• politics
• suicide

The paper by Page and colleagues adds to a growing literature that considers the effect of the political environment (whether from the point of view of which political regime holds power or considering in more detail the proportion of population voting for particular parties) and mortality.^1,2 In this case the specific cause of death in question is suicide, and the paper thus adds to a long tradition of research in sociology and epidemiology on factors beyond the individual that influence societal rates of suicide.^3–5

The findings by Page et al suggest a dose-response or perhaps “true” effect such that during the 20th century the presence of Conservative governments at both State and Federal level in Australia were associated with higher suicide rates. Crucially, the effect is strongest when both levels of government are Conservative, with adjusted relative risks of suicide of 1.17 for men and 1.40 for women compared with years of administration by both State and Federal Labor governments.

What can we infer from the findings of this study? The best societal conditions to minimise suicide rates are as follows: have both a State and Federal Labor regime, economic stability, be at war, control the availability of sedatives, and avoid drought. However, the implications of these results for reducing population suicide are unclear. The controlling of sedatives is perhaps the most easy to implement. But what about war? The authors’ results suggest that not all wars have the same effect on suicide rates; considering all cause mortality might change the perception of war as a positive factor in population health. While Wilkinson⁶ argues that the increased sense of social cohesion brought about by facing a common enemy resulted in an improvement in overall life expectancy in …