Persistent health inequalities between socio-economic groups have been observed in both developed and developing countries 1. Tackling such disparities has featured prominently in the policy agenda globally in recent years. The World Health Organization 2,3, the World Bank 4, and the United Nations Development Programme 5 have all emphasized its importance and made this issue a priority. South Korea is no exception. The New Health Plan 2010, established in 2005, aims to reduce health inequality and ultimately improve overall quality of life of the nation 6. In South Korea, the issue of health inequalities has gained increasing attention with the widening income inequality and increasing social polarization following the country’s economic crisis in the late 1990s 7. There have been widespread concerns that such social changes may also widen the health gap between socioeconomic groups 7. Recent studies examining this issue were largely consistent in reporting persistent and/or widening health inequality 7,8,9. Despite growing awareness of mental health issues and their explicit presence in the New Health Plan 2010, the extent of socioeconomic inequality with respect to mental health problems in South Korea has not been thoroughly examined. Official figures 10,11 indicate a general trend of worsening mental health, with rising rates of suicide and depression in particular. The suicide rate rose dramatically from the national average of 13.0 per 100,000 in 1997 to 26.0 in 2008 11, the highest among countries belonging to the Organization for Economic Cooperation and Development (OECD) 12. Similarly, the lifetime prevalence of major depression rose from 3.1% in 2001 13 to 5.6% in 2006 10, although it is still lower than that reported in Western countries 14,15,16,17. A variety of factors may influence mental health, some of which are potentially amenable to change by individuals or society (e.g., income, education, housing, neighbourhood, relationships, and employment). The mechanisms through which such factors affect the development of mental health problems are contentious 18,19,20. However, many of them are, directly or indirectly, related to income. This study aimed to measure the magnitude of income-related inequalities in the prevalence of depression, suicidal ideation and suicide attempts in South Korea and trace the change in the inequalities over the past 10 years.
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