Unemployment and job insecurity linked to increased ...

“Unemployment causes 45,000 suicides a year worldwide,” The Guardian reports. The story comes from a study that looked at the association between suicide rates and unemployment in 63 countries across the world.

It found that between 2000 and 2011, one in five of an estimated 233,000 annual suicides were linked to unemployment.

The study cannot prove that unemployment causes suicide, although it certainly suggests a strong association.

The research is useful because it looks at the possible link between suicide and unemployment in the long term and not just during times of economic crisis. It estimates that unemployment between 2000 and 2011 was associated with nine times as many suicides annually as those that were attributable to the 2008 economic recession.

Interestingly, it also found that in countries where being out of work is uncommon the link between suicide risk and a rise in unemployment is stronger.

This could be due to a sense of being stigmatised. In the UK, there are regular media stories about people perceived as abusing the benefit system, but these are likely to be the exception, not the rule. Such distorted coverage may increase the sense of stigmatisation.

The researchers make the suggestion that professionals such as social workers and human resource officers who deal with people who are unemployed or at risk of redundancy, should be given advice to spot possible warning signs, as this may help prevent potential suicides.

Where did the story come from?

The study was carried out by researchers from the University of Zurich in Switzerland. There is no information about external funding.

The study was published in the peer-reviewed medical journal The Lancet Psychiatry.

While The Guardian and the Mail Online’s coverage was generally accurate, they both fell into the trap of assuming correlation equals causation – wrongly stating that a direct cause and effect relationship has been proven between unemployment and suicide rates.

Unemployment may have an influence on suicide rates, though other factors such as depression and poor health could also play a part.

So a headline such as The Guardian’s “Unemployment causes 45,000 suicides a year worldwide, finds study” is incorrect.

What kind of research was this?

This was an observational study that looked at the association between suicide and unemployment in 63 countries between 2000 and 2011. Importantly this was a period that included times of economic stability as well as the 2008 global economic recession and its aftermath.

The researchers say that previous research suggests an association between the 2008 economic crisis, rising unemployment and increased suicide rates, with men and those of working age particularly affected.

Unemployment may increase the risk of suicide through mechanisms such as an increased risk of depression, financial strain and reduced affordability of mental health care.

However, they say a specific effect of unemployment on suicide rates has not been clearly shown.

What did the research involve?

The researchers extracted data on suicide rates from 2000 to 2011 by age and sex, from the mortality database of the World Health Organization. They looked at the number of suicides per 100,000 population for the following four age categories, by sex: 15-24 years, 25-44 years, 45-64 years and 65 years and older.

They extracted four economic indicators from 2000 to 2011 from the world economic database of the International Monetary Fund. These were the unemployment rate, Gross Domestic Product (GDP), growth rate and inflation.

For their analysis they selected 63 countries drawn from the four world geographic regions – the Americas, northern and western Europe, southern and eastern Europe, and non-Americas and non-Europe. The countries were chosen based on completeness of data available and sample size.

Using statistical methods they analysed the link between unemployment rates, suicide and other economic factors.

What were the basic results?

The study found that the link between unemployment and suicide was similar in all four world regions. It estimates that in the 63 countries studied between 2000 and 2011:

there were about 233,000 suicides annually
suicides associated with unemployment totalled about 45,000 annually, making up about 20% of all suicides
suicide associated with unemployment rose by 4,983 from 2007 to 2009 (the period of the recent economic downturn)
men and women of all ages were equally vulnerable to suicide associated with unemployment
overall, the relative risk of suicide decreased by 1.1% (95% confidence interval (CI) 0.8-1.4%) annually, during this period

Researchers also found a six-month time lag between higher suicide rate and a rise in unemployment, There was also a stronger association between suicide and unemployment in countries where baseline unemployment was low.

How did the researchers interpret the results?

The researchers say that in countries where unemployment is uncommon, a rise in job losses might trigger greater fears and insecurity than in countries with higher previous unemployment rates. They also comment on the time lag between suicide and the rise in unemployment, suggesting that downsizing and labour market restructuring may create additional stress and a sense of job insecurity.

Suicide associated with unemployment might be severely underestimated if studies focus only on times of economic crisis they argue. “There is a continuous need to focus on preventing suicides, even more so in economically prosperous, stable time periods than in times of lower prosperity, when resources are scarcer,” they say, with prevention efforts needed in countries with both low and high unemployment rates.

Conclusion

This large study suggests there is a strong association between suicide and unemployment in times of economic stability as well as in times of economic recession.

However, analysis at world regional level is unable to take account of clinical and psychosocial factors associated with suicide and further research into individuals at risk in times of high unemployment would be useful. In addition, there is missing information from large countries such as China, India and most of Africa, which may affect the reliability of their estimates.

As an accompanying paper in The Lancet Psychiatry notes, fluctuating unemployment is only one effect of economic recession that may affect mental health. Other economic strains include falling income, zero hour contracts, job insecurity and debt.