Sex-specific impact of socio-economic factors on suicide risk: A population-based case-control study in Denmark

Abstract

Background: Although many authors have investigated the impact of sex on the association between socio-economic status (SES) and suicide, a definite consensus has not yet emerged. Using Danish population registration data including 15 648 suicide deaths of individuals aged 18-65 year during 1981-97 and matched population controls, we investigate the associations of multiple SES factors with suicide risk and explore the sex-specific aspects of these associations. Methods: We use conditional logistic regression models to estimate the statistical relationship between SES, sex and suicide. Results: SES, proxied by low income, unskilled blue-collar work, non-specific wage work and unemployment, increases suicide risk more prominently for men than for women. Marital status has a comparable influence on suicide risk in both sexes; parenthood is protective against suicide, and the effect is larger for women. Living in a large city raises suicide risk for women but reduces it for men; residents with a foreign citizenship in Denmark have a lower risk of suicide compared with Danish citizens, but this protection is confined to male immigrants. Conclusions: Our results demonstrate that suicide risk is associated with a range of SES proxies but the strength and/or direction of the association can differ by sex. Risk assessement and, therefore, prevention approaches should take this into consideration. © 2009 The Author. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.