Phillips Julie A, Nugent Colleen N
Department of Sociology and Institute for Health, Health Care Policy and Aging Research (IHHCPAR), Rutgers University, 112 Paterson Street, New Brunswick, NJ 08901, USA.
Soc Sci Med. 2014 Sep;116:22-31. doi: 10.1016/j.socscimed.2014.06.015. Epub 2014 Jun 14.
After several decades of decline, U.S. suicide rates have risen since 2005, a trend driven largely by increases among those aged 45-64 that began in 1999. A prominent explanation for this pattern relates to deteriorating economic conditions, especially the sharp rise in unemployment associated with the Great Recession of 2007-2009. We pool data from 1997 to 2010 on the 50 U.S. states to examine the role of economic factors in producing the recent rise in suicide rates. Unlike prior studies, we examine trends in the total suicide rate and in the rate disaggregated by sex, age group and time period and include a number of important confounding factors in a multivariate analysis. We find a strong positive association between unemployment rates and total suicide rates over time within states. The association appears stronger in states that had higher female labor force participation rates over the period, suggesting that the Great Recession may generate greater levels of anomie in this context. Once we consider contextual factors such as female labor force participation, we find that rising unemployment had a similar adverse effect on male and female suicide rates. A positive effect of unemployment on temporal variation in middle-aged suicide exists but not for other age groups. Other economic characteristics, such as percent of manufacturing jobs and per capita income, are not associated with temporal variation in suicide rates within states but are associated with variation between states in suicide rates. The findings suggest that the following may be important components of effective prevention strategies: 1) specifically targeting employers and workplaces as important stakeholders in the prevention of suicide, 2) disseminating information about health risks tied to un/employment, and 3) linking the unemployed to mental health resources.
经过几十年的下降后，美国的自杀率自2005年以来有所上升，这一趋势主要由1999年开始的45至64岁人群自杀率上升所驱动。对这一模式的一个突出解释与经济状况恶化有关，尤其是与2007 - 2009年大衰退相关的失业率急剧上升。我们汇总了1997年至2010年美国50个州的数据，以研究经济因素在近期自杀率上升中所起的作用。与先前的研究不同，我们考察了总自杀率以及按性别、年龄组和时间段分类的自杀率趋势，并在多变量分析中纳入了一些重要的混杂因素。我们发现，随着时间推移，各州失业率与总自杀率之间存在很强的正相关关系。在该时期女性劳动力参与率较高的州，这种关联似乎更强，这表明在这种情况下，大衰退可能会产生更高水平的失范。一旦我们考虑诸如女性劳动力参与等背景因素，就会发现失业率上升对男性和女性自杀率都有类似的不利影响。失业率对中年自杀率的时间变化有正向影响，但对其他年龄组则没有。其他经济特征，如制造业就业百分比和人均收入，与各州内自杀率的时间变化无关，但与各州之间自杀率的变化有关。研究结果表明，以下可能是有效预防策略的重要组成部分：1）将雇主和工作场所作为预防自杀的重要利益相关者进行专门针对性干预；2）传播与失业/就业相关的健康风险信息；3）将失业者与心理健康资源联系起来。
