Suicide Rates, Social Capital, and Depressive Symptoms among Older Adults in Japan: An Ecological Study

Abstract

Depression is considered the primary risk factor for older people’s suicide. When considering suicide measures, it is necessary to clarify the relationship between depressive symptoms, social capital, and suicide rates. Therefore, we aimed to clarify the relationship between community-level social capital, depressive symptoms, and suicide rates among older people in Japan. We analyzed the data gathered from 63,026 men and 72,268 women aged 65 years and older, totaling 135,294 subjects in 81 municipalities with a population of over 100,000 participants in the 2013 Sixth Long-Term Care Needs Survey and another survey conducted by Japan Gerontological Evaluation Study (JAGES) in 2013 including the same question items as the survey in Japan. Multiple regression analysis revealed that the male suicide standardized mortality ratio (SMR) was positively correlated with depressive symptoms (B = 2.318, p = 0.002), and received emotional support (B = −2.622, p = 0.014) had a negative correlation with the male suicide SMR. In older males particularly, the received emotional support in the community was independently associated with the suicide rate. Therefore, fostering social support in a community could act as a countermeasure to suicide among older males in Japan.

Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

“…They showed that the male suicide standardized mortality ratio (SMR) was positively correlated with depressive symptoms (p = 0.002). The female suicide SMR was positively correlated with the rate of depressive symptoms (ρ = 0.258) (38).…”

Suicidal ideation and suicide attempts among older recipients of public welfare assistance in Japan

“…In relation to this, the findings of this study suggest that it may be beneficial to make those supporting public welfare recipients aware that the risk of suicidal behaviour might be elevated in some welfare recipients. More specifically, as the recipients of public welfare are visited regularly by caseworkers it is possible that this ‘intervention’ could be more precisely tailored to function as a form of emotional/social support which has been previously linked to better mental health and reduced suicidal behaviour among older adults in Japan 37. Having said this, as the workload of caseworkers is already heavy in terms of the support they provide for recipients, it is essential that concrete systems/policies be established to promote partnerships between healthcare professionals and welfare offices, as is seen in other settings such as in relation to social prescribing and patient navigation 38 39.…”

“…More specifically, as the recipients of public welfare are visited regularly by caseworkers it is possible that this ‘intervention’ could be more precisely tailored to function as a form of emotional/social support which has been previously linked to better mental health and reduced suicidal behaviour among older adults in Japan. 37 Having said this, as the workload of caseworkers is already heavy in terms of the support they provide for recipients, it is essential that concrete systems/policies be established to promote partnerships between healthcare professionals and welfare offices, as is seen in other settings such as in relation to social prescribing and patient navigation. 38 39 It is also important to ensure that the actual welfare provided (income) is sufficient enough to guarantee that recipients are not living in poverty or can slip into poverty or experience financial destitution, which may have been a cause of suicidal behaviour 4 5 in our study.…”

“…Funding This study was supported by Grant-in-Aid for JSPS Fellows (JP20J01910), JSPS KAKENHI Grant Number (JP22K17266, JP15H01972), Health Labour Sciences Research Grant (H28-Choju-Ippan-002), Japan Agency for Medical Research and Development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP20dk0110037), Open Innovation Platform with Enterprises, Research Institute and Academia(OPERA, JPMJOP1831)from the Japan Science and Technology (JST), a grant from Innovative Research Program on Suicide Countermeasures (1-4), a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion and Fitness Foundation, a grant from Chiba Foundation for Health Promotion and Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation (adopted number: 19-2-06), a grant from Niimi University (1915010), grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42).…”

Spatial statistical analysis of regional disparities in suicide among policy units in Japan: Using the Bayesian hierarchical model

“…Three hundred thirty-five areas have been set up to provide efficient medical services as of January 2021 [5]. Studies on suicide have been conducted at each of the following regional levels: prefectures [6][7][8][9][10][11][12], secondary health care areas [13,14], municipal towns and villages [15][16][17][18][19][20], and cities and villages in specific prefectures [21,22]. It is critical to comprehensively assess the efficiency of suicide prevention measures in each administrative unit, such as prefectures, secondary health care areas, and municipalities, to assure the success of suicide prevention measures throughout Japan.…”