Format

Send to

Choose Destination
Int J Epidemiol. 2015 Jun;44(3):956-66. doi: 10.1093/ije/dyv009. Epub 2015 Jun 16.

Economic downturns and suicide mortality in the USA, 1980-2010: observational study.

Author information

1
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada and sam.harper@mcgill.ca.
2
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada and.
3
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.

Abstract

BACKGROUND:

Several studies have suggested strong associations between economic downturns and suicide mortality, but are at risk of bias due to unmeasured confounding. The rationale for our study was to provide more robust evidence by using a quasi-experimental design.

METHODS:

We analysed 955,561 suicides occurring in the USA from 1980 to 2010 and used a broad index of economic activity in each US state to measure economic conditions. We used a quasi-experimental, fixed-effects design and we also assessed whether the effects were heterogeneous by demographic group and during periods of official recession.

RESULTS:

After accounting for secular trends, seasonality and unmeasured fixed characteristics of states, we found that an economic downturn similar in magnitude to the 2007 Great Recession increased suicide mortality by 0.14 deaths per 100,000 population [95% confidence interval (CI) 0.00, 0.28] or around 350 deaths. Effects were stronger for men (0.28, 95% CI 0.07, 0.49) than women and for those with less than 12 years of education (1.22 95% CI 0.83, 1.60) compared with more than 12 years of education. The overall effect did not differ for recessionary (0.11, 95% CI -0.02, 0.25) vs non-recessionary periods (0.15, 95% CI 0.01, 0.29). The main study limitation is the potential for misclassified death certificates and we cannot definitively rule out unmeasured confounding.

CONCLUSIONS:

We found limited evidence of a strong, population-wide detrimental effect of economic downturns on suicide mortality. The overall effect hides considerable heterogeneity by gender, socioeconomic position and time period.

KEYWORDS:

Economic recession; United States; socioeconomic position; suicide

PMID:
26082407
PMCID:
PMC4521126
DOI:
10.1093/ije/dyv009
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center