If the three pillars of health are physical, mental, and social well-being, where is our society most vulnerable? The most painful indicator is suicide. And this problem will never be solved if it is treated only as a personal illness.
According to the 'Health at a Glance 2025' report recently published by the Organization for Economic Cooperation and Development (OECD), Korea's age-standardized suicide rate is 23.2 per 100,000 population, which is more than twice the average of 10.7 for 38 member countries. Korea has been ranked first in this category since 2003. When looking at gender, the gap is more evident.
The suicide rate for men was 33.9 per 100,000 and for women was 14, the highest among member countries for both genders. Korea also ranked first among the 15 countries compared in the rate of patients hospitalized for mental illness committing suicide within one year after being discharged. The actual figures without adjusting for age structure are heavier. Last year, the domestic suicide rate was 29.1 per 100,000 people, the highest in 13 years since 31.7 in 2011. Fortunately, in this year's provisional figures, the number of suicide deaths decreased by 7.4% compared to the previous year, marking the first downward trend in three years.
The government put forward an action plan to lower the suicide rate to 17 per 100,000 in 2018, but failed to achieve it, and has now set another goal of lowering it to below 17 by 2034. In the pursuit of abundance, healthy connections between people have been devastated.
The abnormality of the mind has many faces. These include bipolar disorder and paranoia, schizophrenia and depression, dementia and sleep disorders, alcohol and drug addiction, cyber addiction and neurosis. Among them, depression is the most common yet easily overlooked disease. The attitude of dismissing these mental abnormalities as personal weakness or personal illness increases the problem.
◇ Where did we go wrong?
If we go back to the roots of the disease, we can see the path we have taken. We have raced towards a selfish and self-centered hyper-competitive society with economics and convenience at the forefront. That bill is before us now. The list includes fine dust and misuse of chemicals, the second highest use of antibiotics among OECD countries after Turkmenistan, if not the highest in the world, the prevalence of anger management disorders, and the highest suicide rate.
Here, we cannot leave out the humidifier disinfectant disaster that became known to the world in 2011. The official death toll from humidifier disinfectants sold over a period of 17 years since 1994 is 1,843, and the government has acknowledged damage to 6,048 people. The price of choosing convenience was high.
Types of diseases have also changed along this trend. The focus shifted from infectious diseases to lifestyle diseases and then back to stress-related diseases. New diseases are also born. The development of IT has given rise to unfamiliar diseases such as game addiction and confusion between virtual and reality, and the World Health Organization listed gaming disorder as a new disease in the International Classification of Diseases in 2019. In this way, disease is created not only by causative factors and constitution, but also by the environment: air, water, diet, education, family, and nation.
A change in thinking is needed here. The idea is to view mental abnormalities as social diseases and deal with them socially. This is called ‘social prescription’. It is an approach that connects people to community activities, gatherings, and services to meet the practical, social, and emotional needs that affect their health and well-being. In the UK, each local government, centered around the National Health Service (NHS), has linked personnel called 'link workers' to connect people with chronic diseases, mental health problems, or loneliness with local resources.
It is a system that started from the recognition that social isolation is not the solution.
The key is to actively encourage communication and encourage socialization. A concrete way is to support leisure activities within the community. The stages include sports such as soccer, tennis, lawn bowling, gateball, and park golf, gardening and singing classes, volunteer activities, and civic universities. This also includes opening up opportunities for each person to share their talents. Bringing people into relationships rather than leaving them alone is the basis of prescription.
◇ Efforts not to lose myself
Research that has tracked the path to living a long, healthy life resonates again at this point. In 1938, the Harvard University Adult Development Research Team selected 724 people, including 268 second-year students at Harvard University and 456 boys from the Boston slums, and tracked their lives for over 80 years. According to this study, the quality of human relationships was the strongest predictor of health and happiness in old age, rather than wealth, fame, or academic background.
People who said they were satisfied with their relationships at age 50 were the healthiest physically and mentally in their 80s, and people who were subject to unwanted isolation deteriorated more quickly than those who were not. What people who have lived long and healthy lives have in common is that they are thorough in self-management, have made lifelong friends, avoided excessive stress, and are active in social activities.
There is no definite secret to trying not to lose ‘me’. However, exercise to improve circulation, meditation to improve breathing, and social activities widen the path. Losing myself is ultimately no different from losing my memories. Just as memories disappear when the hippocampus in the brain, which controls memory, is damaged, consciousness is a phenomenon in our body based on memories.
◇ Recovery begins with consideration
The coronavirus incident was an event that condensed all of these stories. Just like the Spanish flu that swept the world 100 years ago, the socially disadvantaged were mainly victims this time. The Spanish flu that occurred in 1918 is estimated to have killed 40 to 50 million people around the world. The Korean Peninsula, which was a Japanese colony at the time, was no exception. According to statistics from the Japanese Government-General of Korea at the time, out of a population of approximately 16.78 million, 7.42 million people contracted the flu, and about 139,000 of them lost their lives. Viruses frequently change their genes and create new strains, and new epidemics are expected in the future.
The principles we can hold to in that regard are surprisingly simple. It is about being considerate, living together, and protecting the ecosystem. Even daily habits such as washing hands and observing cough etiquette ultimately come from consideration for others. The moment we accept mental illness as a social illness, clues to recovery can be found within society.
Eom Yung-ui, professor emeritus at Seoul National University College of Medicine
▲ Served as a professor in the Department of Physiology at Seoul National University ▲ Researcher at Oxford University School of Medicine in the UK and member of the British Physiological Society ▲ Chairman of the Cardiovascular Division of the International Union of Physiological Sciences ▲ Associate Editor-in-Chief of the European Journal of Physiology ‘Plügers Ahipp’ (currently) ▲ Regular member of the Korean Academy of Medical Sciences (currently) ▲ Major in Biomedical Sciences, Department of Interdisciplinary Studies, Daegu Gyeongbuk Institute of Science and Technology Invited Distinguished Professor (current)
