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Original article

Vol. 150 No. 2122 (2020)

Time trend of suicide in Swiss male farmers and comparison with other men: a cohort study

  • Nicole Steck
  • Christoph Junker
  • Matthias Bopp
  • Matthias Egger
  • Marcel Zwahlen
Cite this as:
Swiss Med Wkly. 2020;150:w20251



The ongoing agricultural reforms present serious challenges for Swiss farmers. Pressure is growing with difficult economic situations and the increasing demands for environmental protection, animal welfare and food safety. The aim of this study was to determine whether the strain is associated with higher risk of suicide in farmers than in men in other professions. We also wanted to analyse any changes in trends over time.


Using the Swiss National Cohort, a population-based longitudinal study (1991–2014), we investigated suicide rates for Swiss men aged 35 to 74 years who lived in small communities. We calculated crude rates of suicide and standardised mortality ratios (SMRs) for both calendar periods of four years, and overall. We estimated hazard ratios using Cox proportional hazard regression models of increasing complexity to examine associations with profession (farmer, non-farmer), calendar period, marital status, type of household, religion and language region.


We identified 9006 suicides among 1,796,379 men in the total study population, of which 447 occurred in 89,303 farmers. Age-standardised rates of suicide per 100,000 person-years were higher (38.1, 95% CI 34.6–41.8) in farmers than in men with other professions (32.6, 95% CI 31.9–33.3). Although the age-standardised rates decreased for the whole study population until 2006, the declining trend continued afterwards only in non-farmers. The widening gap between farmers and non-farmers also showed in the SMR, which increased from 1.06 (95% CI 0.88–1.27) in the period 1991–1994 to 1.37 (95% CI 1.05–1.79) in 2011-2014. The Cox regression model analyses also revealed a higher risk of suicide for farmers, with hazard ratios ranging from 1.10 (95% CI 1.00–1.22) to 1.17 (95% CI 1.07–1.29). Usage of firearms was the most common method in the overall population (36.5%). In farmers, however, almost 60% committed suicide by hanging.


The study shows a higher rate of suicide in farmers compared to non-farmers in Switzerland, with the gap widening increasingly after 2006. It underlines the importance of identifying the difficulties and concerns of male farmers at an early stage in order to make appropriate structural adjustments and to offer low-threshold assistance tailored to their needs and preferences.


  1. Federal Statistical office. Todesfälle: Anzahl, Entwicklung und Ursachen. 2014.
  2. eurostat. Eurostat - Death due to suicide, by sex. (accessed 6 Aug 2019).
  3. Steck N, Zwahlen M, Egger M ; Swiss National Cohort. Time-trends in assisted and unassisted suicides completed with different methods: Swiss National Cohort. Swiss Med Wkly. 2015;145:w14153. doi:.
  4. Fountoulakis KN, Kawohl W, Theodorakis PN, Kerkhof AJ, Navickas A, Höschl C, et al. Relationship of suicide rates to economic variables in Europe: 2000-2011. Br J Psychiatry. 2014;205(6):486–96. doi:.
  5. Barr B, Taylor-Robinson D, Scott-Samuel A, McKee M, Stuckler D. Suicides associated with the 2008-10 economic recession in England: time trend analysis. BMJ. 2012;345(aug13 2):e5142. doi:.
  6. Chang SS, Stuckler D, Yip P, Gunnell D. Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ. 2013;347(sep17 1):f5239. doi:.
  7. Lorant V, Kunst AE, Huisman M, Costa G, Mackenbach J ; EU Working Group on Socio-Economic Inequalities in Health. Socio-economic inequalities in suicide: a European comparative study. Br J Psychiatry. 2005;187(1):49–54. doi:.
  8. Steck N, Egger M, Zwahlen M ; Swiss National Cohort. Assisted and unassisted suicide in men and women: longitudinal study of the Swiss population. Br J Psychiatry. 2016;208(5):484–90. doi:.
  9. Milner A, Spittal MJ, Pirkis J, LaMontagne AD. Suicide by occupation: systematic review and meta-analysis. Br J Psychiatry. 2013;203(6):409–16. doi:.
  10. Bossard C, Santin G, Guseva Canu I. Suicide Among Farmers in France: Occupational Factors and Recent Trends. J Agromed. 2016;21(4):310–5. doi:.
  11. Gregoire A. The mental health of farmers. Occup Med (Lond). 2002;52(8):471–6. doi:.
  12. Alexopoulos EC, Kavalidou K, Messolora F. Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study. Saf Health Work. 2016;7(1):1–5. doi:.
  13. Hagen BNM, Albright A, Sargeant J, Winder CB, Harper SL, O’Sullivan TL, et al. Research trends in farmers’ mental health: A scoping review of mental health outcomes and interventions among farming populations worldwide. PLoS One. 2019;14(12):e0225661. doi:.
  14. Kunde L, Kõlves K, Kelly B, Reddy P, De Leo D. Pathways to Suicide in Australian Farmers: A Life Chart Analysis. Int J Environ Res Public Health. 2017;14(4):352. doi:.
  15. Perceval M, Ross V, Kõlves K, Reddy P, De Leo D. Social factors and Australian farmer suicide: a qualitative study. BMC Public Health. 2018;18(1):1367. doi:.
  16. Hawton K, Fagg J, Simkin S. Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976-1993. Br J Psychiatry. 1996;169(2):202–8. doi:.
  17. Daghagh Yazd S, Wheeler SA, Zuo A. Key risk factors affecting farmers’ mental health: A systematic review. Int J Environ Res Public Health. 2019;16(23):4849. doi:.
  18. Agrarreform - Schweizer Landwirtschaft. (accessed 1 Nov 2018).
  19. Federal Statistical Office. Landwirtschaft und Ernährung - Taschenstatistik 2016 | Publikation. 2016. (accessed 1 Nov 2018).
  20. Federal Statistical Office. Landwirtschaft und Ernährung - Taschenstatistik 2019 | Publikation. 2019. (accessed 6 Aug 2019).
  21. Federal Statistical Office. Schweizer Landwirtschaft - Taschenstatistik 2010 | Publikation. 2010. (accessed 6 Aug 2019).
  22. Agroscope. Agrarbericht 2018 - Publikationen. 2018. (accessed 6 Aug 2019).
  23. Sascha Buchbinder. Selbstmorde: Ihn packt die Wut. Zeit Online. 2016. (accessed 1 Nov 2018).
  24. Chi T. Wachsender Druck treibt viele Bauern in den Suizid. TagesAnzeiger. 2016. (accessed 1 Nov 2018).
  25. Bühlmann R. Suizid – Meldungen reissen nicht ab. Schweizer Bauer. 2017.–-meldungen-reissen-nicht-ab-33294.html (accessed 1 Nov 2018).
  26. Bundesamt für Statistik. Berufsspezifische Mortalitätsrisiken der Männer in der Schweiz 1979/83 | Publikation. Neuchâtel: 1997. (accessed 17 Sep 2019).
  27. Guseva Canu I, Bovio N, Mediouni Z, Bochud M, Wild P ; Swiss National Cohort (SNC). Suicide mortality follow-up of the Swiss National Cohort (1990-2014): sex-specific risk estimates by occupational socio-economic group in working-age population. Soc Psychiatry Psychiatr Epidemiol. 2019;54(12):1483–95. doi:.
  28. Bopp M, Spoerri A, Zwahlen M, Gutzwiller F, Paccaud F, Braun-Fahrländer C, et al. Cohort Profile: the Swiss National Cohort--a longitudinal study of 6.8 million people. Int J Epidemiol. 2009;38(2):379–84. doi:.
  29. Spoerri A, Zwahlen M, Egger M, Bopp M. The Swiss National Cohort: a unique database for national and international researchers. Int J Public Health. 2010;55(4):239–42. doi:.
  30. Renaud A. Methodology Report - Coverage Estimation for the Swiss Population Census 2000. Swiss Federal Statistical Office 2004.
  31. Klingelschmidt J, Milner A, Khireddine-Medouni I, Witt K, Alexopoulos EC, Toivanen S, et al. Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis. Scand J Work Environ Health. 2018;44(1):3–15. doi:.
  32. Merriott D. Factors associated with the farmer suicide crisis in India. J Epidemiol Glob Health. 2016;6(4):217–27. doi:.
  33. Federal Statistical office. Beschäftigte, Landwirtschaftliche Betriebe, Landwirtschaftliche Nutzfläche (LN) und Nutztiere auf Klassifizierungsebene 1 nach Kanton. (accessed 13 Feb 2019).
  34. Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016;387(10024):1227–39. doi:.
  35. Hawton K, van Heeringen K. Suicide. Lancet. 2009;373(9672):1372–81. doi:.
  36. Reisch T, Steffen T, Habenstein A, Tschacher W. Change in suicide rates in Switzerland before and after firearm restriction resulting from the 2003 “Army XXI” reform. Am J Psychiatry. 2013;170(9):977–84. doi:.
  37. Yip PSF, Caine E, Yousuf S, Chang SS, Wu KC, Chen YY. Means restriction for suicide prevention. Lancet. 2012;379(9834):2393–9. doi:.
  38. Rihmer Z. Can better recognition and treatment of depression reduce suicide rates? A brief review. Eur Psychiatry. 2001;16(7):406–9. doi:.
  39. Torske MO, Hilt B, Glasscock D, Lundqvist P, Krokstad S. Anxiety and Depression Symptoms Among Farmers: The HUNT Study, Norway. J Agromed. 2016;21(1):24–33. doi:.
  40. Roy P, Tremblay G, Robertson S, Houle J. “Do it All by Myself”: A Salutogenic Approach of Masculine Health Practice Among Farming Men Coping With Stress. Am J Men Health. 2017;11(5):1536–46. doi:.
  41. Obsan. Regionale psychiatrische Inanspruchnahme und Versorgungsbedarf in der Schweiz. 2013.
  42. Roy P, Tremblay G, Oliffe JL, Jbilou J, Robertson S. Male farmers with mental health disorders: a scoping review. Aust J Rural Health. 2013;21(1):3–7. doi:.
  43. Hounsome B, Edwards RT, Hounsome N, Edwards-Jones G. Psychological morbidity of farmers and non-farming population: results from a UK survey. Community Ment Health J. 2012;48(4):503–10. doi:.
  44. Tøllefsen IM, Hem E, Ekeberg Ø. The reliability of suicide statistics: a systematic review. BMC Psychiatry. 2012;12(1):9. doi:.

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