Hong, Jihyung
(2012)
Socio-economic inequalities in mental health and their determinants in South Korea.
PhD thesis, London School of Economics and Political Science.
Abstract
Suicide rates in South Korea (hereafter ‘Korea’) have seen a sharp upward trend over the past decade, and now stand amongst the highest in OECD countries. This raises urgent policy concerns about population mental health and its socioeconomic determinants, an area that is still poorly understood in Korea. This thesis sets out to investigate socio-economic inequalities in the domain of mental
health, particularly for depression and suicidal behaviour, in contemporary Korea. The thesis first evaluates the extent of income-related inequality in the prevalence of depression, suicidal ideation and suicide attempts in Korea and tracks their changes over a 10-year period (1998-2007) in the aftermath of the 1997/98 economic crisis. Based on four waves of the Korea National Health and Nutrition Examination Survey (KHANES) data, concentration indices reveal a growing trend of pro-rich inequalities in all three outcomes over this period. To understand the potential impact of the observed widening income inequality,
the next empirical investigation examines whether income inequality has a detrimental effect on mental health that is independent of a person’s absolute level of income. Due to the paucity of time series data, the analysis focuses on an
association between regional-level income inequality and mental health, using the 2005 KHANES data. The results provide little evidence to support the link between the two at regional level. The thesis pays special attention to suicide mortality rates given their disconcerting trend in contemporary Korea. Using mortality data for 2004-2006,
the third empirical investigation first elucidates the spatial patterns of suicide rates, highlighting substantial geographical variations across 250 districts. The results of a spatial lag model suggest that area deprivation has an important role in shaping the geographical distribution of suicide, particularly for men. The final empirical investigation sets out to understand the suicide trend in Korea in the context of other Asian countries (Hong Kong, Japan, Singapore, and Taiwan), using both panel data and country-specific time-series analyses (1980-2009). Despite similarities in geography and culture, the suicide phenomenon is unique to Korea, particularly for the elderly. The overall findings suggest that low levels of social integration and economic adversity may in part explain the
atypical suicide trend in Korea.
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