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Changes in the inequality of mental health: suicide in Australia, 1907–2003

Published online by Cambridge University Press:  20 April 2010

Darrel P. Doessel ,
Ruth F. G. Williams  and
Jennie R. Robertson
Darrel P. Doessel
Affiliation:
Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia
Ruth F. G. Williams*
Affiliation:
School of Economics and Finance, Victoria University, Melbourne, Victoria, Australia
Jennie R. Robertson
Affiliation:
Queensland Centre for Mental Health Research, The University of Queensland, Brisbane, Queensland, Australia
*
Correspondence to: Dr Ruth Williams, School of Economics and Finance, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia. Email: ruth.williams@vu.edu.au
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Abstract

Rising suicide rates have been identified as a social problem in several Western countries. The application of a Welfare Economics argument justifies a role for policy that reduces the welfare impact of suicide, whereas the measurement of that impact can inform policy making. Two dimensions of the concept can be measured: the social loss from suicide, and the inequality in the distribution of that loss. In this study, an alternative measure of suicide to the conventional suicide headcount, viz. the potential years of life lost (PYLL), is employed. The PYLL measure is a proxy measure of the social impact of suicide, and involves the concept of ‘premature’ loss of life. The PYLL also lends itself to inequality measurement. We apply the approach to inequality measurement of health phenomena that was pioneered in the 1980s by Jacques Silber and Julian Le Grand, in a literature now described as measuring health inequality per se. The empirical part of the paper statistically estimates equations on Australian suicide data for the period 1907–2003 and determines the trends in the social loss from suicide and the inequality of its age distribution. Some illustrative examples assist in interpreting the welfare impact of suicide measured both ways, by the headcount rate and the PYLL rate.

Type
Articles
Information
Health Economics, Policy and Law , Volume 6 , Issue 1 , 26 January 2011 , pp. 23 - 42
Copyright
Copyright © Cambridge University Press 2010

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References

AIHW (2005), State and Territories GRIM (General Record of Incidence of Mortality) Books, Canberra: AIWH.Google Scholar
Alexopoulos, G., Bruce, M. L., Hull, J., Sirey, J. A.Kakuma, T. (1999), ‘Clinical determinants of suicidal ideation and behavior in geriatric depression’, Archives of General Psychiatry, 56: 1048–1053.CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2000), Suicides, Australia 1921–1998, Canberra: ABS.Google Scholar
Australian Bureau of Statistics (2005), Cause of Death: Australia 2003, Canberra: ABS.Google Scholar
Australian Bureau of Statistics (2006), Causes of Death: Australia 2004, Canberra: ABS.Google Scholar
Caldwell, T. M., Jorm, A. F.Dear, K. B. (2004), ‘Suicide and mental health in rural, remote and metropolitan areas in Australia’, Medical Journal of Australia, 181: S10–S14.CrossRefGoogle ScholarPubMed
Camus, A. (1948), The Plague, translated by Stuart Gilbert, New York: Knopf.Google Scholar
Camus, A. (1955), The Myth of Sisyphus, translated by J. O’Brien, London: Hamish Hamilton.Google Scholar
Cantor, C.Neulinger, K. (2000), ‘The epidemiology of suicide and attempted suicide among young Australians’, Australian and New Zealand Journal of Psychiatry, 34: 370–387.CrossRefGoogle ScholarPubMed
Cantor, C., Neulinger, K.De Leo, D. (1999), ‘Australian suicide trends 1964–1997: youth and beyond?’, Medical Journal of Australia, 171: 137–141.CrossRefGoogle ScholarPubMed
Champernowne, D. G.Cowell, F. A. (1998), Economic Inequality and Income Distribution, Cambridge: CUP.Google Scholar
Chatterji, P., Dave, D., Kaestner, R.Markowitz, S. (2004), ‘Alcohol abuse and suicide attempts among youth’, Economics and Human Biology, 2: 159–180.CrossRefGoogle ScholarPubMed
Clark, D. C.Horton-Deutsch, S. L. (1992), ‘Assessment in absentia: the value of the psychological autopsy methods for studying antecedents of suicide and predicting future suicides’, in R. W. Maris, A. L. Berman, J. T. Maltsberger and R. I. Yifti (eds), Assessment and Prediction of Suicide, New York: The Guildford Press, 144–182.Google Scholar
Commission for Children and Young People and Child Guardian (2005), Annual Report: Deaths of Children and Young People, Queensland 2004–2005, http://www.childcomm.qld.gov.au/pdf/publications/reports/annual_report_dcyp_2004-05/AR_DCYP_04-5.pdf [5 December 2005].Google Scholar
Commonwealth Department of Health and Aged Care (2000), Areas for Action: LIFE: A Framework for the Prevention of Suicide and Self-Harm in Australia, Canberra: CDHAC.Google Scholar
Commonwealth Department of Human Services and Health (1994), Better Health Outcomes for Australians: National Goals, Targets and Strategies for Better Health Outcomes into the Next Century, Canberra: AGPS.Google Scholar
Commonwealth Department of Human Services and Health (1995), Here for Life: A National Plan for Youth in Distress, Canberra: AGPS.Google Scholar
Cowell, F. A. (1995), Measuring Inequality, Hemel Hempstead: Prentice-Hall.Google Scholar
Creedy, J. (1998), The Dynamics of Inequality and Poverty: Comparing Income Distributions, Cheltenham: Edward Elgar.Google Scholar
Cutler, D. M., Glaeser, E. L.Norberg, K. E. (2001), Explaining the Rise in Youth Suicide, Cambridge, MA: Harvard Institute of Economic Research.Google Scholar
De Leo, D.Evans, R. (2002), Suicide in Queensland 1996–1998: Mortality Rates and Related Rata, Brisbane: AISRAP.Google Scholar
Dempsey, M. (1947), ‘Decline in tuberculosis: the death rate fails to tell the entire story’, American Review of Tuberculosis, 56: 157–164.Google ScholarPubMed
Department of Health (1992), The Health of the Nation: A Consultative Document for Health in England, London: HMSO.Google Scholar
Department of Health (1999), Saving Lives: Our Healthier Nation, London: The Stationary Office.Google Scholar
Department of Health (2000), National Suicide Prevention Strategy for England, London: Department of Health.Google Scholar
Doessel, D. P., Williams, R. F. G. (2005), ‘Economic Concepts and Measures of Mental Health and Mental Health Inequality: an Empirical Study of Psychiatric Admissions in Queensland from 1964 to 2003’, Victoria University of Technology School of Applied Economics Working Paper Series No: 02/05, Melbourne, Australia.Google Scholar
Doessel, D. P., Williams, R. F. G., Robertson, J. R., Whiteford, H. (2006), ‘Measuring an Aspect of the Distribution of Mental Health: Suicide in Australia 1907–2003’, Victoria University School of Applied Economics Working Paper No: 9/06, Melbourne, Australia.Google Scholar
Doessel, D. P., Williams, Ruth F. G.Whiteford, H. (2009a), ‘The appropriate measure of suicide for policy analysis: a comparison of headcount and PYLL rates in Australia 1907–2005’, Archives of Suicide Research, 13: 87–99.CrossRefGoogle Scholar
Doessel, D. P., Williams, Ruth F. G.Whiteford, H. (2009b), ‘A re-assessment of suicide measurement: some comparative PYLL-based trends, Queensland, 1920–2005’, Crisis, 30: 6–12.CrossRefGoogle Scholar
Friedman, M. (1957), A Theory of the Consumption Function, Princeton: Princeton University Press.CrossRefGoogle Scholar
Fries, J. F. (1980), ‘Aging, natural death, and the compression of morbidity’, New England Journal of Medicine, 303: 130–135.CrossRefGoogle ScholarPubMed
Goldberger, A. S. (1971), ‘Econometrics and psychometrics: a survey of communalities’, Psychometrika, 36: 83–107.CrossRefGoogle Scholar
Goldberger, A. S. (1973), ‘Structural equation models: an overview’, in A. S. Goldberger and O. D. Duncan (eds), Structural Equation Models in the Social Sciences, New York: Seminar Press, 1–18.Google Scholar
Grossman, M. (1972a), ‘On the concept of health capital and the demand for health’, Journal of Political Economy, 80: 223–255.CrossRefGoogle Scholar
Grossman, M. (1972b), The Demand for Health: A Theoretical and Empirical Investigation, New York: Columbia University Press.Google Scholar
Grossman, M. (2000), ‘The human capital model’, in A. J. Culyer and J. P. Newhouse (eds), Handbook of Health Economics, Amsterdam: Elsevier, 347–408.Google Scholar
Gunnell, D.Middleton, N. (2003), ‘National suicide rates as an indicator of the effect of suicide on premature mortality’, Lancet, 362: 961–962.CrossRefGoogle Scholar
Hamermesh, D. S.Soss, N. M. (1974), ‘An economic theory of suicide’, Journal of Political Economy, 82: 83–98.CrossRefGoogle Scholar
Henriksson, M. M., Aro, H. M., Marttunen, M. J., Heikkinen, M. E., Isometsa, E. T., Kuoppasalmi, K. I.Lonnqvist, J. K. (1993), ‘Mental disorders and comorbidity in suicide’, American Journal of Psychiatry, 150: 935–940.Google ScholarPubMed
Hicks, N.Streeten, P. (1979), ‘Indicators of development: the search for a basic needs yardstick’, World Development, 7: 567–580.CrossRefGoogle Scholar
Illsley, R.Le Grand, J. (1987), ‘The measurement of inequality in health’, in A. Williams (ed.), Economics and Health: Proceedings of a Conference, London: Macmillan, 12–36.Google Scholar
Jöreskog, K. G.Goldberger, A. S. (1972), ‘Factor analysis by least squares’, Psychometrika, 37: 243–260.CrossRefGoogle Scholar
La Vecchia, C., Lucchini, F.Levi, F. (1994), ‘Worldwide trends in suicide mortality, 1955–1989’, Acta Psychiatrica Scandinavica, 90: 53–64.CrossRefGoogle ScholarPubMed
Le Grand, J. (1987), ‘Inequalities in health: some international comparisons’, European Economic Review, 31: 182–191.CrossRefGoogle Scholar
Le Grand, J. (1989), ‘An international comparison of distributions of age-at-death’, in J. Fox (ed.), Health Inequalities in European Countries, Aldershot: Gower, 75–87.Google Scholar
Lengers, F. P. (1994), ‘The idea of the absurd and the moral decision: Possibilities and limits of a physician’s actions in the view of the absurd’, Theoretical Medicine and Bioethics, 15: 243–251.CrossRefGoogle ScholarPubMed
Mills, C. W. (1970), The Sociological Imagination, Harmondsworth: Penguin.Google Scholar
Murray, C. J. L. (1996), ‘Rethinking DALYs’, in C. J. L. Murray and A. W. Lopez (eds), The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020, Cambridge, Mass: Harvard School of Public Health, 1–98.Google Scholar
Murray, C. J. L.Lopez, A. D. (1996), The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020, Cambridge, Mass: Harvard School of Public Health.Google Scholar
Pen, J. (1971), Income Distribution, Harmondsworth: Penguin.Google Scholar
Quantitative Micro Software (2000), EViews 4.0 User’s Guide, Irvine: Quantitative Micro Software.Google Scholar
Rocket, I. R. H.Thomas, B. M. (1999), ‘Reliability and sensitivity of suicide certification in higher-income countries’, Suicide and Life-threatening Behavior, 29: 141–149.CrossRefGoogle Scholar
Runciman, W. G. (1972), Relative Deprivation and Social Justice, Harmondsworth: Penguin.Google Scholar
Silber, J. (1982), ‘Health and inequality. Some applications of uncertainty theory’, Social Science and Medicine, 16: 1663–1666.CrossRefGoogle ScholarPubMed
Silber, J. (1983), ‘ELL (The equivalent length of life) or another attempt at measuring development’, World Development, 11: 21–29.CrossRefGoogle Scholar
Silber, J. (1988), ‘On inequality before death and life table summary measures’, Genus, XLIV: 25–39.Google Scholar
Steenkamp, M.Harrison, J. (2000), Suicide and Hospitalised Self-harm in Australia, Canberra: AIHW.Google Scholar
United Nations Development Programme (1990), Human Development Report 1990, New York: Oxford University Press.Google Scholar
US Public Health Service (1999), The Surgeon General’s Call to Action to Prevent Suicide, Washington, DC: Department of Health and Human Service.Google Scholar
Wagstaff, A., van Doorslaer, E.Paci, P. (1989), ‘Equity in the finance and delivery of health care: some tentative cross-country comparisons’, Oxford Review of Economic Policy, 5: 89–112.CrossRefGoogle Scholar
Wilkinson, D.Gunnell, D. (2000), ‘Youth suicide trends in Australian metropolitan and non-metropolitan areas, 1988–1997’, Australian and New Zealand Journal of Psychiatry, 34: 822–828.Google ScholarPubMed
Williams, R. F. G.Doessel, D. P. (2006), ‘Measuring inequality: tools and an illustration’, International Journal of Equity in Health, 5(5), http://www.equityhealthj.com/content/5/1/5.CrossRefGoogle Scholar
Williams, R. F. G.Doessel, D. P. (2007), ‘The role of knowledge accumulation in health and longevity: the puzzling case of suicide’, Prometheus, 25: 283–303.CrossRefGoogle Scholar
Yip, P. S. F., Liu, K. Y.Law, Y. W. (2005), ‘Social and economic burden of suicide in Hong Kong SAR: a year of life lost perspective’, Crisis, 26: 156–159.CrossRefGoogle Scholar