Researchers have known for many years that suicide rates are higher in societies that emphasize the importance of the individual and lower in societies that emphasize the importance of collectives such as the family. Indeed, a nation’s individualism rank is a potent predictor of its suicide rate (Zambrano & White, 2009).

Recent studies have identified another sociocultural variable—the importance of honor—that is statistically related to suicide rates. An honor culture is a society or social group that emphasizes the importance of an individual’s reputation or “honor.” In honor cultures, people are especially polite and avoid offending others. They also strive to establish and maintain a reputation for punishing those who besmirch their honor.

Honor cultures are said to have first developed in herding societies in which a family’s wealth and livelihood could be stolen from them in one fell swoop. In a herding society, it was important to establish a fierce reputation so as to discourage would-be rustlers and poachers. As a result, members of honor cultures are especially sensitive to slights, slurs, and insults. They’re also more willing to use violence to avenge a perceived affront.

Many researchers have identified the southern and western United States as regions with strong historical ties to herding and a culture of honor. These states are associated with dueling practices and family feuds. They have higher rates of gun ownership, divorce, and homicide. They’re also more likely to have “stand your ground” laws.

In 2011, social psychologists Lindsey Osterman and Ryan Brown at the University of Oklahoma reported that honor states in the U.S. have higher rates of depression and suicide, even after controlling for other state-level variables that are typically related to depression and suicide. They also found, in a separate study, that individuals who embraced an honor ideology were more likely to suffer from depression.

Osterman and Brown argued that people living in honor states become especially distressed emotionally when their honor has been challenged. They’re also inclined to use violence in an attempt to restore their honor. This hazardous combination makes them more likely to harm others but also more likely to harm themselves when other attempts to restore their honor have failed.

In 2014, social psychologists Marisa Crowder and Markus Kemmelmeier at the University of Nevada, Reno, conducted a similar study. Using a larger, multi-year data set, they replicated the earlier finding that honor states have higher suicide rates, but they found no evidence that honor states have higher rates of depression.

They also found that honor states had fewer prescriptions written (per capita) for antidepressant medications. On the basis of a sophisticated statistical analysis, Crowder and Kemmelmeier concluded that “the higher rates of suicide among honor states can be attributed to lower levels of ADP [antidepressant drug prescriptions] but not to higher rates of depression” (p. 1154).

The bottom line seems to be this: Depression is a major precursor to suicide, and depression is particularly dangerous in the southern and western United States. Why? Because the men and women who become depressed in these honor states are less likely to seek the help they need to get better. They’re reluctant to seek medical assistance because others might see it as a sign of personal weakness.

It’s always risky to draw conclusions about individuals from aggregate data. And we don’t know if the findings presented here can be generalized to other nations. Still, public health officials would do well to recognize that untreated depression predicts higher suicide rates, especially in cultures of honor.


Crowder, M. K., & Kemmelmeier, M. (2014). Untreated depression predicts higher suicide rates in U.S. honor cultures. Journal of Cross-Cultural Psychology, 45(7), 1145-1161.

Osterman, L. L., & Brown, R. P. (2011). Culture of honor and violence against the self. Personality and Social Psychology Bulletin, 37(12), 1611-1623.

Zambrano, Z., & White, L. T. (2009). Estimating suicide rates in nations that do not report suicide statistics. Undergraduate Research Journal for the Human Sciences, 8. Published on-line at

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