Suicide among Russians in Estonia: database study before and after ind
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《英国医生杂志》
1 Estonian-Swedish Institute of Suicidology, Hariduse 6, Tallinn 10119, Estonia, 2 Swedish National and Stockholm County Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm
Correspondence to: A V?rnik Airi.Varnik@ipm.ki.se
Introduction
During the Soviet era Russians had the lowest suicide rate in Estonia, which might have been due to their privileged status. Russian immigrants in Estonia had privileges in salaries and housing, and their needs received greater attention than local populations in Estonia and in Russia. There was no need for integration and acculturation, and Russians maintained their sense of ethnic identity and confidence in belonging to a privileged class.
After Estonian independence in 1991, Estonian Russians had to adapt themselves to new conditions, study Estonian as an official language, and apply for citizenship. The loss of privileged position and ideals, many years after immigration, may have caused stress leading to suicidal behaviours2 and suicide rates significantly higher than for Estonians in Estonia and Russians in Russia.
During 1995-8, stabilisation and adaptation processes began in Estonian society. Convergence of the Russian and Estonian suicide rates in Estonia in 1998 could be interpreted as an adaptation to sociopolitical changes and efforts of the Estonian government to integrate the Russian minority.3
What is already known on this topic
Migration is an important risk factor for suicide, and immigrants have a higher risk of suicide than exists in their country of origin and in the native population of the new country
What this study adds
During the Soviet period the suicide rate among the Russian minority in Estonia was lower than the rate in native Estonians
When Russians changed from a privileged to a non-privileged minority in independent Estonia, the suicide rate in the Russian minority in Estonia became significantly higher than in native Estonians and in Russians in Russia
The statistics on suicides in the former Soviet Union are valid and reliable.4 5 Then the procedure for reporting and registration was uniform and remained the same in the Russian Federation and also in Estonia. The present study is limited, however, because of the relatively small number of suicides in Estonia.
See also pp 167, 175
This article was posted on bmj.com on 15 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38328.454294.55
We thank Max Goldstein, Swedish National and Stockholm County Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, and Liina-Mai Tooding for advice on statistics.
Contributors: AV and DW designed the study and wrote the paper. KK and AV participated in data collection. KK did the statistical analysis. All authors interpreted the data. AV is guarantor.
Funding: AV received grants from the Swedish Research Council and the Estonian Scientific Foundation Project No 5349. He also holds the Olof Palme professorship at NASP, Karolinska Institute.
Competing interests: None declared.
Ethical approval: Not required.
References
Burwill PW. Migrant suicide rates in Australia and in country of birth. Psychol Med 1998;28: 201-8.
Hovey JD. Acculturative stress, depression, and suicidal ideation among Central American immigrants. Suicide Life Threat Behav 2000;30: 125-39.
V?rnik A, K?lves K. Estonians' and non-Estonians' suicides. Tallinn-Tartu, Estonia: Tallinna Lennuliikluse Trkikoda, 2001: 14.
V?rnik A, Wasserman D, Palo E, Tooding LM. Registration of external causes of death in the Baltic States 1970-1997. Eur J Public Health 2001;11: 84-8.
Wasserman D, V?rnik A, Dankowicz M, Eklund G. Suicide preventive effects of perestroika in the former USSR: the role of alcohol restriction. Acta Psychiatr Scand 1998;98(suppl 394): 1-41.(Airi V?rnik, director, professor of psyc)
Correspondence to: A V?rnik Airi.Varnik@ipm.ki.se
Introduction
During the Soviet era Russians had the lowest suicide rate in Estonia, which might have been due to their privileged status. Russian immigrants in Estonia had privileges in salaries and housing, and their needs received greater attention than local populations in Estonia and in Russia. There was no need for integration and acculturation, and Russians maintained their sense of ethnic identity and confidence in belonging to a privileged class.
After Estonian independence in 1991, Estonian Russians had to adapt themselves to new conditions, study Estonian as an official language, and apply for citizenship. The loss of privileged position and ideals, many years after immigration, may have caused stress leading to suicidal behaviours2 and suicide rates significantly higher than for Estonians in Estonia and Russians in Russia.
During 1995-8, stabilisation and adaptation processes began in Estonian society. Convergence of the Russian and Estonian suicide rates in Estonia in 1998 could be interpreted as an adaptation to sociopolitical changes and efforts of the Estonian government to integrate the Russian minority.3
What is already known on this topic
Migration is an important risk factor for suicide, and immigrants have a higher risk of suicide than exists in their country of origin and in the native population of the new country
What this study adds
During the Soviet period the suicide rate among the Russian minority in Estonia was lower than the rate in native Estonians
When Russians changed from a privileged to a non-privileged minority in independent Estonia, the suicide rate in the Russian minority in Estonia became significantly higher than in native Estonians and in Russians in Russia
The statistics on suicides in the former Soviet Union are valid and reliable.4 5 Then the procedure for reporting and registration was uniform and remained the same in the Russian Federation and also in Estonia. The present study is limited, however, because of the relatively small number of suicides in Estonia.
See also pp 167, 175
This article was posted on bmj.com on 15 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38328.454294.55
We thank Max Goldstein, Swedish National and Stockholm County Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, and Liina-Mai Tooding for advice on statistics.
Contributors: AV and DW designed the study and wrote the paper. KK and AV participated in data collection. KK did the statistical analysis. All authors interpreted the data. AV is guarantor.
Funding: AV received grants from the Swedish Research Council and the Estonian Scientific Foundation Project No 5349. He also holds the Olof Palme professorship at NASP, Karolinska Institute.
Competing interests: None declared.
Ethical approval: Not required.
References
Burwill PW. Migrant suicide rates in Australia and in country of birth. Psychol Med 1998;28: 201-8.
Hovey JD. Acculturative stress, depression, and suicidal ideation among Central American immigrants. Suicide Life Threat Behav 2000;30: 125-39.
V?rnik A, K?lves K. Estonians' and non-Estonians' suicides. Tallinn-Tartu, Estonia: Tallinna Lennuliikluse Trkikoda, 2001: 14.
V?rnik A, Wasserman D, Palo E, Tooding LM. Registration of external causes of death in the Baltic States 1970-1997. Eur J Public Health 2001;11: 84-8.
Wasserman D, V?rnik A, Dankowicz M, Eklund G. Suicide preventive effects of perestroika in the former USSR: the role of alcohol restriction. Acta Psychiatr Scand 1998;98(suppl 394): 1-41.(Airi V?rnik, director, professor of psyc)