The three chapters of this section, by Hassett, Perkins, and Melding, eloquently explore the topics of psychosocial challenges, cognitive challenges, and physical health challenges in older women. As Hassett pointsed out in the introduction to Chapter 23, “Age and gender hierarchies shape female lives across the life course in specific social and historical contexts” (1). I agree. Socio-cultural factors are very important in determining some of the challenges involved. Previous research work about older women has been mostly carried out in developed countries. Relatively few studies have examined the challenges experienced by older women in non-Western cultures. It is likely that these issues differ in diverse cultures, and I would like to illustrate this from a Chinese perspective using suicide as an example.

There are interesting differences in the sex ratio in suicide rates in older people across countries. In most Western countries, the male:female ratio of completed suicide is around 3 to 1. In China, this ratio is 0.8 to 1 (2). China is one of the few countries where the suicide rate of females is higher than that of males. In the Chinese elderly, the male: to female ratio is 1.1 to 1. In addition, there is a striking difference in the rates of suicide between the urban and rural areas in China, with the rural rate three times that of the urban rate (2). If one looks at the actual suicide rates in older women in various countries, the differences are even more striking. In 1999, suicide rates of older women aged 75 or above in Australia, the United Kingdom, the United States, and rural China were 3.4, 5.1, 4.6, and 102.2 per 100,000, respectively (3). Clearly, older women are at considerably higher risk of suicide in China than in many Western countries.