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• Community gender norms, mental health, and suicide ideation and attempts among older Japanese adults: a cross-sectional study

  2024. Mariko Kanamori (et al.). International psychogeriatrics 36 (5), 385-395

  Artikel

  Objectives:Gender norms embedded in communities may restrict opportunities and harm the mental health of older adults, yet this phenomenon has received little attention. This study investigates the connection between older adults' perceptions of community gender norms and mental health and suicide-related outcomes.Design:Cross-sectional.Setting:This study analyzed data from the 2019 wave of the Japan Gerontological Evaluation Study.Participants:In total, 25,937 participants aged 65 years or older in 61 municipalities.Measurements:Perceptions of community gender norms were assessed by the respondents' perceptions of the gender-differentiating language used by those around them such as You should/should not do XXX, because you are a man/woman.Results:The prevalence of all mental health outcomes was higher among both men and women who perceived community gender norms as restrictive. These associations remained in fully adjusted multivariable analyses. Prevalence ratios for men were 1.36 [95% confidence interval: 1.13, 1.65] for psychological resistance to obtaining help, 1.85 [1.54, 2.23] for depressive symptoms, 1.99 [1.34, 2.96] for suicidal ideation, and 2.15 [1.21, 3.80] for suicide attempts. The corresponding figures for women were 1.39 [1.17, 1.65], 1.80 [1.55, 2.10], 2.13 [1.65, 2.74], 2.62 [1.78, 3.87]. There was a more pronounced association between perceiving community gender norms as restrictive and depressive symptoms and suicidal behaviors among those with nonconventional gender role attitudes compared to those with conventional attitudes.Conclusions:Considering the effects of community gender norms, in addition to individual gender role attitudes, may be critical in designing effective public health interventions for improving mental health.

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• Interdependent culture and older adults’ well-being: Health and psychological happiness in Japanese communities

  2024. Yukiko Uchida (et al.). Current Opinion in Psychology 55

  Artikel

  This review article examined perspectives on the well-being and health of older adults in Japan, a nation renowned for its longevity. We emphasized the impact of social capital and social relationships in local communities, considering both individual and societal factors. The prevailing values in Japanese culture tend to foster a sustained and stable form of interdependent happiness among older adults, suggesting that communal support systems play an important role. This article highlights the value of multi-level datasets, such as the Japan Gerontological Evaluation Study (JAGES) dataset, for understanding the influence of social participation on the health and well-being of older adults. A growing body of evidence underscores the central role of social relationships in the health and well-being of older adults.

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• Does increased migration affect the rural-urban divide in suicide? A register-based repeated cohort study in Sweden from 1991 to 2015

  2022. Mariko Kanamori (et al.). Population, Space and Place 28 (1)

  Artikel

  Some countries have high suicide rates in rural areas with a potentially stronger impact of rural context on foreign-born residents. In Sweden, where immigration has been increasing, dispersion policies have directed refugees/migrants to settle in rural areas. We examined whether trends in suicide mortality vary by nativity and rurality. A repeated cohort study was designed using Swedish national register data between 1991 and 2015. Our three-level analysis found that male suicide rates in rural areas were 1.2 times higher than in urban areas, with the rate decreasing over time in both urban and rural areas. We observed fluctuations in suicide mortality among foreign-born men residing in small rural communities, with high suicide rates in the 2000s. The proportion of unemployed was linked to the excess rate of suicide in rural municipalities. Dispersion policies moving migrants to rural areas should take into account the regional characteristics both within municipalities (e.g., income distribution) and between municipalities (e.g., labour market characteristics).

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• Rural life and suicide: Does the effect of the community context vary by country of birth? A Swedish registry-based multilevel cohort study

  2020. Mariko Kanamori (et al.). Social Science and Medicine 253

  Artikel

  Contextual factors varying by residence in rural or urban areas may have different effects on the suicide of residents by nativity, but evidence on the urban-rural gap in suicide according to nativity is lacking. This study aims to evaluate the effect of cross-level interaction between nativity and rurality of residence on suicide risk, at two levels of aggregation (municipalities/neighborhoods). Study design was nationwide register-based cohort study in Sweden, 2011-2016. Participants were all residents 20 years or older. We calculated Incidence Rate Ratios comparing suicide incidence by nativity using three-level (individuals, neighborhoods, and municipalities) Poisson regression, stratified by gender. Among men, suicide incidences were the highest among those born in other Nordic countries, followed by those born in Sweden, other European countries, Middle Eastern countries, and the rest of the world. Residing in rural areas was associated with high IRR of suicide regardless of nativity, compared to residing in urban areas. When evaluating rurality at municipality level, we observed an increased suicide risk from living in rural areas in men born in other European (rural-urban ratio of nativityspecific IRRs: 1.39) and other Nordic (1.37) countries, followed by native Swedes (1.22). When evaluating rurality at neighborhood level, rurality was associated with increased suicide risk in men for all nativities, with the foreign-born showing higher risk than the Swedish-born. Individual sociodemographic characteristics explained the excess suicide risk in rural municipalities, but not the excess risk in rural neighborhoods. Among women, urban residents showed higher suicide incidence than rural residents. We found no consistent patterning of interaction with nativities among women. Foreign-born individuals residing in rural municipalities may have less access to economic resources and employment opportunities. Furthermore, ethnic discrimination, stigma, and exclusion from social networks and community may be more common in rural neighborhood contexts, leading to an increased risk of suicide.

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