Impact of the expanded old age income security programme on suicide mortality among older adults in South Korea: a quasi-experimental study

This study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+. Using aggregate mortality data from 2010 to 2019, we employed event-h...

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Veröffentlicht in:	Journal of epidemiology and community health (1979) Jg. 79; H. 10; S. 765
Hauptverfasser:	Kim, Chungah, Grignon, Michel, Muntaner, Carles, Dunn, James R
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	England BMJ Publishing Group LTD 01.10.2025
Schlagworte:	Age Aged Aged, 80 and over Economic growth Emergency medical care Female GDP Gross Domestic Product Humans Income Low income groups Male Mental depression Mental health Mortality Mortality - trends Old Age Assistance Older people Pensions Pensions - statistics & numerical data Poverty Republic of Korea - epidemiology Statistical analysis Suicide Suicide - statistics & numerical data Suicide prevention Republic of Korea United States > US South Korea MORTALITY GERONTOLOGY ECONOMICS SUICIDE EPIDEMIOLOGY
ISSN:	0143-005X, 1470-2738, 1470-2738
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Abstract	This study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+. Using aggregate mortality data from 2010 to 2019, we employed event-history difference-in-differences (DD), 2×2 DD, and difference-in-difference-in-differences (DDD) approaches, leveraging two identification strategies: (1) regional variations in the proportion of BP beneficiaries and (2) a triple-difference strategy incorporating both regional variation and age-based eligibility. Event study models were used to test the common trends assumption and assess the dynamic effects of the reform. The event study findings revealed that the reduction in suicide mortality among older women became more pronounced over time, with significant decreases emerging 10-16 quarters after the reform's implementation. The 2×2 DD analysis reported a 20% (95% CI -33% to -6%) reduction in suicide rates among older women in high-beneficiary regions compared with low-beneficiary regions, and no significant effects were observed for men. The DDD analysis did not yield statistically significant results, but the estimated effect size for women (-17%; 95% CI -52% to 18%) was consistent in direction with the DD analysis. The doubling of social pension benefits in South Korea appears to have contributed to reduced suicide mortality among older women. These findings suggest that targeted income security programmes may help reduce suicide rates among economically vulnerable older adults. They provide valuable insights for low- and middle-income countries considering similar interventions.
AbstractList	This study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+. Using aggregate mortality data from 2010 to 2019, we employed event-history difference-in-differences (DD), 2×2 DD, and difference-in-difference-in-differences (DDD) approaches, leveraging two identification strategies: (1) regional variations in the proportion of BP beneficiaries and (2) a triple-difference strategy incorporating both regional variation and age-based eligibility. Event study models were used to test the common trends assumption and assess the dynamic effects of the reform. The event study findings revealed that the reduction in suicide mortality among older women became more pronounced over time, with significant decreases emerging 10-16 quarters after the reform's implementation. The 2×2 DD analysis reported a 20% (95% CI -33% to -6%) reduction in suicide rates among older women in high-beneficiary regions compared with low-beneficiary regions, and no significant effects were observed for men. The DDD analysis did not yield statistically significant results, but the estimated effect size for women (-17%; 95% CI -52% to 18%) was consistent in direction with the DD analysis. The doubling of social pension benefits in South Korea appears to have contributed to reduced suicide mortality among older women. These findings suggest that targeted income security programmes may help reduce suicide rates among economically vulnerable older adults. They provide valuable insights for low- and middle-income countries considering similar interventions. IntroductionThis study examined the impact of the expansion, implemented in July 2014, of Korea’s tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+.MethodsUsing aggregate mortality data from 2010 to 2019, we employed event-history difference-in-differences (DD), 2×2 DD, and difference-in-difference-in-differences (DDD) approaches, leveraging two identification strategies: (1) regional variations in the proportion of BP beneficiaries and (2) a triple-difference strategy incorporating both regional variation and age-based eligibility. Event study models were used to test the common trends assumption and assess the dynamic effects of the reform.ResultsThe event study findings revealed that the reduction in suicide mortality among older women became more pronounced over time, with significant decreases emerging 10–16 quarters after the reform’s implementation. The 2×2 DD analysis reported a 20% (95% CI −33% to −6%) reduction in suicide rates among older women in high-beneficiary regions compared with low-beneficiary regions, and no significant effects were observed for men. The DDD analysis did not yield statistically significant results, but the estimated effect size for women (−17%; 95% CI −52% to 18%) was consistent in direction with the DD analysis.ConclusionThe doubling of social pension benefits in South Korea appears to have contributed to reduced suicide mortality among older women. These findings suggest that targeted income security programmes may help reduce suicide rates among economically vulnerable older adults. They provide valuable insights for low- and middle-income countries considering similar interventions. This study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+.INTRODUCTIONThis study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the Basic Pension (BP), on suicide mortality among individuals aged 65+.Using aggregate mortality data from 2010 to 2019, we employed event-history difference-in-differences (DD), 2×2 DD, and difference-in-difference-in-differences (DDD) approaches, leveraging two identification strategies: (1) regional variations in the proportion of BP beneficiaries and (2) a triple-difference strategy incorporating both regional variation and age-based eligibility. Event study models were used to test the common trends assumption and assess the dynamic effects of the reform.METHODSUsing aggregate mortality data from 2010 to 2019, we employed event-history difference-in-differences (DD), 2×2 DD, and difference-in-difference-in-differences (DDD) approaches, leveraging two identification strategies: (1) regional variations in the proportion of BP beneficiaries and (2) a triple-difference strategy incorporating both regional variation and age-based eligibility. Event study models were used to test the common trends assumption and assess the dynamic effects of the reform.The event study findings revealed that the reduction in suicide mortality among older women became more pronounced over time, with significant decreases emerging 10-16 quarters after the reform's implementation. The 2×2 DD analysis reported a 20% (95% CI -33% to -6%) reduction in suicide rates among older women in high-beneficiary regions compared with low-beneficiary regions, and no significant effects were observed for men. The DDD analysis did not yield statistically significant results, but the estimated effect size for women (-17%; 95% CI -52% to 18%) was consistent in direction with the DD analysis.RESULTSThe event study findings revealed that the reduction in suicide mortality among older women became more pronounced over time, with significant decreases emerging 10-16 quarters after the reform's implementation. The 2×2 DD analysis reported a 20% (95% CI -33% to -6%) reduction in suicide rates among older women in high-beneficiary regions compared with low-beneficiary regions, and no significant effects were observed for men. The DDD analysis did not yield statistically significant results, but the estimated effect size for women (-17%; 95% CI -52% to 18%) was consistent in direction with the DD analysis.The doubling of social pension benefits in South Korea appears to have contributed to reduced suicide mortality among older women. These findings suggest that targeted income security programmes may help reduce suicide rates among economically vulnerable older adults. They provide valuable insights for low- and middle-income countries considering similar interventions.CONCLUSIONThe doubling of social pension benefits in South Korea appears to have contributed to reduced suicide mortality among older women. These findings suggest that targeted income security programmes may help reduce suicide rates among economically vulnerable older adults. They provide valuable insights for low- and middle-income countries considering similar interventions.
Author	Grignon, Michel Kim, Chungah Muntaner, Carles Dunn, James R
Author_xml	– sequence: 1 givenname: Chungah orcidid: 0000-0002-9033-3874 surname: Kim fullname: Kim, Chungah email: chungah.kim01@gmail.com organization: School of Kinesiology & Health Science, Toronto, Toronto, Ontario, Canada chungah.kim01@gmail.com – sequence: 2 givenname: Michel surname: Grignon fullname: Grignon, Michel organization: Department of Economics, McMaster University, Hamilton, Ontario, Canada – sequence: 3 givenname: Carles orcidid: 0000-0003-3535-467X surname: Muntaner fullname: Muntaner, Carles organization: JHU-UPF Public Policy Center and Barcelona School of Management (BSM) Department of Political Science, Universitat Pompeu Fabra, Barcelona, Spain – sequence: 4 givenname: James R orcidid: 0000-0003-1054-9956 surname: Dunn fullname: Dunn, James R organization: Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
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Snippet	This study examined the impact of the expansion, implemented in July 2014, of Korea's tax-financed (non-contributory) old age income security programme, the... IntroductionThis study examined the impact of the expansion, implemented in July 2014, of Korea’s tax-financed (non-contributory) old age income security...
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SubjectTerms	Age Aged Aged, 80 and over Economic growth Emergency medical care Female GDP Gross Domestic Product Humans Income Low income groups Male Mental depression Mental health Mortality Mortality - trends Old Age Assistance Older people Pensions Pensions - statistics & numerical data Poverty Republic of Korea - epidemiology Statistical analysis Suicide Suicide - statistics & numerical data Suicide prevention
Title	Impact of the expanded old age income security programme on suicide mortality among older adults in South Korea: a quasi-experimental study
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