Employment transitions and mental health in a cohort of 45 years and older Australians

Background: This study investigated the associations between employment transitions and psychological distress among a cohort of 45 years and older Australians. Methods: This study was based on the 45 and Up Study, a large prospective cohort of participants aged 45 years and older (N = 267,153), followed up over the period 2006–2015. The risk of psychological distress was compared between various employment transitions categories by specifying an ordered logistic regression model adjusting for confounders. Results: Compared to participants who remained employed at baseline and follow-up, higher psychological distress was found among those who transitioned from being employed to unemployed (OR = 2.68, 95%CI 2.13–3.33) and to not being in the labour force or retired (OR = 2.21, 95%CI 1.85–2.62). Higher psychological distress was also evident among those who remained unemployed from baseline to follow-up (OR = 2.00, 95%CI 1.10–3.43), and those who transitioned from being retired to being unemployed (OR = 1.55, 95%CI 1.03–2.27). Conversely, lower psychological distress was found among those who transitioned from being unemployed to being employed (OR = 0.35, 95%CI 0.25–0.51). In general, lower psychological distress was found among ‘positive’ employment transitions (transitioning to being employed or retired). Conclusions: Policies focussing on re-employment in older age, as well as unemployment schemes, might be helpful in reducing psychological distress among middle-and old-age Australians

Trends and socio-economic determinants of suicide in India : 2001–2013

Purpose: To investigate trends and socio-economic determinants of suicide in India over the period of 2001–2013. Method: Suicide rates between 2001 and 2013 were calculated using suicide statistics provided by National Crime Records Bureau (NCRB) and census data provided by Census of India, stratified by sex, age group, and geographical region, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were specified to investigate associations between state-level indicators of economic development, education, employment and religious factors and sex-specific suicide rates. Results: Male suicide rates remained relatively steady (~ 14 per 100,000) while female suicide rates decreased over the study period (9 to 7 per 100,000). The age group of 45–59 years had the highest suicide rate among males while the age group of 15–29 years had the highest suicide rate among females. On average, higher male and female suicide rates were observed in states with: higher levels of development, higher levels of agricultural employment, higher levels of literacy, and higher proportions of people identifying with Hinduism. Higher male suicide rates were also observed in states with higher levels of unemployment. Conclusion: The process of modernization might be contributing towards higher suicide risk in more developed parts of India. Also, increase in farmer suicides since economic liberalization might be contributing towards higher suicide rates among more agricultural regions. Furthermore, ancient sanctions towards religious suicide are possibly still influencing modern Hindu suicides

Estimating patterns in the under-reporting of suicide deaths in India : comparison of administrative data and Global Burden of Disease Study estimates, 2005-2015

Background: It has been proposed that the National Crime Records Bureau (NCRB), which reports suicides in India, differentially underenumerates suicides by geographic and demographic factors. We assessed the extent of potential underenumeration by comparing suicides recorded in NCRB data with recent estimates of Indian suicides developed by the Global Burden of Disease (GBD) initiative. Methods: Age- standardised suicide rates were calculated for both data sources by sex, age and state, and rate ratios of NCRB to GBD estimates by corresponding strata were compared to ascertain the relative under- reporting in the NCRB report. Results: The GBD Study reported an additional 802 684 deaths by suicide (333 558 male and 469 126 female suicide deaths) compared with the NCRB report between 2005 and 2015. Among males, the average underreporting was 27% (range 21%–31%) per year, and among females, the average under- reporting was 50% (range 47%–54%) per year. Under- reporting was more evident among younger (15–29 years) and older age groups (≥60 years) compared with middle age groups. Indian states belonging to low Socio- Demographic Index (SDI) generally had greater underenumeration compared with middle and high- SDI states. Conclusion: NCRB data under- report suicides in India, and differentially by sex, age and geographic area, possibly because of lack of community- level reporting of suicides due to social stigma and legal consequences. While the recent decriminalisation of suicide is expected to improve community- level reporting of suicides, suicide prevention policies should be developed, with a priority to address social stigma attached with suicide and suicidal behaviour, especially among females

The geographic heterogeneity of suicide rates in India by religion, caste, tribe, and other backward classes

Background: Caste, tribal, and religious associations, which are perhaps the most important aspects of personal and social lives in India, have been neglected in Indian suicide research. Aim: To investigate suicide rates in India by religion, caste, tribe, and other backward classes over the period 2014-2015. Method: This study acquired unpublished suicide data from the National Crime Records Bureau (NCRB) for 2014 and 2015 including caste, tribal, and religious associations of suicide cases. National and state-specific suicide rates (2014-2015) were then calculated for Hindus, Muslims, Christians, Sikhs, and other religious groups and for scheduled caste (SC), scheduled tribe (ST), and other backward classes (OBC). Results: The findings show higher suicide rates among Christian and other religious groups compared with Hindus and higher suicide rates among general populations compared with SC, ST, and OBC populations. However, the results varied among different regions highlighting the substantial geographical heterogeneity of suicide rates across India by caste and religion. Limitations: The suicide rates presented might be an underestimation of the true rates. Conclusion: Given the heterogeneity of minority/majority status by religion, caste, tribes, and OBC in different states, further investigation of the relationship between minority status and suicide is warranted