• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.219-226
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• 2018

Objectives: This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. Methods: This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. Results: The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. Conclusions: We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.

• Research in Community and Public Health Nursing
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• v.31 no.spc
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• pp.525-533
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• 2020

Purpose: Workers in special employment relationship (WSERs) are workers in nonstandard employment arrangements who lack worker protection accorded in standard employment arrangements. This study aimed to describe self-rated health (SRH) and depressive symptoms (DS) among Korean WSERs in comparison to regular wage workers (RWW) and identify associations between working conditions and those outcomes. Methods: In this study, secondary data analysis using the 5th Korean Working Conditions Survey was used. The sample totaled 29,120, including 1,538 WSERs and 27,564 RWWs. Sociodemographic and work-related characteristics were employed as explanatory variables and SRH and DS as dependent variables. Using multiple logistic regression, the determinants of fair/poor SRH and DS were identified. Results: The prevalence rates for fair/poor SRH and DS in WSERs were 25.2% and 28.3%, respectively, and 20.7% and 25.0% in RWWs, respectively. Compared to RWWs, WSERs had 31% (aOR=1.31, 95% CI=1.14~1.49) and 20% (aOR=1.20, 95% CI=1.06~1.36) higher odds of SRH and DS, respectively. Some factors, such as a lack of rest guarantee and sickness presenteeism, had a larger influence in the WSER than in the RWW group. Conclusion: Compared to RWWs, WSERs reported having poorer working conditions and were more likely to report poor general and mental health. Therefore, in Korea, public health policymakers should consider measures to protect the working conditions and health of WSERs, a growing segment of the working population. The study produced new epidemiological evidence regarding the relationships between employment arrangements and health.

• Journal of Korean Public Health Nursing
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• v.32 no.1
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• pp.109-121
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• 2018

Purpose: This study was conducted to identify the barriers and improvements to promoting physical activity among children using community child care centers. Methods: A qualitative research using focus group interviews was employed. Three focus group interviews were conducted with a total of 18 service providers, and open-ended questions were used. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis. Results: Two main themes in the barriers to promoting physical activity were 'lack of resources' and 'limitations of program composition'. In addition, five sub-themes emerged as a result of analysis: 1) lack of human resources, 2) lack of finance, 3) lack of space, 4) one-off and short-term physical activity programs, 5) learning-oriented programs. Conclusion: The results indicate that it is necessary to have adequate human resources and a realistic government subsidy that allow community child care centers to provide sufficient services to children. In addition, promoting physical activity can be achieved through physical activity programs focused on peer group advisors, habituation, and development of programs suited to the needs of children and their environment.

• Journal of Korean Academy of Nursing
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• v.53 no.1
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• pp.101-114
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• 2023

Purpose: This study aimed to identify regional differences in problem drinking among adult males in single-person households and predict the determinants. Methods: This study used data from the 2019 Community Health Survey. Geographically weighted regression analysis was performed on 8,625 adult males in single-person households who had been consuming alcohol for the past year. The Si-Gun-Gu was selected as the spatial unit. Results: The top 10 regions for problem drinking among adult males in single-person households were located in the Jeju-do and Jeollanam-do areas near the southern coast, whereas the bottom 10 regions were located in the Incheon and northern Gyeonggi-do areas. Smoking, economic activity, and educational level were common factors affecting problem drinking among this population. Among the determinants of regional disparities in problem drinking among adult males in single-person households, personal factors included age, smoking, depression level, economic activity, educational level, and leisure activity, while regional factors included population and karaoke venue ratio. Conclusion: Problem drinking among adult males in single-person households varies by region, and the variables affecting each particular area differ. Therefore, it is necessary to develop interventions tailored to individuals and regions that reflect the characteristics of each region by prioritizing smoking, economic activity, and educational level as the common factors.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.7-16
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• 2023

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.368-381
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• 2021

Purpose: The obesity prevention and management program led by public health centers are important in the community. This study aims to identify the current status of obesity prevention and management programs at public health centers and perceptions regarding facilitators and barriers when implementing programs. Methods: This study used a concurrent mixed methods design. A survey was conducted to investigate the current status and infrastructure of the obesity prevention and management program at eighty-three public health centers nationwide. Nine program managers and six local residents with experience in the program were interviewed by using a semi-structured questionnaires. Results: Most of the infrastructure facilities for the program were inadequate, and insufficient budgets and lack of professional staff were identified as barriers. Facilitators included diversification of program delivery methods, operator competence, and visible outcomes and rewards. For the effectiveness of the program, it is vital to have adequate assistants, a sufficient budget, various promotional methods, and connections with various institutions in the community. On this basis, it is acknowledged that the public health center serves as a platform for preventing and managing obesity in the community. Conclusion: It is expected that infrastructure improvements in public health centers and the link with community resources are needed. In addition, there is an urgent need to set standards for obesity prevention and management programs implemented in public health centers to 'resolve regional disparities'.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.28-36
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• 2024

Objectives: This study investigated the impact of socioeconomic factors and sexual orientation-related attributes on the rates of coronavirus disease 2019 (COVID-19) vaccination and infection among men who have sex with men (MSM). Methods: A web-based survey, supported by the National Research Foundation of Korea, was conducted among paying members of the leading online portal for the lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) community in Korea. The study participants were MSM living in Korea (n=942). COVID-19 vaccination and infection were considered dependent variables, while sexual orientation-related characteristics and adherence to non-pharmacological intervention (NPI) practices served as primary independent variables. To ensure analytical precision, nested logistic regression analyses were employed. These were further refined by dividing respondents into 4 categories based on sexual orientation and disclosure (or "coming-out") status. Results: Among MSM, no definitive association was found between COVID-19 vaccination status and factors such as socioeconomic or sexual orientation-related attributes (with the latter including human immunodeficiency virus [HIV] status, sexual orientation, and disclosure experience). However, key determinants influencing COVID-19 infection were identified. Notably, people living with HIV (PLWH) exhibited a statistically significant predisposition towards COVID-19 infection. Furthermore, greater adherence to NPI practices among MSM corresponded to a lower likelihood of COVID-19 infection. Conclusions: This study underscores the high susceptibility to COVID-19 among PLWH within the LGBTQ+ community relative to their healthy MSM counterparts. Consequently, it is crucial to advocate for tailored preventive strategies, including robust NPIs, to protect these at-risk groups. Such measures are essential in reducing the disparities that may emerge in a post-COVID-19 environment.

• Korean Journal of Occupational Health Nursing
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• v.25 no.4
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• pp.277-289
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• 2016

Purpose: This study aims to investigate the cross-sectional association of company size and self-rated health using representative data on Korean workers. Methods: We used the data from 2,884 wage workers collected by Korean Labor and Income Panel Study (17th). The association between company size and self-rated health was analyzed using logistic regression with covariates including demographic characteristics, work environment, job satisfaction, and health-related behaviors. Resulst: Odds ratio (OR) for better health status among workers in large-sized company was 1.351 (CI. 1.054~1.731), compared to workers in small-sized company. We performed three separate models stratified by firm size (small, medium, and large companies). Occupation variables showed different effect on health depending on firm sizes. OR for better health of white-color job (referred to blue-color job) was 1.693 in medium-sized company model but it was 0.615 in large company model. OR for better health of the workers working shift work showed 0.606 in large company model but it was not significant in small and medium company models. Conclusion: We found that small-sized company workers have significantly poor self-rated health compared to large-sized firm workers. This study revealed that there exist differences among health related factors depending on firm sizes.

• Nutrition Research and Practice
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• v.9 no.5
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• pp.547-553
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• 2015

BACKGROUNDS/OBJECTIVES: The effects of malnutrition on growth of toddlers and preschoolers by socioeconomic status are not well known. This study aimed to examine the effects of dietary intake on growth outcomes in toddlers and preschoolers by household income level. SUBJECTS/METHODS: The study population was a total of 1,687 children aged 1 to 5 years that participated in the KNHANES from 2009 to 2011. Growth of children was assessed by height for age (HFA) and weight for height (WFH). Children were classified into three groups according to children's HFA and WFH compared to the $10^{th}$ and $90^{th}$ percentiles of the 2007 Korean Children and Adolescent Growth Standard. Average monthly household income was divided into quartile groups. Dietary intake data were obtained by using the one day 24-hr recall method. Risks of inadequate intake of nutrients and unfavorable growth were estimated by using a multiple logistic regression model adjusted for sex, age, region, and energy intake. RESULTS: The low HFA group (<$10^{th}$ percentile) had significantly lower intakes of energy, carbohydrate, and thiamin as compared with the high group (${\geq}90^{th}$ percentile). For WFH status, vitamin C intake was lower in the low group than in the high group. Household income level was related to WFH status but not HFA. Children from lower income households were more likely to have high WFH than those from higher income households (P for trend = 0.038). Household income status was also significantly related with risk of inadequate intake of micronutrients such as thiamin (P for trend = 0.032) and vitamin C (P for trend = 0.002), showing higher odds of inadequate intakes in children from lower income households. CONCLUSIONS: Children from lower income households were prone to be overweight and to have inadequate intakes of micronutrients such as thiamin and vitamin C. To reduce nutritional and health disparities, collective action in the public sector is required from early life.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.312-319
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• 2023

Background: Parental attention is crucial for preventing childhood oral diseases. Mothers play a significant role in maintaining their families' oral health, and their educational level influences their children's oral health behaviors. This study investigates the impact of mothers' educational levels on adult oral health behaviors using data from a national survey. Methods: This study employed a cross-sectional analysis of secondary data. The data used were obtained from the 8th Korea National Health and Nutrition Examination Survey. Descriptive statistics were calculated to identify participant characteristics. Next, t-tests and one-way analysis of variance were conducted to examine the effects of the explanatory variables on the distribution of the dependent variable. Finally, logistic regression analysis was used to investigate the influence of the explanatory variable on the dependent variable, using "no education" as the reference value, and calculate the odds ratios. Results: Children of mothers with a college education or higher had a 1.13 times higher likelihood of receiving oral examinations than those whose mothers had no education. Children whose mothers graduated from college or higher had a 2.23 times higher probability of receiving preventative dental treatment than those whose mothers had no education. Children whose mothers graduated from college or higher had a 1.92 times higher probability of receiving scaling than those whose mothers had no education. Children whose mothers graduated from high school had a 1.35 times higher probability of receiving scaling than those whose mothers had no education. Conclusion: Developing oral health programs is important for low-educated and low-income parents to change theirs and their children's oral health behaviors/attitudes. This will help reduce oral health disparities among adults raised by parents of higher and lower socioeconomic statuses. Therefore, a comprehensive approach is essential for adults to maintain good oral health, regardless of variations in their parental educational levels during childhood.