HOMICIDE AND SUICIDE

Homicide and suicide are significant public health problems that entail heavy social and economic costs. Intentional violence, self-directed and directed at others, was estimated by Christopher J. Murray and Alan D. Lopez to account in 1990 for 2.7 percent of the world's loss of disability-adjusted life years (DALYs), projected to rise to 4.2 percent in 2020.

In 1990, according to World Health Organization (WHO) data, the age-standardized suicide rate per 100,000 persons in 48 countries averaged 15.6 for males and 5.7 for females. Male rates ranged from a high of 52.2 in Hungary to a low of 0.1 in Egypt, and female rates from 17.5 in Sri Lanka to 0.5 in Bahrain. At roughly the same point in time, agestandardized homicide death rates ranged from 1 to 2 per 100,000 in most Western European countries to 9.9 per 100,000 in the United States and nearly 20 per 100,000 in Brazil and Mexico. The distributions used for age standardization are not dissimilar, and so the homicide and suicide death rates are roughly comparable. Although homicide mortality and homicide offender rates are conceptually different, they are often used interchangeably.

Suicide and especially homicide are of special interest insofar as they concern young persons. In virtually all societies the peak age of homicide mortality and commission lies in the range of 18 to 29 years, whereas the peak occurrence of suicide mortality is among the elderly. It is therefore of concern that in many countries, over time, the youth advantage (over the elderly) in terms of suicide rates has weakened and the youth disadvantage in terms of homicide rates has become more pronounced. Because other forms of mortality are low at young ages (in developed countries), suicide and homicide account for a large proportion of all young lives lost.

Suicide

Theories to explain national differences in suicide rates are biological, psychological, or social. The first seem to hold little water because of the huge cross-national variation in basic parameters such as the male–female suicide ratio. In most countries the male suicide rate exceeds the female; China appears to be the one significant exception. One reason that male suicide rates exceed female rates is that males of all ages are likely to choose more lethal methods of self-destruction. A venerable psychological theory holds that both suicide and homicide result from an undifferentiated violent impulse that is turned inward or outward, depending on social conditions. However, if this is so, one would expect suicide and homicide rates to be inversely correlated in an international cross section, whereas they are not.

This leaves social theory, in which the work of the sociologist Emile Durkheim continues to leave a heavy imprint. In basic Durkheimian theory suicide increases as social integration and social regulation–the extent to which behavior is governed by the group–decrease. More generally, Durkheim's hypothesis was that suicide rates vary inversely with the degree of involvement in social life. Subsequent researchers emphasized the impact of social status, which weakens external restraints and thus might be expected to be positively related to the propensity to kill oneself, and the virtuous role of "status integration," or the absence of role conflict. Suicide rates are positively correlated with gross domestic product (GDP) per capita in an international cross section; it might be argued that this is consistent with the Durkheimian hypothesis and its later elaborations. However, there is no correlation between the rate of economic growth in preceding decades and the suicide death rate even though one might expect rapid growth to be associated with the weakening of restraints and accelerated role change.

Differences in national suicide rates are large and stable over time. The most striking international pattern is that suicide rates in Muslim and Catholic countries are significantly lower for both men and women. Immigrants tend to retain the suicide rates of the country of origin. In the United States, Hispanic suicide rates are lower than European-American rates; the reasons cited include a greater role for the extended family, the Catholic religion, and fatalism. The suicide rate among African Americans is also lower than that among European Americans, a difference that has been variously ascribed to greater religiosity and the stronger role of the extended family among African Americans.

Suicides among elderly people are characterized by depression, often associated with acute or chronic illness and/or the loss of a spouse or companion. Another characteristic of elderly suicides is the high ratio of successful to attempted suicides. In most developed countries elderly suicide rates declined between the mid-1980s and mid-1990s after an increase in many of them in the previous decade.

This decline in elderly suicide stands in contrast to the trend in suicides among the young. In the United States age-specific suicide rates among adolescents and young adults (age 15 to 24) tripled between 1950 and 1995. Some of this increase may reflect greater willingness to label self-inflicted deaths among the young as suicide; however, there is little doubt that the data reflect a real phenomenon. As the young have fared worse than the old, males have fared worse than females. Whereas male suicide rates rose in most countries between 1970 and 1984, female suicide rates remained stable.

Homicide

Although experts dispute the particulars, there is little doubt that there has been a massive long-term decline in the prevalence of lethal interpersonal violence. Whereas homicide in advanced nations is largely confined to the poor, in premodern societies it was equally common over the entire social spectrum. The proposed explanation is that as development and modernization proceed, legal means of resolving disputes become available to those who have the resources to pursue them. In some countries declining homicide rates may be related to the longterm decline in the use of alcohol. Data for European countries for the period 1950–1995 show a strong positive relationship between alcohol sales and the homicide rate, with a greater impact on male than on female homicide. The association was especially strong in Northern Europe, with its culture of binge drinking.

Current theories of homicide stress the role of poverty. International cross-sectional analysis shows that homicide rates are positively correlated with the degree of income inequality, with the relationship strongest in wealthy democracies. This lends support to the relative deprivation theory of homicide, in which aggression is held to be spurred by a sense of frustration and relative poverty. A related result is that homicide rates are inversely correlated with the strength of welfare state institutions. Whereas in the United States the entry of the baby boom cohorts into adolescence during the 1960s was clearly reflected in rising aggregate homicide rates, the same compositional effect was not observed in the welfare states of Western Europe. However, work in the United States has shown that the statistical correlation between poverty and homicide persists even when measures of access to social capital, a variable not entirely distinct from the strength of the welfare state, are taken into account. There is also evidence, both from cross-sectional European studies and from U.S. time series that homicide mortality is linked to the weakening of traditional family structures.

Because its homicide rate is so high, the United States has been the focus of special attention. In the United States in 1990 the African-American homicide crude death rate was 38.8 per 100,000, the Hispanic-American crude rate was 15.5, and the European-American crude rate was 5.7. Roughly speaking, the trend in age-standardized U.S. homicide rates was a decline from the 1930s until the 1960s, followed by a rise until the 1990s and then a decline to levels not seen since the 1960s. Increases during the 1960s apparently reflect, in part, an effect by which relatively large cohorts of young persons experience higher homicide mortality than do relatively small ones. This would be consistent with the work of economist Richard Easterlin, who argues that relatively large cohorts fare worse along many dimensions than relatively small ones. The dramatic increase in U.S homicide rates during the 1980s and the equally dramatic decline during the 1990s were closely tied to gun deaths among black teenage males and the crack cocaine epidemic.

Homicide, Suicide, and Firearms

Much of the public health literature on homicide and suicide is concerned with the role of firearms, especially handguns. Studies relating gun control laws to homicide and suicide rates in the United States have tended to be inconclusive because the link between the legal regime and the actual prevalence of firearms is not strong either temporally or in cross section. International cross-sectional data, however, clarify the relationship. Firearm-related suicide and homicide rates vary markedly among countries, as do the proportions of homicide and suicide rates accounted for by firearms. The rate of household gun ownership is positively related to the gun-homicide death rate as well as to the proportion of homicides committed with a gun, and the corresponding correlations are even more significant for suicides. There are no inverse correlations between household gun ownership and the non-gun homicide and suicide death rates; that is, there are no offsetting substitution effects by which lower gun ownership might be associated with higher non-gun violent death rates. In cross-sectional international data, there is a significant positive correlation between firearm prevalence and the male youth suicide rate and an extremely strong correlation between firearm prevalence and the firearm youth suicide rate for males as well as females. In general, firearms accounted for a much higher proportion of male youth suicides than female youth suicides.

Conclusion

Homicide and suicide are not leading causes of death; however, they rank high on the list of causes of young persons' deaths. As an important source of potentially avoidable mortality, they merit close study by demographers, epidemiologists, public health experts, and others concerned with population health.

See also: Crime, Demography of; Infanticide.

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F. Landis MacKellar