Effect of Community Health Determinants on the Trajectory of Suicide Mortality: Using Group-based Trajectory Model
Year: 2024
Type: dissertation
Abstract: Objectives: Despite a decline in the suicide rate in South Korea since 2011, it continues to rank among the highest globally.Notably, there is a lack of systematic research on the trajectory of suicide rates.Consequently, this study aims to analyze the trends in suicide rates across 229 cities, counties, and districts throughout the country over the past two decades.The study seeks to identify risk groups and to gain a more detailed understanding of the trends in suicide rates.Methods: To analyze the trajectory of changes in suicide rates, a group-based trajectory model was applied using age-standardized suicide rates as the dependent variable.This approach aimed to identify clusters of regions with similar patterns of suicide rate changes and to identify their characteristics.Next, to examine the community health determinants that influenced the decreasing trend in suicide rates since 2011, multinomial logistic regression of 14 variables with suicide rate were performed to examine the factors that influenced the suicide rate trajectory groups.Results: Over the past two decades, South Korea exhibited three distinct trajectories in suicide rates.Approximately 49.7% demonstrated a trajectory with a slight decrease, 20.7% maintained a trajectory with minimal change, and 29.6% displayed a trajectory with a significant decrease in suicide rates.The disparities among these trajectories gradually diminished since 2003, indicating a reduction in regional disparities in suicide rate trajectories.Multinomial logistic regression revealed that males and older age groups had a higher likelihood of belonging to trajectories with elevated suicide rates.Higher rates of walking practice were associated with lower suicide rates, along with regions featuring increased numbers of family physicians, psychiatric hospitals, and care facilities.Furthermore, a greater number of cultural facilities, ３ sports facilities, social welfare facilities, and parks were observed to have a positive impact on suicide rates.Conversely, factors such as current smoking, obesity, and divorce were found to have a negative impact in regions with higher suicide rate trajectories.Conclusions: South Korea's regional suicide rate trajectories were categorized into three main groups.The narrowing gap between these trajectories implies an overall reduction in suicide rates and disparities.Considering the various community health determinants identified in this study, proactive interventions at the community level are expected to have a positive impact on reducing suicide rates.These interventions include anti-smoking campaigns, healthcare initiatives such as promoting walking to reduce obesity rates, strengthening the healthcare system with the inclusion of family physicians and psychiatric hospitals, and expanding community facilities such as cultural and sports facilities and parks.
Author: 장라온
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funder: Inje University
OpenAlex ID: W7000039691