Eulji University College of Medicine, Department of Preventive Medicine, Yongdoo-dong 143-5, Joong-gu, Daejeon 301-832, Republic of Korea.
Soc Sci Med. 2010 Apr;70(8):1254-61. doi: 10.1016/j.socscimed.2010.01.004. Epub 2010 Feb 12.
As a result of unprecedented increase in suicides over the last decade, Korea now ranks at the top of OECD countries in suicide statistics (26.1 deaths per 100,000 population in 2005). Our study sought to document socioeconomic inequalities in self-destructive behaviors including suicidal ideation, parasuicide, and completed suicide. For prevalence of suicidal ideation and parasuicide, we used four waves of data from the Korea National Health and Nutrition Examination Survey (1995, 1998, 2001, and 2005). For suicide mortality, we abstracted suicide cases from the National Death Registration records, and linked them with population denominators from the national census in 1995, 2000, and 2005. We examined variation in self-destructive behaviors according to level of educational attainment (at the individual level), as well as area-level characteristics including level of deprivation and degree of urbanicity. Age-standardized rates were calculated through direct standardization using the 2005 census population as the standard. Inequalities were measured by the relative index of inequality and the slope index of inequality. The age-standardized prevalence of suicidal ideation decreased across consecutive surveys in both genders (18.0-13.5% for men, 27.5-22.9% for women). Parasuicides similarly decreased over time. By contrast, completed suicides increased over time (20.9-42.8 per 100,000 for men and 8.9-20.9 for women). The most prominent increases in completed suicides were observed among the elderly in both genders. Lower education, rural residence, and area deprivation was each associated with higher suicide rates. Both absolute as well as relative inequalities in suicide by socioeconomic position widened over time. Our findings suggest that the current suicide epidemic in Korea has social origins. In addition to clinical approaches targeted to the prevention of suicides in high risk individuals, social policies are needed to protect disadvantaged populations at risk of self-destructive behaviors.
由于过去十年自杀率空前上升,韩国目前在经合组织国家的自杀统计数据中排名第一(2005 年每 10 万人中有 26.1 人自杀)。我们的研究旨在记录包括自杀意念、自杀未遂和自杀死亡在内的自我毁灭行为的社会经济不平等现象。对于自杀意念和自杀未遂的流行率,我们使用了韩国国家健康和营养检查调查(1995 年、1998 年、2001 年和 2005 年)的四轮数据。对于自杀死亡率,我们从国家死亡登记记录中提取自杀案例,并将其与 1995 年、2000 年和 2005 年的全国人口普查人口基数相关联。我们根据教育程度(个人层面)以及包括贫困程度和城市化程度在内的地区特征,检查了自我毁灭行为的变化。通过使用 2005 年人口普查作为标准,对年龄标准化率进行了直接标准化计算。不平等程度通过相对不平等指数和斜率不平等指数来衡量。在男性中,自杀意念的年龄标准化流行率在连续的调查中呈下降趋势(18.0-13.5%),在女性中呈下降趋势(27.5-22.9%)。自杀未遂也随着时间的推移而减少。相比之下,自杀死亡人数随着时间的推移而增加(男性为每 10 万人 20.9-42.8 人,女性为每 10 万人 8.9-20.9 人)。在两性中,老年人的自杀死亡人数增幅最大。较低的教育水平、农村居住和地区贫困与较高的自杀率相关。随着时间的推移,社会经济地位导致的自杀的绝对和相对不平等都在扩大。我们的研究结果表明,目前韩国的自杀浪潮具有社会根源。除了针对高危人群预防自杀的临床方法外,还需要社会政策来保护面临自我毁灭行为风险的弱势群体。
J Ment Health Policy Econ. 2013-9
Suicide Life Threat Behav. 2010-10
World Health Stat Q. 1993
Soc Psychiatry Psychiatr Epidemiol. 2024-11
J Korean Med Sci. 2023-12-18