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Increasing income-based inequality in suicide mortality among working-age women and men, Sweden, 1990-2007: is there a point of trend change?
Örebro University, School of Medical Sciences. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-2088-0530
School of Public Health, The University of Tokyo, Bunkyo-ku, Japan.
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
2018 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 72, no 11, p. 1009-1015Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Income inequalities have risen from the 1990s to 2000s, following the economic recession in 1994, but little research has investigated socioeconomic inequalities in suicide mortality for working-age men and women (aged between 30 and 64 years) over the time using longitudinal data in Sweden.

METHODS: Using Swedish national register data between 1990 and 2007 as a series of repeated cohort studies with a 3-year follow-up (sample sizes were approximately 3.7 to 4.0 million in each year), relative and slope indices of inequality (RII and SII respectively) based on quintiles of individual disposable income were calculated and tested for temporal trends.

RESULTS: SII for the risk of suicide mortality ranged from 27.6 (95% CI 19.5 to 35.8) to 44.5 (36.3 to 52.6) in men and 5.2 (0.2 to 10.4) to 16.6 (10.7 to 22.4) in women (per 100 000 population). In men, temporal trends in suicide inequalities were stable in SII but increasing in RII by 3% each year (p=0.002). In women, inequalities tended to increase in both RII and SII, especially after the late-1990s, with 10% increment in RII per year (p<0.001).

CONCLUSIONS: Despite universal social security and generous welfare provision, income inequalities in suicide were considerable and have widened, especially in women. The steeper rise in women may be partially related to higher job insecurity and poorer working conditions in the female dominated public sector after the recession. To reduce health consequences following an economic crisis and widened income inequalities, additional measures may be necessary in proportion to the levels of financial vulnerability.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018. Vol. 72, no 11, p. 1009-1015
Keywords [en]
cohort studies, health inequalities, socio-economic, suicide
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-70021DOI: 10.1136/jech-2018-210696ISI: 000450417500008PubMedID: 30021795OAI: oai:DiVA.org:oru-70021DiVA, id: diva2:1261172
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Ministry of Education, Culture, Sports, Science and Technology, MEXT, Japan  21119002  25253052  18H04071 

Ministry of Health, Labour and Welfare, Japan  H24-chikyukibo-ippan-009 

Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2018-12-05Bibliographically approved

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Hiyoshi, Ayako

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