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

Chapter 2Indeed, the rising rate of suicide in some parts of Canada in recent years has been linked to the increasein the divorce rate (Sakinofsky and Leenars, 1997).An analysis of Canadian data covering three decades (1951–1981) supported the hypothesis that marriage(i.e. a change from single or widowed to married status) reduced suicide risk for men significantly morethan for women (Trovato, 1991). In the case of a transition from divorced to married status, both sexesbenefited equally in reducing suicide potential. However, the analysis was confined to the populationaged 35 years and older because comparable information for younger ages was not available. As well, itis unknown to what degree common-law “marriage” or other forms of cohabitation and informal liaisonsconfer the same benefits as legal marriage. In many Aboriginal communities, extended family and kinshipnetworks may take the place of the reliance on a spouse or a partner in nuclear families. As a result, it isunclear to what extent these data can be generalized to Aboriginal populations. The majority of peoplewho attempted suicide among Alaskan Natives (81%) were single (Gregory, 1994), as were deaths bysuicide among the Inuit of Nunavik (83.1%) (Boothroyd et al., 2001).Changes Over Time: Period and Cohort EffectsVariations in the prevalence of suicide over time and across different age groups may reflect both periodeffects and cohort effects (Tsuang and Tohen, 2002). Period effects are changes in response to somefactors at one point in time that affect the whole population, but may have particular effects on somevulnerable groups in the population; for example, youth at a particular stage of development. Cohorteffects arise from factors that influence a specific birth cohort or generation and may involve events thatoccurred long before the observed change in prevalence. In practice, it may be difficult to disentangle age,period, and cohort effects (Portrait, Alessie, and Deeg, 2002).Suicide attempts increased in prevalence in the United States from 1960 until the late 1980s. Whilethe overall rate of completed suicide was stable from 1950 to 1980, the rate actually decreased amongolder individuals and increased 200–300 per cent among 15 to 24 year olds (Rosenberg et al., 1987).The rate for young people continued to increase more gradually throughout the 1980s (Tsuang et al.,1992). A smaller increase in the rate of suicide also occurred in the age group from 25 to 34 over thissame period. Suicide rates also continued to increase in early adolescence (Velez and Cohen, 1988).These increases have affected both males and, to a lesser extent, females. The rates for males over age20 stabilized in the 1990s. In the last decade, the suicide rate for white males has dropped from about20/100,000 in 1988 to 14/100,000 in 2000. A similar decrease in youth suicide rates of 20 to 30 percent has occurred in England, Finland, Germany, and Sweden. This improvement has been attributed tothe greater availability and use of antidepressant medication (Gould et al., 2003).In contrast to this trend, increasing suicide rates among youth, especially young males, have been reportedamong many Indigenous people internationally, including American Indian and Alaska Natives (Gessner,1997; Kettl and Bixler, 1991), Inuit in Greenland (Grove and Lynge, 1979; Thorslund, 1990; Lynge,1994), Aborigines in South Australia (Cawte, 1991; Clayer and Czechowicz, 1991), and the Indigenouspeople of Micronesia (Rubinstein, 1983; Tousignant, 1998). These changes do not affect just Aboriginalgroups, although they are greatly amplified among both male and female Aboriginal youth ( Jilek-Aall,1988).25