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Diabetes and suicide risk according to area-level deprivation: A nationwide cohort study in Japan

Author

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  • Komura, Yoshikazu
  • Inoue, Kosuke
  • Tsugawa, Yusuke
  • Kondo, Naoki

Abstract

Although area-level deprivation affects the quality of diabetes management, it remains unclear whether the risk of diabetes-related suicide varies by area-level deprivation. We investigate whether the association between diabetes and suicide risk varies by area-level deprivation. We conducted a matched-pair cohort study using a nationwide health insurance database in Japan. Individuals with diabetes were matched 1:1 with those without diabetes by age, sex, and insurance status (i.e., insured person or their dependents). Area-level deprivation was assessed with a census-based Areal Deprivation Index (ADI), and we employed a Cox proportional hazards model to estimate the hazard ratio (HR) and 95 % confidence interval (CI) of suicide for individuals with diabetes by area-level deprivation level. Among 5,316,274 individuals (54.8 % men, mean age 52.9 years), we observed 760 suicides (incidence rate = 6.36/100,000 person-years). Individuals with diabetes experienced a higher risk of suicide than those without diabetes (HR = 1.33 [95 %CI 1.15–1.54]). The association between diabetes and suicide was stronger in less deprived areas than more deprived areas (the least deprived ADI quantile, HR = 1.89 [95 %CI 1.31–2.72]; the most deprived ADI quantile, HR = 1.15 [95 %CI 0.90–1.46]). Our findings suggest greater psychosocial challenges of diabetes diagnosis and management faced by individuals living in less deprived areas, or a possibility that diabetes diagnosis may serve as an equalizer of health disparities by improving healthcare access in more deprived areas.

Suggested Citation

  • Komura, Yoshikazu & Inoue, Kosuke & Tsugawa, Yusuke & Kondo, Naoki, 2025. "Diabetes and suicide risk according to area-level deprivation: A nationwide cohort study in Japan," Social Science & Medicine, Elsevier, vol. 383(C).
    • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625007555
    DOI: 10.1016/j.socscimed.2025.118424
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    1. repec:plo:pone00:0097802 is not listed on IDEAS
    2. Peter C. Austin, 2017. "A Tutorial on Multilevel Survival Analysis: Methods, Models and Applications," International Statistical Review, International Statistical Institute, vol. 85(2), pages 185-203, August.
    3. Cairns, Joanne-Marie & Graham, Eva & Bambra, Clare, 2017. "Area-level socioeconomic disadvantage and suicidal behaviour in Europe: A systematic review," Social Science & Medicine, Elsevier, vol. 192(C), pages 102-111.
    4. Kondo, Naoki & Kawachi, Ichiro & Subramanian, S.V. & Takeda, Yasuhisa & Yamagata, Zentaro, 2008. "Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals," Social Science & Medicine, Elsevier, vol. 67(6), pages 982-987, September.
    5. Duncan, Greg J. & Katz, Lawrence F. & Kessler, Ronald & Kling, Jeffrey R. & Gennetian, Lisa & Adam, Emma & Ludwig, Jens & Sanbonmatsu, Lisa & Tessler, Stacy & McDade, Thomas W. & Whitaker, Robert C., 2011. "Neighborhoods, Obesity and Diabetes –-- A Randomized Social Experiment," Scholarly Articles 8642951, Harvard University Department of Economics.
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