The Epidemiology of Suicide
How Rates Vary by Gender, Race, and Age
Suicide and Social Integration
The study of suicide rates is an important part of the heritage of sociology. As we saw earlier, Emile Durkheim took this form of deviant behavior as a topic for sociological investigation in his classic work, Suicide (1897). Durkheim examined macro-level variations in suicide rates—such as differences between Catholic and Protestant regions in Europe or variations by age and gender—in an effort to show how certain properties of societies could explain suicide as a "social fact." In the case of religious differences, Durkheim argued that the characteristically low rate of suicide in Catholic countries was attributable to a relatively high degree of social integration, where individuals were strongly integrated into the hierarchical religious community of the Catholic church. On the other hand, Durkheim attributed the relatively high rate of suicide in Protestant societies to a state of egoism where there was greater emphasis on the individual and a lower degree of social integration of believers into religious institutions.
Durkheim also examined the family institution as a source of social integration and as a buffer against the propensity of individuals to commit suicide. For instance, Durkheim observed that regions of France that were characterized by larger families tended to have lower rates of suicide than did regions with smaller families. He reasoned that the greater "density" of social relations in larger households protected against excessive individualism and egoistic suicide. Durkheim also found a relationship between marital status and suicide, in which married persons over the age of 20 generally have lower rates of suicide than do their single or widowed counterparts. After conducting additional analyses, Durkheim concluded that men, especially, benefit from the integrative influences of marriage whereas suicide rates for married women are reduced only when they have children.
As we noted in our discussion of deviance theory, one of the lasting contributions of Durkheim's analysis of social integration and egoistic suicide was its influence on the development of control theory as a general explanation of deviant behavior (Hirschi 1969). In addition, Durkheim's specific concern with suicide and the protective influences of family relationships, religious integration, and other bonds to society continues to generate sociological research on self-destructive behavior (Maimon and Kuhl 2008).
Trends and Patterns of Suicide in the United States
Although Durkheim's data showed relatively low rates of suicide for teenagers and extremely high rates among older men, particularly those who were single or widowed, he did not devote much attention to the role of social integration in accounting for age-related patterns of suicide. As shown in the first graph on the right, suicide rates in the United States vary dramatically by age (15-24 versus 65+) as well as by gender and race. In 2005, the suicide rate for white men aged 65 and over was substantially higher than it was in any other gender/race/age status. Thinking in terms of Durkheim's concept of egoistic suicide, what cultural and structural circumstances in the U.S. might weaken social integration among older white men and leave them especially vulnerable to suicide? Conversely, what social conditions potentially promote stronger social integration and generally low rates of suicide among women in the U.S.?
Contrary to stories in the news about growing suicide rates among teenagers, African Americans, and other groups in recent years, the rate of suicide declined during the 1990s for all six of these gender/race/age status categories (see the graph on the left). Most dramatically, the suicide rate for white men aged 65+ dropped sharply from 1950 to 1980, perhaps because of changes in social policy (e.g., Medicare) that improved financial conditions and medical care for older people in the U.S. The suicide rate for older white women also shows a steady decrease from 1950 to 2000, suggesting an improvement in their health and social circumstances as well.
In contrast, two younger status groups—white and black men between the ages of 15 and 24—experienced relatively sharp increases in suicide rates from 1960 to 1990. How might the social and political changes of the 1960s and 1970s have affected the degree to which these younger men were integrated into American society? Other forms of deviant behavior, such as illegal drug use and violent crime, also increased during part of this historical period. As we saw earlier, the use of illegal drugs peaked in the late 1970s and early 1980s, and violent crime generally increased until the early 1990s. Since then, the suicide rate among younger men has declined as have rates of drug use and violence. The extent to which these parallel trends in suicide and other forms of deviant behavior correspond to historical changes in social integration or other underlying conditions in the U.S. is an intriguing question for research (for instance, see O'Brien and Stockard 2006).
Declines in drinking and illegal drug use that we examined earlier probably play a role in decreasing rates of suicide during the 1990s, especially for young men. In addition, a number of researchers have explored the impact of steep increases in the use of antidepressant medications on the reduction of suicide rates in the U.S. during the 1990s and early 2000s (Olfson et al. 2003; McKeown et al. 2006). However, evidence from other societies, such some Scandinavian countries, indicates that suicide rates began to decline prior to the widespread use of antidepressant drugs (Reseland et al. 2006). In other words, the recent drop in suicide rates is not simply due to the introduction of new and better drugs to treat depression and other mood disorders. As Durkheim suggested, we need to look beyond individualistic explanations based on psychological or pharmacological factors to account for the complex and changing "social facts" of the epidemiology of suicide.