AS CHINA AGES, worries are mounting about the mental health of its elderly population. Globally, suicide rates among old people tend to be higher than average. In China this is especially true. People there aged 70 and above kill themselves at more than four times the rate of the general population, compared with around a quarter more in America. Loneliness and inadequate health care are among the main reasons.
It is not all bad news. In the 1990s China’s suicide rate was among the highest in the world. Fatal self-harm was strikingly common among young women in the countryside, who had easy access to lethal pesticides. But in the past 20 years, China’s rate has declined more than any other country’s, mainly as a result of stricter controls on those chemicals and migration to cities, where such poisons are even harder to obtain. In 2019 it was nine per 100,000, compared with 14 in America and 19 in Japan.
Among people aged 70 or over, the suicide rate has also dropped since 1990, from 78 per 100,000 to 35. But as a proportion of all suicides, those by elderly people have risen from 14% to 31%. In part, that is because the elderly’s share of the population has risen, too, from 3.4% in 1990 to 6.8% today. But between 1990 and 2017 suicide rates among the old fell the least of any age group.
Poverty and a lack of social services exacerbate the problem, as does internal migration: younger people often leave older family members behind in the countryside. Because of falling birth rates, elderly people have fewer youngsters to look after them. Research published in March by a group of academics in America and China, including Hanming Fang of the University of Pennsylvania, uses an unusually granular set of data from the Chinese Centre for Disease Control and Prevention to demonstrate the impact of loneliness. It shows that the weekly suicide rate among the elderly—those over 65, in this case—decreases by more than one-tenth during the Chinese New Year holiday, when families reunite (see chart). The holiday does not appear to affect suicides among younger people.
The situation may get worse. At least half of the elderly are empty-nesters, state media say. Their numbers are surging. In 2013 China passed a law requiring those who live apart from elderly parents to “frequently visit or send greetings”. It has, of course, proved difficult to enforce. On November 24th the government published guidelines on care for the elderly, including advice that young adults should live with, or close to, their parents. Many online comments were derisory. How about scrapping household-registration rules that restrict migrants’ access to welfare in the cities, some asked? Only then might ageing parents leave the villages and join their urban offspring.
This article appeared in the China section of the print edition under the headline “Old and sad”