Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

  • Karen Wetherall
  • Michael Daly
  • Kathryn A. Robb
  • Alex M. Wood
  • Rory C. O’Connor
Original Paper



Low income is an established risk factor for suicidal thoughts and attempts. This study aims to explore income within a social rank perspective, proposing that the relationship between income and suicidality is accounted for by the rank of that income within comparison groups.


Participants (N = 5779) took part in the Adult Psychiatric Morbidity Survey across England. An income rank variable was created by ranking each individual’s income within four comparison groups (sex by education, education by region, sex by region, and sex by education by region). Along with absolute income and demographic covariates, these variables were tested for associations with suicidal thoughts and attempts, both across the lifetime and in the past year.


Absolute income was associated with suicidal thoughts and attempts, both across the lifetime and in the past year. However, when income rank within the four comparison groups was regressed on lifetime suicidal thoughts and attempts, only income rank remained significant and therefore accounted for this relationship. A similar result was found for suicidal thoughts within the past year although the pattern was less clear for suicide attempts in the past year.


Social position, rather than absolute income, may be more important in understanding suicidal thoughts and attempts. This suggests that it may be psychosocial rather than material factors that explain the relationship between income and suicidal outcomes.


Suicide Social rank theory Income Social comparisons Defeat 



The data was accessed through the UK Data Archive and can be downloaded from The Adult Psychiatric Morbidity survey (APMS) is archived as SN 6379. This research was supported in part by the Economic and Social Research Council (ESRC) grant ES/K00588X/1.

Conflict of interest

The authors have no conflict of interest.

Ethical standard

All studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Karen Wetherall
    • 1
  • Michael Daly
    • 2
  • Kathryn A. Robb
    • 1
  • Alex M. Wood
    • 2
  • Rory C. O’Connor
    • 1
  1. 1.Suicidal Behaviour Research Laboratory, Institute of Health and WellbeingUniversity of Glasgow, Academic Centre, Gartnavel Royal HospitalGlasgowUK
  2. 2.University of StirlingStirlingUK

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