Suicide, recession, and unemployment

Occupational class differences in male suicide risk in Finland from 1970 to 2019

BACKGROUND

In the last few decades, suicide rates have decreased in most European countries. However, periodic changes in risk by occupational class have not been studied as much in detail.

METHODS

Representative cohorts of Finnish working-age men were followed for nine years on suicide mortality starting from five different census years (1970, 1980, 1990, 2000, 2010). Each cohort included between 300 970 and 332 318 men. Cox regression modelling was used to estimate hazard ratios by census year, occupational class and their interactions. Further models adjusted for age and its interactions with census year and occupational class.

RESULTS

The risk of male suicide has more than halved between 1991 and 2019. The relative hazard ratio of suicide in manual workers compared to managers and professionals was around 1.6 to 1.8 times higher. The period when the suicide risk started to decline differed by occupational class: a significant decrease compared to 1970s' levels was seen for managers and professionals already in the 1990s and for lower non-manual employees around 10 years later (in the 2000s). Manual workers only reached the 1970s suicide risk of managers and professionals in the 2000s and 2010s.

CONCLUSION

A delayed reduction of suicide rates among lower occupational classes suggests that the impact of social changes can occur at different speed in different population groups.

Assessment of risk factors for suicidal behavior: results from the Tehran University of Medical Sciences Employees' Cohort study

Introduction

Suicide is a major issue of concern for public health. It is estimated that suicide accounts for 700,000 deaths every year. A personal history of one or more suicide attempts is the most important determinant of suicide among the general population. This study aimed to assess the major risk factors associated with suicidal behaviors among Iranian employees in a medical setting.

Methods

In this study, 3,913 employees of Tehran University of Medical Sciences who participated in the employees' cohort study conducted by the university were recruited. Suicidal behaviors (SBs) and their associated risk factors were evaluated using the World Mental Health Composite International Diagnostic Interview (CIDI) Version 3.0. Univariate and multivariate logistic regressions were performed to identify the determinants of SBs among the participants, and crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated.

Results

Overall, 49.6% of respondents (n = 1,939) reported that they were tired of life and thinking about death. The lifetime prevalence rate of suicidal ideation (SI) was 8.1% (n = 317), that of suicide planning (SP) was 7.3% (n = 287), and that of suicide attempts (SA) was 3.1% (n = 122). Being female (OR: 1.87, CI: 1.64-2.12), being divorced (OR: 3.13, CI: 1.88-5.22), having a low level of education (OR: 1.57, CI: 1.15-2.14), and working in clinical and medical services (OR: 1.25, CI: 1.09-1.43) were associated with being tired of life and thinking about death. These factors were also associated with SI, SP, and SA.

Discussion

These findings highlight the need to prioritize mental health for suicide prevention, especially for high-risk groups, in workplace mental health promotion programs and policies.

Suicidality Related to the COVID-19 Lockdown in Romania: Structural Equation Modeling

Background

Suicidality is a serious public health concern at a global scale. Suicide itself is considered to be preventable death; worldwide, suicide rates and their trends are under constant scrutiny. As part of the international COMET-G cross-sectional study, we conducted a national level investigation to examine the individual disturbances (such as anxiety, depression, or history of life-threatening attempts) and contextual factors (such as adherence to conspiracy theories or Internet use) associated with suicidality related to the COVID-19 lockdown in a lot of Romanian adults.

Participants and Methods

One thousand four hundred and forty-six adults responded to an anonymous on-line questionnaire, with mean age ± standard deviation of 47.03 ± 14.21 years (1,142 females, 292 males, 12 identified themselves as non-binary). Data were analyzed using descriptive statistics and structural equation modeling (SEM).

Results

Univariate analysis showed strong significant correlation between anxiety and depression scorings among the respondents (Spearman R = 0.776, p < 0.001). Both the suicidality scorings and the Internet use correlated fairly with anxiety and depression, with two-by-two Spearman coefficients between R = 0.334 and R = 0.370 (p < 0.001 for each). SEM analysis substantiated the emotional disturbances, previous life-threatening attempts, and younger age as significant predictors for suicidality. The patterns of reality reading (including religious inquiries, Internet use, and beliefs in conspiracy theories) did not reach the statistical significance as influential factors in the suicidality of these respondents. There was no covariance between the Internet use and belief in conspiracy theories.

Conclusion

The study confirmed the suicidality risk initially hypothesized as being associated with the history of life-threatening attempts, increased depression within the younger population, and higher anxiety during the first year of the COVID-19 pandemic and its related lockdown. National strategies for effective interventions at various levels of the healthcare system should be developed.

Climate rather than economic variables might have caused increase in US homicide but not suicide rates during the Great Depression

BACKGROUND

It is widely believed that during the Great Depression (1929-1933) there was a rise in suicidal rates which was causally related to the increase in unemployment. There are no studies on the effect the Great Depression had on homicidal rates METHODS: The data concerning suicide, homicide, economic and climatic variables for the years 1900-1940 for the whole of the US were gathered from the US Center for Disease Control, the Maddison Project, the National Bureau of Economic Research and the National Climatic Data Center. Time Series Analysis was performed.

RESULTS

The results are inconclusive on the role of economic factors but preclude any role of climate on suicidal rates during the years 1900-1940 in the US. Suicidal rates might have a 24-years periodicity, however much longer time series are needed to confirm this. On the contrary they strongly suggest an effect of higher temperatures on homicidal rates after 1922.

CONCLUSIONS

The results of the current study suggest a direct and clear effect of climate (higher temperatures) on the increasing homicidal rates in the US after 1922 but failed to establish a causal relationship between suicide rates and economic or climate variables. These should be considered together with increasing concerns on the possible effect of climate change on mental health.

The impact of macroeconomic factors on suicide in 175 countries over 27 years

BACKGROUND

Every year, more than 800,000 people die by suicide, three-quarters of which are males. Economic factors influence suicide rates, but a worldwide perspective of their impact according to age and sex is lacking.

METHOD

We queried publicly available datasets on economic factors and on suicide rates stratified according to sex and age, from 1991 to 2017, for 175 countries. Thus, we analyzed approximately 21 million deaths by suicide using a multivariable regression model approach.

RESULTS

Every 1% increase in global unemployment rates is associated with a 1% upsurge in male deaths by suicide (Relative risk (RR) = 1.01 [CI 95% 1.00-1.01] with respect to females) or 5000 excess male deaths. A 1% higher unemployment rate also exerts age-specific effects on suicide rates, since, among adults aged 30-59, the suicide rate is increased by 2-3%. Lastly, for every 1000 US dollar increase in the GDP per capita, suicide rates are reduced by 2% (RR = 0.98 [0.98-0.98]), corresponding to a reduction of 14,000-15,000 suicide deaths per year globally.

CONCLUSIONS

Males who have lost their jobs in adulthood are those at higher risk of suicide and to whom financial support measures should be delivered in a timely manner.

An empirical investigation of the relationship between business performance and suicide in the US

Previous research suggests that mortality rates behave pro-cyclically with respect to economic growth, with suicides representing a notable exception that consistently increase in economic downturns. Over recent years, there is ample evidence in the literature that the working environment in the US has deteriorated significantly, suggesting that suicide rates may not necessarily behave in a counter-cyclical manner with business performance. Utilising recent suicide data, this study empirically tests the hypothesis that adverse working conditions over recent years may have resulted in a pro-cyclical relationship between business performance and suicide. Unlike previous studies, we use a stock market index, a leading macroeconomic indicator, to measure economic conditions from a business perspective. We employ the Autoregressive Distributed Lag (ARDL) co-integration methodology to study the long-run relationship between monthly S&P500 stock market data and age and gender-specific suicide rates during the period January 1999 to July 2017. Our results highlight substantial differences in age groups responses to fluctuations in business performance. We find a clear positive association between business performance and suicide rates for the youngest males and females aged 15-34 years, indicating that there is a human cost associated with improved business performance. Additionally, we investigate the association between economic insecurity, a unique aspect of the recent deterioration in the working environment, using the Implied Volatility Index "VIX" and age and gender-specific suicide rates. Our findings do not support a population-wide adverse impact of economic insecurity on suicide incidences. The exception was males aged 15-24, and females aged 55-64 for whom we find a significant positive association. Teaching work-life management and problem-solving skills to manage everyday work stressors may be important strategies to mitigate the psychological cost of business successes.

Suicide rates in Iceland before and after the 2008 Global Recession: a nationwide population-based study

Background

Economic downturns have been associated with increased suicide rates. The 2008 global financial crisis varied across countries but hit Iceland relatively hard. We aimed to study potential changes in suicide rates in Iceland during this major economic transition.

Methods

Data were retrieved on all suicides in Iceland during 2002–14. The study period was divided into a pre-collapse period (2002–08) and a post-collapse period (2008–14). Poisson regression models were used to estimate the association between pre-to-post economic collapse and suicide rates, expressed as risk ratios (RR) with 95% confidence intervals (CIs). Analyses were stratified by age and sex.

Results

A total of 470 suicides were recorded during the study period. The mean age at death was 45 years and 75% were males. The overall suicide rates per 100 000 were 13.3 pre-collapse and 15 post-collapse revealing no overall differences in pre-to-post collapse (RR 1.12; CI 0.94–1.35). This was true for both men and women (RR 1.18; CI 0.96–1.46 and RR 0.96; CI 0.67–1.38, respectively). An increase in the unemployment rate was not associated with the overall suicide rate (RR 1.07; CI 0.86–1.33), and neither were changes in gross domestic product (RR 1.29; CI 0.94–1.79) or balance of trade (RR 1.08; CI 0.96–1.22).

Conclusion

The economic collapse and rising unemployment rates in Iceland did not result in an overall increase in suicide rates. A strong welfare system and investing in social protection during the economic crisis may have mitigated suicide risk.

Suicides in Greece before and during the period of austerity by sex and age group: Relationship to unemployment and economic variables

BACKGROUND

There is disagreement on the specific mechanism through which the economic recession increased suicides in Greece. Unemployment is considered by many authors to be the determining factor but the data are inconclusive and often negative, especially concerning the temporal relationship between onset of increase in unemployment and increase in suicides AIMS: The aim of this paper was to clarify the specific role of unemployment as well as of other socioeconomic variables on specific age-by-gender groups concerning the increase in suicides.

METHODS

Data of the Hellenic Statistical Authority ELSTAT (www.

STATISTICS

gr) were analyzed with Linear Regression Analysis and Bonferroni correction for multiple testing RESULTS: Unemployment correlates with suicide rates only in males aged 20-24, 50-54 and 60-64 years (p < 0.001). Unemployment could held responsible for an additional 148 male deaths during the period 2009-2015, which accounts for 5.3% of the total (29 additional deaths per year). The changes in all the socioeconomic conditions could held responsible for 317 cases of suicide or 9.4% of total CONCLUSIONS: The results of the current study suggest that there was a 33% increase in deaths by suicide in Greece during the early years of recession (2009-2015); one third could be directly attributed to unemployment, one third to other consequences of recession while another third is of unknown origin. The effect of unemployment is specifically restricted to males at the beginning of their working career (20-24 years old) and to middle aged (45-49 and 55-59 years old).

Suicide rate in Greece stabilizes at historically high levels but still lowest in Europe

INTRODUCTION

There is a debate concerning the nature and the causes of the increase in the suicidal rates observed since 2011 in Greece.

MATERIAL AND METHODS

The data from the recent Hellenic Statistical Authority report on death causes for the year 2015 in Greece were used RESULTS: The rates are stabilizing at a historical zenith (total increase 51.7% for males and 76.2% for females) with a possible decreasing trend (5.4% for males and 6.8% for females) already visible concerning several age groups since the previous year.

DISCUSSION

This coincided temporarily with the relative stabilization of the economic situation although unemployment was still very high. Further processing and analysis of the complete set of data concerning all causes of death throughout the last few years is necessary before definite conclusions can be made.

Unemployment and suicide in Italy: evidence of a long-run association mitigated by public unemployment spending

From the mid-1990s on, the suicide rate in Italy declined steadily, then apparently rose again after the onset of the Great Recession, along with a sharp increase in unemployment. The aim of this study is to test the association between the suicide rate and unemployment (i.e., the unemployment rate for males and females in the period 1977-2015, and the long-term unemployment rate in the period 1983-2012) in Italy, by means of cointegration techniques. The analysis was adjusted for public unemployment spending (referring to the period 1980-2012). The study identified a long-run relationship between the suicide rate and long-term unemployment. On the other hand, an association between suicide and unemployment rate emerged, though statistically weaker. A 1% increase in long-term unemployment increases the suicide rate by 0.83%, with a long-term effect lasting up to 18 years. Public unemployment spending (as percentage of the Italian gross domestic product) may mitigate this association: when its annual growth rate is higher than 0.18%, no impact of unemployment on suicide in detectable. A decrease in the suicide rate is expected for higher amounts of social spending, which may be able to compensate for the reduced level of social integration resulting from unemployment, helping the individual to continue to integrate into society. A corollary of this is that austerity in times of economic recession may exacerbate the impact of the economic downturn on mental health. However, a specific "flexicurity" system (intended as a combination of high employment protection, job satisfaction and labour-market policies) may have a positive impact on health.

Economic crises and suicides between 1970 and 2011: time trend study in 21 developed countries

Background

Existing research on the relationship between economic recessions and suicides has almost completely concentrated on the most recent global financial crisis (2008). We provide the most comprehensive explanation to date of how different types of economic/financial crises since 1970 have affected suicides in developed countries.

Methods

Negative binomial regressions were used to estimate what the suicide rates would have been during and 1 year after each crisis began in 21 Organisation for Economic Co-operation and Development countries from 1970 to 2011 if the suicide rates had followed the pre-crisis trends.

Results

We found that every economic/financial crisis since 1970, except the European Exchange Rate Mechanism crisis in 1992, led to excess suicides in developed countries. Among males, the excess suicide rate (per 100 000 persons) varied from 1.1 (95% CI 0.7 to 1.5) to 9.5 (7.6 to 11.2) and, among females, from 0 to 2.4 (1.9 to 2.9). For both sexes, suicides increased mostly due to stock market crashes and banking crises. In terms of actual numbers, the post-1969 economic/financial crises caused >60 000 excess suicides in the 21 developed countries. The Asian financial crisis in 1997 was the most damaging crisis when assessed based on excess suicides.

Conclusions

Evidence indicates that, when considered in terms of effects on suicide mortality, the most recent global financial crisis is not particularly severe compared with previous global economic/financial crises. The distinct types of crises (ie, banking, currency and inflation crises, and stock market crashes) have different effects on suicide.

Ancestry and different rates of suicide and homicide in European countries: A study with population-level data

INTRODUCTION

There are large differences in suicide rates across Europe. The current study investigated the relationship of suicide and homicide rates in different countries of Europe with ancestry as it is defined with the haplotype frequencies of Y-DNA and mtDNA.

MATERIAL AND METHODS

The mortality data were retrieved from the WHO online database. The genetic data were retrieved from http://www.eupedia.com. The statistical analysis included Forward Stepwise Multiple Linear Regression analysis and Pearson Correlation Coefficient (R).

RESULTS

In males, N and R1a Y-DNA haplotypes were positively related to both homicidal and suicidal behaviors while I1 was negatively related. The Q was positively related to the homicidal rate. Overall, 60-75% of the observed variance was explained. L, J and X mtDNA haplogroups were negatively related with suicide in females alone, with 82-85% of the observed variance described.

DISCUSSION

The current study should not be considered as a study of genetic markers but rather a study of human ancestry. Its results could mean that research on suicidality has a strong biological but locally restricted component and could be limited by the study population; generalizability of the results at an international level might not be possible. Further research with patient-level data are needed to verify whether these haplotypes could serve as biological markers to identify persons at risk to commit suicide or homicide and whether biologically-determined ancestry could serve as an intermediate grouping method or even as an endophenotype in suicide research.

Life events in schizoaffective disorder: A systematic review

BACKGROUND

Life events play a central role in the development of psychiatric disorders and impact course and outcome. We present a systematic review of the literature on the relationship of life events with the onset and long-term course of schizoaffective disorder.

METHODS

MEDLINE was searched with the combination of the key words: 'life events' plus 'schizoaffective'. The PRISMA method was followed in the review process.

RESULTS

From the identified 66 papers only 12 were considered to be of relevance to the current study and 6 more papers were identified by inspecting the reference lists of the identified papers.

LIMITATIONS

There are very few studies focusing on the role of life events in schizoaffective disorder indicating insufficient data concerning the relationship of life events with onset and long-term course of schizoaffective disorder. Reported effects are not generic but concern specific events like the loss of mother, and females seem to be more vulnerable. Patients with schizoaffective disorder manifest high rates of PTSD.

CONCLUSION

The literature on life events with the development and course of schizoaffective disorder is limited and precludes solid conclusions.

Conceptualizations of suicide through time and socio-economic factors: a historical mini-review

Objectives

Suicide is a complex phenomenon determined by the interplay of an articulated network of factors including socio-economic factors which have a decisive role. This paper investigates the development of the modern conceptualization of suicide in Europe, its sociological understandings and its intertwinement with economic cycles throughout time.

Methods

MEDLINE, SCHOLAR, EMBASE using the keywords ‘socioeconomic factors AND suicide’; ‘economic cycles AND suicide’; ‘history AND suicide’ without timeframe limitations. Moreover, journal-by-journal search in journals of related areas was performed.

Results

In total, 51 historical studies focusing on the subjects in European countries were included. Three main areas arose: (a) development of the conceptualization of suicide over time; (b) sociological understandings of suicide according to the structure of society and its economy of power; (c) economic theories explaining the intertwinement of economic cycles and suicides.

Conclusions

Suicide is a deeply human phenomenon inescapably linked to and grounded in society and economic cycles. Understandings from the past show the importance of accurate analysis of socio-economic contexts that shape societies together with man’s own sense of self in order to organize multi-layered tangible and intangible support strategies to better understand and prevent suicide in this day and age.

The association between attempted suicide and stock price movements: Evidence from Taiwan

This study is the first comprehensive analysis to investigate the potential association between stock market fluctuations and attempted suicide events as measured by self-inflicted injuries treated in hospitalization. Using nationwide, 15-year population-based data from 1998 through 2012, we observe that the occurrences for the hospitalizations of attempted suicides are apparently predicted by stock price movements. A low stock price index, a daily fall in the stock index, and consecutive daily falls in the stock index have been shown to be associated with increased risk of hospitalization in patients with attempted suicide. More specifically, stock price index is found to be significant impact on attempted suicide in the 45-54 age groups of both genders, whilst daily change is significant for both genders in the 25-34 and 55-64 age groups and accumulated change is only significant in female aged 25-44 and above 65. On the basis of the results, relevant organizations should consider the suicidal factors that relate prime-working-age and near-retirement-age people to better carry out specific suicide prevention measures, and, meanwhile, encourage those people to pay less attention towards daily stock price movements.

Suicide and the economic situation in Europe: are we experiencing the development of a 'reverse stigma'?

The prevailing picture in both the scientific literature and mass media is that the increase in unemployment acts as a generic risk factor on the entire population and increases the rate of suicide, suggesting that the socioeconomic environment is the determining factor and measures to improve it are the most suitable in the struggle to reduce the number of suicides. As a result, 'horizontal' actions targeting the general population are proposed rather than 'vertical' actions that target specific vulnerable groups. This is not only a mistake but it also constitutes a kind of 'reverse' stigma which deprives mental health patients of their right to receive special and targeted benefits, interventions and care, and deprives mental healthcare of valuable resources.

Climate change but not unemployment explains the changing suicidality in Thessaloniki Greece (2000-2012)

INTRODUCTION

Recently there was a debate concerning the etiology behind attempts and completed suicides. The aim of the current study was to search for possible correlations between the rates of attempted and completed suicide and climate variables and regional unemployment per year in the county of Thessaloniki, Macedonia, northern Greece, for the years 2000-12.

MATERIAL AND METHODS

The regional rates of suicide and attempted suicide as well as regional unemployment were available from previous publications of the authors. The climate variables were calculated from the daily E-OBS gridded dataset which is based on observational data

RESULTS

Only the male suicide rates correlate significantly with high mean annual temperature but not with unemployment. The multiple linear regression analysis results suggest that temperature is the only variable that determines male suicides and explains 51% of their variance. Unemployment fails to contribute significantly to the model. There seems to be a seasonal distribution for attempts with mean rates being higher for the period from May to October and the rates clearly correlate with temperature. The highest mean rates were observed during May and August and the lowest during December and February. Multiple linear regression analysis suggests that temperature also determines the female attempts rate although the explained variable is significant but very low (3-5%)

CONCLUSION

Climate variables and specifically high temperature correlate both with suicide and attempted suicide rates but with a different way between males and females. The climate effect was stronger than the effect of unemployment.

Relationship of suicide rates with climate and economic variables in Europe during 2000-2012

BACKGROUND

It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate.

METHODS

Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression.

RESULTS

The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female suicides correlated with low temperature.

DISCUSSION

The current study reports that the climatic effect (cold climate) is stronger than the economic one, but both are present. It seems that in Europe suicidality follows the climate/temperature cline which interestingly is not from south to north but from south to north-east. This raises concerns that climate change could lead to an increase in suicide rates. The current study is essentially the first successful attempt to explain the differences across countries in Europe; however, it is an observational analysis based on aggregate data and thus there is a lack of control for confounders.

Unemployment and Suicide Mortality: Evidence from Regional Panel Data in Europe

This paper addresses the influence of economic activity on suicide mortality in Europe. To this end, it employs a new panel data set of 275 regions in 29 countries over the period 1999-2010. The results suggest that unemployment does have a significantly positive influence on suicides. In line with economic theory, this influence varies among gender and age groups. Men of working age are particularly sensitive, while old-age suicide mortality (older than 65 years old) hardly responds to unemployment. Moreover, real economic growth negatively affects the suicide rates of working-age men. The results withstand several robustness checks, such as sample variations, and after controlling for serial and spatial autocorrelation.

Rate of suicide and suicide attempts and their relationship to unemployment in Thessaloniki Greece (2000-2012)

INTRODUCTION

Recently there was a debate concerning the relationship between the economic crisis and an increase in attempted and completed suicides in Europe and especially in Greece. The aim of the current study was to calculate the rates of attempted and completed suicide per year in the county of Thessaloniki, Macedonia, northern Greece, for the years 2000-12, and to investigate their relationship with unemployment.

MATERIAL AND METHODS

The archive of the Emergency Outpatient Units of three hospitals was investigated and the results were projected to the county population. Data from the Hellenic statistics authority concerning regional general population and suicides and unemployment were used.

RESULTS

The rate of attempted suicides was 16.69-40.34 per 10(5) inhabitants for males and 41.43-110.82 for females. Medication was the preferred method for 95.93%. The completed suicide rates varied from 3.62 to 5.47 for males and from 0.19 to 1.95 per 10(5) inhabitants for females. The male attempt rate correlated negatively with regional male unemployment (-0.63). For females the respected value was similar (-0.72). Concerning competed suicide rates, the respected values were 0.34 and 0.65. The attempt was repeated by 15.34%; almost half-repeated within the same year and 75% within two years. The female to male ratio varied significantly across years with 2:1 (more females) being the probable value for attempts and 1:3.6 (more males) for completed suicides.

CONCLUSION

This is the first study from Greece reporting rates on the basis of hospital archives. Attempt and suicide rates are low in Greece. Attempts are negatively and suicides are positively correlated with unemployment.

The true cost of the economic crisis on psychological well-being: a review

The recent economic crisis has led to many negative consequences, not the least having to do with the mental health and well-being of the populations involved. Although some researchers say it is still too early to speak about a relationship between the economic crisis and a rise in mental health problems resulting in suicides, there is solid evidence for the existence of such a relationship. However, several moderating or mediating mechanisms can also play a role. The main reactions of most policy makers to the economic crisis are (severe) austerity measures. These measures seem to have, however, a detrimental effect on the mental health of the population: Just when people have the highest need for mental help, cost-cutting measures in the health care sector lead to a (substantial) drop in the supply of services for the prevention, early detection, and cure of mental health problems. Policy makers should support moderating mechanisms such as financial and psychological coping and acculturation and the role of primary health care workers in the early detection of suicidal thoughts, suicide attempts, and suicide in times of economic recession. Several examples show that the countries best off regarding the mental health of their populations during the economic crisis are those countries with the strongest social safety net. Therefore, instead of cutting back on health care and social welfare measures, policy makers should in the future invest even more in social protection measures during economic crises.

Relationship of suicide rates to economic variables in Europe: 2000-2011

BACKGROUND

It is unclear whether there is a direct link between economic crises and changes in suicide rates.

AIMS

The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates.

METHOD

Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation.

RESULTS

There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged.

CONCLUSIONS

Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.

The differential impact of the financial crisis on health in Ireland and Greece: a quasi-experimental approach

OBJECTIVES

Greece and Ireland suffered an economic recession of similar magnitude, but whether their health has deteriorated as a result has not yet been well established.

STUDY DESIGN

Based on five waves (2006-2010) of the European Union Statistics of Income and Living Conditions (EU-SILC) survey a (DID) approach was implemented that compared trends in self-rated health in Greece and Ireland before and after the crisis with trends in a 'control' population (Poland) that did not experience a recession and had health trends comparable to both countries before the crisis.

METHODS

Logistic regression using a (DID) approach.

RESULTS

A simple examination of trends suggests that there was no significant change in health in Greece or Ireland following the onset of the financial crisis. However, DID estimates that incorporated a control population suggest an increase in the prevalence of poor self-rated health in Greece (OR = 1.216; CI = 1.11-1.32). Effects were most pronounced for older individuals and those living in high-density areas, but effects in Greece were overwhelmingly consistent in different population sub-groups. In contrast, DID estimates revealed no effect of the financial crisis on the prevalence of poor self-rated health in Ireland (OR = 0.97; CI = 0.81-1.16).

CONCLUSIONS

DID estimates suggest that the financial crisis led to higher prevalence of reporting poor health in Greece but not in Ireland. Although the research design does not allow the authors to directly assess the role of specific policies, contextual factors including policy responses may have contributed to the different effect of the crisis on the health of the two countries.

Suicide and the 2008 economic recession: who is most at risk? Trends in suicide rates in England and Wales 2001-2011

The negative impacts of previous economic recessions on suicide rates have largely been attributed to rapid rises in unemployment in the context of inadequate social and work protection programmes. We have investigated trends in indicators of the 2008 economic recession and trends in suicide rates in England and Wales in men and women of working age (16-64 years old) for the period 2001-2011, before, during and after the economic recession, our aim was to identify demographic groups whose suicide rates were most affected. We found no clear evidence of an association between trends in female suicide rates and indicators of economic recession. Evidence of a halt in the previous downward trend in suicide rates occurred for men aged 16-34 years in 2006 (95% CI Quarter 3 (Q3) 2004, Q3 2007 for 16-24 year olds & Q1 2005, Q4 2006 for 25-34 year olds), whilst suicide rates in 35-44 year old men reversed from a downward to upward trend in early 2010 (95% CI Q4 2008, Q2 2011). For the younger men (16-34 years) this change preceded the sharp increases in redundancy and unemployment rates of early 2008 and lagged behind rising trends in house repossessions and bankruptcy that began around 2003. An exception were the 35-44 year old men for whom a change in suicide rate trends from downwards to upwards coincided with peaks in redundancies, unemployment and rises in long-term unemployment. Suicide rates across the decade rose monotonically in men aged 45-64 years. Male suicide in the most-to-medium deprived areas showed evidence of decreasing rates across the decade, whilst in the least-deprived areas suicide rates were fairly static but remained much lower than those in the most-deprived areas. There were small post-recession increases in the proportion of suicides in men in higher management/professional, small employer/self-employed occupations and fulltime education. A halt in the downward trend in suicide rates amongst men aged 16-34 years, may have begun before the 2008 economic recession whilst for men aged 35-44 years old increased suicide rates mirrored recession related unemployment. This evidence suggests indicators of economic strain other than unemployment and redundancies, such as personal debt and house repossessions may contribute to increased suicide rates in younger-age men whilst for men aged 35-44 years old job loss and long-term unemployment is a key risk factor.

Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study

PURPOSE

To report on the effects on health that the 2008 Great Recession is producing in Italy, by comparing the consistency of Italian data with general observations reported in the scientific literature, and by pointing out consequences on the rates of all-cause mortality, cardiovascular mortality, male suicidal behaviours, daytime alcohol drinking and traffic fatalities.

METHODS

This is an ecological study in which MEDLINE, PsycINFO and PubMed were searched for the literature with combinations of the following keywords: economic recession, financial crisis, unemployment, health, suicide and mental health. Data from two Italian government agencies (Italian Institute of Statistics, ISTAT, and Italian Agency of Drugs, AIFA) in the years from 2000 to 2010 were obtained and analysed, by producing models of multiple linear regressions.

RESULTS

After the recession onset, all-cause mortality remained stable, and was not associated with the economic fluctuations. Differently, cardiovascular mortality was associated with the rate of unemployment, and showed a significant increase in 2010. Alcohol consumption increased in 2009, the year with the worst real GDP decrease (-5.1 %). Though the total rate of suicide was not associated with the economic situation, male completed and attempted suicides due to financial crisis were significantly associated with the rate of unemployment and the real GDP. The increasing diffusion of antidepressants was not associated with a lowering of the rate of suicide.

CONCLUSIONS

The data on the Italian situation here discussed are sufficiently reliable to conclude that a link exists between the ongoing economic recession and health and mental health of Italians. Further research is needed to understand more in detail and with stronger reliability such link, to support primary and secondary preventive interventions and orient the development of effective sociopolitical interventions.