• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.43-49
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• 2009

Purpose: This study examined the dynamic peak plantar pressure under the foot areas in those with a functional leg length inequality. Methods: The dynamic peak plantar pressure under the foot areas in an experimental group with a functional leg length inequality (n=20) and a control group (n=20) was assessed a using the Mat-Scan system (Tekscan, USA). The peak plantar pressure under the hallux, 1st, 2nd, 3-4th and 5th metatarsal head (MTH), mid foot, and heel was measured while the subject was walking on the Mat-Scan system. Results: The experimental group had significantly higher peak plantar pressure under all foot areas when the dynamic peak plantar pressure in the short leg and long leg sides was compared. The control group had a significantly higher peak plantar pressure under the 1st, 2nd, 3-4th, and 5th MTH when the dynamic peak plantar pressure in the short leg and long leg sides were compared. The experimental group showed a significantly larger difference in the dynamic peak plantar pressure under the hallux, 1st, 2nd, 3-4th and 5th MTH, mid foot and heel than the control group. Conclusion: A functional leg length inequality leads to an increase in the weight distribution and dynamic peak plantar pressure in the side of the short leg.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.297-306
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• 2022

Objectives: The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran. Methods: This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality. Results: The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model. Conclusions: The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.

• The Journal of the Convergence on Culture Technology
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• v.8 no.3
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• pp.385-392
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• 2022

The purpose of this study was to identify the degree of medical inequality in medical vulnerable areas, especially in the southwestern islands, and to prepare improvements. As a research method, 14 pieces were analyzed by systematic literature review with keywords such as 'medical vulnerability', 'medical inequality', and 'island area', and a focus group or in-depth interview (FGI) was conducted on 9 medical personnel in the public medical delivery system to identify the current status and demand. As a result of the study, medical inequality in the southwest region, especially in island areas, was confirmed, and the lack of professional manpower and administrative support system were confirmed through FGI. As a result of the study, it was confirmed that realistic measures should be prepared to increase the efficiency of public health care as well as active administrative support to improve the vulnerability of island areas.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.81-94
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• 2014

The purpose of this study is to investigate factors affecting cancer mortality inequality in Busan according to demographic characteristics identified based on the region's mortality data including cancer incidence and mortality rates, ultimately helping the region improve its existing health policies and establish a more effective cancer prevention policy. To achieve this purpose, this researcher surveyed data about all persons who died in Busan from 2006 to 2009. Data were analyzed with an SPSS 18.0 program using descriptive statistics, Chi-Square(${\chi}^2$), and Logistic Regression analysis. Findings of the study can be summarized as follows. First, in Busan, men were about two times higher in cancer mortality rate than women. Second, persons who died of cancer in Busan were significantly different from one another in terms of demographic characteristics, especially, age, marital status, and job. Third, factors affecting cancer mortality inequality in Busan included such demographic characteristics as gender, age at the time of death, marital status, educational background, and job.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• Health Policy and Management
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• v.28 no.3
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• pp.240-250
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• 2018

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying "the balanced development of the state" or "ensuring the balanced development of all regions." In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the "Special Committee on Regional Balanced Development" with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.419-421
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• 2007

Objectives : The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. Methods : Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. Results : Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. Conclusions : Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.

• Korean Journal of Occupational Health Nursing
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• v.12 no.2
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• pp.171-176
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• 2003

Purpose: To investigate difference in health status by social classes in Korea through second analysis the 1999 Social Statistic Survey raw data performed by National Statistic Office. Method: 52,100 subjects were 20-64 years old and students were excluded. Health status was measured self-rated health and disease prevalence past 2 weeks. Social classes were classified 5 categories by occupations and working status and 1 category by unemployment. Result: Unemployed people reported the worst self-rated health on average, the lower social classes, the worse self-rated health and higher disease prevalence. Health inequality still existed between social classes after adjusting sex, age, and education level. Conclusion: A certain strategy for improving unemployed people's health and people who are working in craft, simple manual labor, agriculture, fishery, and forestry.

• Health Policy and Management
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• v.25 no.4
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• pp.277-284
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• 2015

Background: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight, preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. Methods: 8,648,035 births from National Statistics Offics, 1995-2010 were studied with respect to social variation in adverse birth outcomes and infant mortality in Korea. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. Results: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. Conclusion: The social inequality in adverse birth outcomes (low birth weight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequailiy in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.22-31
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• 2011

Objectives: We examined gender differential changes in employment-related health inequalities according to occupational position (professional/nonprofessional) in South Korea during the last decade. Methods: Data were taken from four rounds of Social Statistical Surveys of South Korea (1995, 1999, 2003, and 2006) from the Korean National Statistics Office. The total study population was 55435 male and 33913 female employees aged 25-64. Employment arrangements were divided into permanent, fixed-term, and daily employment. Results: After stratification according to occupational position (professional/nonprofessional) and gender, different patterns in employment - related health inequalities were observed. In the professional group, the gaps in absolute and relative employment inequalities for poor self-rated health were more likely to widen following Korea's 1997 economic downturn. In the nonprofessional group, during the study period, graded patterns of employment-related health inequalities were continuously observed in both genders. Absolute health inequalities by employment status, however, decreased among men but increased among women. In addition, a remarkable increase in relative health inequalities was found among female temporary and daily employees (p = 0.009, < 0.001, respectively), but only among male daily employees (p = 0.001). Relative employment-related health inequalities had clearly widened for female daily workers between 2003 and 2006 (p = 0.047). The 1997 Korean economic downturn, in particular, seemingly stimulated a widening gap in employment health inequalities. Conclusions: Our study revealed that whereas absolute health inequalities in relation to employment status increased in the professional group, relative employment-related health inequalities increased in the nonprofessional group, especially among women. In view of the high concentration of female nonstandard employees, further monitoring of inequality should consider gender specific patterns according to employee's occupational and employment status.