Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Outcomes
2.3. Political Factors
2.4. Covariates
2.5. Analyses
3. Results
3.1. Descriptive Statistics
3.2. Intercept-Only Models
3.3. Cross-Classified Random Effects Models
4. Discussion
5. Conclusions
Supplementary Materials
Funding
Conflicts of Interest
References
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Individual Covariates | Total | Suicide Attempts | Depressive Symptoms | ||
---|---|---|---|---|---|
n = 829,861 | n = 33,671 (4.1%wt) | n = 274,431 (33.1%wt) | |||
Age | |||||
12 years old | 60,590 | 2685 | (4.6) a | 16,423 | (27.7) a |
13 years old | 144,184 | 6736 | (4.7) | 42,116 | (29.5) |
14 years old | 145,363 | 6577 | (4.6) | 45,257 | (31.4) |
15 years old | 143,456 | 5924 | (4.1) | 47,384 | (33.0) |
16 years old | 140,241 | 5134 | (3.6) | 48,891 | (34.6) |
17 years old | 135,077 | 4571 | (3.3) | 49,894 | (36.6) |
18 years old | 60,950 | 2044 | (3.3) | 24,466 | (40.1) |
Sex | |||||
Male | 428,334 | 12,965 | (3.0) | 120,382 | (28.4) |
Female | 401,527 | 20,706 | (5.2) | 154,049 | (38.4) |
Academic performance | |||||
High | 99,239 | 3326 | (3.4) | 27,129 | (27.5) |
Upper middle | 210,729 | 6453 | (3.1) | 62,595 | (29.7) |
Middle | 212,743 | 7016 | (3.3) | 67,728 | (31.9) |
Lower middle | 211,073 | 9783 | (4.6) | 76,416 | (36.3) |
Low | 96,077 | 7093 | (7.3) | 40,563 | (42.5) |
Household economic status | |||||
High | 57,559 | 2760 | (4.9) | 17,043 | (30.1) |
Upper middle | 211,017 | 7214 | (3.5) | 62,654 | (29.9) |
Middle | 369,119 | 12,228 | (3.3) | 115,635 | (31.5) |
Lower middle | 150,482 | 7455 | (4.9) | 58,673 | (38.8) |
Low | 41,684 | 4014 | (9.7) | 20,426 | (49.5) |
Residential area | |||||
Non-capital non-metropolitan area | 311,350 | 13,069 | (4.0) | 103,752 | (32.7) |
Non-capital metropolitan area | 221,985 | 8625 | (3.8) | 72,985 | (32.3) |
Capital area | 296,526 | 11,977 | (4.2) | 97,694 | (33.8) |
Tobacco use | |||||
Non-user | 629,554 | 18,977 | (3.0) | 188,009 | (30.0) |
Past user | 111,088 | 6217 | (5.6) | 44,185 | (39.8) |
Current user | 47,470 | 4637 | (9.7) | 22,109 | (46.5) |
Daily user | 41,749 | 3840 | (9.0) | 20,128 | (48.0) |
Alcohol use | |||||
Non-user | 409,592 | 10,739 | (2.6) | 107,029 | (26.3) |
Past user | 246,134 | 10,094 | (4.1) | 88,599 | (36.0) |
Current user | 171,682 | 12,262 | (7.1) | 77,351 | (44.9) |
Daily user | 2453 | 576 | (22.5) | 1452 | (58.1) |
Vigorous physical activity | |||||
None | 234,601 | 842 | (4.1) | 81,583 | (34.7) |
1-2 days a week | 314,743 | 12,302 | (3.9) | 104,274 | (33.1) |
3-4 days a week | 169,398 | 6848 | (4.1) | 53,616 | (31.9) |
5 or more days a week | 111,119 | 4679 | (4.2) | 34,958 | (31.8) |
Body mass index | |||||
Normal weight | 664,860 | 26,618 | (4.0) | 220,147 | (33.2) |
Underweight | 53,645 | 2307 | (4.3) | 17,998 | (33.7) |
Overweight | 34,726 | 1815 | (5.3) | 12,103 | (34.8) |
Obesity | 76,630 | 2931 | (3.8) | 24,183 | (31.7) |
Healthy diet | |||||
None | 3116 | 300 | (9.2) | 1166 | (37.3) |
Less than once a day | 757,955 | 30,462 | (4.0) | 252,214 | (33.3) |
Once or more a day | 68,790 | 2909 | (4.3) | 21,051 | (30.9) |
Unhealthy diet | |||||
None | 109,733 | 4131 | (3.8) | 32,420 | (29.6) |
Less than once a day | 713,124 | 28,710 | (4.0) | 238,767 | (33.6) |
Once or more a day | 7004 | 830 | (12.4) | 3244 | (46.7) |
Stress level | |||||
Low | 481,824 | 8062 | (1.7) | 94,769 | (19.8) |
High | 348,037 | 25,609 | (7.3) | 179,662 | (51.6) |
Sleep sufficiency | |||||
Sufficient | 223,724 | 5653 | (2.5) | 51,418 | (23.2) |
Insufficient | 606,137 | 28,018 | (4.6) | 223,013 | (36.8) |
Depressive symptom | |||||
No | 555,430 | 6042 | (1.1) | – | |
Yes | 274,431 | 27,629 | (10.0) | ||
Suicidal thought | |||||
No | 681,173 | 2390 | (0.3) | – | |
Yes | 148,688 | 31,281 | (20.8) |
Variables | Suicide Attempts OR (95% CI) a | Depressive Symptoms OR (95% CI) a | ||
---|---|---|---|---|
Political contextual variables | ||||
Presidency (ref = liberal) | ||||
1st conservative | 0.58 | (0.47–0.73) | 0.71 | (0.53–0.93) |
2nd conservative | 0.76 | (0.63–0.91) | 0.70 | (0.56–0.87) |
CEENC (ref = democratic/liberal) | ||||
Liberal/conservative | 1.37 | (0.92–2.04) | 1.03 | (0.96–1.10) |
Conservative | 2.51 | (1.49–4.22) | 1.15 | (1.04–1.27) |
CEER (ref = liberal) | ||||
1st conservative | 1.35 | (0.99–1.85) | 1.10 | (1.04–1.17) |
2nd conservative | 1.77 | (1.03–3.05) | 1.15 | (1.04–1.27) |
Contextual covariates | ||||
Real household final consumption expenditure per capita | 0.62 | (0.56–0.70) | 0.94 | (0.86–1.03) |
Percentage change of house price index | 1.01 | (1.00–1.02) | 1.02 | (1.01–1.04) |
College enrolment rate | 1.07 | (1.03–1.11) | 1.14 | (1.09–1.20) |
Adolescent crime rate | 1.10 | (1.04–1.17) | 1.02 | (0.95–1.11) |
Labor income share | 0.89 | (0.86–0.93) | 0.95 | (0.91–1.00) |
Individual covariates | ||||
Age (ref = 18 years old) | ||||
12 years old | 1.15 | (0.99–1.33) | 0.76 | (0.72–0.80) |
13 years old | 1.15 | (1.00–1.32) | 0.80 | (0.77–0.84) |
14 years old | 1.16 | (1.04–1.30) | 0.85 | (0.82–0.88) |
15 years old | 1.11 | (1.02–1.22) | 0.87 | (0.84–0.90) |
16 years old | 1.02 | (0.95–1.10) | 0.88 | (0.85–0.90) |
17 years old | 1.00 | (0.94–1.06) | 0.93 | (0.91–0.95) |
Sex (ref = male) | ||||
Female | 1.38 | (1.34–1.42) | 1.61 | (1.59–1.62) |
Academic performance (ref = middle) | ||||
High | 0.99 | (0.95–1.04) | 0.85 | (0.84–0.87) |
Upper middle | 0.93 | (0.89–0.97) | 0.93 | (0.92–0.95) |
Lower middle | 1.08 | (1.04–1.11) | 1.10 | (1.08–1.11) |
Low | 1.28 | (1.23–1.34) | 1.19 | (1.17–1.22) |
Household economic status (ref = middle) | ||||
High | 1.51 | (1.44–1.59) | 1.22 | (1.19–1.24) |
Upper middle | 1.10 | (1.06–1.14) | 1.10 | (1.08–1.11) |
Lower middle | 1.05 | (1.02–1.09) | 1.20 | (1.18–1.21) |
Low | 1.41 | (1.35–1.47) | 1.47 | (1.44–1.50) |
Residential area (ref = non-capital metropolitan area) | ||||
Non-capital non-metropolitan area | 1.06 | (1.03–1.09) | 0.98 | (0.97–1.00) |
Capital area | 1.04 | (1.01–1.07) | 1.02 | (1.01–1.03) |
Tobacco use (ref = non-user) | ||||
Past user | 1.31 | (1.26–1.35) | 1.26 | (1.24–1.28) |
Current user | 1.83 | (1.75–1.91) | 1.46 | (1.43–1.49) |
Daily user | 1.92 | (1.83–2.02) | 1.40 | (1.36–1.43) |
Alcohol use (ref = non-user) | ||||
Past user | 1.11 | (1.07–1.14) | 1.28 | (1.27–1.30) |
Current user | 1.40 | (1.35–1.45) | 1.60 | (1.58–1.63) |
Daily user | 3.54 | (3.11–4.02) | 2.56 | (2.34–2.79) |
Vigorous physical activity (ref = none) | ||||
1–2 days a week | 1.04 | (1.01–1.07) | 1.17 | (1.15–1.18) |
3–4 days a week | 1.10 | (1.06–1.14) | 1.27 | (1.25–1.29) |
5 or more days a week | 1.16 | (1.11–1.21) | 1.28 | (1.26–1.30) |
Body mass index (ref = normal weight) | ||||
Underweight | 1.10 | (1.05–1.16) | 0.99 | (0.97–1.01) |
Overweight | 1.01 | (0.95–1.07) | 0.98 | (0.95–1.00) |
Obesity | 1.02 | (0.98–1.07) | 0.95 | (0.94–0.97) |
Healthy diet (ref = none) | ||||
Less than once a day | 0.58 | (0.50–0.67) | 1.01 | (0.94–1.10) |
Once or more a day | 0.65 | (0.56–0.76) | 1.05 | (0.96–1.13) |
Unhealthy diet (ref = none) | ||||
Less than once a day | 0.96 | (0.92–0.99) | 1.13 | (1.11–1.15) |
Once or more a day | 1.68 | (1.52–1.85) | 1.50 | (1.42–1.58) |
Stress level (ref = low) | ||||
High | 1.16 | (1.13–1.20) | 3.73 | (3.69–3.77) |
Sleep sufficiency (ref = sufficient) | ||||
Insufficient | 1.04 | (1.00–1.07) | 1.39 | (1.37–1.40) |
Depressive symptom (ref = no) | ||||
Yes | 1.97 | (1.91–2.04) | - | |
Suicidal thought (ref = no) | ||||
Yes | 44.41 | (42.45–46.45) | - | |
Intercept | 0.001 | (0.001–0.002) | 0.11 | (0.09–0.14) |
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Eun, S.J. Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea. Int. J. Environ. Res. Public Health 2019, 16, 874. https://doi.org/10.3390/ijerph16050874
Eun SJ. Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea. International Journal of Environmental Research and Public Health. 2019; 16(5):874. https://doi.org/10.3390/ijerph16050874
Chicago/Turabian StyleEun, Sang Jun. 2019. "Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea" International Journal of Environmental Research and Public Health 16, no. 5: 874. https://doi.org/10.3390/ijerph16050874
APA StyleEun, S. J. (2019). Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea. International Journal of Environmental Research and Public Health, 16(5), 874. https://doi.org/10.3390/ijerph16050874