Societal Integration and Age-Standardized Suicide Rates in 21 Developed Countries, 1955–1989

SOCIAL SCIENCE RESEARCH ARTICLE NO.

27, 109–127 (1998)

S0980615

Societal Integration and Age-Standardized Suicide Rates in 21 Developed Countries, 1955–1989 Robert M. Fernquist Central Missouri State University, Warrensburg

and Phillips Cutright Indiana University, Bloomington Gender-specific age-standardized suicide rates for 21 developed countries over seven 5-year periods (1955–59 . . . 1985–89) form the two dependent variables. Durkheim’s theory of societal integration is the framework used to generate the independent variables, although several recent theories are also examined. The results from a MGLS multiple regression analysis of both male and female rates provide overwhelming support for a multidimensional theory of societal integration and suicide, as first suggested by Durkheim. r 1998 Academic Press

Both Morselli (1882) and Durkheim (1897/1951) argued that suicide is largely a social phenomenon because the rates varied greatly from one geographic area to another. Although their research was conducted about a century ago, their conclusions may still be valid today. For example, the mean 1955–89 suicide rate of males in Finland is more than seven times that of males in Greece, while the suicide rate of women in Denmark is nearly seven times that of women in Ireland.1 The explanation of these national differences should be mostly sociological because nonsociological phenomena, such as rates of mental illness or suicide-prone personality types, seem unlikely causes of such large differences in

We are grateful for the generous support of Indiana University, Bloomington, Montana State University, and Ferrum College. We thank Professors Erdman Palmore and Whitney Pope for helpful comments, Carl M. Briggs for invaluable consultation on statistical matters, and Alex Durig, Melissa Milkie, Katie Rosier, and Diane Schaefer for research assistance. We also appreciate the valuable criticisms of both anonymous referees. Address reprint requests to Dr. Phillips Cutright, Rte. 1, Box 243C, Saluda, NC 28773. 1 World Health Organization (1956–1992). See Table 1 below. 109 0049-089X/98 $25.00 Copyright r 1998 by Academic Press All rights of reproduction in any form reserved.

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suicide rates among populations. For discussion, see Durkheim (1951, Book I) and Gibbs (1966, p. 282–288). Although there is no shortage of studies of national suicide rates (see below for a review), there are fundamental problems with most earlier studies. For example, most use only crude suicide rates which control neither national differences in age structure nor sex ratios—two important structural factors in suicide. Indeed, Lester (1992a, p. 310) recommends using age-adjusted gender-specific suicide rates to arrive at a better understanding of how social structures influence male and female suicide rates. Further, most comparative studies ignore the likely impact of multiple structural variables and they usually compare rates between or among countries at only one point in time. Durkheim (1951, Book II), Danigelis and Pope (1979, p. 1085), Stack (1987a, pp. 145–147), and Wasserman (1984, p. 854; 1987, p. 192) all argue that longitudinal, crossnational research is needed to more fully understand levels and trends in suicide rates. To meet these methodological criticisms, we develop age-standardized gender-specific suicide rates from 21 developed countries2 from 1955 through 1989. Our goal is to test Durkheim’s and more recent theories and hypotheses regarding the effect of macro-level social, economic, and cultural structures on male and female age-standardized suicide rates. THEORETICAL AND EMPIRICAL BACKGROUND Durkheim’s Theory of Societal Integration 3 Durkheim’s work on suicide has been called ‘‘the most famous study of suicide’’ (Danigelis, Pope, and Stack, 1987, p. 7), even though Durkheim was not the first to argue that suicide rates are influenced by social factors (see Masaryk, 1881/1970; Morselli, 1882). Durkheim (1951, pp. 208–216) argued that there is a positive relationship between egoism (e.g., when individuals lose connections with society) and suicide. Further, anomic suicide occurs when society loses the power to control the individual. Pope (1976, pp. 42–60) argues that egoism and anomie are the same phenomenon and Durkheim himself says (p. 288) that egoism and anomie are often ‘‘merely two different aspects of one social state.’’ His theory of altruism (pp. 217–240) claims that too much integration will also increase suicide since overly integrated persons are ‘‘always ready to give (their) life’’ (p. 240). Theoretically, then, the relationship between social integration and suicide could be curvilinear. But the proportion of suicides that can be classified as altruistic must be quite small in developed countries and our linear models are unlikely to 2 The countries are: Australia, Austria, Belgium, Canada, Denmark, England and Wales, Finland, France, West Germany, Greece, Ireland, Italy, Japan, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, and the United States. 3 The term, societal integration, includes types of integration not covered by the narrower concept of social integration, e.g., economic, religious, and educational integration. The term, social integration, best fits Durkheim’s concept of domestic integration.

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misspecify the relationship of structural indicators of societal integration and national suicide rates.4 The concept of societal integration encompasses several different components. Each is discussed below. Religious integration. Durkheim reports that Catholics, who stress communal aspects of religiosity, have lower suicide rates than Protestants, who stress individuality in seeking salvation (1951, pp. 157–160). Furthermore, Durkheim (p. 155) reports that Jews have lower rates than Protestants and, ‘‘to a lesser degree, lower than . . . Catholics.’’ Durkheim’s assertion that religion serves to help persons become more integrated with society (1951, p. 170) has been supported elsewhere (Masaryk, 1970, Ch. 6; Morselli, 1882, p. 126; Stack, 1983a, pp. 368–370, 1983b, pp. 246–247; 1985, pp. 440–441). Also, recent research finds that the production of religious books per capita (Wuthnow, 1977, pp. 92–93) is a more accurate way of studying national differences in religiosity than simply classifying populations as Catholic or Protestant. This view is supported by Stack (1983a, p. 368; 1992a, p. 640) who reports an inverse association between national suicide rates and religious book production. Domestic integration. Durkheim writes that ‘‘as suicides diminish, family density regularly increases’’ (1951, p. 199) and ‘‘suicide (in France) . . . increased . . . (while) the birthrate . . . decreased’’ in the late 1880s (p. 200). This is because the state of integration of a social aggregate can only reflect the intensity of the collective life circulating in it. It is more unified and powerful the more active and constant is the intercourse among its members. . . . Just as the family is a powerful safeguard against suicide, so the more strongly it is constituted the greater its protection. (p. 202)

Recent research also reports that the presence of children is associated with lower suicide rates for both men and women (Veevers, 1973, pp. 139–141; Danigelis and Pope, 1979, p. 1094). Danigelis and Pope (1979, pp. 1097–1098) also suggest that ‘‘the presence of children protects women better than men’’ since mothers generally interact with their children more than fathers. This is a testable hypothesis. Durkheim (1951, pp. 259–262) also writes that the divorce rate is positively related to the suicide rate (pp. 259–262) because divorce produces an ‘‘unstable equilibrium’’ (p. 261) in the lives of divorced persons and eliminates an important agent of social regulation (i.e., marriage) in their lives (pp. 270–271). Durkheim classifies divorce as a form of chronic domestic anomie because ‘‘wherever there are many . . . divorces there must be many households more or less close to divorce’’ (p. 263). Whereas marriage serves to regulate the passions, divorce contributes no such regulation, and suicide rates increase (p. 271). Current research finds that divorce rates are positively related with male and female suicide rates (Trovato, 1987, p. 198; Stack, 1992a, p. 640; 1989). Female labor force participation can also be used as an indicator of domestic

4

In fact, tests for heteroscedasticity found little evidence of curvilinearity.

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integration.5 In some studies, it is positively related to suicide (Stack, 1987b, p. 268; 1985, p. 438; 1980b, p. 255), while Breault (1986, p. 643) reports no significant association among U.S. counties. Trovato (1987, p. 198) and Stack (1987b, p. 270) time-series analyses both report a positive association of female labor force participation and male suicide rates. But neither author found the labor force variable to be related to female suicide. We expect higher levels of female labor force to be related to a decline in domestic integration and an effect on both male and female rates. Although the measure has been criticized (Stack, 1978, p. 648), the United Nations (1962, p. 7) concluded that the measure is consistent over time and across the developed countries. Economic integration. Durkheim (1951, pp. 241–254) also hypothesized that abrupt changes in economic conditions, whether fortunate or unfortunate, yield anomic conditions. He (pp. 241–244) reports that economic crises, such as stock market crashes or rapid increases in private wealth, are both associated with higher suicide rates. These abrupt changes decrease social regulation over the individual for a time because the individual’s social equilibrium is disturbed. However, Pope (1976, pp. 122–123) disputes Durkheim’s interpretation of these data. Durkheim’s belief in the power of economic events to influence short-run levels of suicide has been supported by contemporary research. For example, Pierce (1967, p. 462) reports that both fortunate and unfortunate crises are related to higher suicide rates, while Araki and Murata (1987, p. 69) find that ‘‘Suicide . . . rates . . . decrease . . . during periods of economic prosperity and increase . . . during periods preceding economic crises.’’ And Stack (1978, p. 650; 1980a, p. 144) finds that economic growth and suicide rates are positively related. We are unable to test the effects of short-run economic events on suicide because our suicide rates are 5-year averages. Our indicator of economic integration is the Gini index of income inequality. Although Unnithan, Huff-Corzine, Corzine, and Whitt, (1994, pp. 130–131) report that income inequality is inversely related to suicide in 88 countries, we assume that high levels of income inequality in our set of developed nations should result in greater anomie because the prevailing ideology of equality is violated and because the sense of failure to achieve economic success may also be heightened. We expect that high levels of income inequality will have greater impact on males than females, although we would also expect that with higher levels of female labor force participation and declining marriage that inequality will take its toll on women in future years. Hoover (1989) has devoted a good deal of effort to increasing comparability among nations. The data apply to only one year, measured sometime between 1965 and the early 1970s. Because this single year Gini is applied to all periods, regression coefficients should be depressed. Levels of income inequality are 5 Gove and Hughes’ (1980, p. 1169) study of 389 American cities circa 1970 found that the percentage of the population living alone was positively related to suicide rates. They argue (p. 1173) that although ‘‘. . . people who live alone are typically not completely isolated . . . ,’’ they lack both the quantity and quality of relationships that persons living with others have, and thus are comparatively isolated.

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resistant to change over the short run, but can trend up and down. In fact, the zero order correlation of male suicide and income inequality is around .15 from 1955 through 1970. The correlation declines to about .08 from 1970–1984 and then drops to .02 in 1985–89. This pattern of decline is almost identical to the trend between homicide and the same measure of inequality—see Cutright and Briggs (1995, p. 240). Educational integration. Durkheim (1951, pp. 162–168) argued that education is positively related to suicide because education ‘‘weaken(s) . . . traditional beliefs and . . . (encourages a) state of moral individualism’’ (p. 168). However, the populations in this study achieved nearly universal literacy by midcentury and variation in this measure of education is minor. And expecting that a measure such as the percentage of adults with some college-level experience to be positively related to modern suicide rates does not seem to be a reasonable test of Durkheim’s concept. On the other hand, the idea that women’s educational status and social integration will be positively related to their degree of educational equality with men does seem reasonable. Our measure of educational equality is the ratio of female to male enrollment in tertiary-level institutions. Since the effect of this variable may take time to have its expected impact, 10-year lags are used. We expect that the higher the proportion of female to male enrollment, the lower will be the female suicide rate. It seems clear, as Pope (1976, pp. 77, 92, 100) concludes, that Durkheim’s theory of integration deserves further testing. And because other theories of suicide (discussed below) have arisen, it is useful to not only build upon the work of Durkheim, but to test the more recent theories as well. Status integration theory. Gibbs and Martin (1964, p. 27) hypothesize that as role conflict within status configurations decreases, suicide rates will decline because persons in the given status configuration(s) will increasingly share common norms and expectations. For example, if all (or most) construction workers aged 25–54 are white, have a common religion, and are married, the suicide rates for these 25- to 54-year-old males would be lower than if they were in a more heterogeneous configuration. Gibbs and Martin report that ‘‘occupational integration and marital integration tend to vary inversely with suicide rates’’ in the United States (p. 127). Furthermore, they report that marital status integration also varies inversely with suicide rates in some other developed countries (pp. 127–132). Subsequent works by Gibbs (1969, p. 532; 1982, p. 236), Gibbs and Martin (1966, p. 539), and Davis (1981, pp. 117–118) support status integration theory, but Chambliss and Steele (1968, pp. 528–529) do not. More recent work by Stafford and Gibbs (1985, p. 657) found that 1970 occupational status integration had stronger correlations with suicide than did marital status integration. While Gibbs and Martin (1981, p. 819) report that marital status integration was inversely related to white female suicide rates in 1969–71, Stafford and Gibbs (1988, p. 1077) state that marital status integration does not

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explain significant variation in suicide among a number of male and female age-specific groups in the United States. Modernization theory. Early writers argued that, as societies modernize, suicide rates increase because industrial relations become freed from social regulation (Durkheim, 1951, p. 254–255; Morselli, 1882, pp. 130–142). And Halbwachs (1978) has argued that since the ‘‘way of life’’ is drastically different in urban compared to rural areas, suicide rates are generally higher in urban areas. Current research on the relationship between modernization and suicide rates has yielded conflicting results. Using education, industrialization, and urbanization as indicators of modernization, Danigelis et al., (1987, p. 26) report that ‘‘the widely accepted generalization that modernization increases suicide is empirically untenable’’ because modernization is positively associated with suicide rates in fewer than half the countries they examine. Others, however, find that industrialization is associated with increased suicide rates (Miley and Micklin, 1972, pp. 670–671; Stack, 1978, p. 650). However, both of the studies reporting modernization effects included both less and more developed nations in the same analysis. Our sample excludes less developed nations, thus limiting variation in measures of modernization. Lagged Errors of Prediction The twin problems of measurement and specification error are potential pitfalls that haunt crossnational analyses. Cutright and Briggs (1995, p. 222) explain that the lagged errors of prediction help correct probable errors due to national differences in measurement of independent variables. This lagged error term also partially controls unmeasured variables not included in the prediction equation and thus reduces the risk of specification error. To control measurement and specification error, we include the lagged errors of prediction for each country and time period.6 For example, the equation for 1960–64 male suicide includes the errors of prediction (actual minus predicted suicide rate) from the equation predicting 1955–59 male suicide rates. A similar process results in lagged errors for all periods except the first. Therefore, the number of observations is 21 3 6 5 126. Methodological Innovations This research adds to existing knowledge in the sociology of suicide in four ways. First, Stack (1987a, p. 144) notes that there is a need for comparative work to better understand suicide. Our research uses time-series cross-sectional data 6 Without error, explained variance would be about 1.00. Our levels of explained variance are well below this level—see Table 2, columns 1 and 5. Some error is random, but that portion of the error of prediction should be small given our use of 5-year averages. Therefore, a large portion of the errors of prediction must be due to specification and measurement errors. We know that we do not have measures of all relevant causes of suicide and we suspect that the same variable is not measured in exactly the same way by all countries in all years.

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from 21 developed countries. No study to date has examined age-standardized suicide rates on a cross-national, longitudinal scale. Second, since agestandardized gender-specific suicide rates of persons 15 years and older are used, this allows comparisons of the impact of identical measures of societal integration on male and female suicide rates. Third, multiple indicators of societal integration are studied. This yields the most comprehensive multivariate analysis of crossnational suicide rates to date. Fourth, by partially controlling measurement and specification error, the credibility of our modified generalized least squares (MGLS) estimates of the impact of the predictors on male and female rates should be enhanced. DATA AND METHODS Dependent Variables Age-standardized suicide rates were obtained from age–gender-specific suicide rates of persons aged 15–24, 25–34 . . . , 75 and older (World Health Organization, 1956–1992). The World Health Organization is the only worldwide source of annual age–sex specific suicide rates. Using standardization techniques described by Newell (1988, pp. 66–67) and Shryock and Siegel (1976, Ch. 8), a genderspecific age-standardized suicide rate is calculated. The 1971 adult population of England and Wales (see Appendix A) was chosen as the ‘‘standard population.’’ Then each sex age-specific suicide rate was multiplied by the proportion of the population in the same age group, and these products were summed. The standardized rates control national differences in age structure; gender-specific rates control national differences in sex ratios. To increase the reliability of age-standardized rates, they are averaged over a 5-year period (Gartner 1990, p. 100; Cutright and Briggs, 1995, p. 239). Therefore, the dependent variable is an average of the male and female age-standardized rates for the years 1955–1959, 1960–1964 . . . , 1985–1989. Independent Variables As with the dependent variable, independent variables are averaged over 5-year periods—with the exception of income inequality. Domestic integration is measured with three indicators. The divorce rate is the number of divorces per 10,000 males aged 15–64 and it should be positively related to suicide rates. Fertility is the child–woman ratio, which is the number of children per 1000 women aged 15–49 who have children under age 5 and it should be negatively related to suicide rates. This child–woman ratio is age-standardized using the techniques described above. One aspect of fertility that needs to be considered is that of lags, since the childbearing ages of women aged 65–74, for example, have long since passed. Therefore, these fertility rates are lagged by 10 years for women aged 35–44, by 20 years for women 45–54, etc. Data for divorce and fertility are from the United Nations (1950–1992). The third domestic integration proxy is the

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percentage of the labor force that is female (International Labor Office, 1956– 1991; World Bank, 1984; 1988–1989). This predictor should be positively related to suicide rates. Religious book production, our indicator of religious integration, is measured as the annual percentage of all books published that are religious in nature and is expected to take a negative relationship with suicide rates. Data are from UNESCO (1963–1991) and the United Nations (1956–1963). Economic integration is measured with the Gini coefficient for income inequality measured around 1970 (Hoover, 1989) and is expected to increase male suicide rates. No time series data for these Gini coefficients are available, although we know that inequality varies over time. The absence of longitudinal data may suppress the expected effect of inequality on male suicide rates. Educational integration is measured with the ratio of female to male students enrolled in tertiary educational institutions and it should be negatively related to female suicide rates. Data are from UNESCO (1963–1991) and are lagged 10 years behind suicide rates. Our aggregate-level data for status integration only permits examination of marital status by age and sex. Gibbs and Martin (1964, p. 50) encountered similar data problems in their tests of status integration.7 Despite our doubts about the effect of higher levels of modernization on suicide rates in this set of developed countries after the 1950s, we measured modernization with two variables: The number of telephones per 100 population and the number of students enrolled in tertiary-level education per 100,000 inhabitants. Both variables loaded heavily on a single factor and the factor score was our proxy for modernization. Data on telephones and education come from the United Nations (1956–1963) and UNESCO (1963–1991). Finally, our measure to partially correct measurement and specification error is the ordinary least squares (OLS) lagged errors of prediction specific to each gender. Thus, the errors of prediction of 1955–59 male suicide rates become the lagged errors of prediction that are applied to 1960–64 male rates. A similar procedure is applied using the 1955–59 female errors of prediction with the 1960–64 female rates. Lagged errors for 1960–64 are applied to 1965–69 rates, and so on through successive periods. Statistical Procedures To reduce problems of collinearity, we used the residualization techniques described by Cutright and Briggs (1995, p. 230). If any societal integration variables shared a correlation of .40 or higher, they were residualized. (See Appendix B for intercorrelations after residualization.) For example, because divorce, fertility, and religious book production are highly correlated, we re7 For type III integration, Gibbs and Martin (1964, pp. 40–41) differentiate between a total measure of status integration for the entire society and a weighted total measure. We will only use the weighted total measure of status integration.

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gressed divorce on the two other variables and used the residual from this regression as the residualized measure of divorce. Female labor force participation was regressed on lagged female/male enrollment, divorce, religious books, and fertility, and the female labor force errors of prediction form the residualized measure of female labor force participation. All 21 3 7 5 147 observations were used to residualize divorce and female labor force participation. MGLS is used in these analyses because MGLS is appropriate for a pooled cross-sectional time series research design (SAS, 1993, p. 179). MGLS estimation involves a weighted transformation of the dependent variable which corrects for both cross-sectional heteroscedasticity and first-order autocorrelation. The traditional R2 with OLS techniques is not a valid indicator of explained variance when MGLS techniques are employed (Greene, 1990, p. 386), and so an alternative measure of explained variance (Buse R2) is employed, as described by Judge, Griffiths, Hill, Lutkepohl, and Lee (1985, Ch. 12). RESULTS Table 1 orders nations from the highest to lowest male suicide rates. We have noted the huge national difference in these rates, both male and female. Although the mean male rate is 2.37 times the mean female rate, this ratio varies from a low of 1.43 in Japan and 1.54 in the Netherlands to a high of 4.05 and 3.57 in Finland and Portugal, respectively. Still, the five highest female rates are all larger than any male rates in the six countries with the lowest male rates.8 Mean male and female suicide rates do not appear to vary much from period to period. For example, male rates average 26.6 in the first period, drop to around 25 in the next three periods, rise to 26 in the fifth period, and increase again to 28.2 in the last two periods. While the mean rates for all 21 nations seem to vary little from period to period, the 1.6 point decline from 1955–59 to 1960–64 is almost entirely the result of a record high 13.7 point decline in male Japanese rates and a drop of 6.7 points in Denmark and Switzerland. Over the last several periods, male rates increased by as many as 5 to 10 points in Belgium, Canada, France, Ireland, New Zealand, and Norway, while male rates declined after 1965 in W. Germany, Portugal, and Sweden. U.S. male rates vary by no more than 1 point from period to period. There are distinct trends in the various predictors. For example, between 1955–59 and 1985–89, religious book production declined steadily from 7.1 to 3.8. For the same years, mean fertility also declined from 382 to 305. The proportion female to male enrollment increased from .22 to .39, female labor force participation went from 28 to 37, and divorce rates jumped from 22 to 57. A theoretical explanation of these trends by Davis (1984) is discussed below. Means, standard deviations, and zero-order correlations are reported in Appen-

8 See Travis (1990) for single-year data on gender differences in age-standardized suicide in 42 more and less developed nations. He found higher female than male rates only in Kuwait in 1987.

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FERNQUIST AND CUTRIGHT TABLE 1 Mean Age-Standardized Suicide Rates, by Gender: 1955–1989 Gender Nation

Male

Female

Finland Austria Switzerland Denmark W. Germany Sweden France Japan Belgium Australia U.S.A. Canada Portugal New Zealand Norway England/Wales Netherlands Italy Spain Ireland Greece Mean Standard Deviation

52.2 45.9 40.3 40.0 35.1 35.1 34.4 32.4 31.0 24.9 24.8 23.9 21.8 20.9 20.1 15.5 14.8 12.4 11.1 9.2 6.7 26.31 12.71

12.9 18.0 15.6 22.3 16.7 13.5 12.6 22.7 14.4 10.3 7.9 7.7 6.1 9.2 6.7 9.2 9.6 5.1 3.9 3.4 2.9 10.97 5.99

Source: World Health Organization (1962– 1992).

dix Table B. Under multivariate analysis, neither the Gibbs and Martin marital status integration measure nor the modernization factor scores had a significant effect on suicide rates. Therefore, we reject marital status integration and modernization theories as having a discernible impact, net of our measures of societal integration, on suicide rates in this set of nations over 1955–1989. Table 2 displays the metric and standardized (b) regression coefficients from the trimmed models that take 1960–65 through 1985–89 suicide rates as the dependent variable.9 N equals 126 in all eight equations.10 The equations for each 9 For regression models in Table 2, we examined variance inflation factors (VIFs). Neter et al. (1990, p. 409) say that a ‘‘value in excess of 10 is . . . taken as an indication that multicollinearity’’ is problematic. Stack (1992b, p. 330) says that a value over 5 is cause for concern. All variance inflation factors in these models are below 5. 10 We used SHAZAM—version 7. The ‘‘same estimated rho for all cross-sections’’ coefficients are in the bottom row of Table 2. Including the lagged error term results in a significantly lower (by t test) rho in both male and female equations.

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TABLE 2 MGLS Estimates of Trimmed Models of 1960–89 Male and Female Age-Standardized Suicide Rates with a Proxy for Measurement Error: 21 Developed Countries, N 5 126 Gender Male Independent variables Residual female labor force Fertility Residual divorce Religious books Income inequality Lag F/M enrollment Lagged errors of prediction Constant Buse R2 Est. pooled rho

Metric (1)

Beta (2)

Metric (3)

Female Beta (4)

Metric (5)

Beta (6)

Metric (7)

Beta (8)

.718 .24** 1.424 .47** .499 .36** .615 .44** 2.063 2.30** 2.084 2.40** 2.035 2.37** 2.042 2.43** .043 .09* .095 .20** .033 .15* .029 .13** 2.412 2.10** 2.607 2.15** 2.392 2.20** 2.501 2.26** 32.01 .12 22.25 2.01 – – – – – – – – 2.141 2.21** 2.169 2.25** – – .890 .61** – – .748 .44** 38.05 59.10 30.14 33.02 .60 .94 .68 .86 .90 .24 .83 .15

* p $ .01; ** p $ .001.

gender begin with the trimmed model that uses residual female labor force, fertility, residual divorce, and religious books. Income equality is added to the male equation and female/male enrollment is the fifth predictor for females. Metric (or unstandardized) regression coefficients measure the effect a change of 1.0 in the independent variable has on the suicide rate. For example, in column 1, we find that a change of 1.0 in residual female labor force participation will increase the male suicide rate by 0.718, net of other variables. Because the mean male and female rates are so different, and because the meaning of a change of 1.0 varies so drastically among the independent variables, we focus our attention on the b coefficients. In general, the larger the standardized regression coefficient, the more important is the predictor (Hargens, 1976). We order the independent variables in Table 2 by the rank order of the b coefficients in column 4. This rank order is generally maintained in the remaining seven equations, indicating a high level of stability in both male and female equations. The data for males in columns 1 and 2 provide strong support for Durkheim’s societal integration theory, although the income inequality measure is not statistically significant. The same may be said of the results for females in columns 5 and 6. The addition of the female/male enrollment measure does exert a negative and significant effect on female suicide rates. While all of the first four indicators of societal integration are significant for both males and females, the female labor force and fertility b coefficients are about twice the size of the divorce and religious book bs. For males, the addition of the lagged errors of prediction (columns 3 and 4) boosts Buse R2 34 points, increases the size of the significant male metric and b

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coefficients, but does not alter the significance or sign of the coefficients. The addition of the lagged errors of prediction (columns 7 and 8) to the female equation increases explained variance by 18 points. The female b coefficients for the five societal integration measures are virtually unchanged. Introducing the lagged errors of prediction results in a larger gain in explained variance for males than females, and the larger male b coefficient for the lagged error measure also suggests that specification errors are more important to understanding male than female suicide rates.11 THEORETICAL IMPLICATIONS What explains variation in suicide rates? Based on these cross-national analyses, the concept of overwhelming importance is Durkheim’s generalized concept of societal integration—with domestic integration variables being the most important, followed by religious integration. Economic integration was not significant in male (or female) equations, but greater educational integration of women significantly reduced their suicide rates. We consider the lagged errors to be a statistical control variable of unknown empirical content. Davis (1984, pp. 401–405) argues that the decline of the ‘‘breadwinner’’ family system (in which the husband worked in paid employment outside the home and the wife was the homemaker) has, in most developed nations, been giving way to the ‘‘egalitarian’’ family system during this century. This shift has proceeded more rapidly in some countries than in others. Whereas the husband was previously viewed as the dominant figure in the home, both in terms of family matters and economics, male and female roles are undergoing drastic change. While women have been accorded more power in the workforce and in the home, men have lost power in these same areas. This shift in societal roles over the past several decades has been accompanied by increasing female labor force participation, declining fertility, increasing divorce, a decline in marriage rates, and increases in single parent families and single adult households. In Durkheimian terms, this shift in roles should reduce domestic integration—a change that affects both men and women. We now discuss each indicator of domestic integration. Divorce rates are positively related to age-standardized suicide for both sexes. Although the social stigma on being divorced has been in decline in many populations and divorce is more accepted today (Glendon 1987, pp. 63–64), divorce weakens domestic integration because divorced persons feel they have failed at something in which they have invested a lot of time and energy. Furthermore, divorced persons may experience severe depression due to interpersonal losses (Wallerstein and Kelly,

11 An anonymous referee has noted that ‘‘. . . the estimates of the regression coefficients in models containing the lagged prediction errors may be somewhat biased. . . .’’ However, the general conclusions about the relative importance of the six societal integration predictors are about the same with or without the lagged errors.

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1980, pp. 155–156) as well as ‘‘shifts in social interactional patterns’’ (Wasserman 1984, p. 856). These psychological and social changes would weaken domestic integration since there are fewer persons in the household with whom individuals can develop close social bonds. Also, a population with high divorce rates may also present a generalized feeling of impermanence to marriage that weakens social ties between husbands and wives. And the prospect of likely divorce may also depress marriage rates. Increases in female labor force participation may decrease social integration for males if they feel they are losing power in their families, that their wives are becoming too independent and are financially able to leave an unhappy marriage. Husbands of working wives may also think that their wives do not have enough time to be ‘‘their counselors, comforting them from the vicissitudes of life,’’ and that they (husbands) have less leisure time because of increased time they must now spend in household and childrearing activities (Stack, 1987b, p. 272). Female labor force participation increases gender competition in the job market—both in getting and retaining a job. This, too, could cause stress among men in all marital statuses. For females, stress from working is not only related to employment but with what Hochschild calls the ‘‘Second Shift.’’ She explains (Hochschild and Machung, 1990, pp. 6–10) that, after working, women (especially mothers) come home to another full-time job. Hochschild writes that while wives appreciate the work their husbands do inside and outside the home, husbands are less appreciative of the work their wives do inside the home because they expect their wives to do this work (1990, pp. 37–58). As ‘‘women (today) differ more from their mothers than men differ from their fathers’’ in terms of attitudes toward gender roles, there is ‘‘a broad . . . social tension’’ between the sexes (1990, p. 205) in all marital statuses. Furthermore, women all over the world work longer hours than men because‘‘ . . . family responsibilities to household and children are not equally shared by fathers’’ (Scarr, Phillips, and McCartney 1989, p. 1402). The positive association of female labor force participation with the suicide rates of the elderly (Fernquist, 1996, Table 11) may, in part, be due to the effect that female labor force participation may have on the frequency of contact between children and their elderly parents. Female participation (past and present) may also allow more elderly men and women to live alone, instead of with children or other relatives. Both these possibilities would reduce the domestic integration of older persons and increase their rates of suicide. Age-standardized fertility rates are inversely related to age-standardized suicide rates for both sexes. This supports Durkheim’s assertion that larger family size is inversely related to suicide (1951, pp. 197–199). The more interactions individuals have in the home, the lower the suicide rate should be because these frequent interactions increase domestic integration. The belief of Durkheim (1951, p. 189) and Danigelis and Pope (1979, pp. 1098–1098) that large family size increases domestic integration more for women than for men was not

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supported in these analyses since the standardized coefficient of fertility for females is not significantly larger than the male coefficient. Religious book production, our measure of religious integration, is inversely related to suicide rates. Durkheim (1915/1961, pp. 464–465) says that religion provides a sense of community because people act together: . . . society cannot make its influence felt unless it is in action, and it is not in action unless the individuals who compose it are assembled together and act in common (1961, p. 465).

Maris (1981, p. 255) writes that religion does more than just integrate people with society; it also teaches ‘‘certain concepts of death that may make it easier . . . to tolerate adverse life conditions.’’ When problems arise, religious persons look past this life to the afterlife for comfort. Since the teaching ‘‘Thou shalt not kill’’ is common throughout religious circles, suicide violates this commandment ‘‘and would result in eternal punishment in the hereafter. . . .’’ (Maris, 1981, p. 255). Thus, certain religious beliefs, as well as religious integration, may play a role in lowering suicide rates.12 CONCLUSION This work adds to Durkheim, as well as recent research by Trovato (1987), Lester (1988), and Stack (1991, 1992a, 1992b), in that: (1) measurements of suicide have been refined by separating suicide by gender and by using agestandardized suicide rates; (2) the number of independent variables examined simultaneously is greater than in earlier studies; (3) these analyses were restricted to developed nations with reliable measures of the independent and dependent variables; (4) this is the first MGLS analysis applied to cross-national suicide time series data; (5) Durkheim’s theory of domestic and religious integration was supported. Our test of the impact of economic integration on males found no support, while the role of educational integration in reducing female suicide was confirmed; (6) alternative theories of status integration and modernization were not supported; and (7) the lagged errors of prediction sharply boosted R2 of both males and females. Including the lagged errors boosted the impact of divorce on male suicide, but did little to alter our estimates of the relative impact of the remaining predictors. These findings strongly support Durkheim’s theory of suicide and should serve as a guide for future research. However, we need to build upon Durkheim’s theory of societal integration by including theoretically relevant variables that may

12 The religiosity structural effect may interact with the ‘‘culture of suicide’’—see discussion of this concept in the Conclusion. For example, in a population high on religiosity, both the religious and the irreligious will respond to cultural norms condemning suicide. In less religious populations, both the religious and the irreligious will less likely conform with antisuicide norms. For empirical analysis of the structural effect of high vs low community religiosity on youthful deviance, see Stark (1994, pp. 98–102).

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reduce specification errors. Such a measure is the culture of suicide. The theoretical argument behind the idea that a culture of suicide exists is that societies differ in the extent to which the normative order condemns or condones self-destruction. Lester (1987, p. 317) writes that shared values and attitudes ‘‘may be related to suicide due to a rejection of a normative order that condemns suicide.’’ Even Durkheim admits that ‘‘society (cannot) impose its supremacy upon (individuals) when they refuse to accept this subordination as legitimate’’ (1951, p. 209). We argue that nations vary in the degree to which the normative order condones or condemns suicide. Therefore, national rates should differ with variation in the culture of suicide. The fact that age-standardized suicide rates for the sexes covary (the correlation is .79—see Table B) also suggests that a culture of suicide exists. The more the normative order condones suicide, the higher will be the suicide rates of both sexes. Whether a culture condoning suicide in general exists, or whether it applies only to certain situations (e.g., economic distress, terminal illness) is an empirical issue that deserves cross-national study.13 There are other drawbacks to this research. For example, all four of our basic measures of societal integration changed sharply in a suicide promoting direction between 1955–59 and 1985–89, but mean suicide rates did not share a similar proportional increase. We believe this anomaly may be partially explained by considering the potential weakness of using age-standardized suicide rates. That weakness can be illustrated with the 1955–89 U.S. age-specific trends. Over that period, the youthful suicide rate increased at the same time the rates for older persons were in sharp decline. The increase among the young was offset by the decrease in older age groups and a stable age-standardized rate is the result. If changes in domestic integration have a more rapid impact on the young than on the old, then the anomaly we are discussing would be partially explained. A study of age-specific trends should be a priority of future research.14 This research can also be faulted for its lack of systematic attention to gender differences in suicide. Gove’s (1985) discussion of gender (and age) differences in deviance, and Johnson’s (1979) and Lester’s (1988; 1992b) reviews of gender differences in suicide could guide future studies.15 A major challenge will be the development and testing of a theoretical framework that explains the overall gender difference in suicide rates and the reasons why these gender differences vary among nations.

13 Researchers investigating this issue might follow the lead of sociologists who have asked the public for their attitudes about legal abortion for women in different situations. 14 See McCall and Land (1994) for a literature review and empirical tests of structural factors’ differential effects on suicide rates of different male age groups in the United States, 1946–1988. See also Pampel (1996) for age-specific analysis—the subject of a forthcoming article using our 21-country data set. 15 See also Pampel (forthcoming) ‘‘National Context, Social Change, and Sex Differences in Suicide Rates,’’ American Sociological Review.

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FERNQUIST AND CUTRIGHT APPENDIX A Percentage of Persons By Age and Gender: England and Wales, 1971 Gender Age

Male

Female

15–24 25–34 35–44 45–54 55–64 65–74 751 Total:

20.2% 17.5% 16.2% 16.7% 15.5% 9.8% 4.0% 99.9%

18.0% 15.6% 14.6% 15.8% 15.6% 12.5% 7.9% 100.0%

Source: United Nations, Demographic Yearbook, 1973: Table 6. APPENDIX B Means, Standard Deviations and Zero-Order Correlations of Dependent and Independent Variables: N 5 126 Variable number Variables

Var. no.

(1)

Male suicide rate (1) 1.00 Female suicide rate (2) .79 Residual divorce (3) .28 Residual female labor force (4) .49 Religious books (5) 2.31 Fertility (6) 2.50 Lag female/male enrollment (7) .18 Income inequality (8) .09 Male lag errors (9) .64 Female lag errors (10) .33 Modernization (11) .25 Marital status integration (12) 2.29 Mean Standard Deviation

(2)

(3)

(4)

(5)

1.00 .26 .47 2.40 2.50 2.07 2.01 .35 .56 .18 2.03

1.00 2.06 2.09 2.22 .00 2.02 2.01 .02 .58 2.14

1.00 2.04 2.01 2.00 .04 .06 .04 2.12 2.05

1.00 .26 2.24 .04 2.05 2.10 2.43 2.01

(6)

(7)

(8)

(9)

(10) (11) (12)

1.00 2.28 1.00 2.20 2.13 1.00 .00 .02 2.01 1.00 2.01 2.00 2.23 .55 1.00 2.36 .56 2.06 2.07 .03 1.00 .37 2.40 2.05 2.08 .15 2.33 1.00

26.26 11.05 0.09 0.08 4.95 349.0 12.61 5.85 26.53 4.23 3.05 60.3

30.82 0.34 0.31 0.09 0.02 0.59 8.55 0.05 8.61 3.45 0.11 0.06

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