한국안광학회지 (Journal of Korean Ophthalmic Optics Society)

한국안광학회 (The Korean Ophthalmic Optics Society)
권호 표지

노인의 가구 소득과 눈 건강과의 관계

Study on Relationship between Eye Health and Household Income of the Elderly

  • 박지현 (단국대학교 일반대학원 보건학과) ;
  • 김효진 (백석대학교 보건학부 안경광학과) ;
  • 예기훈 (백석대학교 보건학부 안경광학과)
  • Park, Jee-Hyun (Department of Public Health Science, The Graduate School, Dankook University) ;
  • Kim, Hyo-Jin (Department of Visual Optics, Division of Health Science, Baekseok University) ;
  • Ye, Ki-Hun (Department of Visual Optics, Division of Health Science, Baekseok University)
  • 투고 : 2011.04.29
  • 심사 : 2011.06.18
  • 발행 : 2011.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 본 연구는 노인의 가구 소득과 눈 건강과의 관계를 확인함으로써 노인의 눈 건강 불평등 정도를 알아보고, 향후 저소득층 노인의 삶의 질 향상을 위한 안보건 정책 수립의 기초자료를 제공하고자 한다. 방법: 국민건강영양조사(2009) 데이터를 이용하여 만 65세 이상의 노인 1,668명을 대상으로 가구 소득에 따른 눈 건강 관련요인(시력, 백내장 유무, 군날개 유무, 안압, 망막이상소견, 나이관련 황반변성, 당뇨망막병증, 근시, 원시, 난시, 부동시 유병률)을 t-test 및 ${\chi}^2$ 검정하였다. 결과: 자동굴절계검사의 굴절이상도와 안압은 저소득군이 낮았고, 나안시력과 교정시력은 0.1~0.5 미만에서 저소득군이 높았고, 원시는 고소득군에서 높았다. 백내장과 최대교정시력 0.8미만인 사람의 백내장 유병여부는 저소득군에서 더 높게 발생하였고, 흡연, 음주, 직업, 교육수준과 유의한 관계가 있었다. 결론: 노인의 가구 소득에 따른 눈 건강 불평등이 존재함을 알 수 있었고, 특히 백내장은 삶의 질과 밀접한 관계가 있는 안질환으로 저소득층 노인의 눈 건강 불평등 해소를 위한 안보건 정책이 필요할 것으로 사료된다.

Purpose: In this study, eye-health inequity was investigated by analyzing the relationship between household incomes and eye-health of senior citizens. Further, this study suggested the preliminary data for establishment of public eye-health policy in order to improve low income senior citizens' life quality. Methods: The data from the 2009 Survey of Korea National Health and Nutrition Examination were analyzed in this study. The objectives of the KNHNE survey were over 65 year old group (1,668 people). Main factors of eye-health (visual acuity, cataract, pterygium, intraocular pressure, retinophathy, age-related macular degeneration, diabetic retinophathy, myopia, hyperopia, astigmatism, and anisometropia prevalence) were analyzed with t-test and chi square test. Results: Low income group revealed that refractive error rate and intraocular pressure were low, however, naked eye visual acuity and corrected visual acuity were high at 0.1 to less than 0.5. On the other hands, in the high income group, there was high prevalence of hyperopia. Cataract mainly occurred at low income group besides group which maximum corrected visual acuity was below 0.8 also highly showed cataract. Moreover, the prevalence of cataract showed that it related with smoking, drinking, occupation, and education level. Conclusions: Results revealed that there was inequity of eye-health which related with socioeconomic status of the elderly. Especially, the prevalence of cataract was correlated with life quality. Consequently, establishment of public eye-health policy seems to be required for eye-health inequity of low income senior citizens.

키워드

참고문헌

  1. 김병덕, 이석호, "고령화 진전에 따른 정책과제", 한국 금융연구원, 2011(2):3-15(2011).
  2. 통계청, "2010 한국의 사회지표 통계표", 통계청, 서울, pp.1-8(2011).
  3. 우해봉, 윤인진, "한국노인의 안구사회학적 특성별 건강 지위의 차이", 보건과 사회과학, 2(1):67-106(2001).
  4. WHO, "Targets for health for all: targets in support of the European regional startegy for health for all", Copenhagen, WHO, (1985).
  5. U.K., Department of Health, "The National Health Inequalities Targets", U.K., Department of Health, (2001).
  6. U.S., "Department of Health and Human Service. Healthy People 2010: Understanding and improving Health", Washington, D.C., U.S., Goverment Printing Office, (2000).
  7. 보건복지부한국보건사회연구원, "새국민건강증진종합계획 수립", 서울, 보건복지부한국보건사회연구원, (2005).
  8. Adler N. E., Marmot M., McEwen B. S., and Stewart J., "Socioeconomic status and Health industrial nations: social, psychological, and biological pathways", Ann. N.Y. Acad. Sci., 896:1-2(1999). https://doi.org/10.1111/j.1749-6632.1999.tb08100.x
  9. 배상수, "국민 건강 결정요인 3: 질병 및 의료이용형태", 예방의학회지, 26(4):508-533(1993).
  10. 이석구, 전소연, "노인들의 사회경제적 수준과 건강수준, 건강행태와의 관계", 예방의학회지, 38(2):154-162(2005).
  11. Marmot M.G., Theorell T., and Siegrist J., "Work and coronary heart disease", BMJ Books, London, (2002).
  12. 김혜경, 배상수, "도시지역 노인의 성에 따른 건강행위 및 관련요인의 차이", 보건행정학회지, 14(2):117-137(2004).
  13. 이선자, 이상욱, "노인의 건강문제", 대한 간호학회지, 22:13-23(1985).
  14. 국민건강보험공단, "2007 건강보험 주요 통계", 국민건강보험공단, (2008).
  15. 송기준, 한무영, 김신영, 하정윤, 김응권, "선별검사자료 를 이용한 백내장 유병률의 추정", 대한안과학회지, 48(6):768-773(2007).
  16. 손미아, "사회계급과 건강행위가 유병률에 미치는 영향", 대한예방의학회지, 35(1):57-64(2002).
  17. Cackett P., Tay W. T., Aung T., Wang J. J., Shankar A., Saw S. M., Mitchell P., and Wong T. Y., "Education, socio-economic status and age-related macular degeneration in Asians: the Singapore Malay Eye Study", Br. J. Ophthalmol., 92(10):1312-1315(2008). https://doi.org/10.1136/bjo.2007.136077
  18. Krishnaiah S., Vilas K., Shamanna B. R., Rao G. N., Thomas R., and Balasubramanian D., "Smoking and its association with cataract: results of the Andhra Pradesh eye disease study from India", Invest. ophthalmol. Vis. Sci., 46(1):58-65(2005). https://doi.org/10.1167/iovs.04-0089
  19. Foster P. J., Wong T. Y., Machin D., Johnson G. J., and Seah S. K. L., "Risk factors for nuclear, cortical and posterior subcapsular cataracts in the Chinese population of Singapore: the Tanjong Pagar Survey", Br. J. Ophthalmol., 87(9):1112-1120(2003). https://doi.org/10.1136/bjo.87.9.1112
  20. Arnarsson A., Jonasson F., Sasaki H., Ono M., Jonsson V., Kojima M., Katoh N., and Sasaki K.; Reykjavik Eye Study Group, "Risk factors for nuclear lens opacification: the Reykjavik Eye Study", Dev. Ophthalmol., 35:12- 20(2002).
  21. Lavanya R., Wong T. Y., Aung T., Tan D. T., Saw S. M., Tay W. T., and Wang J. J.; SiMES team, "Prevalence of cataract surgery and post-surgical visual outcomes in an urban Asian population: the Singapore Malay Eye Study", Br. J. Ophthalmol., 93(3):299-304(2009). https://doi.org/10.1136/bjo.2008.148650
  22. Nirmalan P. K., Robin A. L., Katz J., Tielsch J. M., Thulasiraj R. D., Krishnadas R., and Ramakrishnan R., "Risk factors for age related cataract in a rural population of southern India: the Aravind Comprehensive Eye Study", Br. J. Ophthalmol., 88(8):989-994(2004). https://doi.org/10.1136/bjo.2003.038380
  23. Kuper H., Polack S., Eusebio C., Mathenge W., Wadud Z., and Foster A., "A case-control study to assess the relationship between poverty and visual impairment from cataract in Kenya, the Philippines, and Bangladesh", PLoS Med., 5(12):e244(2008). https://doi.org/10.1371/journal.pmed.0050244
  24. Polack S., Kuper H., Wadud Z., Fletcher A., and Foster A., "Quality of life and visual impairment from cataract in Satkhira district, Bangladesh", Br. J. Ophthalmol., 92(8):1026-1030(2008). https://doi.org/10.1136/bjo.2007.134791
  25. Ng J. Q., Morlet N., and Semmens J. B., "Socioeconomic and rural differences for cataract surgery in Western Australia", Clin. Experiment Ophthalmol., 34(4):317-323(2006). https://doi.org/10.1111/j.1442-9071.2006.01214.x
  26. Wu R., Wang J. J., Mitchell P., Lamoureux E. L., Zheng Y., Rochtchina E., Tan A. G., and Wong T. Y., "Smoking, Socioeconomic Factors, and Age-Related Cataract: The Singapore Malay Eye Study", Arch. Ophthalmol., 128(8):1029-1035(2010). https://doi.org/10.1001/archophthalmol.2010.147
  27. Klein B. E., Klein R. E., and Lee K. E., "Incident cataract after a five-year interval and lifestyle factors: the Beaver Dam eye study", Ophthalmic Epidemiol., 6(4):247-255 (1999). https://doi.org/10.1076/opep.6.4.247.4190
  28. Tan J. S., Wang J. J., Younan C., Cumming R. G., Rochtchina E., and Mitchell P., "Smoking and the long-term incidence of cataract: the Blue Mountains Eye Study", Ophthalmic Epidemiol., 15(3):155-161(2008). https://doi.org/10.1080/09286580701840362
  29. Navarro Esteban J. J., Gutirrez Leiva J. A., Valero Caracena N., Buenda Bermejo J., Calle Purn M. E., and Martnez Vizcano V. J., "Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain", Eur. J. Ophthalmol., 17(1):29-37(2007). https://doi.org/10.1177/112067210701700105
  30. Raju P., George R., Ve Ramesh S., Arvind H., Baskaran M., and Vijaya L., "Influence of tobacco use on cataract development", Br. J. Ophthalmol., 90(11):1374-1377(2006). https://doi.org/10.1136/bjo.2006.097295
  31. Xu L., Cui T., Zhang S., Sun B., Zheng Y., Hu A., Li J., Ma K., and Jonas J. B., ""Prevalence and risk factors of lens opacities in urban and rural Chinese in Beijing", Ophthalmology, 113(5):747-755(2006). https://doi.org/10.1016/j.ophtha.2006.01.026
  32. GiuffrG., Dardanoni G., and Lodato G., "A case-control study on risk factors for nuclear, cortical and posterior subcapsular cataract: The Casteldaccia Eye Study", Acta Ophthalmol. Scand., 83(5):567-573(2005). https://doi.org/10.1111/j.1600-0420.2005.00475.x
  33. Pokhrel A. K., Smith K. R., Khalakdina A., Deuja A., and Bates M. N., "Case-control study of indoor cooking smoke exposure and cataract in Nepal and India", Int. J. Epidemiol., 34(3):702-708(2005). https://doi.org/10.1093/ije/dyi015
  34. Klein B. E., Klein R., Lee K. E., and Meuer S. M., "Socioeconomic and lifestyle factors and the 10-year incidence of age-related cataracts", Am. J. Ophthalmol., 136(3):506-512(2003). https://doi.org/10.1016/S0002-9394(03)00290-3
  35. Tsai S. Y., Hsu W. M., Cheng C. Y., Liu J. H., and Chou P., "Epidemiologic study of age-related cataracts among an elderly Chinese population in Shih-Pai, Taiwan", Ophthalmology, 110(6):1089-1095(2003). https://doi.org/10.1016/S0161-6420(03)00243-4
  36. Morris M. S., Jacques P. F., Hankinson S. E., Chylack L. T. Jr., Willett W. C., and Taylor A., "Moderate alcoholic beverage intake and early nuclear and cortical lens opacities", Ophthalmic Epidemiol., 11(1):53-65(2004). https://doi.org/10.1076/opep.11.1.53.26439
  37. Athanasiov P. A., Casson R. J., Sullivan T., Newland H. S., Shein W. K., Muecke J. S., Selva D., and Aung T., "Cataract in rural Myanmar: prevalence and risk factors from the Meiktila Eye Study", Br. J. Ophthalmol., 92(9): 1169-1174(2008). https://doi.org/10.1136/bjo.2008.139725
  38. James W. P. T., Nelson M., Ralph A., and Leather S., "Socioeconomic determinants of health", BMJ., 314(7093): 1545-1549(1997). https://doi.org/10.1136/bmj.314.7093.1545
  39. Fernandez M. M. and Afshari N. A., "Nutrition and the prevention of cataracts", Curr. Opin. Ophthalmol., 19(1):66- 70(2008). https://doi.org/10.1097/ICU.0b013e3282f2d7b6
  40. Dherani M., Murthy G. V., Gupta S. K., Young I. S., Maraini G., Camparini M., Price G. M., John N., Chakravarthy U., and Fletcher A. E., "Blood levels of vitamin C, carotenoids and retinol are inversely associated with a cataract in a North Indian population", Invest. Ophthalmol. Vis. Sci., 49(8):3328-3335(2008). https://doi.org/10.1167/iovs.07-1202
  41. Truscott R. J. W., "Age-related nuclear cataract-oxidation is the key", Exp. Eye Res., 80(5):709-725(2005). https://doi.org/10.1016/j.exer.2004.12.007