3.1. Indebtedness

Most studies identified indebtedness as the predominant single factor associated with farmer suicides [1,3,5,7,10–15]. Dongre and Deshmukh [10] found that farmers in the Vidarbha region of Maharashtra ranked debt as the most important reason for farmer suicides, followed by addictions, environmental problems, and price issues, amongst others [10]. Two other studies concluded that unpaid loans are a correlate of those who die by suicide [3,7]. Kale [12] found that in a small sample from Vidarbha, 95% of farmer suicide victims were indebted, while of control households, this was only 25%. Another in the same region found that 197 of 200 victims (98.5%) were indebted [16]. Mishra [7] also found that debt was the most common factor in Maharashtra at 86.5%, followed by deterioration in the farmers’ economic status (73.9%). A comparison of these farmers with those who had not died by suicide showed they had three times as much debt, and the difference was significant to the 95% confidence interval [7]. An investigation of the socioeconomic causes of farmer suicide in Karnataka also found that agricultural debt was given as the primary factor, leading to farmer suicides in 29/30 suicide cases [13] and Gedela [15] calculates that indebtedness is one of the statistically significant factors identifying suicide farmers from controls in Andhra Pradesh.

3.2. Cash crops

The increased use of cash crops (which are a higher cost and grown primarily to be exported) as opposed to food crops (low cost and designed to be sold more locally) has been identified as an issue in some studies [3,7,14]. The suggestion is that farmers using these are more prone to becoming indebted if one of their high cost crops fails, as they have invested significantly more in their production [7], and that potentially, their use makes them more vulnerable to global price fluctuations. Kennedy and King [14] found that “cash crop cultivators, with marginal landholdings and debts” are most at risk, and that these three characteristics account for ∼75% of the variation in overall male suicide rates seen across India. When charting cash crop percentage against the male suicide rate by State in 2003, there is a clear, statistically significant, positive correlation between the two (r = 0.628). Gujarat and Rajasthan are the only exceptions, and the authors suggest that this is because they had amongst the lowest proportions of marginal farmers, indicating that this crisis is focused on the most weak and vulnerable at the bottom of the socioeconomic scale [14].

3.3. Bt cotton

The impact of one particular cash crop, the genetically modified Bt cotton, is considered one of the most contentious issues surrounding farmer suicides following its introduction in 2002. Two small studies in Vidarbha that break down crop productivity in small groups of farmers were returned [12,16]. Kale [12] shows Bt cotton to have slightly lower yields than non Bt cotton crops between 2007 and 2008, while Kale et al. [16], using data for 2004–2005 and 2005–2006, show Bt cotton having greater productivity. Statistical significance is not assessed and it is likely that these figures are too small to draw conclusions from. However, Kale [12] presents a much larger drop in productivity in all crops when comparing suicidal farmers with nonsuicidal farmers, and it is likely to be this observation that is more important in explaining suicides amongst them.

Two broader studies were identified which attempted to estimate the economic impact of Bt cotton for Indian farmers. A review conducted by Gruere and Sengupta [3] estimates that while farmers using Bt cotton have annual costs 15% higher than controls, factors such as reduced pesticide use and costs, and increased yields (plus 36.2%) lead to a net return 58.2% higher. The benefits in net returns are observed in all states with some variability. Qaim [17] found similar results in a sample of farms in four Indian states between 2002 and 2006. However, both analyses report large amounts of variability in the early years of Bt cotton’s introduction when not all were profiting, and suggest that the positive average values may obscure large levels of volatility in its effects on individual farmers [3,17]. Two main explanations are offered for this volatility. Firstly, not all farmers cultivated it under the correct conditions due to a lack of information [3,17], particularly by spraying too many pesticides [18]. Secondly, the development of a rapidly growing secondary market for so called “stealth” or “spurious” seeds meant the quality of the seeds could not be verified [19]. Assessing the strength of these explanations is beyond the scope of this report.

Perhaps most importantly, overriding much of the individual analysis concerning the consequences of Bt cotton, is the observation that as opposed to a sharp jump, the official number of farmer suicides has kept growing steadily since its introduction in 2002, even as the area of land sown with the seed has risen significantly [3]. While it may play a part in individual cases, its introduction seems unlikely to have played a large role in the suicide crisis and no study has found an empirical link between Bt cotton and farmer suicides [1,3,7,10,11].

3.4. Agrarian crisis and neoliberal reforms

More broadly an agrarian crisis, often blamed on the neoliberal reforms of the late 1980s, has been linked to farmer suicides [1]. Mishra [7] describes how the agricultural sector, responsible for 56% of gross domestic product in 1950–1951, was by 2001–2012 responsible for only 25%, while 58% of workers (specifically “cultivators or agricultural labourers”) remained reliant on it. Statistics from 2015 suggest that 48% of the population rely on agriculture, while it has a reduced 17.6% share of the total Gross Value Added [20]. Not only is the role of the farmer within Indian society reducing and increasingly the reserve of small and marginal farmers [7,20,21], estimated to represent up to 85% of all holdings [20], their role in a more global marketplace has led to extra pressures being placed on the viability of their livelihoods.

While shifting trade patterns are hard to directly analyse, as the whole country is affected by the liberalisation of trade barriers and the effect of US government subsidies for example, two studies suggest that the opening up of economic barriers somewhat protecting Indian farmers from international competition has reduced the price received for cotton production for example, and contributed to lower revenues [1,3]. Indian farmers have complained about the saturation of the market with highly subsidised United States (US) crops in this period [22], while they receive reduced government support. For example, Lake et al. [23] estimate that cotton, wheat, and rice are produced by US farmers for 47%, 28%, and 26% below costs due to significant government subsidies. The criticism of this policy was particularly strong in light of the Indian government’s agreement to reduce tariffs on these imports from 35% to 5% in 2002–2003 [7].

Alongside this, the opening up of the financial sector and declining government investment are suggested to have had a direct impact on two other factors, credit availability and irrigation.

3.5. A broad picture

In the developed world, suicide is associated overwhelmingly with mental illness [26]. This has not been identified in the studies presented above and there is no suggestion it is an important factor. The research indicates that the characteristics associated with farmer suicide correspond to socioeconomic pressures or factors that worsen it, such as indebtedness and credit difficulties. This corresponds with studies of suicide in India’s general population that found it to be associated much more with socioeconomic and psychosocial stress, with mental health disorders rare [27–29].

Nonetheless, beyond talking of risk factors for what the report has (for brevity) referred to invariably as “suicide cases”, “victims”, amongst others, this paper has not addressed what it means to be the individual farmer, or more specifically the individual person, who dies by suicide. While there are numerous strong associations, suicide is not solely completed by, for example, the marginal farmer who is indebted to moneylenders, but by a wide variety of farmers who may come to find the pressures coming down on their lives too much to bear, and who sadly come to take their own lives. Some of these personal factors were observed in some small-scale studies presented in Table 3. Farmers have struggles beyond indebtedness, with potentially stressful roles within their families as the head of the household, arguments with their wives and other family members, alcohol abuse, and difficulties adjusting to changing statuses in their local communities if and when they find themselves in difficulties.

Furthermore, not all debt is acquired to aid their occupation, with only 60% of outstanding loans being for “productive purposes” in 2002 [24]. Chhikara and Kodan [30] estimated that for marginal and small farmers in Haryana, respectively, 23.7% and 20.7% of loans were taken out to fulfil social obligations such as ceremonies and marriages.

A predominance of suicide by pesticide poisoning was also noted amongst farmers (Table 4), which could plausibly have an impact on the figures as farmers have easier access to this method of self-poisoning that has a particularly high case fatality rate [31].

Pesticide poisoning is the most common method in successful suicide attempts, at approximately 49% and 44% for men and women, respectively, in India [2], but considering historically the majority of the population was engaged in agriculture, this observation adds little to help determine whether farmers’ easy access to pesticides might inflate their suicide rates. In Sri Lanka, death rates from pesticide self-poisoning halved after regulations were instituted on the sale of highly toxic pesticides in 1995, even though pesticide self-poisoning attempts increased [31]. It is hard to predict whether similar measures would significantly alter the numbers of farmers that attempt and eventually complete suicide compared to the general population, especially as suicide in these groups appears to arise from long-term socioeconomic stress as opposed to transient moments of hopelessness that might pass.

It should also be noted that studies in other countries have proposed links between long-term pesticide use and depression or suicide [32–34]. Considering the specific socioeconomic factors identified here, this is unlikely to be a significant factor, although it has not been assessed.

Another factor that could be altering farmer suicide rates is the substantial grants given to the families of farmers who die by suicide in various states [35,36]. It has been suggested this may provide an incentive for suicides [3,37]. Unfortunately, no study was found that satisfactorily assessed the impact of this on farmer suicide numbers.

Lastly, there is no accurate, authoritative estimate on just how many farmers and non-farmers are dying by suicide in India. As Table 5 shows, there are significant discrepancies in reported suicide rates in India. The NCRB figures, for which the studies in the introduction proposing an increasing farmer suicide rate come from [1,7] are considered significant underestimates as, for example, they only use police records to classify deaths, and due to the stigma associated with suicide in a country where it was illegal until a government decision in 2014. Of all the estimates in Table 5, they are by far the lowest.

While the official suicide numbers are likely significant underestimates across the whole population, for farmers, a further underestimation may result from only counting and designating individuals as farmers who have explicit title to land [1]. Farm workers who rent their land, or are reliant on work from someone who does, are not officially counted as farmers. Nagaraj [1] suggests this may also significantly understate suicides amongst female farmers and it is notable that amongst 200 farmer suicides reported by Kale et al. [16], only six were female, and in a sample of 30 reported by Nagthan et al. [13], 29 were male.

3.6. Limitations and further research

Trying to present a broad picture of the evidence available in such a small space led to limitations. More databases could be searched, studies presented, and background given to the specific details of each study. This report is also not an authoritative review of every study. Not all available reports were found and of those that were, not all could be included here. Considering the large amount of data, included and not included in this paper, a more authoritative and objective systematic or literature review is warranted. Further research could also compare the situation of farmers in India directly with those of other countries.

To better understand this issue, large case-control or cohort studies are particularly important. While numerous, interrelated results are presented here that seem to be plausible, it should be noted that of the studies assessed, there was a lack of these kinds of studies and many of the verbal autopsy studies only had a few hundred participants at best. Few studies were able to present statistically significant results. Another potential limitation was the assumption that each study has a similar meaning when referring to what a “suicide” is, and what a “farmer” is.

Importantly, while these studies can identify associations and risk factors, we cannot know precisely why these farmers kill themselves and thus our knowledge is severely compromised and has to be inferred from risk factors and verbal autopsies.

Considering the scale of this crisis, and the potential applicability of these features (indebtedness, credit problems) to other countries, it is surprising that there are not significantly more substantial assessments in the literature. However, the lack of large, authoritative studies does not overshadow the fact that the large number of studies presents a broad picture of the pressures on the Indian farmer and the risk factors most associated with suicide.