For decades, boys have committed suicide far more frequently than girls, even though girls attempt suicide and report contemplating it more often.
In the suicide prevention world, the phenomenon is known as the gender paradox.
The paradox still exists today—but a new study published in JAMA Psychiatry suggests the gap not between male and female but between female nurses and other women.
Female nurses are also 70 percent more likely to take their own lives than female doctors, according to the findings.
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And researchers say the “extraordinary” demands that the Covid-19 pandemic has placed on women – from homeschooling to finding child care – will further increase the stress on nurses.
Study lead author Dr. Matthew Davis, Associate Professor at University of Michigan School of Nursing in the US, said: “It’s much higher than I expected.
“The takeaway for me is we’ve focused so much on physician welfare that, historically, we haven’t paid enough attention to this huge workforce that, based on our data, is at much higher risk.”
Dr Davis explained that the study did not include data from the pandemic, meaning the numbers “could be even higher” now.
The research team analyzed mortality data from 2007 to 2018, identifying 2,374 suicides among nurses, 857 among doctors, and 156,141 in the general US population.
Co-author Professor Christopher Friese, of the University of Michigan School of Public Health, said nurses and physicians face many similar risk factors for suicide, but those risk factors are “potentially exacerbated” in nurses by long hours and less autonomy.
He said: “I’m worried about two key issues in today’s workplace.
“First, health care systems are placing increased demands on nurses, physicians and other health care workers.
“Even before Covid, nurses reported substantial workplace stressors, including reduced staffing, increased complexity of care and additional bureaucratic tasks.
“Nurses have been working non-stop caring for seriously ill patients and facing their own exposure to this virus.
“Second, the nurses I work with routinely face tougher challenges at home that place added stress on them, such as caregiving for children or parents.
“You put the workplace and home stressors together and it’s no surprise that nurses are struggling. I worry that without concerted action, things may get worse before they get better.”
Study co-author Professor Julie Bynum, of Michigan Medicine, says she has been struck by the widespread use of data to better understand women’s health.
However, she added: “Until our recent paper, it has not been used to understand the health of these women – as nurses – who are central to a well-functioning health care workforce.”
“As the population ages, the need for both bedside nurses and nurses who take on roles as advanced practitioners will become ever more crucial.”
Among male nurses, the risk of suicide is no higher than the general male population, the study found.
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But the researchers were surprised by the high number of suicides among female nurses compared to doctors, and they found no difference in the suicide rates of physicians and the general public, which differs from previous studies.
Prof Friese says one major hurdle to seeking help is the stigma that people fear for their livelihoods.
He said: “Employers need to make it easy for nurses, doctors and other health care workers who are struggling to access the help they need.”
The findings, published in JAMA Psychiatry, also show that nurses are 90 per cent more likely to experience on-the-job problems and 20 to 30 per cent more likely to be depressed than the general population.
The most common form of suicide among nurses was overdose, according to the findings.
Both nurses and doctors are more likely to have antidepressants, benzodiazepines, barbiturates, and opiates in their system which, the researchers say, suggests a need for greater behavioral health awareness among health care professionals.
Prof Davis added: “The reason we looked at this is because people who work in health care have easier access to medications and know how to use them to overdose, which also increases their risk.
“Simply not having a way to do it may be enough of a deterrent to suicide.”