The Impact of Improving Suicide Death Classification in South Korea: A Comparison with Japan and Hong Kong

被引:38
作者
Chan, Chee Hon [1 ,2 ]
Caine, Eric D. [3 ]
Sen Chang, Shu [1 ,2 ,4 ,5 ]
Lee, Won Jin [6 ]
Cha, Eun Shil [6 ]
Yip, Paul Siu Fai [1 ,2 ]
机构
[1] Univ Hong Kong, Dept Social Work & Social Adm, Hong Kong, Hong Kong, Peoples R China
[2] Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Hong Kong, Hong Kong, Peoples R China
[3] Univ Rochester, Med Ctr, Dept Psychiat, Injury Control Res Ctr Suicide Prevent, Rochester, NY 14627 USA
[4] Natl Taiwan Univ, Coll Publ Hlth, Inst Hlth Policy & Management, Taipei 10764, Taiwan
[5] Natl Taiwan Univ, Dept Publ Hlth, Coll Publ Hlth, Taipei 10764, Taiwan
[6] Korea Univ, Coll Med, Dept Prevent Med, Seoul 136705, South Korea
关键词
UNDETERMINED DEATHS; ECONOMIC-CRISIS; RATES; AGE; STATISTICS; MORTALITY;
D O I
10.1371/journal.pone.0125730
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
070301 [无机化学]; 070403 [天体物理学]; 070507 [自然资源与国土空间规划学]; 090105 [作物生产系统与生态工程];
摘要
Introduction The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. Method We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. Results We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Conclusion Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.
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页数:9
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