Analyzing the changing relationship between personal consumption and suicide mortality during COVID-19 pandemic in Japan, using governmental and personal consumption transaction databases

During the early stages of the ongoing COVID-19 pandemic, suicides did not increase in most countries/regions. Japan, however, was an exception to this, reporting increased numbers of female suicides with no changes in male suicide. To explore the trends of increasing suicides, the fluctuations of personal consumption (as an indicator of lifestyle) and standardized suicide death rate (SDR) disaggregated by age, sex, and prefecture, were determined using a linear mixed-effect model. Additionally, fixed effects of personal consumption on SDR during the pandemic were also analyzed using hierarchical linear regression models with robust standard errors. During the first wave of the pandemic, SDR for both sexes decreased slightly but increased during the second half of 2020. SDR of females younger than 70 years old and males younger than 40 years old continued to increase throughout 2021, whereas SDR for other ages of both sexes did not increase. Personal consumption expenditures on out-of-home recreations (travel agencies, pubs, and hotels) and internet/mobile communication expenses decreased, but expenditures on home-based recreations (contents distribution) increased during the pandemic. Increased expenditures on internet/mobile communication were related to increasing SDR of both sexes. Increasing expenditures on content distributions were related to increasing females' SDR without affecting that of males. Decreasing expenditures on pubs were related to increasing SDR of both sexes in the non-metropolitan region. These findings suggest that transformed individual lifestyles, extended time at home with a decreased outing for contact with others, contributed to the progression of isolation as a risk of suicide. Unexpectedly, increasing compensatory contact with others using internet/mobile communication enhanced isolation resulting in increased suicide risk.

Automated summary

During the early stages of the COVID-19 pandemic, most countries/regions did not see an increase in suicides. However, Japan was an exception, with an increase in female suicides while male suicides remained unchanged. Personal consumption and standardized suicide death rates were analyzed to understand the trends in suicides during the pandemic. It was found that during the first wave of the pandemic, suicide rates for both sexes slightly decreased but increased during the second half of 2020. The suicide rates for females under 70 years old and males under 40 years old continued to increase in 2021. Changes in personal consumption, such as decreased expenditures on out-of-home recreations and increased expenditures on home-based recreations, were observed. Increased expenditures on internet/mobile communication were associated with an increase in suicide rates for both sexes, while increased expenditures on content distributions were associated with an increase in suicide rates for females only. Decreased expenditures on pubs were related to an increase in suicide rates for both sexes in non-metropolitan areas. These findings suggest that the changes in individual lifestyles during the pandemic, including more time spent at home and decreased social interactions, contribute to an increased risk of suicide.