Yasuyuki Sawada - Economic Analysis of Suicide Prevention: Towards Evidence-Based Policy-Making

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Springer Nature Singapore Pte Ltd. 2017

Yasuyuki Sawada , Michiko Ueda and Tetsuya Matsubayashi Economic Analysis of Suicide Prevention Economy and Social Inclusion Creating a Society for All

1. Introduction

Yasuyuki Sawada 1, Michiko Ueda 2 and Tetsuya Matsubayashi 3

(1)

Faculty of Economics, The University of Tokyo, Bunky, Tokyo, Japan

(2)

Faculty of Political Science and Economics, Waseda University, Shinjuku, Tokyo, Japan

(3)

Osaka School of International Public Policy, Osaka University, Toyonaka, Osaka, Japan

Michiko Ueda

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Introduction

Suicide is a significant social issue. The World Health Organization (WHO) reports that over 800,000 people die by suicide each year. Although suicide rates have consistently been highest in the elderly, suicide is among the leading causes of death of youths in many countries.

There may be a cultural aspect to attitudes towards suicide. For example, in Japan there is a long history of ritual suicide. Thus, Japanese society may seem more accepting of suicide when compared to other societies. However, views towards suicide often transcend such cultural or geographical boundaries and can be very diverse simply because different people view suicide differently. Furthermore, attitudes towards suicide may generate controversy because they are often based upon each individuals own sense of morality. For example, some may claim suicide is a personal choice made by individuals, and the government and others should not intervene in their decisions.

In this book, rather than debating whether suicide is a choice, we seek to understand the causes and consequences of suicide from the perspective of economics. We argue that the risk of suicide can be shaped by economic and institutional settings. Thus, our approach here differs from those in the medical, psychiatric, epidemiological, and sociological studies of suicide that tend to focus on the personal causes of suicide.

In the following chapters, we examine those economic and institutional causes of suicide, and what strategy the society and government should choose to prevent suicide in the constraint of scarce resources. What is more, we argue that suicide imposes a tremendous economic cost on society and therefore that suicide prevention could alleviate a massive substantial economic burden. We also argue that the risk of suicide changes dramatically in the event of economic and natural disasters, and also when the government implements policies with certain economic implications. The relevance of school-related issues for the risk of suicide in school children and adolescents is also discussed. In addition, we consider effective prevention strategies to prevent railway and subway suicides as well as effective public awareness campaigns. Ultimately, this book contributes to the understanding of the socioeconomic aspect of suicide and to the development of evidence-based policy proposals.

When testing hypotheses on the link between economic and institutional settings and suicide, we use data from Japan and other high-income nations. Suicide is a particularly serious problem in Japan, as more than 30,000 people died by suicide each year from 1998 to 2011. Figure shows that men have a much higher suicide count than women. Finally, the graph indicates that the suicide rate started to decline in 2010 and that the number of suicide victims continued to decrease to 24,025 in 2015.

Fig. 1

Suicide rate in Japan, 19782015

Figure displays the 20 highest age-adjusted suicide rates in 2012 around the world. The top panel indicates that the suicide rate in Japan for men and women combined is the 18th highest in the world and 3rd highest among the OECD countries. The middle panel shows that the male suicide rate in Japan is the 20th highest in the world and 4th highest among the OECD countries. The female suicide rate in Japan is the 18th highest in the world and the 2nd highest among the OECD countries.

Fig. 2

Cross-national comparison of suicide rates

Figure displays temporal shifts in the suicide rates of four sets of countries that belong to OECD between 1960 and 2013. These countries were chosen for comparison because they experienced similar levels of economic development and political stability in those 50 years. We separated the countries into 4 groups: European, Americas and Oceania, Japan, and Korea. The suicide rate in Japan was the highest of the groups from 1960 up to the early 2000s, when it was exceeded by Koreas suicide rate. The suicide rates in the European nations and Americas and Oceania have declined in the last two decades.

Fig. 3

Temporal comparison of suicide rates

Japan has had a long struggle with suicide. Coupled with the fact that individual death records and aggregated suicide counts are available for sub-regions and for an extensive period of time, we decided to focus our investigation on suicide in Japan. While most hypotheses in the following chapters are tested against data in Japan, we believe that our findings have important implications to suicide prevention literature and suicide prevention in other countries.

Book Outline

The remaining chapters of this book are divided into two parts. Part I includes Chaps. discusses the need to reduce suicide by focusing on the negative externalities that suicide generates. Negative externalities here include the effect on the bereaved, the so-called Werther effect, and the economic costs that suicide imposes.

In Chaps. focuses on the effect of natural disasters on suicide.

Chapter focuses on railway suicides that are prevalent in Japan. We start by presenting descriptive data of railway suicides in Japan which includes the annual frequencies, demographic characteristics of the deceased, and the timing of occurrence. We then discuss the economic costs imposed by railway suicides and overview our studies that examined the effectiveness of prevention strategies, such as blue light-emitting-diode (LED) lamps on platforms and platform screen doors (PSD).

The second part of this book explores prevention policies that may contribute to reducing the number of suicides, using cross-national data as well as data from Japan. In Chap. uses panel data from the 47 prefectures in Japan to examine whether the expansion of economic and welfare policies by prefectural governments can reduce suicide rates.

Chapter highlights the importance of government suicide prevention efforts. We evaluate the effectiveness of comprehensive suicide prevention programs developed by national government in 21 OECD nations. Moreover, we discuss the effectiveness of suicide prevention programs led by subnational governments in Japan since 2009. In addition, we look at the effectiveness of public awareness campaigns by using data from Nagoya City, Japan.

Footnotes

The suicide rate is the total number of suicide victims in a year divided by the population of the same year and then multiplied by 100,000.

Springer Nature Singapore Pte Ltd. 2017

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