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The Decline of Suicide in Sweden: 1950-2000

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The Decline of Suicide in Sweden: 1950-2000 The Pennsylvania State University The Graduate School Department of Sociology THE DECLINE OF SUICIDE IN SWEDEN: 1950-2000 A Dissertation in Sociology and Demography by Julianne Ohlander 2010 Julianne Ohlander Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy May 2010 ii The dissertation of Julianne Ohlander was reviewed and approved* by the following: Gordon De Jong Distinguished Professor of Sociology and Demography Co-Chair of Committee Dissertation Advisor Robert Schoen Professor Emeritus of Sociology and Demography Co-Chair of Committee Duane Alwin McCourtney Professor of Sociology and Professor of Demography Emily Greenman Assistant Professor of Sociology and Demography Mark Leach Assistant Professor of Rural Sociology and Demography John McCarthy Professor of Sociology and Department Head *Signatures are on file in the Graduate School iii ABSTRACT Sweden's high suicide rate became common knowledge in the early 1960s after then- American President Dwight D. Eisenhower implicated the country's socialist economy as its cause. Sweden's suicide rate was high at the time, particularly for men; about 20 persons committed suicide per 100,000 inhabitants (the rate was 31 for men and 9 for women). The suicide rate of older males, however, began declining during the 1950s and the rates for younger adult males and all females older than 25 have been declining since the 1970s. In 2000, only 13 Swedes per 100,000 committed suicide (rates of 18 for men and 7 for women). Other European countries experienced similar declines, but they occurred at least a decade following Sweden's descent. This study attempts to uncover the causes for the decline of suicide in Sweden. My central hypothesis, based on a combination of Max Weber's and Emile Durkheim's sociological theories, is that a change in Swedes' collective identity played a major role. I argue that Sweden's previous high suicide rate was associated with its citizens' collective identity as the hard-working Protestant individuals who Weber described in his classic monograph, The Protestant Ethic and the Spirit of Capitalism. I trace the decline in suicide to a change in that identity to one that is more inclusive and based on solidarity. I describe these social forces as a change in Durkheimian social regulation, or as a change in the external constraints placed on Swedes by their society. Interviews I conducted with researchers and professionals in Sweden helped form additional hypotheses evaluated in this dissertation. The quantitative, government data I use were compiled from various Swedish agencies and include statistics on population, mortality, antidepressant use, immigration patterns, alcohol consumption, economic indicators, and various population health indicators for the period 1950-2000. The national data are supplemented with individual-level analyses from the Swedish National Election Studies (covering 1956-2002) and iv the World Value Surveys (1982-1999) to examine the roles of attitude change and cohort differences in the decline. Cohort analyses and decomposition of work ethic and solidarity measures were used to ascertain differences between cohorts born before and after World War II. The results of my analyses support the central hypothesis. A rise in solidarity is associated with a decline in the work ethic, a decline in religiosity and the decline in suicide. Earlier-born males and females have a stronger work ethic on an extensive array of measures; males born before 1945 have the strongest measured work ethic. Factors suggested by my interviewees also appear to have played some role. The decline in suicide in Sweden is associated with rising antidepressant use, changing immigration patterns, and changing alcohol consumption away from hard liquor and toward a more continental style of drinking. The importance of the findings is discussed, and future research is suggested. v TABLE OF CONTENTS LIST OF FIGURES ................................................................................................................. ix LIST OF TABLES ................................................................................................................... xi ACKNOWLEDGMENTS ....................................................................................................... xiv Part 1 Background and Theoretical Explanations for Suicide in General................................ 1 Chapter 1 Some Background ................................................................................................... 2 Introduction ...................................................................................................................... 2 Overview .......................................................................................................................... 5 Views about suicide ......................................................................................................... 6 The move toward secular explanations ............................................................................ 10 Secular explanations ........................................................................................................ 11 Individual characteristics .......................................................................................... 11 Social characteristics ................................................................................................ 13 Summary .......................................................................................................................... 15 Chapter 2 Explanations and Evidence ..................................................................................... 18 Building upon Durkheim ................................................................................................. 18 Family life ................................................................................................................ 18 Religious factors ....................................................................................................... 20 Immigration and migration ....................................................................................... 22 Work and economic factors ...................................................................................... 23 The mental health link ...................................................................................................... 25 Mental health ............................................................................................................ 28 Medicalization of suicide: antidepressants ............................................................... 30 Summary .......................................................................................................................... 33 Part 2 Explanations for Suicide in Sweden ............................................................................. 34 Chapter 3 Explanations for the Decline of Suicide in Sweden ................................................ 35 Antidepressant use ........................................................................................................... 36 The weather and sunshine ................................................................................................ 39 Other mental health explanations ..................................................................................... 40 A more open society ........................................................................................................ 41 Alcohol consumption ....................................................................................................... 44 A population shift and the availability of weapons .......................................................... 45 Improved medical care ..................................................................................................... 46 Religious factors .............................................................................................................. 47 Immigration ...................................................................................................................... 48 Summary .......................................................................................................................... 52 vi Chapter 4 Thesis of Dissertation .............................................................................................. 53 Identity ............................................................................................................................. 53 Identity in Sweden before 1900: John Calvin, Martin Luther, and Max Weber .............. 55 Max Weber and the Protestant ethic......................................................................... 57 Lutheranism and Sweden ................................................................................................. 60 Evidence of the preeminence of the work identity ........................................................... 62 Suicide, work, and identity............................................................................................... 64 Solidarity: a change in Swedes’ collective identity ......................................................... 66 On the road to solidarity ................................................................................................... 67 The impact of World War II............................................................................................. 68 A new generation ............................................................................................................
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