The impact of transitions from employment to retirement on suicidal behaviour among older aged Australians
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ORIGINAL PAPER
The impact of transitions from employment to retirement on suicidal behaviour among older aged Australians Andrew Page1 · Sandro Sperandei1 · Matthew J. Spittal2 · Allison Milner2 · Jane Pirkis2 Received: 2 April 2020 / Accepted: 31 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Transition from employment to retirement may be detrimental to mental health, and associated with suicidal behaviour. This study investigated the association between employment and retirement status and suicidal behaviour among older aged Australians. Methods This study was based on the ‘45 and Up Study’, a large prospective cohort study of participants from New South Wales (Australia) aged 45 years and older (N = 267,153), followed up over the period 2006–2018. The risk of attempted suicide and suicide was compared between categories of employment and retirement status in a series of recurrent event survival analysis models adjusting for identified time variant and invariant confounders. Results Compared to those who were employed, the risk of attempted suicide was higher among those who were not in the labour force and not retired (predominantly those who were sick or disabled, or carers) (HR = 1.97–95% CI 1.49–2.62), those who retired involuntarily (HR = 1.35–95% CI 1.03–1.77), and to a lesser extent those unemployed (HR = 1.31–95% CI 0.89–1.92). Risk of attempted suicide among those who retired voluntarily was similar to those who remained employed (HR = 1.09–95% CI 0.82–1.45). A similar pattern was evident for suicide, with a higher risk of suicide among those who were not in the labour force or retired, and those who retired involuntarily, compared to those who remained employed; however, these differences were not statistically significant. Conclusion Transition from employment to retirement may be an important precipitating factor for suicidal behaviour, affected by current and previous mental health status. Services and programs facilitating continued or re-employment in older age, and adjustment to the transition from employment to retirement may prevent suicidal behaviour. Keywords Suicide · Employment · Retirement · Older age
Introduction
Allison Milner: Deceased. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00127-020-01947-0) contains supplementary material, which is available to authorized users. * Andrew Page [email protected] 1
Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
2
Suicide rates in Australia have continued to increase since 2013, following a period of historically low rates in the first decade of the twenty-first century [1]. Increases have been particularly prominent for middle (≥ 45 years) and older (≥ 65 years) aged men, [2] and it is unclear why this is the case. Previous Austral
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