Factors Associated with Regional Years of Life Lost (YLLs) due to Suicide in South Korea

Spatially clustered patterns of suicide mortality rates in South Korea: a geographically weighted regression analysis

BACKGROUND

Suicide mortality remains a global health concern, and community characteristics affect regional variations in suicide. This study investigated spatially clustered patterns of suicide mortality rates in South Korea and evaluated the impact of community factors on suicide.

METHODS

Suicide mortality rates were estimated by sex, age group, and district, using the 2021 Cause of Death Statistics in South Korea from the MicroData Integrated Service. Community-determinant data for 2021 or the nearest year were collected from the Korean Statistical Information Service. The spatial autocorrelation of suicide by sex and age was examined based on Global Moran's I index. Geographically weighted regression (GWR) was used to discern the influence of community determinants on suicide.

RESULTS

Suicide mortality rates were significantly higher among men (40.64 per 100,000) and adults over the age of 65 years (43.18 per 100,000). The male suicide mortality rates exhibited strong spatial dependence, as indicated by a high global Moran's I with p < 0.001, highlighting the importance of conducting spatial analysis. In the GWR model calibration, a subset of the community's age structure, single-person household composition, access to mental healthcare centers, and unmet medical needs were selected to explain male suicide mortality. These determinants disproportionately increased the risk of male suicide, varying by region. The GWR coefficients of each variable vary widely across 249 districts: aging index (Q1:0.06-Q3:0.46), single-person households (Q1:0.22-Q3:0.35), psychiatric clinics (Q1:-0.20-Q3:-0.01), and unmet medical needs (Q1:0.09-Q3:0.14).

CONCLUSIONS

Community cultural and structural factors exacerbate regional disparities in suicide among men. The influencing factors exhibit differential effects and significance depending on the community, highlighting the need for efficient resource allocation for suicide. A regionally tailored approach is crucial for the effective control of the community's mental health management system.

Life expectancy and mental related burden of disease among people living with HIV/AIDS

Mental health problems leads to serious disease burden among people living with HIV/AIDS (PLHIV). The study aimed at measuring the mental disorders-caused burden of disease based on PLHIV in mainland China. The data used was from the national HIV/AIDS case reporting system, life expectancy (LE) and LE-eliminated suicide were evaluated by the life-table method. The total YLLs and YLLs caused by suicide in each age group were calculated. The disability weights were estimated by the scale of depression symptoms (CES-D) from the multi-center cross-sectional survey, then calculated the corresponding YLDs as a burden of mental illness among PLHIV. Results showed that the LE had been prolonged by implementing antiviral therapy for PLHIV. The proportion of YLLs caused by suicide was the highest (5·46%) in the 15-24 age group. The YLDs in the 25-34 age group were the highest. The YLLs caused by suicide in males were higher than those in the same age group of females. The YLDs and YLLs were higher in heterosexual-infected PLHIV than in homosexual-infected PLHIV, except for YLLs in the 25-34 age group. In summary, this study first provided localized data on the disease burden caused by mental health problems among PLHIV.

Dynamic effect of economic growth on the persistence of suicide rates

Positive and negative economic growth is closely related to the suicide rate. To answer the question whether economic development has a dynamic impact on this rate, we used a panel smooth transition autoregressive model to evaluate the threshold effect of economic growth rate on the persistence of suicide. The research period was from 1994 to 2020, and the results show that the suicide rate had a persistent effect, which varied over time depending on the transition variable within different threshold intervals. However, the persistent effect was manifested in different degrees with the change in the economic growth rate and as the lag period of the suicide rate increased, the effect of the influence gradually decreased. We investigated different lag periods and noted that the impact on the suicide rate was the strongest in the first year after an economic change and then reduced to be only marginal after three years. This means that the growth momentum of the suicide rate within the first two years after a change in the economic growth rate, should be included in policy considerations of how to prevent suicides.

Epidemiological changes, demographic drivers, and global years of life lost from suicide over the period 1990-2019

OBJECTIVE

To quantify the contributions of epidemiological changes (age- and gender-specific suicide rates) and demographic forces (population growth and aging) to global changes in years of life lost (YLLs) from suicide over the last 30 years.

METHOD

A decomposition analysis was used to assess the impacts of population growth, population aging, and suicide prevalence on global changes in YLLs from suicide between 1990 and 2019.

RESULTS

From 1990 to 2019, global YLLs from suicide reduced by 2,073,714 years (5.9%), from 35,246,316 years to 33,172,602 years. This was mainly due to the decline in age-specific suicide rates, which reduced the overall YLLs from suicide by 20,185,691 years (973.4%). However, this decline was offset by the impacts of population growth and population aging, which increased global YLLs from suicide by 14,949,110 years (-720.9%) and 3,442,074 years (-166.0%), respectively. The combined effects of epidemiological and demographic drivers were also reflected in different trends in YLLs from suicide across genders and World Bank income level regions, with particularly notable increases in low- income and lower-middle income countries and the aging population.

CONCLUSIONS

With the significant effects of epidemiological and demographic drivers, global and regional YLLs from suicide may be expected to change greatly in the future. Efforts to reduce the burden of suicide require appropriate allocation of resources for suicide-prevention strategies and further consideration of demographic factors.

Years of life lost associated with COVID-19 deaths in the USA during the first 2 years of the pandemic

Background

Prior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic.

Methods

We employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs.

Results

We estimated roughly 9.7 million YLLs due to COVID-19 deaths. The number of YLLs per 10 000 capita was 297.5, with the highest rate in Mississippi (482.7) and the lowest in Vermont (61.4). There was substantial interstate variation in the timing of YLLs and differences in YLLs by gender. YLLs per death increased from 9.2 in the first year of the pandemic to 10.8 through the first 2 years.

Conclusions

Our findings improve our understanding of how the mortality effects of COVID-19 have evolved. This insight can be valuable to public health officials as the disease moves to an endemic phase.

Revised road traffic safety law and years of life lost due to traffic deaths in China, 2002-2019

Legal intervention is a powerful tool to reduce road traffic injuries (RTIs). China amended the Road Traffic Safety Law in 2011, but the impact of amended law on traffic crash deaths is still unknown. In this study, we conducted an interrupted time series analysis and examined years of life lost (YLLs) per 100,000 population as the assessment indicator to evaluate the association of road traffic safety law and traffic crash mortality. Annual YLLs data due to traffic deaths from 2002 to 2019 in China were obtained from the Global Burden of Disease (GBD) 2019. After implementation of the revised law, the average level of total YLLs per 100,000 population due to traffic deaths decreased from 1133.14 to 848.87, and the slope of annual YLLs per 100,000 population decreased by 30.11 (95% CI: 22.46, 37.75), indicating a steeper downward trend. The revised traffic law was associated with YLLs reduction due to traffic deaths for males, females, all age groups, pedestrians, motor vehicle users, and other road users, as well as traffic deaths attributed to alcohol use and tobacco use. These findings suggested that the revised Road Traffic Safety Law improved road safety by decreasing YLLs due to traffic deaths in China. However, the burden of RTIs is still heavy and efforts to further improve traffic laws and the adoption of other interventions are urgently needed.

Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic

Background

Years of Life Lost (YLLs) measure the shortfall in life expectancy due to a medical condition and have been used in multiple contexts. Previously it was estimated that there were 1.2 million YLLs associated with coronavirus disease 2019 (COVID-19) deaths in the USA through 11 July 2020. The aim of this study is to update YLL estimates for the first full year of the pandemic.

Methods

We employed data regarding COVID-19 deaths in the USA through 31 January 2021 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs.

Results

We estimated roughly 3.9 million YLLs due to COVID-19 deaths, which correspond to roughly 9.2 YLLs per death. We observed a large range across states in YLLs per 10 000 capita, with New York City at 298 and Vermont at 12. Nationally, the YLLs per 10 000 capita were greater for males than females (136.3 versus 102.3), but there was significant variation in the differences across states.

Conclusions

Our estimates provide further insight into the mortality effects of COVID-19. The observed differences across states and genders demonstrate the need for disaggregated analyses of the pandemic’s effects.

Years of life lost associated with COVID-19 deaths in the United States

BACKGROUND

The mortality effects of COVID-19 are a critical aspect of the disease's impact. Years of life lost (YLLs) can provide greater insight than the number of deaths by conveying the shortfall in life expectancy and thus the age profile of the decedents.

METHODS

We employed data regarding COVID-19 deaths in the USA by jurisdiction, gender and age group for the period 1 February 2020 through 11 July 2020. We used actuarial life expectancy tables by gender and age to estimate YLLs.

RESULTS

We estimated roughly 1.2 million YLLs due to COVID-19 deaths. The YLLs for the top six jurisdictions exceeded those for the remaining 43. On a per-capita basis, female YLLs were generally higher than male YLLs throughout the country.

CONCLUSIONS

Our estimates offer new insight into the effects of COVID-19. Our findings of heterogenous rates of YLLs by geography and gender highlight variation in the magnitude of the pandemic's effects that may inform effective policy responses.