Institute of Health and Environment, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
Institute of Health Policy and Management, Seoul National University Medical Research Center, 71 Ihwajang-gil, Jongno-gu, Seoul, 03087, Republic of Korea.
BMC Public Health. 2024 Sep 2;24(1):2380. doi: 10.1186/s12889-024-19899-4.
Suicide mortality remains a global health concern, and community characteristics affect regional variations in suicide. This study investigated spatially clustered patterns of suicide mortality rates in South Korea and evaluated the impact of community factors on suicide.
Suicide mortality rates were estimated by sex, age group, and district, using the 2021 Cause of Death Statistics in South Korea from the MicroData Integrated Service. Community-determinant data for 2021 or the nearest year were collected from the Korean Statistical Information Service. The spatial autocorrelation of suicide by sex and age was examined based on Global Moran's I index. Geographically weighted regression (GWR) was used to discern the influence of community determinants on suicide.
Suicide mortality rates were significantly higher among men (40.64 per 100,000) and adults over the age of 65 years (43.18 per 100,000). The male suicide mortality rates exhibited strong spatial dependence, as indicated by a high global Moran's I with p < 0.001, highlighting the importance of conducting spatial analysis. In the GWR model calibration, a subset of the community's age structure, single-person household composition, access to mental healthcare centers, and unmet medical needs were selected to explain male suicide mortality. These determinants disproportionately increased the risk of male suicide, varying by region. The GWR coefficients of each variable vary widely across 249 districts: aging index (Q1:0.06-Q3:0.46), single-person households (Q1:0.22-Q3:0.35), psychiatric clinics (Q1:-0.20-Q3:-0.01), and unmet medical needs (Q1:0.09-Q3:0.14).
Community cultural and structural factors exacerbate regional disparities in suicide among men. The influencing factors exhibit differential effects and significance depending on the community, highlighting the need for efficient resource allocation for suicide. A regionally tailored approach is crucial for the effective control of the community's mental health management system.
自杀死亡率仍然是一个全球关注的健康问题,社区特征影响着自杀的区域差异。本研究调查了韩国自杀死亡率的空间聚类模式,并评估了社区因素对自杀的影响。
使用韩国微观数据综合服务 2021 年死因统计数据,按性别、年龄组和地区估计自杀死亡率。从韩国统计信息服务中收集了 2021 年或最近年份的社区决定因素数据。基于全局 Moran's I 指数,检查了按性别和年龄划分的自杀的空间自相关。使用地理加权回归(GWR)来辨别社区决定因素对自杀的影响。
男性(40.64/10 万)和 65 岁以上成年人(43.18/10 万)的自杀死亡率显著较高。男性自杀死亡率表现出强烈的空间依赖性,全局 Moran's I 很高,p<0.001,这表明进行空间分析的重要性。在 GWR 模型校准中,选择了社区年龄结构、单人家庭组成、获得精神卫生保健中心的机会和未满足的医疗需求的一部分来解释男性自杀死亡率。这些决定因素不成比例地增加了男性自杀的风险,因地区而异。249 个地区的每个变量的 GWR 系数差异很大:老龄化指数(Q1:0.06-Q3:0.46)、单人家庭(Q1:0.22-Q3:0.35)、精神病诊所(Q1:-0.20-Q3:-0.01)和未满足的医疗需求(Q1:0.09-Q3:0.14)。
社区文化和结构因素加剧了男性自杀的地区差异。影响因素因社区而异,具有不同的影响和重要性,这突出了有效分配资源进行自杀预防的必要性。区域性的方法对于有效控制社区心理健康管理系统至关重要。