• 보건의료산업학회지
• /
• 제7권3호
• /
• pp.287-296
• /
• 2013

The aim of this study was to compare the regional difference of death from intentional self-harm. The analysis was based on data of intentional self-harm deaths (31,450) from the 2010-2011 vital statistics of Korea. The suicide rate (per 100,000 population) was 46.2 in male and 22.3 in female. Gender ratio (male / female) of suicide rate was 2.07, and Jeju province had the lowest gender ratio (1.82), and Chungbuk province had the highest gender ratio (2.42). In the age-gender standardized death rate (per 100,000) of self-harm by region, the highest suicide rate was observed in Gangwon province (44.8) and Chungnam province (44.3), and the lowest in Seoul metropolitan city (28.9) and Ulsan metropolitan city (29.2). There was a significant increase in the rate of suicide in city areas (odds ratio: 1.11, 95% CI: 1.08-1.13), county areas (1.62, 1.56-1.67) as compared with the rate of suicide in metropolitan areas. The commonest methods of suicide were hanging (53.7 percent), self-poisoning by pesticides (16.8 percent) and jumping from a height (14.3 percent). The methods used for suicide differed between rural (county) and urban areas (metropolitan city and city). In county areas, 43 percent of suicides used pesticides as compared to only 7-18 percent of those in urban areas. In urban areas, jumping was more common (13-17 percent vs. 6 percent). There were no difference in hanging between urban and rural areas. The odds ratio of death by pesticides was 9.86 in rural areas compared with death rate of metropolitan areas. The odds ratio of death by jumping was 0.59 in rural compared with death rate of metropolitan areas.

• 한국콘텐츠학회논문지
• /
• 제22권5호
• /
• pp.518-526
• /
• 2022

현대화에 따른 평균수명의 연장은 노년기 돌봄과 질병에 있어 수혜 시간의 연장을 의미한다. 그러나 노인 증가에 비해 자녀들의 부모부양책임에 대한 태도는 점점 약화되어 가고 있다. 이러한 사회현상은 노년기 삶에 소외, 절망감, 스트레스를 가져다주고 이로 인한 무망감으로 자살 생각이나 의도적인 죽음(자살)을 불러오는 요인이 되어 사회문제가 되고 있다. 노인의 의도적인 죽음(자살)은 주변에서 흔히 일어나는 사회현상으로 영화를 통해서도 그 실상을 알 수 있다. 본 연구에서는 영화 '죽여주는 여자'에 등장하는 주인공 '소영'과 주변 인물인 '송 노인', '종수', '재우' 등의 대화 속에서 노인 문제와 죽음 요인에 해당되는 내용을 매트릭스(Matrix) 분류체계 방법으로 정리한 후, 임병우(2019)가 정리한 '현대화에 따른 노인 문제 발생 흐름도'에 적용하여 의도적 죽음(자살) 요인을 탐구하였다. 분석 결과 4명의 노인들은 질병, 소외와 고독, 빈곤, 상실 등 노인 문제에 노출되었으나, 현대화로 인한 지위 하락과 부양의식 태도 변화로 인한 돌봄 부족의 스트레스가 지속되자, 삶에 대한 절망감에 빠져 의도적 죽음(자살)을 선택한 것으로 분석되었다.

• 보건행정학회지
• /
• 제28권1호
• /
• pp.87-90
• /
• 2018

Suicide has been a public health issue in many countries, and Korea has ranked highest suicide rate among Organization for Economic Cooperation and Development (OECD) countries over a decade. To address these issues, we updated the recent trends in suicidal ideation and suicide attempts among Korean adults followed by previous data observation. We used data from five sources: Korean National Health and Nutrition Examination (KNHANES, '07-12, '13, '15-16), Korean Community Health Survey (KCHS, '08-09, '13), Korean Wealth Panel Study (KOWEPS, '12-16), Korea Health Panel Survey (KHP, '10-13), and cause of death data from Statistics Korea ('07-16). We used weighted frequencies and trend tests. The rate of suicidal ideation as recent year was 5.10% (KNHANES, '15), 8.95% (KCHS, '13), 2.08% (KOWEPS, '16), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.59% (KNHANES, '16), 0.41% (KCHS, '13), and 0.08% (KOWEPS, '16). Annual percentage change of suicidal ideation was -2.80% (KNHANES, '07-12), 5.78% (KNHANES, '13-15), 0.62% (KCHS, '08-13), -8.50% (KOWEPS, '12-16), and -10.94% (KHP, '10-13). Annual percentage change of suicide attempts was -3.84% (KNHANES, '07-12), 2.26% (KNHANES, '13-16), -2.53% (KCHS, '08-13), and -20.22% (KOWEPS, '12-16). Annual percentage change of death by intentional self-harm was -0.49% (Statistics Korea, '07-16). Individuals who had lower income level were more likely to experience suicidal ideation and suicide attempts. According to these results, the rate of suicidal ideation and suicide attempts showed the decreasing tendency. However, the suicide rate of Korea has remained higher than that of OECD countries. Thus, continuous data observation and effective policies on suicide are needed.

• 한국노년학
• /
• 제39권4호
• /
• pp.883-893
• /
• 2019

인구 고령화에 따른 노인의 우울장애와 자살의 연관성에 대해 사회적 관심이 높아지고 있는 실정이다. 연구 목적은 고의적 자해로 입원한 노인 우울증 환자 특성을 분석하였다. 질병관리본부(Korea Centers for Disease Control and Prevention, KCDC)의 퇴원손상심층조사자료(Korean National Hospital Discharge In-depth Injury Survey)를 활용하여 3,280명을 대상으로 하였으며, 통계 프로그램 STATA 12.0을 이용하여 빈도분석, 교차분석, 그리고 로지스틱 회귀분석을 실시하였다. 분석결과, 성별[여(OR, 0.694; CI, 0.583-0.827)], 거주지[중소도시(OR, 0.078; CI, 0.648-0.935)], 자해결과[사망(OR, 0.461; CI 0.315-0.674)]의 경우에 우울증이 적었으나, 위험 요인[재정적 문제(OR, 3.485; CI 2.500-4.857), 정신적 문제(CI 2.917; CI 2.356-3.612), 육체적 질병(OR, 2.678; CI 1.869-3.836), 가족구성원과의 갈등(OR, 1.828, CI 1.437-2.325)], 발생장소[거주지 외(OR, 1.416; CI 1.182-1.695)], 자해수단[중독(OR, 1.695; CI 1.345-2.317)]의 경우 우울증이 많았으며, 통계적으로 유의하였다. 이러한 결과를 바탕으로 의료기관은 고의적 자해 환자 입원시 우울증을 사전에 감지하고 이를 최소화 시키는 기초자료로 활용될 수 있을 것이다.

• 대한임상독성학회지
• /
• 제15권2호
• /
• pp.131-139
• /
• 2017

Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.

• 보건행정학회지
• /
• 제31권2호
• /
• pp.232-239
• /
• 2021

This study aimed to update suicide-related indicators including suicidal ideation, suicide attempts, and the number of suicidal deaths. Based on up-to-date information, we observed the trends of suicide-related indicators. In this study, five data sources were used to observe the trends of suicide-related indicators: Statistics Korea (1983-2019), Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-19), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-19), and Korea Health Panel Survey (KHP, '10-13, '16-17). The suicide rate, which peaked in 2011, declined until 2017 and then started to rise again from 2018, recording a suicide rate of 26.9 per 100,000 people in 2019. The rate of suicidal ideation estimated based on the recently available data was 4.62% (KNHANES, '19), 3.51% (KHP, '16), 2.87% (KHP, '17), and 1.70% (KOWEPS, '19). That of suicide attempt as recent year was 0.43% (KNHANES, '19), 0.07% (KOWEPS, '19). Annual percentage change of death by intentional self-harm was -2.11% (Statistics Korea), and that of suicidal ideation was -14.7% (KNHANES), -2.5% (KCHS), -10.6% (KOWEPS), and -11.3% (KHP). Annual percentage change of suicide attempt was -5.0% (KNHANES), -4.4% (KCHS), and -11.3% (KOWEPS). The lower the income level, the higher the probability of experiencing suicide ideation and suicide attempts. Considering the recent increase in suicide rate in contrast to the continuing decline in suicidal ideation and suicide attempts, continuous data observation and appropriate policies regarding suicide prevention are needed.

• 보건행정학회지
• /
• 제30권1호
• /
• pp.112-119
• /
• 2020

Suicide has been a long-standing problem for global public health, along with almost 800,000 deaths from suicide worldwide in 2016, accounting for 1.4% of all deaths. South Korea was ranked first in suicide mortality in 2018 among countries in the Organization for Economic Cooperation and Development. This study aimed to suggest up-to-date information about suicide-related indicators such as the rate of suicidal ideation, suicide attempt, and suicide death, and its trends by applying sampling weight to make it nationally representative. In this study, we used the data sources: Korea National Health and Nutrition Examination (KNHANES, '07-13, '15-18), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-18), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). The rate of suicidal ideation as recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 2.29% (KOWEPS, '18), and 5.39% (KHP, '13). That of suicide attempt as recent year was 0.51% (KNHANES, '18), 0.32% (KCHS, '17), and 0.15% (KOWEPS, '18). Annual percentage change (APC) of suicidal ideation was -15.4% (KNHANES, '07-13, '15, '17), -2.5% (KCHS, '08-09, '13, '17), -10.8% (KOWEPS, '12-18), and -10.9% (KHP, '10-13). APC of suicide attempt was -4.4% (KNHANES, '07-13, '15-18), -4.4% (KCHS, '08-09, '13, '17), and -13.6% (KOWEPS, '12-18). APC of death by intentional self-harm was -1.25% (Statistics Korea, '07-18). All suicide-related indicators were found to be decreasing in the overall from 2009. Individuals with lower income level were more likely to experience suicidal ideation and suicide attempts. Even though suicide rate had been continuously decreasing from its highest point in 2011 (suicide rate: 31.7 per 100,000 population) to 2017 (suicide rate: 24.3 per 100,000 population), it increased again in 2018 (suicide rate: 26.6 per 100,000 population). This information would be grounded on policy implementation for suicide prevention, thus continuous data observation is necessary.

• Journal of Preventive Medicine and Public Health
• /
• 제51권3호
• /
• pp.163-168
• /
• 2018

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

• 대한임상독성학회지
• /
• 제14권1호
• /
• pp.47-53
• /
• 2016

Purpose: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. Methods: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. Results: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). Conclusion: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.

• 항공우주정책ㆍ법학회지
• /
• 제30권2호
• /
• pp.279-310
• /
• 2015

몬트리올협약은 국제항공운송에서 발생한 사고에 따른 여객의 사망이나 상해에 관하여 항공운송인의 책임을 배타적으로 규율하고 있다. 국제항공산업의 재정적인 안정과 항공사를 파산으로 이끌 수도 있는 과도한 배상책임으로부터 항공산업을 보호할 목적으로 몬트리올협약은 금전배상에 있어서 책임제한제도를 운영하고 있다. 하지만 여객의 사망이나 상해가 항공사 혹은 그 대리인의 직접적인 과실이나 불법적인 작위 혹은 부작위의 결과라는 점이 인정될 경우에 그러한 책임제한원칙은 유지될 수 없고, 손해배상을 청구하는 자는 협약이 정하는 제한책임액 이상의 배상을 받을 수도 있다. 한편, 몬트리올협약은 손해배상을 청구하는 원고가 소송을 제기할 수 있는 법정지에 관해서도 관할권 관련 조항에서 일정한 제한을 두고 있다. 이러한 관할권은 특히 피고 항공운송인의 영업소나 원고의 주소지가 주요 결정요인이 된다. 지난 2015년 3월, Germanwings 항공사 9525편에 발생한 사고는 당시 심한 우울증을 앓고 있었던 부기장의 의도적인 행동이 원인이었고, 해당 항공기가 프랑스령 알프스산맥에 추락하면서 대부분의 탑승 여객과 승무원의 사망이라는 결과로 이어졌다. 보도 자료에 따르면 사고 직후, 항공사는 사망승객의 국적에 따라 금액의 차이는 있지만 미화 8,300불에서 4백5십만불에 이르는 손해배상액을 합의금으로 제시하였다고 한다. 이러한 합의제안에 대해 몇몇 유가족들은 보다 많은 배상액을 얻기 위하여 미국과 같이 피해자에게 관대한 법정지에서 소송제기를 계획하고 있다고 한다. 본 논문은 위 사고와 관련하여 두 가지 쟁점에 관하여 기술하고 있다. 첫째, 본 논문은 몬트리올협약상 관할권 조항과 관련하여 미국 시민이 아닌 피해자가 미국 법정지에서 소송을 제기할 가능성에 대해 살펴보았다. 둘째, 본 사고의 직접적인 원인이 부기장의 의도된 사고유발 행동이었던 점에서 사안의 항공사는 몬트리올협약이 규정하고 있는 책임제한원칙이 부정될 가능성이 있다. 이에 관하여 본 논문은 해당 항공사가 그럼에도 불구하고 협약상 책임제한규정을 원용할 수 있는 가능성이 있는지 여부를 중점적으로 살펴보았다.