• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.392-402
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• 2009

Objectives : The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). Methods : The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. Results : The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. Conclusions : The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

• 치위생과학회지
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• 제17권4호
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• pp.375-381
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• 2017

2002~2013년도 국민건강보험공단 표본 코호트자료를 활용하여 만 40세 이상 치주질환 환자를 대상으로 CVD 누적 치료 경험률 및 개인의 소득과 지역의 CDI의 차이에 따른 치료 경험률을 파악한 본 연구의 결론은 다음과 같다. 첫째, 치주질환이 있는 대상자에서 고혈압은 34.3%, 뇌졸중은 12.6%의 누적 치료 경험률이 확인되었다. 둘째, 치주질환이 있는 대상자에서 지역적 차이(CDI)에 따른 고혈압의 치료 경험률의 차이는, CDI가 높은 집단이 낮은 집단에 비해 치료 경험률이 높은 것으로 나타났다(p<0.001). 셋째, 치주질환이 있는 대상자에서 소득분위에 따른 고혈압 치료 경험률의 차이는, 소득분위가 낮은 집단에서 치료 경험률이 높은 것으로 확인되었다(p<0.001). 넷째, 치주질환이 있는 대상자에서 지역적 차이(CDI)에 따른 뇌졸중 치료 경험률의 차이는, CDI가 높을수록 뇌졸중 치료 경험률이 높은 것으로 나타났다(p<0.001). 다섯째, 치주질환이 있는 대상자에서 소득분위에 따른 뇌졸중 치료 경험률의 차이는, 소득분위가 높아질수록 뇌졸중의 치료 경험률이 낮은 것으로 조사되었다(p<0.001). CVD와 치주질환의 관계에 지역의 CDI와 개인의 소득은 역의 관계를 보이는 것으로 나타났다. 향후 국민의 구강 및 보건의료 소비에 있어 사회경제적, 지역간 격차 해소에 대한 정책적 대안으로, 사회경제적 취약계층에 대한 보건의료서비스 제공으로 보건의료에 대한 접근성 개선과, 공공의료기관의 확충으로 보건의료서비스의 지리적 접근성 취약지를 해결하고 동시에 보건의료서비스의 이용 가능성을 높이는 등 다각적 노력을 기울여야 할 것으로 생각된다.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.51-62
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• 2014

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

• 보건행정학회지
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• 제22권2호
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• pp.207-224
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• 2012

This study estimates the total health expenditure of ambulatory dental care and explores the factors related to disbursements. The study used two waves of a 2008 Korea Health Panel (KHP) survey, of which each wave is composed of 7866 households and 24,659 persons. The KHP includes missing expanses of reimbursement data of the National Health Insurance (NHI), such as out-of-pocket, drugs, and private health insurance. The study estimates total monthly ambulatory dental expenditure and the sub-special categories of dental care. For influential factors analyses, the study exploits log-linear model with age, gender, education, job, equivalence income, the status of chronic diseases, means-tested benefit recipients, private insurance, and the composite deprivation index as independent variables. The total monthly outpatient health spending is estimated to be 102,468 won per household, and for dental, each household spends 31,115 won per month. Older age, means-test recipients, non-regular workers are more likely to spend less money on dental care, whereas private insurers, high income, and those who live in less deprived areas are more likely to spend more money for dental services. From the study we found that the KHP data are more suitable to estimate the total amount of health care markets, especially when the NHI coverage is low, such as for dental care in Korea.