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Suicide in paradise: aftermath of the Bali bombings

Published online by Cambridge University Press:  18 December 2008

L. K. Suryani ,
A. Page ,
C. B. J. Lesmana ,
M. Jennaway ,
I. D. G. Basudewa  and
R. Taylor
L. K. Suryani
Affiliation:
School of Medicine, Udayana University, Bali, Indonesia
A. Page
Affiliation:
Discipline of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, Australia
C. B. J. Lesmana
Affiliation:
School of Medicine, Udayana University, Bali, Indonesia
M. Jennaway
Affiliation:
Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Brisbane, Australia
I. D. G. Basudewa
Affiliation:
Dr Radjiman Wediodiningrat Lawang, East Jawa, Indonesia
R. Taylor*
Affiliation:
Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Brisbane, Australia
*
*Address for correspondence: R. Taylor, Professor of International Health, Division of International and Indigenous Health, School of Population Health, Public Health Building, Herston Road, University of Queensland, Herston, QLD 4006, Australia. (Email: r.taylor@sph.uq.edu.au)
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Abstract

Background

The relationship between the Bali (Indonesia) bombings of October 2002 and suicide has not previously been investigated, despite anecdotal evidence of the economic and psychological consequences of these attacks.

Method

Suicide rates were calculated over the period 1994–2006 in three Bali regencies to determine whether suicide increased in the period following the first Bali bombings. Poisson regression and time-series models were used to assess the change in suicide rates by sex, age and area in the periods before and after October 2002.

Results

Suicide rates (age-adjusted) increased in males from an average of 2.84 (per 100 000) in the period pre-2002 to 8.10 in the period post-2002, and for females from 1.51 to 3.68. The greatest increases in suicide in the post-2002 period were in the age groups 20–29 and ⩾60 years, for both males and females. Tourist arrivals fell significantly after the bombings, and addition of tourism to models reduced relative risk estimates of suicide, suggesting that some of the increase may be attributable to the socio-economic effects of declines in tourism.

Conclusions

There was an almost fourfold increase in male suicide risk and a threefold increase in female suicide risk in the period following the 2002 bombings in Bali. Trends in tourism did not account for most of the observed increases. Other factors such as indirect socio-economic effects and Balinese notions of collective guilt and anxieties relating to ritual neglect are important in understanding the rise in suicide in the post-2002 period.

Keywords

Balisocioeconomic factorssuicideterrorism
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 8 , August 2009 , pp. 1317 - 1323
Copyright
Copyright © 2008 Cambridge University Press

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