Urban/rural and gender differentials in suicide rates: East and West

Abstract

Background: Many epidemiological studies indicate suicide rates are higher for males than females and for urban than rural. Here we re-examine gender, urban and rural differentials in suicide in Australia and Beijing (China). More specifically, to test the two hypotheses (i) that the male to female ratio is larger than one; (ii) that the urban suicide rate is higher than the rural in both places. Methods: Suicide data with information of gender, rural and urban regions for Australia and Beijing (China) for the period of 1991-1996 were used. Ratios between the gender-specific urban and rural suicides rates with the associated confidence intervals were constructed to examine gender, urban and rural differentials in Australia and Beijing. Results: The rural suicide rate in Beijing for both genders was higher than for their urban counterparts. Further, the elderly had the highest suicide rate followed by women aged 20-29. Also, the male to female ratio in China was less than one. In Australia, the rural male suicide rate was higher than the urban whereas the urban female suicide rate was higher than the rural. The male to female ratio was 4 to 1. The differences in rural to urban and male to female ratios between Australia and Beijing are statistically significant. Conclusions: In contrast to the west, male suicide rates are not higher than female rates in China. Urban rates are not necessarily higher than rural rates - not even in a western setting. Cultural factors and regional differences in socio-economic situation are significant in explaining the low gender ratio and the relatively higher suicide rates in rural China. Limitations: The suicide rate in the Beijing region might not exactly reflect the same for the whole of China. Copyright (C) 2000 Elsevier Science B.V.