Relationship among Health Practices, Depression Counseling, and Suicide Rates: Urban Areas vs. Non-Urban Areas

This study analyzed whether there are differences in the impact of health practices on depression counseling and suicide between urban and non-urban areas. Additionally, it tested whether depression counseling mediates the relationship between health practices and suicide in both regions. To this end, the study utilized data from 227 cities and counties in 2020 and conducted a mediation effect analysis using the bootstrap method. The results of the analysis regarding direct effects are as follows: First, in urban areas, the rate of health practices positively (+) influenced both the rate of depression counseling and the suicide rate, while no significant effect was found in non-urban areas. Second, the rate of depression counseling did not have a significant impact on the suicide rate across all regions as an independent variable. The mediation effect analysis revealed that the pathway of health practices → depression counseling → suicide rate was not confirmed in any region. In summary, the causal relationships among the three variables were confirmed in urban areas: practicing a healthy lifestyle increased the likelihood of seeking mental counseling for depression and reduced the suicide rate, while the mediating role of depression counseling was not observed across all regions. This study suggests that healthy lifestyle habits are effective in preventing suicide across all regions, but the effectiveness of mental counseling in suicide prevention may be limited. Furthermore, the association between healthy lifestyle habits and increased mental counseling in urban areas highlights the importance of preventive mental health care, particularly in densely populated regions.