• Health Policy and Management
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• v.14 no.2
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

• Korean Journal of Social Welfare Studies
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• v.49 no.1
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• pp.51-83
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• 2018

This study examines whether the widening gap between income groups is worsening in the distribution of time use, similar to the worsening of income distribution after the IMF. To do this, we conducted multilevel analysis (HLM) on six countries including France, the Netherlands, Spain, the United Kingdom, the United States and Korea. The results of the analysis are as follows. First, in all countries, low income groups have a longer paid working time and shorter leisure time. Second, the low income groups in Korea have the longest paid work time and the shortest leisure time, the lowest level of work-leisure balance, and this aspect has not recovered since the IMF. Third, as the result of multilevel analysis, the lower the household income, the more time paid labor increased and the work-leisure balance decreased. Fourth, while average annual working hours increase paid working time, the expansion of family policy expenditure, redistribution policy and income maintenance policy has reduced it. Fifth, the annual average working hours decreased the work-leisure balance, but the family policy expenditure, the redistribution policy and the income guarantee policy increased the work-leisure balance. The significance of this study is that after the IMF, not only the income distribution but also the inequality among the income class in time use has deepened. Based on the results of the research this study suggests the reinforcement of labor time regulation, the activation of parental leave system, the realization of the income replacement rate, the expansion of the policy related to income redistribution, and the complementary development of the income guarantee and the time guarantee policy as the policy intervention strategy that restructures time.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.214-223
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• 2019

Objectives: Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran. Methods: A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran. Results: The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran. Conclusions: This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.

• Journal of the Korean Home Economics Association
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• v.43 no.6 s.208
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• pp.47-60
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• 2005

This study analyzed the factors that affect the use and expenditure of households for childhood education and care centers. The data were drawn from KLIPS(Korea Labor and Income Panel study), vol. 5(2002). From this dataset, 1,171 households were selected for this study. The results of this study were as follows. First, when compared to unemployed mother's households, employed mother's households tended to use childhood education and care centers. Second, with rising household income, the use of childhood education and care centers decreased. Third, the expenditure was much larger for the households with a large income than those with a small income.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1034-1040
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• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.

• Asian Journal for Public Opinion Research
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• v.12 no.2
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• pp.75-101
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• 2024

This study investigates the variation in anxiety levels across income classes in the wake of the COVID-19 pandemic in Indonesia. The research is based on data from nationally representative surveys conducted in 2017 and 2021, and it employs a multilevel mixed-effects ordered logistic model. The unique aspect of this investigation lies in its utilization of the Cantril ladder, a commonly employed tool in public opinion research, to gauge anxiety levels. Participants are prompted to assess their present life circumstances concerning their daily worries and anxieties. The empirical findings provide evidence that individuals in provinces with higher exposures to COVID-19 reported heightened anxiety levels. Furthermore, the results highlight a consistent association between higher household income and lower levels of anxiety. Notably, individuals from the highest income group experienced a substantial decline in anxiety levels during the pandemic. When examining specific income classes, the study reveals heightened anxiety among women in higher-income brackets and among lower-income households residing in urban areas. Furthermore, regarding macroeconomic circumstances, the results illustrate a positive correlation between economic prosperity and anxiety levels among members of low-income households. The study also uncovers a positive connection between income inequality and self-assessed anxiety within upper-middle and high-income brackets.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1026-1033
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• 2018

Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

• Health Policy and Management
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• v.13 no.3
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• Journal of Preventive Medicine and Public Health
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• v.41 no.3
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• pp.186-194
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• 2008

Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.437-463
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• 2013

As polarization and class reproduction between generations are considered to be serious problems in Korean society, increasing number of assortative mating, which means marrying between homogeneous family background, income class, and educational background, is on the spotlight socially. Some worry that the increase of assortative mating can reinforce closure of social mobility so it deepens inequality and limits class mobility between generations. This research analyzes the effects of accomplishment characteristics of husbands and wives and ascriptive characteristics of parents which consist the concept of assortative mating, on income, consumption, and assets those represent economic status of a family. The purpose of this research is to suggest empirical understanding on the role of assortative mating that affect on inequality within generations and income mobility between generations in Korean society. In the result of multiple regression analysis on the effect of assortative mating on income, consumption, and assets, high educational background was the factor that increase income and consumption level as accomplishment characteristics of assortative mating. As ascriptive characteristics of assortative mating, educational homogeneous of fathers was the factor that increased asset level. While accomplishment characteristics affect income and consumption, ascriptive characteristics of homogeneous had significant effect on assets. Thus, it was found that transfer between generations had effects around asset rather than income. In particular, ascriptive characteristics in young husbands and wives aged 20s or 30s had significant effect only on the assets.