Social influences on suicide in South Korea

Abstract

The suicide rate in South Korea has increased sharply over the last two decades. This is a significant public health concern. Social influences, including internal migration, economic recession, and media coverage of suicide have all been proposed as factors which affect suicide at the population level. An improving death classification can also lead to an “artificial” increase in suicide statistics. This thesis evaluates these influences on suicide rates in South Korea. Data used in this thesis were mainly collected from Statistics Korea, which is the official government body to collect and disseminate Korean national data. Analytical approaches employed in this thesis were spatial analysis and time-trend investigation.

The first investigation shows that, during a period where South Korea’s death classification was steadily improving (1992-2011), the increase in suicide corresponded to a reduction in the accidental death rate. The results indicate that the increase in suicide in South Korea in earlier years was masked, in part, by misclassification, and so could be partly attributable to its administrative improvements.

The second investigation illustrates a substantial change in geospatial inequalities in suicide in South Korea from 1992-2012, when the country was undergoing a rigorous process of internal migration. To be more specific, at the beginning of the study period (1992-1996), the suicide rates for older adults were higher in urban areas. Subsequently, the suicide rate increased faster among rural-dwelling elders, as compared to their urban counterparts, so that they were higher by the end of the study period (2008-2012). In contrast, suicide rates among the younger-age were higher in rural regions throughout the entire study period. In this context, the increase in suicide rates among this population were greater among urban dwellers, resulting in a reduction in the overall rural-urban difference.

The third investigation addresses the impact of the 2008 economic crisis on suicide in South Korea. It shows that the increase in unemployment was significantly associated with the rise in the suicide rates among both the employed and unemployed, with a two-to-three month lag. It also demonstrates that, during the recession of 2009-2010, there was a significant increase in the suicide rate of working-age adults in most subgroups stratified by age, sex, employment status and occupational categories.

The fourth investigation examines the impact of media coverage of celebrity suicide on subsequent suicide rates in South Korea from 2003-2009. The analysis shows that three of eleven celebrity suicide incidents were followed by a significant increase in Korean national suicides, controlling for secular trends, seasonality, and unemployment. Also, two high-profile celebrity suicides elicited a small but significant increase in suicide toward the end of the study period, indicating the significant longer-term impact of media coverage.

This thesis highlights social influences on suicide in the South Korean context. Its findings draw the attention of public health professionals to the contextual influences on suicide.