Identification of socio-demographic, occupational, and societal factors for guiding suicide prevention: A cohort study of Swiss male workers (2000-2014)

Abstract

Introduction: We modeled suicidal rate among Swiss working-age males, considering three groups of factors at socio-demographic, occupational, and societal levels jointly. Our goal was twofold: to verify the effect of occupation after adjustment for non-occupational factors and to identify protective and risk factors relevant for suicide prevention in working male adults.

Methods: The study population included all men aged [18-65] years at the 2000 population census and followed up within the Swiss National Cohort (SNC). The risk of suicide was modeled using Poisson regression.

Results: The cohort comprised 1,534,564 men and 4371 deaths by suicide. Suicide rate varied significantly according to age, civil status, nationality, highest education achieved, and socio-professional category at socio-demographic level; occupation, occupational activity branch, weekly working hours, and home-to-work commute time at occupational level; calendar period of death, region, religious affiliation, and volunteering activity at societal level. After adjustment for non-occupational factors, agricultural and fishery laborers, military and civil security workers, and health and social workers were identified as high-risk groups with respect to suicide.

Conclusion: This study evidenced a complex web of factors at socio-demographic, occupational, and societal levels behind the suicide in Swiss male workers and identified the most at-risk groups, deserving targeted prevention efforts.