Differentiation of direct and indirect socioeconomic effects on suicide attempts in South Korea

Myung Ki, Eui Seong Sohn, Byungduck An, Jiseun Lim

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Despite the wide recognition of the inverse association between socioeconomic position (SEP) and suicidal behaviors, its underlying process and potential mediators are little known. This study investigated the pathway from SEP to suicide attempts with attention to potential mediators. From the Korean Health and Nutrition Examination Survey 2007.2013, which is a nationwide cross-sectional survey of the health and nutritional status, a total of 34,565 participants (≥30 years) were included in the analysis. To unfold the pathways linking SEP to suicide attempts, the direct and indirect effects of 3 SEP measures (educational attainment, household income, and occupational group) and 3 mediators (physical illness, mental health problems, and problematic drinking) were differentiated using structured equation model (SEM). Most of direct and indirect effects of educational attainment, household income, and occupational group on suicide attempts were significant; Nonemployment status had the largest total (b=-0.291, P<.01) and direct effects (b=0.212, P<.01), while educational attainment had the largest indirect effect (b=-0.124, P<.01). Educational attainment was mainly mediated by physical illness and problem drinking, whereas household income and occupational group were mainly mediated by anxious or depressed mood and problem drinking. Physical illness played a major role in explaining suicide attempts, compared to mental health problem and problem drinking. Overall, experience of socioeconomic disadvantage increased suicide attempts independently of mental and physical problems. An extension of suicide prevention program is required for comprehensively targeting people with general problems such as physical illness and low SEP, complemented to narrowly targeting high risk group with, such as mental health problem.

Original languageEnglish
Article numbere9331
JournalMedicine (United States)
Issue number51
Publication statusPublished - 2017 Dec 1
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science, ICT & Future Planning) awarded to JL (approval number: NRF-2015R1C1A1A02037283) and by the Ministry of Education awarded to MK (Grant number: NRF-2016026583). MK was also supported by the Social Science Program (Grant number: NRF-2014S1A3A2035458) through the NRF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2017 the Author(s).


  • mediating effect
  • physical illness
  • socioeconomic position
  • suicide attempts

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Differentiation of direct and indirect socioeconomic effects on suicide attempts in South Korea'. Together they form a unique fingerprint.

Cite this