Abstract

Background
South Korea has long recorded one of the highest suicide rates among OECD countries, with men dying by suicide at more than twice the rate of women. Male wage workers are especially exposed to occupational and economic stressors linked to suicidal ideation. Because the COVID-19 pandemic generated large-scale labor market disruption, the factors driving suicidal ideation in this group may have changed. This study compared the prevalence and determinants of suicidal ideation among Korean male wage workers before and during the pandemic.
Methods
Using nationally representative data from the Korea National Health and Nutrition Examination Survey, we analyzed 2,566 male wage workers in the pre-pandemic period (2017–2019) and 2,131 in the pandemic period (2020–2022). Suicidal ideation was self-reported. Socioeconomic factors (age, education, marital status, household income) and occupational factors (occupation group, employment status, weekly working hours) were examined using survey-weighted chi-square tests and multivariable logistic regression, conducted separately for each period.
Results
The weighted prevalence of suicidal ideation rose from 2.2% to 2.8% across the two periods. Before the pandemic, elementary school education (adjusted odds ratio [aOR] 5.05, 95% confidence interval [CI] 1.12–22.91) and daily employment (aOR 3.06, 95% CI 1.13–8.28) were independently associated with suicidal ideation. During the pandemic, low household income became the sole independent determinant (aOR 4.07, 95% CI 1.45–11.40), while the pre-pandemic associations with education and employment status no longer reached significance. Occupation and weekly working hours were not associated with suicidal ideation in either period.
Conclusions
Among Korean male wage workers, suicidal ideation was associated with structural vulnerabilities before the pandemic and with economic vulnerability during it, although between-period differences were not formally tested. These findings indicate that suicide prevention for male workers should be context-dependent—addressing precarious employment and low education in ordinary times, while prioritizing income protection during large-scale crises.

• Keywords: COVID-19; Suicidal Ideation; Occupational Health; Male; Republic of Korea