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Historical trends in suicide risk for the residents of mainland China: APC modeling of the archived national suicide mortality rates during 1987–2012

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Abstract

Purpose

Distinctive and dramatic changes in the history of China with a rapid suicide decline in recent years present an opportunity to investigate the risk of suicide. In this study, we investigated suicide risk with a historical perspective with archived data to inform suicide research and prevention policies and strategies.

Method

Documented age-specific suicide mortality rates in 1987–2012 were decomposed into age, period, and cohort effect using APC-modeling method and intrinsic estimator (IE) technique. The estimated effects were further analyzed by numerical differentiation.

Results

The data satisfactorily fit the constructed APC models. Cohort effect indicated that suicide risk in China fluctuated at very high levels during 1903–1967, followed by a sharp decline during 1968–1977, and reached the lowest level in 1983–1987 before increased again. Period effect confirmed the declining trend since 1987. Three sunny cohorts with reduced suicide risk and four cloudy cohorts with increased risk were, respectively, associated with significant cultural, social, political, and economic events in China since the 1900s.

Conclusions

The mega trends in the suicide risk at the population level are closely related to significant historical events in China. Suicide is anticipated to increase because of the growing risk for the young cohorts (particularly young females) as the country further develops. Study findings suggest the significance of national strategies for suicide prevention and control, including maintenance of social harmony and stability, provision of more opportunities for development, enhancement of social integration, and restriction of suicide facilitating factors.

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Fig. 1

Data source: Prepared with data from China Statistical Yearbook

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Acknowledgements

The study was supported in part by the four participation schools, including Wuhan University, University of Florida, The Pennsylvania State University, and University of Maryland.

Funding

The study was supported by the Humanities and Social Sciences Project of China Ministry of Education (17YJCZH155) and National Natural Science Foundation of China (71573192, 71303012). In addition, author Chen X was supported in part by the Clinical and Translational Science Institute (CTSI) at the University of Florida.

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Authors and Affiliations

  1. Global Health Institute, Wuhan University, 299 Bayi Road, Wuchang District, Wuhan, 430072, Hubei, China

    Xinguang Chen, Yang Sun & Peigang Wang

  2. Department of Epidemiology, University of Florida, Gainesville, FL, USA

    Xinguang Chen & Bin Yu

  3. Department of Public Affairs and Management, School of Political Science and Public Administration, Wuhan University, Wuhan, China

    Yang Sun

  4. Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA

    Zhi Li

  5. Department of Sociology, University of Maryland, College Park, Maryland, USA

    Ge Gao

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  1. Xinguang Chen
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  2. Yang Sun
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  3. Zhi Li
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  4. Bin Yu
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  5. Ge Gao
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Contributions

XC initiated the idea and worked with the team to establish the framework, guided data analysis, write most of the manuscript. YS participated in framing the research, collected data and participated in data analysis, results interpretation and manuscript development. ZL participated in later-stage in reframing the research topic, collected part of the data, and conducted most of the analysis, contributed much for manuscript preparation. BY and GG assisted in literature search, data analysis, results tabulation and graphing, manuscript writing and reviewing. PW participated in results interpretation and manuscript development.

Corresponding author

Correspondence to Yang Sun.

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Conflict of interest

None of the authors has a conflict of interest associated with the reported research.

Availability of data and material

The data sets generated and/or analyzed during the current study are available in the NHFPC (National Health and Family Planning Commission of the People’s Republic of China) repository, http://www.nhfpc.gov.cn/zwgk/tjnj1/ejlist.shtml, and published on Annual China Health Statistical Yearbook, which renamed as China Health and Family Planning Statistics Yearbook from year 2014.

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Chen, X., Sun, Y., Li, Z. et al. Historical trends in suicide risk for the residents of mainland China: APC modeling of the archived national suicide mortality rates during 1987–2012. Soc Psychiatry Psychiatr Epidemiol 54, 99–110 (2019). https://doi.org/10.1007/s00127-018-1593-z

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  • DOI: https://doi.org/10.1007/s00127-018-1593-z

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