Presenter:

Dean Lillard

Authors:

Dean R. Lillard

Chair: David Cutler; Discussant: Pinka Chatterji Mon June 5, 2006 10:45-12:15 Room 313

In early work, Hammermesh and Soss (1974) use the rational choice framework of economics to ask whether patterns in suicides can be explained by models of utility maximization. Despite interesting findings, the empirical literature on the economics of suicides has received little attention. Recently, however, Marcotte (2003) extended the role suicide plays by examining not successful suicides but both attempted and successful suicides. He first observes an empirical regularity that income of suicide attempters is higher than people who consider but do not actually attempt to commit suicide. He then incorporates this finding into a utility maximization model by positing state dependent utility functions. In this paper, I take a different approach to investigate whether suicide attempts and successes change in response to the cost of mental states of being. In particular, I take advantage of the fact that, since 1958, new pharmacological breakthroughs have led to the development of new drugs that treat depression. Three waves of drug development have occurred over this time period, each successive development yielding more effective treatments with fewer side effects. As shown by Berndt and coauthors (Berndt, Busch, and Frank 2001, Berndt, Frank, and McGuire 1997, Frank, Busch, and Berndt 1998) the market for these drugs grew phenomenally over the 1990s. In this empirical analysis I investigate how the probability of suicide attempts and completed suicides vary with the availability and cost of anti-depressant drugs. I use data from the National Comorbidity Survey (used also by Marcotte), the National Health Interview Surveys, and data on aggregate rates of suicides by state. To these individual and aggregate data I merge data on the number and type of anti-depressant drugs on the market in each year, the average list price of those drugs, and the flow of advertising for those drugs in 27 nationally distributed consumer magazines. Data on availability and list prices are taken from the Red Book from 1959-2004. Data on advertising of these products come from a print magazine advertisement archive collected and compiled at Cornell University. I then investigate whether the probability of attempted or successful suicide varies with these factors. I also investigate whether the same patterns are present in aggregate (state level) suicide rate data. The estimation strategy is to treat the arrival of the anti-depressant drugs as an event that treats individuals born in different years exogenously. I empirically compare decisions to attempt/complete suicide across age, race, income, and demographic characteristics.