Suicide risk in relation to socioeconomic and occupational disadvantage in middle- and old-aged men - A national register-based study.

BACKGROUND: Suicide rate is highest amongst middle- and old-aged, and men with socioeconomic disadvantages are particularly vulnerable to die by suicide. This examines how socioeconomic and occupational disadvantage impacts suicide risk amongst Norwegian men aged ≥35 years. METHODS: Using data from Norwegian registries, we conducted a nested case-control study of 6993 suicide deaths and 104,895 age-matched controls between 1992 and 2018. Socioeconomic indicators included marital status, labour market status, educational status, income level and occupation groups. RESULTS: Separated men had the highest odds of suicide (adjusted OR = 4·96, 95% CI: 4·44-5·54), followed by all additional unmarried statuses. Men outside the labour market also had substantially increased odds (adjusted OR = 2·43, 95% CI: 2·22-2·66). Occupational analyses were non-significant for the full population but showed increased suicide odds amongst "professionals" and "plant and machine operators and assemblers" amongst men ≥65. Population attributable fraction estimates of all ≥35 suggested that being single (19·0%) and being outside the labour market (18.9%) accounted for substantial attributable proportions of suicide deaths and fractions varied by age group. Overall, age-stratified analyses indicated that socioeconomic associations were particularly evident amongst men aged 35-49, whilst occupational associations were more prominent in men ≥65. CONCLUSIONS: Socioeconomic disadvantages, particularly being outside of the labour markets, marital breakdown, low income and education are strongly associated with suicide risk in middle- and old-aged men. Prevention efforts and social support should incorporate socioeconomic vulnerability to better mitigate suicide risk within this population.