7 ms·
A non-profit that figured out how to massively cut suicide rates in Sri Lanka
- tomp 9y agoOk I unfortunately don't have the time to listen to the whole episode, but whatever hard data is included in the text of the article doesn't look to fit the title. > the suicide rate in Sri Lanka has dropped significantly. So, from 57 deaths per 100,000 population in ’95, it has dropped now to 17. This is a 70% reduction. So, it’s a very significant success, in fact the greatest decrease in suicide rate ever seen. So the first thing we see is that 70% reduction amounts to the suicide rate dropping from 0.057% to 0.017%. That would still put Sri Lanka at or near the top (=most suicidal) according to Wikipedia [1], so I guess it's pretty significant; it's just that I always view relative percentages with suspicion ("we reduced the death rate by INFINITY percent!" "oh yeah you saved one life"). Second, if the rate of suicide decreased by 70% in 20 years, that doesn't mean that it can be 100% percent attributed to lack of pesticides (in fact, I cannot think of any scenario where that could be true). 20 years is a lot of time, especially in Asia, so I don't know, maybe it was just the improvement of the quality of life, or (mental) health-care? Edit: I hope the recording sheds more light on why they attribute any part of the drop to lack of pesticides... Anyways, it's discouraging, and therefore I judge the title as "click-bait-y". [1] https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate https://en.wikipedia.org/wiki/List_of_countries_by_suicide_r...
- danielvf 9y agoAlso Sri Lanka had something resembling a civil war from 1983 to 2009.
- malikNF 9y agoNot "something resembling" it was an actual civil war https://en.wikipedia.org/wiki/Sri_Lankan_Civil_War https://en.wikipedia.org/wiki/Sri_Lankan_Civil_War
- ArneVogel 9y agoThe gdp per person increased by 5x between 1995 and 2016 [1]. That makes be believe pesticides were only a small part of the change. [1] https://www.google.com/search?q=sri+lanka+gdp+per+person https://www.google.com/search?q=sri+lanka+gdp+per+person
- tomp 9y agoAh, there's a transcript "below the cut". So, scanning it, it seems they draw conclusions based on the strong temporal correlation between pesticide use and suicide. > the suicide rate had increased dramatically after the introduction of highly hazardous pesticides into the agriculture > in ’94, the most toxic insecticides [...] were banned [...] another very toxic pesticide [...] was banned in ’98, and further class two pesticides were banned in 2008 to 2011 So I guess it could be true but it's still making huge leaps of faith from the data. Now, my moral value system doesn't classify suicide as negative, so I can't really agree with the premise of the article, yet I definitely support limitations on the availability and use of pesticides, e.g. to prevent children accidentially poisoning themselves etc.
- awild 9y ago> Now, my moral value system doesn't classify suicide as negative, so I can't really agree with the premise of the article, yet I definitely support limitations on the availability and use of pesticides, e.g. to prevent children accidentially poisoning themselves etc. I have a similar painpoint with this: even if their attempt at reducing suicide succeeded, they didn't help people much. Assuming (as they have to) that the situation in Sri Lanka is the same or similar as with toxic pesticides, the only thing they achieved is make escaping that shitty situation harder, not making the lives better, by effectively reducing suicidal thoughts. The point they are trying to make that suicide is a spontaneuous/irrational decision hardly counts in a statistic like that.
- Anderkent 9y ago>Assuming (as they have to) that the situation in Sri Lanka is the same or similar as with toxic pesticides, the only thing they achieved is make escaping that shitty situation harder, not making the lives better, by effectively reducing suicidal thoughts. The point they are trying to make that suicide is a spontaneuous/irrational decision hardly counts in a statistic like that. How does it not??? If the suicide is a decision made under the influence of a 30-minute-long depressive episode, and outside that episode the person would prefer to live, how is preventing the suicidies by making them harder to perform spontaneously not making people's lives better? Why does it 'hardly count'?
- tdb7893 9y agoThey attribute the drop to lack of pesticides because according to the researcher the drops coincided with changes in policy, drops were also seen in other countries that banned pesticides, and simular situations were seen when access to common forms of suicide were restricted in other countries also saw a drop in rates (i.e. gun restrictions led to fewer suicides). It's hard to run controlled trials at a macro scale so it's unlikely that the effect was only pesticides but it sounds like historically these sorts of interventions do work.
- kbuchanan 9y agoRegression to the mean?
- Chathamization 9y agoThis study seems to take that into account[1]: > Restrictions on the import and sales of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998, coincided with reductions in suicide in both men and women of all ages. 19,800 fewer suicides occurred in 1996-2005 compared to 1986 – 1995. Secular trends in unemployment, alcohol misuse, divorce, pesticide use and the years associated with Sri Lanka’s Civil war did not appear to be associated with these declines. Here's another study[2]: > Overall suicide mortality dropped by 21% between 2011 and 2015, from 18.3 to 14.3 per 100,000. The decline in pesticide suicides during this same period was larger than for overall suicides: from 8.5 to 4.2 per 100,000, a 50% reduction. This was accompanied by a smaller concurrent rise in non-pesticide suicide mortality with a 2% increase (9.9 to 10.1 per 100,000). [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154644/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154644/ [2] http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172893 http://journals.plos.org/plosone/article?id=10.1371/journal....
- achileas 9y agoPretty much every time someone complains about the whole correlation != causation thing, it's a huge red flag that they didn't read the actual research or have no experience in academic research. It's easily accounted for and is the lowest hanging methodological fruit, and pretty much is always addressed when actually appropriate. It's an undergrad stats thing, and I know for my degree I had to have at least a year of graduate level stats, and the same for undergrad.
- toasterlovin 9y agoOn the other hand, epidemiology is fundamentally incapable of proving positive causation. It can prove that something is not a cause by showing that there is no correlation, but that’s it.
- tomp 9y agothe kind of conclusion as "all of 70% decrease was caused by this single factor" (as the title implies) is incredibly intelectually dishonest to ever make. So I'm not looking at the data from the perspective "I bet they were too stupid/uneducated to think about correlation != causation", but rather from the "looks like they're trying to find data to substantiate their political agenda" perspective. Edit: having said that, yeah, I don't have any actual research experience, and the data does look pretty convincing - as in, banning pesticides probably does contribute to a reduction in suicides a non-trivial amount.
- contravariant 9y agoThose are pretty much all valid points, however at first glance a drop from 57 incidents to 17 is at least statistically significant. The standard deviation can be assumed to be at most around sqrt(57) = ~7.5, so a difference of 40, which would be over 5 standard deviations, shouldn't normally happen. You're right that relative percentages are sometimes a bit dubious (and even in this case you'd fluctuations on the order of 1/sqrt(57) = ~13 percentage points) but 57 is high enough that it actually has some meaning.
- jmull 9y ago> ...therefore I judge the title as "click-bait-y" I think you're out-of-line here. It's fine to be suspicious of relative percentages, but that just means you need to dig into the numbers to understand it. In this case underlying numbers are huge... With a population of 22 million, this is a drop from about 12,500 suicides to around 3,700 per year. And, the suicide rates themselves are high as your own source points out, so a large proportionate change is quite significant from that perspective as well. Your argument would make sense for a similar proportionate change for a country near the bottom of of the wikipedia list, but not the top. To your second point, yes, it's hard to have complete certainty (there's no way to ethically or morally test something like this in a scientifically rigorous way) but they do attempt to account for other factors. It's not like people shouldn't try to reduce suicide rates and attempt to measure the results of those efforts the best they can, simply because they can't have rigorous certainty in those measurements.
- emiliobumachar 9y agoSummarizing, this is about decreasing the effectiveness of suicide attempts, not their rate. About a fifth of the world's suicides are done by drinking pesticides. When removing that alternative, people turn to less effective methods. Those that fail are unlikely to try again. Very eye-opening.
- jessriedel 9y ago> When removing that alternative, people turn to less effective methods. Is there data on this? The article mentions that most people contemplate the decision for less than 30 minutes, so if pesticides aren't accessible they literally might not try anything else. (Or by "less effective methods", you might just mean they are less likely to complete suicide, which is true.)
- emiliobumachar 9y agoBy "less effective methods", I did mean that they'll still try, but probably fail.
- Anderkent 9y agoOr if the method is less immediately available, they may not try at all, as the longer consideration time is enough to realise they don't actually want to die. As they say: > Leah Utyasheva: Exactly. The research shows that it is in majority of cases with pesticide self poisoning, it is an impulsive event, and people think for less than 30 minutes before actually poisoning themselves, less than 30 minutes. And this of course, is a life altering event. And the other thing is that apart from low planning, it is also low repetition event. Less than 10% of people who tried killing themselves will go on to try to do it again.
- deleted 9y ago[deleted]
- xiphias 9y agoThe headline was about decreasing suicide rate, not about decreasing the number of attempts (and actually that was the main point of the article: decrease the ratio of successful attempts)
- Talyen42 9y agothankfully, absolutely nothing else changed for this population in 20 years, so we know this is a legit controlled study
- shaki-dora 9y agoYes! And where would we be without internet commentators mentioning that “correlation does not prove causation”, and devising intricate interventions to study in the clueless scientists’ stead?
- manjushri 9y agoMaybe I'm missing the humor here, but is doubt due to the lack of a control group not a crucial element of the scientific method?
- deleted 9y ago[deleted]
- deleted 9y ago[deleted]
- sajithdilshan 9y agoThis is a classic example for "correlation does not imply causality". I believe the rate has decreased mainly due to improved education, and other suicide prevention services by NGOs, not because of the lack of availability of pesticides.
- achileas 9y agoIt would probably help if you read the research. That's the lowest hanging fruit, I guarantee you any published paper (in a real journal, as this one was) handles that in one way or another - e.g. there are ways to give evidence for causality or a causal relationship.
- Anderkent 9y agoUm, there's a very clear causative model: not having toxic pesticide on hand makes poisoning yourself with pesticide much harder! Did you even read the article before assuming the two must be unrelated?
- nickthemagicman 9y agoAlso Star Wars Battle front was released during that time so that might have also been the cause.
- wronag1 9y agoyou can't commit suicide by pesticide, but you can purchase an in-game add-on where your character can
- nickthemagicman 9y agoExactly. It's cathartic!
- exabrial 9y agoI'm not sure if the clickbait title was intentional or not, but I flagged it for now.
- jbreckmckye 9y agoAnnoyingly, it was edited from something much more timid and factual.
- DanCarvajal 9y agoWell they also had a civil war that lasted for 25 years so I'm sure that ending helped a bit too.
- ketsa 9y agoReading that title I thought they decreased agricultural pesticide usage...
- deleted 9y ago[deleted]
- tjic 9y agoThere is a an issue in all statistics: "the seen and the unseen". It basically means "measuring benefits but not measuring costs". Even if the statistics is accurate. Even if denying people the right to self-determination is a positive in your ethical system. Even if X, Y, Z are true... I still have to ask: what about the COST? Pesticides exist because they do something useful - kill off pests. They increase food production and decrease labor. What if we've saved some lives...but also made 200,000 farmers each spend an extra five hours a week bent over in their fields, picking bugs off leaves? Or made them plant more land in order to harvest the same amount of food?
- Anderkent 9y ago> Even if denying people the right to self-determination is a positive in your ethical system You are not denying people right to self-determination, in any way. If someone really wants to have a suicide method handy so that they can commit suicide immediately when they feel the impulse, you can buy it ahead of the time. > What if we've saved some lives...but also made 200,000 farmers each spend an extra five hours a week bent over in their fields, picking bugs off leaves? Or made them plant more land in order to harvest the same amount of food? Do you have any reason to think any of that is true? If you have to go to a specialist shop to buy pesticide instead of the grocery store where it's right next to your food; or if you have to use pesticide that's slightly more expensive but not toxic to humans, suddenly it's like you need to pick bugs off leaves? Measuring costs is a fine idea; and 80000 hours definitely do that. Making up costs just to seem contrary is something completely different.
- exolymph 9y agoGP's point is not that XYZ are the specific costs of reducing pesticide use, but that costs should be discussed when making policy judgments.
- alwaysanagenda 9y agoLet's do a little digging, shall we? Who is 80,000 Hours? https://en.wikipedia.org/wiki/80,000_Hours https://en.wikipedia.org/wiki/80,000_Hours "[80,000 hours is]...one of the nonprofits funded by startup accelerator Y Combinator in 2015...William MacAskill is the Founder and President of 80,000 Hours..." Who is William MacAskill? https://en.wikipedia.org/wiki/William_MacAskill https://en.wikipedia.org/wiki/William_MacAskill He is a proponent of Effective Altruism https://en.wikipedia.org/wiki/Effective_altruism https://en.wikipedia.org/wiki/Effective_altruism For an article that says it will cover " What types of events are causing people to have the crises that lead to attempted suicide?" All the commentary we have is this: > "Robert Wiblin: Do you know what kinds of events are causing people to have these crises and attempt suicide? > Leah Utyasheva: Well, as I said, quite often it is a cry for help. It is the acceptability of using suicide as means of solving certain life problems. For example, if a child is having, a student is having problems at school, or an old person feeling sick, or a couple argues. So, all this could lead to an attempted suicide. And quite often, as I said, people just need a little bit more time to think about it, and then maybe they decide that this is not a good solution to their problems. Then they move on. That doesn't sound like a very robust discussion around the real problem. More importantly, for such a lengthy discussion about pesticide use, nobody speaks about who benefits from switching pesticides. Leah informs us that: "I must point out that the United Nations and the WHO agencies are highly behind this, and they are supportive of the ban of the most hazardous substances. There are a lot of guidelines and tools developed to find out what alternatives to highly hazardous pesticides are available, and what other substances or agricultural production methods could be used instead of highly hazardous pesticides." We have an enormous amount of posturing without a single mention of what the replacement pesticide should be. It sounds more like the UN and WHO woud like some kind of "moral" ground to push their own agenda. I find it all very disingenuous.
- vanderZwan 9y ago> So, this harm minimization, harm reduction strategy was developed by William Haddon, who was a U.S traffic administrator, the head of the U.S traffic administration authority, who realized in the 60s that the traffic accidents in the United States have gone up, and the fatality of this traffic accidents have gone up significantly as well. > So, what he suggested is that radically new approach to the problem. He says instead of telling people to stop having accidents, and become better drivers, he suggested that, “Let’s accept that traffic accidents, road accidents will happen, but let’s minimize the harm from them.” Tangent: it's interesting how this suggests that getting people to drive less was not an option in this discussion (which is the most appropriate analogy to banning really toxic pesticides, I would say). Yet that was one of the major factors behind why the Netherlands switched to a policy of encouraging other means of transportation, and why we ended up with our bike infrastructure (ignoring that the Netherlands also has the geographical advantage here, being small, flat and typically with compact cities).