racial/ethnic and sexual discrimination. The relationship of power to suicide in these contexts is extremely complex; the power a certain group has on a macro-social level must be disentangled from individuals’ perceived personal and interpersonal control, economic power, and self-perception of the ability to foster change. Emerging areas of community and cultural psychology refer to this latter concept as “sociopolitical control,” and have found evidence that sociopolitical control may moderate the relationship between certain risk factors and mental health outcomes (e.g., Zimmerman et al., 1999) by contributing to self-esteem and promoting self-efficacy. Other research shows that lack of power may engender hopelessness and exacerbate stress. Studies that focus on these concepts could help explicate phenomenological and etiological aspects of suicide among marginalized and disadvantaged sub-populations.
Consistently, suicide rates are higher in rural areas than in urban areas (see Chapter 2). In China, the rate is two to five times greater in the rural regions (Ji et al., 2001; Jianlin, 2000; Phillips et al., 1999; Yip, 2001). Young Chinese women kill themselves three times more often in rural areas than in urban areas (Ji et al., 2001). This same trend has also been documented in young males in Australia (Wilkinson and Gunnell, 2000). Even among Greek adolescents where the suicide rate is relatively low, urban areas reported significantly lower suicide rates than rural areas (Beratis, 1991). In the Ukraine, suicide is also more frequent in rural areas and in industrially developed regions than in the cities (Kryzhanovskaya and Pilyagina, 1999). Over time in some countries, the effects of rural– urban residence are changing. In Japan, for example, the discrepancy between suicide rates in rural and urban districts increased from 1975 to 1985 but declined in subsequent years (Goto et al., 1994).
From the beginnings of the social science study of suicide rates, massive social change, especially that evidenced by the rise of the industrial age, has been implicated as a major cause of rising suicide rates (Masaryk, 1970; Porterfield, 1952). Not surprising then, is the recent decrease in suicide in many Western European countries and the contrasting increase in Eastern European countries (Sartorius, 1995). The rates in Russia during the post-Soviet era have increased, in keeping with an overall increase in age-adjusted mortality and morbidity. Age-standardized suicide rates have almost doubled between 1970 and 1995 in Latvia (Kalediene, 1999). In the Ukraine, the suicide rate increased by 57 percent between 1988 and