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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

A population-based analysis of increasing rates of suicide mortality in Japan and South Korea, 1985–2010

Authors: Sun Y. Jeon, Eric N. Reither, Ryan K. Masters

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

In the past two decades, rates of suicide mortality have declined among most OECD member states. Two notable exceptions are Japan and South Korea, where suicide mortality has increased by 20 % and 280 %, respectively.

Methods

Population and suicide mortality data were collected through national statistics organizations in Japan and South Korea for the period 1985 to 2010. Age, period of observation, and birth cohort membership were divided into five-year increments. We fitted a series of intrinsic estimator age-period-cohort models to estimate the effects of age-related processes, secular changes, and birth cohort dynamics on the rising rates of suicide mortality in the two neighboring countries.

Results

In Japan, elevated suicide rates are primarily driven by period effects, initiated during the Asian financial crisis of the late 1990s. In South Korea, multiple factors appear to be responsible for the stark increase in suicide mortality, including recent secular changes, elevated suicide risks at older ages in the context of an aging society, and strong cohort effects for those born between the Great Depression and the aftermath of the Korean War.

Conclusion

In spite of cultural, demographic and geographic similarities in Japan and South Korea, the underlying causes of increased suicide mortality differ across these societies—suggesting that public health responses should be tailored to fit each country’s unique situation.
Footnotes
1
The second identification issue potentially applicable to tabular data arranged in an age-by-period matrix is that A, P and C are linearly related to the outcome variable, Y. However, because equation (1) specifies A, P and C as categorical rather than continuous variables, no assumptions are made regarding the functional form of associations between Y and these temporal dimensions [19]. In such a model, the second identification issue only holds when the categorical variables reveal exactly linear associations between A, P, C and Y. In practice, it is exceedingly rare to observe such perfectly arranged associations— and it is clearly not applicable in any of the APC models in our investigation.
 
2
Because this process is only affected by a and p, some scholars have endorsed it as a non-arbitrary way to constrain the model and identify a unique set of APC estimates [20]. Moreover, while IE and CGLIM yield similar point estimates when a priori assumptions are valid, IE provides superior statistical efficiency [12].
 
3
According to Held and Riebler [27], rotation among the APC coefficients can occur without altering model fit by using different referent categories in IE models. The apc_ie module in Stata uses the last APC categories as reference groups by default; to check the extent of rotation, we estimated four additional models using ie_rate/ie_norm modules [28]. Each model used different A-P-C groups as referent categories. For one such model, we used the first groups (1-1-1), and for the other three models we used randomly selected groups (14-4-14, 9-4-3, 11-4-2) of A-P-C. Our results show negligible coefficient rotation, meaning that the patterning of APC effects was nearly identical across all five models.
 
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Metadata
Title
A population-based analysis of increasing rates of suicide mortality in Japan and South Korea, 1985–2010
Authors
Sun Y. Jeon
Eric N. Reither
Ryan K. Masters
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3020-2

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