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Suicide Rates in Korea

KOREA HAS BEEN RANKED 1ST IN SUICIDE SINCE 2003 – WHY?
Guk-Hee Suh, MD, PhD
Professor of Psychiatry, Hallym University College of Medicine, Korea

Sociological framework.
Emile Durkheim, a French sociologist, argued that people might be driven to suicide because of lesser or higher integration with society, suggesting that committing suicide may be mainly due to social reasons. Social centripetal force increases happiness or life satisfaction while social centrifugal force increases pain or suffering.

There are four main domains of these social forces:

  1. Health (physical, emotional, cognitive); in particular, emotional problems such as depression, anxiety, irritability, impulsivity, risk-taking behaviors, and drug use (whether prescribed or illegal) may increase suicide risk
  2. Interpersonal relationships based on love, solidarity, regular activities or businesses, and social commitment in family or kinship relations, friendship, marriage, work, clubs, neighborhoods and associations
  3. Affluence to meet various needs (i.e., food, shelter, safety, love, acceptance, belonging, respect)
  4. Capacity made by synergy between knowledge (know what), skills (know how) and attitude (know why)

If all four centrifugal forces are pushing out a person (i.e., an ill, isolated, poor, and unable or ignorant condition), we can diagnose “PROBABLE” suicide risk. If any of three centrifugal forces are together, it should be diagnosed “POSSIBLE” suicide risk.

Economic context in South Korea.
This framework is especially useful when researching suicide in South Korea, a rapidly modernized capitalistic society which has achieved rapid economic transformation from an agriculture-based to a manufacturing economy in a very short period of time. South Korea exhibited the world’s fastest economic growth rate from the 1970s to 1990s, just after Japan from the 1950s to 1960s and before China in the 1990s. Now Korea, Japan, and China are commonly estimated to have the world’s highest suicide rate.

After the Korean financial crisis in 1997, suicide rates in Korea suddenly jumped up and began to increase to be the World 1st in 2003, despite the Korean economy’s complete recovery and even growth by 2000. The more South Korea became democratized and globalized, the higher its suicide rate became. About 25 years ago, South Korea was still a newly democratized country, and with an economy not yet globalized, the suicide rate was at its lowest level of about 5 per 100,000 persons. During its period of highest economic growth, Korean people considered themselves to be the middle class, because political propaganda, rising incomes, and lottery-like investments raised their expectations for quality of life.

Thus, the sudden economic downturn had a strong impact on Korean people, greatly influencing the suicide rate in 1998 onwards. Unemployed, homeless, divorced people were more likely to commit suicide. Individuals who could not adjust from being in the middle or high class to being in the working, working poor or under- class were often more likely to commit suicide. Most of them could never return to the middle or high class, due to the gap between rich and poor, which has widened since 1997.

Social trends in South Korea.
In the past Korea had a closeknit society, where family and community bonding were very strong. The rapid industrialization and urbanization broke these social bonds and made people individualized and alienated in society. In towns and cities, most people live lonely and secluded life. Several signs of social disintegration have appeared in Korea. For example, single households have become the most frequent type of household in Korea, and the total fertility rate is very low, nearing 1.0. Now, the “live alone” trend has become very popular: people dine alone, drink alone, and travel alone, which young people feel is “cool.” In rural villages, many more older people are leading lonely, isolated lives. One out of two older people is living below the poverty line, and most older people in poverty are living in rural areas.

After 1997, unemployment, homelessness, divorce and suicide increased greatly, which greatly influenced others, especially older parents who had been dependent on adult children. Older Korean parents had typically spent all their earnings on their children’s education, with the expectation that their children would look after them in old age, just as their own parents had looked after the generation before. This was necessary because benefits of social insurance systems (SISs) for older people were greatly insufficient for unexpected rainy days. Then and now, poor, isolated, and illiterate older people are highly likely to commit suicide, partly because they do not want to be a financial burden on poor adult children, and partly because the Confucian tradition that children must look after their parents has largely disappeared in the 21st century. It would be like a situation where a government of a Western developed country does not provide any benefits of SISs, despite older people having already paid all SIS premiums.

Global implications.
Surely this scenario is not only applicable to Korea, but also to rapidly industrializing countries, and we have already seen it happen in developed countries. History repeats itself.

Emmanuel Todd, a French historian and anthropologist, once pointed to “rising literacy and a shrinking birth rate” as an outcome of modernization. This phenomenon is easily observable everywhere around the world. There exists an intervening factor between literacy rate and birth rate: the “independent individual” constantly pursuing happiness and freedom. Literacy allows a person to become an independent individual, rather than a dependent subject in a group. It is essential to become a laborer capable of economic security and independence, and without these, true individual freedom cannot exist. In 19th century Europe, the concept of the independent individual was popularized, and now, modern education teaches the universal values of freedom, equality, human rights and human dignity. In Afganistan, where patrilinear family and intimate community persist, the literacy rate of women is still less than 5%. However, the problem in the developed world, where the literacy rate has surpassed 90%, is the collapse of the family and the intimate community, which previously functioned as welfare system, insurance company, education system, pension fund, and so on. Now, the state and market has replaced family and intimate community in these functions, and they continue to urge people to purchase goods and services, and to pay SIS premiums using money earned by labor.

Regardless, it is impossible to go back to the past, and by no means ideal. Happiness is much more closely related to subjective expectations, rather than objective conditions. Those who have higher expectations may not be happier than others, even at the same objective conditions. Even if objective conditions turn better later, some people may feel less happy, because their expectations have already raised higher. Thus, living in a highly affluent society with the availability of every advanced high-technology facility may not guarantee happiness. An obsessive desire to be happier and happier would be a chronic, incurable disease.

Excerpted article as reprint from IPA's newsletter, the IPA Bulletin, Volume 34, Number 3
IPA Members can read the full issue on the members' site.

Acknowledgements

Acadia Pharmaceuticals Otsuka Pharmaceuticals Cambridge University Press Avanir Pharmaceuticals
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