Analyzing the changing relationship between personal consumption and suicide mortality during COVID-19 pandemic in Japan, using governmental and personal consumption transaction databases

Abstract

During the early stages of the ongoing COVID-19 pandemic, suicides did not increase in most countries/regions. Japan, however, was an exception to this, reporting increased numbers of female suicides with no changes in male suicide. To explore the trends of increasing suicides, the fluctuations of personal consumption (as an indicator of lifestyle) and standardized suicide death rate (SDR) disaggregated by age, sex, and prefecture, were determined using a linear mixed-effect model. Additionally, fixed effects of personal consumption on SDR during the pandemic were also analyzed using hierarchical linear regression models with robust standard errors. During the first wave of the pandemic, SDR for both sexes decreased slightly but increased during the second half of 2020. SDR of females younger than 70 years old and males younger than 40 years old continued to increase throughout 2021, whereas SDR for other ages of both sexes did not increase. Personal consumption expenditures on out-of-home recreations (travel agencies, pubs, and hotels) and internet/mobile communication expenses decreased, but expenditures on home-based recreations (contents distribution) increased during the pandemic. Increased expenditures on internet/mobile communication were related to increasing SDR of both sexes. Increasing expenditures on content distributions were related to increasing females' SDR without affecting that of males. Decreasing expenditures on pubs were related to increasing SDR of both sexes in the non-metropolitan region. These findings suggest that transformed individual lifestyles, extended time at home with a decreased outing for contact with others, contributed to the progression of isolation as a risk of suicide. Unexpectedly, increasing compensatory contact with others using internet/mobile communication enhanced isolation resulting in increased suicide risk.

Suicidal Mortality and Motives Among Middle-School, High-School, and University Students

“…In this study, the trends, discontinuity, and their effect size of SMRPs of male and female middle-school, high-school, and university students from 2007 to 2022 were analyzed by joinpoint regression analysis (JPRA) using the Joinpoint Regression Program version 5.0.2 (National Cancer Institute) . The differences in SMRPs among sexes (male and female students) and schools (middle school, high school, and university) from 2007 to 2022 were compared using linear mixed-effect models with the Scheffe post hoc test using SPSS statistical software for Windows version 27 (IBM) . The detailed statistical methods are described in the eAppendix in Supplement 1.…”

“…The SMRP was 2.5 times greater among male individuals vs female individuals during 2009 to 2019, but the differential decreased to 2.0 in 2021, indicating that the increase in SMRP during the pandemic was more pronounced among female individuals. Indeed, before the pandemic (2016-2019), the SMRPs were 2.5 among individuals younger than 20 years and 3.8 among those aged 20 to 29 years; during the pandemic (2020-2022), SMRPs were 17.2 among those younger than 20 years and 21.3 among those aged 20 to 29 years . Therefore, the young generation (ie, individuals aged <30 years) is currently considered a high-risk group .…”

“…[3][4][5] However, the SMRP increased after the COVID-19 pandemic outbreak. 1,2,[10][11][12][13][14] During the initial stage of the pandemic (2020-2021), the SMRP of working-age male individuals continuously decreased, but SMRPs for working-age female individuals and individuals younger than 30 years increased. 1,2,[10][11][12][13][14] The SMRP was 2.5 times greater among male individuals vs female individuals during 2009 to 2019, 4,6 but the differential decreased to 2.0 in 2021, 10,12,13 indicating that the increase in SMRP during the pandemic was more pronounced among female individuals.…”

“…1,2,[10][11][12][13][14] During the initial stage of the pandemic (2020-2021), the SMRP of working-age male individuals continuously decreased, but SMRPs for working-age female individuals and individuals younger than 30 years increased. 1,2,[10][11][12][13][14] The SMRP was 2.5 times greater among male individuals vs female individuals during 2009 to 2019, 4,6 but the differential decreased to 2.0 in 2021, 10,12,13 indicating that the increase in SMRP during the pandemic was more pronounced among female individuals. Indeed, before the pandemic (2016-2019), the SMRPs were 2.5 among individuals younger than 20 years and 3.8 among those aged 20 to 29 years; during the pandemic (2020-2022), SMRPs were 17.…”

“…The main frameworks of suicide prevention programs were enhancing regional (prefectural and municipal) welfare and social safety nets and protection systems, including personal and telephone and internet consultations, development of gatekeepers, enlightenment, and specific interventions . However, the SMRP increased after the COVID-19 pandemic outbreak …”