Poor diabetics have 4.3 times higher suicide risk than rich non-diabetics

The risk of suicide among economically disadvantaged people with diabetes is 4.34 times higher than among high-income people without diabetes, indicating the need for social attention and practical support.

The Korean Diabetes Association said so in its analysis of “Association of Suicide by Socioeconomic Status of Diabetic Patients” based on data from the National Health Insurance Service.

The association divided total health insurance premiums paid by 3,439,170 people aged 30-64 who underwent national health checkups from 2012 to 2022 (1-20 quartile) into four quartiles to examine the association of suicide by income.

It found that the lower the income, the higher the suicide rate whether they had diabetes or not, and the rate was higher among those with diabetes than those without diabetes.

Specifically, in the highest income quartile, the risk of suicide was 1.25 times higher for people with diabetes than those without diabetes, and the risk increased as income decreased. Recipients of medical benefits with diabetes had a 4.34 times higher risk of suicide than high-income individuals without diabetes.

The risk of suicide was even higher for people with diabetes who had been in low-income status longer. Those who were in the lowest 25 percent income quintile five times in a row during the study period had twice the risk of suicide as non-diabetics who were not in the lowest income quintile.

Frequent changes in income level also increase the risk of suicide.

When categorized into four income quartiles, the risk of suicide was 1.21 times higher among those with the lowest income volatility (Q1) compared to those without diabetes. Still, this risk rose 1.89 times among those with the highest income volatility (Q4). Even when analyzing only those with diabetes, the risk of suicide increased according to income levels.

Compared to diabetics in the highest income quartile, those on medical benefits were 3.48 times more likely to commit suicide. People with diabetes in the lowest 25 percent of low-income households for 10 consecutive years were 1.56 times more likely to commit suicide than those who did not experience persistent low income.

“Long-term illness of diabetes patients can lead to economic poverty due to difficulties in working life, job loss, and career interruption,” said Dr. Cha Bong-soo, chair of the Korean Diabetes Association and a professor of endocrinology at Severance Hospital. “Depression in individuals due to low income can lead to family discord and decreased family bonding, which often leads to suicide.”

Therefore, it is urgent to come up with policy alternatives, including early screening and support for diabetes patients who may be at increased risk of suicide due to hardship, the association said.

“As people with diabetes age, their medical expenses can snowball due to complications,” Cha said. “The government should take a closer look at not only the financial difficulties of people with diabetes but also the mental health problems they face.”