Suicide Rates by Occupation in 17 States, 2012 and 2015: Construction and the Arts Highest

From 2000 to 2016, the U.S. suicide rate among people of working age (16–64) rose 34%, from 12.9 to 17.3 per 100,000. To inform prevention, CDC looked at suicides by occupation using the National Violent Death Reporting System (NVDRS) in the 17 states that took part in both 2012 and 2015: Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia and Wisconsin.

How it was done

• Data: the usual lifetime occupation on the death certificates of 22,053 people aged 16–64 who died by suicide, coded with CDC's National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System into Standard Occupational Classification (SOC) major groups and checked by coding experts.
• Rates: suicides per 100,000 civilian noninstitutionalized working people in each group, from the Current Population Survey.
• Left out of the rates: people not employed at death, those in the military or with unpaid occupations (not working, homemakers, students), and those whose occupation couldn't be classified — 5,089 (23%), plus 2,236 (10%) not employed at the time.

Results

Share of suicides: in both years, the largest share of men's suicides — 15%–16% — was in construction and extraction. For women, the largest share (29%) had unpaid occupations; among classifiable jobs, the largest was office and administrative support (9% in 2012, 10% in 2015).

Highest rates:

Biggest increases, 2012 to 2015:

• Men in arts, design, entertainment, sports and media: 26.9 → 39.7 (+47%).
• Women in food preparation and serving: 6.1 → 9.4 (+54%).

Farming (men only; too few women): farmers, ranchers and other agricultural managers 44.9 (2012) and 32.2 (2015); agricultural workers 20.4 and 17.3 — each based on small numbers of deaths.

What it means

Suicide rates varied widely by occupation and rose in many groups. The causes are many: work factors such as little job control or insecurity, and non-work factors such as relationship conflict, are linked to distress and suicide, and occupation may be confounded by access to lethal means at work and by income and education. Other studies differ: one in Colorado also found high rates among construction workers, while an international meta-analysis found higher risk in laborers and cleaners.

Because adults spend much of their time at work, the workplace is an important but underused setting for prevention. Most workplace efforts train gatekeepers to spot people at risk and refer them; more research is needed on primary prevention, such as better working conditions and less stress. CDC recommends a comprehensive approach — social connectedness, economic supports, encouraging help-seeking and reducing stigma, referrals to mental health services, reducing access to lethal means for people at risk, response plans for employers after a suicide, support for survivors, and safe media reporting. More workplace prevention resources are at theactionalliance.org.

Limits

• Lifetime occupation on the death certificate was compared with the current jobs of the working population. Without excluding people not working at death, rates would be higher for every group, though the top and bottom rankings would stay the same.
• Income and education, which vary widely within groups (the "management" group includes both farmers and chief executives of large companies), weren't accounted for.
• Occupation data depend on what families report, and one occupation may not describe people with several careers.
• The 17 states aren't nationally representative.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States.

Sources

Based on Peterson C, Stone DM, Marsh SM, et al., "Suicide Rates by Major Occupational Group — 17 States, 2012 and 2015," MMWR Morbidity and Mortality Weekly Report, volume 67, Centers for Disease Control and Prevention, with its erratum (MMWR volume 68, PMC6385711); a work of the United States government in the public domain. The copy imported here carried the uncorrected percentages (19%–20% of men's suicides in construction and extraction, 15% of women's in office and administrative support); the erratum's corrected figures are used, and its correction leaves the ranking of occupations by rate unchanged.