Kreitman N, Carstairs V, Duffy J
Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, United Kingdom.
J Epidemiol Community Health. 1991 Sep;45(3):195-202. doi: 10.1136/jech.45.3.195.
The aim was to investigate suicide and "undetermined" deaths by age, economic activity status, and social class in Great Britain among males of working age.
The study was a cross sectional analysis of Registrar General's data for England and Wales around 1981, repeated for around 1971, and for Scotland around 1971 and 1981.
For England and Wales around 1971, suicide and undetermined death rates showed a progressive increase with age and a markedly higher rate in the lower social classes. A significant interaction effect was identified in the central age groups of the lower occupational categories. This interaction was confirmed in the remaining three data sets, notwithstanding some differences in the profile of age specific mortality. Other findings included a higher standardised mortality ratio for the economically inactive, who also showed an earlier peak in age specific mortality, and a relative concentration of undetermined as compared to suicide deaths in the lower social classes, but not all these further results were fully replicated.
There is a concentration of suicide and undetermined deaths in the middle age groups of the lower social classes. Plausible explanations include both the social drift and the social genesis hypotheses, the latter including the effects of long term unemployment.
旨在调查英国劳动年龄男性中按年龄、经济活动状况和社会阶层划分的自杀及“死因不明”死亡情况。
该研究是对1981年前后英格兰和威尔士总登记官数据的横断面分析,1971年前后重复进行,以及对1971年和1981年前后苏格兰的数据进行分析。
对于1971年前后的英格兰和威尔士,自杀率和死因不明死亡率随年龄逐渐上升,且在社会阶层较低者中显著更高。在较低职业类别的中年组中发现了显著的交互作用效应。尽管年龄别死亡率的分布存在一些差异,但在其余三个数据集中证实了这种交互作用。其他发现包括经济不活跃者的标准化死亡率更高,他们的年龄别死亡率也更早达到峰值,以及与自杀死亡相比,死因不明死亡在社会阶层较低者中相对集中,但并非所有这些进一步的结果都得到了完全重复。
社会阶层较低的中年组中存在自杀和死因不明死亡的集中现象。合理的解释包括社会流动和社会成因假说,后者包括长期失业的影响。