Program in Public Health, Graduate School, Korea University, Seoul, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea.
Department of Preventive Medicine, Eulji University, 77 Gyeryong-ro 771beon-gil, Yongdu-dong, Jung-gu, Daejeon, Republic of Korea.
J Affect Disord. 2021 Nov 1;294:889-896. doi: 10.1016/j.jad.2021.07.102. Epub 2021 Aug 1.
Socioeconomic factors influence suicide risk but a systematic understanding of the role of financial hardship is unclear. We examined whether financial hardship had cumulative or contemporaneous impacts on suicide ideation and any gender and age differences in a large Korean sample.
Data of 67,728 observations from 14,321 individuals were extracted from seven waves of Korean Welfare Panel Study. The association of financial hardship at baseline and its change over two years with suicide ideation was investigated using generalized estimation equation to account for repeated measurements within an individual, adjusting for other socioeconomic factors.
Financial hardship was associated with suicide ideation but the magnitude of association varied across age and gender groups. Specifically, the impact of financial hardship was persistent over two years presenting a cumulative effect among men aged 50-64 years and ≥65 years; e.g., adjusted OR (adjusted odds ratio) = 3.87, 95 % CI = 2.71-5.54 for emergent hardship group vs adjusted OR = 4.22, 95 %CI = 3.00-5.93 for persistent group in those aged ≥65 years. Financial hardship increased the risk of suicide ideation incrementally with age, although the pattern was less clear among women.
Financial hardship was identified as having changing nature, though it was assumed to occur over two years.
In general, financial hardship plays a role in amplifying suicide ideation in a contemporaneous way but also in a cumulative way, predominantly among late-middle-aged and elderly men. Monitoring and intervention for financial hardship would be a promising strategy for suicide prevention.
社会经济因素会影响自杀风险,但对于经济困难所起的作用,我们还没有系统的认识。我们在一个大型韩国样本中检验了经济困难是否对自杀意念有累积或同期影响,以及是否存在性别和年龄差异。
从韩国福利纵向研究的七轮数据中提取了 14321 名个体的 67728 个观测值。使用广义估计方程,考虑到个体内部的重复测量,在调整其他社会经济因素的同时,调查了基线时的经济困难及其在两年内的变化与自杀意念的关系。
经济困难与自杀意念有关,但关联的程度在不同年龄和性别群体中有所不同。具体来说,经济困难的影响在两年内持续存在,对 50-64 岁和≥65 岁的男性呈现出累积效应;例如,对于新出现的困难组,调整后的比值比(调整后的优势比)=3.87,95%置信区间(95%置信区间)=2.71-5.54;对于持续困难组,调整后的比值比=4.22,95%置信区间=3.00-5.93。经济困难随着年龄的增长增加自杀意念的风险,尽管女性的模式不太明显。
虽然假设经济困难在两年内发生变化,但它是作为一个具有变化性质的变量来确定的。
一般来说,经济困难在同期以一种放大自杀意念的方式发挥作用,但主要在中老年男性中也以一种累积的方式发挥作用。监测和干预经济困难将是预防自杀的一个有前途的策略。