ArticleInternational journal of environmental research and public health2025
The Double Burden of Isolation and Unemployment: Suicide Risk in Structurally Vulnerable Populations in Japan-A Case Study of Akita Prefecture (2018-2022).
Article in International journal of environmental research and public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Suicide in Japan remains elevated and uneven across regions. We hypothesized that (H1) unemployment and (H2) living alone each increase suicide mortality, and that (H3) their combination yields more-than-additive risk, especially among middle-aged men. Using specially tabulated mortality data (2018-2022) from the Japan Suicide Countermeasures Promotion Center, we cross-classified deaths and denominators into 24 strata by sex, age (20-39, 40-59, ≥60), employment (employed/unemployed), and cohabitation (with others/alone). Five-year average rates per 100,000 were computed; between-group differences were tested with chi-square (Holm-adjusted contrasts). Additive interaction between unemployment and living alone was quantified with the Interaction Contrast (ICR) and Synergy Index (SI), and Akita rates were benchmarked against national strata. Prefecture-level quantification and national benchmarking are rarely reported in Japan. Rates differed significantly across employment-by-cohabitation groups in every sex-by-age stratum (
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