Why The Armed Forces Are Looking to Black Women For Answers: Suicide in the Military, Part II: What Protects Black Women?

We left off yesterday with a run-down of the devastating statistics of suicide in the military (one a day, so far, for 2012), and the VA’s knowledge that it has to act–and fast.

And in what sounds like a decision made in theatre, in their search for answers, the VA turned to black women, the single racial/ethnic group with the lowest suicide rate (by far) in the country.

Perhaps, goes the thinking, if the VA can learn the protective factors behind the low suicide rates for these women, they can use that information to help their men and women in uniform.

What they will find, in examining the protective factors against suicide in the demographic of black women, is information that’s been known for decades.

Religion and spirituality, coupled with strong social support, hold these women afloat, even as circumstances are challenging, at best.

Let’s take a look.

******************************************************************************************************************************************

“It’s a White Thing”: Black Opposition to Suicide

Even before we enter the main arguments, there is a ‘pre-argument,’ so to speak, for why black suicide rates are so much lower than whites’.

A paper entitled “Suicide Among Black Americans,” put out by the Suicide Prevention Resource Center, makes a claim echoed elsewhere: Suicide is just not a ‘black thing.’ They write,

African American beliefs about suicide may act as a protective factor. Religious communities condemn suicide while secular attitudes regard suicide as unacceptable and a behavior of white culture, alien to black culture. [emphasis mine]

In fact, a major paper describing blacks’ beliefs about suicide is entitled “It’s a white thing”: An explanation of beliefs about suicide in the African-American community. (Early & Akers 1993)

And that does seem to encapsulate the views of a significant number of blacks regarding suicide–it’s just ‘a white thing.’ In the paper, researchers interviewed pastors at black churches and found that the “view of suicide as a white thing” by blacks may protect them against suicide. Through ongoing struggle, pastors said, black Americans developed a culture of resilience in which suicide was seen as a contradiction to the black experience.

So before we even hit the main protective factors against suicide for black women specifically, we’ve learned that blacks’ entire view of the experience of suicide is as somehow alien to their own experience, something ‘others’ do, something that they have struggled too much and come too far to succumb to.

It will be hard–borderline impossible–to recreate that experience for any other ethnic group, and certainly for the military, where suicide has become extremely accepted, as the numbers indicate.

The VA will have to look elsewhere for practical assistance.

******************************************************************************************************************************************

Two Major Factors

So let’s move on to two major protective factors for black women that show up in study after study.

To return to Ronald Marris, known suicide expert and Professor att the University of South Carolina, and his statistics from yesterday’s post:

If indeed, as he claimed,

African-American women, particularly in midlife, are virtually immune to suicide,

surely the army would like to know. . .why?

Marris poses some possibilities, and his assertions are backed up by significant research over decades. I clump them into two main categories:

1. Higher degrees of social involvement are negatively correlated with the suicide rate.

Marris reported that suicide is increased by lack of social support.

In a survey study in Chicago, Marris found a negative correlation between the number of people living in a household and suicide rate. Further he found that the ‘natural death controls,’ who were studied in contrast to those who died by suicide, had twice as many close friends as the suicides.

2. Religion plays a protective role against suicide.

To start at the simplest level, surveys have indicated that more frequent church-goers tend to be happier–a good sign if you’re after suicide prevention..

Presenters at the Healing & “Recovery Through the Power of Diversity” workshop in California explain:

African American beliefs about suicide may act as a protective factor. Religious communities condemn suicide, and blacks’ connection to organized religion is amazingly strong.

In study after study, religiosity was a protective factor against suicide. Interestingly enough, it often wasn’t ‘spirituality’ that served to tether people, but rather practical religious commitments, like church attendance.

In lead author Daniel Rasic’s paper, “Spirituality, religion and suicidal behavior in a nationally representative sample,” the authors found that a link between “a person’s attendance at religious worship service,” and their desire to commit suicide.

The findings were based on health surveys of 37,000 Canadians which included information about their spirituality – and specifically – their church attendance.

The post “Churchgoing linked to lower suicide risk” highlighted the uniqueness of the research:

It is the first study to use national data to look at the relationship between spirituality, worship and suicidal behavior in the general population, and in people with a history of a mental disorder,

something that many who suicide in the military may be struggling with.

Rasic found that people who don’t attend church/synagogue were twice as likely to have attempted suicide as more regular-goers. (These attendees were factored out from those who called themselves ‘spiritual’ but were not regular churchgoers; their effect was significantly less).

Said Mr. Rasic,

Among people with a history of mental illness – those at the highest risk of suicide – religious attendance appears associated with a decrease in suicide attempts. [my emphasis]

David Lester in a 1987 paper found that, in inter-state comparisons, higher levels of church attendance were associated with lower rates of suicide.

**********************************************************************************************************************

The Social and Religious Realities for Many Black Women

These two theories, of the power of religious beliefs and social support to prevent black female suicide, are backed up by extensive research, but, interestingly enough, time and again the two factors intertwine in the studies, as church-going comes to be viewed as a further means of social support.

Let’s take a step back to establish the bona fides of the characters here:

Blacks take it away in the surveys that analyze religiosity in this country. Analysis of the U.S. Religious Landscape Survey, conducted in 2007 by the Pew Research Center’s Forum on Religion & Public Life, found blacks scored higher in a number of measures of religiosity, including affiliation with a religion, attendance at services, frequency of prayer, and importance of religion in one’s life. A full 87% describe themselves as belonging to a religious group. 79% say religion is ‘very important’ in their lives (vs 56% among all U.S. adults), 53% attend religious services at least once a week, while 76% pray on a daily basis, and a surprisingly high 88% say they are absolutely certain God exists. These numbers earn them the status of most religiously committed racial or ethnic group in the country.

They are one of the few ethnic groups for whom church attendance is increasing–even for young people.

To complete the picture for our purposes, black women outperform even black men in the religion arena. When it comes to lack of affiliation with any religion, only 9% of women avow this independence–as opposed to 16% of men.

In terms of social support, black women are known for having extended ‘family’ members living with them within one household. One researcher theorizes as to how that situation came about.

Kelly L. Patterson from the State University of New York at Buffalo seemed to almost marvel at what she found to be consistently high self-esteem among black women [“Recent research solidifies the notion that Black girls, adolescents, and women have high levels of self-esteem (Crain & Weisman, 1972; DeFrancisco & Chatham-Carpenter, 2000; Hoelter, 1983; Myers, 1975, 1980; Richman, Clark, & Brown, 1985; Rosenberg & Simmons, 1972; Turner & Turner, 1974, 1982”].

And she finds that it is the social support systems that create such high self-esteem and resilience–and that it is black women (not men) who are in possession of extended and strong social support systems.

Suggesting a possibility for why black women’s support systems are so extensive compared, say, to a white male’s, she offers that they were an outcome of slavery, where the slave women had to rely upon one another for survival, and, later, when women had to enter the work force and child care costs became prohibitive, they “relied on fictive kin” for help in supporting and caring for families.

Thus born of poor circumstances, this tendency to connect with and depend upon others served these women well–and may be doing so up to this current day, if the VA has it right.

Paterson writes that black women in a particular study

asserted that the social support they received from immediate and extended family, which included fictive kin, friends, and church members, served the nurturing purpose of instilling the values of pride, respect, self-reliance, and racial esteem. . . . [S]ocial support was so central to their participants’ overall senses of self because it gave them the adaptive skills to survive, and even thrive, in an oppressive society.

The Council on Contemporary Families notes that blacks have more ties to their extended families than whites. Black women (and men) are more likely to live with or near their relatives than their Caucasian counterparts. And, when it comes to supporting other women, blacks have much more hands-on ways in assisting than whites who support their friends, yielding, perhaps, the tightness of the social circle.

When it comes to help and support, Black and White men are similar. It’s women who are different. Black women are much more involved in giving help with housework, rides and child care to their relatives, although White women are more likely to give money or emotional support.

Between religious commitment, family structure, more independence from husbands [black women marry less than their white counterparts], and some deeply engrained societal longings, black women tend to have a greater degree of social support than almost any other race, ethnicity, or gender.

*****************************************************************************************************************************************

Religion and Social Support Mutually Reinforce Each Other–Yielding Further Protection Against Suicide

And then the lines blur, as the research studies have a hard time teasing out religiosity from social support–but, finding that black women score high on both scales, use this information to explain the low suicide rates among black women.

Take Dr. Cook. Joan M. Cook, Ph.D, a geriatric psychologist at the Department of Veterans Affairs (VA) Medical Center in Philadelphia and the University of Pennsylvania, interviewed, together with her colleagues, 835 African American senior citizens who lived in a Baltimore housing project. They asked questions about suicide, and the role religion and family and social network played in the respondents’ lives.

They found 97% of those interviewed–quite a high number–had no inclinations toward suicide at all.

Approximately 91 percent of those said religion and social support were important in their lives.

Write Cook et al:

[of] the variables associated with less suicidality, more Social Support and Religiosity were consistent with earlier theories of racial differences in suicide. In fact, Religiosity remained uniquely negatively associated with both passive and active suicidal ideation in the multivariate analyses. [emphasis mine]

In a 1994 paper, Kenneth F. Ferraro and Jerome R. Koch, both professors of sociology, claim that religion is a boon–in this case to physical health, but its protective features apply equally to mental health and suicidal desires–because it is: a) ‘a mechanism of social integration,’ and b) ‘a source of consolation,’ and hence a coping mechanism when life gets difficult. Thus the issues of social support and religion come together–religion is itself a source of social support.

According to the professors, research on religion has repeatedly demonstrated that connections to religious groups provide

emotional, cognitive and material support, fostering the individual’s perception that he [or in our case ‘she’] is cared for and esteemed.

Ferraro & Koch quote a 1992 study that found that white congregations’ outreach ministries focus mainly on the following activities: recreation/camp programs for the youth, refugee-related programs, and right-to-life issues. In contrast, black congregations’ ministries focus in part, on meal service, social justice, community development, and public education on disease.

In short, they and others believe, the black church

does [so] much more to provide for overall well-being of its members. . . .[that its] social support. . . may yield special benefits. [emphasis mine]

Along those lines, Christina G. Watlington and Christopher M. Murphy from the University of Baltimore, found that both religion and social support correlated with mental health–and, once again, correlated with each other.

They found that women with greater religious involvement reported lower levels of depression, a significant risk factor in suicide.

And they found, again, that it’s often the confluence of the variables that create a more resilient woman, as they determined that

women who reported higher levels of spirituality reported utilizing higher levels of religious coping strategies and women who reported higher levels of religious involvement reported higher levels of social support. [emphasis mine]

Thus religion and social support reinforce each other, and, as each is a protective factor against suicide, are in essence ‘double-trouble’ when it comes to the demons that speak of self-harm.

They are two of the crucial components of that graph that so tempts the military, and whose percentages have stayed fairly constant even as the decade progressed:

******************************************************************************************************************************************

So when the Suicide Prevention Resource Center (SPRC), on their fact sheet, “Risk and Protective Factors for Suicide” includes as protective factors (see entire table below): a) Social support and b) Religion (not to mention presence of children in the family)–well, they could have been talking about why black women do so well on the suicide front.

But let’s return for a moment to the task at hand–to figure out why the military is doing so poorly in that very same battle. Does a mere lack of these two protective factors make people vulnerable to suicide?

It turns out that just might be the case.

So let’s take a look at how religion and social support impact the military, and begin to think about what can be done about these factors–in the next post.

REFERENCES: Cook JM, et al. Suicidality in Older African Americans: Findings From the EPOCH Study. American Journal of Geriatric Psychiatry 2002; 10:437–446. Dervic K, Oquendo MA, Grunebaum MF, et al. Religious Affiliation and Suicide Attempt. American Journal of Psychiatry 2004; 161:2303-2308. . Ferraro KF, Koch JR. Religion and Health Among Black and White Adults: Examining Social Support and Consolation. Journal for the Scientific Study of Religion 1994; 33(4):362-375. Garlow SJ, Purselle D, Heninger M. Ethnic differences in patterns of suicide across the life cycle. American Journal of Psychiatry. 2005; 162:319-323. Goldsmith SK. Risk factors for suicide: Summary of a workshop. Washington, DC: National Academy Press, 2001. Griffith EEH, Bell C. Recent Trends in Suicide and Homicide Among Blacks. JAMA 1989; 262(16):2265-2269. Gulshan Y, Melendez C, McShan Y, Presenters. “Healing & Recovery Through the Power of Diversity!”: Multi Cross-Cultural Workshop. California Network of Mental Health Clients; June 27-28, 2011. Joe S, et al. Prevalence of and Risk Factors for Lifetime Suicide Attempts Among Blacks in the United States. JAMA 2006; 296:2112–2123. Lester D. Religiosity and Personal Violence: A Regional Analysis of Suicide and Homicide Rates. The Journal of Social Psychology 1987; 127(6):685-686. Patterson KL. A Longitudinal Study of African American Women and the Maintenance of a Healthy Self-Esteem. Journal of Black Psychology 2004; 30( 3):307-328. Rasic D, et al. Spirituality, religion and suicidal behavior in a nationally representative sample Watlington CG, Murphy CM. The Roles of Religion and Spirituality Among African American Survivors of Domestic Violence. Journal of Clinical Psychology 2006; 62(7):837-857.

Related articles