Department of Public Health Sciences, The University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
College of Nursing, University of Kentucky, 760 Press Ave., Suite 361, Lexington, Kentucky, USA.
Am J Ind Med. 2021 Nov;64(11):960-968. doi: 10.1002/ajim.23287. Epub 2021 Sep 5.
Studies suggest that agricultural workers and rural residents may have an elevated suicide risk. However, suicide is relatively rare, and rural and farming populations have significantly declined, limiting their representation in national surveys. Many studies have inadequate samples for meaningful analysis.
We pooled 29 years of data from the Mortality-Linked National Health Interview Survey, 1986-2014, then measured suicide mortality in groups including agriculture workers, and variation in suicide across rural and urban areas. Exposure variables indicated whether participants worked in a farm-related occupation or industry, or lived in a rural area. We used survey-weighted Poisson regression to estimate suicide mortality rates and rate ratios.
Age-adjusted suicide mortality rate per 100,000 was: 22.3 for farmers and farm managers; 21.6 for farmworkers; 28.7 in farming, forestry, and fishing; 15.3 across all other occupations; 16.1 among rural residents. Among farmworkers, age-adjusted rates were 28.3 in rural areas, 17.1 in urban areas (not significantly different). The age-adjusted suicide mortality rate ratio (RR) comparing workers in the agriculture, forestry, and fishery industries to those in all other industries was 1.34 (95% confidence interval, [CI]: 1.05-1.72) (not statistically significant after further adjustment for demographic characteristics). Age-adjusted results were consistent with a higher suicide risk for workers in forestry and fishing than in all other occupations (RR: 1.88, 95% CI: 0.79-4.46).
Workers in agriculture, forestry, and fishing may have an elevated suicide risk. National surveys should consider oversampling of rural residents, who have increased morbidity and mortality risks.
研究表明，农业工人和农村居民的自杀风险可能较高。然而，由于自杀相对较少见，且农村和农业人口显著减少，这限制了他们在全国性调查中的代表性。许多研究的样本量不足，无法进行有意义的分析。
我们汇总了 1986 年至 2014 年 29 年的 Mortality-Linked National Health Interview Survey 数据，然后测量了包括农业工人在内的不同群体的自杀死亡率，以及农村和城市地区的自杀差异。暴露变量表明参与者是否从事与农场相关的职业或行业，或居住在农村地区。我们使用调查加权泊松回归来估计自杀死亡率和比率。
调整年龄后的每 10 万人自杀死亡率为：农民和农场经理 22.3；农场工人 21.6；农业、林业和渔业 28.7；所有其他职业 15.3；农村居民 16.1。在农场工人中，农村地区的调整年龄后死亡率为 28.3，城市地区为 17.1（无显著差异）。与所有其他行业相比，农业、林业和渔业行业工人的调整年龄后自杀死亡率比率（RR）为 1.34（95%置信区间[CI]：1.05-1.72）（进一步调整人口统计学特征后无统计学意义）。调整年龄后的结果表明，林业和渔业工人的自杀风险高于所有其他职业（RR：1.88，95%CI：0.79-4.46）。
农业、林业和渔业工人的自杀风险可能较高。全国性调查应考虑对农村居民进行过采样，因为他们的发病率和死亡率风险增加。
