Suicide Among Aboriginal People in Canada - Institut universitaire ...

Chapter 2slashing) (Velez and Cohen, 1988). A comparison of community surveys in nine countries found thatrates for suicide ideation were slightly higher in females than males at all sites; whereas, there was asignificant two- to three-fold increase in risk of suicide attempts for females compared to males at mostof the sites (Weissman et al., 1999). However, the gender ratio is sensitive to social and cultural factors.For example, the rate of death by suicide in rural regions in China is higher among young females thanmales ( Ji, Kleinman, and Becker, 2001; Qin and Mortensen, 2001; Phillips, Lesyna, and Paight, 2002;Prichard, 1996; Shiang et al., 1998). This has been attributed to the difficulties faced by young womenin Chinese society; suicide attempts in rural areas often use agricultural poisons with high lethality. Thisexample is a clear illustration of the profound impact of social factors on suicide.The gender differences in suicide rates among Aboriginal people amplify the pattern of male predominanceseen in the general population. The majority of deaths by suicide are among young men. In Manitobabetween 1984 to 1988, males comprised 83.8 per cent of all completed suicides among youth (Sigurdsonet al., 1994). Similarly, among the Inuit of Nunavik from 1982 to 1996, 83 per cent of all completedsuicides were males (Boothroyd et al., 2001). However, a review covering the period from 1988 to 1994found that 30 per cent of suicides in the Aboriginal population were female compared to 19.2 per cent inthe general female population (Malchy et al., 1997).Female adolescent status Indians are 7.5 times more likely to die by suicide than female adolescents in thetotal population. In the age range of 20 to 29, the suicide rate for female status Indians is 3.6 times therate for all Canadian females. Female status Indians have higher suicide rates than all female Canadiansup to 69 years of age. Rates for male status Indians are higher than the total male population from ages10 to 50. Adolescent males are more than 5 times as likely to die by suicide than the average Canadianmale adolescent (Medical Services Branch Steering Committee on Native Mental Health, 1991a).In Aboriginal populations, suicide attempts are generally more frequent among women than men,although this is owing to a greater tendency to use more lethal means, and the gender difference is notas large as in the general population (Clarkson et al., 1992). In a survey of 11,666 high school studentson reservations in the United States, 21.8 per cent of girls compared to 11.8 per cent of boys reportedone or more suicide attempts for a ratio of 2:1 (Borowsky et al., 1999). Two studies among the Inuit ofNunavik actually found a slightly higher rate of attempted suicide among Inuit males compared to females(Kirmayer, Malus, and Boothroyd, 1996) or no significant difference in rates (Kirmayer et al., 1998). Aswill be discussed in Chapters 3 and 4, this cultural and regional variation in gender ratio likely reflectsspecific stressors that differentially affect young Aboriginal males and females. Males have experiencedgreater discontinuity in social roles with rapid cultural change; females are more liable to have suffereddomestic violence and abuse, but are also more likely to seek out help for depression or other forms ofemotional distress.Marital StatusIn the general population, suicide is more frequent among both men and women who are single, separated,divorced, or widowed compared to those who are married (Trovato, 1991). Those who are married withchildren have still lower rates. Suicide attempters are more often single, separated or divorced, and livealone (Wasserman, 1988). Community surveys in nine countries found that both suicidal attempts andideation were two to four times more prevalent among divorced individuals (Weissman et al., 1999). Therate of suicide is correlated with divorce rates across Canadian provinces (Leenaars and Lester, 1999).24