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Impact of 2008 global economic crisis on suicide: time trend study in 54 countries

BMJ 2013; 347 doi: (Published 17 September 2013) Cite this as: BMJ 2013;347:f5239
  1. Shu-Sen Chang, research assistant professor123,
  2. David Stuckler, senior research leader45,
  3. Paul Yip, professor16,
  4. David Gunnell, professor2
  1. 1HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China
  2. 2School of Social and Community Medicine, University of Bristol, Bristol, UK
  3. 3Ju Shan Hospital, Taoyuan, Taiwan
  4. 4Department of Sociology, University of Oxford, Oxford, UK
  5. 5Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London. UK
  6. 6Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
  1. Correspondence to: S-S Chang shusen.chang{at}
  • Accepted 12 August 2013


Objective To investigate the impact of the 2008 global economic crisis on international trends in suicide and to identify sex/age groups and countries most affected.

Design Time trend analysis comparing the actual number of suicides in 2009 with the number that would be expected based on trends before the crisis (2000-07).

Setting Suicide data from 54 countries; for 53 data were available in the World Health Organization mortality database and for one (the United States) data came the CDC online database.

Population People aged 15 or above.

Main outcome measures Suicide rate and number of excess suicides in 2009.

Results There were an estimated 4884 (95% confidence interval 3907 to 5860) excess suicides in 2009 compared with the number expected based on previous trends (2000-07). The increases in suicide mainly occurred in men in the 27 European and 18 American countries; the suicide rates were 4.2% (3.4% to 5.1%) and 6.4% (5.4% to 7.5%) higher, respectively, in 2009 than expected if earlier trends had continued. For women, there was no change in European countries and the increase in the Americas was smaller than in men (2.3%). Rises in European men were highest in those aged 15-24 (11.7%), while in American countries men aged 45-64 showed the largest increase (5.2%). Rises in national suicide rates in men seemed to be associated with the magnitude of increases in unemployment, particularly in countries with low levels of unemployment before the crisis (Spearman’s rs=0.48).

Conclusions After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss.


  • Contributors: DG and S-SC had the idea for the study and designed the study with input from DS and PSFY. S-SC was responsible for obtaining data and statistical analysis, with input from PSFY. S-SC, DG, and DS led interpretation of the findings with additional input from PSFY. S-SC wrote the first draft, with input from DG and DS, and all authors contributed to successive drafts. S-SC is guarantor. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. S-SC is supported by the Hong Kong Research Grants Council (RCG) general research fund (grants HKU784210M and HKU784012M) and a grant from the University of Hong Kong (Project Code 201203159017). DS is funded by a European Research Council investigator award. DG is a UK National Institute for Health Research senior investigator. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interest: All authors have completed the ICMJE uniform disclosure form at (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: Not required.

  • Data sharing: No additional data available.

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