Higher rates of suicide are more frequent in occupations of lower prestige, class, and salary (Boxer et al., 1995). When demographic factors of race, gender, age, and, particularly, marital status are controlled, this relationship between manual labor occupations and suicide does not remain significant (Charlton, 1995; Stack, 2001). In fact, Stack’s (2001) recent study found that clerks are 15 percent and farm workers 30 percent less likely to complete suicide after controlling for demographic variables.

A population-based study from Denmark examining the income-suicide relationship suggests that for higher income/occupational level, hospital admission for serious mental illness may be associated with greater suicide risk (Agerbo et al., 2001). These investigators speculate that those in prestigious occupations may face greater stigma, and may have greater illness severity before hospital admittance due to delaying treatment. A smaller study in the United States found similar results with high education level (Martin et al., 1985). A large, prospective Finnish study found fewer violent suicides and greater admissions for psychoses among those in higher occupational levels (Koskinen et al., in press).

Health professions carry increased suicide risk independently from demographic factors. Adjusted odds ratios for suicide have been calculated as 5.4 for dentists, 2.3 for physicians, and 1.6 for nurses (Stack, 2001). The reasons for high suicide risk within medical professions remain unclear; these occupations are largely client-dependent and afford easy access to lethal methods. Mathematicians and scientists, artists, and social workers also appear to experience occupation-related increased suicide risk (Stack, 2001).

The police force has often been cited as at higher risk for suicide, but closer examination reveals inconsistent results. A few controlled studies (e.g., Schmidtke et al., 1999) show moderately increased suicide rates for police that vary according to region and across time (Hem et al., 2001). Violanti and colleagues (1998) conducted a cohort mortality survey from 1950 to 1990 and found higher than expected mortality rates among male officers for all-cause mortality, including suicide. When compared to other working-age men, as opposed to the general population, however, police appear to have only a slightly increased suicide risk (Burnett et al., 1992; Hem et al., 2001; Stack and Kelly, 1994).

Sexual Orientation

Fewer than 5 percent of adults in the United States identify themselves as homosexual or bisexual (Michaels, 1996). This population faces societal stigma, discrimination, and violence victimization, among other stressors (Faulkner and Cranston, 1998; Herek, 1996; Hershberger and



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement