Risk of Suicide among US Adults with Work Disability.

Introduction: Prior research has not evaluated whether US adults with federally qualified work disability have an increased risk of suicide. A basic understanding of their suicide risk could help inform preventive interventions.

Methods: A nationally representative sample, ages 20-61 years, from the 2008 American Community Survey (N=2,403,000) was followed through 2019 to calculate suicide rates with 95% confidence intervals per 100,000 person-years. Cox models estimated hazard ratios of suicide for adults with compared to without work disability controlling for age, sex, race and ethnicity, marital status, education, residence, employment, and income. Separate models were stratified by age, sex, and functional impairment (hearing, visual, cognitive, mobility, self-care, and independent living skills). Data were collected in 2008-2019 and analyzed in 2025.

Results: Annual suicide rates per 100,000 persons were 34.6 (95%CI=31.0-38.4) for adults with disability and 13.5 (95%CI=13.1-38.4) for those without work disability. After controlling for age, sex, race and ethnicity, marital status, education, residence, employment, and income, the adjusted hazards of suicide for work disability were 1.44 (95%CI=1.26-1.64). In fully adjusted models, hazards of suicide for work disability were 1.90 (95%CI=1.52-2.38) for females and 1.30 (95%CI=1.11-1.52) for males and 1.84 (95%CI=1.46-2.31) for younger adults and 1.29 (95%CI=1.11-1.51) for older adults. Adults with work disabilities and each functional impairment, except hearing, had significantly increased hazards of suicide.

Conclusions: Relative to US adults without work disability, US adults with work disability were at increased risk of suicide, including especially women, younger adults, and those with a visual, cognitive, mobility, self-care, or independent-living impairment.