Suicide by profession: lots of confusion, inconclusive data

Police officers end their lives more often than those in other professions, right? Or is it dentists? Or psychologists?

Assertions about which occupational group has the most suicides float around like urban myths.

Various occupational groups have called the National Center for Health Statistics (NCHS), each to confirm that their occupation has the highest rates of suicide, says Jim Weed, NCHS analyst.

But experts on suicide say that statistics on its relation to occupation are not clear. There is no national data set on occupation and suicide. Local studies indicate elevated rates in different occupations, but the data usually "turn out to be frail," says prominent suicide researcher David Clark, PhD.

And in fact, points out Ronald Maris, PhD, director of the Center for the Study of Suicide and Life-Threatening Behavior at the University of South Carolina, "Occupation is not a major predictor of suicide and it does not explain much about why the person commits suicide."

One of the largest studies in the area was conducted by the National Institute of Occupational Safety and Health (NIOSH) in 1995, which concluded that there is a higher suicide rate in the medical field. But beyond that, NIOSH researchers said, the picture is equivocal: Often the studies are only of one geographic area, sometimes they have methodological problems, and sometimes they contradict each other.

That's in great part because the statistics are surprisingly difficult to gather. Only about half the states put occupation on their death certificates. And even when they do, there are questions as to whether the physician, medical examiner or coroner filling in the certificates always gets the occupation or the cause of death right.

In addition, statistical conclusions are hampered by the fact that when the 30,000 annual U.S. suicides are divided into occupations, the numbers for many job categories are relatively small.

Some larger studies in the last few years provide at least some thought-provoking questions about connections between jobs and suicide. For example, in 1997, NIOSH and other government agencies analyzed 1980-84 death certificates by all occupations and causes of death, and found statistically significant elevated rates of suicide for:

• White male physicians.

• Black male guards (including supervisors, crossing guards, police, protective service occupations, but not correctional institution occupations).

• White female painters, sculptors, craft-artists and artist printmakers.

In another study, a sociology researcher at the University of California, Riverside, Augustine Kposowa, PhD, looked at records over nine years for about half a million people of whom 545 committed suicide. After controlling for such variables as age, income, race, marital status and region of residence, he found that only laborers and the unemployed had significantly higher risks.

On the other hand, he found "dramatic" differences for suicide among the industries where people work. At highest risk were those in mining, business and repair services, wholesale and retail trade and construction.

In the end, say some researchers, occupation may not be much of a factor in suicide. Psychologists have long documented that among the top predictors for suicide are diagnosable mental disorder, co-morbid substance use, loss of social support and availability and access to a firearm.

--K. FOXHALL