India tops the world in the number of suicide deaths with Karnataka and Tamil Nadu facing the highest burden.
Published Oct 12, 2024 | 7:00 AM ⚊ Updated Oct 12, 2024 | 7:00 AM
(Representational/ iStock)
A new study published in The Lancet Regional Health highlights the immense economic cost of suicide in India, revealing a loss of over $16 billion (approximately ₹1,12,624 crore) in 2019.
India tops the world in the number of suicide deaths. This study looks at one very limited impact of suicide, calculating only how much money the country lost from people dying by suicide.
The southern states of Karnataka and Tamil Nadu faced the highest burden, contributing to nearly one-third of the total economic loss.
Karnataka incurred the highest costs, with losses of around $2.79 billion (approximately ₹19,643 crore), while Tamil Nadu followed with about $2.55 billion (approximately ₹17,957 crore).
Maharashtra experienced costs of $2.18 billion (approximately ₹15,337 crore), and Nagaland had the lowest burden, totaling just over $9.3 million (approximately ₹65 crore).
India accounts for 25.73 percent of global suicide deaths in 2019 – over a quarter of all people who die by suicide are Indians. The age-standardised suicide rate in India was 13.8 per 100,000 people, higher than the global rate of nine per 100,000.
Note: The authors of the study took 1 USD = 70.39 INR (2019 average rate)
On the question of whether it’s right to put a value of money on human lives and how to use that information is complex, especially in low- and middle-income countries like India, the author said. This highlights the financial costs of not addressing the issue of mental health and suicide.
While preventing suicide should be a top priority for public health, decision-makers often focus on other issues that seem to offer better returns on investment.
“Public health ethics guide that suicide prevention should be a policy priority, regardless of the problem’s magnitude. However, for decision-makers allocating limited budgets to competing social issues, who intend to see greater returns for the public, suicide prevention can get off the priority,” said the authors.
They also added that the current study adds to the toolbox of suicide prevention and mental health advocates who typically rely on ethical, medical, and public health, development, and social well-being arguments and evidence to invest urgently in suicide prevention.
This research underscores the need for a comprehensive analysis of the economic burden of suicide, as such economic evidence can drive policy changes and resource allocation for suicide prevention.
“Suicide has deep economic consequences in addition to psychological ones. Loss of human capital is one such concern. This study is well suited to answer key economic implications of suicide,” Senior Consultant Psychiatrist at Manas Institute of Mental Health and Neurosciences Hubballi Dr Alok Kulkarni told South First.
He added that in India, more than a lakh people die by suicide annually. This results in the loss of a productive workforce. “Furthermore, attempted suicides lead to significant healthcare expenditures including hospitalisation. Suicides can push families into poverty, disrupt social networks, and lead to intergenerational trauma, perpetuating economic hardship,” said Dr Kulkarni.
He also said that suicide is a key public health problem. It is important to address the economic consequences via practical steps.
“There’s evidence to show that cash transfers reduce the rates of farmer suicides. In the light of all these aforementioned points, the recent Lancet article has come at a right time addressing key questions concerning the economic consequences of suicide,” said Dr Kulkarni.
One of the most alarming findings of the study was the disproportionate impact on India’s youth. The age group of 20 to 34 years accounted for 53 percent of the national economic burden of suicide, translating to nearly $8.9 billion(₹62,647 crore). Young adults between the ages of 20 and 24 were particularly affected, representing the largest share of the economic loss.
Those in the age groups 20-24, 25-29, and 30-34 contributed roughly $3.38 billion(₹23,789 crore), $3.05 billion(₹21,472 crore), and $2.46 billion(₹17,313 crore), respectively.
The study also found significant gender disparities in the economic burden of suicide. In 20 states and Union Territories, the economic impact was higher for females than for males. The total economic impact for females was about $8.67 billion (₹61,029 crore) (about 52 percent of the total), while for males, it was around $8.07 billion(₹56,834 crore). Most states had a greater economic impact for females than for males.
The top three states for females were:
For males, the top states were:
When looking at both age and gender together, the study analyzed 36 different groups based on age and sex. It found that the age groups 20-24, 25-29, and 30-34 had the largest economic burdens for both females and males.
Among females, the 20-24 age group faced the highest costs, totaling about $1.73 billion (approximately ₹12,175 crore), followed by 25-29 at around $1.57 billion (approximately ₹11,055 crore) and 30-34 at approximately $1.28 billion (approximately ₹9,002 crore).
For males, the 20-24 age group also had the highest economic burden, with about $1.64 billion (approximately ₹11,539 crore), followed by 25-29 at around $1.48 billion (approximately ₹10,415 crore) and 30-34 at about $1.18 billion (approximately ₹8,303 crore).
Overall, these findings show that young adults, particularly those aged 20-34, have a significant economic impact due to suicide, with notable differences between the sexes.
In 2019, the suicide rates in India showed that for every 100,000 people, about 15.35 men and 12.67 women died by suicide. Globally, the rates were lower, with around 12.6 men and 5.4 women per 100,000.
This means that both Indian men and women have higher suicide rates than those in other countries. The National Crime Records Bureau (NCRB) highlights that young people in India are especially at risk for suicide.
Suicide is more common among people with only primary education, those who are unemployed, and those living in rural areas. Studies show that the reasons for suicide vary widely across different states, religions, and social groups.
The NCRB reports that social pressures—like family problems, poverty, unemployment, issues related to marriage, and societal attitudes towards romantic relationships—account for over half of all suicide deaths.
Health issues and addictions make up about 25 percent of the cases. For women, marriage-related pressures and dowry issues are significant contributors.
This study employed a retrospective cross-sectional analysis using the human capital approach. It covered 28 Indian states and three Union territories, analysing data from 195,336 suicide deaths in 2019.
The analysis utilised data from the Global Burden of Disease (GBD) 2019 study, which provided estimates of suicide deaths for Indian states. Variables included the number of suicide deaths, Gross Domestic Product (GDP) per capita, government health expenditure, and years of life lost (YLL).
The study used the Human Capital Approach (HCA) to quantify the economic burden of suicide deaths. HCA estimates productivity losses due to premature mortality. It calculates the total monetary value of years of life lost (TMVYLL) based on state-specific GDP, life expectancy, and discount rates.
The study performed multiple sensitivity analyses, varying the discount rates and life expectancy thresholds to understand the robustness of the economic burden estimates under different scenarios.
The total monetary value of years of life lost (TMVYLL) is a way to quantify the economic impact of premature deaths, particularly in contexts like suicide. It begins with the concept of years of life lost (YLL), which measures how many years a person could have lived if they had not died early, calculated by subtracting their age at death from their expected lifespan.
To express this impact in economic terms, researchers assign a monetary value to each year of life lost, often based on potential income or a standard value of life year. TMVYLL is then computed by summing these monetary values for all individuals who died prematurely within a specific group during a given timeframe.
This calculation helps policymakers understand the broader economic consequences of mortality due to specific causes, such as suicide, and provides crucial evidence for allocating resources and funding health programs aimed at preventing such deaths.
If a study finds that:
The TMVYLL would be calculated as follows:
The author said that the economic burden of suicides in India should be an impetus for investing in suicide prevention.
“Despite an existing National Suicide Prevention Strategy, barriers to its implementation are evident and widespread. One critical barrier is poor financing. This is mainly due to the failure to acknowledge suicide as a societal problem requiring concerted attention beyond the health ministry,” the authors of the study pointed.
It further said that despite India’s introduction of the National Suicide Prevention Strategy (NSPS) in 2022, which aims to reduce suicide mortality by 10 percent by 2030, the implementation of these initiatives has been sluggish, largely due to underfunding and poor coordination.
They added that the large economic burden noted here necessitates intersectoral involvement from the Ministries of Finance, Youth Development, Women’s Welfare, Rural Development, and Agriculture in India. Hence, intersectoral coordination, along with investment strategic scale-up, is needed to reduce the disease and economic burden of suicide.
(Edited by Rosamma Thomas)
