Standardized suicide mortality rates per 100,000 population (SMRs) in Japan consistently decreased from 2009–2019, but these decreasing trends were reversed to increase in 2020. To clarify the mechanisms of recent increasing suicide in Japan, temporal fluctuations of SMRs disaggregated by sex and employment status (employed and unemployed individuals) and labor indices such as working hours, wages, and regular employment opportunity index (REO) from January 2012 to June 2023 were analyzed using interrupted time-series analysis. Additionally, temporal causalities from labor indices to SMRs were analyzed using vector autoregressive and non-linear auto-regressive distributed lag analyses. Decreasing trends among employed SMRs of both sexes were attenuated after the enactment of the “Work Style Reform Program” in 2018, but male SMRs were unaffected by the COVID-19 pandemic. However, female employed SMRs sharply increased, synchronized with the “Work Style Reform Act” and the COVID-19 pandemic outbreak (the COVID-19 impact was greater than the “Work Style Reform Act”). Additionally, unemployed SMRs of both sexes sharply increased with the revision and scale-down of countermeasures against economic deterioration caused by COVID-19 (“revision of economic supportive countermeasures against economic deterioration caused by COVID-19”). Unexpectedly, after enacting the “Work Style Reform Act”, wages decreased due to possibly decreasing working hours. Increasing REO, which consistently increased, was a protective factor for male suicides, but unemployed SMRs were not affected by any labor indices. It has been established that controlling a heavy workload plays an important role in suppressing the deterioration of physical and mental conditions, including suicide; however, this study suggested that, at least within appropriate ranges of working hours, decreasing working hours due to excessive management probably contributes to increasing suicides of some vulnerable individuals via de-creasing their wages. Although governmental welfare and economic support measures had to be revised according to rapidly changing situations during the COVID-19 pandemic, this study also suggested that temporal gaps among a part of revisions of several welfare and economic support measures were unexpectedly involved in drastically/sharply increasing suicides of unemployed individuals in 2022.

中文翻译：

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日本 COVID-19 大流行之前和期间工作时间、工资和正常就业机会对就业和失业人员自杀死亡率的影响

日本每 10 万人的标准化自杀死亡率 (SMR) 从 2009 年至 2019 年持续下降，但这种下降趋势在 2020 年逆转为上升。为了阐明日本近期自杀增加的机制，按性别和就业分类的 SMR 的时间波动采用断续时间序列分析方法，对 2012 年 1 月至 2023 年 6 月的就业状况（就业和失业个人）以及工作时间、工资和常规就业机会指数（REO）等劳动指数进行了分析。此外，还使用向量自回归和非线性自回归分布式滞后分析来分析从劳动力指数到 SMR 的时间因果关系。 2018 年“工作方式改革计划”颁布后，男女就业 SMR 的下降趋势有所减弱，但男性 SMR 并未受到 COVID-19 大流行的影响。然而，与“工作方式改革法”和COVID-19大流行爆发同步，女性就业SMR急剧增加（COVID-19的影响大于“工作方式改革法”）。此外，随着针对 COVID-19 造成的经济恶化的对策的修订和规模缩小（“针对 COVID-19 造成的经济恶化的经济支持对策的修订”），男女失业 SMR 急剧增加。没想到，《工作方式改革法》颁布后，工资因工作时间可能减少而下降。 REO 的持续增加是男性自杀的保护因素，但失业的 SMR 不受任何劳动力指数的影响。现已证实，控制繁重的工作量对于抑制身心状况恶化（包括自杀）具有重要作用；然而，这项研究表明，至少在适当的工作时间范围内，由于过度管理而减少工作时间可能会导致一些弱势群体通过降低工资而自杀。尽管在COVID-19大流行期间，政府的福利和经济支持措施必须根据迅速变化的情况进行修订，但这项研究还表明，多项福利和经济支持措施的部分修订之间的时间差距意外地导致了急剧/急剧增加。 2022 年失业人员自杀情况。