Variations In the Effects of COVID-19 on Suicidal Behavior across Age Groups In South Korea

Background: Although the World Health Organization declared the end of COVID-19 global health emergency in 2023, concerns remain about the pandemic’s lasting mental health consequences. This issue is especially important in South Korea, which has recorded the highest suicide rate among OECD countries for the last two decades. In 2020, the suicide mortality rate in Korea was 24.1 deaths per 100,000 inhabitants, with the highest rates among older adults. This study examines whether the association between the pandemic and suicidal behavior differed across age groups in South Korea and whether the factors associated with suicidal behavior changed over time.

Methods: We used data from the 2019 and 2021 Korea National Health and Nutrition Examination Survey and applied an independently pooled repeated cross-sectional design. The analytic sample included 12,558 individuals aged 19 years and older. Suicidal behavior was defined as suicidal ideation or suicide planning during the previous year and was coded as a binary outcome. Age was categorized into three groups: young adults (19-39 years), middle-aged adults (40-59 years), and older adults (60 years or older). We then examined whether the pandemic period was associated with suicidal behavior across age groups and whether related risk factors changed over time.

Results: The pandemic period was associated with a significant increase in the likelihood of suicidal behavior among young adults, whether older adults showed a significant decrease. The factors associated with suicidal behavior also shifted over time. Household compositional variables, such as living alone and household size, were significant predictors before the pandemic but not during it, whereas employment status and income became more strongly associated with the suicidal behavior during the pandemic.

Implications: These preliminary findings suggest that the association between suicidal ideation or suicide planning were not evenly distributed across age groups and were closely tied to economic insecurity. Suicide prevention efforts should prioritize accessible and affordable mental health services, particularly for young adults and economically vulnerable populations. For practice, the findings underscore the need for targeted outreach, early screening, and stronger community-based support. Further research is needed to assess whether these patterns persist in the long-run post pandemic period.