• 보건행정학회지
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• 제14권2호
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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.

• 사회복지연구
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• 제49권1호
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• pp.51-83
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• 2018

본 연구는 IMF 이후 소득 차원에서의 분배 악화와 유사하게 시간사용의 분배에서도 소득계층간 격차가 심화되고 있는 지를 검토하고, 그 영향요인을 분석하였다. 이를 위해 다국가시간사용조사(MTUS)와 생활시간조사 자료를 활용하여 프랑스, 네덜란드, 스페인, 영국, 미국, 한국 등 6개국을 대상으로 다층분석(HLM)을 실시하였다. 주요 분석결과를 제시하면, 첫째, 분석대상 국가들에서 저소득층은 유급노동시간은 길고 여가시간은 짧은 반면, 고소득층은 유급노동시간이 짧고 여가시간은 긴 것으로 나타났다. 둘째, 한국의 저소득층은 비교 국가 중 유급노동시간이 가장 길고 여가시간은 가장 짧아, 일-여가 균형이 가장 낮은 수준이었고, 이러한 양상은 IMF 이후 회복되지 않고 있었다. 셋째, 다층분석 결과, 가구소득이 낮을수록 유급노동시간은 증가하고 일-여가 균형은 감소하여 장시간 노동이 특정 집단으로 귀결되는 시간 불평등 양상이 포착되었다. 넷째, 연평균노동시간은 유급노동시간을 증가시키는 반면, 가족정책지출, 재분배 정책, 소득보장정책은 유급노동시간을 감소시키는 요인으로 드러났다. 다섯째, 연평균노동시간은 일-여가 균형을 감소시켰으나, 가족정책지출, 재분배정책, 소득보장정책은 일-여가 균형을 증가시켰다. 본 연구의 의의는 IMF 이후 한국 사회에서 소득 분배뿐 아니라 시간 사용에서의 계층 간 불평등이 심화되어 왔음을 규명하였다는 것이다. 연구결과에 기초하여 본 연구는 시간을 재구조화하는 정책적 개입 전략으로 노동시간 규제 강화, 육아휴직제도 활성화와 소득대체율 실질화, 소득 재분배 관련 정책 확대, 소득보장과 시간보장 정책의 상호보완적 발전 등을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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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.

• 대한가정학회지
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• 제43권6호
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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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• 제59권9호
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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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• 제12권2호
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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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• 제59권9호
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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.

• 보건행정학회지
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• 제13권3호
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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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• 제41권3호
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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.

• 사회복지연구
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• 제44권2호
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• pp.437-463
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• 2013

양극화와 세대간 계층재생산이 한국 사회의 심각한 사회문제로 여겨지는 상황에서, 동질적인 부모의 배경, 동일한 소득계층, 동일한 학력 간에 끼리끼리 이루어지는 동질혼의 증가가 사회적 주목을 받고 있다. 동질혼의 증가가 사회 이동의 폐쇄성을 강화함으로써 불평등을 심화시키고 세대간 계층 이동을 제한시킬 것이라는 우려 때문이다. 이 연구는 동질혼의 개념을 구성하는 부부의 성취적 특성 및 부모의 귀속적 특성이 가구의 경제적 상태를 대표하는 소득, 소비, 자산에 미치는 영향을 분석하고 있다. 이를 통하여 한국 사회의 세대내 불평등 및 세대간 계층이동성에 영향을 미치는 동질혼의 역할에 대한 실증적 이해에 기여하고자 하였다. 동질혼이 소득과 소비, 그리고 자산에 미치는 영향에 관한 다중회귀분석 결과, 동질혼의 성취적 특성으로는 고학력 동질혼이 소득과 소비 수준을 증가시키는 요인으로 나타났으며, 동질혼의 귀속적 특성으로는 아버지들의 교육적 동질혼이 자산수준을 증가시키는 요인으로 나타났다. 소득과 소비에는 동질혼의 성취적 특성이 영향을 미치는 반면, 자산에는 동질혼의 귀속적 특성이 유의미한 영향을 미치는 것으로 나타나, 세대간 이전이 소득보다 자산을 중심으로 영향을 미치고 있음을 발견하였다. 특히 20-30대 젊은 부부에게는 귀속적 특성이 자산에 대해서만 유의미한 영향을 미친다는 점도 밝혀졌다.