From: Miller-McCune
Turning research into solutions

Two economists say increased public health spending may lower suicide rates. But how?

By: Ryan Blitstein |  June 13, 2008  |  01:25 PM (PDT

After falling during the Bush I and Clinton years, suicide rates in the United States are on an upswing, adding urgency to a long-standing academic debate over how to make sense of the cause of 32,000 American deaths per year.

Obvious answers, such as mental illness and psychological problems, are only part of the equation, according to many suicidologists. For decades, economists and other researchers have been analyzing how such macro-level indicators as unemployment, divorce, religious worship and income inequality correlate with individuals’ decisions.

A recent paper analyzes how state government affects the problem, arguing that higher public spending levels decrease the suicide rate. Yet how government policies make an impact remains an open question.

Suicide ranks in the top 10 causes of death among American males and the top 20 for women — and for every suicide, another 20 people attempt to take their own lives, according to the Centers for Disease Control and Prevention, whose published numbers run through 2005.

The conventional economic explanation for suicide, first proposed in the mid-1970s, holds that a person takes his or her own life when his or her expected lifetime utility reaches zero. The steely equation describes this utility as a function of age, income and the cost of staying alive. While much research has shown a mixed relationship between income and suicide, the studies have established that people kill themselves at least partly due to external factors, not merely due to social isolation or mental problems.

Two academics, Camelia Minoiu (then at Columbia University, now at the International Monetary Fund) and University of Castilla-La Mancha visiting professor Antonio Rodriguez Andres, noticed that few researchers had included government spending in their analyses. “We found socioeconomic variables that captured activity by the state were generally ignored,” Minoiu said.

The most comprehensive data they could obtain were state-by-state figures of health and welfare spending, expressed as a percentage of each state’s total outlay. Though these statistics encompass far more than just suicide prevention programs, Minoiu and Andres believed the numbers might act as a proxy for the quality and size of each state’s health care system and for how much of a priority governments placed on such issues.

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