Skip to main content
Springer Nature Link
Log in

Suicide rates in China from 2002 to 2011: an update

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purposes

The aims of this study were: (1) to present the time trend of suicide rate among people aged 15 or above in China over the period 2002–2011 and (2) to examine the current profile of completed suicides during 2009–2011.

Methods

Data on suicide rate in 2002–2011 were provided by the Chinese Ministry of Health (MOH). The trends of region-, gender-, and age-specific suicide rates were examined using Poisson regression models. The mean number of completed suicides for each cohort during 2009–2011 was calculated and a mean national suicide rate was estimated.

Findings

The overall suicide rate decreased significantly over the past decade, but rates in young males and rural older adults did not reduce and in fact increased among older adults in both urban and rural areas towards the end of the study period. For 2009–2011, 44 % of all suicides occurred among those aged 65 or above and 79 % among rural residents. The estimated mean national suicide rate was 9.8 per 100,000 and was slightly higher for males than females.

Conclusion

The benefits of economic growth, such as higher employment and more educational opportunities for the rural population in particular, may have contributed to the reduced suicide rate in China. However, the recent rapid changes in socioeconomic conditions could have increased stress levels and resulted in more suicides, especially among the elderly. Despite the significant reduction reported here, the latest figures suggest the declining trend is reversing. It will be important to continue monitoring the situation and to examine how urbanization and economic changes affect the well-being of 1.3 billion Chinese.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Varnik P (2012) Suicide in the world. Int J Environ Res Public Health 9(3):760–771

    Article  PubMed Central  PubMed  Google Scholar 

  2. Phillips MR, Liu H, Zhang Y (1999) Suicide and social change in China. Cul Med Psychiatry 23(1):25–50

    Article  CAS  Google Scholar 

  3. Phillips MR, Li X, Zhang Y (2002) Suicide rates in China, 1995–99. Lancet 359(9309):835–840

    Article  PubMed  Google Scholar 

  4. He ZX, Lester D (2002) Sex ratio in Chinese suicide. Percept Motor Skills 95(2):620

    Article  PubMed  Google Scholar 

  5. Ji J, Kleinman A, Becker AE (2001) Suicide in contemporary China: a review of China’s distinctive suicide demographics in their sociocultural context. Harv Rev Psychiatry 9(1):1–12

    Article  CAS  PubMed  Google Scholar 

  6. Qin P, Mortensen PB (2001) Specific characteristics of suicide in China. Acta Psychiatr Scand 103(2):117–121

    Article  CAS  PubMed  Google Scholar 

  7. Yip PS, Callanan C, Yuen HP (2000) Urban/rural and gender differentials in suicide rates: east and west. J Affect Disord 57(1–3):99–106

    Article  CAS  PubMed  Google Scholar 

  8. Yang GH, Phillips MR, Zhou MG, Wang LJ, Zhang YP et al (2005) Understanding the unique characteristics of suicide in China: national psychological autopsy study. Biomed Environ Sci 18(6):379–389

    PubMed  Google Scholar 

  9. Durkheim E (1952) Suicide: a study in sociology (initially published in 1897). Routledge and Kegan Paul Ltd, London

    Google Scholar 

  10. Perkins DH (2012) Rapid growth and changing economic structure: the expenditure side story and its implications for China. China Econ Rev 23(3):501–511

    Article  Google Scholar 

  11. Barboza D (2010) China passes Japan as second-largest economy. The New York Times

  12. Stack S (1993) The effect of modernization on suicide in Finland, 1800–1985. Soc Perspect 36(2):137–148

    Article  Google Scholar 

  13. Stack S (2000) Suicide: a 15-year review of the sociological literature part II: modernization and social integration perspectives. Suicide Life Threat Behav 30(2):163–176

    CAS  PubMed  Google Scholar 

  14. Steen DM, Mayer P (2004) Modernization and the male–female suicide ratio in India 1967–1997: divergence or convergence? Suicide Life Threat Behav 34(2):147–159

    Article  PubMed  Google Scholar 

  15. Lester BY (2001) Learnings from Durkheim and beyond: the economy and suicide. Suicide Life Threat Behav 31(1):15–31

    Article  CAS  PubMed  Google Scholar 

  16. Stack S (2000) Suicide: a 15-year review of the sociological literature. Part I: cultural and economic factors. Suicide Life Threat Behav 30(2):145–162

    CAS  PubMed  Google Scholar 

  17. Zhang J, Ma J, Jia C, Sun J, Guo X et al (2010) Economic growth and suicide rate changes: a case in China from 1982 to 2005. Eur Psychiatry 25(3):159–163

    Article  CAS  PubMed  Google Scholar 

  18. Ying YH, Chang K (2009) A study of suicide and socioeconomic factors. Suicide Life Threat Behav 39(2):214–226

    Article  PubMed  Google Scholar 

  19. Otsu A, Araki S, Sakai R, Yokoyama K, Scott Voorhees A (2004) Effects of urbanization, economic development, migration of workers on suicide mortality in Japan. Soc Sci Med 58(6):1137–1146

    Article  PubMed  Google Scholar 

  20. Chang SS, Gunnell D, Sterne JA, Lu TH, Cheng AT (2009) Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Soc Sci Med 68(7):1322–1331

    Article  PubMed  Google Scholar 

  21. Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M (2011) Effects of the 2008 recession on health: a first look at European data. Lancet 378(9786):124–125

    Article  PubMed  Google Scholar 

  22. Reeves A, Stuckler D, McKee M, Gunnell D, Chang SS et al (2012) Increase in state suicide rates in the USA during economic recession. Lancet 380(9856):1813–1814

    Article  PubMed  Google Scholar 

  23. Chang SS, Stuckler D, Yip P, Gunnell D (2013) Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ 17(347):f5239. doi:10.1136/bmj.f5239

    Article  Google Scholar 

  24. Moniruzzaman S, Andersson R (2008) Economic development as a determinant of injury mortality—a longitudinal approach. Soc Sci Med 66(8):1699–1708

    Article  PubMed  Google Scholar 

  25. Blasco-Fontecilla H, Perez-Rodriquez MM, Garcia-Nieto R, Fernandez-Navarro P, Galfalvy H et al (2012) Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study. BMJ Open 2(3). pii: e000785

  26. Yip PS, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social changes. Soc Psychiatry Psychiatr Epidemiol 40(10):792–798

    Article  PubMed  Google Scholar 

  27. Yang G, Hu J, Rao KQ, Ma J, Rao C et al (2005) Mortality registration and surveillance in China: history, current situation and challenges. Popul Health Metr 3(1):3

    Article  PubMed Central  PubMed  Google Scholar 

  28. McCullagh P, Nelder JA (1989) Generalized linear models (2nd). Chapman and Hall, London

    Book  Google Scholar 

  29. National Bureau of Statistics of China (2008) China’s Fifth National Census Results. http://www.stats.gov.cn/tjsj/pcsj/rkpc/dwcrkpc/. Accessed 21 Sept 2013

  30. National Bureau of Statistics of China (2012) China statistical yearbook 2011. China Statistics Press, Beijing

    Google Scholar 

  31. Sun J, Guo X, Zhang J, Jia C, Xu A (2013) Suicide rates in Shandong, China, 1991–2010: rapid decrease in rural rates and steady increase in male–female ratio. J Affect Disord 146(3):361–368

    Article  PubMed  Google Scholar 

  32. Chen YY, Wu KC, Yousuf S, Yip PS (2012) Suicide in Asia: opportunities and challenges. Epidemiol Rev 34(1):129–144

    Article  CAS  PubMed  Google Scholar 

  33. Titelman D, Oskarsson H, Wahlbeck K, Nordentoft M, Mehlum L et al (2013) Suicide mortality trends in the Nordic countries 1980–2009. Nord J Psychiatry (epub ahead of print)

  34. Salmerón D, Cirera L, Ballesta M, Navarro-Mateu F (2013) Time trends and geographical variations in mortality due to suicide and causes of undetermined intent in Spain, 1991–2008. J Public Health 35(2):237–245

    Article  Google Scholar 

  35. Knight J (2013) The economic causes and consequences of social instability in China. China Econ Rev 25:17–26

    Article  Google Scholar 

  36. Minzner C (2006) Social instability in China, causes, consequences, and implications. http://csis.org/files/media/csis/events/061205_mizner_abstract.pdf. Accessed 29 April 2013

  37. Rockett IR, Hobbs G, De Leo D, Stack S, Frost JL et al (2010) Suicide and unintentional poisoning mortality trends in the United States, 1987–2006: two unrelated phenomena? BMC Public Health 10:705

    Article  PubMed Central  PubMed  Google Scholar 

  38. Li X, Xiao Z, Xiao S (2009) Suicide among the elderly in mainland China. Psychogeriatrics 9(2):62–66

    Article  PubMed  Google Scholar 

  39. He ZX, Lester D (2001) Elderly suicide in China. Psychol Rep 89(3):675–676

    Article  CAS  PubMed  Google Scholar 

  40. Conwell Y, Duberstein PR, Caine ED (2002) Risk factors for suicide in later life. Biol Psychiatry 52(3):193–204

    Article  PubMed  Google Scholar 

  41. O’Connell H, Chin AV, Cunningham C, Lawlor BA (2004) Recent developments: suicide in older people. BMJ 329(7471):895–899

    Article  PubMed Central  PubMed  Google Scholar 

  42. Conwell Y, Van Orden K, Caine ED (2011) Suicide in older adults. Psychiatr Clin N Am 34(2):451–468

    Article  Google Scholar 

  43. Phillips MR, Yang G, Zhang Y, Wang L, Ji H et al (2002) Risk factor for suicide in China: a national case–control psychological autopsy study. Lancet 360(9347):1728–1736

    Article  PubMed  Google Scholar 

  44. Cheng AT (1995) Mental illness and suicide. A case-control study in east Taiwan. Arch Gen Psychiatry 52(7):594–603

    Article  CAS  PubMed  Google Scholar 

  45. Phillips MR, Cheng HG (2012) The changing global face of suicide. Lancet 379(9834):2318–2319

    Article  PubMed  Google Scholar 

  46. Sutherland D, Yao S (2011) Income inequality in China over 30 years of reforms. Camb J Reg Econ Soc 4(1):91–105

    Article  Google Scholar 

  47. Parmet S, Lynm C, Glass RM (2004) JAMA patient page. Suicide in older persons. JAMA 291(9):1158

    Article  CAS  PubMed  Google Scholar 

  48. Wanta BT, Schlotthauer AE, Guse CE, Hargarten SW (2009) The burden of suicide in Wisconsin’s older adult population. WMJ 108(2):87–93

    PubMed  Google Scholar 

  49. Chen W, Liu J (2009). Future population trends in China: 2005–2050. http://monash.edu.au/policy/ftp/workpapr/g-191.pdf. Accessed 30 Sept 2013

  50. Abas M, Crawford MJ (1999) A national target for reducing suicide. Suicide in older people must be reduced. BMJ 318(7177):191

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  51. Pritchard C (1996) Suicide in the People’s Republic of China categorized by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 93(5):362–367

    Article  CAS  PubMed  Google Scholar 

  52. He ZX, Lester D (1997) The gender difference in Chinese suicide rates. Arch Suicide Res 3(2):81–89

    Google Scholar 

  53. Shiang J, Barron S, Xiao SY, Blinn R, Tam WCC (1998) Suicide and gender in the People’s Republic of China, Taiwan, Hong Kong, and Chinese in the US. Transcult Psychiatry 35(2):235–251

    Article  Google Scholar 

  54. Zhang J, Jiang C, Jia S, Wieczorek WF (2002) An overview of suicide research in China. Arch Suicide Res 6(2):167–184

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  55. Canetto SS (2008) Women and suicidal behavior: a cultural analysis. Am J Orthopsychiatry 78(2):259–266

    Article  PubMed  Google Scholar 

  56. Weiyuan C (2009) Women and suicide in rural China. Bull World Health Org 87(12):888–889

    Article  PubMed  Google Scholar 

  57. Burnett J (2010) Women’s employment rights in China: creating harmony for women in the workforce. Ind J Global Legal Stud 17(2):289–318

    Article  Google Scholar 

  58. Cantor CH (2000) Suicide in the western world. In: Hawton K, van Heeringen K (eds) The international handbook of suicide and attempted suicide. John Wiley & Sons, Chichester, pp 9–28

  59. Gunnell D, Lopatatzidis A, Dorling D, Wehner H, Southall H et al (1999) Suicide and unemployment in young people—analysis of trends in England and Wales, 1921–1995. Br J Psychiatry 175:263–270

    Article  CAS  PubMed  Google Scholar 

  60. Gunnell D, Middleton N, Whitley E, Dorling D, Frankel S (2003) Why are suicide rates rising in young men but falling in the elderly?—a time-series analysis of trends in England and Wales 1950–1998. Soc Sci Med 57(4):595–611

    Article  PubMed  Google Scholar 

  61. Wu P, Li LP, Jin J, Yuan XH, Liu X et al (2012) Need for mental health services and service use among high school students in China. Psychiatr Ser 63(10):1026–1031

    Article  Google Scholar 

  62. Zhang J, Jia CX (2011) Suicidal intent among young suicides in rural China. Arch Suicide Res 15(2):127–139

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  63. Cash SJ, Bridge JA (2009) Epidemiology of youth suicide and suicidal behavior. Curr Opin Pediatr 21(5):613–619

    Article  PubMed Central  PubMed  Google Scholar 

  64. World Health Organization (2013). Counting the dead in China. http://www.who.int/bulletin/volumes/84/3/news30306/en/index.html. Accessed 03 July 2013

  65. Chinese CDC (2010) Chinese DSP system mortality data 2005. Jun Shi Yi Xue Chu Ban She, Beijing

    Google Scholar 

  66. Chinese CDC (2010) Chinese DSP system mortality data 2006. Jun Shi Yi Xue Chu Ban She, Beijing

    Google Scholar 

  67. Chinese CDC (2010) Chinese DSP system mortality data 2007. People’s Medical Publishing House, Beijing

    Google Scholar 

  68. Chinese CDC (2010) Chinese DSP system mortality data 2008. People’s Medical Publishing House, Beijing

    Google Scholar 

  69. Chinese CDC (2011) Chinese DSP system mortality data 2009 report (unpublished report). Chinese CDC

  70. Tian M, Zhang X (2011) The impact of the global economic slowdown on enterprises and employees in China. J Asian Public Policy 4(1):76–102

    Article  Google Scholar 

  71. Fernquist RM (2003) Perceived income inequality and suicide rates in Central/Eastern European countries and Western countries, 1990–1993. Death Stud 27(1):63–80

    Article  PubMed  Google Scholar 

  72. Stubbs B (2010) A replication of a cross-national study of the relationship between elderly suicide rates and urbanization. Psychogeriatrics 30:1–10

    Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Centre on Behavioral Health, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong, China

    Chong-Wen Wang

  2. Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China

    Cecilia L. W. Chan

  3. Centre for Suicide Research and Prevention, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong, China

    Paul S. F. Yip

Authors
  1. Chong-Wen Wang
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Cecilia L. W. Chan
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Paul S. F. Yip
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Chong-Wen Wang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, CW., Chan, C.L.W. & Yip, P.S.F. Suicide rates in China from 2002 to 2011: an update. Soc Psychiatry Psychiatr Epidemiol 49, 929–941 (2014). https://doi.org/10.1007/s00127-013-0789-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-013-0789-5

Keywords