한국 청소년의 주관적 건강상태에 영향을 미치는 요인 분석: 가정환경, 건강행태, 심리적 요인 및 식습관

Self-rated Health Status among Korean Adolescents: Differences in Home Environmental Factors, Health Behaviors, Psychological Factors, and Dietary Habits

  • 황성희 (세명대학교 바이오식품산업학부) ;
  • 계승희 (가천대학교 교육대학원)
  • Hwang, Seonghee (School of Food and Nutrition Science for Bioindustry, Semyung University) ;
  • Kye, Seunghee (Graduate School of Education, Gachon University)
  • 투고 : 2017.09.22
  • 심사 : 2018.04.11
  • 발행 : 2018.04.30

초록

목적: 본 연구는 한국 청소년의 가정환경, 건강행태, 심리적 요인 및 식습관 요인에 따른 주관적 건강상태의 차이를 분석하고, 주요 관련요인을 파악하고자 수행되었다. 방법: 분석자료로서 2015~2016년도 한국 청소년 건강행태 온라인조사 자료를 이용하였으며, 분석대상자 수는 중학생 53,791명, 고등학생 50,959명, 총 104,750명이었다. 학생들의 건강수준은 주관적 건강상태를 기준으로 건강집단과 비건강집단으로 구분하였다. 건강수준에 영향을 미치는 요인으로서 성별, 가정환경, 건강행태, 심리적 요인 및 식습관이 검토되었다. 이들 요인 간 건강집단과 비건강집단의 비율차이 검증을 위해 표본설계 정보를 반영한 Rao-scott 카이제곱검정을 실시하였다. 또한 주관적 건강수준에 영향을 주는 요인을 알아보고자 로지스틱회귀분석을 실시하였다. 결과 및 결론: 주관적 건강수준은 양친부모와 살지 않은 경우, 모의 교육수준이 낮을 때, 주관적 가정경제수준이 낮을수록 낮았다. 음주군, 고강도운동이나 근력운동을 실천하지 않는 군, 과체중이나 비만인군에서 주관적 건강수준이 낮았다. 또한 스트레스나 우울감 등 부정적인 감정이나 행복감을 느끼지 못할 때도 주관적 건강수준은 낮았다. 아침을 결식하거나 탄산음료, 고카페인음료, 패스트푸드 등의 비건강식품을 자주 섭취하는 군에서도 주관적 건강수준은 낮은 것으로 관찰되었다. 한국 청소년들에게서 건강 불평등(health inequalities)은 가정환경, 건강행태, 심리적 요인, 식습관 등 여러 요인들로부터 제기되는 것을 알 수 있었다. 이러한 요인들을 충분히 반영하여 청소년들이 건강해 질 수 있는 다각적 접근 방안이 모색되어야 할 것이다.

키워드

참고문헌

  1. Ahn BC, Joung HJ. Decomposition of health inequality in high school students. J of Korean Soc. of School Health 2007;20(1):63-75.
  2. An JS, Kim HJ. A study on the determinants of children and adolescents’ health inequality in Korea. Studies on Korean Youth 2013;24(2): 205-231.
  3. Blacksher E. Children’s health inequality: ethical and political challenges to seeking social justice. Hastings Center Report 2008;38(4):28-35. https://doi.org/10.1353/hcr.0.0035
  4. Bombak AE. Self-rated health and public health: a critical perspective. Frontiers in Public Health 2013;1:1-4.
  5. Burton LJ, Van Heest JL. The importance of physical activity in closing the achievement gap. Nat Assoc Kinesiol Phys Educ High Educ 2007;59:212-218.
  6. Chen E, Martin AD, Matthews KA. Socioeconomic status and health: do gradients differ within childhood and adolescence? Soc Sci Med 2006;62:2161-2170. https://doi.org/10.1016/j.socscimed.2005.08.054
  7. Delpierre C, Lawwers-Cances V, Datta GD, Berkman L, Lang T. Impact of social position on the effect of cardiovascular risk factors on self-rated health. Am J Public Health 2009;99:1278-1284. https://doi.org/10.2105/AJPH.2008.147934
  8. Diliberti JH. The relationship between social stratification and ill-cause mortality among children in the United States. Pediatrics 2000;105(1):1968-1992
  9. Due P, Lynch J, Holstein B, Modvig J. Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health 2003;57:692-698. https://doi.org/10.1136/jech.57.9.692
  10. Gable S, Lutz S. Household, parent, and child contributions to childhood obesity. Family Relations 2000;49(3):293-300. https://doi.org/10.1111/j.1741-3729.2000.00293.x
  11. Gunja N, Brown JA. Energy drinks: health risks and toxicity. Med J Aust 2012;196: 46-49.
  12. House JS. Understanding social factors and inequalities in health: 20th-century progress and 21th-century prospects. J Health Soc Behav 2001;43:125-142.
  13. Jackson MI. Cumulative inequality in child health and academic achievement. J Health Social Behav 2015;56(2):262-280. https://doi.org/10.1177/0022146515581857
  14. Khang YH, Lee SI, Lee MS, Jo MW. Socioeconomic mortality inequalities in Korea labor & income panel study. Korean J Health Policy Admin 2004;14(4):1-20.
  15. Kim HR. Obesity and underweight among children in low income families: status and policy options for childhood health equality. Health and Welfare Policy Forum 2012;6: 55-66.
  16. Kim HY. Community inequalities in health: the contextual effect of social capital. Korean J Sociol 2010;44(2):59-92.
  17. Kim JE. A comparison between elementary school children in grandparent-grandchild family and those in normal family in terms of health status and health behavior [master's thesis]. Kwangju: Chonbuk National University; 2008
  18. Kim TH, Kwon SW, Lee YJ. Health inequality of Seoul citizens by individual effects and community effects. Seoul Studies 2012;13(3): 15-35.
  19. Kim YH. The differences between gender and age in adolescents’ health behaviors and health related psychological variables. Korean J School Phys Educ 2000;10:55-67.
  20. Lee HS. A study on the relationship between based on the 6th grader's dietary habits and characters [dissertation]. Chuncheon: Chuncheon National University; 2003
  21. Lee JS, Lee YG. The effect of family’s social and economical position on adolescents’ social exclusion. Korean J Youth Studies 2009;16(7):1-27.
  22. Lee JH. Health inequalities in children and adolescents: a review with implications for the sociology of education. Korean J of Sociol Educ 2016;26(4):69-95. https://doi.org/10.32465/ksocio.2016.26.4.003
  23. Lee JH, Yi KH. An analysis of the determinants of adolescents’ health inequality in Korea: a view from the students’ self-rated health condition and obesity. Korea Educ Rev 2015;21(2):217-243.
  24. Lee KJ. Psychological characteristics of high risk group in adolescent suicide [master's thesis]. Bucheon: Catholic University of Korea; 2003
  25. Lee YW. Family income and child health gradient in Korea. Health Social Welfare Rev 2014;34(3):7-32. https://doi.org/10.15709/hswr.2014.34.3.7
  26. Ludberg O, Manderbacka K. Assessing reliability of measure of self-rated health. Scandinavian J Pub Health 1996;24(3): 218-224. https://doi.org/10.1177/140349489602400314
  27. Macintyre S, Hunt K. Socio-economic position, gender and health. J of Health Psychology 1997;2(3):315-334. https://doi.org/10.1177/135910539700200304
  28. Macintyre S, West P. Lack of class variation in health in adolescence: an artifact of an occupational measure of social class? Social Sci Med 1991;32(4):395-402. https://doi.org/10.1016/0277-9536(91)90340-I
  29. Marmot MG. Social determinants of health inequalities. Lancet 2005;365:1099-1104. https://doi.org/10.1016/S0140-6736(05)74234-3
  30. Moon SJ, Kim JW, Kim HJ, Lee DK. Association between dietary habits and mental health in Korean adolescents: a study based on the 10th (2014) adolescent health behavior online survey. Korean J Fam Pract 2017;7(1):66-71. https://doi.org/10.21215/kjfp.2017.7.1.66
  31. Oh WS. A study on the correlation between perception of family environment and mental health of boy's high school students [master's thesis]. Daegu: Kyungbook National University; 1992
  32. Olson ME, Dielema D, Elliott BA, Renier CM. Impact of income and income inequality on infant health outcomes in the United States. Pediatrics 2010;126(6):1165-1173. https://doi.org/10.1542/peds.2009-3378
  33. Park JH, Chun JS, Lee SH. The correlates analysis between parental socioeconomic factors and eye health of the primary school children. Korean J Vision Sci 2011;13(1):11-19.
  34. Park SW. Health behaviors among adolescents in the rural area in Korea. J Agri Med Commun Health 2009;34(2):202-213. https://doi.org/10.5393/JAMCH.2009.34.2.202
  35. Park Y, Patton L, Kim H. Clustering of oral and general health risk behaviors in Korea adolescents: a national representative sample. J Adolesc Health 2010;47(3):277-281. https://doi.org/10.1016/j.jadohealth.2010.02.003
  36. Poulos NS, Pasch KE. Energy drinks consumption is associated with unhealthy dietary behaviours among college youth. Perspect Pub Health 2015;135:316-321. https://doi.org/10.1177/1757913914565388
  37. Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Social Science & Medicine 2013;90:24-31. https://doi.org/10.1016/j.socscimed.2013.04.026
  38. Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U. Socioeconomic determinants of health-related quality of life in childhood and adolescence: results from a European study. J Epidemiol Commun Health 2006;60:130-135. https://doi.org/10.1136/jech.2005.039792
  39. Sepehri A, Guliani H. Socioeconomic status and children’s health: evidence from a low-income country. Soc Sci Med 2015;130: 23-31. https://doi.org/10.1016/j.socscimed.2015.01.045
  40. Starfield B, Riley AW, Witt WP, Robertson J. Social class gradients in health during adolescence. J Epidemiol Commun Health 2002;56:354-361. https://doi.org/10.1136/jech.56.5.354
  41. Suk MH, Oh WO. Determinants of health status in adolescents. J of Korean Community Nursing 2002;13 (3):493-502.
  42. Taras H, Potts-Datema W. Obesity and student performance at school. J School Health 2005;75(8):291-295. https://doi.org/10.1111/j.1746-1561.2005.00040.x
  43. Vander Lucht F, Groothoff, J. Social inequalities and health among children aged 10-11 in the Netherlands: cause and consequence. Soc Sci Med 1995;40(9): 1305-1311. https://doi.org/10.1016/0277-9536(94)00185-V
  44. Vander Ploeg KA, Maximova K, McGavock J, Davis W, Veugelers P. Do school-based physical activity interventions increase or reduce inequalities in health? Soc Sci Med 2014;112:80-87. https://doi.org/10.1016/j.socscimed.2014.04.032
  45. Veugelers PJ, Fitzgerald AL. Prevalence of and risk factors for childhood overweight and obesity. CMAJ 2005;173(6):607-613. https://doi.org/10.1503/cmaj.050445
  46. Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, Currie C. Adolescence and the social determinants of health. Lancet 2012;379:1641-1652. https://doi.org/10.1016/S0140-6736(12)60149-4
  47. West P. Health inequalities in the early years: is there equalization in youth? Social Sci Med 2004;44(6):833-858. https://doi.org/10.1016/S0277-9536(96)00188-8
  48. Whitehead M. The concepts and principles of equity and health. Int J Health Services 1992;22(3):429-445. https://doi.org/10.2190/986L-LHQ6-2VTE-YRRN
  49. WHO. At a glance: the global strategy for women's children's and adolescents' health (2016-2030) [Internet]. [cited 2017 July 5]. Available from: http://www.who.int/life-course/partners/global-strategy/en/
  50. Yang MJ, Lee EK, Lee HW. A study on psychosocial characteristic, environmental variables and mental health variables of adolescent. Korea J Youth Couns 2006;14(1): 63-76
  51. Yoo JA, Chung GH, Lee SG. The association between the latent classes of household economic deprivation experience and parent-reported measures of child health. Korean J Social Welfare Stud 2015;46(1): 397-431. https://doi.org/10.16999/kasws.2015.46.1.397
  52. Yoon TH, Kim JY, Yu SH, Kim JM, Lee YH, Hong YS, Lee SY. The relationship between parental socioeconomic position and childhood mortality. Health Soc Sci 2007;20:29-46.
  53. You J, Slack J, Holl J. The impact of material hardship on children’s physical health trajectories. J Korean Society Child Welfare 2012;37:103-137.