DOI QR코드

DOI QR Code

Income Differences in Smoking Prevalences in 245 Districts of South Korea: Patterns by Area Deprivation and Urbanity, 2008-2014

  • Kim, Ikhan (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Bahk, Jinwook (Institue of Health Policy and Management, Seoul National University Medical Research Center) ;
  • Yoon, Tae-Ho (Department of Preventive and Occupational Medicine, Pusan National University School of Medicine) ;
  • Yun, Sung-Cheol (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Khang, Young-Ho (Department of Health Policy and Management, Seoul National University College of Medicine)
  • Received : 2016.07.07
  • Accepted : 2017.02.09
  • Published : 2017.03.31

Abstract

Objectives: The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity. Methods: Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence. Results: Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men. Conclusions: This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.

Keywords

References

  1. Warren GW, Alberg AJ, Kraft AS, Cummings KM. The 2014 Surgeon General's report: "The health consequences of smoking--50 years of progress": a paradigm shift in cancer care. Cancer 2014;120(13):1914-1916. https://doi.org/10.1002/cncr.28695
  2. GBD 2013 Risk Factors Collaborators, Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;386(10010):2287-2323. https://doi.org/10.1016/S0140-6736(15)00128-2
  3. Choi S, Kim Y, Park S, Lee J, Oh K. Trends in cigarette smoking among adolescents and adults in South Korea. Epidemiol Health 2014;36:e2014023.
  4. Organization for Economic Cooperation and Development. Non-medical determinants of health [cited 2016 Jun 21]. Available from: http://www.oecd-ilibrary.org/social-issuesmigration-health/data/oecd-health-statistics/oecd-healthdata-non-medical-determinants-of-health_data-00546-en.
  5. Khang YH, Cho HJ. Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003. Prev Med 2006;42(6):415-422. https://doi.org/10.1016/j.ypmed.2006.02.010
  6. Park EJ, Kim H, Kawachi I, Kim IH, Cho SI. Area deprivation, individual socioeconomic position and smoking among women in South Korea. Tob Control 2010;19(5):383-390. https://doi.org/10.1136/tc.2009.032763
  7. Khang YH, Yun SC, Cho HJ, Jung-Choi K. The impact of governmental antismoking policy on socioeconomic disparities in cigarette smoking in South Korea. Nicotine Tob Res 2009;11(3):262-269. https://doi.org/10.1093/ntr/ntn036
  8. Khang YH, Lynch JW, Jung-Choi K, Cho HJ. Explaining age-specific inequalities in mortality from all causes, cardiovascular disease and ischaemic heart disease among South Korean male public servants: relative and absolute perspectives. Heart 2008;94(1):75-82. https://doi.org/10.1136/hrt.2007.117747
  9. Ministry of Health and Welfare. Health Plan 2010. Seoul: Ministry of Health and Welfare; 2005, p. 211 (Korean).
  10. Ministry for Health, Welfare and Family Affairs. Health Plan 2020. Seoul: Ministry for Health, Welfare and Family Affairs; 2011, p. 96 (Korean).
  11. Ministry of Health and Welfare. Health Plan 2020. Sejong: Ministry of Health and Welfare; 2015, p. 36 (Korean).
  12. Khang YH, Jung-Choi K, Cho SH, Cho HJ, Kim MH, Kim KW, et al. Health policy plan for tackling health inequalities in Seoul. Seoul: Seoul Metropolitan Goverment; 2012, p. 136-137 (Korean).
  13. Jung-Choi K, Kong KA, Kim MH, Kim YM, Park JH, Yoon TH. Monitoring trends in health ineuqalities in Seoul. Seoul: Seoul Metropolitan Goverment; 2014, p. 67-77 (Korean).
  14. Shin H, Lee S, Chu JM. Development of composite deprivation index for Korea: the correlation with standardized mortality ratio. J Prev Med Public Health 2009;42(6):392-402 (Korean). https://doi.org/10.3961/jpmph.2009.42.6.392
  15. Choi MH, Cheong KS, Cho BM, Hwang IK, Kim CH, Kim MH, et al. Deprivation and mortality at the town level in Busan, Korea: an ecological study. J Prev Med Public Health 2011;44(6):242-248. https://doi.org/10.3961/jpmph.2011.44.6.242
  16. Kim YT, Choi BY, Lee KO, Kim H, Chun JH, Kim SY, et al. Overview of Korean Community Health Survey. J Korean Med Assoc 2012;55(1):74-83 (Korean). https://doi.org/10.5124/jkma.2012.55.1.74
  17. Khang YH, Kim HR. Socioeconomic mortality inequality in Korea: mortality follow-up of the 1998 National Health and Nutrition Examination Survey (NHANES) data. J Prev Med Public Health 2006;39(2):115-122 (Korean).
  18. Bahk J, Khang YH. Trends in childhood obesity and central adiposity between 1998-2001 and 2010-2012 according to household income and urbanity in Korea. BMC Public Health 2016;16:18.
  19. Korean Statistical Information Service. The household income and expenditure survey. Share by quintile and decile, household deficit ratio and boundaries (2 and more, household basis) [cited 2016 May 27]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1L6E004&vw_cd=MT_ZTITLE&list_id=G_A_4_3_1&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=E1.
  20. Jarman B, Townsend P, Carstairs V. Deprivation indices. BMJ 1991;303(6801):523.
  21. Carstairs V. Deprivation indices: their interpretation and use in relation to health. J Epidemiol Community Health 1995;49 Suppl 2:S3-S8. https://doi.org/10.1136/jech.49.Suppl_2.S3
  22. Yoon TH, Noh M, Han J, Jung-Choi K, Khang YH. Deprivation and suicide mortality across 424 neighborhoods in Seoul, South Korea: a Bayesian spatial analysis. Int J Public Health 2015;60(8):969-976. https://doi.org/10.1007/s00038-015-0694-7
  23. Lopez AD, Collishaw NE, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tob Control 1994;3(3):242-247. https://doi.org/10.1136/tc.3.3.242
  24. Shortt NK, Tisch C, Pearce J, Mitchell R, Richardson EA, Hill S, et al. A cross-sectional analysis of the relationship between tobacco and alcohol outlet density and neighbourhood deprivation. BMC Public Health 2015;15:1014. https://doi.org/10.1186/s12889-015-2321-1
  25. Pucci LG, Joseph HM Jr, Siegel M. Outdoor tobacco advertising in six Boston neighborhoods. Evaluating youth exposure. Am J Prev Med 1998;15(2):155-159. https://doi.org/10.1016/S0749-3797(98)00034-8
  26. Barbeau EM, Wolin KY, Naumova EN, Balbach E. Tobacco advertising in communities: associations with race and class. Prev Med 2005;40(1):16-22. https://doi.org/10.1016/j.ypmed.2004.04.056
  27. Ministry of Government Legislation. National Health Promotion Act: Article 9; 2014 [cited 2017 Feb 26]. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=181391&efYd=20160903#0000 (Korean).
  28. Kim CS, Yun SC, Kim HR, Khang YH. A multilevel study on the relationship between the residential distribution of high class (power elites) and smoking in Seoul. J Prev Med Public Health 2006;39(1):30-38 (Korean).
  29. Cho HJ, Khang YH, Yun SC. Occupational differentials in cigarette smoking in South Korea: findings from the 2003 Social Statistics Survey. J Prev Med Public Health 2006;39(4):365-370 (Korean).
  30. Yeom KS. 2013 Convenience store. Seoul: Korean Association of Convenience Store Industry; 2013, p. 126-132 (Korean).
  31. Kim MH, Seo JH, Son JI, Cho HJ, Choi YJ. Tobacco control policy in Korea and health inequalities. Seoul: People's Health Institue; 2011, p. 140-143 (Korean).
  32. Ling PM, Glantz SA. Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents. Am J Public Health 2002;92(6):908-916. https://doi.org/10.2105/AJPH.92.6.908
  33. Sepe E, Ling PM, Glantz SA. Smooth moves: bar and nightclub tobacco promotions that target young adults. Am J Public Health 2002;92(3):414-419. https://doi.org/10.2105/AJPH.92.3.414
  34. Scanlan JP. The mismeasure of health disparities. J Public Health Manag Pract 2016;22(4):415-419. https://doi.org/10.1097/PHH.0000000000000423
  35. Jung-Choi KH, Khang YH, Cho HJ. Hidden female smokers in Asia: a comparison of self-reported with cotinine-verified smoking prevalence rates in representative national data from an Asian population. Tob Control 2012;21(6):536-542. https://doi.org/10.1136/tobaccocontrol-2011-050012

Cited by

  1. Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea vol.39, pp.None, 2017, https://doi.org/10.4178/epih.e2017011
  2. Sensitivity analysis on the ecological bias for Seoul tuberculosis data vol.25, pp.3, 2018, https://doi.org/10.1007/s10651-018-0408-4
  3. Tobacco company strategies for maintaining cigarette advertisements and displays in retail chain stores: In-depth interviews with Korean convenience store owners vol.16, pp.None, 2018, https://doi.org/10.18332/tid/94829
  4. Prevalence of Overweight and Income Gaps in 245 Districts of Korea: Comparison Using the National Health Screening Database and the Community Health Survey, 2009–2014 vol.33, pp.1, 2017, https://doi.org/10.3346/jkms.2018.33.e3
  5. Comparison of District-level Smoking Prevalence and Their Income Gaps from Two National Databases: the National Health Screening Database and the Community Health Survey in Korea, 2009–2014 vol.33, pp.6, 2017, https://doi.org/10.3346/jkms.2018.33.e44
  6. The Disease Burden of Lung Cancer Attributable to Residential Radon Exposure in Korean Homes vol.33, pp.29, 2017, https://doi.org/10.3346/jkms.2018.33.e223
  7. An ecological study of geographic variation and factors associated with cesarean section rates in South Korea vol.19, pp.None, 2017, https://doi.org/10.1186/s12884-019-2300-0
  8. A publicly well-accepted measure versus an academically desirable measure of health inequality: cross-sectional comparison of the difference between income quintiles with the slope index of inequality vol.9, pp.6, 2019, https://doi.org/10.1136/bmjopen-2018-028687
  9. Hospitalizations for ambulatory care sensitive conditions as an indicator of access to primary care and excess of bed supply vol.19, pp.None, 2017, https://doi.org/10.1186/s12913-019-4098-x
  10. A spatial analysis of geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea vol.19, pp.None, 2017, https://doi.org/10.1186/s12890-019-0798-6
  11. Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992-2016 vol.18, pp.1, 2017, https://doi.org/10.1186/s12939-019-1051-x
  12. Convenience store visitors recall cigarette advertisements even if they do not purchase cigarettes vol.41, pp.4, 2019, https://doi.org/10.1093/pubmed/fdy166
  13. Life Expectancy in Areas around Subway Stations in the Seoul Metropolitan Area in Korea, 2008–2017 vol.35, pp.44, 2017, https://doi.org/10.3346/jkms.2020.35.e365
  14. The Gaps in Health-Adjusted Life Years (HALE) by Income and Region in Korea: A National Representative Bigdata Analysis vol.18, pp.7, 2017, https://doi.org/10.3390/ijerph18073473