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Abstract
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The impact of the COVID‐19 pandemic on the labour market, as well as the government’s response to mitigate risk via social isolation and quarantine, has resulted in the greatest and most rapid change in the employment sector ever recorded in the US. Notwithstanding emergency government financial response, it is anticipated that a significant percentage of the labour market will contract1. Moreover, the predicted increase in unemployment is expected to approximate, and perhaps exceed, that reported during the Great Depression lasting from 1929 to 1939 (i.e., 24.9%)2. The foregoing rapid rise in unemployment and associated economic insecurity is likely to significantly increase the risk for suicide.
In fact, during the most recent economic recession, a 1% rise in unemployment was associated with a rise in the suicide rate of 0.99% in the US (95% CI: 0.60‐1.38, p<0.0001)3. Similarly, each percentage point increase in unemployment was accompanied by a 0.79% rise in suicide (95% CI: 0.16‐1.42, p=0.016) in individuals 65 years of age or younger in Europe (e.g., Spain, Greece)4. During the 1997‐1998 Asian economic recession, unemployment was a critical determinant mediating the increase in suicides in Japan, Hong Kong, and South Korea5.
We used time‐trend regression models to assess and forecast excess suicides attributable to the economic downturn following the COVID‐19 pandemic. Suicide mortality was estimated for three possible scenarios: a) no significant change in unemployment rate (i.e., 3.6% for 2020, 3.7% for 2021); b) moderate increase in projected unemployment rate (i.e., 5.8% for 2020, 9.3% for 2021), mirroring unemployment rates in 2008‐2009; and c) extreme increase in projected unemployment rate (i.e., 24% for 2020, 18% for 2021).
The annual suicide mortality rate accelerated in the US by 1.85% (95% CI: 1.70‐2.00, p<0.0001) between 1999 and 2018. We found that a percentage point increase in unemployment was associated with an increase in suicide rates of 1.00% (95% CI: 1.02‐1.06, p<0.0001) between 1999 and 2018. The suicide rate was 14.8 per 100,000 in 2018 (N=48,432).
In the first above‐mentioned scenario (i.e., unemployment rate remains relatively consistent), the predicted suicide rates per 100,000 are 15.7 (95% CI: 15.3‐16.1) in 2020 and 16.2 (95% CI: 15.7‐16.8) in 2021. The foregoing suicide rates would result in 51,657 suicides in 2020 and 53,480 in 2021 (assuming 2019 population size of 329,158,518). In the second scenario (i.e., moderate increase in projected unemployment rate), suicide rates per 100,000 will increase to 16.9 in 2020 (95% CI: 16.4‐17.5; N=52,728) and 17.5 in 2021 (95% CI: 16.8‐18.2; N=55,644). This second scenario would result in a total of 3,235 excess suicides over the 2020‐2021 period, representing ...
Language: en |