Suicide Trends over Time by Occupation in Korea and Their Relationship to Economic Downturns.

We analyzed suicide mortality by occupation using administrative data from 1993 to 2016.

Methods

National death records from 1993 to 2016 of the Korea National Statistical Office (KNSO) were used. Suicidal death was taken from Korean Classification of Disease codes as intentional self-harm (X60-X84) and sequelae of intentional self-harm (Y870). Occupational groups were categorized into "Manager," "Officer," "Service-Trade," "Agricultural-Fishery-Forestry" (AFF), "Skilled Manual," and "Unskilled Manual." Direct standardized mortality (DSM) and standardized mortality ratio (SMR) with 95% confidence interval (95% CI) were calculated. Overall, suicide rates increased during economic downturns, especially among lower socio-economic occupation classes. Both DSM and SMR were highest in AFF, followed by Unskilled Manual, Service-Trade, Officer, Skilled Manual, and Manager categories among men, whereas women showed the highest DSM and SMR in AFF, followed by Service-Trade, Officer, Unskilled Manual, Manager, and Skilled Manual categories. The age-stratified analysis showed that age groups with increasing trends in suicide differed according to occupation and gender. In certain occupational groups, the time-point prevalence fluctuated with socio-economic background in suicidal mortality and differed by age and gender.