Job Strain, Long Work Hours, and Suicidal Thoughts

Posted on by Sarah Mitchell, MPH, and BongKyoo Choi, ScD, MPH

September 9-15th, 2018 is National Suicide Prevention week. Workplace suicide and mental health in general are often underrepresented in workplace health and safety discussions. However, globally, more than 300 million people suffer from depression, the leading cause of disability (WHO, 2017). In the US, the suicide mortality rate increased by 24% from 1999 to 2014, particularly among middle-age adults. The suicide mortality rate in US working populations has been also on the rise.

A recent study by Dr. BongKyoo Choi at University of California Irvine, Job Strain, Long Work Hours, and Suicidal Ideation in US Workers: A Longitudinal Study, addresses aspects of work that can impact suicidal ideation, or suicidal thoughts, in workers.

Currently, there are only a few longitudinal studies that examine chronic psychosocial work stressors related to attempted suicide or mortality in working populations (Milner et al 2018), and few control for family history. The purpose of the study was to investigate whether chronic psychosocial work stressors (job strain, supervisor and coworker support, job insecurity, job control, and work hours) are longitudinally associated with suicidal ideation in a middle-aged US working population, particularly after controlling for a family history of suicide. It is necessary to identify the work-related risk factors for suicidal thoughts to help prevent suicide among working populations.

The study used data from the National Survey of Midlife Development in the United States (MIDUS) II study (2004-2009), which examines the “roles of behavioral, psychological, and social factors in understanding age-related differences in physical and mental health.” Of the 582 study subjects, those who identified as experiencing some kind of suicidal thoughts answered the following question positively, “During the past week, how much you have felt or experienced thought about death or suicide? (Not at all, A little bit, Moderately, Quite a bit, or Extremely)” during the follow-up.

About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. Results show that there are significantly positive associations of job strain (a combination of low job control and high job demands) and long work hours (> 40 hours per week) with moderate to severe suicidal ideation in a working population, controlling for age, marital status, other chronic work stressors, family history of suicide, and suicidal ideation at baseline. The odds for moderate to severe suicidal ideation were about four times greater in those with job strain or those who reported long work hours. This means that job strain and long work hours may be categorized as occupational risk factors for suicidal thoughts in working populations. These results indicate that job design interventions to improve working conditions may be an important strategy to prevent suicide in working populations.

Suicide prevention programs at the workplace are often focused on training and education for detecting those at high risk of suicide and connecting them with mental health services. This helps to address those already considering suicide but does not address the source of suicide ideation. This study suggests that creating and maintaining a healthy work organization should be an important strategy for the prevention of suicide in working populations.

While work is good for mental health, negative working conditions can cause harm to one’s physical and mental health (WHO 2018). There are many effective strategies that organizations can implement to promote better mental health in the workplace. The NORA Healthy Work Design and Well-being Cross-sector Council works with partners to improve the design of work, work environments, and management practices in order to advance worker safety, health, and well-being. For more information, check out resources below.

We would like to hear from you. How has your company taken steps to promote better mental health or implement suicide prevention programs? What challenges does your organization face in implementing programs that promote better mental health in the workplace? Please share them in the comment sections below.


Sarah Mitchell, MPH, is an ORISE Fellow working in Research Translation and Communication in the NIOSH Office for Total Worker Health ®.

BongKyoo Choi, ScD MPH, is an Assistant Professor, at the University of California, Irvine, School of Medicine, Center for Occupational and Environmental Health, and Environmental Health Sciences Graduate Program and Program in Public Health. He is also a member of the NORA Healthy Work Design and Well-being Cross-Sector Council.   


This research was presented at the 2nd International Symposium to Advance Total Worker Health® in May, 2018. For more information on the symposium and the other research presented click here:



Choi B. Job strain, long work hours, and suicidal ideation in US workers: a longitudinal study. Int Arch Occup Environ Health.2018; 91 (7): 865-875.

McIntosh WL, Spies E, Stone DM, Lokey CN, Trudeau AT, Bartholow B. Suicide Rates by Occupational Group — 17 States, 2012. MMWR Morb Mortal Wkly Rep 2016;65:641–645. DOI:

Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med. 2018;75(4):245-253 https :// -2017-104531

WHO 2018 <>


NIOSH Related Resources:

Previous NIOSH Science Blog on Workplace Suicide

NIOSH Stress at Work Topic Page

NIOSH Healthy Work Design and Well-being Program

Fundamentals of Total Worker Health® Approaches: Essential Elements for Advancing Worker Safety, Health, and Well-Being

Previous NIOSH Science Blogs on Stress


Other Related Resource:

The LuvU Project


Posted on by Sarah Mitchell, MPH, and BongKyoo Choi, ScD, MPH

8 comments on “Job Strain, Long Work Hours, and Suicidal Thoughts”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Suicide is still treated as the dirty little secret, banished to hush conversation and whispers, never properly addressed and confronted. CDC/NIOSH WTC Health program and the Agencies who responded to the World Trade Center are right there in the forefront of this problem. If the Rescue and Recovery worker commits suicide his death is not counted as a WTC related death, even if it is clearly spelled out in the suicide note. cited work Mortality among rescue and recovery workers and community members exposed to the September 11, 2001 World Trade Center terrorist attacks,2003–2014. I have seen great men and women break, I have read the sad stories of some of the best paramedics and fire chiefs who have had that one bad call too many, and ended their lives. The problem is first responders usually get it right the first time, ensuring the desired outcome. Suicide needs to be treated as a disease and the social penalties and stigmas need to be removed. Everyone has a breaking point, to deny this is crazy. A first responder or anyone should be able to say I need to speak, I need a break, I need help, without fear of repercussion or penalty for doing so.

    Thanks for your comments and reminding us of the high suicide risk of first responders. The three occupations with the largest workplace suicide rate were protective service occupations (i.e. police officers and fire-fighters) at 5.3 per 1,000,000 workers, farming/fishing/and forestry occupations with 5.1 per 1,000,000, and installation, maintenance, and repair occupations (i.e. auto mechanics) at 3.3 per 1,000,000.

    Thanks you and I admire you to have the courage the talk about this,This was a very meaningful post for me. Thank you.

    The retail industry is still all but ignored when it comes to suicidal ideation. I confidently guess around 15% of retail thinks about suicide at least once per month. I, personally, am closer to daily but I have an abusive boss and a house payment, so no fix for me lol.
    It’s great to post bits like this for HR people, but HR people are’nt actually reading them. And those that do are powerless to change anything.
    There needs to be a fundamental shift in the way we care for workers if we dont want to keep seeing them kill themselves.

    If you or someone you know needs support now, call or text 988 or chat 988 connects you with a trained crisis counselor who can help.

    The NIOSH Total Worker Health® program highlights the important role employers have in addressing the work environment, while also ensuring that workers have a voice in decisions about working conditions. We encourage readers to share the blog Critical Steps Your Workplace Can Take Today to Prevent Suicide with leaders in their organizations.

    I am looking for research that goes into job strain more in-depth. Specifically, I am looking for studies of construction that show the strain on workers of harsh communication such as yelling and degrading “jokes”. That show the strain of male-on-male harassment and bullying. As a former construction worker, I observed many instances of this and saw for myself how it affected the emotional stability of my co-workers. And I believe, but have not seen any studies, that experiencing these things leads to the high suicide rate of construction workers. Thanks for any studies you might recommend.

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Page last reviewed: May 23, 2019
Page last updated: May 23, 2019