• Journal of Preventive Medicine and Public Health
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• v.45 no.1
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• pp.14-20
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• 2012

Objectives: The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea. Methods: In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score. Results: Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively. Conclusions: Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.

• Journal of Preventive Medicine and Public Health
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• v.56 no.5
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• pp.458-466
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• 2023

Objectives: The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea. Methods: The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted. Results: Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status. Conclusions: Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

• Communications for Statistical Applications and Methods
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• v.28 no.2
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• pp.119-134
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• 2021

Lung cancer is one of the leading causes of cancer deaths in the world. Investigation of mortality rates is pivotal to adequately understand the determinants causing this disease, allocate public health resources, and apply different control measures. Our study aims to analyze and forecast age-specific US lung cancer mortality trends. We report functions of mortality rates for different age groups by incorporating functional principal component analysis to understand the underlying mortality trend with respect to time. The mortality rates of lung cancer have been higher in men than in women. These rates have been decreasing for all age groups since 1990 in men. The same pattern is observed for women since 2000 except for the age group 85 and above. No significant changes in mortality rates in lower age groups have been reported for both gender. Lung cancer mortality rates for males are relatively higher than females. Ten-year predictions of mortality rates depict a continuous decline for both gender with no apparent change for lower age groups (below 40).

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• Journal of Chest Surgery
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• v.5 no.2
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• pp.125-134
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• 1972

Pulmonary resectlon has evolved as the treatment of choice in certain pulmonary tuberculosis cases. This study represents an analysis of 640 cases of pulmonary resections between March, 1953 and August, 1966 and 370 cases of 13 years follow-up results at the 36th Army Hospital. 1] The ages ranged from 20 to 45 years and all cases were males. 2] The extent of disease revealed 116 Far advanced, 472 Moderate advanced and 52 Minimal Cases. 3] The extent of resections were 373 lobectomies, 130 segmental resections, 58 pneumonectomies,25 multlple lobectomies, 25 lobectomies with thoracoplasties, 22 lobectomies with segmental resections, and 7 wedge resections. 4] The postoperative complications occurred in 71 cases[11.09 percent]. Of these complications,bronchopleural fistula occurred in 13 cases [2.03 percent]. 5] The early operative mortality within 24 hours was 2.0 percent and late mortality within 6 months was 1.4 percent, a total mortality from all causes of 3.4 percent: 15.5 percent following pneumonectomy, 2.1 percent following lobectomy, 1.5 percent following segmental resectlon. 6] All 370 patients were followed for periods ranging from 6 months to 5 years and 5 years to 13 years. Of these former group of 241 patients, 73.3 percent of the cases had returned to full active llfe and remained well, while 15.4 percent were still under treatment. Of these latter group of 129 patients, 76.0 percent of the cases were well and 4.7 percent were still under treatment. 7] In the follow-up results according to extent of disease, the cure rate was greatest in cases of minimal group and lowest in cases of far advanced group. 8] In the results by extent of resection, the cure rate was greatest in cases of lobectomy group. 9] Through the all follow-up periods, 11 patents [3.0 percent] were died. Of these, 3 were suicide and 8 were unknown causes.

• Health Policy and Management
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• v.24 no.3
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• pp.271-282
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• 2014

Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

• Journal of Preventive Medicine and Public Health
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• v.2 no.1
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• pp.61-76
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• 1969

A review has been made of mortality trends in Korea from 1958 to 1967 analyzing the data by sex, age and cause of death. The crude death rates and age specific death rates were estimated by the model of N. Keyfitz life table which had been developed by the data of the 1960's national census. The cause specific death rates shown in this article are based on the following: all deaths occurring in the death-registration are expressed as a numberator, while the denominator was estimated from the regular national census data by interpolation method. It is estimated that only an average of about 40% of deaths which occurred during a year were registered during 1958 to 1967. The validity and the reliability of the diagnosis of causes of death seem to be extremely poor in this country. Therefore the cause specific death rates in this article are aimed to reveal trends of causes of registered death ana not for the actual level of death rates. For 10 years very interesing mortality trends were observed : 1. The trend in the crude death rates was downward slowly. 2. The estimated death rate for the infant in 1960 was still high up to 100 per 1,000. 3. The rates for mortality attributed to such infectious diseases as pneumonia, bronchitis, gastroenteritis and measles decreased an average 40-60%. 4. The death rates for over-all tuberculosis decreased only 9.8%. 90% of the decrease was contributed by those in the less-than-15 year age group. 5. The death rates for chronic diseases, such as vascular diseases affecting the central nervous system, malignant neoplasm, major heart diseases and all accidents rose about 40-60%. 6. The rank order of the 10 leading causes of death showed large changes over the years, except for pneumonia and tuberculosis which occupyed 1st and 2nd places respectively. Vascular diseases affecting the central nervous system moved from 5th to 3rd place and malignant neoplasm from 6th to 4th place, The major heart diseases moved from 10th to 6th place and all accidents from 10th to 7th place. On tile other hand, gastroenteritis moved from 3rd to 5th place and influenja from 4th to 8th place.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.414-414
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• 2005

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1201-1206
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• 2015

Background: Tobacco is consumed in both smoking and smokeless forms in India. About 35-40% of tobacco consumption in India is in the latter. The study objective was to describe the association between chewing tobacco and adult mortality. Materials and Methods: A case-control study was conducted in urban (Chennai city) and rural (Villupuram district) areas in Tamil Nadu state in South India. Interviewed in 1998-2000 about 80,000 families (48,000 urban and 32,000 rural) with members who had died during 1995-1998. These were the cases and their probable underlying cause of death was arrived at by verbal autopsy. Controls were 600,000 (500,000 urban, 100,000 rural) individuals from a survey conducted during 1998-2001 in the same two study areas from where cases were included. Results: Mortality analyses were restricted to non-smoking non-drinkers aged 35-69. The age, sex, education and study area adjusted mortality odds ratio was 30% higher (RR:1.3, 95%CI:1.2-1.4) in ever tobacco chewers compared to never chewers and was significant for deaths from respiratory diseases combined (RR:1.5, 95%CI:1.4-1.7), respiratory tuberculosis (RR:1.7, 95%CI:1.5-1.9), cancers all sites combined (RR:1.5, 95%CI:1.4-1.7) and stroke (RR:1.4, 95%CI:1.2-1.6). Of the cancers, the adjusted mortality odds ratio was significant for upper aero-digestive, stomach and cervical cancers. Chewing tobacco caused 7.1% of deaths from all medical causes. Conclusions: The present study is the first large study in India analysing non-smoking non-drinkers. Statistically significant excess risks were found among ever tobacco chewers for respiratory diseases combined, respiratory tuberculosis, stroke and cancer (all sites combined) compared to never tobacco chewers.