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Suicide Rates by Major Occupational Group--17 States, 2012 and 2015.

During 2000-2016, the suicide rate among the U.S. working age population (persons aged 16-64 years) increased 34%, from 12.9 per 100,000 population to 17.3 (https:// www.cdc.gov/injury/wisqars). To better understand suicide among different occupational groups and inform suicide prevention efforts, CDC analyzed suicide deaths by Standard Occupational Classification (SOC) major groups for decedents aged 16-64 years from the 17 states participating in both the 2012 and 2015 National Violent Death Reporting System (NVDRS) (https://www.cdc.gov/violenceprevention/nvdrs). The occupational group with the highest male suicide rate in 2012 and 2015 was Construction and Extraction (43.6 and 53.2 per 100,000 civilian noninstitutionalized working persons, respectively), whereas the group with the highest female suicide rate was Arts, Design, Entertainment, Sports, and Media (11.7 [2012] and 15.6 [2015]). The largest suicide rate increase among males from 2012 to 2015 (47%) occurred in the Arts, Design, Entertainment, Sports, and Media occupational group (26.9 to 39.7) and among females, in the Food Preparation and Serving Related group, from 6.1 to 9.4 (54%). CDC's technical package of strategies to prevent suicide is a resource for communities, including workplace settings (1).

NVDRS combines data on all violent deaths (defined as those resulting from the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community), including suicide, based on death certificates, coroner/medical examiner reports, and law enforcement reports. Data on usual lifetime occupation among 22,053 suicide decedents aged 16-64 years from the 17 states* that participated in NVDRS in 2012 and 2015 were analyzed. CDC's National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS 3.0) (https://wwwn.cdc.gov/nioccs3) was used to assign 2010 U.S. Census civilian occupation and industry codes to NVDRS decedent records based on decedents' usual lifetime occupation and industry as reported on the death certificate. Results are reported by 2010 SOC major groups, converted from U.S. Census codes by NIOCCS. Records that could not be coded by NIOCCS were manually coded using the NIOCCS computer-assisted feature. All coding assignments were reviewed by industry and occupation coding experts for accuracy.

Suicide counts are presented by year, sex, and usual lifetime occupational group. Suicide rates were calculated using annual civilian noninstitutionalized working population counts by occupational group (based on longest job held during the previous calendar year) from the Current Population Survey Annual Social and Economic Supplement (2) as the denominator; 95% confidence intervals (CIs) were calculated using the National Center for Health Statistics method for death rates (3). The rate change from 2012 to 2015 is presented for each occupational group by sex, as is each group's rank for rate change (i.e., where rank position 1 signifies the greatest suicide rate increase). Decedents whose NVDRS data from coroner/ medical examiner reports or law enforcement reports indicated that the decedent was not employed at the time of death (unemployed, disabled, incarcerated, homemaker, or student) were excluded from rate calculations, as were decedents with military or unpaid occupations, and those with insufficient information to classify occupation. Separate analyses of suicide deaths among males in agriculture-related SOC detailed groups were conducted; such rates were not calculated for female decedents because of small numbers.

NIOCCS classified 83% (8,858 in 2012 and 9,508 in 2015) of decedent records (Table 1); this count includes those that the NIOCCS program determined to have insufficient information to classify occupation. After expert review of NIOCCS automated code assignments, 231 (3%) of 2012 records and 290 (3%) of 2015 records were recoded. The remaining 1,799 (2012) and 1,888 (2015) (17% for both years) records were coded using the NIOCCS computer-assisted feature. For 2012 and 2015 combined, 5,089 (23%) decedents were not included in suicide rate calculations because they were in the military, had unpaid occupations (e.g., did not work, homemaker, or student), or had insufficient information to classify lifetime occupation. Another 2,236 (10%) were excluded because they were not employed at the time of death.

In both 2012 and 2015, the largest percentage of male suicides (19%--20% of decedents) occurred among those in the Construction and Extraction group (SOC 47) (Table 2); the largest percentage of female suicides in both years occurred among decedents with unpaid occupations (29%). The largest percentage of female suicides among classifiable occupations occurred in the Office and Administrative Support group (SOC 43) in both years (15%). In both years, the highest suicide rates among males were in the Construction and Extraction group (43.6 in 2012 and 53.2 in 2015 per 100,000 civilian noninstitutionalized working persons) (Table 3). Among females, the highest suicide rates in both years were in the Arts, Design, Entertainment, Sports, and Media group (SOC 27) (11.7 in 2012 and 15.6 in 2015). Among males, the largest suicide rate increase from 2012 to 2015 (47%) occurred in the Arts, Design, Entertainment, Sports, and Media group (from 26.9 to 39.7), and among females (54%) in the Food Preparation and Serving Related group (SOC 35) (from 6.1 to 9.4). Rate changes among females in six SOC major groups were not reported because of small numbers (<20 decedents in one or both years).

The 2012 and 2015 male suicide rates among Farmers, Ranchers, and Other Agricultural Managers (SOC 11-9013, a subgroup of the SOC 11 Management major group) were 44.9 (CI = 34.2-57.9) and 32.2 (CI = 24.2-42.0) per 100,000, based on 59 and 54 suicides in 2012 and 2015, respectively. The 2012 and 2015 male suicide rates for Agricultural Workers (SOC 45-2000, a subgroup of the SOC 45 Farming, Fishing, and Forestry major group) were 20.4 (CI = 13.8-29.1) and 17.3 (CI = 12.1-23.9), based on 30 and 36 suicides in 2012 and 2015, respectively.

Discussion

Suicide rates varied widely across occupational groups in both 2012 and 2015, and rates among males and females increased in many occupational groups. The etiology of suicide is multifactorial, and identifying the specific role that occupational factors might play in suicide risk is complicated; both work (e.g., little job control or job insecurity) and nonwork (e.g., relationship conflict) factors are associated with psychological distress and suicide (4). The relationship between occupation and suicide might be confounded by access to lethal means on the job and socioeconomic factors such as lower income and education (5,6). Previous studies have employed a range of methodologies to study the proposed association between suicide and occupation and, at times, have arrived at different conclusions. For example, although this analysis aligns with another that found high suicide rates among construction workers in Colorado (7), a meta-analysis using an international occupational classification system found persons in other less-skilled occupations, such as laborers and cleaners, to be at higher risk (6).

A better understanding of how suicides are distributed by occupational group might help inform prevention programs and policies. Because many adults spend a substantial amount of their time at work, the workplace is an important but underutilized location for suicide prevention (8). Workplaces could potentially benefit from suicide prevention activities.

Additional and tailored prevention approaches might be necessary to support workers at higher risk. Workplace suicide prevention efforts to date have focused primarily on early detection and tertiary intervention through the training of persons (i.e. gatekeepers) to identify those at risk for suicide and refer them to supporting services. However, more research on the role of the workplace in primary suicide prevention is needed, including improving working conditions and reducing stress (8).

The findings in this report are subject to at least four limitations. First, because of the nature of the data that were available, and consistent with previous research methods, this report compared decedents' usual lifetime occupation as recorded on the death certificate with occupations of the employed population to calculate suicide rates. Additional data from coroner/medical examiner and law enforcement reports were used to exclude decedents identified as not in the labor force at time of death. Separate analyses indicated that if no such exclusion were applied, suicide rates would have been higher for all groups, although the top and bottom eight ranked occupational groups in 2015 by male suicide rate would maintain the same rank position, as would the top three and bottom four occupational groups by female suicide rate. Second, this report did not address confounding factors that might account for higher or lower rates of suicide between and within occupational groups, including education and income (9,10). Within SOC major occupational groups, employee education and income might vary widely. For example, the Management SOC major group includes farmers, ranchers, and chief executives of large companies, and the Construction and Extraction group includes both employees who might be salaried (e.g., supervisors) and those who might be paid hourly wages (e.g., roofer helpers). Future research might benefit from using more narrowly defined occupational groups and controlling for education and income to refine understanding of the relationship between occupation and suicide. Third, industry and occupation data obtained from death certificates rely on the accuracy and completeness of employment information provided by decedents' family members. It is also possible that completeness and accuracy of that information might be associated with decedents' job history. For example, categorization based on single lifetime industry and occupation might not accurately reflect employment for those persons with multiple lifetime occupations and those who worked across industries. Finally, this report is based on data from 17 U.S. states that participated in NVDRS in 2012 and 2015, and the data are not nationally representative.

To address the multifactorial etiology of suicide, CDC recommends a comprehensive approach to prevention (1). Strategies might include enhancing social connectedness and expanding access to relevant resources, strengthening state or local economic supports, implementing practices that encourage help-seeking and decrease stigma, and providing referrals to mental health and other services (1). Strategies can be implemented to assure support and reduce access to lethal means among persons at risk. Decision makers, including employers, can create a response plan, should a suicide affect their organization. Surviving family and friends can be supported to reduce their own suicide risk. The media can follow reporting recommendations to avoid sensationalized reporting and can refrain from providing details on suicide methods (1). Further workplace prevention resources are available at https://theactionalliance.org/, and help is available at 1-800-273-TALK.

Summary

What is already known about this topic? From 2000 to 2016, the U.S. suicide rate among working aged (16-64 years) adults increased 34% from 12.9 per 100,000 population to 17.3.

What is added by this report?

2012 and 2015 National Violent Death Reporting System data from 17 states indicated the major occupational group with the highest male suicide rate was Construction and Extraction (43.6 [2012] and 53.2 [2015]). The Arts, Design, Entertainment, Sports, and Media major occupation group had the highest female suicide rate in 2012 (11.7) and 2015 (15.6).

What are the implications for public health practice?

A comprehensive approach to suicide prevention, including workplace-based approaches, is needed. CDC's technical package of strategies to prevent suicide is a resource for communities and workplaces to identify prevention strategies with the best available evidence.

Acknowledgments

Jeff Purdin, Matt Hirst, Susan Burton, Jenny Huddleston, Elizabeth Smith, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

References

(1.) Stone DM, Holland K, Bartholow B, Crosby A, Davis S, Wilkins N. Preventing suicide: a technical package of policies, programs, and practices. Atlanta, GA: US Department of Health and Human Services, CDC; 2017. https://www.cdc.gov/violenceprevention/pdf/ suicideTechnicalPackage.pdf

(2.) US Census Bureau. Current population survey annual social and economic supplement 2013 and 2016. Washington, DC: US Census Bureau; 2018.

(3.) National Center for Health Statistics. Vital statistics of the United States: mortality, 1999 technical appendix. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2004. https://www.cdc.gov/nchs/data/statab/techap99.pdf

(4.) Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med 2018;75:245-53. https://doi.org/10.1136/ oemed-2017-104531

(5.) Milner A, Witt K, Maheen H, LaMontagne AD. Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data. BMC Psychiatry 2017;17:125. https://doi.org/10.1186/ s12888-017-1288-0

(6.) Milner A, Spittal MJ, Pirkis J, LaMontagne AD. Suicide by occupation: systematic review and meta-analysis. Br J Psychiatry 2013;203:409-16. https://doi.org/10.1192/bjp.bp.113.128405

(7.) Stallones L, Doenges T, Dik BJ, Valley MA. Occupation and suicide: Colorado, 2004-2006. Am J Ind Med 2013;56:1290-5.

(8.) Milner A, Page K, Spencer-Thomas S, Lamotagne AD. Workplace suicide prevention: a systematic review of published and unpublished activities. Health Promot Int 2015;30:29-37. https://doi.org/10.1093/heapro/ dau085

(9.) Daly MC, Wilson DJ, Johnson NJ. Relative status and well-being: evidence from U.S. suicide deaths. Rev Econ Stat 2013;95:1480-500. https://doi.org/10.1162/REST_a_00355

(10.) Phillips JA, Hempstead K. Differences in U.S. suicide rates by educational attainment, 2000-2014. Am J Prev Med 2017;53:e123-30. https://doi.org/10.1016Zj.amepre.2017.04.010

Cora Peterson, PhD [1]; Deborah M. Stone, ScD [2]; Suzanne M. Marsh, MPA [3]; Pamela K. Schumacher [4]; Hope M. Tiesman, PhD [3]; Wendy LiKamWa McIntosh, MPH [2]; Colby N. Lokey, MS [2]; Aimee-Rika T. Trudeau, MPH [2]; Brad Bartholow, PhD [2]; Feijun Luo, PhD [1]

Corresponding author: Deborah M. Stone, dstone3@cdc.gov, 770-488-3942.

[1] Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC; [2] Division of Violence Prevention, National Center for Injury Prevention and Control, CDC; [3] Division of Safety Research, National Institute for Occupational Safety and Health, CDC; [4] Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC.

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

* Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin.
TABLE 1. Procedure for Identification of analysis cohort of suicide
decedents, by occupation--National Violent Death Reporting
System (NVDRS)--17 U.S. states* 2012 and 2015

Analytic procedure                                 2012 no.   2015 no.

Suicide decedents obtained from NVDRS data set     12,811     13,967
  ([dagger])
Excluded before assignment of occupation code
Aged <16 years or >64 years or missing sex         2,154      2,571
Assignment of occupation code
Assigned based on decedent usual lifetime          10,657     11,396
  occupation
Autocoded by NIOCCS                                8,858      9,508
Manually reassigned using the NIOCCS computer-     231        290
  assisted feature
Manually assigned using the NIOCCS computer-       1,799      1,888
  assisted feature
Rate analysis
Decedents presumed to be in the labor force at     6,881      7,847
  time of death ([section])

Abbreviation: NIOCCS = National Institute for Occupational Safety
and Health Industry and Occupation Computerized Coding System.

* Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New
Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode
Island, South Carolina, Utah, Virginia, and Wisconsin.

([dagger])The total number of deaths (including suicides) reported in
the NVDRS data set (June 2018) for the 17 U.S. states analyzed
included 19,885 decedents in 2012 and 21,884 decedents in 2015.

([section]) Because annual U.S. population count data by
occupational group reflects the longest held job in the previous
year among civilian, noninstitutionalized persons, suicide
decedents whose NVDRS data from coroner/medical examiner or law
enforcement reports indicated no employment (e.g., retired,
unemployed, disabled, incarcerated, home maker, or student) at the
time of death were excluded from rate analysis. Decedents were
excluded if NVDRS current occupation information contained any of
the following: "student, unemp*, not empl*, laid off, retir*,
disab*, incarcer*, inmate, prisoner, homemaker, home maker,
housewife, house wife, never worked, or not working." Manual review
of records excluded based on these criteria resulted in five
records being reinstated (e.g., "student teacher" and two
occupations listed for a decedent with just one occupation
explicitly identified as retired).

TABLE 2. Number and percentage of suicide decedents* in Standard
Occupational Classification (SOC) major group, by year and sex--
National Violent Death Reporting System, 17 states, ([dagger])
2012 and 2015

                                                           Male

SOC                                             2012         2015

code   Occupational group                     no. (%)      no. (%)

11     Management                             534 (8)      611 (9)
13     Business and Financial                 155 (2)      145 (2)
         Operations
15     Computer and Mathematical              208 (3)      237 (3)
17     Architecture and Engineering           172 (3)      167 (2)
19     Life, Physical, and Social Science      56 (1)       52 (1)
21     Community and Social Service            41 (1)       48 (1)
23     Legal                                   54 (1)       49 (1)
25     Education, Training, and Library        91 (1)       87 (1)
27     Arts, Design, Entertainment,           140 (2)      186 (3)
         Sports, and Media
29     Health Care Practitioners and          145 (2)      169 (2)
         Technical occupations
31     Health Care Support                     35 (1)      34 (<1)
33     Protective Service                     232 (4)      226 (3)
35     Food Preparation and                   214 (3)      301 (4)
         Serving Related
37     Building and Grounds                   316 (5)      315 (4)
         Cleaning and Maintenance
39     Personal Care and Service               81 (1)       85 (1)
41     Sales and Related                      555 (9)      553 (8)
43     Office and Administrative              244 (4)      260 (4)
         Support
45     Farming, Fishing, and Forestry          68 (1)       71 (1)
47     Construction and Extraction           1,216 (19)   1,404 (20)
49     Installation, Maintenance, and         549 (9)      621 (9)
         Repair
51     Production                             605 (9)      679 (10)
53     Transportation and                     736 (11)     817 (11)
         Material Moving
NA     Military                               228 (3)      203 (2)
NA     Unpaid                                 822 (10)     913 (11)
NA     Insufficient Information to            651 (8)      425 (5)
         Classify Occupation
                                                    Female

SOC                                            2012        2015

code   Occupational group                     no. (%)     no. (%)

11     Management                             117 (7)     118 (7)
13     Business and Financial                 81 (5)      84 (5)
         Operations
15     Computer and Mathematical              22 (1)      32 (2)
17     Architecture and Engineering           10 (1)      15 (1)
19     Life, Physical, and Social Science     15 (1)      21 (1)
21     Community and Social Service           39 (2)      40 (2)
23     Legal                                  34 (2)      29 (2)
25     Education, Training, and Library       82 (5)      84 (5)
27     Arts, Design, Entertainment,           54 (3)      76 (4)
         Sports, and Media
29     Health Care Practitioners and         220 (14)    225 (12)
         Technical occupations
31     Health Care Support                    97 (6)      124 (7)
33     Protective Service                     29 (2)      32 (2)
35     Food Preparation and                   112 (7)     154 (9)
         Serving Related
37     Building and Grounds                   36 (2)      46 (3)
         Cleaning and Maintenance
39     Personal Care and Service              98 (6)      102 (6)
41     Sales and Related                     170 (11)    212 (12)
43     Office and Administrative             234 (15)    268 (15)
         Support
45     Farming, Fishing, and Forestry         7 (<1)      5 (<1)
47     Construction and Extraction            12 (1)      17 (1)
49     Installation, Maintenance, and          8 (1)        NR
         Repair
51     Production                             64 (4)      81 (4)
53     Transportation and                     52 (3)      39 (2)
         Material Moving
NA     Military                               15 (1)      13 (<1)
NA     Unpaid                                724 (29)    795 (29)
NA     Insufficient Information to            177 (9)     123 (4)
         Classify Occupation

Abbreviation: NA = not assigned; NR = not reported due to cell size
<5.

* Aged 16-64 years.

([dagger]) Alaska, Colorado, Georgia, Kentucky, Maryland,
Massachusetts, New Jersey, New Mexico, North Carolina, Ohio,
Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and
Wisconsin.

TABLE 3. Suicide rate per 100,000 civilian, noninstitutionalized
working persons aged 16-64 years, by sex, based on suicide
decedents (N = 14,728) presumed in the labor force at time of death
using Standard Occupational Classification (SOC) major
groups--National Violent Death Reporting System, 17 states,* 2012
and 2015

Males

SOC
code   Occupational group                        2012        2015

47     Construction and Extraction
       Rate rank ([section])                       1           1
       Rate per 100,000                          43.6        53.2
       95% CI ([paragraph])                    40.9-46.3   50.2-56.1
       Suicide decedents, no.                    1,009       1,248
       Population, no.                         2,313,934   2,345,952
27     Arts, Design, Entertainment, Sports,
         and Media
       Rate rank                                   7           2
       Rate per 100,000                          26.9        39.7
       95% CI                                  22.1-31.8   33.6-45.8
       Suicide decedents, no.                     117         162
       Population, no.                          434,177     408,113
49     Installation, Maintenance, and Repair
       Rate rank                                   2           3
       Rate per 100,000                          31.6        39.1
       95% CI                                  28.7-34.4   35.8-42.3
       Suicide decedents, no.                     473         542
       Population, no.                         1,498,263   1,387,681
53     Transportation and Material Moving
       Rate rank                                   4           4
       Rate per 100,000                          28.4        30.9
       95% CI                                  26.2-30.7   28.6-33.1
       Suicide decedents, no.                     615         721
       Population, no.                         2,164,530   2,336,133
51     Production
       Rate rank                                   3           5
       Rate per 100,000                          28.4        30.5
       95% CI                                  26.0-30.9   28.1-33.0
       Suicide decedents, no.                     524         607
       Population, no.                         1,843,879   1,987,864
33     Protective Service
       Rate rank                                   6           6
       Rate per 100,000                          27.1        28.2
       95% CI                                  23.3-30.9   24.2-32.1
       Suicide decedents, no.                     198         194
       Population, no.                          730,044     689,034
37     Building and Grounds Cleaning and
         Maintenance
       Rate rank                                   5           7
       Rate per 100,000                          27.3        26.8
       95% CI                                  24.1-30.5   23.6-30.0
       Suicide decedents, no.                     281         276
       Population, no.                         1,028,779   1,029,385
29     Health Care Practitioners and
         Technical
       Rate rank                                  14           8
       Rate per 100,000                          20.8        25.6
       95% CI                                  17.1-24.6   21.5-29.8
       Suicide decedents, no.                     119         145
       Population, no.                          571,387     565,768

45     Farming, Fishing, and Forestry
       Rate rank                                   8           9
       Rate per 100,000                          26.3        22.8
       95% CI                                  20.0-34.0   17.7-29.0
       Suicide decedents, no.                     58          67
       Population, no.                          220,364     293,746
41     Sales and Related
       Rate rank                                  11          10
       Rate per 100,000                          21.3        21.5
       95% CI                                  19.4-23.2   19.6-23.4
       Suicide decedents, no.                     487         489
       Population, no.                         2,282,361   2,276,666
35     Food Preparation and Serving Related
       Rate rank                                  19          11
       Rate per 100,000                          14.6        20.9
       95% CI                                  12.5-16.7   18.4-23.3
       Suicide decedents, no.                     180         276
       Population, no.                         1,234,381   1,321,800
31     Health Care Support
       Rate rank                                   9          12
       Rate per 100,000                          22.1        19.5
       95% CI                                  14.8-31.7   12.5-29.0
       Suicide decedents, no.                     29          24
       Population, no.                          131,497     123,003
17     Architecture and Engineering
       Rate rank                                  10          13
       Rate per 100,000                          21.6        19.4
       95% CI                                  18.1-25.1   16.3-22.6
       Suicide decedents, no.                     145         147
       Population, no.                          670,938     756,515
23     Legal
       Rate rank                                  12          14
       Rate per 100,000                          21.3        18.7
       95% CI                                  15.7-28.2   13.4-25.4
       Suicide decedents, no.                     48          41
       Population, no.                          225,681     219,171
11     Management
       Rate rank                                  17          15
       Rate per 100,000                          16.4        17.8
       95% CI                                  14.9-17.9   16.3-19.3
       Suicide decedents, no.                     477         530
       Population, no.                         2,906,468   2,981,498
39     Personal Care and Service
       Rate rank                                  13          16
       Rate per 100,000                          20.9        16.5
       95% CI                                  16.2-26.4   12.9-20.7
       Suicide decedents, no.                     68          73
       Population, no.                          326,037     443,543

15     Computer and Mathematical
       Rate rank                                  15          17
       Rate per 100,000                          18.1        16.1
       95% CI                                  15.5-20.8   13.9-18.4
       Suicide decedents, no.                     179         202
       Population, no.                          986,994    1,252,275
43     Office and Administrative Support
       Rate rank                                  20          18
       Rate per 100,000                          14.1        15.8
       95% CI                                  12.2-16.1   13.7-17.9
       Suicide decedents, no.                     206         223
       Population, no.                         1,456,242   1,411,453
19     Life, Physical, and Social Science
       Rate rank                                  16          19
       Rate per 100,000                          17.3        15.0
       95% CI                                  12.7-23.0   11.0-20.0
       Suicide decedents, no.                     47          47
       Population, no.                          271,690     312,925
21     Community and Social Service
       Rate rank                                  21          20
       Rate per 100,000                          12.8        14.6
       95% CI                                  8.8-17.9    10.7-19.6
       Suicide decedents, no.                     33          45
       Population, no.                          258,744     307,829
13     Business and Financial Operations
       Rate rank                                  18          21
       Rate per 100,000                          14.6        13.0
       95% CI                                  12.1-17.2   10.7-15.3
       Suicide decedents, no.                     125         122
       Population, no.                          855,329     941,806
25     Education, Training, and Library
       Rate rank                                  22          22
       Rate per 100,000                          10.9        10.9
       95% CI                                  8.6-13.6    8.6-13.5
       Suicide decedents, no.                     78          79
       Population, no.                          713,321     727,167

SOC                                                 Rate change
code   Occupational group                       %     Rank ([dagger])

47     Construction and Extraction
       Rate rank ([section])                   +22%          5
       Rate per 100,000
       95% CI ([paragraph])
       Suicide decedents, no.
       Population, no.
27     Arts, Design, Entertainment, Sports,
         and Media
       Rate rank                               +47%          1
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
49     Installation, Maintenance, and Repair
       Rate rank                               +24%          3
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
53     Transportation and Material Moving
       Rate rank                               +9%           8
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
51     Production
       Rate rank                               +7%          10
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
33     Protective Service
       Rate rank                               +4%          11
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
37     Building and Grounds Cleaning and
         Maintenance
       Rate rank                               -2%          14
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
29     Health Care Practitioners and
         Technical
       Rate rank                               +23%          4
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.

45     Farming, Fishing, and Forestry
       Rate rank                               -13%         21
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
41     Sales and Related
       Rate rank                               +1%          12
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
35     Food Preparation and Serving Related
       Rate rank                               +43%          2
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
31     Health Care Support
       Rate rank                               -12%         18
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
17     Architecture and Engineering
       Rate rank                               -10%         15
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
23     Legal
       Rate rank                               -12%         19
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
11     Management
       Rate rank                               +8%           9
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
39     Personal Care and Service
       Rate rank                               -21%         22
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.

15     Computer and Mathematical
       Rate rank                               -11%         16
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
43     Office and Administrative Support
       Rate rank                               +12%          7
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
19     Life, Physical, and Social Science
       Rate rank                               -13%         20
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
21     Community and Social Service
       Rate rank                               +15%          6
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
13     Business and Financial Operations
       Rate rank                               -11%         17
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
25     Education, Training, and Library
       Rate rank                               -1%          13
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.

Females

       Occupational group                        2012        2015

27     Arts, Design, Entertainment, Sports,
         and Media
       Rate rank ([section])                       1           1
       Rate per 100,000                          11.7        15.6
       95% Cl [paragraph])                     8.6-15.5    12.1-19.8
       Suicide decedents, no.                     47          67
       Population, no.                          403,305     429,424
33     Protective Service
       Rate rank                                   2           2
       Rate per 100,000                          11.6        12.2
       95% CI                                  7.5-17.1    8.1-17.7
       Suicide decedents, no.                     25          28
       Population, no.                          215,345     228,862
31     Health Care Support
       Rate rank                                   5           3
       Rate per 100,000                           8.4        11.0
       95% CI                                  6.7-10.4    8.9-13.0
       Suicide decedents, no.                     83          108
       Population, no.                          993,407     984,369
35     Food Preparation and Serving Related
       Rate rank                                  11           4
       Rate per 100,000                           6.1         9.4
       95% CI                                   4.9-7.5    7.8-11.0
       Suicide decedents, no.                     94          139
       Population, no.                         1,539,199   1,479,822
23     Legal
       Rate rank                                   3           5
       Rate per 100,000                          11.1         9.2
       95% CI                                  7.5-15.9    5.8-13.9
       Suicide decedents, no.                     30          22
       Population, no.                          269,243     238,870
29     Health Care Practitioners and
       Technical
       Rate rank                                   4           6
       Rate per 100,000                          10.3         9.0
       95% CI                                  8.9-11.8    7.7-10.3
       Suicide decedents, no.                     195         193
       Population, no.                         1,890,885   2,140,217
51     Production
       Rate rank                                   7           7
       Rate per 100,000                           7.6         9.0
       95% CI                                  5.8-10.0    7.0-11.3
       Suicide decedents, no.                     55          72
       Population, no.                          719,183     800,640
39     Personal Care and Service
       Rate rank                                   9           8
       Rate per 100,000                           6.8         7.7
       95% CI                                   5.5-8.4     6.2-9.5
       Suicide decedents, no.                     89          92
       Population, no.                         1,308,535   1,187,811

41     Sales and Related
       Rate rank                                  10           9
       Rate per 100,000                           6.4         7.7
       95% CI                                   5.3-7.4     6.6-8.7
       Suicide decedents, no.                     148         192
       Population, no.                         2,325,223   2,505,186
15     Computer and Mathematical
       Rate rank                                  NR          10
       Rate per 100,000                           NR          7.3
       95% CI                                     NR       5.0-10.5
       Suicide decedents, no.                     20          30
       Population, no.                          390,260     408,410
53     Transportation and Material Moving
       Rate rank                                   6          11
       Rate per 100,000                           8.3         6.9
       95% CI                                  6.0-11.2     4.8-9.7
       Suicide decedents, no.                     43          33
       Population, no.                          517,082     477,143
21     Community and Social Service
       Rate rank                                   8          12
       Rate per 100,000                           7.3         6.0
       95% CI                                  5.1-10.2     4.2-8.4
       Suicide decedents, no.                     34          36
       Population, no.                          464,942     595,582
43     Office and Administrative Support
       Rate rank                                  14          13
       Rate per 100,000                           4.7         6.0
       95% CI                                   4.1-5.4     5.2-6.8
       Suicide decedents, no.                     201         239
       Population, no.                         4,267,892   3,985,105
13     Business and Financial Operations
       Rate rank                                  12          14
       Rate per 100,000                           5.7         5.4
       95% CI                                   4.4-7.2     4.2-6.8
       Suicide decedents, no.                     70          71
       Population, no.                         1,235,880   1,321,724
37     Building and Grounds Cleaning and
         Maintenance
       Rate rank                                  15          15
       Rate per 100,000                           4.6         5.2
       95% CI                                   3.1-6.5     3.7-7.2
       Suicide decedents, no.                     31          36
       Population, no.                          673,483     688,809
11     Management
       Rate rank                                  13          16
       Rate per 100,000                           5.6         4.9
       95% CI                                   4.5-6.7     4.0-5.9
       Suicide decedents, no.                     104         103
       Population, no.                         1,855,055   2,083,968
25     Education, Training, and Library
       Rate rank                                  16          17
       Rate per 100,000                           3.3         3.4
       95% CI                                   2.6-4.2     2.7-4.2
       Suicide decedents, no.                     69          74
       Population, no.                         2,091,706   2,186,483
17     Architecture and Engineering
       Rate rank                                  NR          NR
       Rate per 100,000                           NR          NR
       95% CI                                     NR          NR
       Suicide decedents, no.                     10          12
       Population, no.                          135,632     144,852
19     Life, Physical, and Social Science
       Rate rank                                  NR          NR
       Rate per 100,000                           NR          NR
       95% CI                                     NR          NR
       Suicide decedents, no.                     13          19
       Population, no.                          225,992     204,566
45     Farming, Fishing, and Forestry
       Rate rank                                  NR          NR
       Rate per 100,000                           NR          NR
       95% CI                                     NR          NR
       Suicide decedents, no.                      7           5
       Population, no.                          54,068      91,967
47     Construction and Extraction
       Rate rank                                  NR          NR
       Rate per 100,000                           NR          NR
       95% CI                                     NR          NR
       Suicide decedents, no.                      9          14
       Population, no.                          55,164      76,173
49     Installation, Maintenance, and Repair
       Rate rank                                  NR          NR
       Rate per 100,000                           NR          NR
       95% CI                                     NR          NR
       Suicide decedents, no.                      8          NR
       Population, no.                          73,231      46,136

                                                     Rate change

       Occupational group                       %     Rank ([dagger])

27     Arts, Design, Entertainment, Sports,
         and Media
       Rate rank ([section])                   +34%          2
       Rate per 100,000
       95% Cl [paragraph])
       Suicide decedents, no.
       Population, no.
33     Protective Service
       Rate rank                               +5%           9
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
31     Health Care Support
       Rate rank                               +31%          3
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
35     Food Preparation and Serving Related
       Rate rank                               +54%          1
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
23     Legal
       Rate rank                               -17%         15
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
29     Health Care Practitioners and
       Technical
       Rate rank                               -13%         13
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
51     Production
       Rate rank                               +18%          6
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
39     Personal Care and Service
       Rate rank                               +14%          7
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.

41     Sales and Related
       Rate rank                               +20%          5
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
15     Computer and Mathematical
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
53     Transportation and Material Moving
       Rate rank                               -17%         14
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
21     Community and Social Service
       Rate rank                               -17%         16
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
43     Office and Administrative Support
       Rate rank                               +27%          4
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
13     Business and Financial Operations
       Rate rank                               -5%          11
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
37     Building and Grounds Cleaning and
         Maintenance
       Rate rank                               +14%          8
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
11     Management
       Rate rank                               -12%         12
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
25     Education, Training, and Library
       Rate rank                               +3%          10
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
17     Architecture and Engineering
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
19     Life, Physical, and Social Science
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
45     Farming, Fishing, and Forestry
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
47     Construction and Extraction
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.
49     Installation, Maintenance, and Repair
       Rate rank                                NR          NR
       Rate per 100,000
       95% CI
       Suicide decedents, no.
       Population, no.

Abbreviations: CI = confidence interval; NR = not reported; number
of decedents not reported <5, and rates were not calculated for
occupational groups with <20 decedents; SOC = Standard Occupational
Classification.

([dagger]) Rate change rank refers to each occupational group's
rank order for rate change from 2012 to 2015, where rank position 1
signifies the greatest suicide rate increase.
([section])
Occupational groups were ranked by 2015 suicide rate, separately
for males and females. Because of rounding, some rate and rate
change results are not precisely calculable from the data
presented.

([paragraph]) 95% CIs were calculated using CDC's National Center
for Health Statistics methods, including confidence limit factors
for mortality rates based on <100 decedents.
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Author:Peterson, Cora; Stone, Deborah M.; Marsh, Suzanne M.; Schumacher, Pamela K.; Tiesman, Hope M.; McInt
Publication:Morbidity and Mortality Weekly Report
Date:Nov 16, 2018
Words:5868
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