Men’s work, women’s work and suicide: a retrospective mortality study in Australia

Abstract

Objectives: This research sought to investigate the influence of being a in male‐dominated occupation on suicide. Methods: A population‐level retrospective mortality study was conducted over the period 2001 to 2015. Data from the Australian Census and the National Coronial Information System were combined. Negative binomial regression was used to assess the relationship between occupational gender ratio and suicide rates, controlling for age, socioeconomic status and year of death. Probabilistic sensitivity analysis accounted for unmeasured confounding due to common mental disorders. Results: Males in male‐dominated occupations had a rate ratio (RR) of 7.50 (95%CI 6.07 to 9.25) compared to males in female‐dominated occupations. Females in male‐dominated occupations had a RR of 0.13 (95%CI 0.07 to 0.26) compared to females in female‐dominated occupations. Results for males were maintained after adjusting for common mental disorders. There was evidence of interaction on both additive and multiplicative scales. Conclusions: The gendered context of an occupation influences suicide, with varying risks for women and men. More research is needed to understand the mechanisms of this relationship. Implications for public health: These results suggest the need for targeted suicide prevention activities in male‐dominated occupational groups.

Method-Specific Suicide Mortality Trends in Australian Men from 1978 to 2017

“…In higher-income countries, the incidence of male suicide is three to four times greater than that of female suicide, due in part to the fact that men use more lethal means, such as hanging, while women use methods such as drug overdose, which is less likely to cause death, and women are also more likely to seek medical attention after intentional self-harm [ 7 ]. The relevant factors driving these global and sex-based differences in the choice and prevalence of suicide methods appear to be physical and cognitive availability, lethality and socio-cultural acceptability [ 8 , 9 , 10 ].…”

Health Literacy in Male-Dominated Occupations

“…Our results indicating that men working in male-dominated occupations have poorer health literacy must be considered in the context of previous research that has demonstrated the effects of occupational gender ratio on mental health (Milner, King, LaMontagne, et al, 2018), suicide (Milner and King, 2019), and mental health service use (Milner, King, et al, 2018a; Milner, Scovelle, et al, 2018b). Other studies have suggested that health literacy is a mediator of the relationship between socioeconomic status and health outcomes (Stormacq et al, 2019).…”

“…The evidence substantiating this is extensive and far reaching. In Australia, evidence from retrospective mortality studies (Milner et al, 2014; Milner and King, 2019) and a systematic review (Milner et al, 2013) has indicated that males employed in male-dominated occupations are at an elevated risk of suicide. Across the world, the construction industry is male dominated, and cohort data from male workers in the German construction industry identified an increased risk of fatal injuries and accidents compared to that for other workers (Arndt et al, 2004).…”

The Public Health Association of Australia’s advocacy to prevent suicide

“…Perceived racism has also been linked to suicidality, with a mediating role of depression and moderating role of religiosity 10 . Male‐dominated industries such as the construction industry have also been linked to higher suicide rates (especially for men), 11 with research showing that those in the most unskilled occupations are most at risk within the construction industry 12 . While economic crises are associated with a spike in the suicide rate, 16 research from Spain showed that this trend is more pronounced for those aged 35 to 54 years and unemployed males 13 .…”