Abstract
Korea has the highest suicide rate of developed countries, two times higher than the USA. Suicide trends among Koreans Americans living in the USA during the same period have not yet been described. We report suicide mortality rates and trends for four groups: (1) Korean Americans, (2) non-Hispanic White (NHW) Americans, (3) selected Asian American subgroups and (4) Koreans living in the Republic of Korea. We used US national (n = 18 113 585) and World Health Organization (WHO) (n = 232 919 253) mortality records for Korea from 2003 to 2012 to calculate suicide rates, all expressed per 100 000 persons. We assessed temporal trends and differences in age, gender and race/ethnicity using binomial regression. Suicide rates are highest in Koreans living in the Republic of Korea (32.4 for men and 14.8 for women). Suicide rates in Korean Americans (13.9 for men and 6.5 for women) have nearly doubled from 2003 to 2012 and exceed rates for all other Asian American subgroups (5.4-10.7 for men and 1.6-4.2 for women). Suicide rates among NHWs (21.0 for men and 5.6 for women) remain high. Among elders, suicide in Korean Americans (32.9 for men and 15.4 for women) is the highest of all examined racial/ethnic groups in the USA. Suicide in Korean Americans is higher than for other Asian Americans and follows temporal patterns more similar to Korea than the USA. Interventions to prevent suicide in Korean American populations, particularly among the elderly, are needed.
Highlights
Despite improvements in all-cause mortality, suicide persists as a leading cause of death in the USA, with a rate of 12.4 per 100 000 persons in the past two decades (Heron, 2013)
non-Hispanic Whites (NHWs) had the highest rate of suicide among men (21.0) in the USA while Korean Americans had the highest rate of suicide among women (6.5) in the USA
Male-to-female suicide ratios were more similar between Koreans (2.2) and Korean Americans (2.1) than NHWs (3.8)
Summary
Despite improvements in all-cause mortality, suicide persists as a leading cause of death in the USA, with a rate of 12.4 per 100 000 persons in the past two decades (Heron, 2013). The USA exhibits wide racial/ethnic disparities in suicide mortality (Baron et al 2013). The Centers for Disease Control and Prevention (CDC) & National Center for Health Statistics (2013) Health Disparities and Inequalities Report showed that suicide mortality is highest among American Indian/Alaska Natives and non-. Hispanic Whites (NHWs) and relatively low in nonHispanic Blacks, Asian/Pacific Islanders and Hispanics (Baron et al 2013). These racial/ ethnic groups obscure mortality trends within highly heterogeneous populations, for Asian Americans (Holland & Palaniappan, 2012). Contrary to the expected low suicide mortality among Asian Americans at the national level, there is wide variation among Asian American subgroups. The rate of suicide mortality in the Republic of Korea (hereafter: Korea) has nearly tripled from 1990 to 2010, and is the highest of all developed countries
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