al., 2005). With the introduction of Durkheim’s “On Suicide”, scholars show a stronger tendency to explain the causes of suicide among older people in the dimensions of the social structure and its changes and changes in family relations (Yang and Ou, 2013; Liu, 2014b). Besides, humanistic factors such as religion, culture and values also account for the suicide of older people (Chen, 2007; Wu, 2007; Yang and Fan, 2009). Nevertheless, there are four factors that require special attention since 2000. 3 One is that the decline in offspring number in the context of family old age support; the second is the fierce social competition has weakened the function of family support for older people; the third is attributed to the loss of filial piety; the fourth is the physical and mental suffering of illness among older people. Suicide poses a serious threat to people’s psychological and life safety. Every 100,000 deaths caused by suicide correspond to 800,000 attempted suicide and one suicide death exerts great influence on 6 people, with the lasting psychological harm to others for up to 10 years. At the same time, 2 people are seriously affected by one case of attempted suicide and the psychological harm will continue for half a year (Huang, 2011). The suicide of rural older people will not only make their children feel double penalized in terms of the reputation loss in public opinions and the anxiety and guilt of conscience (He and Guo, 2012), but also produce the imitation effect among the older people around. Consequently, suicide of older people in rural China has become a serious social and public health issue (Deng, 2014). Chinese professionals and organizations should pay more attention to the suicide crisis among the rural older people (Li et al., 2009). On the basis of the literature review, especially the literature in Chinese, this paper aims to exhibit the trend and ways of suicide among rural older people and explore the causes of suicide, as well as the social changes in rural China reflected by suicide. The remaining of this paper consists of five sections. Section Two presents the suicide trend of rural older people. Section Three specifies the main suicide methods of older people. Section Four analyzes four factors that cause the suicide of older people –the decline in offspring number in the context of family old age support, the fierce social competition, the loss of filial piety and the suffering of illness. Section Five deals with the social changes in rural areas reflected by suicide such as the imbalance of intergenerational relations in rural areas, the destruction of traditional family system caused by gender imbalance and challenges to families in supporting older people. The last section, the conclusion part makes a summary of the major findings. It is expected that the analyses below will help to understand the current suicide situation of older people in rural China and provide scientific bases for intervention measures against the suicidal behaviors of rural older people. 4 2- SUICIDE TREND OF RURAL OLDER PEOPLE The suicide rate of older people in rural China is comparatively high. Internationally, countries with the suicide rate of more than 30/1000,000 is regarded as countries of high suicide rates, while countries with low annual average suicide rate maintain the rate of less than 10/100,000 (Khan, 2005). The annual average suicide rate of older people in rural China is 82/ 100,000 from 1995 to 1999 (Phillips et al., 2002a). Table 1 provides official statistics on suicide rates in China from 2002 to 2014, showing a relatively high suicide rate among the rural older people. At the same time, it shows that the suicide rate of old men is evidently higher than that of women, which can be accounted for the poorly social skills of the male elderly, as well as their loss of family status. Table 2 presents some survey data concerning the suicide of rural older people. Having analyzed the data of several decades in one or several villages, these surveys have found that the annual average suicide rate among the rural older people is higher than 30/100,000 and reaches a maximum of 861.30/100,000 in some villages in Guizhou province. Although the sample of the data is too small to represent the average level of suicide among older people, the occurrence of so many suicide cases in one or several rural areas also accounts for the seriousness of suicide among rural older people. Table 1 Suicide rate of older people by age group in rural China (per 100,000） Age group Year 60-64 65-69 70-74 75-79 80-84 85 及以上 overall male female overall male female overall male female overall male female overall male female overall male female 2002 32.25 39.94 23.92 42.91 54.48 31.67 61.83 77.66 47.62 90.44 107.23 77.86 95.22 132.65 72.73 113.12 137.11 101.58 2003 38.48 42.13 36.25 57.20 59.24 50.33 77.04 88.55 64.13 131.79 109.67 77.86 159.12 130.79 72.73 138.18 101.42 101.58 2004 26.09 30.07 21.61 30.24 33.47 26.86 44.88 53.12 37.10 59.68 53.33 64.86 89.53 123.32 66.86 107.62 94.48 114.32 2005 22.87 25.03 20.13 39.15 39.82 38.35 42.89 46.00 39.33 65.16 74.23 56.30 82.98 96.54 71.93 97.50 77.12 111.71 2006 20.89 24.24 17.20 26.35 29.67 22.91 36.11 45.01 27.82 48.02 58.04 40.08 65.82 87.89 51.59 74.03 83.46 69.61 2007 22.34 27.27 17.13 28.45 34.27 22.67 40.55 51.69 30.23 57.21 67.46 48.85 86.73 103.51 75.13 97.52 127.97 81.08 2008 18.52 17.96 19.14 20.51 27.32 13.60 26.93 31.46 22.76 41.18 47.19 36.40 51.87 68.40 41.28 62.48 106.10 42.47 2009 19.83 22.09 17.38 23.68 26.48 20.80 35.10 43.21 27.34 53.00 64.07 43.80 81.16 90.31 74.78 104.92 130.25 91.90 2010 17.67 18.57 16.73 27.02 29.19 24.81 44.25 51.44 37.31 68.78 88.71 52.30 108.13 151.03 79.49 191.74 256.81 159.70 2011 17.82 19.48 16.04 25.59 29.57 21.47 35.23 41.69 28.87 46.36 50.99 42.39 78.50 104.13 60.52 93.46 148.44 63.76 2012 15.49 16.71 14.18 19.79 21.64 17.83 26.58 29.90 23.20 43.47 47.50 39.79 53.08 64.93 43.79 71.17 92.21 58.72 2013 15.56 17.62 13.40 22.06 25.47 18.59 30.96 37.05 24.79 43.95 53.66 35.27 59.18 73.17 48.38 72.40 95.03 58.92 2014 15.16 16.80 13.44 21.44 25.31 17.52 30.99 35.46 26.50 42.02 49.16 35.53 55.83 67.51 46.62 70.29 93.54 56.19 Data sources: The Ministry of Health in China (2003-2012); National Health and Family Planning Commission in China (2013-2015).
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