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Dijk H, Mierau J. Mental health over the life course: Evidence for a U-shape? HEALTH ECONOMICS 2023; 32:155-174. [PMID: 36237151 PMCID: PMC10091793 DOI: 10.1002/hec.4614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Mental health problems impose substantial individual and societal costs over the life-cycle. The age-profile of mental health problems is, however, not well understood. Hence, we study the age-profile of mental health while introducing minimal bias to reach identification. Using mental health data from the United States Panel Study of Income Dynamics we apply first difference estimation to derive an unbiased estimate of the second derivative of the age effect as well as an estimate up to a linear period trend of the first derivative. Next, we use a battery of estimators with varying restrictions to approximate the first derivative. Our results suggest that the age profile of mental health in the US is not U-shaped and we find tentative evidence that the age-profile could follow an inverse U-shape where individuals experience a mental health high during their life course. Further analyses, using German and Dutch data, confirm that these results do not only apply to the US, but also to Germany and the Netherlands.
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Affiliation(s)
- Hermien Dijk
- Faculty of Economics and BusinessUniversity of GroningenGroningenThe Netherlands
- AccareGroningenThe Netherlands
| | - Jochen Mierau
- Faculty of Economics and BusinessUniversity of GroningenGroningenThe Netherlands
- Lifelines Cohort Study and BiobankRodenThe Netherlands
- Team Strategy & External RelationsUniversity Medical Center GroningenGroningenThe Netherlands
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Kim UR, Sung H. Urban parks as a potential mitigator of suicide rates resulting from global pandemics: Empirical evidence from past experiences in Seoul, Korea. CITIES (LONDON, ENGLAND) 2022; 127:103725. [PMID: 35530723 PMCID: PMC9066293 DOI: 10.1016/j.cities.2022.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 05/07/2023]
Abstract
Globally, the increased suicide rate of the general population has become a concern not only because of the COVID-19 pandemic, but also because of its associated socioeconomic insecurity, loss of jobs, and economic shocks. This study employed robust fixed-effects panel models to empirically identify the mitigating effects of infectious diseases, via urban parks, on the suicide rate, and to examine gender differences in this regard, based on previous experiences in Seoul, Korea. We found that the differentiating mitigating effect did not significantly affect suicide rates during the 2015 MERS epidemic. However, during the 2009 H1N1 pandemic, wherein the number of confirmed cases was very high and diffused nationwide, urban parks significantly reduced the suicide rates for both men and women. The role of parks as a mitigator was more enhanced in cities with a high number of confirmed cases if it was associated with economic shocks. However, this effect was significant only in the suicide rates of men, not women. During a pandemic, urban parks can help maintain social interaction and sustain physical activities (i.e., walking and exercise) while maintaining physical distance. National and local governments should develop urban parks to actively control the suicide rate influenced by movement restriction measures inevitably occurring during the spread of infectious diseases.
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Affiliation(s)
- U-Ram Kim
- Department of Urban and Regional Development, Graudate School of Urban Studies, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
- Center for Housing Policy Research, Seoul Metropolitan Government, 04514, Korea
| | - Hyungun Sung
- Department of Urban and Regional Development, Graudate School of Urban Studies, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
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Martínez-Alés G, Gimbrone C, Rutherford C, Keyes K, López-Cuadrado T. Role of Foreign-Born Status on Suicide Mortality in Spain Between 2000 and 2019: An Age-Period-Cohort Analysis. Int J Public Health 2022; 67:1604538. [PMID: 35664647 PMCID: PMC9156625 DOI: 10.3389/ijph.2022.1604538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: To examine recent age-period-cohort effects on suicide among foreign-born individuals, a particularly vulnerable sociodemographic group in Spain. Methods: Using 2000-2019 mortality data from Spain's National Institute of Statistics, we estimated age-period-cohort effects on suicide mortality, stratified by foreign-born status (native- vs. foreign-born) and, among the foreign-born, by Spanish citizenship status, a proxy for greater socioeconomic stability. Results: Annual suicide mortality rates were lower among foreign- than native-born individuals. There was heterogeneity in age-period-cohort effects between study groups. After 2010, suicide mortality increased markedly among the foreign-born-especially for female cohorts born around 1950, and slightly among native-born women-especially among female cohorts born after the 1960s. Among native-born men, suicide increased linearly with age and remained stable over time. Increases in suicide among the foreign-born were driven by increases among individuals without Spanish citizenship-especially among cohorts born after 1975. Conclusion: After 2010, suicide in Spain increased markedly among foreign-born individuals and slightly among native-born women, suggesting an association between the downstream effects of the 2008 economic recession and increases in suicide mortality among socioeconomically vulnerable populations.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigacion Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Catherine Gimbrone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Teresa López-Cuadrado
- National Centre of Epidemiology, Carlos III Health Institute (ISCIII), Madrid, Spain
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Chen YY, Yang CT, Pinkney E, Yip PSF. The Age-Period-Cohort trends of suicide in Hong Kong and Taiwan, 1979-2018. J Affect Disord 2021; 295:587-593. [PMID: 34509074 DOI: 10.1016/j.jad.2021.08.084] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The global age-standardized suicide rate fell by 32.7% between 1990 and 2016. The decrease was largely due to suicide rate reductions in China and India. High-income Asian regions did not see such reductions. The aim of the current study was to explore recent suicide rate trends in Hong Kong and Taiwan to decompose which factors - age, period or cohort - explain suicide rate changes in these two regions. METHODS Official mortality data for 1979-2018 in Hong Kong and Taiwan were collected. We utilized Web Tool from the NIH (National Institute of Health, USA) to analyze the Age-Period-Cohort (APC) effects. RESULTS We found marked age-effect that suicide rates increased with age in both genders in both places. Period effect related to the dissemination of charcoal burning suicide was found during 1999-2003 in Hong Kong and 2004-2008 in Taiwan. Increasing suicide rates in the middle- and young-age male cohorts were found in both regions. No increase in suicide risks in young female cohorts was observed. Older cohorts in Hong Kong and older female cohorts in Taiwan also had high suicide rates, but older male cohorts in Taiwan had low rate. LIMITATIONS The interpretations and observations at the population level might not hold at the individual level. CONCLUSIONS The high suicide risk in middle- and young male cohorts in both regions contribute to the persistent high suicide rates in these two regions. Special attention should be turn to the factors underlying such increasing trends.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Chi-Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong
| | - Edward Pinkney
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Paul S F Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
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Martínez-Alés G, Pamplin JR, Rutherford C, Gimbrone C, Kandula S, Olfson M, Gould MS, Shaman J, Keyes KM. Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement. Mol Psychiatry 2021; 26:3374-3382. [PMID: 33828236 PMCID: PMC8670065 DOI: 10.1038/s41380-021-01078-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
The role of sex, race, and suicide method on recent increases in suicide mortality in the United States remains unclear. Estimating the age, period, and cohort effects underlying suicide mortality trends can provide important insights for the causal hypothesis generating process. We generated updated age-period-cohort effect estimates of recent suicide mortality rates in the US, examining the putative roles of sex, race, and method for suicide, using data from all death certificates in the US between 1999 and 2018. After designating deaths as attributable to suicide according to ICD-10 underlying cause of death codes X60-X84, Y87.0, and U03, we (i) used hexagonal grids to describe rates of suicide by age, period, and cohort visually and (ii) modeled sex-, race-, and suicide method-specific age, period, and cohort effects. We found that, while suicide mortality increased in the US between 1999 and 2018 across age, sex, race, and suicide method, there was substantial heterogeneity in age and cohort effects by method, sex, and race, with a first peak of suicide risk in youth, a second peak in older ages-specific to male firearm suicide, and increased rates among younger cohorts of non-White individuals. Our findings should prompt discussion regarding age-specific clinical firearm safety interventions, drivers of minoritized populations' adverse early-life experiences, and racial differences in access to and quality of mental healthcare.
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Affiliation(s)
| | - John R Pamplin
- Center for Urban Science and Progress, New York University, New York, NY, USA
| | | | | | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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Chen YY, Yang CT, Cha ES, Sha F, Yip PSF. Quantifying the contributions of age, sex, methods, and urbanicity to the changing suicide rate trends in South Korea, 2001-2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1121-1132. [PMID: 32189039 DOI: 10.1007/s00127-020-01855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Suicide rates in South Korea have been one of the highest in the world. The aim of this study is to quantify the contributions of age, sex, method, and place of residence to the trends of the suicide rates between 2001 and 2016 in South Korea. METHODS Using the suicide data obtained from the South Korean National Death Registration data set for the years 2001-2016, a Joinpoint regression analysis was conducted to determine if there was a significant change in the trend of suicide rates. Next, a decomposition analysis method was used to quantify the contributions of age, sex, method, and places of residence to the changes in the suicide rates. RESULTS Suicide rates increased between 2001 and 2010, and decreased between 2010 and 2016. Among all the age groups, the 65-79 age group contributed most to the rise (18% in men and 7% in women) and fall (- 15% in men and - 14% in women) of suicide rates. Men contributed much more than women to the increasing trend of suicide rate (63.0% vs. 37.0%). Hanging was the key method of suicide, dominating the ups and downs of the suicide rates. The rates of suicide by pesticide poisoning have been decreasing since 2005 and suicide by charcoal burning continued to increase against a decreasing trend of suicide rate during the period of 2010-2016. The gap of the metropolitan-city-rural suicide rates was narrowing during the period under study, although the rural areas remained to have the highest suicide rates. CONCLUSION The ups and downs of suicide rates in South Korea were not uniform across different sociodemographic groups. Age, sex, method, and place of residence contributed differently to the changes in suicide rates. Suicide prevention measures can be more focused on certain age-sex-method-region subgroups.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Chi-Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eun-Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Feng Sha
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong. .,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
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Age, period, cohort trends of suicide in Japan and Korea (1986-2015): A tale of two countries. Soc Sci Med 2019; 235:112385. [PMID: 31276968 DOI: 10.1016/j.socscimed.2019.112385] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/16/2019] [Accepted: 06/24/2019] [Indexed: 02/04/2023]
Abstract
Japan and South Korea have among the highest suicide rates in the world. However, the age, gender, and time trends in each country differ substantially. Age-Period-Cohort (APC) analysis of suicide rates was conducted to better understand these differences. Using age- and gender-specific data on suicide between 1986 and 2015 in Japan and Korea, we implemented APC analysis to decompose the country-specific trends into age, calendar period, and birth cohort effects. APC analysis revealed three trends: (1) there was a sharp increase in suicide around retirement age in Korea but not in Japan (age effect); (2) there was a dramatic increase in suicide during the three decades of observation in Korea (period effect) whereas rates were more stable in Japan; and (3) the post-War generation in Japan (including baby boomer) had lower rates of suicide compared to generations born before 1916 or after 1961 (birth cohort effect), whereas suicide rate has increased linearly in each generation in Korea. Although Japan & Korea share high suicide rates, our APC analysis suggests divergent causes underlying these trends. Japanese suicide rates plateaued among the cohorts who experienced the post-War rapid economic growth (women born in 1951-1956 and men born in 1916-1961) (birth cohort effect) due to a strong social safety net for this cohort, while suicide rates in Korea continue to rise with each generation and is particularly elevated in post-retirement age. Japan and Korea need to pay more attention to suicide prevention in more recent birth cohorts.
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