Suicide Among Minority Elderly: A Preliminary Investigation

ABSTRACT: In the United States, suicide has traditionally been considered a White elderly phenomenon. Suicide rates have been increasing for Nonwhites in recent years, but it is not clear how this may have affected the age distribution, particularly for specific Nonwhite groups. An investigation of official 1976 suicide statistics among minority elderly revealed that suicide rates are also highest among the old for Chinese-, Japanese- and Filipino-Americans. Among Blacks and Native Americans, however, suicide rates are extremely low for the aged. Explanations for these findings are suggested and the need for a long-term study is indicated.     

Association of suicide rates of elderly persons with fertility rates

A negative correlation between societal suicide rates and social integration has been reported, but rarely specifically examined for suicide rates of the elderly although suicide rates of elderly persons are among the highest. The associations of suicide rates of elderly persons and fertility rates for 81 countries were examined using data from the World Health Organisation and United Nations. Fertility rates were considered a proxy measure for social integration. Multiple regression analysis indicated that suicide rates for males and females in the age bands 65-74 years and 75+ years were independently (negative) correlated with fertility rates. Fertility rates, as a measure of social integration, may interact with, modify and mediate the effect of cultural factors on suicide rates of elderly persons.     

Prevalence of suicide attempts in a Mexican-American population: prevention implications of immigration and cultural issues

Self-reported suicide ideation and suicide attempts were examined among 2,393 Mexican-Americans (706 born in Mexico, 538 born in the United States) and non-Hispanic whites (1,149 born in the United States). Mexican-Americans born in Mexico reported significantly lower age- and gender-adjusted lifetime rates of suicide thoughts (4.5%, 2.7-6.3%) than Mexican-Americans born in the United States (13.0%, 10.0-15.9%), who reported significantly lower rates than non-Hispanic whites born in the United States (19.2%, 17.4-21.0%). Adjusted rates of suicide attempt were lowest among Mexican-Americans born in Mexico (1.6%, 0.6-2.6%) and higher among both Mexican-Americans (4.8%, 2.4-7.2%) and non-Hispanic whites (4.4%, 3.4-5.4%) born in the United States. Rates were not affected by degree of acculturation when immigration status was controlled. High schools and the Catholic church are suggested as sites for programs designed to prevent suicide and suicide attempts among Mexican-Americans.     

Epidemiologic Characteristics and Trends of Fatal Suicides among the Elderly in Taiwan

Taiwan has one of the highest suicide rates in the world, especially among its elderly. The epidemiologic characteristics and trends of the surging elderly suicide rates from 1993 to 2003 are described, with a special emphasis on the risk groups, the methods used in suicide, and their geographical variations. Data on annual mortality for persons over 65 years of age with external cause‐of‐death codes E950–E959 were obtained from the Death Certification data file provided by the Department of Health and used in the analysis. The suicide rate for each 5‐year age group over 65 years old increased during the 11‐year period. Elderly males had the highest suicide rate and experienced an increased rate of 49% during the decade. The average suicide ratio between elderly males and females was about 2:1. Never‐married males had the highest age‐adjusted as well as sex‐ and marital status‐specific suicide rates, and showed an increased rate of 66% over the 11‐year period. Geographical variations in suicide rates were significant, with the lest urbanized eastern Taiwan having a higher rate than other regions. Hanging, strangulation, and suffocation were the most used methods for committing suicide by the elderly, but their use had decreased from 63% to 54% during the decade; but jumping off a building and drowning increased significantly. Variation in suicide rate among months was not significant. With the increase in the elderly suicide rate, more governmental and societal interventions are needed to alleviate this social and human problem.     

Multicultural perspectives on suicide

Cultural differences exist as to suicide rates, suicide attempts, suicide attitudes such as acceptability, and appropriate treatment of suicide. Although suicide has been studied cross-nationally to highlight cross-cultural differences, the nuances of suicide among racioethnic groups within the United States have been at times been overlooked. The present article discusses suicide among the four (African American, Hispanic American, Native American, Asian American) most populous minority sociopolitical groups in the United States, and makes culture-specific recommendations for treatment and research.     

Older Adults: The Next Suicide Epidemic?

Suicide rates historically and currently are highest by age among those over the age of 65. Predictions of markedly higher rates for future older adults have been advanced. Possible alternative factors that might produce lower risk among future elderly Americans are presented and it is argued that future trends are uncertain. Predictions of elderly suicide are made based on an assumption of stable rather than changing rates. Constant rates produce estimates of more than twice the current number of suicides and a proportionate increase in the number of suicides from one in five for the 1980s to one in three by the year 2030. The elderly are and likely will be a group with high suicide risk. Immediate efforts to lower elderly suicide risk and avert high future rates are recommended.     

Trends in suicide ideation and suicidal behavior among high school students in the United States, 1991-1997

To examine trends in suicide ideation and behavior over time, the authors analyze data from nationally representative samples of between 10,904 and 16,296 students participating in the 1991, 1993, 1995, and 1997 Youth Risk Behavior Surveys. These data describe the proportion of United States students in grades 9 through 12 that reported having (1) seriously considered attempting suicide, (2) made a plan to attempt suicide, (3) attempted suicide, and (4) made an injurious suicide attempt. From 1991 to 1997, the percentage of students seriously considering suicide and the percentage that made a suicide plan showed significant linear decreases. However, the percentage of students that made an injurious suicide attempt showed a significant linear increase. These trends make it unlikely that relevant national health objectives for the year 2000 will be met. Additional efforts are needed to identify and disseminate strategies that effectively reduce suicidal thoughts and behaviors among adolescents.     

Managing Elder Suicide: A Profile of American and Canadian Crisis Prevention Centers

Suicides among older adults in the United States and Canada in the last decade have accounted for an increasing share of all suicides. In both countries the use of firearms among older adults has steadily increased. Despite these trends, little is known about the extent to which crisis centers are prepared to prevent elder suicide. A survey of AAS-listed crisis prevention centers examined the training, knowledge, and current practices relevant to elder suicide among personnel in 321 crisis prevention centers in both countries. Results revealed insufficient training, a lack of familiarity with recent suicide trends, and limited outreach to older adults.     

Suicide and Homicide Rates in Canada and the United States

Suicide and homicide rates by age were analyzed for Canada and the United States, indicating that suicide is higher in Canada and that homicide is higher in the United States. Results indicated a positive association between homicide and suicide rates in the United States but these two rates of death were not significantly associated in Canada. Holinger (1987) had associated the relative size of the cohort to the rates of suicide and homicide in young people in the United States. The more current data in both countries did not support Holinger's results. Using the measure devised by Easterlin (1980) and Ahlburg and Schapiro (1984) –that is, the proportion of youths aged 15–24 relative to adults aged 25–64–the correlation between the size of the youth cohort and the suicide rate of youths aged 15–24 was negative. It is concluded that the two patterns in these two countries may be explained from a historical perspective.     

The relationship between firearms and suicide: A review of the literature

Suicide rates are affected by many factors—psychiatric, biological, familial and situational. This paper focuses on one potential risk factor for completed suicide in the United States—the availability of firearms. Whether the availability of firearms might increase the rate of attempted suicide is not examined. This article is not an exhaustive review of every existing firearm-related suicide study. Rather, it provides a detailed review of the most commonly cited, representative, and thorough empirical studies in the published peer-reviewed literature relating firearms and suicide, focusing largely on the United States. The empirical studies reviewed are grouped according to whether the unit of analysis is the individual (e.g., case-control studies) or a population (e.g., ecological studies) and further divided depending on whether the analysis uses cross-sectional or time-series (longitudinal) data. We begin with a very brief overview of the suicide problem in the United States.     

Suicide: The Psychosocial Dimension

ABSTRACT: This paper explores the relationships among culture, character, and suicide. It draws on the author's research in Scandinavia and his studies of suicide among United States urban blacks and college students. The differences in motivation and significance of suicide in Sweden and Denmark are illustrated. The United States is an amalgam of subcultures which must be studied separately to identify the psychosocial determinants of behavior. The varying rates and motivations for suicide in different cultures and subcultures, the differences between men and women, between young and old, differences in ways of coping with love and loss, life and death make clear that suicide is part of a culture's possibilities. The varying psychodynamic ways in which the suicidal individual in differing cultures and subcultures conceives of, uses, and absorbs death also has much to tell us about how we live.     

Occupational status and suicide

The relationship between occupational status and suicide was examined using data from Sacramento County, California. Data were obtained from coroner's records filed routinely on all cases of sudden, violent, or unexpected death since 1925. Occupation- and age-specific suicide rates were calculated for males and age-adjusted for overall comparison for the decades 1945-1954, 1955-1964, and 1965-1974. Findings show an inverse relationship between occupational status and suicide for all age groups over the past 30 years. Over time, male suicide rates have increased particularly for employed males over 65, employed males aged 14 to 24, and males in low-status occupations. General economic insecurity among workers of low socioeconomic status (SES), particularly the elderly, is suggested as a contributing factor to these trends.     

The Associations Between Infant Homicide,Homicide, and Suicide Rates: An Analysis of World Health Organization and Centers for Disease Control Statistics

Previous studies have found that rates of homicide of children aged under one (infant homicide) are associated with rates of suicide, but not with rates of homicide. Linear regression was used to examine associations among infant homicide, homicide, and suicide in samples of regions in the United States and other countries. Infant homicide rates were significantly and independently associated in all analyses with both total homicide and total suicide rates. The epidemiological evidence supports the clinical observation that infant homicides are due to a range of causes, including maternal mental illness, but are also related to the level of serious violence within a community.     

8 African-American Suicide: A Cultural Paradox

African-American suicide rates have traditionally been lower than White rates despite a legacy of racial discrimination, persistent poverty, social isolation, and lack of community resources. This paper focuses on four issues: (1) patterns and trends of Black suicide across the lifespan; (2) risk and protective factors in subgroups of Blacks; (3) the influence of cultural factors on suicide patterns of Blacks; and (4) implications of these patterns for prevention and early intervention of suicidal behavior among African Americans. Risk factors for Black suicide include: male sex, early adulthood, substance abuse, psychiatric disorders, family or interpersonal conflict, antisocial behavior, and homosexuality. Protective factors that mitigate the risks of suicide include religiosity, older age, southern residence, and social support. Implications for preventive policies and programs are discussed to counter the recent trend of rising suicide rates among adolescents and very elderly Blacks.     

The impact of epidemic, war, prohibition and media on suicide: United States, 1910-1920.

The paper utilizes a natural experiment approach to estimate the impact of exogenous social and political events on suicide behavior in the United States between 1910 and 1920. The study is concerned with determining the impact of World War I, the great Influenza Epidemic, and the prohibition experiment on suicide. Estimating the monthly population in the United States registration area from 1910 to 1920, monthly suicide and mortality rates are computed. A time-series model is postulated, and second-order autoregressive estimates are used to determine the impact of the independent variables in the model. It is concluded that World War I did not influence suicide; the Great Influenza Epidemic caused it to increase; and the continuing decline in alcohol consumption between 1910 and 1920 depressed national suicide rates. Further individual-level aggregate studies are needed to confirm the findings of the study.     

Suicide: A decade review of the sociological literature

Major works on suicide are reviewed and classified into four analytic categories according to their theoretical emphasis: cultural, economic, modernization, and social integration perspectives. The research under these paradigms is assessed in terms of four themes. First, attention is drawn to research evidence that questions traditional theories. An example is Durkheim's position on social class and suicide. Second, the review notes several new theories including Phillips’ imitation thesis and the author's own model of migration's effects on suicide. Third, the paper observes and reviews explanations of new trends in suicide rates such as the rapid increase in youth suicide and the decline in suicide among the elderly. Finally, the review calls attention to explanations of suicide, such as that linking suicide to low marital solidarity, that have withstood the test of the more rigorous empirical testing of recent times.     

The Elderly Poor,the Future,and the Church

This paper examines the future of the elderly poor in the United States in the light of the im act of certain demographic, economic, and political trends present& in place. These trends are then projected for four generational groups now of "working age" in an attempt to discern the extent of poverty among the elderly of the future. If present trends continue, an ominous future awaits those Americans now between twenty and sixty-five years of age. The capacity of the Church to respond to this situation is discussed, and a variety of roles it can perform are suggested.     

Possible relation of suicide rates of elderly with societal crime: a cross-national study

There are few studies examining the relationship between elderly suicides and societal crime. Therefore, a cross-national study examining the relationship between suicide rates of elderly persons and the percentage of the population victimised by different categories of crime was undertaken by using cross-national data from the World Health Organisation and United Nations databases. The main finding was a negative correlation between suicide rates in elderly men age 75+ years and women in both the elderly age-bands with the percentage of the population victimised by the crime of robbery. The findings were at variance with the study's hypothesis and may be explained by several factors, including methodological issues. Individual-level case-control or cohort studies of suicides and attempted suicides by elderly persons are suggested to examine the relationship of suicides by elderly and experience of being victimised by crime.     

Suicide in Later Life

SUMMARY

This paper outlines the suicide trends of different groups in Australian society, highlighting the continuing very high rates among elderly men in particular. Risk factors and protective factors are examined. As up to 90% of those who complete suicide have a depressive disorder at the time, this paper concentrates on the detection and treatment of depression. Treatment of depression at a broad community level may offer the best hope of suicide prevention. Survivors face intense unpleasant emotions, and sometimes allocate blame, which can be painful and divisive for all concerned.