Impact of a government-led employment program on the onset of depressive symptoms and suicidal ideation in older adults: A nationwide longitudinal study

Abstract

Background As populations age rapidly, understanding the psychological benefits of sustained employment has become increasingly important. In South Korea, where the suicide rate among older adults is one of the highest among Organisation for Economic Co-operation and Development (OECD) countries, identifying modifiable social determinants, such as employment, may inform effective prevention strategies.Methods This retrospective cohort study used data from the Korean Welfare Panel Study (2009-2024), a nationally representative longitudinal survey. Individuals with depressive symptoms or suicidal ideation at baseline were excluded. The main exposure was participation in a government-led senior employment program. We employed discrete-time survival analysis using a generalized linear model with a complementary log-log link function, which appropriately handled the interval-censored structure of the panel data.Results Older adults who participated in the employment program had a significantly lower risk of developing depressive symptoms (adjusted hazard ratio [HR] = 0.76, 95% confidence interval [CI]: 0.67-0.86) and suicidal ideation (adjusted HR = 0.60, 95% CI: 0.45-0.81) compared to those who did not participate. Subgroup analyses revealed that the strength of the association was particularly strong among individuals aged >= 80 years, those with chronic illness, poor self-rated health, and those who were previously or never married.Conclusion Structured government-supported employment may mitigate the risk of depressive symptoms and suicidal ideation in later life. These findings support the potential of senior employment programs as effective mental health promotion and suicide prevention strategies for aging populations.