Place of birth and suicide in Hungary: is there a

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that took place in Hungary during the past fifty years or so, subsequent ..... _____. (1989). Suicide rates in immigrant groups and their countries of origin:.
Archives of Suicide Research, 7 (2003) 341-352.

Place of birth and suicide in Hungary: is there a regional subculture of self-destruction?*

Ferenc Moksony Department of Sociology and Social Policy Budapest University of Economic Sciences and Public Administration

*

Direct correspondence to: Ferenc Moksony, Department of Sociology and

Social Policy, Budapest University of Economic Sciences and Public Administration, Fõvám tér 8, H-1093 Budapest, Hungary. E-mail: [email protected]. The research reported in this paper was supported by the Hungarian National Research Fund, Grant no. F6733. Professor Péter Sótonyi, Albert Antal, Katalin Kevevári, Gabriella Tarjányi and Ildikó Urbán provided invaluable help in the data collection, which is gratefully acknowledged. Thanks are also due to Lisa Catanzarite, Maria Charles, Rita Hegedûs and Ákos Róna-Tas for useful comments on earlier drafts of this article.

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Abstract Suicide in Hungary varies widely across regions, rates being highest in the Southeast and lowest in the West. Most researchers explain this fact by cultural differences, arguing that people in the Southeast learn, as they grow up, to regard self-destruction as an acceptable way of responding to problems encountered in everyday life. I tested this explanation by looking at the longerterm impact of region of birth, controlling for current place of residence. Conducting a case-control study, I found that those born in the Southeast but moving to another region later in their life retained, as predicted, their greater propensity to suicide. This effect persisted even after ruling out a number of alternative explanations such as differential selection and residential mobility.

Key words: case-control study, deviant behavior, subculture, suicide, region

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Place of birth and suicide in Hungary: is there a regional subculture of self-destruction?

Hungary has long been known among researchers for its exceptionally high suicide rate. In fact, this rate was highest all over the world for many decades and although slightly declining recently, it still exceeds the corresponding figures for most other nations. Behind this high overall level, however, are large variations across regions; variations, moreover, that have been remarkably stable over time. Despite the profound socio-economic changes that took place in Hungary during the past fifty years or so, subsequent volumes of demographic yearbooks invariably tell much the same story: selfdestruction peaks in the Southeast and is least common in the West (see Table 1).

TABLE 1 ABOUT HERE

Understanding this regional pattern of suicide has long been a great challenge for research workers. The first studies, conducted in the late 1960s and the early 1970s, were based on the idea that the differences observed across regions in the level of self-destruction can be traced to differences in the sociodemographic composition of the population.1 Areas with a substantial share of

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the elderly, for example, could be expected to have a relatively high suicide rate simply because old people are themselves more inclined to take their life. Using ecological correlations (Andorka et al., 1968) and rate standardization (Jobb, 1973), these early studies failed to find significant composition effects, however. These negative findings lent support to an alternative explanation, one based on the notion of deviant subculture. In this view, the high rate of selfdestruction in the Southeast is the product of norms and values that prevail in the local community and that accept or even encourage suicide as a response to problems encountered in everyday life. Although their historical roots are not yet well understood, childhood socialization is generally believed to be the major vehicle with which these norms and values spread across generations. People living in this region are said to learn, as they grow up, a self-destructive coping strategy; a deviant behavior pattern that may be silent for decades, just to revive later.

Theoretical background and related research Cultural explanations such as the one proposed to account for the high level of suicide in Southeastern Hungary have a venerable history in research on deviance. In fact, the great bulk of the theories that have been advanced in this field can be sorted in two groups, structural and cultural. In structural

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explanations like Durkheim‘s integration theory or Hirschi‘s control theory, people who commit crime or take their life are seen as being detached from the main stream of interpersonal relations, as lacking the social bonds that would be necessary to restrain or regulate their behavior. Cultural explanations, in contrast, such as Sutherland‘s differential association theory, stress the role that attachment to a community and following its norms and values play in the causation of deviance. (For a useful comparison of these two lines of thought, see, Hawkins and Fraser, 1985.) Cultural theories have also often been used to explain regional differences in deviant behavior. The high prevalence of homicide in the southern part of the United States, for example, has been seen by many to be the product of what Gastil (1971) once called a regional culture of violence. This concept is generally interpreted as referring to a set of attitudes and behaviors that are shared by those living in the South and that permit or facilitate the use of force in certain situations. Although Gastil‘s idea owes much to the subculture of violence theory advanced by Wolfgang and Ferracuti (1967), there also are differences between the two that are worth noting. First, the scope of Gastil‘s notion is somewhat broader, including not just norms and values that explicitly condone violence but also factors that more indirectly favor the use of force. Second, and perhaps more importantly for our purposes, “[t]he regional concept ... suggests more persistence over time and intergenerational reinforcement than does the subcultural concept.” (Gastil, 1971: 416) As will

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become more evident soon, this latter feature of Gastil‘s theory is especially relevant in the context of the present article. Empirical studies conducted to test the idea of a regional culture of violence came up with mixed results: some of them reported findings that were largely supportive of the theory (e.g., Messner, 1983), whereas others concluded that differences in the level of crime across regions can better be explained by structural factors such as poverty (e.g., Loftin and Hill, 1974). In what is probably one of the most thorough analyses in this field, McCall and her associates argued that while norms and values might not account for all types of violent crime, they do seem to play an important role in some forms of them, namely in crimes committed to defend someone‘s person, family or property (McCall, Land and Cohen, 1992). Although originally confined to crime and delinquency, the notion of regional culture of violence has been applied to suicide as well. Most of these applications aimed to explain variations across areas in the methods used for self-destruction. Marks and Abernathy (1974) and Lester (1986-1987), for example, showed that firearm suicides are more common in the Southeast than in other parts of the United States and they related this fact to the prevalence in that region of norms and values that support violent forms of problem solving. A somewhat different approach was taken by Lester and Leenaars (1998), who, in a recent study of Canadian provinces, looked at the ecological relationship between suicides, homicides and accidental deaths from firearms.

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They found all these causes of deaths to be positively correlated with each other and interpreted this result as supporting the notion of a regional subculture of firearm violence. In addition to completed suicide, cultural theories have also been invoked to account for geographical differences in suicide attempts. Platt (1985), for instance, in his study in Edinburgh, Great Britain, contrasted areas with high and low levels of self-destruction to see if they also differ in terms of what he called “a subculture of parasuicide”. The results were rather mixed, some of them plainly contradicting the initial expectations. For example, people living in areas characterized by a high rate of attempted suicide were, on average, less, rather than more, tolerant to this form of deviance. They found parasuicide “less understandable, more deserving of punishment [and] more morally wrong” (p. 287). Although not entirely free of methodological problems2, these findings clearly represent a challenge for anyone wishing to use cultural theories to account for spatial patterns in self-destruction.

Region of birth and suicide In order to assess the role that cultural factors might play in regional differences in suicide in Hungary, the study to be reported in this paper looked at the effect of region of birth on self-destruction, while holding current residence constant. The idea underlying this approach was that if deviant norms and values acquired through childhood socialization really are as

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important as advocates of cultural theories suggest, then region of birth should have a lasting effect, one that persists even when one moves, at a later stage of one’s life, to a different part of the country. People born in the Southeast but living elsewhere should have retained, at least in part, their original attitudes and their propensity to kill themselves should, therefore, exceed that of those born in other regions, where the dominant cultural climate is less favorable to suicide. Previous research generally supports this idea of a long-term effect of place of birth on self-destruction. Sainsbury and Barraclough (1968), for example, found a high positive correlation between the suicide rates for immigrants to the United States and the rates for their countries of origin. Although this finding was mainly used to demonstrate the reliability of official statistics, it also suggests that people moving to another country preserve the behavior patterns characteristic to their homeland. While Sainsbury and Barraclough used data from the late 1950s, a more recent investigation by Lester (1989) employed suicide rates back from the 1920s. The results reported in this study were very similar to the ones reported by Sainsbury and Barraclough: immigrants to the United States from countries with a high level of selfdestruction had a much greater risk of suicide than had those arriving from countries where this form of deviance is less prevalent. Long-term effects of place of birth on suicide have also been reported from countries other than the United States. In their study in Australia, for example,

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Taylor and his associates found that immigrants from Southern Europe, where self-destruction is relatively rare, are less likely to kill themselves than are those born in Australia, while people coming from Eastern and Northern Europe, where suicide is more prevalent, generally have rates that much surpass the corresponding figures for the non-immigrant part of the population (Taylor et al., 1998). Similarly, Burvill obtained a strong positive relationship between the suicide rates for 11 European nations and the suicide rates for those arriving from these countries to Australia (Burvill, 1998). All these results seem to suggest that in addition to their bags, individuals leaving their homeland also take with them the attitudes and behavior patterns characteristic to their country of origin.3

Socialization and control: the dual effects of subculture In order to understand the role that region of birth plays in conveying the effects of norms and values, it seems useful, following Felson and his associates, to distinguish two different ways in which cultural factors can operate (Felson et al., 1994: 157-158). One is socialization - the process in which people “internalize the values of their group and then behave accordingly” (p. 157). The other is social control - the complex system of reinforcement and punishment through which the group constrains the behavior of its members.

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These two alternative causal paths or mechanisms are parallel to the two basic approaches to social action distinguished by Granovetter (1985). The first approach focuses on roles, values and norms that individuals acquire early in their life and that exert their effects later in a relatively constant manner, largely independently of the immediate social context. The second approach, in contrast, emphasizes just this context and the impact that ongoing social relations have on people‘s attitudes and actions. Although Granovetter is rather critical of the first of these two strategies, a full grasp of the determinants of human behavior requires I believe the simultaneous study both of the situation in which this behavior takes place and of the personality factors that have been developed decades ago and that remain fairly stable across situations. No matter how we think about this issue, however, the two approaches Granovetter identifies is obviously closely related to the two causal forces Felson and his associates distinguish in their paper: while socialization is mainly rooted in the past and its effects are largely independent of specific social contexts, social control is more immediate and is more strongly tied to the concrete behavioral situation. But what does all this has to do with the impact of region of birth on suicide? The distinction I have just drawn between the two causal mechanisms that convey the impact of cultural factors is relevant for our purpose because it enables us to separate conceptually the effects of place of birth from those of place of residence. Effects of place of birth may be taken as primarily

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reflecting the influence of norms and values acquired at the early stages of one‘s life, through childhood socialization,4 whereas effects of place of residence may be viewed as mainly reflecting the operation of control exerted by people present in one‘s immediate social environment (see Figure 1).

FIGURE 1 ABOUT HERE

Data and methods To assess the impact that region of birth has on the risk of suicide, I performed a case-control study (Schlesselman, 1982), using two different sets of data. The first was a probability sample of 610 non-suicidal individuals living in Budapest, the capital of Hungary. Information on these persons was collected in the spring of 1994 as part of a large nation-wide longitudinal survey, known as the Hungarian Household Panel Study. The second data set contained 1165 suicides committed in 1993 and 1994 by individuals residing in Budapest. These data came from death certificates stored at the Institute for Forensic Medicine of the Semmelweis Medical School. This institute performs autopsy in all suicides occurring in Budapest

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and its immediate surroundings, regardless of place of residence. Consequently, the initial data set was both broader and narrower in scope than desired: it included deaths by people living outside the city; and it excluded cases in which the person, although residing in Budapest, took his or her life in some other parts of the country. While suicides erroneously included could easily be deleted using information on permanent residence, those falsely excluded could unfortunately not be located. The data set employed in the present study thus omits a small fraction of deaths that occurred to people living in Budapest, but this does not I believe distort the results in any important way. During the analysis, I merged the two data sets and created a dummy variable that indicated which sample a particular observation came from. Cases from the suicide sample were coded 1 and those from the panel study were coded 0. I took this binary variable as the outcome to be explained and used logistic regression. I preferred this technique over ordinary least squares regression for two reasons. First, with dichotomous dependent variables, traditional OLS regression tends to produce predicted values that fall outside the acceptable 01 range (Gujarati, 1988: 469-471). Logistic regression copes with this difficulty by assuming a non-linear relationship, with the effects of the explanatory variables gradually decreasing toward the two extremes.5 The second reason for choosing logistic regression had to do with the sampling design used in the investigation. In case-control studies, where the distribution

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of the dependent variable is set by the researcher, ordinary regression yields biased results because the coefficients produced are affected by the sampling fractions (Andersen, 1990; Loftin and McDowall, 1988). The appropriate measure of effect in this situation is the odds ratio, which is invariant to the selection of cases (Morgan and Teachman, 1988: 930). Given that the parameters of logistic regression models can, after exponentiation, be interpreted directly as odds ratios, this technique appeared especially suitable for the type of data at hand.6 The major explanatory variable in the study was region of birth. I entered this variable as a dichotomy in the regression, with people born in the Southeast coded 1 and all others coded 0. While the great majority of cases was successfully assigned to one of these two categories, those born outside the current borders of Hungary had to be deleted from the analysis. This reduced the size of the sample from 1775 to 1646.

Results I first ran logistic regression with region of birth (REGION) as the only independent variable. The results obtained are presented as Model 1 in Table 2. As can be seen from the coefficient for REGION, the log odds of suicide for

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those born in the Southeast exceeds the log odds for those born elsewhere by a factor of 0.73. The odds ratio corresponding to this logit difference is 2.08, indicating that people of southeastern origin have an odds of suicide about twice as large as have individuals born in other parts of the country.

Alternative explanations These findings, while clearly supporting the idea of a regional subculture of suicide, should still be taken with some caution. One possible confounding factor that has not yet been considered is geographical mobility.7 People born in the Southeast and moving to Budapest later in their life are, by definition, all geographically mobile, whereas a fair proportion (about 60%) of those in the other group were born and lived, at the time of their death, in the same city (Budapest). There is, then, an inherent positive correlation between being born in the Southeast and being geographically mobile and this positive correlation may give rise to spurious region effects, provided, as seems plausible, that mobility affects the risk of suicide.

TABLE 2 ABOUT HERE

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To guard against such spurious findings, I reran the regression with a new explanatory variable. This variable (MOBILE) was created to capture residential mobility and it had just two values: people who were born in Budapest and also lived there at the time of their death (“immobiles”) were coded with 0, while those who were born somewhere else but moved to this city later (“mobiles”) were coded with 1. The results obtained with this new variable included in the analysis are shown as Model 2 in Table 2. As can be seen, the effect of region of birth has declined after controlling for geographical mobility: the coefficient for REGION is now 0.41 and the corresponding odds ratio is 1.51, indicating that people of Southeastern origin have a risk of suicide about 50% greater than have those born in other parts of the country. This difference is still statistically significant, however, and it is also substantively important. It thus seems that being born in the Southeast does indeed elevate the risk of suicide, even when the impact of geographical mobility is ruled out as an alternative explanation. Before going too far with our conclusions, however, another potential source of bias has to be checked. It is possible that changing place of residence entails some sort of selective migration in the sense that those moving to Budapest from any part of the country are, for some reason, inherently more prone to self-destruction. It is also possible that this selection is more pronounced in the Southeast than in other regions. If this is really the case, then people born in

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the Southeast may be more likely to kill themselves, not because of their cultural origins, but simply because of these regional differences in selective migration. Unfortunately, the data available from this study do not permit a direct assessment of this alternative explanation. By using information from another research of mine, however, an indirect test is still possible. As part of the 1994 wave of the Hungarian Household Panel Study, I asked people about their attitudes toward self-destruction. These data allow us to establish whether people who left their region of birth are more tolerant to suicide than are those who stayed there and whether this sort of selection is really greater in the Southeast than in the West. Although taking people‘s views about selfdestruction as indicators of their propensity to take their life clearly requires a great deal of caution, this approach I believe nevertheless provides at least a crude estimate of the bias that selective migration might produce. As an initial step, I created two indices that I then used as dependent variables in a linear regression analysis. The first index was based on questions that were designed to tap how individuals think about a person who suffers from incurable illness and decides to kill him/herself. Respondents were asked to indicate on a four-point scale the degree to which they believe (1) that suicide is understandable in this situation (2) that it provides some sort of solution for the individual involved and (3) that they themselves would behave in the same way if they faced the same problem. In forming the index, I simply added the

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coded values of the response categories, arriving at a variable that ranged from 3 (least tolerant) to 12 (most tolerant). The second index was constructed in a similar manner, except that in addition to incurable illness, I now included four more life situations (loneliness, death of a close relative, severe financial problems and unemployment). The new variable indicated the number of times respondents gave the most tolerant answer and it ranged from 0 (least tolerant) to 15 (most tolerant). Having finished creating the dependent variables, I moved on to the independent variables. The first was a dummy variable (BIRTHREG) that distinguished people born in the Southeast (1) from those born in the West (0). This variable, then, contrasted regions with the highest and the lowest suicide rates. The second was also a dummy variable (MOVED) and it separated individuals whose region of birth was the same as their region of residence (“immobiles” = 0) from those who lived, at the time of the survey, in a region different from the one they were born in (“mobiles” = 1). Finally, I multiplied these two dummy variables to get a cross-product term that captured possible interaction effects. The coefficient for this cross-product variable will show if there are regional differences in selective migration. Table 3 reports the results from two linear regression analyses, one for each of the two indices. The coefficient for BIRTHREG is positive in both regressions, indicating that individuals of southern origin are more tolerant to suicide than are those born in the West. The coefficient for the migration variable

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(MOVED) is also positive, suggesting that those who left their region of birth are more likely to accept the idea of self-destruction. While this finding clearly points to the presence of selective migration, the crucial question is if this selection effect is different in the two regions. This question is answered by the coefficient for the interaction term (INTER). In none of the two regressions is this coefficient statistically significant, so on the basis of these data, selective migration does not seem to be a plausible alternative explanation.8

TABLE 3 ABOUT HERE

Differences in region effects by age groups As a further check of the validity of the subcultural explanation, I examined possible age differences in the impact of region of birth on suicide. The idea underlying this approach was that older people have presumably been living away from their place of origin for a longer time than have younger ones and are, therefore, less exposed to the influence of norms and values characteristic of their region of birth. If this is indeed the case, then region effects can be expected to decline with age. I tested this expectation by running three logistic regressions, one for each of three different age groups (below 40, between 40 and 60 and over 60). The

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results are presented in Table 4. The trend in the coefficients for REGION conforms, as can be seen, to the predicted pattern – the impact of region of birth is strongest for the young and weakest for the old, with middle-aged individuals in between. While in the youngest age group, people born in the Southeast have an odds of suicide more than 3 times larger than have those born elsewhere, in the oldest age group, region of birth makes almost no difference (the odds ratio is very close to 1, the value indicating no effect). These findings are consistent with the view that the influence of the normative climate prevailing in one‘s region of origin tends to diminish as age advances and thus they provide further support for the idea that cultural factors are implicated in the high prevalence of self-destruction in southeastern Hungary.

TABLE 4 ABOUT HERE

Summary and conclusions My aim in this paper was to assess a subcultural explanation of regional differences in suicide in Hungary. I tested this explanation by looking at the effect of region of birth on self-destruction, while holding current residence constant. The idea underlying this approach was that if deviant norms and values acquired through childhood socialization really are as important as advocates of cultural theories suggest, then region of birth should have a

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lasting effect, one that persists even when one moves, at a later stage of one’s life, to a different part of the country. All in all, the results presented here supported this prediction, showing that people who were born in the Southeast but lived in Budapest at the time of their death do in fact have a higher risk of suicide than those born in other regions. This effect of region of birth persisted even after ruling out geographical mobility and selective migration as alternative explanations, although the magnitude of the effect declined when geographical mobility was added as a control variable. The subcultural theory tested in this study gained further credibility from the observation that the impact of region of birth on suicide was largest among the young, where the norms and values prevailing in one‘s region of origin are most likely to be alive, and it was smallest among the old, where the significance of these factors have probably already been faded. While these findings all seem to attest the importance of cultural patterns in explaining regional differences in suicide, the study reported in this paper also has some limitations that should be kept in mind. One of these has to do with the external validity of the results. Although I do not think there is much reason to assume that people moving to Budapest form a select group in terms of suicide, it still remains to be seen whether the same differences found in this city between those of southeastern origin and those born elsewhere can also be observed in other parts of the country. This issue could unfortunately not be

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addressed in the present investigation, due to the lack of data on deaths occurring at places other than Budapest. Another limitation of the study concerns the internal validity of the findings presented. The dummy variable distinguishing the Southeast from other regions was used here implicitly as a measure of differences in attitudes toward suicide. This same dichotomy may, however, also reflect variations in other factors, such as the genetic composition of the population.9 In the absence of separate indicators for each aspect of the region dummy, all we can do is to derive contrasting empirical implications from the rival explanations and then look to see which of them is true.10 If, for example, biological processes are at work, then differences between those born in the Southeast and those born elsewhere should not vary with length of residence in Budapest. If, on the other hand, norms, values and attitudes are rather involved, then the differences could be expected to be larger for newcomers than for old dwellers. Our results have shown, as we have seen earlier, this latter prediction to be true, thus providing support for a cultural, as against a genetic, explanation.

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References Andersen, B. (1990). Methodological errors in medical research. Oxford: Blackwell. Andorka, R. et al. (1968). Társadalmi elítélés alá esõ magatartások elõfordulásának területi különbségei. [Regional differences in deviant behavior] Statisztikai Szemle, (1-2), 43-54., 145-148. Blalock, H.M. (1982). Conceptualization and measurement in the social sciences. Beverly Hills: Sage. Burvill, P.W. (1998). Migrant suicide rates in Australia and in country of birth. Psychological Medicine, 28, 201-208. Davis, J.A. (2001). Testing the demographic explanation of attitude trends: secular trends in attitudes among U.S. householders, 1972-1996. Social Science Research, 30, 363-385. Felson, R.B., Liska, A., South, S. & McNulty, T. (1994). The subculture of violence and delinquency: individual vs. school context effects. Social Forces, 73, 155-173. Gastil, R.D. (1971). Homicide and a regional culture of violence. American Sociological Review, 36, 412-427. Granovetter, M. (1985). Economic action and social structure: the problem of embeddedness. American Journal of Sociology, 91, 481-510.

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Greenberg, M. & Schneider, D. (1992). Region of birth and mortality of blacks in the United States. International Journal of Epidemiology, 21, 324328. Gujarati, D.N. (1988). Basic econometrics. New York: McGraw-Hill. Hawkins, J.D. & Fraser, M.W. 1985. Social networks of street drug users: a comparison of two theories. Social Work Research and Abstracts, 21, 3-12. Jobb, S. (1973). Az öngyilkosságok területi jellemzõi Magyarországon. [Regional distribution of suicide in Hungary] Területi Statisztika, 23, 39-53. Lave, C.A. & March J.G. (1975). An introduction to models in the social sciences. New York: Harper and Row. Lester, D. (1986-1987). Southern subculture, personal violence, suicide and homicide, and firearms. Omega, 17, 183-186. _____. (1989). Suicide rates in immigrant groups and their countries of origin: an examination of data from early in the 20th century. Psychological Reports, 65, 818. Lester, D. & Leenaars, A.A. (1998). Is there a regional subculture of firearm violence in Canada? Medical Science and the Law, 38, 317-320. Loftin, C. & Hill, R.H. (1974). Regional subculture and homicide: an examination of the Gastil–Hackney thesis. American Sociological Review, 39, 714-724.

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Loftin, C. & McDowall, D. (1988). The analysis of case-control studies in criminology. Journal of Quantitative Criminology, 4, 85-98. Marks, A. & Abernathy, T. (1974). Toward a sociocultural perspective on means of self-destruction. Life-Threatening Behavior, 4, 3-17. McCall, P.L., Land, K.C. & Cohen L.E. (1992). Violent Criminal Behavior: Is There a General and Continuing Influence of the South? Social Science Research, 21, 286-310. Messner, S. F. (1983). Regional and racial effects on the urban homicide rate: the subculture of violence revisited. American Journal of Sociology, 88, 997-1007. Moksony, F. (1994). The whole, its parts, and the level of analysis: Durkheim and the macrosociological study of suicide. In D. Lester (Ed.) Durkheim 'Le suicide'. One hundred years later (pp. 101-114). Philadelphia: Charles Press. Moksony, F. (1990). Ecological analysis of suicide: problems and prospects. In D. Lester (Ed.) Current concepts of suicide (pp. 121-138). Philadelphia: Charles Press. Morgan, S.P. & Teachman J.D. (1988). Logistic regression: description, examples, and comparisons. Journal of Marriage and the Family, 50, 929-936. Sainsbury, P. & Barraclough, B. (1968). Differences between suicide rates. Nature, 220, 1252.

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Schlesselman, J.J. (1982). Case-control studies: design, conduct, and analysis. Oxford: Oxford University Press. Schneider, D., Greenberg, M. & Lu L. (1997). Region of birth and mortality from circulatory diseases among black Americans. American Journal of Public Health, 87, 800-804. Stinchcombe, A.L. (1968). Constructing social theories. New York etc.: Harcourt, Brace and World. Taylor, R., Morrell, S., Slaytor, E. & Ford, P. (1998). Suicide in urban New South Wales, Australia 1985-1994: socio-economic and migrant interactions. Social Science and Medicine, 47, 1677-1686. Wolfgang, M.E. and Ferracuti, F. (1967). The subculture of violence. London: Tavistock.

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TABLE 1 Suicide rates in Hungary by county and region, 1960–1995

Region

County

1960

1970

1980

1990

1995

Bács-Kiskun

47.1

58.0

67.1

52.6

48.3

Békés

30.1

43.3

54.9

52.4

43.3

Csongrád

37.9

54.2

64.1

55.2

51.4

Hajdú-Bihar

30.2

41.5

63.8

49.4

42.0

Gyõr-Moson-Sopron

15.8

22.9

20.4

25.7

19.0

Vas

13.1

22.7

21.1

24.3

19.1

Zala

14.0

20.0

26.7

28.8

20.9

Southeast

West

Note: Suicide rates are per 100,000 population. Counties in the first four rows are located in the Southeast, while those in the last three rows are located in the West.

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TABLE 2 Effect of region of birth on suicide. Logistic regression results

Model 1

Model 2

Coefficient

Odds ratio

Coefficient

Odds ratio

0.73**

2.08

0.41*

1.51

Variable REGION

(0.19)

(0.20)

MOBILE

0.50**

1.65

(0.12) CONSTANT

n = 1646

0.58

0.40

(0.06)

(0.07)

*p < 0.05

**p < 0.001

Notes: Numbers in parentheses are standard errors. REGION is a dummy variable indicating region of birth (1 = South-East, 0 = all other areas); MOBILE is a dummy variable indicating geographical mobility (0 = born in Budapest, 1 = born somewhere else).

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TABLE 3 Selective migration as an alternative explanation. Ordinary least squares regression results

Variable

Index 1 (incurable illness)

Index 2 (five life situations)

(n = 770)

(n = 722)

Coefficient Standard error Coefficient

Standard error

BIRTHREG

0.68**

0.26

0.42**

0.15

MOVED

1.40*

0.54

0.58

0.32

-0.10

0.64

-0.21

0.38

6.68

0.18

0.92

0.11

INTER CONSTANT * p < 0.05

** p < 0.01

Notes: BIRTHREG = 1 if born in the Southeast, 0 if born in the West; MOVED = 0 if region of residence is the same as region of birth, 1 = if region of residence is different from region of birth; INTER = BIRTHREG * MOVED.

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Archives of Suicide Research, 7 (2003) 341-352.

TABLE 4 Effect of region of birth by age. Logistic regression results

Below 40 (n = 457) Variable

Coefficient

Between 40 and 60 (n = 592)

Over 60 (n = 597)

Odds ratio

Coefficient

Odds ratio

Coefficient

Odds ratio

REGION

1.31**

3.69

0.61*

1.84

-0.02

0.98

MOBILITY

0.13

1.14

0.46**

1.58

0.33

1.39

CONSTANT

0.06

* p < 0.1

0.45

0.85

** p < 0.05

Notes: REGION is a dummy variable indicating region of birth (1 = SouthEast, 0 = all other areas); MOBILITY is a dummy variable indicating geographical mobility (0 = born in Budapest, 1 = born somewhere else).

Archives of Suicide Research, 7 (2003) 341-352.

Figure caption

Figure 1. Socialization and control: the dual effects of subculture

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Archives of Suicide Research, 7 (2003) 341-352.

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Region of birth (Socialization) Subculture

Deviant behavior Region of residence (Social control)

Archives of Suicide Research, 7 (2003) 341-352.

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Endnotes

1

This idea represents a broader class of arguments known as demographic

explanations. For a more detailed analysis of the general logic of demographic explanations, see Stinchcombe (1968) and Davis (2001). See also Moksony (1994) for a comparison of demographic and sociological explanations. 2

The greatest weakness of Platt‘s study is that it fails to separate true

contextual or environmental effects from sheer composition effects. In fact, Platt vacillates between these two interpretations: although he starts from the conclusion of earlier studies that differences in suicide across areas cannot entirely be due to differences in the socio-economic composition of the population, he still maintains that the "geographical location of the subculture of parasuicide follows from the epidemiological finding that all three extremely high-rate parasuicide areas in Edinburgh are overwhelmingly working class in social composition." (p. 260). For a more detailed analysis of the methodological problems of ecological studies of suicide, see, Moksony (1990). 3

Longer-term effects of place of birth have also been reported in studies on

causes of death other than suicide. Greenberg and Schneider, for example, found that mortality rates for black Americans are more similar to their region of birth than their region of residence (Greenberg & Schneider, 1992; see also Schneider, Greenberg & Lu, 1997).

Archives of Suicide Research, 7 (2003) 341-352.

4

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As noted earlier, Gastil described his concept of regional culture of violence

as suggesting “more persistence over time and intergenerational reinforcement” than the subcultural theory advanced by Wolfgang and Ferrecuti. This characterization seems to add to the viability of the idea of using place of birth to capture long-term effects of a regional culture of selfdestruction. 5

In addition to failing to constrain predicted values to lie within the 0-1 range,

OLS regression, applied to binary outcomes, also has the problem that the error terms do not meet the some of the conditions necessary for statistical inference - namely, they are not homoscedastic and are not normally distributed. These, however, generally are less serious weaknesses, since heteroscedasticity can be handled using weighted least squares and with large samples, the regression coefficients are approximately normally distributed even when the error terms themselves are not. 6

It should be noted, though, that while the slope coefficients from logistic

regression are unaffected by the sampling design, the constant is not. This, however, is less of a concern in the present case, since our aim in this analysis is to establish the effects of specific independent variables and this does not require knowledge of the constant. 7

I am indebted to Ákos Róna-Tas (University of California, San Diego) for

raising this point. 8

The outcome of significance test depends, of course, also on the degree of

multicollinearity, which can be rather high with cross-product terms. To check

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the seriousness of this problem, I looked at the two measures most often suggested in the methodological literature as indicators of multicollinearity, the variance inflation factor and the condition index. In none of the regressions I ran were the values of these measures greater then the critical or threshold levels commonly given in statistics and econometrics texts. It seems fairly safe to conclude, then, that the insignificance of the coefficient for the interaction variable is not probably due to extreme levels of multicollinearity present in the data. 9

The problem we are facing here is a fairly general one and arises, basically,

from the multidimensional nature of categorical variables. For a more detailed discussion of this issue, see, Blalock, 1982. 10

This strategy is known in the methodological literature as the crucial

experiment (Stinchcombe, 1968; Lave & March, 1975).