Suicide Rate and Social Environment Characteristics in South Korea: The Roles of Socioeconomic, Demographic, Urbanicity, General Health Behaviors, and Other Environmental Factors On Suicide Rate

Background: Suicide is a serious worldwide public health concern, and South Korea has shown the highest suicide rate among Organisation for Economic Co-operation and Development (OECD) countries since 2003. Nevertheless, most previous Korean studies on suicide had limitations in investigating various social environment factors using long-term nationwide data. Thus, this study aimed to examine how various social environment characteristics are related to the suicide rate on a district-level, using nationwide longitudinal data over 11 years. Methods: : We used the district-level age-standardized suicide rate and a total of 12 annual social environment characteristics of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental characteristics from 229 administrative districts in South Korea. A linear mixed-effect model (LMEM) was used to examine the association between the rate of suicide and the social environment indicators selected for the study. Results: : In the total population, the indicators “% population aged 65 and older eligible for the basic pension”, “% vacant houses in the area”, “% divorce”, “% detached houses”, and “% current smokers” showed positive associations with the suicide rate. In contrast, “% people who regularly participated in religious activities” and “number of sports facilities per 1,000 persons” showed negative associations with suicide rate. The associations between social environment characteristics and suicide rate were generally more pronounced in males and more urbanised areas, than in females and less urbanised areas; however, associations differed amongst age groups, depending on the social environment characteristic variable under study. Conclusions: : This study investigated the complex role of social environments on suicide rate in South Korea and revealed that higher suicide rates were associated with lower values of socioeconomic status, physical exercise, and religious activities, and with higher social isolation and smoking practice. Our results can be used in the development of targeted suicide prevention policies.