Effect on suicide rate of having reduced unemployment is uncertain

doi:10.1136/bmj.318.7188.941

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Ilkka Henrik Mäkinen, Researcher (Ilkka.Makinen@sh.se)

Centre on Health of Societies in Transition, University College of South Stockholm, Box 4101, 141 04 Huddinge, Sweden

EDITOR—Lewis and Sloggett recommend policies to reduce unemployment in order to prevent suicide.1 They show that those unemployed in 1981 were overrepresented among suicides 2-11 years later. This seems to imply that the suicides are caused by the unemployment. Their exclusion of cases up to two years after registration to “reduce selection effects” shows that they think that the consequences are long term. Selection problems can hardly be avoided or reduced here by exclusion of the cases nearest in time to registration; it just blurs the hypothesis by excluding …