In 2023, the suicide rate in South Korea was particularly high among the elderly population over the age of **, with **** deaths per 100,000 population. The overall suicide rate among people aged 10 to 79 years increased compared to the previous year. Suicide was the leading cause of death among people aged 10 to 39 years. Suicide among the elderlySouth Korea has the highest suicide rate in the Organisation for Economic Co-operation and Development (OECD). One driving factor for suicide among the elderly is poverty. Almost half of the senior citizens in the country live with less than half the median disposable income. Many do not want to become a financial burden for their families and end up committing suicide as a result of not being able to support themselves.Suicide prevention Since the South Korean government implemented its initial suicide prevention program in 2004, numerous measures have been put in place to address the alarmingly high suicide rate. However, these efforts have not been very successful. Despite an increase in the annual budget for suicide prevention, it still remains significantly lower compared to international standards. If you are having suicidal thoughts, or you know someone who is, it is essential to seek help. Many countries have suicide crisis or prevention lines that offer free advice and support in such situations. If you live in the United States, you can reach the Suicide & Crisis Lifeline by simply calling *** to receive free and confidential support ****. If you live in South Korea you can call the suicide prevention hotline ***.

The countries with the highest suicide mortality rate worldwide in 2021 included Lesotho, South Korea, and Eswatini. In 2021, there were around 27.5 suicide deaths per 100,000 population in South Korea. Suicide in the United States Although the United States is not among the countries with the highest suicide mortality rate, suicide is still a major issue in the country. As with other countries, the suicide rate among males in the U.S. is much higher than among females. In 2022, there were around 23 suicide deaths among males in the United States per 100,000 population, compared to 5.9 deaths per 100,000 females. The states with the highest suicide rates are Montana, Wyoming, and Alaska, while New Jersey and Massachusetts have the lowest rates. Risk factors and help Major risk factors for suicide include mental health issues and substance abuse problems; however, it can be difficult to predict who is at risk. Warning signs such as talking about wanting to die, expressing feelings of depression, suicidal ideation, and abusing drugs or alcohol should be taken seriously and help should be sought as soon as possible. Suicide hotlines exist in many countries around the world and one should not hesitate to discuss such issues and feelings with a health care provider.

Background: High suicide rate in the elderly is an important global public health problem but has not received the attention it deserves. This study aimed to examine time trends of suicide mortality for people aged 70 years and over by sex, age, and location from 1990 to 2017, and to provide predictions up to 2030.Methods: Using data from the Global Burden of Disease study 2017, we presented elderly suicide mortality changes and compared the patterns for the elderly with that for all ages. We estimated associations between socio-demographic index (SDI) and suicide mortality rates using a restricted cubic spline smoother, and predicted suicide mortality rates up to 2030.Results: In 2017, 118,813 people aged 70 years and over died from suicide, indicating a mortality rate of 27.5 per 100,000, with the highest rates in Eastern Sub-Saharan Africa, Western Sub-Saharan Africa, and Central Sub-Saharan Africa, and for countries and territories, the highest were in South Korea, Zimbabwe, Lesotho, Mozambique, and Senegal. Between 1990 and 2017, suicide mortality rate for the elderly aged 70 years and over decreased globally (percentage change −29.1%), and the largest decreases occurred in East Asia, Southern Latin America, and Western Europe. Nationally, the largest decrease was found in Chile, followed by Czech Republic, Hungary, Turkey, and Philippines. For most countries, the elderly mortality rate was higher than the age-standardized rate, with the largest percentage differences in China and countries in Sub-Saharan Africa. The elderly suicide mortality rate decreased as SDI increased, except for a slight rebound at mid to high SDI. According to projections, 10 out of 195 countries were expected to meet the SDGs indicator of a third reduction by 2030.Conclusions: Variability in suicide mortality rates for the elderly aged 70 years and over by sex, age, region, country, and SDI can guide preventive policies, but causes of the variability need further study. Comprehensive strategies should be adopted to reduce suicide rates and close the gap to the 2030 SDGs.

In 2024, Japan reported 16.4 suicides per 100,000 inhabitants. The country's suicide rate resumed its downward trend after an unexpected surge in recent years, likely connected to the COVID-19 pandemic. What are the reasons behind Japan’s high suicide rates?  While the majority of suicides in Japan stemmed from health reasons, existential concerns and problems directly related to work also accounted for thousands of self-inflicted deaths in the past years. One of the most profound issues faced by employees in Japan leading to self-harm is exhaustion. “Karoshi,” or death by overwork, is a well-known phenomenon in Japanese society. In addition to physical fatigue, karoshi may be precipitated by mental stress resulting from employment. Occupational stress or overwork-induced suicide is referred to as “karojisatsu (overwork suicide)” in Japan. Which demographic groups are affected? Although middle-aged men are frequently depicted as the most at-risk demographic for suicide in Japan, the increasing occurrence of suicides among the elderly people and schoolchildren is causing concern. Bullying, isolation, and the lack of a proficient mental healthcare system can be additional factors contributing to the country’s high suicide rates among all age groups.

Background: Despite most suicides occurring in low-and-middle-income countries (LAMICs), limited reports on suicide rates in older adults among LAMICs are available. In Ecuador, high suicide rates have been reported among adolescents. Little is known about the epidemiology of suicides among older adults in Ecuador.Aim: To examine the sociodemographic characteristics of suicides among older adults living in Ecuador from 1997 to 2019.Methods: An observational study was conducted using Ecuador's National Institute of Census and Statistics database from 1997 to 2019 in Ecuadorians aged 60 and older. International Classification of Diseases 10th Revision (ICD-10) (X60-X84)-reported suicide deaths were included in addition to deaths of events of undetermined intent (Y21-Y33). Sex, age, ethnicity, educational level, and method of suicide were analyzed. Annual suicide rates were calculated per 100,000 by age, sex, and method. To examine the trends in rates of suicide, Joinpoint analysis using Poisson log-linear regression was used.Results: Suicide rates of female older adults remained relatively stable between 1997 and 2019 with an average annual percentage increase of 2.4%, while the male rates increased between 2002 and 2009, 2014 and 2016, and maintained relatively stable within the past 3 years (2017–2019). The annual age-adjusted male suicide rate was 29.8 per 100,000, while the female suicide rate was 5.26 per 100,000 during the study period. When adding deaths of undetermined intent, the annual male rate was 60.5 per 100,000, while the same rate was 14.3 for women. The most common suicide method was hanging (55.7%) followed by self-poisoning (26.0%). The highest suicide numbers were reported in urban districts, men, and those with lower education status.Conclusion: This study contributes to building the baseline for further studies on suicide rates of older adults in Ecuador. Results highlight priority areas of suicide prevention. By examining suicide trends over 23 years, findings can help inform policy and future interventions targeting suicide prevention.

Over the past couple decades the death rate from intentional self-harm (suicide) in Canada has remained relatively stable. In 2000, the death rate from suicide was **** per 100,000 population. However, the rate had slightly decreased by 2023 to *** deaths per 100,000. Suicidal thoughts and behaviors are always considered a psychiatric emergency that requires immediate assistance from a health care provider. Suicide globally The statistics on suicide vary drastically by country. As of 2019, the countries with the highest rates of suicide included Lesotho, Guyana, and Eswatini. Suicide statistics also vary by gender. As an example, the suicide rate among men in Lithuania in 2021 was almost five times greater than the suicide rate among Lithuanian women. Suicide in North America Suicide rates in North America also differ drastically by age and gender. In Canada, the rate of deaths due to suicide is highest among those aged 50 to 54 years. Much like in Canada, the United States shows higher rates of suicides among older adults, with those aged 45 to 64 years with the highest rates of suicide. In North America, as well as globally, the death rate from suicide is higher among men. In the United States, the death rate from suicide among men is almost four times greater than the death rate from suicide among women.

BackgroundThe United States Food and Drug Administration (FDA) maintains a black-box warning for antidepressants warning of an increased risk of suicidality in children and young adults that is based on proprietary clinical trial data from study sponsors that were submitted for regulatory approval. This article aimed to assess whether the black-box warning for antidepressants is still valid today using recent drug safety data.MethodsPost-marketing adverse drug event data were obtained from the US FDA’s Adverse Event Reporting System (FAERS) for the years 2017 through 2023. Logistic regression analysis was conducted using the case versus non-case methodology and adjusted for gender, age group, drug role (primary drug, secondary drug, interacting drug, and concomitant drug), initial FDA reporting year, reporter country, and a drug*gene*age group interaction.ResultsIn the multivariate analysis, compared to fluoxetine and patients aged 25 to 64 years, children [adjusted reporting odds ratio (aROR) = 7.38, 95% CI, 6.02–9.05] and young adults (aROR = 3.49, 95% CI, 2.65–4.59) were associated with an increased risk of reporting suicidality, but not for the elderly (aROR = 0.76, 95% CI, 0.53–1.09). Relative to fluoxetine, esketamine was associated with the highest rate of reporting suicidality in children (aROR = 3.20, 95% CI, 2.25–4.54); however, esketamine was associated with a lower risk of reporting suicidality in young adults (aROR = 0.59, 95% CI, 0.41–0.84), but not significantly in the elderly (aROR = 0.77, 95% CI, 0.48–1.23). For country-specific findings, relative to the USA, the Slovak Republic, India, and Canada had the lowest risk of reporting suicidality. For the overall study population, desvenlafaxine (aROR = 0.61, 95% CI, 0.46–0.81) and vilazodone (aROR = 0.56, 95% CI, 0.32–0.99) were the only two antidepressants associated with a reduced risk of reporting suicidality.ConclusionThis study shows that with recent antidepressant drug safety data, the US FDA’s black-box warning for prescribing antidepressants to children and young adults is valid today in the USA. However, relative to the USA, 15 countries had a significantly lower risk of reporting suicidality, while 16 countries had a higher risk of reporting suicidality from 38 antidepressants and lithium.

The global human euthanasia services market is projected to reach USD XXX million by 2033, exhibiting a CAGR of XX% during the forecast period (2023-2033). The rising prevalence of terminal illnesses, increasing acceptance of assisted dying, and legalization of euthanasia in several countries are key drivers fueling market growth. Moreover, the growing elderly population and the increasing demand for end-of-life care services are further contributing to the market expansion. The application segment is classified into hospitals, clinics, and hospice care centers, with hospitals dominating the market due to the availability of advanced medical facilities and specialized healthcare professionals. The types segment includes passive euthanasia, active euthanasia, and physician-assisted suicide, with physician-assisted suicide gaining traction as it provides greater autonomy to patients. Regionally, North America holds a significant share of the market owing to the presence of favorable regulatory frameworks and a high adoption rate of assisted dying practices. Europe is another major market, with countries like the Netherlands, Belgium, and Switzerland having legalized euthanasia. The Asia Pacific region is expected to witness substantial growth in the coming years due to the rising elderly population and increasing awareness of euthanasia as an ethical and humane end-of-life option. Key players in the market include Dignitas, Exit International, and Life Circle, among others. Strategic partnerships, collaborations, and the development of innovative euthanasia methods are expected to shape the competitive landscape in the years to come. This comprehensive report provides a detailed analysis of the human euthanasia services market, with a focus on global and United States markets. The report includes key market insights, industry developments, and emerging trends.

Abstract

Purpose: The multi-country Study on Global Ageing and Adult Health (SAGE) is run by the World Health Organization's Multi-Country Studies unit in the Innovation, Information, Evidence and Research Cluster. SAGE is part of the unit's Longitudinal Study Programme which is compiling longitudinal data on the health and well-being of adult populations, and the ageing process, through primary data collection and secondary data analysis. INDEPTH SAGE Wave 1 (2006/7) provides data on the health and well-being of adults in: Ghana, India and South Africa.

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: INDEPTH SAGE's first full round of data collection included persons aged 50 years and older in the health and demographic surveillance sites. All persons aged 50+ years (for example, spouses and siblings) were invited to participate. Standardized SAGE survey instruments were used in all countries consisting of two main parts: 1) household questionnaire; 2) individual questionnaire. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content - Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

• Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 8000 Impact of Caregiving 9000 Interviewer Assessment

Geographic coverage

Rural subdistrict Mpumalanga Province

Analysis unit

household and individuals

Universe

Agincourt Health and Demographic Surveillance Site fifty plus population

Kind of data

Sample survey data [ssd]

Sampling procedure

Simple random sample of 575 persons 50 years and older with an oversample of women from the 2005 HDSS census.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. An Individual questionnaire was administered to eligible respondents identified from the household roster. The questionnaires were developed in English and were piloted as part of the SAGE pretest. All documents were translated into Shangaan.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the CSPro files (4) range and consistency secondary edits in Stata

Response rate

86% of participants accepted to participate, 10% were not found and 4% refused to participate.

Abstract

Purpose: The multi-country Study on Global Ageing and Adult Health (SAGE) is run by the World Health Organization's Multi-Country Studies unit in the Innovation, Information, Evidence and Research Cluster. SAGE is part of the unit's Longitudinal Study Programme which is compiling longitudinal data on the health and well-being of adult populations, and the ageing process, through primary data collection and secondary data analysis. SAGE baseline data (Wave 0, 2002/3) was collected as part of WHO's World Health Survey http://www.who.int/healthinfo/survey/en/index.html (WHS). SAGE Wave 1 (2007/10) provides a comprehensive data set on the health and well-being of adults in six low and middle-income countries: China, Ghana, India, Mexico, Russian Federation and South Africa. Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 8000 Impact of Caregiving 9000 Interviewer Assessment

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in 19 of the 28 states in India which covers 96% of the population. Institutionalised populations are excluded. The individual section covered all persons aged 18 years and older residing within individual households.

Kind of data

Sample survey data [ssd]

Sampling procedure

World Health Survey Sampling India has 28 states and seven union territories. 19 of the 28 states were included in the design representing 96% of the population. India used a stratified multistage cluster sample design. Six states were selected in accordance with their geographic location and level of development. Strata were defined by the 6 states:(Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh and West Bengal), and locality (urban or rural). There are 12 strata in total. The 2000 Census demarcation was used as the sampling frame. Two stage and three stage sampling was adopted in rural and urban areas, respectively. In rural areas PSUs(villages) were selected probability proportional to size. The measure of size being the 2001 Census population in the village. SSUs (households) were selected using systematic sampling. TSUs (individuals) were selected using Kish tables. In urban areas, PSUs(city wards) were selected probability proportional to size. SSUs(census enumeration blocks), two were randomly selected from each PSU. TSU (households) were selected using systematic sampling. QSU (individuals) were selected as in rural areas. A sample of 379 EAs was selected as the primary sampling units(PSU).

SAGE Sampling The SAGE sample was pre-determined as all PSUs and households selected for the WHS/SAGE Wave 0 survey were included. Exceptions are three PSUs in Assam which were replaced as they were inaccessible due to flooding. And a further six PSUs were omitted for which the household roster information was not available. In each selected EA, a listing of the households was conducted to classify each household into the following mutually exclusive categories: 1)Households with a WHS/SAGE Wave 0 respondent aged 50-plus: all members aged 50-plus including the WHS/SAGE Wave 0 respondent were eligible for the individual interview. 2)Households with a WHS/SAGE Wave 0 respondent aged 47-49: all members aged 50-plus including the WHS/SAGE Wave 0 respondent aged 47-49 was eligible for the individual interview. 3)Households with a WHS/SAGE Wave 0 female respondent aged 18-46: all females members aged 18-49 including the WHS/SAGE Wave 0 female respondent aged 18-46 were eligible for the individual interview. 4)Households with a WHS/SAGE Wave 0 male respondent aged 18-46: three households were selected using systematic sampling and one male aged 18-49 was eligible for the individual interview. In the households not selected, all members aged 50-plus were eligible for the individual interview.

Stages of selection Strata: State, Locality=12 PSU: EAs=375 surveyed SSU: Households=10424 surveyed TSU: Individual=12198 surveyed

Mode of data collection

Face-to-face [f2f] PAPI

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to households that had a death in the last 24 months. An Individual questionniare was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. A Womans Questionnaire was administered to all females aged 18-49 years identified from the household roster. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into Hindi, Assamese, Kanada and Marathi. SAGE generic questionnaires are available as external resources.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the CSPro files (4) range and consistency secondary edits in Stata

Response rate

Household Response rate=88% Cooperation rate=92%

Individual: Response rate=68% Cooperation rate=92%

Abstract

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 9000 Interviewer Assessment

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in the People's Republic of China. Two special administrative regions Hong Kong and Macau are excluded. Institutionalised populations are also excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older were selected with a smaller comparative sample of respondents aged 18-49 years

Kind of data

Sample survey data [ssd]

Sampling procedure

The People's Republic of China(PRC) administers 22 provinces. These were grouped into Eastern, Central and Western provinces based on geographical location and economic status.PRC used a stratified multistage cluster sample design. Eight provinces were sampled. Strata were defined by the eight province(Guangdong,Hubei,Jilin,Shaanxi,Shandong,Shanghai,Yunnan,Zhejiang) and locality (urban or rural), there were 16 strata in total. One district(urban) and one county(rural) was randomly selected from each province. From each district/county 4 communities/townships were selected probability proportional to size; the measure of size being the number of households in the community/township. From each community/township 2 residential blocks/villages were selected probability proportional to size; the measure of size being the number of households in the residential blocks/villages. In each selected residential block/village 84 households were randomly selected:70 50 plus households and 14 18-49 households. All 50 plus members of the 50 plus households were eligible for the individual interview. One person aged 18-49 was eligible for the individual interview, and the individual to be included was selected using a Kish Grid.

Stages of selection Strata: Province, Locality=16 PSU: Township/Community=64 surveyed SSU: Village/Neighbourhood Community=127 surveyed TSU: Households=10278 surveyed QSU: Individuals=15050 surveyed

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. An Individual questionniare was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into Chinese. All SAGE generic questionnaires are available as external resources.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the CSPro files (4) range and consistency secondary edits in Stata

Response rate

Household Response rate=95% Cooperation rate=99%

Individual: Response rate=93% Cooperation rate=98%

Abstract

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content

Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 8000 Impact of Caregiving 9000 Interviewer Assessment

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in all ten administrative regions in Ghana. Institutionalised populations are excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older were selected with a smaller comparative sample of respondents aged 18-49 years.

Kind of data

Sample survey data [ssd]

Sampling procedure

Ghana used a stratified, multistage cluster design. The sample was stratified by administrative region (Ashanti, Brong Ahafo, Central, Eastern, Greater Accra, Northern, Upper East, Upper West, Volta and Western) and type of locality (urban/rural) resulting in 20 strata and is nationally representative. The Census Enumerated Areas (CEA) of the 2000 Population and Housing Census was used as the sampling frame. A sample of 251 EAs was selected as the primary sampling units (PSU). One of the selected PSUs was not used. This was because the EA which was expected to be located at Korle Bu Teaching hospital cccould not be traced. The number of EAs to be selected from each strata was based on proportional allocation (determined by the number of EAs in each strata specified on the census frame). EAs were then selected from each stratum with probability proportional to size; the measure of size being the number of individuals aged 50 years or more in the EA. In each selected EA, a listing of the households was conducted to classify each household into the following mutually exclusive categories: (1) WHS/SAGE Wave 0 follow-up households with one or more members aged 50 years or more; (2) New households with one or more members aged 50 years or more; (3) WHS/SAGE Wave 0 follow-up households which did not include any members aged 50 years or more, but included residents aged 18-49; and, (4) New households which did not include any members aged 50 years or more, but included residents aged 18-49.

Twenty-four households were randomly selected from each selected EA. All WHS/SAGE Wave 0 follow-up 50-plus households were eligible for the household interview (one household respondent was selected). Twenty such households were selected. If this target number was not reached, then the balance was selected using systematic sampling from the new 50-plus households. All 50+ members of the household were eligible for the individual interview (multiple individual interviews possible in these households).

Stages of selection Strata: Region, Locality=20 PSU: EAs=235 surveyed SSU: Households=5269 surveyed TSU: Individual=5573 surveyed

Sampling deviation

One of the 251 selected PSUs was not used. This was because the EA which was expected to be located at Korle Bu Teaching hospital cccould not be traced.

Mode of data collection

Face-to-face [f2f] PAPI

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to households that had a death in the last 24 months. An Individual questionniare was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into three local languanges: Akan, Ga and Twi. All SAGE generic questionnaires are available as external resources.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the CSPro files (4) range and consistency secondary edits in Stata

Response rate

Household Response rate=86% Cooperation rate=98%

Individual: Response rate=80% Cooperation rate=92%

In 2023, the relative poverty rate in South Korea stood at around **** percent, which was the same as the previous year. The relative poverty rate, the share of people living with less than half of the national median disposable income, has fallen in recent years. However, the numbers are still relatively high by global standards, especially among older people. Relative poverty among older adults The share of older people in South Korea continues to rise. In 2023, the elderly population aged 65 years and older accounted for about ** percent of the total South Korean population. In 2024, South Korea has become a 'super-aged' society, with people aged 65 and older accounting for more than 20 percent of the total population. However, the economic situation of older people has improved little – around ** percent of the elderly population lives in relative poverty, which is among the highest rates of member countries of the Organization for Economic Co-operation and Development (OECD). Poverty and suicide risk among older adults South Korea has the highest suicide rate in the OECD, with ****** people taking their own lives in 2023. The suicide rate among older adults is exceptionally high. The suicide rate was highest among the elderly male population aged 80 years and older. The most cited causes of suicide among people aged 65 years and older were health problems and financial difficulties.

Abstract

The multi-country Study on Global Ageing and Adult Health (SAGE) is run by the World Health Organization's Multi-Country Studies unit in the Health Systems and Innovation Cluster. SAGE is part of the unit's Longitudinal Study Programme which is compiling longitudinal data on the health and well-being of adult populations, and the ageing process, through primary data collection and secondary data analysis. SAGE baseline data (Wave 0, 2002/3) was collected as part of WHO's World Health Survey http://www.who.int/healthinfo/survey/en/index.html (WHS). SAGE Wave 2 (2014/15) provides a comprehensive data set on the health and well-being of adults in six low and middle-income countries: China, Ghana, India, Mexico, Russian Federation and South Africa.

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content: - Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

• Verbal Autopsy questionnaire Section 1: Information on the Deceased and Date/Place of Death Section 1A7: Vital Registration and Certification Section 2: Information on the Respondent Section 3A: Medical History Associated with Final Illness Section 3B: General Signs and Symptoms Associated with Final Illness Section 3E: History of Injuries/Accidents Section 3G: Health Service Utilization Section 4: Background Section 5A: Interviewer Observations

• Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilisation 6000 Social Networks 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 8000 Impact of Caregiving 9000 Interviewer Assessment

• Proxy Questionnaire Section1 Respondent Characteristics and IQ CODE Section2 Health State Descriptions Section4 Chronic Conditions and Health Services Coverage Section5 Health Care Utilisation

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in 31 of the 32 federal states in Mexico. Colima was excluded. Institutionalised populations are excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older was selected with a smaller comparative sample of respondents aged 18-49 years.

Kind of data

Sample survey data [ssd]

Sampling procedure

In Mexico strata were defined by locality (metropolitan, urban, rural). All 211 PSUs selected for wave 1 were included in the wave 2 sample. A sub-sample of 211 PSUs was selected from the 797 WHS PSUs for the wave 1 sample. The Basic Geo-Statistical Areas (AGEB) defined by the National Institute of Statistics (INEGI) constitutes a PSU. PSUs were selected probability proportional to three factors: a) (WHS/SAGE Wave 0 50plus): number of WHS/SAGE Wave 0 50-plus interviewed at the PSU, b) (State Population): population of the state to which the PSU belongs, c) (WHS/SAGE Wave 0 PSU at county): number of PSUs selected from the county to which the PSU belongs for the WHS/SAGE Wave 0 The first and third factors were included to reduce geographic dispersion. Factor two affords states with larger populations a greater chance of selection.

All WHS/SAGE Wave 0 individuals aged 50 years or older in the selected rural or urban PSUs and a random sample 90% of individuals aged 50 years or older in metropolitan PSUs who had been interviewed for the WHS/SAGE Wave 0 were included in the SAGE Wave 1 ''primary'' sample. The remaining 10% of WHS/SAGE Wave 0 individuals aged 50 years or older in metropolitan areas were then allocated as a ''replacement'' sample for individuals who could not be contacted or did not consent to participate in SAGE Wave 1. A systematic sample of 1000 WHS/SAGE Wave 0 individuals aged 18-49 across all selected PSUs was selected as the ''primary'' sample and 500 as a ''replacement'' sample.

This selection process resulted in a sample which had an over-representation of individuals from metropolitan strata; therefore, it was decided to increase the number of individuals aged 50 years or older from rural and urban strata. This was achieved by including individuals who had not been part of WHS/SAGE Wave 0 (which became a ''supplementary'' sample), although the household in which they lived included an individual from WHS/SAGE Wave 0. All individuals aged 50 or over were included from rural and urban ''18-49 households'' (that is, where an individual aged 18-49 was included in WHS/SAGE Wave 0) as part of the ''primary supplementary'' sample. A systematic random sample of individuals aged 50 years or older was then obtained from urban and rural households where an individual had already been selected as part of the 50 years and older or 18-49 samples. These individuals then formed part of the ''primary supplementary'' sample and the remainder (that is, those not systematically selected) were allocated to the ''replacement supplementary'' sample. Thus, all individuals aged 50 years or older who lived in households in urban and rural PSUs obtained for SAGE Wave 1 were selected as either a primary or replacement participant. A final ''replacement'' sample for the 50 and over age group was obtained from a systematic sample of all individuals aged 50 or over from households which included the individuals already selected for either the 50 and over or 18-49. This sampling strategy also provided participants who had not been included in WHS/SAGE Wave 0, but lived in a household where an individual had been part of WHS/SAGE Wave 0 (that is, the ''supplementary'' sample), in addition to follow-up of individuals who had been included in the WHS/SAGE Wave 0 sample.

Strata: Locality = 3 PSU: AGEBs = 211 SSU: Households = 6549 surveyed TSU: Individual = 6342 surveyed

Mode of data collection

Face-to-face [f2f], CAPI

Research instrument

The questionnaires were based on the SAGE Wave 1 Questionnaires with some modification and new additions, except for verbal autopsy. SAGE Wave 2 used the 2012 version of the WHO Verbal Autopsy Questionnare. SAGE Wave 1 used an adapted version of the Sample Vital Registration iwth Verbal Autopsy (SAVVY) questionnaire. A Household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to 50 plus households only. In follow-up 50 plus household if the death occured since the last wave of the study and in a new 50 plus household if the death occurred in the

Over *** thousand deaths due to suicides were recorded in India in 2022. Furthermore, majority of suicides were reported in the state of Tamil Nadu, followed by Rajasthan. The number of suicides that year had increased from the previous year. Some of the causes for suicides in the country were due to professional problems, abuse, violence, family problems, financial loss, sense of isolation and mental disorders. Depressive disorders and suicide As of 2015, over ****** million people worldwide suffered from some kind of depressive disorder. Furthermore, over ** percent of the total population in India suffer from different forms of mental disorders as of 2017. There exists a positive correlation between the number of suicide mortality rates and people with select mental disorders as opposed to those without. Risk factors for mental disorders Every ******* person in India suffers from some form of mental disorder. Today, depressive disorders are regarded as the leading contributor not only to disease burden and morbidity worldwide, but even suicide if not addressed. In 2022, the leading cause for suicide deaths in India was due to family problems. The second leading cause was due to illness. Some of the risk factors, relative to developing mental disorders including depressive and anxiety disorders, include bullying victimization, poverty, unemployment, childhood sexual abuse and intimate partner violence.

Abstract

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content

Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 9000 Interviewer Assessment

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in all seven federal districts of the Russian Federation. Institutionalised populations are also excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older were selected with a smaller comparative sample of respondents aged 18-49 years.

Kind of data

Sample survey data [ssd]

Sampling procedure

All seven federal districts were included in the sample and constitute the strata. The sample is nationally representative. Moscow city and St Petersburg which are federal cities and Moscow oblast were included with absolute certainty. Atenum, which are polling districts, constitute the PSUs. 267 atenum were selected probability proportional to size, the measure of size being the number of inhabitants aged 18 and above in the atenum. Households which were randomly selected constitute the SSUs. In the final stage, all persons aged 50 and over in 50-plus households were eligible for the individual interview, and one person aged 18-49 years was eligible for the individual interview.

Stages of selection Strata: Federal District = 7 PSU: Atenum = 150 surveyed SSU: Household = 4 644 surveyed TSU: Individual = 4 947 surveyed

Mode of data collection

Face-to-face [f2f], PAPI

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to households that had a death in the last 24 months. An Individual questionniare was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into Russian. All SAGE generic questionnaires are available as external resources.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the CSPro files (4) range and consistency secondary edits in Stata

Response rate

Household Response rate=79% Cooperation rate=79%

Individual: Response rate=83% Cooperation rate=88%

Abstract

Purpose: The multi-country Study on Global Ageing and Adult Health (SAGE) is run by the World Health Organization's Multi-Country Studies unit in the Innovation, Information, Evidence and Research Cluster. SAGE is part of the unit's Longitudinal Study Programme which is compiling longitudinal data on the health and well-being of adult populations, and the ageing process, through primary data collection and secondary data analysis. SAGE baseline data (Wave 0, 2002/3) was collected as part of WHO's World Health Survey http://www.who.int/healthinfo/survey/en/index.html (WHS). SAGE Wave 1 (2007/10) provides a comprehensive data set on the health and well-being of adults in six low and middle-income countries: China, Ghana, India, Mexico, Russian Federation and South Africa.

Objectives: To obtain reliable, valid and comparable health, health-related and well-being data over a range of key domains for adult and older adult populations in nationally representative samples To examine patterns and dynamics of age-related changes in health and well-being using longitudinal follow-up of a cohort as they age, and to investigate socio-economic consequences of these health changes To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains To collect health examination and biomarker data that improves reliability of morbidity and risk factor data and to objectively monitor the effect of interventions

Additional Objectives: To generate large cohorts of older adult populations and comparison cohorts of younger populations for following-up intermediate outcomes, monitoring trends, examining transitions and life events, and addressing relationships between determinants and health, well-being and health-related outcomes To develop a mechanism to link survey data to demographic surveillance site data To build linkages with other national and multi-country ageing studies To improve the methodologies to enhance the reliability and validity of health outcomes and determinants data To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision-making processes about the health and well-being of older adults

Methods: SAGE's first full round of data collection included both follow-up and new respondents in most participating countries. The goal of the sampling design was to obtain a nationally representative cohort of persons aged 50 years and older, with a smaller cohort of persons aged 18 to 49 for comparison purposes. In the older households, all persons aged 50+ years (for example, spouses and siblings) were invited to participate. Proxy respondents were identified for respondents who were unable to respond for themselves. Standardized SAGE survey instruments were used in all countries consisting of five main parts: 1) household questionnaire; 2) individual questionnaire; 3) proxy questionnaire; 4) verbal autopsy questionnaire; and, 5) appendices including showcards. A VAQ was completed for deaths in the household over the last 24 months. The procedures for including country-specific adaptations to the standardized questionnaire and translations into local languages from English follow those developed by and used for the World Health Survey.

Content

Household questionnaire 0000 Coversheet 0100 Sampling Information 0200 Geocoding and GPS Information 0300 Recontact Information 0350 Contact Record 0400 Household Roster 0450 Kish Tables and Household Consent 0500 Housing 0600 Household and Family Support Networks and Transfers 0700 Assets and Household Income 0800 Household Expenditures 0900 Interviewer Observations

Individual questionnaire 1000 Socio-Demographic Characteristics 1500 Work History and Benefits 2000 Health State Descriptions and Vignettes 2500 Anthropometrics, Performance Tests and Biomarkers 3000 Risk Factors and Preventive Health Behaviours 4000 Chronic Conditions and Health Services Coverage 5000 Health Care Utilization 6000 Social Cohesion 7000 Subjective Well-Being and Quality of Life (WHOQoL-8 and Day Reconstruction Method) 8000 Impact of Caregiving 9000 Interviewer Assessment

Geographic coverage

National coverage

Analysis unit

households and individuals

Universe

The household section of the survey covered all households in all 32 federal states in Mexico. Institutionalised populations are excluded. The individual section covered all persons aged 18 years and older residing within individual households. As the focus of SAGE is older adults, a much larger sample of respondents aged 50 years and older were selected with a smaller comparative sample of respondents aged 18-49 years.

Kind of data

Sample survey data [ssd]

Sampling procedure

In Mexico strata were defined by locality (metropolitan, urban, rural). A sub-sample of 211 PSUs were selected from the 797 WHS PSUs. The Basic Geo-Statistical Areas (AGEB) defined by the National Institute of Statistics (INEGI) constitutes a PSU. PSUs were selected probability proportional to three factors: a) (WHS/SAGE Wave 0 50plus): number of WHS/SAGE Wave 0 50-plus interviewed at the PSU, b) (State Population): population of the state to which the PSU belongs, c) (WHS/SAGE Wave 0 PSU at county): number of PSUs selected from the county to which the PSU belongs for the WHS/SAGE Wave 0; The first and third factors were included to reduce geographic dispersion. Factor two affords states with larger populations a greater chance of selection.

All WHS/SAGE Wave 0 individuals aged 50 years or older in the selected rural or urban PSUs and a random sample 90% of individuals aged 50 years or older in metropolitan PSUs who had been interviewed for the WHS/SAGE Wave 0 were included in the SAGE Wave 1 ''primary'' sample. The remaining 10% of WHS/SAGE Wave 0 individuals aged 50 years or older in metropolitan areas were then allocated as a ''replacement'' sample for individuals who could not be contacted or did not consent to participate in SAGE Wave 1. A systematic sample of 1000 WHS/SAGE Wave 0 individuals aged 18-49 across all selected PSUs was selected as the ''primary'' sample and 500 as a ''replacement'' sample.

This selection process resulted in a sample which had an over-representation of individuals from metropolitan strata; therefore, it was decided to increase the number of individuals aged 50 years or older from rural and urban strata. This was achieved by including individuals who had not been part of WHS/SAGE Wave 0 (which became a ''supplementary'' sample), although the household in which they lived included an individual from WHS/SAGE Wave 0. All individuals aged 50 or over were included from rural and urban ''18-49 households'' (that is, where an individual aged 18-49 was included in WHS/SAGE Wave 0) as part of the ''primary supplementary'' sample. A systematic random sample of individuals aged 50 years or older was then obtained from urban and rural households where an individual had already been selected as part of the 50 years and older or 18-49 samples. These individuals then formed part of the ''primary supplementary'' sample and the remainder (that is, those not systematically selected) were allocated to the ''replacement supplementary'' sample. Thus, all individuals aged 50 years or older who lived in households in urban and rural PSUs obtained for SAGE Wave 1 were selected as either a primary or replacement participant. A final ''replacement'' sample for the 50 and over age group was obtained from a systematic sample of all individuals aged 50 or over from households which included the individuals already selected for either the 50 and over or 18-49. This sampling strategy also provided participants who had not been included in WHS/SAGE Wave 0, but lived in a household where an individual had been part of WHS/SAGE Wave 0 (that is, the ''supplementary'' sample), in addition to follow-up of individuals who had been included in the WHS/SAGE Wave 0 sample.

Strata: Locality = 3 PSU: AGEBs = 211 SSU: Households = 4 968 surveyed TSU: Individual = 5 449 surveyed

Mode of data collection

Face-to-face [f2f], CAPI

Research instrument

The questionnaires were based on the WHS Model Questionnaire with some modification and many new additions. A household questionnaire was administered to all households eligible for the study. A Verbal Autopsy questionnaire was administered to households that had a death in the last 24 months. An Individual questionniare was administered to eligible respondents identified from the household roster. A Proxy questionnaire was administered to individual respondents who had cognitive limitations. The questionnaires were developed in English and were piloted as part of the SAGE pretest in 2005. All documents were translated into Spanish. All SAGE generic questionnaires are available as external resources.

Cleaning operations

Data editing took place at a number of stages including: (1) office editing and coding (2) during data entry (3) structural checking of the FoxPro files (4) range and consistency secondary edits in Stata

Response rate

Household Response rate=59%

Individual Response rate=51%

The Philippines has seen a gradual decline in its suicide mortality rate over the past decade, with *** deaths per 100,000 inhabitants recorded in 2021. This trend is particularly noteworthy given the country's strong religious foundations, which often play a significant role in shaping societal attitudes and mental health perceptions. Religious influence on mental health Religion holds immense importance in Filipino society, with ** percent of respondents in a 2020 survey stating that it was critical to them. The Philippines is predominantly Catholic, with about ** million people affiliated with the Roman Catholic Church. This religious landscape may contribute to the country's approach to mental health issues and suicide prevention, as faith typically serves as a source of comfort and support for many Filipinos. Challenges and prevention efforts Despite the overall declining trend in suicide rates, the Philippines faced a significant increase in suicide cases during the COVID-19 pandemic. In 2020, deaths caused by intentional self-harm rose by **** percent compared to the previous year. This surge highlights the need for improved mental health support systems, especially during times of crisis. The National Center for Mental Health reported over ***** suicide-related calls in 2022, indicating a growing awareness and willingness to seek help. However, stigma surrounding mental health issues remains a challenge, emphasizing the importance of continued efforts to promote open discussions and support in Filipino society.