Socio-Economic Position and Suicidal Ideation in Men

Abstract

People in low socio-economic positions are over-represented in suicide statistics and are at heightened risk for non-fatal suicidal thoughts and behaviours. Few studies have tried to tease out the relationship between individual-level and area-level socio-economic position, however. We used data from Ten to Men (the Australian Longitudinal Study on Male Health) to investigate the relationship between individual-level and area-level socio-economic position and suicidal thinking in 12,090 men. We used a measure of unemployment/employment and occupational skill level as our individual-level indicator of socio-economic position. We used the Index of Relative Socio-Economic Disadvantage (a composite multidimensional construct created by the Australian Bureau of Statistics that combines information from a range of area-level variables, including the prevalence of unemployment and employment in low skilled occupations) as our area-level indicator. We assessed suicidal thinking using the Patient Health Questionnaire (PHQ-9). We found that even after controlling for common predictors of suicidal thinking; low individual-level and area-level socio-economic position heightened risk. Individual-level socio-economic position appeared to exert the greater influence of the two; however. There is an onus on policy makers and planners from within and outside the mental health sector to take individual- and area-level socio-economic position into account when they are developing strategic initiatives.

Suicidal ideation among Chinese methadone-maintained patients: prevalence and correlates

“…Similarly, we found that female gender was independently associated with 1.69-fold increase in risk of lifetime suicidal ideation in MMT patients. Consistent with the elevated risk of suicidal behaviors in individuals with low socio-economic status [ 28 , 29 ], we found that a low level of education and poor economic status were independent predictors of suicidal ideation. These associations might be explained by low socioeconomic status’ negative effects on health and wellbeing, which, in turn, place individuals at increased risk for suicidal behaviors.…”

Mental health by gender-specific occupational groups: Profiles, risks and dominance of predictors

“…For suicide, the risk among men was the highest in the lowest skill-level occupations, whereas the analysis for women did not show as clear pattern, possibly partly due to power limitations. These findings agree with those from prior studies (Milner et al, 2013;Pirkis et al, 2017). Some characteristics of instrumentality, including denial of weakness or vulnerability and dismissal of need for help, may be more common among the low vs. high-skilled occupations, and contribute to the findings for men.…”

“…Some characteristics of instrumentality, including denial of weakness or vulnerability and dismissal of need for help, may be more common among the low vs. high-skilled occupations, and contribute to the findings for men. It has also been suggested that the elevated risk in the low-skilled occupations may derive from powerlessness, frustration and disrespect (Pirkis et al, 2017), or poorer overall socioeconomic circumstances (Roberts et al, 2013). However, in our data this association remained even after adjusting for income.…”

Self-rated health inequalities in the intersection of gender, social class and regional development in Spain: exploring contributions of material and psychosocial factors

“…Intermediary determinants comprise material circumstances, psychosocial processes and behaviours and biological factors [23]. Many studies have assessed the intermediary determinants of health in relation to social positions of gender or social class [24,25], but less so their contribution to intersectional inequalities in health. A Spanish example demonstrates contribution of intermediary determinants, including material factors, on the intersection between gender and social class and its effects on SRH [26].…”