Associated Factors with the Trajectory of Local Elderly Suicide Rate

Background/Purpose: The elderly mortality rates associated with suicide in South Korea is the highest among the members of the OECD. With the population of the elderly increasing rapidly, suicides among the elderly is an important public health concern that poses challenges for prevention strategies. However, there have been very few studies in South Korea that have explored trend of elderly suicide rate and examined factors related to elderly suicide rate at the regional level. Thus, this study aims to estimate the trajectory of elderly suicide rates in 229 local governments and to examine the associated factors with the trajectory.

Methods: We used the data generated from various related data sets including the causes of death statistics by Statistical Office and administrative data from 229 local governments over 2012 to 2018. Data were analyzed with latent growth curve modeling: (i) To estimate the trajectory of elderly suicide rates, we constructed an unconditional model. (ii) To examined factors related associated with the trajectory of local elderly suicide rate, we examined a conditional model after adding economic factors(i.e., the recipient rates of national basic livelihood security benefit among the elderly aged 65 and over and the recipient rates of old age pension), social factors(i.e., crude divorce rate and number of senior leisure welfare facilities per 1,000 elderly), and mental health infrastructure factors(i.e., number of psychiatrists per 100,000 people and number of community mental health centers per 100,000 people).

Results: Major findings are as follows. First, the results of unconditional model revealed that the trajectory of local elderly suicide rates rapidly decreased at the beginning of the 7-year research period and then slowly decreased during the later part of the research period. Second, the results of conditional model showed that several economic, social, and mental health infrastructure factors were significantly associated with the trajectory of local elderly suicide rate. Specifically, [i] higher the recipient rates of national basic livelihood security benefit among the elderly aged 65 (β=-.204, p<.05) and higher the number of psychiatrists per 100,000 people (β=-.168, p<.01) were associated with lower initial local elderly suicide rate. Also, this trend remained unchanged over time (β=.040, p>.05; β=.052 p>.05, respectively). [ii] Regions with higher the recipient rates of old age pension were lower in initial suicide rate (β=-.387, p<.001) and experienced a lesser reduction in suicide rate over time (β=.138, p<.001). [iii] Higher crude divorce rate (β=.263, p<.001), higher number of senior leisure welfare facilities per 1,000 elderly (β=.293, p<.05), and higher number of community mental health centers per 100,000 people (β=.205, p<.001) were associated with higher initial local elderly suicide rate and with greater decline in local elderly rate over time (β=-.078, p<.05; β=-.172 p<.05; β=-.077 p<.05, respectively).

Conclusion/Implications: This research contributes to the accumulation of knowledge in the study of elderly suicide by identifying the trend of elderly suicide rate over time and related factors. Based on these results, we suggest that practitioners and researchers should take into account the economic, social, and mental health infrastructure factors that affect elderly suicide problem.