1、从城乡变迁看中国人自杀格局的演变 Changing Patterns of Suicide in the Context of Urban & Rural Transformations in China,清华大学社会学系教授 Department of Sociology景军 Jing Jun 2011.3.18,格局与变化 (1987-2009) Patterns & Changes,全国自杀率的下降 Decline of National Suicide Mortality 农村自杀率的下降 Decline of Rural Suicide Morality 农村女性自杀率的大幅度下降
2、Dramatic Decline of Female Suicides in Rural Areas 城市老人自杀率的大幅度上升 Dramatic Increase of Elderly Suicide in Urban Areas,全球自杀趋势 Global Suicide Trends,据国际自杀预防协会报告，2008年全球自杀率是十万分之十四点五（14.5/100,000）, 到2009年上升至十万分之十六（16/100,000）.这意味着全球每年大约有100万人死于自杀。世界卫生组织的自杀预防文献显示，全球自杀率在过去四十五年年上升了六十个百分点。In the last 45 year
3、s, the global suicide mortality rate went up 60 %. In 2009, the global suicide rate is 16/100,000, costing one million lives a year. 除精神疾病和心理困扰，导致自杀的原因包括社会秩序的崩溃、家庭的解体、婚姻的不幸、经济的拮据、家庭暴力、重病中的绝望情绪。Psychiatric and other mental problems work together with the breakdown of social order, family, and marriag
4、e as well as economic burdens, domestic violence and despondence due to terminal illness.,中国大陆自杀趋势 Trend of Suicides in China,中国的自杀趋势与全球的自杀趋势正相反，在过去20多年内出现一个明显下降的趋势。目前，中国的全国自杀率已远低于全球自杀率。Our analysis shows a different picture in China where the suicide mortality rate went down significantly in the la
5、st 20 years, becoming much lower the suicide mortality rate worldwide.,1987年-2009年中国自杀率下降趋势（1/10万）,全国数据描述 A Snapshot of National Data,中国的自杀率一度处于一个在世界范围也算得上较高的水平。例如，1987年-1995年期间曾经浮动于17.65/100,000到16.16/100,000之间; 但在1996年-2003年期间有所下降，尤其在2004年-2009年期间出现较比明显的下降，从10.87/100,000降到了7.17/100,000。Chinas suic
6、ide rate used to be rather high by international standards. For example, it stayed between 17.65/100,000 to 16.16/100,000 from 1987 to 1995, then went down a little bit in the 8 years that followed, and eventually declined significantly from 2004 to 2008, dropping from 10.87/100,000 to 7.17/100,000.
7、,1987年与2009年的中国自杀率比较（1/10万）,Chinas Suicide Rate by Gender & Residence in 1987 & 2009,中国自杀率下降的拉力 A Major Factor of Suicide Decline in China,从1987年到1997年，农村女性自杀率曾明显高于农村男性自杀率，之后出现一个下降趋势；到2006年，农村女性自杀率开始略低于农村男性自杀率。农村女性自杀率的下降是全国自杀率下降的关键，其背后是大批农村女性从乡村到城市的劳动力迁移。,From 1987-1997，more women killed themselves
8、than men did in rural areas and this situation began to change thereafter. By 2006, the suicide rate of rural women became lower than that of rural men. This can be traced to rural-to-urban migration.,19872009年中国自杀率的城乡分布（1/10万）,Suicide Rate by Urban-Rural Division from 1987 to 2009,（1/100,000）,19872
9、009年中国农村自杀率 Rural Suicides in China from 1987 to 2009,农村女性的三个“远离” Rural Womens “3 Departures”,4千4百万农村女性远离了既往的从属地位 Departure of 4.4 million rural women from subordination 大量农村女性远离了既往的家庭冲突情境 Departure from nearly insurmountable family conflicts打工的农村女性远离了既往自杀工具 - 农药 Departure from pesticides as a suici
10、de tool,全国自杀率和农村自杀率与农村外出劳动力比重的逐年比较,Increase of rural labor outflow and decrease of rural and nationwide suicide trends,2006年农民工的性别、年龄与教育程度 Gender, Age, & Education among Migrant Workers in 2006,第二期中国妇女社会地位调查 Second National Survey of Chinese Womens Social Status,婚姻完全由父母决定 Marriage Decided by Parents
11、,2000年农村男文化程度比较 Gender Difference in Education Attainment,家庭纠纷与其他诱因在农村人口自杀死亡中所占的百分例 Family Conflicts as compared with Other Causes,六个地区报告的服用农药自杀数据 Suicide Mortality Associated with Use of Pesticide,根据亚洲的自杀与自杀预防报告介绍，中国农民最常使用的自杀工具是杀虫剂，每100例自杀案件中就有62例为服用杀虫剂。,令人担忧的两个问题 Two Concerns,农村老年人的自杀率近年来虽然缓解了许多，但
12、依然很高。以农村70-74岁的老人为例。在2002-2008年期间，这个年龄组的年均自杀率是47.05/10万,为全球极为少见的老年人自杀率。In past few years, the problem of suicides among elders eased a great deal in the rural areas and yet it remains very serious nonetheless. From 2002 to 2008, the suicide rate among rural elders in the 70-74 age group averaged 47/
13、100,000 per year，a situation rarely seen elsewhere in the world. 更令人担忧是城市老年人各个年龄组的年均自杀率在千禧年之后的明显上升。以70-74岁的城市老年人为例。这个年龄组的年均自杀率在1991-1999年期间为13.39/10万，2002-2008年间上升到33.76/10万。More disturbing is the rise of suicides among elders in urban areas. From 1991 to 1999, the suicide rate among urban elders in
14、 the 70-74 age group averaged 13.39/100,000 a year. But from 2002 to 2008, that average went up to 33.76/100,000.,按年龄组计算的中国城乡老人年均自杀率（1/10万）,Suicide rates of urban and rural elders in two periods,按年龄组计算的中国城乡老人年均自杀率（1/10万）,Suicide rates of urban elders in two periods,已攀援的老年人自杀高点 A Peak of Elder Suicid
15、e,2002-2005年期间当属中国城市老年人的自杀高峰期.各个年龄组的自杀率远远高于90年代。The period from 2002 to 2005 witness the peak of elder suicide in urban China. In each of these in 1990s. every age groups suicide rate became higher than the levels reached in the 90s.城市老年人的自杀率在2006年开始明显下降。The year 2006 marked the beginning of a drama
16、tic decline,中国城市老年人自杀的主要诱因和方式,Major Causes and Methods of Suicide among Urban Elders Causes: (1) Despondence in Illness, (2) Family Conflicts Methods: (1) Hanging, (2) Poison, (3) Jumping, (4) Drowning,大环境因素 Environmental Factors,城市老人医保问题 Medical Insurance for the Elderly城市搬迁过程中的老人赡养问题 Old-Age Suppo
17、rt in Change of Residence,医保问题 Medical Insurance,即便在北京，2002年的一项研究发现某老城区内大约有20%的老年人没有医疗保险，需要自费看病。Even a study in Beijing found 20% of the elderly in an rural district did not have any form of medical insurance in 2002. 在2006年政府展开城镇居民医保试点工作之前，许多城市老人由于没有过正式的工作或原有的正式工作单位被解散或宣告破产而不能获益于城镇职工的医保制度。虽然有商业性医保的
18、存在，贫困老人通常没有经济能力或不愿购买保险公司提供的医保计划。Before the government decided in 2006 to provide universal-plus-basic insurance for all urbanites for medical treatment, medical insurance plans only covered those who have work units, leaving out those who never had a formal job or were laid off from state enterprise
19、s. Although commercial plans for medical insurance were available, the poor among the elderly in urban areas could not afford to would not like to buy them.,城市老人搬迁后的三个“反差” “3 Contrasts” after Relocation,既往社会网络被弱化social networks weakened 从熟人社会变为陌生邻里unfamiliar neighbors 子女探望老人的路途距离增大 distance of visit
20、ation increased,以北京胡同数量的减少趋势为例 （1949-2005年） The Number of Beijings Hutong from 1949 to 2005,恰恰在北京胡同消失最快的15年内，北京的人口老龄化在加速,社会保障政策的有效性 Policys Effectiveness,城市老人自杀率连续四年处在历史最高峰之后，2006-2008年期间城市老人自杀率陡然下降。到了2009年，没有一个年龄组老人的自杀率超过32/10万。这很可能说明中国城市居民基本医疗保险的出台挽救了数以万计的生命。After reaching a 4-year peak, the moral
21、ity rate of suicides committed by the elderly in urban China went down significantly from 2006 to 2008. Not a single age-set group among the urban elders saw a rate higher than 32/100,000 by 2009. This suggests that the universal-plus-basic medical insurance policy designed for urbanites may have sa
22、ved thousands of lives.,到2007年底，全国加入城市居民基本医疗保险的人数到达了4千多万；到2008年底，参保人数接近了1亿2千万；到2009年底，参保人数达1亿8千万之多。对参保的城市老人而言，城市居民基本医疗保险意味着至少一半以上的住院费由医保基金担负，最高额度在不同城市每年度内可以达到4万至7万人民币。对那些生活极为困难的城市老人而言，其住院费由医保基金承担的份额可以更高。,老人自杀可以预防 Elder Suicide is Preventable,老龄化加剧并不一定意味着老人自杀率的上升。世界卫生组织对120多个国家的自杀数据收集和整理工作证明，世界上大多数国家
23、的自杀问题更多地同青少年和中青年关联。相比之下，老人自杀率超过低年龄人群的国家为数较少。Entry into an aging society do not necessarily mean more suicides among the elderly. More than 120 nations have been reporting suicide figures to WHO and most of these countries do not have a serious problem of elder suicides. Instead, the proportions of y
24、ounger people who commit suicides are larger than that of the elderly people.,Where Many Elder Suicides Are found?,Korea Taiwan China Serbia Slovenia Hungary Japan Switzerland Cuba Hong Kong France Germany Singapore Argentina,涂尔干自杀理论中社会整合问题 Social Integration in Durhmeims Suicide Theory,举例：气候、宗教、经济的
25、繁荣与萧条与自杀的关系,缺乏社会整合 Egoistic 个体主义类型的自杀 （如未婚者或不合群的人们） 过度社会整合 fatalistic 悲观绝望类型的自杀（如感到无望的犯人或奴隶） 社会整合失效 anomic 社会失范类型的自杀 （如感到现实与价值观扭曲的人） 高度社会整合 altruistic 利他主义类型的自杀（如勇于为他者或事业献身的人）,Relative Deprivation Theory 相对剥夺理论,Runciman在1966年出版的相对剥夺与社会正义一书中提出了形成相对剥夺的四个条件：人们知道自己没有X one knows he does not have x 人们知道他人
26、拥有X one knows other people have x人们非常想获得到X one very much wants to have x 人们认为能够得到X one feels it is realistic to have x在这四个条件的相互作用下，可能出现不同的相对剥夺感。期待的获得值和实际的获得值之间的距离越大，相对剥夺感也就变得越大。 Relative deprivation is created when realities do not match expectations, and the greater mismatch it is, a greater sense
27、of dissatisfaction occurs.,三个远离 3 Departures,三个反差 3 Contrasts,住房面积（平方米）,An Example of expectations and realties with regarding housing,相对剥夺理论对社会整合理论的补充 Considering a Theory of Relative Deprivation,三种相对剥夺图示 Three Situations of Relative Deprivation,结 Conclusion 论,Relative deprivation theory applies to
28、 the decline of rural womens suicides and the rise of elder suicides in urban areas. The core question for both cases is the interaction between expectations and social realities.,相对剥夺理论对农村女性自杀率的下降和城市老人自杀率的上升具有同样的解释力其提出的核心问题乃是期待和现实的互动,最后 One More Point 一点,中国还没有一个针对自杀预防的国家政策或计划.PRC still has no suicide prevention policy.上海在1920-30年代就出台了自杀预防政策。In Old Shanghai, such a policy was at work in the 192030s.,Department of Sociology 清华大学社会学系教授景军 Jing Jun 手机： 1391 740 452,
