Socioeconomic Conditions and the Suicide Mortality Rate: A Trend Analysis in Taiwan, 1981-2007

社會經濟狀況與自殺死亡率的關係：台灣1981－2007年之趨勢分析

10.30074/FJMH.201306_26(2).0005

江弘基(Hung-Chi Chiang)；胡賦強(Fu-Chang Hu)

自殺死亡率 ； 經濟指標 ； 社會指標 ； 失業率 ； 國民生產毛額 ； 消費者物價指數 ； 財務危機 ； 迴歸分析 ； 預測 ； suicide mortality rate ； economic determinants ； social determinants ； unemployment rate ； gross national product (GNP) ； consumer price index (CPI) ； financial crisis ； time series analysis ； linear regression ； prediction

中華心理衛生學刊

26卷2期（2013 / 06 / 01）

307 - 336

英文

研究目的：本研究主要目的在於透過瞭解台灣整體社會、經濟狀態與自殺死亡率變化趨勢之間的關聯性，來預測自殺死亡率。研究方法：蒐集1981-2007年期間台灣的自殺死亡資料（衛生署）、人口資料及各項經濟、社會指標資料（內政部社會指標統計資料），分別計算性別、年齡別及地區別之自殺死亡率，運用多元線性迴歸時間序列分析（multiplelinear regression time series analysis）的方法，找出整體經濟、社會因素對於自殺死亡率的相對關聯程度，並據此建立自殺死亡率之預測模型。研究結果：預測模型（判別係數R2= 0.8661）顯示，(1)若3年前的男性失業率愈高，當年的自殺死亡率愈高；(2)若1年前人均國民生產毛額比2年前高出新台幣1萬元以上，當年的自殺死亡率愈會下降；(3)若2年前的消費者物價指數≥80，當年的自殺死亡率會上升。依據此模型估算2008及2009年自殺死亡率，與本研究期間之後公布的官方統計數字相當接近。研究結論：相較於社會因素，台灣整體經濟環境與自殺死率變化趨勢之間的關聯性較高；上述三項經濟決定指標，對於台灣從1981到2007年的自殺死亡率，具有1至3年的延遲衝擊效應。根據預測結果，2007年到2009年期間，台灣自殺死亡率大幅降低的機率不高。

Purpose: This macro-epidemiologic study aimed to develop a statistical regression model for identifying important predictors of the crude annual suicide mortality rate in Taiwan. Methods: A time series analysis with seasonality was conducted to examine the associations between 33 socioeconomic variables and the crude annual suicide mortality rates using the male and female data of 4 age groups in 7 regions of Taiwan between 1981 and 2007. Results: A well-fitted multiple linear regression time series model (coefficient of determination, R2 = 0.8661) revealed that conditioning on the effects of the past crude annual suicide mortality rates and temporal oscillations, (1) the higher the male unemployment rate of the t - 3 year, the higher the crude annual suicide mortality rate of the current year t; (2) if the gross national product (GNP) per capita of the t - 1 year minus that of the t - 2 year was larger than NT $10,000, then the crude annual suicide mortality rate of the current year t would drop; and (3) if the consumer price index of the t - 2 years was greater than or equal to 80, then the crude annual suicide mortality rate of the current year t would go up. Based on this statistical regression model, the crude annual suicide mortality rates of 2008 and 2009 were predicted and found to be reasonably close to the actual values of the official death statistics released after the study period. Conclusions: The fluctuation of economic conditions had a much stronger and more direct impact on the suicide mortality than that of social conditions in Taiwan. In particular, 3 economic indices were identified as having 1- to 3-year short-term lagged effects on the crude annual suicide mortality rates from 1981 to 2007. Given the relatively poor economy from 2007 to 2009 in Taiwan, a remarkable decrease in the crude annual suicide mortality rate is not expected in the coming years.

1. Wu, R.,Cheng, Y.(2008).Trends in suicide mortality in Taiwan, 1959-2006.Taiwan Journal of Public Health,27,110-120.
   連結：
2. DGBAS. (2009a). Taiwan's economic performance in the second quarter of 2009 and outlook for 2009-2010. News Release of Directorate General of Budget, Accounting and Statistics (DGBAS), Executive Yuan, Taipei, Republic of China (Taiwan), August 20, 2009.
3. DGBAS. (2009b). Unemployment rate hit record high in June. News Release of Directorate General of Budget, Accounting and Statistics (DGBAS), Executive Yuan, Taipei, Republic of China (Taiwan), June 22, 2009.
4. DGBAS. (2007). Social Indicators (2006). Directorate General of Budget, Accounting and Statistics, Executive Yuan, Republic of China (Taiwan).
5. Mishara, B. L. (2008). Suicide and the economic depression: Reflections on suicide during the Great Depression. International Association of Suicide Prevention (IASP) News Bulletin. Retrieved March 21, 2010, from http://www.iasp.info/.
6. World Bank. (2009b). Global Development Finance: Charting a Global Recovery. Retrieved March 21, 2010, from http://web.worldbank.org/.
7. American Association of Suicidology. (2008). AAS Statement on: The Economy and Suicide. Retrieved March 21, 2010, from http://www.suicidology.org/.
8. World Bank. (2009a). The New World Bank Updates Global Economic Forecasts (World Bank Press Release No: 2009/285/DEC). Retrieved March 21, 2010, fromhttp://web.worldbank.org/..
9. Altinanahtar, A.,Halicioglu, F.(2009).A dynamic econometric model of suicides in Turkey.The Journal of Socio-Economics
10. Berk, M.,Dodd, S.,Henry, M.(2006).The effect of macroeconomic variables on suicide.Psychological Medicine,36,181-189.
11. Burr, J. A.,McCall, P. L.,Powell-Griner, E.(1997).Female labor forceparticipation and suicide.Social Science and Medicine,44,1847-1859.
12. Chang, S. S.,Gunnell, D.,Sterne, J. A. C.,Lu, T. H.,Cheng, A. T. A.(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.Social Science and Medicine,68,1322-1331.
13. Chen, V. C.,Chou, J. Y.,Lai, T. J.,Lee, C. T.(2009).Suicide and unemployment rate in Taiwan: A population-based study, 1978-2006.Social Psychiatry and Psychiatric Epidemiology
14. Chen, Yip, S. F.,Lee, C.,Fan, H. F.,Fu, K. W.(2010).Economic fluctuations and suicide: A comparison of Taiwan and Hong Kong.Social Science and Medicine,71,2083-2090.
15. Chuang, H. L.,Huang, W. C.(2007).A re-examination of the suicide rates in Taiwan.Social Indicators Research,83,465-485.
16. Chuang, H. L.,Huang, W. C.(1996).A reexamination of "sociological and economic theories of suicide: A comparison of the U.S.A. and Taiwan.".Social Science and Medicine,43,421-423.
17. Coles, O. B.(2005).Relationship between economic development and suicide mortality: A global cross-sectional analysis in an epidemiological transition perspective by Moniruzzaman and Andersson.Public Health,119,71-72.
18. Cryer, J. D.,Chan, K. S.(2008).Time Series Analysis with Applications in R (2nd Ed.).New York:Springer Science+Business Media.
19. Deaton, A.(2003).Health, inequality, and economic development.Journal of Economic Literature,41,113-158.
20. Durkheim, E.(1951).Suicide: A Study in Sociology.New York:Free Press.
21. Graeff, P.,Mehlkop, G.(2007).When Anomie becomes a reason for suicide: A new macro-sociological approach in the Durkheimiantradition.European Sociological Review,23,521-535.
22. 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.Social Science and Medicine,57,595-611.
23. Hamermesh, D. S.,Soss, N. M.(1974).An economic theory of suicide.The Journal of Political Economy,82,83-98.
24. Inoue, K.,Tanii, H.,Abe, S.,Kaiya, H.,Nata, M.,Okazaki, Y.,Fukunaga, T.(2007).The significant correlation between increases in suicide rates and increases in male unemployment rates in Mie Prefecture, Japan, between 1995 and 2002.International Medical Journal,14,287-289.
25. Jegannathan, B.,Kullgren, G.(2011).Gender differences in suicidal expressions and their determinants among young people in Cambodia, a post-conflict country.BMC Psychiatry,11
26. Kposowa, A. J.,McElvain, J. P.,Breault, K. D.(2008).Immigration and suicide: The role of marital status, duration of residence, andsocial integration.Archives of Suicide Research,12,82-92.
27. Lester, B.(2001).Learnings from Durkheim and beyond: The economy and suicide.Suicide and Life-Threatening Behavior,31,15-31.
28. Lester, D.,Yang, B.(1991).The relationship between divorce, unemployment and female participation inthe labour force and suicide rates in Australia and America.Australian & New Zealand Journal of Psychiatry,25,519-23.
29. Lin, J. J.,Lu, T. H.(2008).Suicide mortality trends by sex, age and method in Taiwan, 1971-2005.BMC Public Health,8,6.
30. Lucey, S.,Corcoran, P.,Keeley, H. S.,Brophy, J.,Arensman, E.,Perry, I. J.,Perry, I. J.(2005).Socioeconomic change and suicide: A time-series study from the Republic of Ireland.Journal of Crisis Intervention and Suicide,26,90-94.
31. Lundin, A.,Hemmingsson, T.(2009).Unemployment and suicide.Lancet,374,270-271.
32. Marcotte, D.(2003).The economics of suicide, revisited.Southern Economic Journal,69,628-643.
33. McKeowan, T.,Record, R.,Turner, R.(1975).An interpretation of the decline of mortality in England and Wales during the nineteenth century.Population Studies,29,391-422.
34. Merton, R. K.(1957).Social Theory and Social Structure, Rev. Ed..New York:Free Press.
35. Milner, A.,McClure, R.,De Leo, D.(2012).Socio-economic determinants of suicide: an ecological analysis of 35 countries.Social Psychiatry and Psychiatric Epidemiology,47,19-27.
36. Moniruzzaman, S.,Andersson, R.(2004).Relationship between economic development and suicide mortality: A global cross-sectional analysis in an epidemiological transition perspective.Public Health,118,346-348.
37. Moniruzzaman, S.,Andersson, R.(2008).Economic development as a determinant of injury mortality-A longitudinal approach.Social Science and Medicine,66,1699-1708.
38. Neumayer, E.(2003).Are socioeconomic factors valid determinants of suicide? Controlling for national cultures of suicide with fixed-effects estimation.Cross-Cultural Research,37,307-329.
39. Newman, J. F.,Whittemore, K. R.,Newman, H. G.(1973).Women in thelabor force and suicide.Social Problems,21,220-230.
40. Pickering, W. S. F.(Ed.),Walford, G.(Ed.)(2000).Durkheim's Suicide: A Century of Research and Debate.London:Routledge.
41. Pierce, A.(1967).The economic cycle and the social suicide rate.American Sociological Review,32,457-462.
42. Rehkopf, D. H.,Buka, S. L.(2006).The association between suicide and the socioeconomic characteristics of geographical areas: A systematic review.Psychological Medicine,36,145-157.
43. Rin, H.,Chen, T.,Headley, L. A.(Ed.)(1983).Taiwan in Suicide in Asia and the Near East.Berkeley, CA:University of California.
44. Shumway, R. H.,Stoffer, D. S.(2011).Time Series Analysis and Its Applications: With R Examples.New York:Springer Science+Business Media.
45. Söderlund, N.,Zwi, A. B.(1995).Traffic-related mortality inindustrialized and less developed countries.World Health Organization Bulletin,73,175-182.
46. Stack, S.(2000).Suicide: A 15-year review of the sociological literature. Part I: Cultural and economic factors.Suicide and Life-Threatening Behavior,30,145-162.
47. Stack, S.(2000).Suicide: A 15-year review of the sociological literature. Part II: Modernization and social integration perspectives.Suicide and Life-Threatening Behavior,30,163-176.
48. Stack, S.(1987).The effect of female participation in the labor force on suicide: A time series analysis, 1948-1980.Sociological Forum,2,257-277.
49. Stack, S.(2007).Societal economic costs and benefits from death: Another look.Death Studies,31,363-372.
50. Stack, S.,Wasserman, I.(2007).Economic strain and suicide risk: A qualitative analysis.Suicide and Life-Threatening Behavior,37,103-112.
51. Stuckler, D.,Basu, S.,Suhrcke, M.,Coutts, A.,McKee, M.(2009).The public health effect of economic crises and alternative policy responses in Europe: An empirical analysis.Lancet,374,315-323.
52. Taylor, R.,Page, A.,Morrell, S.,Harrison, J.,Carter, G.,Taylor, R.,Carter, G.(2005).Mental health and socio-economic variations in Australian suicide.Social Science and Medicine,61,1551-1559.
53. Trovato, F.,Vos, R.(1992).Married female labor force participationand suicide in Canada, 1971 and 1981.Social Forum,7,661-677.
54. Wasserman, I. M.(1987).Social indicators linking divorce and suicide: A reply to Stack.Journal of Marriage and Family,49,206-207.
55. Wasserman, I. M.(1984).A longitudinal analysis of the linkage between suicide, unemployment, and marital Dissolution.Journal of Marriage and Family,46,853-859.
56. Wilkinson, R. G.(1997).Socioeconomic determinants of health-Health inequalities: Relative or absolute material standards?.British Medical Journal,314,591-595.
57. Wintemute, G. J.(1985).Is motor vehicle-related mortality a diseaseof development?.Accident Analysis and Prevention,17,223-237.
58. Wu, E. Q.,Birnbaum, H. G.,Shi, L.,Ball, D. E.,Kessler, R. C.,Moulis, M.,Aggarwal, J.(2005).The economic burden of schizophrenia in the United States in 2002.Journal of Clinical Psychiatry,66,1122-1129.
59. Yamasaki, A.,Sakai, R.,Shirakawa, T.(2005).Low income, unemployment, and suicide mortality rates for middle-age persons in Japan.Psychological Reports,96,337-348.
60. Yang, B.(1992).The economy and suicide: A time-series study of the U.S.A..American Journal of Economics and Sociology,5,187-199.
61. Yang, B.,Lester, D.,Yang, C. H.(1992).Sociological and economic theories of suicide: A comparison of the U.S.A. and Taiwan.Social Science and Medicine,34,333-334.
62. Ying, Y. H.,Chang, K.(2009).A study of suicide and socioeconomic factors.Suicide and Life-Threatening Behavior,39,214-226.
63. Yur''yev, A.,Varnik, A.,Varnik, P.,Sisask, M.,Leppik, L.(2012).Employment status influences suicide mortality in Europe.International Journal of Social Psychiatry,58,62-68.
64. Zhang J.,Lester D.(2008).Psychological tensions found in suicide notes: A test for the strain theory of suicide.Archives of Suicide Research,12,67-73.
65. Zhang, J.,Ma, J.,Jia, C.,Sun, J.,Guo, X.,Xu, A.,Li, W.(2010).Economic growth and suicide rate changes: A case in China from 1982 to 2005.European Psychiatry,25,159-163.

1. 謝仁和、陳冠志、曹淑琳(2015)。臺灣自殺死亡率與經濟發展之實證研究。高雄應用科技大學人文與社會科學學刊，1(1)，11-23。