• Journal of agricultural medicine and community health
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• v.40 no.2
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• pp.72-79
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• 2015

Objectives: To identify the importance of preventing tuberculosis for HIV (Human Immunodeficiency Virus) infectees and to monitor their management of health, we investigated the proportion of HIV-TB (Tuberculosis) deaths among the HIV deaths and its related factors. Methods: Data for HIV deaths from 2002 to 2010 was acquired from Statistics Korea, after which the HIV deaths were reclassified into HIV-TB deaths or other deaths according to the KCD (Korean Classification of Diseases). We analyzed the proportion of HIV-TB deaths among HIV disease deaths and the relationship between HIV-TB deaths and related variables such as sex, age, educational level, marital status, etc. Results: There were 774 HIV deaths in South Korea between 2002 and 2010. TB was the main cause of death in 10.1% of all HIV deaths. The total proportion of HIV-TB deaths was 10.1% but its proportion reached 16.3% between 2005-2007 and then decreased to 4% in 2010. Also, the proportion of HIV-TB deaths was significantly high in the young age groups, but its proportion was significantly low in married groups and well educated groups (p<0.05). Conclusions: The result implies that the policy that takes care of HIV infectee regarding TB prevention has been getting systemized on a national scale. Also, HIV-TB deaths have been affected by social factors such as education and marriage status.

• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.177-187
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• 2017

Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.151-161
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• 2021

The purpose of this study was to identify citizens' needs and what they perceive the health-related problems are so public opinion can be reflected in the Daegu Community Health Plan. A citizen participation group was organized, and two roundtable discussions were held in June and July 2018. The number of participants in the first and second round was 40 and 44, respectively. Customer itinerary guidance, DVDM (Definition, Value, Difficulty, and Method) Map, and Persona-based scenario method were used for the roundtable discussions. The measures to improve the health status proposed by the citizens included expanding access to health services, establishing health services centered on small-living areas, expanding mental health services, creating health-friendly environments, resolving environmental problems, and improving social health. In addition, enhancing communication and creating harmonized environments, improving access to healthcare, generating pleasant physical environments, and assigning socials roles for vulnerable individuals were brought up as the means to resolve health disparities. The strength of the present study lies in the fact that, unlike survey methods, the citizens' exact needs were identified by sharing their thoughts. Moreover, it was proven that practical measures would be needed to implement citizen participation in planning health-related projects.

• The Korean Journal of Emergency Medical Services
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• v.27 no.2
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• pp.91-111
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• 2023

Purpose: This study aims to compare 119 emergency medical services (EMS) in South Korea and Japan to provide essential data for EMS improvement in South Korea. Methods: Recent data and regulations on firefighting and EMS in South Korea and Japan were analyzed and compared. Results: South Korea follows a centralized approach to EMS, whereas Japan operates with autonomous bodies that establish their own criteria. Japan considers more regional variables than South Korea. In South Korea, there are shortages in fire station deployment among the 119 emergency medical resources in certain regions, leading to significant regional disparities. South Korea has a larger population served by its 119 emergency medical resources with a higher workload and dispatch numbers than Japan. The percentage of non-transported patients among the total number of dispatches was higher in South Korea. Conclusion: Increasing the number of medical professionals and ambulances per population to the level of Japan to reflect local conditions and include various underlying variables such as daytime population, aging, and emergency dispatch conditions in the deployment of 119 emergency resources, and to reduce the deployment gap between regions, will contribute to improving the performance of the South Korea EMS system.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9453-9458
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• 2014

Background: Breast cancer is the second leading cause of cancer death for women in the United States. Differences in survival of breast cancer have been noted among racial and ethnic groups, but the reasons for these disparities remain unclear. This study presents the characteristics and the survival curve of two racial and ethnic groups and evaluates the effects of race on survival times by measuring the lifetime data-based half-normal model. Materials and Methods: The distributions among racial and ethnic groups are compared using female breast cancer patients from nine states in the country all taken from the National Cancer Institute's Surveillance, Epidemiology, and End Results cancer registry. The main end points observed are: age at diagnosis, survival time in months, and marital status. The right skewed half-normal statistical probability model is used to show the differences in the survival times between black Hispanic (BH) and black non-Hispanic (BNH) female breast cancer patients. The Kaplan-Meier and Cox proportional hazard ratio are used to estimate and compare the relative risk of death in two minority groups, BH and BNH. Results: A probability random sample method was used to select representative samples from BNH and BH female breast cancer patients, who were diagnosed during the years of 1973-2009 in the United States. The sample contained 1,000 BNH and 298 BH female breast cancer patients. The median age at diagnosis was 57.75 years among BNH and 54.11 years among BH. The results of the half-normal model showed that the survival times formed positive skewed models with higher variability in BNH compared with BH. The Kaplan-Meir estimate was used to plot the survival curves for cancer patients; this test was positively skewed. The Kaplan-Meier and Cox proportional hazard ratio for survival analysis showed that BNH had a significantly longer survival time as compared to BH which is consistent with the results of the half-normal model. Conclusions: The findings with the proposed model strategy will assist in the healthcare field to measure future outcomes for BH and BNH, given their past history and conditions. These findings may provide an enhanced and improved outlook for the diagnosis and treatment of breast cancer patients in the United States.

• Journal of agricultural medicine and community health
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• v.38 no.3
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• pp.174-181
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• 2013

Objectives: Socioeconomic status plays an important role in health care and disease prevention. This study aimed to examine the association between socioeconomic status, measured by education levels and household income, and gastric cancer screening. Methods: A total of 21,220 community-dwelling adults aged 40 to 69 years within a defined geographic area participated in a community health survey in 2009 and 2010. The survey was conducted using a structured questionnaire by trained investigators who visited the subjects' households directly. Logistic regression analysis was used to determine the relationship between self-reported participation in gastric cancer screening and socioeconomic variables (education and household income). Results: The gastric cancer screening rate was 52.1% for subjects in their forties, 63.7% for those in their fifties, and 67.3% for those in their sixties. In multivariate analysis, higher education and income levels were associated with higher rates of gastric cancer screening (high school vs. elementary school: odds ratio [OR] 1.41, 95 % confidence interval [CI] 1.26-1.58; highest income quartile vs. lowest income quartile: OR 1.62, 95% CI 1.44-1.84). The gradient between income and screening rate was more pronounced in the population aged 40 to 49 years than in the other age groups. Conclusions: This study demonstrates that lower socioeconomic status is associated with decreased participation in gastric cancer screening. Our findings suggest that the screening program should be focused on low-income and less-educated populations, especially among younger adults, to reduce health disparities.

• 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 the Korean Institute of Landscape Architecture
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• v.42 no.3
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• pp.76-89
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• 2014

The functions of urban park including health related benefit and climate adaptation and mitigation are expanding. However, in-depth research and discourse on the equitable distribution of expanded park function has been limited so far. Following research suggests Green Welfare concept to reflect distributive equity and multifunctionality in the process of urban park policy development and execution. This study developed park welfare indices to analyze disparities of neighborhood urban park(NUP) distribution viewed from green welfare by literature review. The findings analyzed through the Correlation Analysis and Cluster Analysis by SPSS 18.0. The results of the study are as follows. First, green welfare is defined as "to receive equitable benefits and participate in the delivery process of green services which are promoting health and securing safety from climate change risks for every citizen by life cycle regardless of socioeconomic status". Second, NUP per person in Seoul indicate meaningful differences by socioeconomic and environmental status of Seoul administrative districts. Park welfare indices correlated to NUP per person were shown population density(negative), percentage of individuals $aged{\geq}65$(positive), percentage of self-reliance of local finance(positive), flood and air pollution vulnerability by climate change(negative). Third, the cluster analysis identifies three significant clusters that indicate differences of park welfare level. Thus, it was found that NUP in Seoul from a green welfare perspective was provided disproportionately. Future urban park policy in Seoul was required equitable distribution of multifunctionality of park beyond quantitative expansion, and priority consideration should be given to park service consumer.

• Journal of Sasang Constitutional Medicine
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• v.30 no.3
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• pp.24-39
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• 2018

Introduction The purpose of this study was to systematically review previous studies on Sasang type-specific pathophysiological symptoms in urination and defecation. Methods Peer-reviewed articles on type-specific pathophysiological symptoms of urination and defecation published until September 2016 were extracted from domestic and international six databases. Clinical characteristics from thirteen extracted articles were categorized into three urination domains of appearance of urine, capacity of bladder and urinary discomfort, and three defecation domains of irritability of bowel movement, functional constipation and discomfort from irregularity. Results As for the urination, Tae-Eum type showed dark color with foam, however So-Eum type had frequent urination and sensitivity to dysuria but no nocturia and residual urine sense. As for the defecation, So-Yang type showed frequent urgency and constipation, however So-Eum type reported loose stool. So-Yang type showed varied level of health status depending on defecation irregularity. There were disparities with rectal tenesmus among Sasang types. Discussion Six domains of urination and defecation related type-specific pathophysiological clinical symptoms were provided in this study. This study would contribute to the standardized clinical measures of Sasang typology in the near future.

• Nutrition Research and Practice
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• v.11 no.2
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• pp.139-146
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• 2017

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing "very difficult" or "difficult", were combined to form the chewing difficulty group. Similarly, those who found chewing "moderately difficult", "easy", and "very easy" were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.