Suicide, deprivation, and unemployment: record linkage study

BMJ 1998;317:1283-1286 ( 7 November )

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Suicide, deprivation, and unemployment: record linkage study

Glyn Lewis, professor of community and epidemiological psychiatry, ^a Andy Sloggett, lecturer in medical demography. ^b

^a Division of Psychological Medicine, University of Wales College of Medicine, Cardiff CF4 4XN, ^b Centre for Population Studies, London School of Hygiene and Tropical Medicine, London WC1E 7HT

Correspondence to: Professor Lewis wpcghl{at}cardiff.ac.uk

Objectives: To investigate the association between suicideand socioeconomic status, unemployment, and chronicillness.
Design: Longitudinalstudy.
Setting: England andWales.
Subjects: Individuals from the Office for National Statisticslongitudinal study for whom 1981 census data were available. Thelongitudinal study is a representative 1% sample of the populationof England and Wales in which census variables are linked to mortality data.
Main outcome measures: Suicide and undetermined deaths occurringbetween 1983 and 1992. Odds ratios estimated with logistic regressionadjusted for attrition of cohortmembers.
Results: There was a strong independent associationbetween suicide and individuals who were unemployed (odds ratio2.6; 95% confidence interval 2.0 to 3.4) and permanently sick(2.5; 1.6 to 4.0). Those without access to a car had an increasedrisk (1.3; 1.0 to 1.5), but other measures of socioeconomic statuswere not associated withsuicide.
Conclusions: The association between suicide and unemploymentis more important than the association with other socioeconomicmeasures. Although some potentially important confounders werenot adjusted for, the findings support the idea that unemploymentor lack of job security increases the risk of suicide and thatsocial and economic policies that reduce unemployment will alsoreduce the rate ofsuicide.

Key messages

Suicide is a major cause of premature mortality and is increasing in young men
Unemployment was associated with a doubling of the suicide rate in data from the Office for National Statistics longitudinal study
There was little or no association between suicide and measures of socioeconomic status such as social class and housing tenure once the association with unemployment had been taken into account
This study could not adjust for some potential confounders but provides strong support for the possibility that reduction in unemployment would also reduce rates of suicide

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