An ecological study of social fragmentation, socioeconomic deprivation, and suicide in rural China: 2008–2010

Abstract

China accounts for a large number of suicides worldwide, and most occur in rural areas. Suicide research in China has primarily focused on individual-level risk factors, few have studied the influence of neighborhood contexts. This ecological study examines the association of suicide rates with social fragmentation and socioeconomic deprivation in Chinese rural villages. Data from the community survey of the China Health and Retirement Longitudinal Study were analyzed using negative binomial regression. A total of 307 rural villages were included. The community survey collected data about the villages from local leaders. Suicide counts were measured by the leaders' report of the number of suicide deaths in the villages. Social fragmentation was indicated by out-migration, in-migration and ethnic diversity; socioeconomic deprivation was indicated by physical infrastructure, illiteracy rates and public transit accessibility. Results show that higher incidence rates of suicide occurred in villages with high proportions of out-migration (vs. low), inflow of migrants (vs. no migrants), mixes of Han and ethnic minority residents (vs. Han only), high degrees of infrastructure deficiency (vs. low) and poor access to public transportation (vs. excellent). Villages with higher percentages of older adults also had higher suicide rates. This is one of the first studies to examine the association between neighborhood contexts and suicide in China. The findings have implications for suicide prevention in rural China.