Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Department of Community Medicine and Global Health (Department of Health and Society), University of Oslo, Oslo, Norway.
BMC Public Health. 2023 Jun 20;23(1):1181. doi: 10.1186/s12889-023-16084-x.
There is a known association between employment status and suicide risk. However, both reason for non-employment and the duration affects the relationship. These factors are investigated to a lesser extent. About one third of the Norwegian working age population are not currently employed. Due to the share size of this population even a small increase in suicide risk is of importance, and hence increased knowledge about this group is needed.
We used discrete time event history analysis to examine the relationship between suicide risk and non-employment due to either unemployment or health-problems, and the duration of these non-employment periods. We analyze data from the Norwegian population registry from 2004 to 2014, which includes all Norwegian residents in the ages 19-58 born between 1952 and 1989. In total the data consists of 1 063 052 men and 1 024 238 women, and 2 039 suicides.
The suicide risk among the non-employed men and women is significantly higher than that of the employed. For the unemployed men, the suicide risk is significantly higher than the employed within the first 18 months. For the unemployed women we only find a significant association with suicide risk among those unemployed for six to twelve months. The suicide risk is especially increased among those with temporary health-related benefits. In the second year of health-related non-employment men have eightfold and women over twelvefold the OR for suicide, compared to the employed.
There is an association between non-employment and suicide risk. Compared to the employed both unemployed men and men and women with health-related non-employment have elevated suicide risk, and the duration of non-employment may be the driving force. Considering the large share of the working age population that are not employed, non-employment status should be considered in suicide risk assessment by health care professionals and welfare providers.
就业状况与自杀风险之间存在已知关联。然而,非就业原因和持续时间都会影响这种关系。这些因素的研究还不够充分。大约三分之一的挪威劳动年龄人口目前没有就业。由于该人群的规模较大,即使自杀风险略有增加也很重要,因此需要增加对这一群体的了解。
我们使用离散时间事件历史分析来研究由于失业或健康问题导致的非就业与自杀风险之间的关系,以及这些非就业期的持续时间。我们分析了 2004 年至 2014 年期间挪威人口登记处的数据,其中包括 1952 年至 1989 年出生的所有年龄在 19 至 58 岁之间的挪威居民。数据共包括 1 063 052 名男性和 1 024 238 名女性,以及 2039 例自杀。
失业男性和女性的自杀风险明显高于就业人群。对于失业男性,在最初的 18 个月内,其自杀风险明显高于就业男性。对于失业女性,只有在失业 6 至 12 个月的人群中,才发现与自杀风险存在显著关联。临时与健康相关的福利领取者的自杀风险尤其增加。在相关健康问题非就业的第二年,男性的自杀风险是就业人群的 8 倍,女性是 12 倍以上。
非就业与自杀风险之间存在关联。与就业人群相比,失业男性以及因健康问题而非就业的男性和女性自杀风险更高,且非就业时间可能是驱动因素。考虑到劳动年龄人口中有很大一部分人没有就业,医疗保健专业人员和福利提供者在进行自杀风险评估时应考虑就业状况。