Revisiting suicide rate during wartime: Evidence from the Sri Lankan civil war.
case_control · Level III
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- Record sourced from PubMed, PMID 33112885.
- Also identified by DOI 10.1371/journal.pone.0240487 and PMC identifier 7592752.
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Abstract
After the seminal work of Durkheim (1897), many subsequent studies have revealed a decline in suicide rates during wartime. However, their main focus was inter-state wars and whether the same argument holds for civil conflicts within a country is an important unresolved issue in the modern world. Moreover, the findings of the previous studies are not conclusive due to unobserved confounding factors. This study investigated the relationship between civil war and suicide rate through a more rigorous statistical approach using the Sri Lankan civil war as a case study. For this purpose, we employed a linear regression model with district and year fixed effects to estimate a difference-in-difference in the suicide rate between the peacetime and wartime periods as well as the contested and non-contested districts. The results indicate that the suicide rate in the contested districts in the wartime was significantly lower than the baseline by 11.8-14.4 points (95% CI 6.46-17.22 and 7.21-21.54, respectively), which corresponds to a 43-52% decline. The robustness of the possible confounding factors was analyzed and not noted to have so much effect as to alter the interpretation of the results. This finding supports the Durkheimian theory, which places importance on social integration as a determinant of suicide, even for civil conflicts.
Medical subject headings
- Armed Conflicts
- Suicide