• Health Policy and Management
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• v.18 no.4
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• pp.1-22
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• 2008

Burden of disease analysis provides a unique perspective on health by integrating fatal and non-fatal outcomes, yet allows the outcome of two classes to be examined separately. Although many studies have shown the inequality in health outcomes across socioeconomic status (SES), an analysis and comparison of Disability Adjusted Life Year (DALY) between different socioeconomic groups has been rare. This paper calculates the DALY and analyzes the distribution of DALYs for different SES. This study draws from 3,278 cases from the survey on "The Livelihood and Welfare Needs of the Elderly (2004)". It first provides a comprehensive assessment of the burden of 10 chronic diseases of the elderly based on DALY. Then this paper analyzes inequalities in the burden of disease by the levels of SES such as education, income, family size, occupation, and subjective economic conditions. For the elderly, the burden of disease is the highest for hypertension, arthritis and cancer. DALY rate per 1,000 people for the most socio-economically disadvantaged group is expressed as a multiple of the standardized rate for the least disadvantaged group (Rate Ratios). Family size is strongly related to. the difference in the burden of disease between SES groups, and the elderly Who live alone have higher DALY rate than those who live with their family. Other significant variables related to SES groups include subjective economic conditions, occupation, elderly income, and household income.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.107-116
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• 2005

Objectives : We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. Methods : The study subjects were a total of 8,923 employee households and a total of 7,296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). Results : For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased ($\beta$=0.232, p<0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased ($\beta$=0.186, p<0.05), although its change was smaller than that in the employee group. Conclusions : The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

• Journal of the Korean Home Economics Association
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• v.29 no.2
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• pp.135-154
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• 1991

The purposes of this study are: 1) To find out overall family life issues percieved by the middle-classhousewives in their forties. 2) To examine detailed aspects related to middle years crises, leisure activities, children issues, family economy issues, and housing issues. 3) To clarify solutions to, and provide basic data on family issues raised by the middle-class families. The middle-class housewives in their forties living in the Seoul area were the subject of the survey. The sample size analysed in this study was 422. Data were analysed by the frequency, mean, percentile, standard deviation, X2-test, analysis of variance, multiple classification analysis, analysis of multiple regression, and Scheffe-test as a post-hoc analysis. The conclusions are as follows: First, the middle-class housewives tend to give more importance on children issues, especially on academic achievement and career development. Second, family cohesion of middle-class families is comparatively high and intra-familial conflict is low, and middle years crisis of housewives is comparatively low, too. Third, the stability of middle-class families can be found in household economic management patterns. one fourth of the families own stocks and two fifths of the families own real estate except their own dwelling house. Be based on their property income add to their labor income, middle-class families are showed their economic stability, however, intra-class inequality is found, too. Fourth, the great part of middle-class families that possess their own house, tend to be unsatisfied with their housig scale, and a half of the families expect to enlarge their housing scale for more comfortable and convient living.

• Journal of the Korean Home Economics Association
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• v.45 no.4
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• pp.17-28
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• 2007

The purpose of the study was to provide informations about the financial status of elderly households using financial ratios. The data was obtained from 2000 national households, consisting of 4,824 of elderly households. Descriptive tatistics were used to analyze the financial ratios and eleven different financial ratios. The results of this study were as follows. The financial status of elderly households need to be analyzed in detail according to age group, income level and asset level. In addition, some financial ratios already developed in previous studies may not applicable which necessitates the development of financial ratios specifically for application to elderly households for finanical counselors. The study results suggest the possibility of inequality among elderly households. The following studies need to focus on the limitation of these studies.

• Research in Community and Public Health Nursing
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• v.31 no.1
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• pp.13-23
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• 2020

Purpose: This study explored the contribution of social support resources to the explanation of socioeconomic inequalities in depressive symptoms of older Korean men and women. Methods: Data were derived from Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. The data were analyzed by using multiple logistic regression. The sample consisted of 4,046 men and 6,036 women aged ≥65 years. The Korean version of the Geriatric Depression Scale-Short form (SGDS-K) was employed as an outcome variable. Results: Compared to the older men and women who were in higher socioeconomic status, those in lower socioeconomic status had significantly higher risk of depressive symptoms after adjusting for other covariates. When social support resources were individually included in the base model, each factor contributed to inequalities in depressive symptoms. Social networks explained about 20% of the differential impact of education and 10% to 15% of the differential impact of household income for depressive symptoms in men. Among women, it mitigated 23.6% to 39.0% of education and household income inequalities for depressive symptoms. Social participation contributed to buffer depressive symptom inequalities of 24.0% to 46.3% among men and those of 11.7% to 45.3% among women. Conclusion: Our findings suggest community care nurses acknowledge the value of social support resources to alleviate socioeconomic inequality in depressive symptoms among older men and women.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.1
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• pp.1-14
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• 2018

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

• 한국노년학
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• v.39 no.4
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• pp.959-976
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• 2019

The purpose of this study was to understand socio-demographic factors related to older adults' participation patterns in lifelong education. For the purpose, this study used the raw data of 2017 Survey of the Living Conditions of the Elderly (SLCE) conducted by The Korea Institute for Health and Social Affairs. From the data of 10,073 older adults, their lifelong education participation, participating program types, participating organizations, and participating frequency were analyzed by their sex, age, educational level, household income, the longest job status, and health status. This study found that female, age of 70-74 and 75-79, educational levels of high school and higher, the longest job status of regular employees and unpaid family workers, and decent health status of older adults more participated in lifelong education. According to lifelong education program types, significant differences were found between education groups of middle school/lower and groups of high school/higher and between 1, 2 quintile income groups and 3, 4, 5 quintile income groups. In relation to the participating organizations, groups of 70 years and older, middle school and higher education level, under 3 quintile income, and poor health tended to participate in lifelong education at the elderly welfare center, senior citizens, and elderly classrooms. In terms of participation frequency, high school and college/higher than 0 year of school education, and regular workers than unpaid family workers were more frequently participated in lifelong education. This study showed the inequality in lifelong education participation according to older adults' demographic characteristics; finally, this study suggested necessary policies and academic discussions for future older adults' lifelong education.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.291-298
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• 2023

Purpose : Although Korea's health insurance system and access to medical care are well established compared to other countries, the rate of non-fulfillment of dental treatment is high. Medical use rates can be affected by economic characteristics, individual heatlh condtions, health concerns, and health behaviors. This study was implemented to investigate the effect of the middle-aged elderly people's family living together on the dental examination rate and to use it as basic data for program development, research, and poicies to promote oral health. Methods : Raw data from the 7th national health and nutrition survey conducted by the Korea centers for disease control and prevention (2016~2018) were used and analyzed using SPSS 21.0 Version (IBM, United States). Results : As a result of the study family types accroding to general characteristics, the more women are (p<.001), the higther the age (p<.001), the lower the hosehold income level (p<.001), the lower the educational background (p<.001), the more people who live in Eup-Myeon (p<.001) It was fouend that the rate of living alone was high. The dental examination rate according to general characteristics was related to age (p<.001), income (p<.001), and educational background (p<.001), and the higher the examination rate was in the same (p<.001), and the higher the family living together (p<.001). Factors influencing whether or not dental treatment was not performed were in the following order: household income (p<.001), age (p=.001), and family type (p=.017). Conclusion : The above results confirmed the relationship between family membership and dental examination rates, and measures such as the development and operation of participatory programs to improve public oral health by resolving medical inequality and enhancing health equity, and it is believed that the development of professional manpower and the operation of education and programs for professionals are necessary.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.505-511
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• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• Health Policy and Management
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• v.11 no.2
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• pp.85-122
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• 2001

This study compared and analyzed the effect of income-redistribution, collecting data on the basis of the estimated details of insurance contribution and individual money wage lists for each one year before and after the combination of medical insurance program for industrial workers, by systematic sampling, extracting 4,160 families(14,764 people) among people applied to medical insurance program for self employees in Taegu City on the basis of Oct. 1st in 1998 with 227 associations of medical insurance program for self employees and medical insurance program for government employees and private school teachers combined, comparing the effect of income redistribution of before and after the combination of medical insurance program for self employees. The insurance contribution by household after the combination of medical insurance program for self employees showed the increase rate of average 20.9%, among them households of 68.8% increased and 31.2% decreased. The effect of income-redistribution was more positive because the degree of inequality was more deepened from 0.64 of the before-combination to 0.45 of the after-one in decile distribution ratio, from 0.26 to 0.34 in Gini -coefficient. Decile distribution ratio on the basis of insurance benefits by household was from 0.09 in the before-combination to 0.14 in the after-one, Gini-coefficient from 0.16 in the before-combination to 0.57 in the after-one was a little lowered. And decile distribution ratio of insurance benefits on the basis of insurance contribution was higher from 1.08 in the before-combination to 1.23 in the after-one, concentration index was a little lowered from 0.14 to 0.11, the effect of income-redistribution was improved in the phase of insurance benefits. The income-transfer rate of medical insurance program for self employees (the occupied rate of insurance benefits/ the occupied rate of insurance contribution) showed a lower trend in all of the before and after-combination towards upper classes, it was known that the income-transfer rate was higher from 1st degree to 7th degree in the after-combination in comparison with the before-one, but the effect of income¬redistribution was high because the income-transfer rate was lowered from 8th degree to 10th degree. The rate of medical insurance benefits (insurance benefits/ insurance contribution) increased from 0.79 in the before-combination to 1.07 in the after-one, and showed over 1.0 under 3th degree before the combination, but all of it was higher than 1.0 under 7th degree after the combination, the after-combination was more improved than the before-one in view of the rate of insurance benefits. As the result of above, on the basis of Oct. 1st in 1998 that 227 associations of medical insurance program for self employees was combined into one, we could say that the equality of imposing medical insurance contribution was more re-considered in the after-combination than in the before-one. But this study analyzed with classes divided, anyway, on the basis of insurance contribution, we have limit in explaining the correct effect of income-redistribution, because it was not analyzed according to classes of income, though it helps to analogize the effect of income-redistribution. So there must be analysis about the effect of income-redistribution, on the basis of the system, building up the system to grasp the correct income of the insureds of medical insurance program for self employees.