DOI QR코드

DOI QR Code

Multilevel analysis and regional variation of physical activities in Korean adults based on the 4th Korea National Health and Nutrition Examination Survey

  • Jang, Min-Young (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Lee, Moo-Sik (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Hong, Jee-Young (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Kim, Hyunsoo (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Kim, Kwang-Hwan (Department of Hospital Management, Konyang University) ;
  • Bae, Seok-Hwan (Department of Radiology, Konyang University)
  • Received : 2016.04.21
  • Accepted : 2016.09.22
  • Published : 2016.09.30

Abstract

Objectives: Physical activity is well known as one of the most effective health behaviors for maintaining and promoting health. The purpose of this study was to investigate the regional variation, compositional and contextual factors on physical activities in Korea. Methods: This study analyzed data of 6,353 adults in 4th-1, 2 Korea National Health and Nutrition Examination Survey (KNHANES). Independent variables were compositional factors that included general characteristics, health behaviors, health status, and contextual factors that included physical environment, political environment, and social safety net. Dependent variables were vigorous physical activity, moderate physical activity, and walking activity. Multilevel analysis were used to determine a variation of physical activity between levels of compositional factors and contextual factors. Results: Physical activities of the Korean people were affected by the regional variables. Financial independence and population density were related with moderate physical activity significantly. Population density, school sport or rally spaces, cultural facilities, and social safety concerns were related with walking activity significantly. These variables impacted on physical activities along with variables at the individual level. Variance Partition Coefficient were 9.94% at moderate physical activity and 2.91% at walking activities, respectively. Conclusions: The results suggest that the regional variables should be considered when planning public intervention to promoting physical activities in Korean adults.

Keywords

References

  1. Cho, W. H., & Kim H. J. (1991). Small area variation. Korean J Health Policy & Administration, 1(1), 42-53.
  2. Cho, W.H., Lee S. H., Park, E. C., Shon, M. S., & Kim, S, R. (1994). An analysis of small area variation of hospital services utilization in Korea. J Prev Med Public Health, 27(3), 609-626.
  3. Cunningham, G. O., & Michael, Y. L. (2004). Concepts guiding the study of the impact of the built environment on physical activity for older adults: a review of the literature. Am J Health Pro ,18, 435-443. https://doi.org/10.4278/0890-1171-18.6.435
  4. Dever. (1991). A Community Health Analysis. Second Edition, Am Aspen Publication.
  5. Diez-Roux, A. V. (1998). Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health, 88(2), 216-222. https://doi.org/10.2105/AJPH.88.2.216
  6. Diez-Roux, A. V. (2002). Multilevel analysis in public health research. Annu Rev Public Health, 22, 172-192.
  7. Hagberg, J. M., Montain, S. J., Martin, W. H., & Ehsani, A. A. (1989). Effect of exercise training on 60-69 year old persons with essential hypertension. Am J Cardiol, 64, 348-353. https://doi.org/10.1016/0002-9149(89)90533-X
  8. Hancox, R. J., Milne, B. J., & Poulton, R. (2004). Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet, 364, 257-261. https://doi.org/10.1016/S0140-6736(04)16675-0
  9. Jang. M.Y. (2011). The Determinants and Regional Variation of Physical Activity in Korea. Graduate School of Konyang University(Korean), 32- 40.
  10. Jung, J. H., Kwon, S. M., Kim, K. H., Lee, S. K., & Kim, D. S. (2010). Impact of health insurance type on the quality of hemodialysis service: multilevel analysis. J Prev Med Public Health, 43(3), 245-256. https://doi.org/10.3961/jpmph.2010.43.3.245
  11. Kaplan, G. A., Pamuk, E. R., & Lynch, J. W. (1996). Inequality in incomed mortality in the United States: analysis of mortality and potential pathways. BMJ, 312, 999-1003. https://doi.org/10.1136/bmj.312.7037.999
  12. KCDC (2007). KHNANES 3rd: Health behavior adults. Korea Centers for Disease Control& Prevention. 107-265
  13. KCDC (2007). KHNANES 3rd: Illness of adults. Korea Centers for Disease Control& Prevention. 107-120
  14. KCDC (2007). KHNANES 4th-1 the KNHANES(2007). Korea Centers for Disease Control& Prevention. 77-621
  15. KCDC (2010). The comparison of physical activity by socioeconomics factors: KHNANES 2001, 2005, 2007. Public Healthy Weekly Report 3(8), 122-129.
  16. KCDC (2010). Health behaviors in Korea adults: smoking, drinking and physical activity. Public Healthy Weekly Report, 2(5), 729-733.
  17. KCDC (2009). Highlights of 2008 Community Health Survey. Public Healthy Weekly Report, 2(21), 321-324.
  18. Kennedy, B. P., Kawachi, I., & Prothrow-Stith, D. (1996). Income distribution and mortality: cross sectional ecological study of the Robin Hood Index in the United States. BMJ, 312, 1004-1007. https://doi.org/10.1136/bmj.312.7037.1004
  19. Korean Ministry of Health & Welfare(2009). KCDC. KNHANES 4th-2 the (2008), 3-610.
  20. Kim, Y. H., & Cho, Y. T. (2008). Impacts of area characteristics on the health of vulnerable population in Seoul. Korean J of Population Research, 1, 1-26.
  21. Kang, Y. J. (2009). Multilevel analysis of the relationship between income inequality and health: Using Korean Labor and income panel study data [dissertation]. Graduate School of Administration, Seoul National University(Korean).
  22. Kim, J. H., & Yoon, T. H. (2008). Comparisons of health inequalities in small area with using the standardized mortality ratios in Korea. J Prev Med Public Health, 41(5), 102-107.
  23. Kim, M. H., & Cho, Y. T. (2007). Social determinants of oral pain and dental service utilization among elderly Seoul residents: A multilevel study. Korean Academy of Oral Health, 31(1), 103-114.
  24. Kim, M. H. (2002). A multilevel analysis on the association between socioeconomic factors and the metabolic syndrome [dissertation].Graduate School of Hanyang University(Korean).
  25. Kim, C. S., Yoon, S. C., Kim, H. L., & Kang, Y. H. (2006). Multilevel study on the relationship between the residential distribution of high class(power elites) and smoking in Seoul. J Prev Med Public Health, 391(1), 30-38.
  26. Kindig, D. A., & Stoddart. (2003). What is population health? Am J Public Health ;93:366-369. https://doi.org/10.2105/AJPH.93.3.366
  27. King, A. C., Stariano, W. A., & Marti J, Zhu. (2008). Multilevel modeling of walking behavior: Advanced in understanding the interactions of people, place, and time. Med. Sci. Sports Exerc , 40(7), 584-593. https://doi.org/10.1249/MSS.0b013e31817c66b7
  28. Lalonde, M. (1974). A new perspective on the health of Canadians. A working document. Ottawa; Government of Canada.
  29. Larry, A. T. (1993). Television viewing and physical fitness in adults. Res Q Exerc Sport, 25, 71-80.
  30. Leon, A. S., Casal D, & Jacobs D, Jr (1996). Effects of 2,000 kcal per week of walking and stair climbing on physical fitness and risk factors for coronary heart disease. J Cardiopulm Rehabil , 16, 183-192. https://doi.org/10.1097/00008483-199605000-00006
  31. Lee, C. G., & Cho, Y. T. (2009). Relationship between perceived neighborhood characteristics and vigorous physical activity among adult Seoul resident. J Prev Med Public Health; 42(4):215-222. https://doi.org/10.3961/jpmph.2009.42.4.215
  32. Lee, S. H. (1994). An analysis of small area variation of health services utilization in Korea [dissertation]. Department of Preventive Medicine & Public health, Graduate School of Public Health, Yonsei University(Korean).
  33. Manson, J. E., Nathan D, M., Krolewski A. S., Stampfer M. J., Willett W.C., & Hennekens C. H. (1992). A prospective study of exercise and incidence of diabetes among US male physicians. JAMA, 268, 63-67. https://doi.org/10.1001/jama.1992.03490010065031
  34. Nam, J. M., Lee, S. H., & Cho, W. H. (1999). A study on the statistical distribution and testing of variation indices at the small area. J Prev Med Public Health , 32(1), 80-87.
  35. Paffenbarger, R. S., Wing, A. L.,Hyde, R. T., & Jung D.L. (1983). Physical activity and incidence of hypertension in college alumni. Am J Epidemiol, 117, 245-257. https://doi.org/10.1093/oxfordjournals.aje.a113537
  36. Robert, S. A.(1998). Community-level socioeconomic status effects on adult health. J of Health and Soc Behavior, 39(1), 18-37. https://doi.org/10.2307/2676387
  37. Sallis, J. F., & Owen, N. (1996). Ecological models. In Health Behavior and Health Education: theory, research and practice, 2nd Edition; Glanz K., Lewis., Rimer, F. M., Eds, B. K.; Jossey-Bass: San Francisco, USA.
  38. Sallis, J. F., Hovell, M. F., Hofstetter, C. R., Faucher P, Elder J. P., & Blanchard, J. (1989). A multivariate study of determinants of vigorous exercise in a community-sample. Prev Med, 18, 20-34. https://doi.org/10.1016/0091-7435(89)90051-0
  39. Statistics Korea(2005, 2006, 2007, 2008.). Community of statistics (administrative district).
  40. Yang, Y. J., Yoon, Y. S., Oh, S. W., & Lee, Y. S. (2005). The amount of physical activity of Korean adults measured from the 2001 KNHANES. Korean J Fam Med ;26:22-30.
  41. Yang, Y. J., Jin, Y. S., Choi, D. H., Cho, S. I., Seong, B. J., Ko, B. G., Lee, Y. S. (2007). Development of physical activity questionnaire and guideline for Korean adults. Korean Ministry of Health & Welfare.
  42. Yoon, T.H. (2003). The relationship between social class distribution on mortality. Korean J Health Policy & Administration 13(4), 99-114. https://doi.org/10.4332/KJHPA.2003.13.4.099