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

Abstract

Connor, R. C. (2015) Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income. Social Psychiatry and Psychiatric Epidemiology, 50(6) 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.Results. 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 actions, 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.Conclusions. 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.

Does income relate to health due to psychosocial or material factors? Consistent support for the psychosocial hypothesis requires operationalization with income rank not the Yitzhaki Index

“…This parallels findings with mental health and depressive symptoms as the outcome (Elgar et al, 2013;Hounkpatin et al, 2015;Wetherall, Daly, Robb, Wood, & O'Connor, 2015;Wood, Boyce, et al, 2012) as well findings from a study by Subramanyam et al (2009) which indicated that percentile income rank significantly predicted self-rated health in a US population after controlling for actual income. The income rank specification is consistent with the psychosocial hypothesis but differs from the Yitzhaki Index in that it proposes that health is not necessarily related to the magnitude of the difference, but rather the position of income on the income distribution within a comparison group.…”

The interactive role of income (material position) and income rank (psychosocial position) in psychological distress: a 9-year longitudinal study of 30,000 UK parents

“…A growing body of evidence reports that low rank is associated with higher psychological distress (Wood, Boyce, et al, 2012) and depressive symptoms (Hounkpatin et al, 2015) and a higher likelihood of suicidal thoughts and suicide attempts (Wetherall et al, 2015), independent of absolute income. Moreover, associations between income rank and allostatic load strengthen the pathway between rank, stress and psychological distress, strongly suggesting that income rank relates to health (Daly, Boyce and Wood, 2015).…”

“…Moreover, associations between income rank and allostatic load strengthen the pathway between rank, stress and psychological distress, strongly suggesting that income rank relates to health (Daly, Boyce and Wood, 2015). These studies do however have methodological limitations: suicidal thoughts and attempts were restricted to cross-sectional analyses (Wetherall et al, 2015) and the longitudinal analyses (Wood, Boyce, et al, 2012;Hounkpatin et al, 2015) did not control for unobserved variance, introducing the possibility that unobserved variance influenced their results. In the current study, examining the comparative strength of income rank and distance from the mean determines whether people are more sensitive to income rank -implicating an evolutionary explanation for the negative association between income and psychological distress -or whether the magnitude of income differences (distance from the mean) is more relevant to psychological distress.…”

“…This is standard practice and approximates spending power (Wood, Boyce, et al, 2012;Daly, Boyce and Wood, 2015;Wetherall et al, 2015). Absolute income was log transformed to reduce skew, then normalised between 0 and 1.…”

“…Their relevance to psychological distress has previously been confirmed (Wood, Boyce, et al, 2012;Wetherall et al, 2015). Income rank Ri captures the income position Pi of parent i divided by the size of comparison group n to identify the proportion of lower-ranking parents (Brown et al, 2008):…”