King-Wa Fu

Changes in suicide rates following media reports on celebrity suicide: a meta-analysis

Background A growing number of studies indicate that sensationalist reporting of suicide is associated with increases in suicide rates, but in the light of some negative findings, the issue has remained controversial. The aim of this study was to evaluate the best current evidence on the association between celebrity suicide stories and subsequent suicides. Methods Literature searches of six data sources (Medline, Psychlit, Communication Abstracts, Education Resources Information Center, Dissertation Abstracts and Australian Public Affairs Database (APAIS)) were conducted. Studies were included if they (1) adopted an ecological design, (2) focused on celebrity suicide, (3) had completed suicide as outcome variable, (4) analysed suicide rates across all suicide methods, (5) used data from after World War II and (6) satisfied basic quality criteria. Results 10 studies with totally 98 suicides by celebrities met the criteria. The pooled estimate indicated a change in suicide rates (suicides per 100 000 population) of 0.26 (95% CI 0.09 to 0.43) in the month after a celebrity suicide. There was substantial heterogeneity between studies, which was explained by the type of celebrity (entertainment elite vs others) and the region of study, as indicated by mixed-effects meta-regression. The region-of-study–specific effect of reporting a suicide by an entertainment celebrity was 0.64 (95% CI 0.55 to 0.73) in North America, 0.58 (95% CI 0.47 to 0.68) in Asia, 0.36 (95% CI −0.10 to 0.61) in Australia and 0.68 (95% CI 0.51 to 0.85) in Europe. There was no indication of publication bias. Conclusions Reports on celebrity suicide are associated with increases in suicides. Study region and celebrity type appear to have an impact on the effect size.

The effects of a celebrity suicide on suicide rates in Hong Kong

Abstract Background Deaths of celebrities, especially by suicide, can be followed by an increase in population suicide rates, particularly where there is extensive media reporting. We have examined the impact on suicides following the death of a famous Hong Kong pop singer whose death from suicide by jumping from a height, occurred on 1st April 2003, and resulted in extensive and often dramatic media coverage. Methods Data on suicides were obtained from the Hong Kong Census and Statistics Department and the Coroners Court. The numbers of suicides in 2003 before and after the death of celebrity were compared to the same period in 1998–2002. The case files and suicide notes of people who died by suicide in 2003 were also studied qualitatively. Results There was a significant increase in suicides following the celebrity death, compared with the average over the preceding three months as well as the corresponding monthly average during 1998–2002. It was particularly marked in a subgroup comprising males, aged 25–39 years, many of whom died by jumping. The name of the celebrity was often mentioned in case files and suicide notes. Limitations The statistical results in showing the excess of suicides were based on aggregated data only. Conclusions This study provides further confirmation of the potential harmful consequences of sensational and excessive reporting of celebrity deaths.

Reality Check for the Chinese Microblog Space: A Random Sampling Approach

Chinese microblogs have drawn global attention to this online application’s potential impact on the country’s social and political environment. However, representative and reliable statistics on Chinese microbloggers are limited. Using a random sampling approach, this study collected Chinese microblog data from the service provider, analyzing the profile and the pattern of usage for 29,998 microblog accounts. From our analysis, 57.4% (95% CI 56.9%,58.0%) of the accounts’ timelines were empty. Among the 12,774 non-zero statuses samples, 86.9% (95% CI 86.2%,87.4%) did not make original post in a 7-day study period. By contrast, 0.51% (95% CI 0.4%,0.65%) wrote twenty or more original posts and 0.45% (95% CI 0.35%,0.60%) reposted more than 40 unique messages within the 7-day period. A small group of microbloggers created a majority of contents and drew other users’ attention. About 4.8% (95% CI 4.4%,5.2%) of the 12,774 users contributed more than 80% (95% CI,78.6%,80.3%) of the original posts and about 4.8% (95% CI 4.5%,5.2%) managed to create posts that were reposted or received comments at least once. Moreover, a regression analysis revealed that volume of followers is a key determinant of creating original microblog posts, reposting messages, being reposted, and receiving comments. Volume of friends is found to be linked only with the number of reposts. Gender differences and regional disparities in using microblogs in China are also observed.

Restricting the means of suicide by charcoal burning

We conducted an exploratory controlled trial to examine the efficacy of restricting access to charcoal in preventing suicides from carbon monoxide poisoning by charcoal burning in Hong Kong. All charcoal packs were removed from the open shelves of major retail outlets in the intervention region for 12 months; in the control region, charcoal packs were displayed as usual. The suicide rate from charcoal burning was reduced by a statistically significant margin in the intervention region (P<0.05) but not in the control region. We observed no significant change in the suicide rate using other methods in either location.

Suicide rates among working-age adults in South Korea before and after the 2008 economic crisis

Background Multiple studies have shown that macroeconomic factors are associated with changes in suicide rates. We investigated how changes in economic conditions associated with the recent economic crisis in South Korea influenced suicide rates among working-age adults. Methods Time-series analyses were performed to examine the temporal associations of national unemployment rates and sex-employment-specific suicide rates in South Korea from 2003 to 2011, with particular attention to the increases of suicides that occurred during the recessionary period that began in 2008. We also compared the relative risk of suicide among different occupations. Results National unemployment rates were positively associated with suicide rates among employed and unemployed men and women, with a 2-month to 3 month lagged period. Significant increases of suicide rates among working-age adults during the recession were detected in most of the subgroups stratified by age, sex and employment status. Forty-three per cent of the increase of suicides was derived from the employed population. Compared with workers in elementary occupations, the relative risk of suicide for mangers increased by threefold during the recessionary period. Among those who were employed, half of the increases in suicides occurred among clerks and workers involved in sales and services. Conclusions Changes in macroeconomic conditions are tied to population-level suicide risks for employed and unemployed persons. However, these associations vary depending on sex, employment status and occupational roles. In advance of future economic crises, it is important to develop prevention initiatives intended to reach the diverse populations potentially exposed to the adverse effects of sudden economic disruptions.

Ebola and the social media

In October 2014, during heightened news coverage about cases of Ebola in the USA, anecdotal observations suggested that many Americans were anxious about Ebola. Given the negligible risk of infection, their anxiety was arguably driven by perceived rather than actual risk. Exaggeration or reassurance from the media can infl ame or subdue people’s perceived risk of Ebola infection. Fear can also be acquired by observation of other people’s experiences, as expressed on social media. Thus, social media amplifi ed fear about the imported Ebola case. As discussed in The Lancet Editorial (Nov 8, 2014), Twitter traffi c shows an imbalance across the digital divide; there were more tweets about Ebola in the USA, where transmission was contained, than in Guinea, Liberia, and Sierra Leone, where there was and remains a continuing epidemic. Despite the risk to most Americans being negligible, many people expressed anxiety. The figure shows how worldwide traffi c on Twitter and Google about Ebola increased as news spread about the fi rst US case and how they compare with influenza (flu)-related searches and tweets. Similar peaks were observed when other news about Ebola was released. In a random sample of tweets, we observed that the frequency of Ebola-related tweets associated with negative emotions, anxiety, anger, swearing, and death, as well as discrepant thinking (eg, shouldn’t), were higher than those associated with infl uenza (see fi gure in appendix). Twitter data can provide public health practitioners with a quantitative indicator of anxiety, anger, or negative emotions in the general public where Twitter penetration is high. This indicator could help to alleviate anxiety and correctly communicate the risk associated with Ebola.

Chinese social media reaction to the MERS-CoV and avian influenza A(H7N9) outbreaks

BackgroundAs internet and social media use have skyrocketed, epidemiologists have begun to use online data such as Google query data and Twitter trends to track the activity levels of influenza and other infectious diseases. In China, Weibo is an extremely popular microblogging site that is equivalent to Twitter. Capitalizing on the wealth of public opinion data contained in posts on Weibo, this study used Weibo as a measure of the Chinese people’s reactions to two different outbreaks: the 2012 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak, and the 2013 outbreak of human infection of avian influenza A(H7N9) in China.MethodsKeyword searches were performed in Weibo data collected by The University of Hong Kong’s Weiboscope project. Baseline values were determined for each keyword and reaction values per million posts in the days after outbreak information was released to the public.ResultsThe results show that the Chinese people reacted significantly to both outbreaks online, where their social media reaction was two orders of magnitude stronger to the H7N9 influenza outbreak that happened in China than the MERS-CoV outbreak that was far away from China.ConclusionsThese results demonstrate that social media could be a useful measure of public awareness and reaction to disease outbreak information released by health authorities.

Long-term impact of celebrity suicide on suicidal ideation: results from a population-based study

Background: The short-term effect of celebrity suicide on the overall suicide rate is widely known, but long-term effects remain unclear. Objective: To examine whether celebrity suicide is associated with suicidal ideation over a longer period. Design: This is a study on the effect of the suicide of a famous Hong Kong entertainment celebrity, who committed suicide on 1 April 2003, on suicide thoughts of the community. A population-based survey was conducted between December 2003 and July 2004. Respondents were asked about their suicidal ideation, psychological well-being, life events, and whether or not they had been affected by celebrity suicide. Setting: Hong Kong Special Administrative Region, the People’s Republic of China. Participants: 2016 respondents aged between 20 and 59 years. Results: After controlling for some known suicide risk factors, celebrity suicide was shown to be independently associated with suicidal ideation. People who had indicated to have been affected by celebrity suicide were 5.93 times (95% CI 2.56% to 13.72%, p = 0) more likely to have severe level of suicidal ideation (Adult Suicidal Ideation Questionnaire score ≧31) than people who had not been affected. Respondents having greater anxiety symptoms, less reason for living and more focus on irrational values were also found to have had their suicide ideation affected by celebrity suicide. Conclusions: Celebrity suicide is a risk factor for suicidal ideation over a short term as well as over a long term. Raising awareness of the possible negative effect of celebrity suicide through suicide prevention programmes in the community is needed.

A study of the impact of thirteen celebrity suicides on subsequent suicide rates in South Korea from 2005 to 2009

A number of ecological studies have found a pattern of increasing suicide rates after suicides of several Asian entertainment celebrities. However, the finding may be subject to positive outcome bias where cases with no perceived impact may be routinely excluded. In this study, we deploy interrupted time-series analysis using ARIMA transfer function models to investigate systematically the impact of thirteen celebrity suicides on subsequent suicide rates in South Korea. We find that three out of eleven cases were found to be followed by a significant increase in suicide rate, while controlling for seasonality, secular trends, and unemployment rates. Such significant increases could last for nine weeks. Non-significance cases may be attributable to the small amount of media coverage, the “displacement” effect of preceding case, and the negative connotation of celebrity deaths. We therefore conclude that whether or not the impacts were detected may be largely conditioned by various contextual factors. Current evidence based on ecological studies is insufficient to draw a firm conclusion. Further studies using multiple approaches should be developed.

Changes in Reporting of Suicide News After the Promotion of the WHO Media Recommendations

Media recommendations on suicide reporting are available in many countries and in different languages. Hong Kong newspapers have been found to be noncompliant with WHO recommendations. A booklet containing WHO media guidelines Preventing Suicide: A Resource for Media Professionals, and an awareness campaign were launched in November 2004 in Hong Kong. Content analysis was then conducted to compare the reporting of suicide news before and after the launch. Results indicate that certain reporting styles were changed in accordance with the recommendations; namely, lessened use of pictorial presentations and headlines mentioning suicides. Most of the changes were attributed to the tabloid-style newspapers. This study suggests that programs to promote media recommendations tailored for journalists appear to be efficacious in altering their way of reporting.