Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905-1940 and 1959-2012

Yi-Han Chang, David J Gunnell, Chia-Yueh Hsu, Shu-Sen Chang*, Andrew Tai-Ann Cheng

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

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Abstract

Background:
Suicide rates are higher in males than females in most countries, although the gender ratios vary markedly worldwide. We investigated long-term trends in suicide rates and the male-to-female ratios in relation to age, method, and economic factors in Taiwan during the Japanese colonial (1905-1940) and post-war (1959-2012) periods.

Methods:
Suicide data were from the Statistical Reports of Taiwan Governor’s Office (1905-1940), Vital Statistics (1959-1970) and cause-of-death mortality data files (1971-2012). Annual age-standardised and age/method-specific suicide rates by gender and the gender ratios were calculated and examined graphically. The associations between trends in economic indicators, suicide, and suicide gender ratio were investigated using Prais-Winsten regression.

Results:
The male-to-female suicide rate ratio increased from below one in the 1900s to around two by 2000; the reversal was mainly due to a marked reduction in suicide rates in young females coupled with a rise in male suicide between 1905-1940. The gender ratio increased again from the 1980s onwards. Poisoning was the most common method in the 1970s-80s but its use decreased afterwards, more in females than males proportionally. The use of gassing for suicide increased markedly in the 2000s and contributed to the rises in overall suicide and the gender ratio. Unemployment rates were more strongly associated with male suicide than female suicide in 1959-2012. Unemployment rates and GDP per capita were positively associated with suicide gender ratios.

Conclusions:
Gender differences in suicide changed remarkably in Taiwan over the past century; such change may be related to cultural, socioeconomic, and method-specific factors
Original languageEnglish
JournalJournal of Epidemiology and Community Health
Early online date14 Jul 2020
DOIs
Publication statusE-pub ahead of print - 14 Jul 2020

Keywords

  • Suicide
  • Trend
  • Epidemiology
  • Taiwan
  • Time trend analysis
  • Gender difference

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