The Effects of Education, Social Class and Income on Non-alcohol- and Alcohol-Associated Suicide Mortality: A Register-based Study of Finnish Men Aged 25–64

Abstract

This study aimed to analyse the effects of different socioeconomic indicators on non-alcohol-associated and alcohol-associated suicide in Finland. The data used comprised the 1990 census records for men who were 25–64-years old linked to the death register for 1991–2001. Poisson regression was used to calculate the adjusted relative mortality rates. There were 6,452 suicides among the study population, and in 42% of them alcohol intoxication was a contributory cause. Education, occupation-based social class and household income were inversely and strongly related to suicide regardless of the link with alcohol. For non-alcohol-associated suicide, the effect of education was largely mediated by social class and income, the effect of social class was partly explained by education and partly mediated by income, and the effect of income was rather small after adjustment for the other two indicators. When alcohol was involved, social class mediated a large part of educational effect, but a strong association also remained. Respectively, education explained a large proportion of the social class differences. Income had a minor effect. Adjustment for employment status explained some of the income differences, but living arrangements had little effect. The findings imply that low social class is associated with increased suicide risk regardless of employment status, and that the roots of socioeconomic differences in alcohol-associated suicide lie in early adulthood when education and health behavioural patterns are set. This casts some doubt on claims that current material factors are the main drivers of socioeconomic differences in suicide.