• 한국사회정책
• /
• v.24 no.2
• /
• pp.245-275
• /
• 2017

It is attempted here to explain change in welfare attitudes for two decades in 10 countries with the cohort effect, especially differences in societal values between generations. It was found that for the last 20 years pro-welfare attitudes of the public has been strengthened, on which the generation has impact, more by the cohort effect than by the age effect, and that the Millennials/Y-generation are the strongest supporters for the state welfare. Value-differences between cohorts, as a background factor for the cohort effect on welfare attitudes, are clear but show a kind of linear trend from the older to the younger cohorts. As for the cohort effect on welfare attitudes, it is expected, at least for the short-term future, in the direction toward supporting the expansion of the state welfare. Korean welfare attitudes show an exceptional pattern - preferring income inequality as incentives, and at the same time, the expansion of governmental welfare responsibility, which echoes recent arguments of contradictoriness and non-class-orientedness of Korean welfare attitudes. Especially, Korean Millennials/Y-G shows this contradictory welfare attitudes the most strongly, which is unique between 10 countries in this study, implying their fierce competition is being internalized. It is expected that the contradictoriness of Korean welfare attitudes may limit its possibility to back up welfare expansion in Korea.

• Journal of Preventive Medicine and Public Health
• /
• v.53 no.6
• /
• pp.409-418
• /
• 2020

Objectives: This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan. Methods: We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort. Results: Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women. Conclusions: Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

• Analyses & Alternatives
• /
• v.8 no.2
• /
• pp.31-64
• /
• 2024

The recent trend of declining consciousness regarding the necessity of unification among South Korean citizens is evident. Does a cohort effect exist in this downward trend in the perception of the necessity of unification? The purpose of this study is to analyze whether birth cohorts statistically significantly influence the consciousness of the necessity of unification. To this end, the hierarchical age-period-cohort (HAPC) model was employed as the analytical model, and data from the Unification Consciousness Survey conducted by Seoul National University's Institute for Peace and Unification Studies from 2007 to 2021 was used. The analysis results showed evidence that the progress of economic inequality at the birth cohort level affected the decline in the perception of the necessity of unification. The 1980s birth cohort, which faced socioeconomic difficulties during their social advancement due to income and wealth polarization, is observed to have a distinctly negative perception of unification requiring massive financial resources, compared to the 1960s and 1970s birth cohorts.

• Journal of Preventive Medicine and Public Health
• /
• v.52 no.3
• /
• pp.188-194
• /
• 2019

Objectives: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. Methods: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ${\leq}14years$ residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. Results: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. Conclusions: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8589-8594
• /
• 2016

Background: Liver cancer is one of the most common causes of death in the world. In Korea, hepatitis B virus (HBV) is a major risk factor for liver cancer but infection rates have been declining since the implementation of the national vaccination program. In this study, we examined the secular trends in liver cancer mortality to distinguish the effects of age, time period, and birth cohort. Materials and Methods: Data for the annual number of liver cancer deaths in Korean adults (30 years and older) were obtained from the Korean Statistical Information Service for the period from 1984-2013. Joinpoint regression analysis was used to study the shapes of and to detect the changes in mortality trends. Also, an age-period-cohort model was designed to study the effect of each age, period, and birth cohort on liver cancer mortality. Results: For both men and women, the age-standardized mortality rate for liver cancer increased from 1984 to 1993 and decreased thereafter. The highest liver cancer mortality rate has shifted to an older age group in recent years. Within the same birth cohort group, the mortality rate of older age groups has been higher than in the younger age groups. Age-period-cohort analysis showed an association with a high mortality rate in the older age group and in recent years, whereas a decreasing mortality rate were observed in the younger birth cohort. Conclusions: This study confirmed a decreasing trend in liver cancer mortality among Korean men and women after 1993. The trends in mortality rate may be mainly attributed to cohort effects.

• Journal of Preventive Medicine and Public Health
• /
• v.40 no.2
• /
• pp.95-101
• /
• 2007

Focusing on complex diseases of public health significance, strategic issues regarding the on-going Korean Genome Cohort were reviewed: target size and diseases, measurements, study design issues, and follow-up strategy of the cohort. Considering the epidemiologic characteristics of Korean population as well as strengths and drawbacks of current research environment, we tried to tailor the experience of other existing cohorts into proposals for this Korean study. Currently 100,000 individuals have been participating the new Genome Cohort in Korea. Target size of de novo collection is recommended to be set as between 300,000 to 500,000. This target size would allow acceptable power to detect genetic and environmental factors of moderate effect size and possible interactions between them. Family units and/or special subgroups are recommended to parallel main body of adult individuals to increase the overall efficiency of the study. Given that response rate to the conventional re-contact method may not be satisfactory, successful follow-up is the main key to the achievement of the Korean Genome Cohort. Access to the central database such as National Health Insurance data can provide enormous potential for near-complete case detection. Efforts to build consensus amongst scientists from broad fields and stakeholders are crucial to unleash the centralized database as well as to refine the commitment of this national project.

• Journal of the Economic Geographical Society of Korea
• /
• v.23 no.2
• /
• pp.166-181
• /
• 2020

This paper attempts to compare and analyze the intensity, trend, and regional gap of income inequality, capitalizing upon the Age-Period-Cohort model which considers age, time and cohort effects, with the 1998-2018 Korea Labor Panel (KLIPS) survey data for respondents living in the Capital and Non-Capital Regions. The main analysis results are as follows. First, in the case of both cohort and age effects, those in their 50~60s, including the so-called baby boomers and '386 generation' living in the Capital Region, have relatively lower income inequality effect compared to that of other age groups and cohorts in the Non-Capital Region. Second, the micro-individual characteristics cannot be ignored to account for a regional gap in income inequality, but rather the effects of structural and institutional omitted variables and the social discrimination effects of individual characteristics variables are more significant in explaining it. Overall, intra-and inter-cohort income inequalities appear to overlap.

• Journal of Preventive Medicine and Public Health
• /
• v.55 no.3
• /
• pp.253-262
• /
• 2022

We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

• Journal of Society of Preventive Korean Medicine
• /
• v.28 no.1
• /
• pp.69-87
• /
• 2024

Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.9
• /
• pp.4501-4504
• /
• 2012

In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.