Patterns of suicide by occupation in England and Wales: 2001–2005

Abstract

Although the relationship between suicide and unemployment has been extensively studied [1][2][3][4] demonstrating an increased rate of suicide among the unemployed, the relationship between suicide and occupation has been much less frequently studied, probably because of the relatively smaller number of people in each occupational group compared with the population in other socio-demographic groups defined, for example, by age or geography. Mortality data collated by the Office for National Statistics (ONS) in England and Wales have, however, been an invaluable source for examining the relationship between suicide and occupation. [5][6][7][8] In the late 1990s these findings were updated to cover trends in suicide in England and Wales, and suicide data for 1982-1987 and 1991-1996 were used to calculate proportional mortality ratios (PMRs) for both men and women according to their occupation. 9 In addition to the national statistics describing the relationship between occupation and suicide, a number of studies have looked in more detail at some of the specific occupations with high suicide PMRs. These included health-related occupations such as doctors, 10-12 nurses, 13 farmers (including horticulturalists and farm managers), 14 armed forces, 15 students 16,17 and artists. 18,19 We aim to identify the occupations in 2001-2005 with significantly high suicide rates in England and Wales, and to compare these with patterns in suicide rates by occupation over earlier decades. The data from 2001-2005 can be regarded as a further update with the possibility of examining the stability of patterns. MethodUsing data collected by the ONS from death registrations in England and Wales over the calendar years 2001-2005, PMRs were calculated for suicides by occupation. Standardised mortality ratios (SMRs) were also calculated.The ONS usually classifies deaths from suicide as those with an underlying cause of suicide or death from injury or poisoning of undetermined intent. These latter deaths are traditionally assumed to be probable suicides for the purposes of calculating the number of suicides in England and Wales. 20 The ICD-10 was used to code cause of death based on coroners' verdicts. 21 Grouping both deaths from suicide and undetermined intent together to give an estimate of suicides removes biases that may be introduced if there are differences between occupations in the propensity of coroners to record a suicide verdict.The deceased's occupation is collected from the informant at death registration and is based on the last gainful occupation of the deceased if they were retired or unemployed. This is then coded by the ONS using the Standard Occupational Classification 2000 (SOC2000). 22 This contains 352 occupation codes at its lowest (four-digit) level. Data from the 2001 Census were also coded using the SOC2000, and are based on the occupation of respondents in the week before census, or their last occupation in the past 5 years not working. We restricted our analysis to the age range 20-64 years to improve the li...

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