• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.201-209
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• 2017

Objectives: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.459-467
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• 2013

The purpose of this study was to identify the differences in medical care utilization by regional economic status using the National Hospital Discharge Patients Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized 5 quintiles according to their financial self-reliance ratio. The main results are as follows. First, low economic region has high age-standardized admission rate and standardized mortality rate. Second, of 16 major diseases, cerebrovascular and heart diseases, lung cancer, and stomach cancer reported greater changes in standardized mortality rate by regional economic status. Third, the rate of admission via emergency room in low economic region is higher than that of high economic region. Lastly, in the major illnesses, lower economic status led to an increase in average length of stay. Therefore, In order to bridge the gap in health inequality across regions, a regional medical policy tailored for each region and characteristics of the economic status should be established.

• Journal of Preventive Medicine and Public Health
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• v.38 no.3
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• pp.359-365
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• 2005

Objectives : An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001. Methods : Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression). Results : Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period. Conclusions : The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.

• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.258-263
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• 2018

Purpose: Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP. Methods: A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile. Results: The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ${\leq}3days$ after admission and hospital stay ${\leq}6days$. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ${\leq}3days$. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile. Conclusion: Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.

• Journal of Nutrition and Health
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• v.39 no.5
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• pp.451-459
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• 2006

The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and 8MI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and $20.0\;kg/m^2$ respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed $50{\sim}200\;g$ of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD $(g/cm^2)$of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ. and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.

• Journal of Nutrition and Health
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• v.45 no.1
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• pp.20-29
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• 2012

Metabolic syndrome (MetS) has become a global epidemic. In particular, it is known that there is a dramatic increase in the prevalence of MetS among women during the postmenopausal period. Recently, accumulating studies have suggested that vitamin D deficiency may be inversely associated with the risk factors regarding MetS. However, evidence from postmenopausal women is limited. In this study, we examined the association between the serum 25-hydroxyvitamin D [25(OH)D] and the MetS in Korean adult women aged 20-69 years (n = 2,618) by using the 2007-2008 Korean National Health and Nutrition Examination Survey data. The geometric mean of plasma 25(OH)D were $17.16{\pm}6.28\;ng$/mL and $20.20{\pm}7.69\;ng$/mL for premenopausal and postmenopausal women, respectively. The percentages of vitamin D deficiency [25(OH)D < 12 ng/mL] were 22.5% and 14.4%, respectively. MetS was more prevalent in postmenopausal women (43.0%) compared with premenopausal women (11.2%). When serum concentrations of 25(OH)D were categorized in quintiles, there was no relationship in the prevalence of MetS in both premonopausal and postmenopausal women. However, in premenopausal women, compared with the lowest 25(OH)D quintile, the odds ratio for hypertriglyceridemia in the highest quintile was 0.57 (95% CI 0.34-0.95, $P_{trend}$ = 0.041) and for low serum HDL cholesterol 0.60 (95% CI 0.42-0.85, $P_{trend}$ = 0.014) after adjusting for all potential confounders. On the other hand, we observed the tendency of an inverse relationship for 25(OH)D regarding low serum HDL cholesterol (OR 0.78, 95% CI 0.50-1.22, $P_{trend}$ = 0.029) and a direct relationship with abdominal obesity (OR 1.94, 95% CI 1.01, 3.74, $P_{trend}$ = 0.049) in postmenopausal women. Further studies are needed to confirm these findings in other research settings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.382-390
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• 2017

This study was conducted to identify the factors affecting the quality of life of cancer patients based on demographic characteristics, health status, and mental health using the results of the 6th National Health and Nutrition Survey. The research tool used the demographic characteristics, health status, mental health, and quality of life of the KNHANES VI-2. Data analysis was conducted using SAS 9.3 version. There were significant differences in the quality of life in the study results by age, gender, economic activity, individual income quartile, subjective health status, mental health status, activity limitation, stress perception, and experience of depression symptoms. Factors influencing the quality of life of cancer patients included age, sex, income quintiles(individual), subjective health status, activity limitation, and experience of depression symptoms, which together explained 39.1% of the quality of life. To improve the quality of life of cancer patients, comprehensive management is required from diagnosis to treatment to return to society. It is also necessary to develop and apply long-term programs including multidimensional approaches and improvement of quality of life, early screening of cancer and cancer prevention education, management of depression symptoms, and social support.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.374-381
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• 2017

The LAP (lipid accumulation product) index is an indicator of excessive fat accumulation in combination with the fasting triglyceride concentration and waist circumference. This study examined the relationship between the LAP index and ALT (alanine aminotransferase) level and the effect of the LAP index on the ALT level. Cross-sectional studies were conducted on healthy adult males without a history of liver disease. From January 2015 to June 2017, 13,854 adults between 20 and 70 years of age, who underwent health screening at a general hospital in Gyeonggi-do, were enrolled in this study. The LAP index was calculated as [waist circumference (cm)-65]${\times}$[triglyceride (mmol/L)] for males. Serum ALT abnormalities were set at 40 IU/L or more in males. All subjects underwent measurements of the anthropometric indicators and physiological examinations. A significant increase in ALT with increasing LAP quintiles was observed (p<0.001). The LAP index correlated with ALT (r=0.238, p<0.001). Insulin (r=0.449, p<0.001) and HDL-cholesterol (r=-0.369, p<0.001) were strongly correlated with LAP. In addition, the LAP index is a factor affecting the ALT level (p<0.001). As the LAP index increased, the risk of an elevated ALT was higher (p<0.001). In conclusion, the LAP index was a predictor of an ALT elevation in Korean men.

• Parasites, Hosts and Diseases
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• v.53 no.5
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• pp.553-559
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• 2015

Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

• Journal of the Korean Data Analysis Society
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• v.20 no.6
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• pp.3139-3153
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• 2018

The purpose of this study is to analyze the gap of private tutoring expenditure using data from 2001 to 2016 of Korean labor and income panel study (KLIPS). The final analysis target is about 1,300 to 1,800 households nationwide who participated in the Korean labor panel survey in each year. As a result of the analysis, the expenditure of private tutoring expenditure has been continuously increased since 2001, and it is analyzed that there is a large gap in expenditure of private tutoring even in the comparison of groups divided by the quintile. The spending gap on private tutoring expenditure in the first and fifth quintiles has increased steadily, reaching 11 times in recent years. By forecasting the polarization of private tutoring expenditure since 2016 using the Brown's smoothing method, it is highly likely that the polarization of private tutoring expenditure will be further expanded. The implications for preparing an alternative educational policy and suggestions of conducting a follow-up study for private tutoring expenditure gaps were also discussed.