The Double Burden of Isolation and Unemployment: Suicide Risk in Structurally Vulnerable Populations in Japan – A Case Study of Akita Prefecture (2018–2022)

Suicide remains a persistent public health challenge in Japan, with disproportionately high rates in rural, aging, and economically fragile regions. This study investigates the intersectional impact of unemployment and social isolation on suicide mortality in Akita Prefecture—a demographically vulnerable area—from 2018 to 2022. Using disaggregated data from the Japan Suicide Countermeasures Promotion Center, we analyzed suicide mortality across 24 demographic subgroups defined by sex, age, employment status, and cohabitation. Findings reveal a sharp amplification of suicide risk when unemployment and living alone co-occur, particularly among middle-aged men, whose mortality rate exceeded 300 per 100,000—over 14 times higher than their employed, cohabiting counterparts. While women exhibited lower overall suicide rates, similar patterns of compounded vulnerability were observed. These results support theories of egoistic and anomic suicide, highlighting the psychosocial strain of economic detachment and social disconnection. The study underscores the need for context-sensitive suicide prevention strategies that address both individual vulnerabilities and structural determinants, including community disintegration, labor precarity, and demographic decline.