In most countries suicide mortality increases with age. In India, the opposite happens. The suicide rate among young adults aged 15-29 is more than three times the national average. This makes us a country with one of the highest suicide rates among youth in the world.
What explains this oddity? The answer lies in yet another oddity: India has a relatively high suicide rate among young adult women.
Globally, suicide is much commoner among men than women. The battle to reduce suicide has also been more successful for women than men. Across nations, suicide rates for men are three to seven times as high as for women. The same pattern prevails in India across most age groups, though here the gender gap is less sharp.
The oddity is among young adults for whom the gender gap virtually vanishes, and in certain locations, suicide is higher among women. One study published in the Lancet a few years ago found that suicide rate of girls aged 15-19 around Vellore, Tamil Nadu, was 148 per lakh, almost thrice the rate for similarly aged boys.
The gender gap in suicide gets worse after marriage. Here is another oddity. In most Western countries, married women are less likely to commit suicide than formerly married women. India is an outlier: married women are more likely to commit suicide than divorced, widowed and separated women, according to the Million Death study, a research project based on a nationally representative mortality survey on the causes of death occurring in 1.1 million homes in 6,671 areas chosen randomly across the country.
Science does not tell us much about the exact cause of suicide. Broadly, we know that biological, environmental and cultural factors make certain populations more vulnerable than others. High suicide rates for young married women in India could flow from a combination of these factors.
It is tempting to interpret this high rate as the result of psychological and physical torture from husbands and in-laws, that is common in India. Curiously, a geographic element weakens the gender explanation of high suicide rates among young married women. South Indian states, well-known for better gender relations and female empowerment than north Indian states, have much higher youth mortality. Neighbouring Sri Lanka, with excellent social indicators and higher women’s empowerment, also has a high youth female suicide rate. This could simply reflect greater sociocultural tolerance of suicide as a way out of mental stress.
In India, we have a tendency to link suicides with income or economic distress. Farmers have captured all the recent attention on suicides. Suicide among farmers is considered evidence of exceptionally high economic distress among them. Public discourse is politically motivated, highly charged, generally irreverent of facts, and substantially non-serious. In fact the suicide rate is lower for farmers than non-farmers.
Most extant research does not associate poverty with suicide mortality. Indeed, suicide mortality in India is higher among the more educated, who are typically better off than the less educated. Cross-country comparisons also reject a link between poverty and suicide. Among well-off OECD countries, Japan has the highest suicide rate at 20 per lakh population, followed by Switzerland at 14 per lakh. Much-poorer India’s suicide rate is 11 per lakh population.
Data across Indian states lead to the same conclusion. Suicide rates are up to 10 times higher in richer southern states than in poorer northern states. Now, economic or other shocks can push the vulnerable over the edge. The collapse of the Soviet Union, for instance, sharply increased the suicide rate there. What matters is a relative worsening of economic conditions, not the absolute level of incomes.
While the exact causes of suicide remain obscure, the good news is that, globally, the battle against suicides has been a successful one. Since 1994, suicide rates have fallen by more than a third globally. The sharpest decline has been in Russia, South Korea and Japan – the three countries that also have among the highest rates in the world.
As in many dimensions of well-being, China has been a leader in the battle against suicide. Its rate has fallen to 7 per lakh in recent years. Like India, China used to have high suicide rates for young women, but that rate has fallen by 90% since the mid-1990s. A contributing factor is urbanisation that granted women greater freedom of work; opportunities to leave violent husbands and in-laws; and live relatively stress-free lives in cities.
Means restriction is one of the most effective strategies. In Britain, simply repackaging of painkillers from bottles to blister packs reduced suicide death from overdose of paracetamol by 44%. Limiting access to guns in Australia and restricting alcohol distribution in Russia lowered suicides. In India, toxic pesticides are often used to end life. Better packaging and restricted access of pesticides could reduce the risk of suicide in rural areas.
Globally, a major factor contributing towards reduced suicide is better diagnosis and treatment of mental illnesses. Anti-depressants, psychiatric help, access to suicide lifelines, and just the availability of somebody to talk to sympathetically can curb suicides. It would have to be a societal effort and not just something left to the government. This requires compassion and caring towards a targeted vulnerable population, and cannot be simply addressed with buckets of money. Farm loan waiver, every politician’s favourite policy choice to tackle suicide, is extremely blunt, leaky and wasteful. Imagine the chance that a state or nation-wide loan waiver will reach the 0.008% of farmers who are at risk of committing suicide?
DISCLAIMER : Views expressed above are the author’s own.