Open Access
Highlights
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- We study the relation between suicide rates and Portuguese output.
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- Our dataset has more than a century where we analyze several economic, social and political events.
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- Suicide rates tend to severely increase during times of recessions.
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- In general, males are more sensitive to GDP fluctuations than females.
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- Males react more, on average, to war events.
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- Women are more affected by events related to social stability.
Abstract
Suicides
are a major concern for public health first and foremost because they
are an unavoidable cause of death. Moreover, they can be an indicator of
self-reported emotional satisfaction and a good marker of overall
well-being.
In this study we examine how different
economic and social aspects affected Portuguese suicide rates for more
than one hundred years (1910–2013). We place this exercise in the
specific historical context of the XX and early XXI century in Portugal,
emphasizing the role of economic recessions and expansions. Controlling
for aspects like wars, health care availability, political instability,
and demographic changes, we find a strong association between a decline
in the growth rate of real output and an increase in suicide rates for
the whole population. In this regard, while male suicide rates are
non-negligibly influenced by economic downturns, female suicide rates
are in general more responsive to a more open political and economic
environment. Our results are robust if we consider the mid-term cyclical
relationship.
Our findings advocate that, during
recessions, public health responses should be seen as a crucial
component of suicide prevention.
Keywords
- Suicide rates;
- Portugal;
- Mental health;
- Crisis;
- Austerity;
- Marriage
“The victim׳s acts which at first seem to express only his personal temperament are really the supplement and prolongation of a social condition which they express externally”Emile Durkheim
1. Introduction
The
relationship between suicidal behavior and the economic cycle is a
major question of debate among social scientists. While it is clear that
suicide is influenced by medical, psychological and cultural factors,
economic aspects may also play a role. Moreover, if they do, their
precise connection is complex. The World Health Organization (WHO)
defines suicide as “an act deliberately initiated and performed by a
person in the full knowledge or expectation of its fatal outcome”.
Already in 2009, the WHO forewarned its concern regarding the potential
impacts of the crisis on global suicide rates (WHO, 2009a and WHO, 2009b). In its first report exclusively dedicated to the theme (WHO, 2014),
the organization assures that “every 40 s a person dies by suicide
somewhere in the world” and that “for each adult who died of suicide
there may have been more than 20 others attempting”.
Several
researchers estimate that the Great Recession is associated with “at
least 10.000 additional economic suicides between 2008 and 2010” in
North America and Europe (Chang et al., 2013 and Stuckler et al., 2014).
The widespread concern that periods of economic downturn adversely
affect health outcomes was however challenged by a series of influential
papers by Ruhm (2000, 2003, 2005), Neumayer (2004) and Granados, 2005 and Granados, 2008, who concluded that recessions tend to lower mortality rates.
In
this paper we assess how the economic cycle distressed the suicide rate
in Portugal, using a long term approach and taking into consideration
well-known variables in the literature as well as the specific
historical background. We hope that using a sufficiently long economic
time series will help us unveil the liaison between the two mentioned
phenomena and constitute a rich source for relevant theoretical work and
policy prevention. By using the Gross Domestic Product (GDP) growth and
the GDP transformed by the Hodrick–Prescott filter, we are able to
contrast the effects of short-run and cyclical economic fluctuations in
suicide rates.
Fig. 1 covers the evolution of suicide rates and GDP growth rates in Portugal for more than one century long.
- Fig. 1.Suicide and GDP growth rates in Portugal (1910–2013). (Source: own construction, data from INE and Banco de Portugal).
During
this period, the country participated in two wars – the World War I and
the Portuguese Colonial War (1961–1974) – was ruled under three
political regimes – the First Republic (1910–1926), a right-wing
Dictatorship (1926–1974), and a period of Democracy (1975–2013) – and
underwent a series of profound economic and social transitions. Portugal
remained centered on agriculture until late in the 20th century,
suffering with high levels of financial volatility, poverty, and
illiteracy (68.1% of the Portuguese population was still classified as
illiterate in the 1930 census). These coincide with a period of high
volatility in GDP growth, as can be seen from the dashed line in the
picture above.
