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Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters

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  • Thomas Niederkrotenthaler
  • Petter Tinghög
  • Sidra Goldman-Mellor
  • Holly C Wilcox
  • Madelyn Gould
  • Ellenor Mittendorfer-Rutz

Abstract

Background: Individuals with a history of suicide attempt have a high risk for subsequent labour market marginalization. This study aimed at assessing the effect of individual and parental factors on different measures of marginalization. Methods: Prospective cohort study based on register linkage of 5 649 individuals who in 1994 were 16–30 years old, lived in Sweden and were treated in inpatient care for suicide attempt during 1992–1994. Hazard ratios (HRs) for labour market marginalization defined as long-term unemployment (>180 days), sickness absence (>90 days), or disability pension in 1995–2010 were calculated with Cox regression. Results: Medical risk factors, particularly any earlier diagnosed specific mental disorders (e.g., schizophrenia: HR 5.4 (95% CI: 4.2, 7.0), personality disorders: HR 3.9, 95% CI: 3.1, 4.9), repetitive suicide attempts (HR 1.6, 95% CI: 1.4, 1.9) were associated with a higher relative risk of disability pension. Individual medical factors were of smaller importance for long-term sickness absence, and of only marginal relevance to long-term unemployment. Country of birth outside Europe had an opposite effect on disability pension (HR 0.6, 95% CI: 0.4, 0.8) and long-term unemployment (HR 1.5, 95% CI: 1.3, 1.8). Female sex was positively correlated with long-term sickness absence (HR 1.6, 95% CI: 1.4, 1.7), and negatively associated with long-term unemployment (HR: 0.8, 95% CI: 0.7, 0.9). Conclusions: As compared to disability pension, long-term sickness absence and unemployment was more strongly related to socio-economic variables. Marginalization pathways seemed to vary with migration status and sex. These findings may contribute to the development of intervention strategies which take the individual risk for marginalization into account.

Suggested Citation

  • Thomas Niederkrotenthaler & Petter Tinghög & Sidra Goldman-Mellor & Holly C Wilcox & Madelyn Gould & Ellenor Mittendorfer-Rutz, 2016. "Medical and Social Determinants of Subsequent Labour Market Marginalization in Young Hospitalized Suicide Attempters," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
  • Handle: RePEc:plo:pone00:0146130
    DOI: 10.1371/journal.pone.0146130
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    1. Bäckström, Peter, 2023. "Swedish Veterans After Bosnia: The Relationship Between Military Deployment and Labour Market Marginalisation," Umeå Economic Studies 1011, Umeå University, Department of Economics.

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