Suicide mortality follow-up of the Swiss National Cohort (1990–2014): sex-specific risk estimates by occupational socio-economic group in working-age population
To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality.
For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990–1998/1999–2006/2007–2014).
The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007–2014 period compared with 1999–2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists.
The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation.
KeywordsLongitudinal study Job-skill level Psychosocial conditions Gender differences Social inequality Managers
We thank the Swiss federal statistical office for providing mortality and census data, and for the support that made the Swiss National Cohort (SNC) and this study possible. This work was supported by the Swiss National Science Foundation (Grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). The members of the Swiss National Cohort Study Group are Matthias Egger (Chairman of the Executive Board), Adrian Spoerri and Marcel Zwahlen (all Bern), Milo Puhan (Chairman of the Scientific Board), Matthias Bopp (both Zurich), Martin Röösli (Basel), Michel Oris (Geneva) and Murielle Bochud (Lausanne). We also thank Claudia Berlin from ISPM Bern for her help in data management of federal census data and Saheil Nazeri from IST, Lausanne for his help in translation and data management of the economic activity variable in the SNC database.
Compliance with ethical standards
Conflict of interest
This work was conducted in frame of the SNC nested study contract no. 2365. The authors have no conflicts of interest to declare.
The SNC and the present study were approved by the Cantonal Ethics Committees of Bern and Zurich, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The manuscript does not contain clinical studies or patient data.
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