Suicide risk in relation to socioeconomic and occupational disadvantage in middle- and old-aged men - A national register-based study.

BACKGROUND

Suicide rate is highest amongst middle- and old-aged, and men with socioeconomic disadvantages are particularly vulnerable to die by suicide. This examines how socioeconomic and occupational disadvantage impacts suicide risk amongst Norwegian men aged ≥35 years.

METHODS

Using data from Norwegian registries, we conducted a nested case-control study of 6993 suicide deaths and 104,895 age-matched controls between 1992 and 2018. Socioeconomic indicators included marital status, labour market status, educational status, income level and occupation groups.

RESULTS

Separated men had the highest odds of suicide (adjusted OR = 4·96, 95% CI: 4·44-5·54), followed by all additional unmarried statuses. Men outside the labour market also had substantially increased odds (adjusted OR = 2·43, 95% CI: 2·22-2·66). Occupational analyses were non-significant for the full population but showed increased suicide odds amongst "professionals" and "plant and machine operators and assemblers" amongst men ≥65. Population attributable fraction estimates of all ≥35 suggested that being single (19·0%) and being outside the labour market (18.9%) accounted for substantial attributable proportions of suicide deaths and fractions varied by age group. Overall, age-stratified analyses indicated that socioeconomic associations were particularly evident amongst men aged 35-49, whilst occupational associations were more prominent in men ≥65.

CONCLUSIONS

Socioeconomic disadvantages, particularly being outside of the labour markets, marital breakdown, low income and education are strongly associated with suicide risk in middle- and old-aged men. Prevention efforts and social support should incorporate socioeconomic vulnerability to better mitigate suicide risk within this population.