Association Between Changes in the Employment Environment and Suicide Attempts During the COVID-19 Pandemic

Background: The COVID-19 pandemic disrupted employment, but whether distinct types of employment change are differentially associated with suicidal behavior remains unclear. This study examined the association between pandemic-related employment changes and past-year suicide attempts. Methods: We conducted a cross-sectional analysis of 172,970 adults aged ≥19 years who were economically active before January 2020, using data from the 2021 Korea Community Health Survey (KCHS). Employment change was classified as no change, job loss, deteriorated employment conditions or improved employment conditions. Survey-weighted multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results: Overall, 520 participants reported a suicide attempt in the past year. Compared with no change, job loss (AOR, 2.548; 95% CI, 1.777–3.654) and deteriorated employment conditions (AOR, 1.435; 95% CI, 1.116–1.845) were associated with higher odds of suicide attempts, whereas improved employment conditions were not (AOR, 0.678; 95% CI, 0.302–1.521). Job loss was associated with higher odds than deteriorated employment conditions (AOR, 1.776; 95% CI, 1.230–2.564). The interaction was significant for age (p = 0.0130) and income (p = 0.0035), but not for sex (p = 0.1008). Conclusions: Job loss and deteriorated employment conditions were differentially associated with past-year suicide attempts. Because of the cross-sectional design, temporal order and causality cannot be established.