Socioeconomic inequalities in suicide by herbicide poisoning before and after the implementation of the Paraquat ban in South Korea

Abstract

TPS 642: Environmental justice and impacts, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background: Paraquat is a lethal herbicide. This study explored whether the effect of the Paraquat regulation on suicide deaths varied by the level of educational attainment. Methods: Death certificate data between 2008 and 2015 and population denominators from census data for the years 2005, 2010, and 2015 were obtained from Statistics Korea. Age-standardized mortality rates in suicide by herbicide poisoning (ICD-10: X60-X84 & T603) for men and women according to education (no formal education or primary, secondary, and tertiary), absolute (rate difference) and relative (rate ratio) educational inequalities before (2008-2010) and after (2013-2015) the implementation of the Paraquat ban were examined. Results: During post-regulatory periods (2013-2015), age-standardized mortality rates in suicide by herbicide poisoning decreased for all education groups in both men and women compared with pre-regulatory periods (2008-2010). However, the decrease rate of suicide by herbicide poisoning was the lowest in the people with no formal education or primary education. The absolute inequality between the highest and the lowest education groups decreased after the implementation of the Paraquat ban in both men and women, while relative inequalities remained stable in both men and women. Conclusions: Not all intervention policies are intended to reduce health inequality. Some interventions improve the average health level of the population, but also exacerbate inequality. The Paraquat regulation reduced the magnitude of absolute inequalities in suicide by herbicide poisoning. More research needs to be done in the future to examine changes of socioeconomic inequalities in suicide death by other methods after the Paraquat regulation, or to explore whether the use of suicide methods to replace Paraquat vary by socioeconomic status.