Rethinking suicide: notes toward a critical epidemiology.

Where the genesis of "disease" owes much to causes that are social and economic in nature, epidemiology holds unrealized potential as a tool of social criticism. A particularly interesting example is provided by suicide and suicide research. Methodological difficulties are explored in detail, major findings reviewed, and the dominant interpretations of such findings criticized. Research has consistently pointed to the risks of marginal or minority status, unemployment, weak community supports, situational crises, and the pressures people are subjected to during periods of economic depression. It is argued that the sociostructural implications of such research have been systematically ignored, attention being devoted instead to more efficient management of the suicidal individual--this in spite of the lack of success of suicide prevention centers. Initial steps toward an alternative framework are outlined, with emphasis laid on the need to disaggregate the suicide act. It is further suggested that self-destruction is a far commoner--indeed, integral--part of our social environment than the bare rack of suicide statistics would suggest.