• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6883-6888
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• 2015

Background: Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. Materials and Methods: The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. Results: One-third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Conclusions: Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.

• Korean Journal of Health Education and Promotion
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• v.9 no.1
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• pp.14-29
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• 1992

의학이 발달하고 수명이 연장되고, 그리고 식사가 보다 서양화되는 등 생활양식이 변화됨에 따라 성인병이 1970년대부터 한국에 보다 늘어나게 되었다. 본 연구는 면접 및 설문지법을 이용하여 성인병, 특히 고혈압, 당뇨병 및 암에 관하여 도시 및 시골 거주자들의 지식, 태도 및 실천을 비교 연구하였다. 연구기간은 1990년 1월 부터 12월까지 1년동안이었고 대상은 전체 716명으로 그중 360명은 부산시 거주자였고 356명은 부산 근교의 시골거주자였다. 고혈압, 당뇨병 및 암에 대해 알고 있다고 응답한 대상자는 각각 92.6%, 92.0% 및 74.7%였다. 고혈압, 당뇨병 및 암의 지식도에 있어서 도시 거주자들이 시골 거주자보다 유의하게 더 많이 알고 있었다(각각 p<0.001). 그러나 성인병에 관한 태도와 지식에 있어서는 도시 거주자와 시골 거주자 사이에 유의한 차이가 없었다(p<0.05). 고혈압의 지식도는 거주지(r=0.2159, p<0.01) 및 수입 (r=0.1882, p<0.01)과 유의한 상관관계가 있었고, 당뇨병에 관한 지식도는 거주지(r=0.3952, p<0.001), 수입(r=0.3663, p<0.001) 및 직업(r=0.2576, p<0.001), 수입(r=0.4138, p<0.001), 직업(r=0.3044, p<0.001) 및 성별(r=-0.1887, p<0.01)과 유의한 상관관계가 있었다. 성인병에 관한 태도는 성별(r=0.4748, p<0.001), 경제상태(r=0.2209, p<0.01) 및 고혈압 지식도(r=0.1844, p<0.01)와 유의한 상관관계를 나타내었다. 성인병에 관한 실천은 본 연구에서 어떤 변수와도 상관관계가 없는 것으로 나타났다. 성인병이 이전보다 더 많아짐에 따라 연령이 증가하는 나라와 개발국가에서 성인병이 주요한 대상질환이 될 것이고, 질병예방과 건강증진의 차원에서 성인병을 예방하기 위해 보건교육에 보다 중점을 두어야 할 것이다.

• 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 dental hygiene science
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• v.16 no.4
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• pp.293-301
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• 2016

This study aimed to design and operate a complementary integrated health management program based on the connection between the hypertension and diabetes management programs and the oral health programs at a public health center. It also proposed to suggest the phased evaluation indicators. In this study, 48 adults registered in the hypertension and diabetes management program were selected from the Gangneung public health center. The clinic-specific programs were led by dental hygienists and operated for visitors twice every two weeks. The programs were designed based on the logical model, and indicators for evaluating the structure, process, and outcome were presented and applied to the input, process, output, and outcome. The evaluation indices consisted of quantitative and qualitative indicators, and the planning and operation, goal achievement, and effect of each program were assessed. The process evaluations were assessed by the appropriateness of the managers and the operating fidelity of the programs. Indicators for evaluating the outcomes were gingival bleeding, oral health knowledge, oral health awareness, and the satisfaction of the participant and the manager. The clinic-specific programs resulted in positive changes in the evaluated outcomes. The integrated health management of visitors to the hypertension and diabetes management program is important as the general and oral health has common risk factors. Furthermore, long-term operation and continuous monitoring of oral health programs are necessary to evaluate the common factors in chronic disease management.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.1
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• pp.92-99
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• 2017

People have become more interested in fiber intake due to the rise of noncommunicable diseases such as hyperlipemia and abdominal obesity. This study was carried out to develop dacquoise incorporating different amounts of rice bran dietary fiber (5%, 10%, 15%, and 20%). Dacquoise characteristics such as viscosity, specific volume, moisture content, color, and texture were measured. Consumer acceptance and check-all-that-apply on characteristics of dacquoise with rice bran dietary fiber were observed. Increasing amounts of rice bran dietary fiber resulted in increasing viscosity of batter as well as higher specific volume, lightness, and hardness of finished product. On the contrary, yellowness and redness of dacquoise increased as the amount of rice bran dietary fiber increased. While there was no effect of rice bran dietary fiber on moisture content (range of 26.53~25.35%). According to the consumer acceptance test, dacquoise with 5% of rice bran dietary fiber showed the highest liking score in color and overall acceptance (5.9 and 5, respectively). The findings from the principle component analysis of principle component (PC) 1 (71.04% explanation) showed that as rice bran dietary fiber increased, texture of the product got drier, and consumers described the product with 20% rice bran dietary fiber as cotton mouth and 5% rice bran dietary fiber as sticky. PC2 (16.54% explanation) demonstrated 5% and 10% rice bran dietary fiber, and dacquoise had nutty and soybean notes while 15% and 20% rice bran dietary fiber dacquoise had flour, bitter, and salty flavors. Based on these results, the optimum addition level of rice bran dietary fiber for dacquoise is 5%.