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

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          Abstract

          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.

          Highlights

          • Indicators showed economic hardship was increasing 5 years prior to the 2008 economic recession.

          • The downward trends in younger male suicide rates (16–34 year olds) halted around 2006.

          • Economic strain and unemployment may contribute to rises in suicide rates in men aged 35–44 years old.

          • There was no clear evidence of an impact of the 2008 economic recession on suicide rates in females.

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          Most cited references26

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          Permutation tests for joinpoint regression with applications to cancer rates.

          The identification of changes in the recent trend is an important issue in the analysis of cancer mortality and incidence data. We apply a joinpoint regression model to describe such continuous changes and use the grid-search method to fit the regression function with unknown joinpoints assuming constant variance and uncorrelated errors. We find the number of significant joinpoints by performing several permutation tests, each of which has a correct significance level asymptotically. Each p-value is found using Monte Carlo methods, and the overall asymptotic significance level is maintained through a Bonferroni correction. These tests are extended to the situation with non-constant variance to handle rates with Poisson variation and possibly autocorrelated errors. The performance of these tests are studied via simulations and the tests are applied to U.S. prostate cancer incidence and mortality rates. Copyright 2000 John Wiley & Sons, Ltd.
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            Health effects of financial crisis: omens of a Greek tragedy.

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              Impact of economic crisis on cause-specific mortality in South Korea.

              Economic changes can be powerful determinants of health. In the late 1990s, South Korea experienced a steep economic decline. This study examines whether the massive economic changes affected trends in all-cause and cause-specific mortality in South Korea. Mid-year population estimates of 5 year age groups (denominators) and death certificate data (numerators) from the National Statistical Office of Korea were used to compute cause-specific age-standardized mortality rates before and after the economic crisis. All-cause mortality continued to decrease in both sexes and all age groups during the crisis. Cerebrovascular accidents, stomach cancer, and liver disease contributed most to this decline. A remarkable decrease in transport accident mortality rates was also observed. The most salient increase in mortality was suicidal death. Mortality from homicide, pneumonia, and alcohol dependence increased during the economic crisis, but these accounted for a small proportion of total mortality. Short-term mortality effects of the South Korean economic crisis were relatively small. It appears that any short-term effects of the economic decline were overwhelmed by the momentum of large declines in causes of death such as stroke, stomach cancer, and liver disease, which are probably related to exposures with much longer aetiological periods. However, this study focused on rather immediate mortality effects and follow-up studies are needed to elucidate any longer-term health effects of the South Korean economic crisis.
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                Author and article information

                Contributors
                Journal
                Soc Sci Med
                Soc Sci Med
                Social Science & Medicine (1982)
                Pergamon
                0277-9536
                1873-5347
                1 September 2014
                September 2014
                : 117
                : 100
                : 76-85
                Affiliations
                [a ]School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
                [b ]Centre for Suicide Research, University of Oxford, Department of Psychiatry, Warneford Hospital, Headington, Oxford OX3 7JX, UK
                [c ]Centre for Suicide Prevention, Centre for Mental Health and Risk, Institute of Brain, Behaviour and Mental Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
                [d ]Life Events and Population Sources Division, Office for National Statistics, Cardiff Road, Newport, Wales NP10 8XG, UK
                Author notes
                []Corresponding author. caroline.coope@ 123456bristol.ac.uk
                Article
                S0277-9536(14)00453-5
                10.1016/j.socscimed.2014.07.024
                4151136
                25054280
                697351ec-2657-4d4a-b0fb-680f50e24169
                © 2014 The Authors
                History
                : 14 April 2014
                : 20 June 2014
                : 8 July 2014
                Categories
                Article

                Health & Social care
                suicide rates,suicide trends,economic recession,england and wales,risk,joinpoint regression

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