Why the global suicide rate is falling

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STORIES ABOUT suicide that appear in the news tend to focus on celebrities who have taken their own lives and on clusters of deaths among students. They miss the bigger picture: that, at a global level, suicide has declined by 29% since 2000. Among most Western countries, rates have been falling for decades. In Britain, for instance, the rate peaked in 1934, during the Depression. But elsewhere, the decline has happened more recently. China’s rate started to come down in the 1990s; in Russia, Japan, South Korea and India rates have all fallen significantly in the past decade. Western Europe’s rate is still declining slowly. America is the big exception: its rate has risen by 18% this century. Twenty years ago, America’s rate was half China’s. Now it is twice China’s. But the net gain is still huge. The drop in the global rate has saved 2.8m lives since 2000. Three times as many as have been killed in battle in that period. 

There is no one reason for the global decline, but it is particularly notable among three sets of people. One is young women in China and India. In most of the world, older people kill themselves more often than the young, and men more often than women. But in China and India, young women have been unusually prone to suicide. That is decreasingly the case. The rate among young Chinese women has dropped by 90% since the mid-1990s. Another group is middle-aged men in Russia. After the collapse of the Soviet Union, rates of alcoholism and suicide rocketed among them. Both have now receded. A third category is old people all around the world. The suicide rate among the elderly remains, on average, higher than that among the rest of the population, but it has also fallen faster than among other groups since 2000.

Social change is partly responsible for the falling numbers. Asian women have more freedom and opportunity than before, and thanks to urbanisation fewer have access to the highly toxic pesticides that were once the group’s favoured means of suicide. Social stability has returned to Russia and unemployment is down. Among the old, poverty has declined at a global level faster than among younger people. Social change may also be partly responsible for the rise in America: suicide has risen most among middle-aged, white, poorly educated rural people—the victims of the “deaths of despair” identified by Anne Case and Sir Angus Deaton, Princeton University economists. 

Policy also plays a role. When Mikhail Gorbachev introduced restrictions on alcohol in the Soviet Union in 1985, consumption and suicide both plunged; something similar has happened since Vladimir Putin introduced new rules in 2005. Restricting access to easy means to kill oneself can make a big difference because suicide is a surprisingly impulsive act. Of 515 people who survived the leap from San Francisco’s Golden Gate Bridge between 1937 and 1971, 94% were still alive in 1978—which suggests that a suicide postponed is likely to be a suicide prevented. The banning of toxic pesticides has had a clear impact on rates in countries such as South Korea and Sri Lanka. Selling paracetamol and aspirin in only very small quantities has also been shown to reduce rates. Investing in health services—particularly palliative care, which helps make life tolerable for the sick—can make a difference. And if America restricted gun ownership, rates would almost certainly crash. America’s rate is twice Britain’s (which has tight gun controls), half America’s suicides are by firearm, and the difference in rates between states, which range from 26 per 100,000 each year in Montana to five in Washington, DC, is largely explained by variations in levels of gun ownership.

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