South Korea has a problem: thousands of people, many middle aged and isolated, are dying alone each year, often going undiscovered for days or weeks.
This is “godoksa,” or “lonely deaths,” a widespread phenomenon the government has been trying to combat for years as its population rapidly ages.
Under South Korean law, a “lonely death” is when someone who lives alone, cut off from family or relatives, dies due to suicide or illness, with their body found only after “a certain amount of time” has passed.
The issue has gained national attention over the past decade as the number of lonely deaths increased. Factors behind the trend include the country’s demographic crisis, gaps in social welfare, poverty and social isolation – all of which have become more pronounced since the Covid-19 pandemic.
Last year, the country recorded 3,378 such deaths, up from 2,412 in 2017, according to a report released last Wednesday by the Ministry of Health and Welfare.
The ministry’s report was the first since the government enacted the Lonely Death Prevention and Management Act in 2021, under which updates are required every five years to help establish “policies to prevent lonely deaths.”
Although lonely deaths affect people across various demographics, the report showed middle aged and elderly men appear particularly at risk.
The number of men suffering lonely deaths was 5.3 times that of women in 2021, up from four times previously.
People in their 50s and 60s made up to 60% of lonely deaths last year, with a large number in their 40s and 70s as well. People in their 20s and 30s accounted for 6% to 8%.
The report did not go into possible causes. But the phenomenon has been studied for years as authorities try to understand what drives these lonely deaths, and how to better support vulnerable people.
“In preparation for a super-aged society, it is necessary to actively respond to lonely deaths,” said South Korea’s legislative research body in a news release earlier this year, adding that the government’s priority was to “quickly identify cases of social isolation.”
South Korea is one of several Asian countries – including Japan and China – facing demographic decline, with people having fewer babies and giving birth later in life.
The country’s birth rate has been dropping steadily since 2015, with experts blaming various factors such as demanding work culture, rising costs of living, and stagnating wages for putting people off parenthood. At the same time, the work force is shrinking, raising fears there won’t be enough workers to support the ballooning elderly population in fields such as health care and home assistance.
Some of the consequences of this skewed age distribution are becoming apparent, with millions of aging residents struggling to survive on their own.
As of 2016, more than 43% of Koreans aged over 65 were under the poverty line, according to the Organization for Economic Co-operation and Development – more than three times the national average of other OECD countries.
The lives of middle-aged and elderly Koreans “rapidly deteriorate” if they are excluded from the labor and housing markets and this is “a major cause of death,” Song In-joo, senior research fellow at the Seoul Welfare Center, wrote in a 2021 study about lonely deaths.
The study analyzed nine lonely death cases, and conducted in-depth interviews with their neighbors, landlords and case workers.
One case involved a 64-year-old laborer who died from alcohol-related liver disease, a year after losing his job due to disability. He had no education, family or even a cell phone. In another case, an 88-year-old woman suffered financial hardship following the death of her son. She died after the elderly welfare center she attended, which provided free meals, closed at the onset of the pandemic.
“The difficulties expressed before death by those at risk of dying alone were health problems, economic difficulties, disconnection and rejection, and difficulties in managing daily life,” Song wrote.
Compounding factors included delayed government assistance and a “lack of at-home care” for those with serious or chronic illness.
The findings of the 2021 study were echoed in the Ministry of Health and Welfare report, which said many of those at risk found their life satisfaction “rapidly declining due to job loss and divorce” – especially if they were “unfamiliar with heath care and housework.”
Many of the people in the 2021 study lived in cramped, dingy spaces such as subdivided apartments known as jjokbang, where residents often share communal facilities, and basement apartments known as banjiha, which made headlines earlier this year when a family was trapped and drowned during record rainfall in Seoul.
In major cities like Seoul, the notoriously expensive housing market means these apartments are some of the most affordable options available. And apart from the poor living conditions, they also carry the risk of further isolation; these housing structures “have already been criticized as slums … and are also stigmatized,” with many residents living “anonymous” lives, said the 2021 study.
“It’s concerning because the (housing concentration) of lonely deaths could be another characteristic of the poverty subculture,” Song wrote.
Rising public concern over lonely deaths has prompted various regional and national initiatives over the years.
In 2018, the Seoul metropolitan government announced a “neighborhood watcher” program, in which community members pay visits to single-person households in vulnerable areas such as basement apartments and subdivided housing, according to news agency Yonhap.
Under this plan, hospitals, landlords and convenience store staff play the role of “watchmen,” notifying community workers when patients or regular customers are not seen for a long time, or when rent and other fees go unpaid.
Several cities, including Seoul, Ulsan and Jeonju, have rolled out mobile apps for those living alone, which automatically send a message to an emergency contact if the phone is inactive for a period of time.
Other organizations such as churches and nonprofits have also stepped up outreach services and community events – as well as handling funeral rites for the deceased who have nobody left to claim or mourn them.
The Lonely Death Prevention and Management Act passed last year was the latest and most sweeping measure yet, ordering local governments to set up policies to identify and assist residents at risk. Apart from establishing the five-yearly situation report, it also required the government to write up a comprehensive preventative plan, which is still in the works.
In another study published November, Song recommended authorities create more systems of support for those trying to get back on their feet, including education, training and counseling programs for the middle-aged and elderly.
In a news release accompanying Wednesday’s report, the Minister of Health and Welfare Cho Kyu-hong said South Korea was working to “become like other countries, including the United Kingdom and Japan, that recently launched strategies … (to deal with) lonely deaths.”
“This analysis is meaningful as the first step for the central and local governments to responsibly deal with this crisis of a new blind spot in welfare,” he said.