Activity

Activity ID

11212

Expires

September 26, 2026

Format Type

Journal-based

CME Credit

1

Fee

$30

CME Provider: JAMA

Description of CME Course

Importance  Historically elevated risks of suicide among physicians may have declined in recent decades. Yet there remains a paucity of information concerning suicide risks among other health care workers.

Objective  To estimate risks of death by suicide among US health care workers.

Design, Setting, and Participants  Cohort study of a nationally representative sample of workers from the 2008 American Community Survey (N = 1 842 000) linked to National Death Index records through December 31, 2019.

Main Outcomes and Measures  Age- and sex-standardized suicide rates were estimated for 6 health care worker groups (physicians, registered nurses, other health care–diagnosing or treating practitioners, health technicians, health care support workers, social/behavioral health workers) and non–health care workers. Cox models estimated hazard ratios (HRs) of suicide for health care workers compared with non–health care workers using adjusted HRs for age, sex, race and ethnicity, marital status, education, and urban or rural residence.

Results  Annual standardized suicide rates per 100 000 persons (median age, 44 [IQR, 35-53] years; 32.4% female [among physicians] to 91.1% [among registered nurses]) were 21.4 (95% CI, 15.4-27.4) for health care support workers, 16.0 (95% CI, 9.4-22.6) for registered nurses, 15.6 (95% CI, 10.9-20.4) for health technicians, 13.1 (95% CI, 7.9-18.2) for physicians, 10.1 (95% CI, 6.0-14.3) for social/behavioral health workers, 7.6 (95% CI, 3.7-11.5) for other health care–diagnosing or treating practitioners, and 12.6 (95% CI, 12.1-13.1) for non–health care workers. The adjusted hazards of suicide were increased for health care workers overall (adjusted HR, 1.32 [95% CI, 1.13-1.54]), health care support workers (adjusted HR, 1.81 [95% CI, 1.35-2.42]), registered nurses (adjusted HR, 1.64 [95% CI, 1.21-2.23]), and health technicians (adjusted HR, 1.39 [95% CI, 1.02-1.89]), but adjusted hazards of suicide were not increased for physicians (adjusted HR, 1.11 [95% CI, 0.71-1.72]), social/behavioral health workers (adjusted HR, 1.14 [95% CI, 0.75-1.72]), or other health care–diagnosing or treating practitioners (adjusted HR, 0.61 [95% CI, 0.36-1.03) compared with non–health care workers (reference).

Conclusions  Relative to non–health care workers, registered nurses, health technicians, and health care support workers in the US were at increased risk of suicide. New programmatic efforts are needed to protect the mental health of these US health care workers.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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Educational Objectives

To identify the key insights or developments described in this article.

Keywords

Medical Education, Hypertension

Competencies

Medical Knowledge

CME Credit Type

AMA PRA Category 1 Credit

DOI

10.1001/jama.2023.15787

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