Financial Stress, Unemployment, and Suicide - A Meta-Analysis.

Abstract

Background: Socioeconomic factors such as financial stress and unemployment are known predictors of suicide. However, no large-scale meta-analyses exist. Aims: Determine the suicide risk following unemployment or financial stress. Method: Literature searched through July 31, 2021. Robust meta-analysis and metaregression of the risk of suicide following financial stress (23 studies) or unemployment (43 studies), from 20 nations. Subgroup meta-analyses by sex, age, year, country, and methodology. Results: The suicide risk following financial stress or unemployment was not significantly elevated among those with diagnosed mental illness. In the general population, we found significantly elevated suicide risks for financial stress (RR: 1.742; 95% CI: 1.339, -2.266) and unemployment (RR: 1.874; CI: 1.501, -2.341). However, neither was significant among studies controlling for physical/mental health (perhaps partially due to lower statistical power). We observed no significant differences by sex, age, or by GDP. We observed a higher suicide risk following unemployment in more recent years. Limitations: Publication bias was evident. We could not examine some individual-level characteristics, most notably the severity/duration of unemployment/financial stress. Heterogeneity was high for some meta-analyses. Studies from non-OECD countries are under-represented. Conclusion: After accounting for physical/mental health, financial stress and unemployment weakly associated with suicide, and the associations may be nonsignificant.