Suicide deaths by occupation skill level and educational attainment in the United States

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Abstract
Objectives: To estimate the association between suicide deaths and both occupational skill level and educational attainment in the United States. Methods: Suicide deaths, employment, education, and demographic data from the 2021 National Center for Health Statistics Multiple Cause of Death Files, for ages 18-64 with a lifetime history of employment, were combined with comparable participants from the 2020-2022 Current Population Survey. Outcomes of interest were associations between suicide death and occupational skill level, assessed as a 5-level variable, and educational attainment. Logistic regression models were used to estimate these associations before and after adjusting for educational attainment, age, and sex, in each racial/ethnic subpopulation. Results: We found a significant gradient in suicide death across occupational skill levels, with lower-skill occupations associated with higher suicide rates than higher-skill occupations. This gradient was more pronounced among non-Hispanic White (NHW) people and non-Hispanic Black (NHB) people than Hispanic people. However, upon controlling for educational attainment, this association was attenuated, indicating that the initial link was likely confounded by education. Conclusions: The results suggest that educational attainment is a more robust predictor of suicide risk than occupational skill level. Targeted interventions addressing educational and ethnic disparities within higher-risk occupational groups can mitigate suicide risk.

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