Effect on suicide rate of having reduced unemployment is uncertain

BMJ 1999;318:941 ( 3 April )

Letters

Effect on suicide rate of having reduced unemployment is uncertain

The first 150 words of the full text of this article appear below.

EDITOR $---$ Lewis and Sloggett recommend policies to reduce unemployment in order to prevent suicide.¹ They show that thoseunemployed in 1981 were overrepresented among suicides 2-11 yearslater. This seems to imply that the suicides are caused by theunemployment. Their exclusion of cases up to two years after registrationto "reduce selection effects" shows that they think that the consequencesare long term. Selection problems can hardly be avoided or reducedhere by exclusion of the cases nearest in time to registration;it just blurs the hypothesis by excluding the most obvious examples(becoming unemployed as a suicidalcrisis).

Causal hypotheses may be supported by studies at the collective level since these avoid confounders at the individual level² $---$ forexample, changes in the Swedish unemployment rate and male suiciderate correlated significantly over 1920-41.³ The effect appearedin the first year of periods of massunemployment.

As unemployment re-emerged dramatically . . . [Full text of this article]

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