Alan A. Cavaiola Ph.D.

Impossible to Please

Work and Suicide

A rise in the risk of suicide in our new economy

Posted Nov 21, 2015

Photo by Dreamstime. Used with permission
Source: Photo by Dreamstime. Used with permission

A recent study published by Anne Case and Angus Deaton (both faculty at Princeton University) has revealed some rather astounding findings, which have received attention recently in several media sources.  The study examines suicide rates in various ethnic/racial, gender and age groups and finds that middle-aged white males in the U.S. are considered to be among the high-risk groups for suicide and deaths related to “alcohol and drug poisoning” (i.e. overdose).  Another predictor of increased suicide potentiality was the presence of chronic pain in the middle age European-American male group. 

What is important however, is that Anne Case and Angus Deaton are not mental health epidemiologists but rather economists and their research is published by the National Bureau of Economic Research in the June, 2015 Working Paper series in an article entitled, “Suicide, age and well-being: An empirical investigation”.  Case and Deaton examine how economic forces impact on this population of middle-aged white males. They found that a sense of well-being not only correlated to physical health and freedom from pain but also was related to whether one was able to work and provide for themselves and their families. However, one of the most astounding findings of their research is that well-being was not predictive of suicide. Overall, suicide rates were found to be lower among those of higher socioeconomic status, which also correlated with higher education and better employment opportunities.

What makes this research so important is in terms of age is that suicide epidemiology has consistently identified young males ages 15-24 as being at highest risk for suicide followed by older age males (>45 years old). Angry and distressed young white males were traditionally considered to be the high risk group for suicide, certainly not middle-aged white men! Also important was that Case and Deaton’s research does not suggest that the Hispanics or African Americans were not impacted by physical pain or lack of adequate, well-paying jobs. However there appeared to be other mitigating factors that accounted for their lower rates of suicide, and alcohol/drug overdoses.

So you may be asking, what do these statistics have to do with work and employment?  Perhaps everything; especially when one looks at these statistics from the point of view of those middle-aged white males who are unable to find adequate, well-paying work to support their families or those who were injured on the job and are then are relegated to living on Social Security Disability (SSD).  As indicated earlier, chronic pain and prescription opioid medication figure heavily into Case and Deaton’s findings. Historically, it was hypothesized that prescription opioid epidemic began in places like Maine and West Virginia because of the high rates of work-related injuries in the shipbuilding industry in Maine and the coal-mining industry in places like West Virginia and other coal-mining states (hence the pejorative nickname for prescription opioids such as Oxycontin became “hillbilly heroin”).  Those disabled by work-related injuries either needed the pain medication to function while others found that they could supplement their SSD payments by selling their pain medication for sometimes up to $40. per pill.  Chronic pain has always been known to be a predictor of suicide so it is not so surprising that Case and Deaton found similar results. However what’s unique about Case and Deaton’s study is that they approach this issue of suicide from the lens of economists, not that of mental health professionals.  Their findings suggest that suicide may result from these men feeling that they have “low utility” therefore they conclude that they have no reason to live if they are “worth more dead than alive”.  

Another work-related issue that may be a possible explanation of Case and Deaton’s findings is that of wage stagnation.  For many wage earners the issue of income stagnation has never been greater than in today’s job market. So not only are job opportunities dwindling (despite low unemployment rates) but there are fewer well-paying jobs. Job growth and income disparity has been hot issues in the recent Presidential debates as well they should be. However; it remains to be seen how the income disparity issue will play out after the 2016 elections. Talk is cheap and congress has not exactly done any stellar life-changing work recently. Several years ago when  Daimler-Mercedes Benz had bought out Chrysler, one of the problems encountered as upper management was being absorbed into the German automaker’s ranks was that American executives were being paid far more than their counterparts in Europe.  So as the line in the song “Ain’t We Got Fun” goes, the “rich get rich and the poor get poorer”.  Although the song was written during the Great Depression of the 30’s the same hold true today perhaps more than ever. Some attribute wage stagnation to American jobs vanishing and going overseas, while others point to the dwindling role of labor unions, which in the past had helped to guarantee better wages and benefits for their members. 

And what about those who work under highly stressful working conditions?  In past blogs we have written about how the American workforce is often “disengaged” from their work, as if going through the motions until they can move to some other, more fulfilling type of work or career. Perhaps this is where those with higher education were less at risk for suicide. Aside from Senator Marco Rubio’s comment about our needing more welders and fewer philosophers, the truth is that higher levels of education often correlates with higher pay and better job opportunities (and according to Case & Dean lower suicide rates!).

Probably the most astounding finding in the Case and Deaton study was when they examined a state-by-state comparison of suicide rates, New Jersey was among the lowest!  Some of you may remember that at one point, New Jersey was considering making Bruce Springsteen’s hit, “Born to Run” it’s official State Song!  However, it was pointed out that if that were to have happened, we would have had the ONLY state song in the nation to have mention of “suicide” in the lyrics. (I think the lyrics go something like this…”it’s a death trap, it’s a suicide rap, we gotta get out while we’re young, cause tramps like us, baby we were born to run”.  Well, I guess the song does provide a directive for we New Jerseyans. Maybe that’s why people are leaving New Jersey in droves, given low employment opportunities, stagnant wages, and a high cost of living.

 I guess they took Bruce’s advice.    

Source: Photo by Author

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