• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.352-359
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• 2021

Objectives: The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods: Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. Results: The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. Conclusions: Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.

• Journal of Environmental Health Sciences
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• v.37 no.6
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• pp.397-405
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• 2011

Objectives: The impact of climate change on the health has been of increasing concern due to a recent temperature increase and weather abnormality, and the research results of the impact varied depending on regions. We synthesized risk estimates of the overall health effects of low and high temperature taking account of the heterogeneity. Methods: A comprehensive literature search was conducted using PUBMED to identify journal articles of low and/or high temperature effects on mortality. The search was limited to the English language and epidemiological studies using time-series analysis and/or case-crossover design. Random-effect models in meta analysis were used to estimate the percent increase in mortality with $1^{\circ}C$ temperature decrease or increase with 95% confidence intervals (CI) in cold or hot days. Results: Twenty three studies were presented in two tables: 1) low temperature effects; 2) high temperature effects on mortality. The combined effects of low and high temperatures on total mortality were 2% (95% CI, 1-4%) per $1^{\circ}C$ decrease and 4% (95% CI, 2-5%) per $1^{\circ}C$ increase of temperature, respectively. Conclusions: This meta analysis found that both low and high temperatures affected mortality, and the magnitude of high temperature appeared to be stronger than that of low temperature.

• Nutrition Research and Practice
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• v.18 no.4
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• pp.554-566
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• 2024

BACKGROUND/OBJECTIVES: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea. SUBJECTS/METHODS: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural). RESULTS: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed. CONCLUSION: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2325-2327
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• 2016

Gall bladder cancer is generally fatal. The high morbidity and mortality due to gall bladder cancer exerts a significant impact on efforts towards cancer control in high risk populations of the World and a rationale program for control of gall bladder cancer mortality has remained as an unmet need in these populations. Currently there are no effective strategies for controlling gall bladder cancer mortality. This mini review is to highlight the need and feasibility for secondary prevention of gall bladder cancer by screening in high risk populations. A way forward is to assess the role of secondary prevention of gall bladder cancers by conducting randomized-controlled screening trials in high risk populations.

• Journal of Korean Society for Atmospheric Environment
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• v.24 no.5
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• pp.523-537
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• 2008

In Korea, the global warming leads to more frequent high temperature region. increasing the need for research into physical damage caused by high temperature. We therefore analyzed the differences of mortality, caused by extreme heat, among gender and age. We also examined the trend of mortality from high temperature-sensitive diseases. Women are more affected by exposure to high temperature than are men; People over 65 years old have higher mortality rate (1.5 times) than under 65. As for high temperature-related diseases, cerebrovascular disease was the number one cause of death, and chronic lower respiratory disease and cardiovascular disease followed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5003-5006
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• 2012

Objective: Yanting County is a high risk area for esophageal cancer (EC) in China. The purpose of this study was to describe the mortality and mortality change of EC from 2004 to 2009 in Yanting County. Methods: EC mortality data from 2004 to 2009 obtained from the Cancer Registry in Yanting were analyzed. Annual percentage changes (APC) were calculated to assess the trends in EC mortality. Age-standardized mortality was calculated based on world standard population of 2000. Results: The average EC mortality was 54.7/$10^5$ in males and 31.6/$10^5$ in females over the 6 years. A decline in EC mortality with time was observed in both genders, with a rate of -8.70% per year (95% CI: -13.23%~-3.93%) in females and -4.11% per year (95%CI: -11.16%~3.50%) in males. Conclusion: EC mortality decreased over the six years in both genders, although it remained high in the Yanting area. There is still a need to carry out studies of risk factors for improved cancer prevention and further reduction in the disease burden.

• Journal of Environmental Health Sciences
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• v.39 no.1
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• pp.19-31
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• 2013

Objectives: Elevated temperatures during summer months have been reported since the early 20th century to be associated with increased daily mortality. However, future death impacts of high temperatures resulting from climate change could be variously estimated in consideration of the future changes in historical temperature-mortality relationships, mortality, and population. This study examined the future death burden of high temperatures resulting from climate change in Seoul over the period of 2001-2040. Methods: We calculated yearly death burden attributable to high temperatures stemming from climate change in Seoul from 2001-2040. These future death burdens from high temperature were computed by multiplying relative risk, temperature, mortality, and population at any future point. To incorporate adaptation, we assumed future changes in temperature-mortality relationships (i.e. threshold temperatures and slopes), which were estimated as short-term temperature effects using a Poisson regression model. Results: The results show that climate change will lead to a substantial increase in summer high temperature-related death burden in the future, even considering adaptation by the population group. The yearly death burden attributable to elevated temperatures ranged from approximately 0.7 deaths per 100,000 people in 2001-2010 to about 1.5 deaths per 100,000 people in Seoul in 2036-2040. Conclusions: This study suggests that adaptation strategies and communication regarding future health risks stemming from climate change are necessary for the public and for the political leadership of South Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5621-5624
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• 2013

Mucosal head and neck cancers are squamous cell carcinomas that develop in the upper-aero digestive epithelium. Together they constitute the sixth most common cancer with an estimated 900,000 new cases and 350,000 deaths each year reported worldwide. The risk factors are tobacco, alcohol and human papillomavirus (HPV). Our research team initially reported a high incidence rate of HNC in the indigenous population of the Northern Territory. Mortality rates also vary in the Australian States and Territories, with particularly high mortality observed in the Northern Territory. There is a paucity of incidence studies of HNC for the Australian States and Territories. Therefore this review primarily focuses on variation in incidence and mortality iacross the country and highlights specifically the high incidence and mortality in the Northern Territory. Attention is also given to sex-specific incidence and mortality rates.

• Health Policy and Management
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• v.28 no.2
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• pp.168-177
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• 2018

Background: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. Methods: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. Results: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. Conclusion: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.