Household income during childhood and risk of youth suicide attempts and deaths: a register-based study from Finland.

purposeSocioeconomic inequalities during childhood are related to a variety of adverse mental health outcomes. However, youth suicide deaths have rarely been studied in this respect. We examined whether household income during childhood is associated with the risk of youth suicide attempts and deaths.

methodsIn this register-based cohort study all individuals born in Finland between 1991 and 2005 were followed from the age of 15 to either suicide or suicide attempt, death by other causes, emigration, or the end of the study period (31st December 2020). Household income was measured throughout childhood with two commonly used measures, cumulative income and income trajectories, and at specific ages (5, 10, and 15). Penalized splines and Cox regression models estimated the associations between household income and suicide attempts and deaths. We selected additionally adjusted models with a best-fitting set of cofactors for both outcomes. Additionally, we reported income-specific cumulative risks.

resultsDuring the follow-up period of 6.8 million person-years (n = 886,748), 9,811 first suicide attempts (60.9% females) and 964 suicides (28.5% females) occurred. Lower household income was associated with an increased risk of suicide attempts after adjusting for cofactors including parental mental disorders, suicide, education, urbanicity, birth origin and age. However, household income was not associated with suicide deaths when parental mental disorders were considered.

conclusionLow income during childhood is associated with youth suicide attempts, but not with suicide deaths. Dying from suicide is a rare and extreme event, and treating non-lethal suicidal acts as a proxy for suicide requires caution.