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Decomposition of Health Inequality in High School Students  

Ahn, Byung-Chul (School of Economics and Finance, Yeungnam University)
Joung, Hyo-Jee (School of Public Health, Seoul National University)
Publication Information
Journal of the Korean Society of School Health / v.20, no.1, 2007 , pp. 63-75 More about this Journal
Abstract
Purpose: With economic development and prolonged longevity, the level of health and health disparities have became growing concerns for individual and society as well. Since youth's health status are influenced by households' socioeconomic status and associated with heath status in later stage of life, assessing health inequality in the youth is a significant step toward lessening health disparity and promoting health. We measured health inequality in high school students and decomposed it into health factors. Methods: The subjects included 3,787 high school students of 12th graders from the Korea Education and Employment Panel (KEEP) in 2004. True health status was assumed as a latent variable and estimated by ordered logistic regression model. The predicted health was used as a measure of individual health after rPSraling to [0,1] interval. Total health inequality was then measured by Gini coefficient and was decomposed into health factors. Results: Health inequality in high school students was observed. Of total health inequality, 44% was explained by biological factors such as body mass index (BMI) (32.5%) and gender (13.5%). Behavioral factors such as smoking, drinking, physical activity, hours in bed and hours of computer ussge added to 11.7%. Household income and work experiences explained 5.6% and 8.8%, respectively. School satisfaction explained 14.6%. Other school related factors such as self-assessed achievement and experience of being bullied accounted for 15.5%. Conclusion: Among the health factors, biological factor was the most important contributor in health disparity. Other factors such as health behaviors, socioeconomic factors, school satisfaction and school related factors exhibited somewhat similar magnitude. For policy purposes, it is recommended to look into modifiable factors depending BM, gender and school surroundings.
Keywords
health inequality; Gini coefficient; concentration index; high school student
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Times Cited By KSCI : 1  (Citation Analysis)
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1 강영호(2005). 아동기의 사회경제적 위치에 따른 성인기 사망률의 차이. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/06_10.pdf [2007, June 7]
2 김철웅(2005). 소득계층별 암 발생, 암 치명률 및 암 의료비용의 불평등 연구-건강보험 지역가입자와 의료급여대상자를 중심으로. 서울대학교, 박사학위논문, 1-127, 서울
3 Kim, H.(2006). A casual analysis of the health-incomehttp://www.kli.re.kr/kli/html_kor/labp/down/7차/07_20.pdf [2007, June 7]
4 Manderbacka, K., Kareholt, I., Martikainen, P., Lundberg, O.(2003). The effect of point of reference on the association between self-rated health and mortality. Soc Sci & Med, 56(7), 1447-1452   DOI   ScienceOn
5 U.S. Department of Health and Human Services(2000). Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. [Online] Available: http://www.healthypeople.gov/Document/pdf/uih/uih.pdf [2007, June 7]
6 van Doorslaer, E., Jones, A.(2003). Inequalities in self-reported health: validation of a new approach to measurement. J of Health Economics, 22, 61-87   DOI   ScienceOn
7 김창석, 윤성철, 김혜련, 강영호(2006). 서울시 동별 상류계층(파워엘리트) 주거분포와 흡연과의 관련성에 대한 다수준분석. 예방의학회지, 39(1), 30-38   과학기술학회마을
8 김철웅, 이상이, 홍성철(2003). 제주도 주민의 소득계층에 따른 암 입원 의료비용의 차이. 보건행정학회지, 13(3), 104-128
9 Wagstaff, A., van Doorslaer, E., Watanabe, N.(2003). On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J of Econometrics, 112, 207-223   DOI   ScienceOn
10 Lahiri, K., Pulungan, Z.(2006). Between- and Within-Groups Health Inequality in the U.S. Population. Manuscript SUNY Albany
11 김창엽, 이덕희(2003). 건강상태와 노동시장 성과의 이중인과관계에 대한 연구. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/04_30.pdf [2007, June 7]
12 정최경희, 강영호(2007). 청소년기 사회경제적 위치가 성인기 건강수준 및 건강행태에 미치는 영향. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/8차/08_15.pdf [2007, June 7]
13 Idler, E., Angel, R.(1990). Self-rated Health and Mortality in the NHANES-I Epidemiologic Follow-Up Study. Am J of Public Health, 80(4), 446   DOI   ScienceOn
14 McCallum, J., Shadbolt, B., Dong, W.(1994). Self-rated Health and Survival: A 7-year follow-up of Australian elderly. Am J of Public Health, 84(7), 1100-1105   DOI   ScienceOn
15 Ahn, B., Joung, H.(2006). Self-rated Health And Indicators; A Case of Korean National Health And Nutrition Examination Survey 2001. J of Comm Nutr, 8(1), 38-43
16 Dasbach, E., Klein, R., Klein, B., Moss, S.(1994). Self-rated health and mortality in people with diabetes. Am J of Public Health, 84(11), 1775-1779   DOI   ScienceOn
17 강영호(2004). 사망률에서의 사회경제적 불평등: 한국노동패널 조사의 사망 추적결과 (1998-2002). [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/05_03.pdf [2007, June 7]
18 강영호, 이상일, 이무속, 조민우(2004). 사회경제적 사망률 불평등: 한국노동패널 조사의 추적결과. 보건행정학회지, 14(4), 1-20
19 한국직업능력개발원(2004). 한국교육고용패널. [Online] Available: http://www.hnrd.net/jsp[2007, June 7]
20 허순임, 최숙자(2006). 소득수준에 따른 의료 이용. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/7차/07_21.pdf [2007, June 7]
21 안주엽(2004). 주관적 건강상태와 노동시장 성과. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/05_08.pdf [2007, June 7]
22 World Health Organization(2005). World Health Report 2006 - working together for health. [Online] Available: http://www.who.int/entity/whr/ 2006/annex/06_annex1_en.pdf [2007, June 7]
23 보건복지부(2007). 국가비전 2030에 부응하는 건강투자 전략. [Online] Available: http://www.kihasa.re.kr/html/jsp/lib/notice_down?bid=3&ano=1231 [2007, June 7]
24 van Doorslaer, E., Wagstaff, A., Bleichrodt, H., Calonge, S., Gerdtham, U., Gerfin, M., Geurts, J., Gross, L., Hakkinen, U., Leu, R., O'Donnell, O., Propper, C., Puffer, F., Rodriguez, M., Sundberg, G., Winkelhake, O. (1997). Income-related inequalities in health: some international comparisons. J of Health Economics, 16, 93-112   DOI   ScienceOn
25 강영호(2006). 한국의 건강 불평등 현황, 한겨레-한국건강형평성학회 공동토론회, 1-20
26 Doran, T., Drever, F., Whitehead, M.(2004). Is there a north-south divide in social class inequalities in health in Great Britain? Cross sectional study using data from the 2001 census. BMJ, 328, 1043-1045   DOI   ScienceOn
27 Miilunpalo, S., Vuori, I., Oja, P., Pasanen, M., Urponen, H.(1997). Self-rated health status as a health measure: The predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J of Clinical Epidemiology, 50(5), 517-528   DOI   ScienceOn
28 김창엽(2006). 건강 불평등 어떻게 대처할 것인가. 한겨레-한국건강형평성학회 공동토론회, 21-34
29 김학주(2007). 아동기 사회경제적 위치가 청.장년기 건강에 미치는 영향. [Online] Available: http://www.kli.re.kr/kli/html_kor/labp/down/8차/08_14.pdf [2007, June 7]
30 보건복지부(2005). 국민건강증진종합계획 - Health Plan 2010. 보건복지부. 1-240
31 한국은행(2004). 한국은행 경제통계시스템. [Online] Available: http://ecos.bok.or.kr [2007, June 7]
32 Lee, Y., Shinkai, S.(2003). A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea. Archives of Gerontology and Geriatrics, 37(1), 63-76   DOI   ScienceOn
33 Shadbolt, B.(1997). Some correlates of self-rated health for Australian women. Am J of Public Health, 87(6), 951-956   DOI   ScienceOn
34 Franks, P., Gold, MR., Fiscella, K.(2003). Sociodemographics, self-rated health, and mortality in the US. Soc Sci & Med, 56(12), 2505-2514   DOI   ScienceOn
35 Kakwani, N., Wagstaff, A. and van Doorslaer, E.(1997). Socioeconomic inequalities in health: measurement, computation, and statistical inference. J of Econometrics, 77, 87-103   DOI   ScienceOn