Social and Personal Determinants of Suicidal Ideation Among Korean Older Adults

Background/Purpose:
Suicide remains a major social and public health problem in South Korea. In 2024, the national suicide rate was 29.1 per 100,000 population, while the rate among adults aged 65 and older reached 37.9, highlighting later life as a high-risk period. Although suicide prevention efforts in Korea have expanded, they have been criticized for focusing mainly on personal risk factors and medicalized interventions while giving less attention to broader social and structural conditions. Prior research suggests that suicidal ideation is shaped by both personal vulnerability and social context, yet most studies have relied on cross-sectional data and offered limited evidence on how these factors operate together among older adults. Guided by ecosocial theory and the vulnerability-stress model, this longitudinal study aims to examine the direct and interaction effects of social and personal determinants on suicidal ideation among Korean older adults.

Methods:
This study used a longitudinal design combining the Korean Welfare Panel Study (2012–2024) with annual national-level data (2010–2022). The final sample included 8,965 adults aged 65 and older with complete responses on key variables, yielding 59,181 person-year observations. Suicidal ideation was the outcome. Social determinants included income inequality and the social welfare budget ratio, representing structural risk and institutional protection. Personal determinants included deprivation, depressive symptoms, subjective health, and social capital. Because suicidal ideation referred to experiences during the previous year, social-level variables from two years prior were linked to reflect antecedent social conditions. Generalized linear mixed models with a logit link and random intercepts were used to estimate direct and interaction effects.

Results:
A higher social welfare budget ratio was associated with a lower risk of suicidal ideation. Higher deprivation and depressive symptoms were associated with greater odds of suicidal ideation, whereas better subjective health and higher social capital were associated with lower odds. The direct effect of income inequality was not statistically significant. However, the effect of depressive symptoms on suicidal ideation varied significantly by levels of income inequality and social welfare budget. These findings suggest that suicidal ideation in later life is shaped not only by personal vulnerabilities but also by broader social conditions that may intensify or buffer the effect of depressive symptoms.

Conclusions and Implications:
Suicidal ideation among older adults cannot be understood solely as a matter of personal vulnerability. The moderating roles of income inequality and social welfare budget suggest that broader social conditions shape how psychological risk is translated into suicidal ideation. Suicide prevention for older adults should therefore extend beyond individually focused mental health intervention and incorporate structural and policy approaches that reduce inequality and strengthen social protection.