Differences in all-cause and suicide mortality between health care and other employees in Lithuania: a census-linked mortality follow-up study, 2011-2019

Abstract

Abstract Background Lithuania shows one of the highest suicide rates worldwide. Studies from other countries report the elevated suicide risk among certain healthcare occupations even though mortality from other causes of death among medical doctors has become generally lower than mortality in the general population. Methods This study is based on the census-linked mortality dataset covering the entire population of Lithuania. The anonymised individual-level dataset includes all records from the 2011 census and death and emigration records between 1 March 2011 and 31 December 2019. The main variable of analysis identifies three groups: physicians, nurses and assistant nurses, and other health care employees. All-cause and suicide mortality rate ratios were estimated using a simple Cox survival regression model controlling for sex and age. Results Physicians, nurses and assistant nurses, and other health care employees have significantly higher all-cause mortality than the highly educated employees working in all other sectors (1.32 (1.07–1.64), 1.42 (1.21–1.66), and 1.48 (1.23–1.76), respectively). The corresponding rate ratios for suicide risk were 1.75 75 (0.87–3.55) for physicians and 0.58 (0.19–1.82) for nurses and assistant nurses, indicating lacking statistically significant relationships. Lacking statistically significant results for suicides can be explained by overall very low numbers of suicides among highly educated people (also including health workers). Conclusions The study indicates that healthcare workers show statistically significant excess all-cause mortality. The same (albeit statistically insignificant) tendency was observed in suicide risk among physicians.