• 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.

• The Journal of the Convergence on Culture Technology
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• v.7 no.4
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• pp.351-361
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• 2021

The purpose of this study is to provide basic data for resolving individual and regional health inequalities by identifying factors that affect healthy living practices, and to protect the access to health equity and the access to health equity and the people's right to health. Raw data from the 2019 Community Health Survey were used, and descriptive statistical analysis and multivariate logistic regression analysis were performed using SAS 9.4 and IBM SPSS ver. 21. The healthy living practice rate was 33.8% overall, and there was a difference of 11~20% by region. In terms of individual factors, healthy living practices were significantly different in gender, age, occupation, sleep time, subjective health status, and subjective stress level. In the interpersonal factor, there was a difference in social activity for healthy living practice, and in the community factor, positive attitude toward the local physical environment, annual unsatisfied medical care, and use of health institutions were significant. In order to increase the practice of healthy living by region based on the research results, comprehensive policies and cooperative measures that can be approached at the individual, social and national level should be implemented along with specific strategies.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.49-59
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• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.300-306
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• 2008

Objectives : This study was performed to compare the standardized mortality ratios among different small areas and to explore the usefulness of standardized mortality ratios in South Korea. Methods : To calculate the standardized mortality ratio (SMR), we obtained the national deaths certificate data (2004-2006) and national registration population data (2003-2006), and these were provided by the National Statistical Office. The small areas (Eup.Myoun.Dong) were based on the subdivisions of counties. Among the 3,580 small areas classified by the National Statistical Office, 3,571 areas were included in this study. The basic statistics and decile distributions of the SMRs for all the regional levels were calculated, and the small area maps were also produced for some selected regions. To evaluate the precision of SMR, we calculated the 95% confidence intervals of the SMR in selected small areas. Results : The mean and the standard deviation of the SMRs among all small areas were 100.8 and 17.0, respectively. The range was 30.6-211.7 and the inter-quartile range was 20.7. Seoul metropolitan city displayed the lowest mean SMR among 16 regions in South Korea, and 34.6 percent of the small area SMRs belonged to the first decile(the lowest group). On the contrary, the mean SMR of Gyeongsangnam province was highest, and 26.1 percent of the small area SMRs belonged to the tenth decile(the highest group). In some areas, the precision of the SMR, which was calculated by the 95% confidence intervals, remained questionable, yet it was quite stable for almost areas. Conclusions : The standardized mortality ratios can be useful for allocating health resources at the small area level in Korea.

• Journal of the Economic Geographical Society of Korea
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• v.4 no.2
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• pp.57-77
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• 2001

The Honam region has been recognized as one of the most lagging regions in Korea. Drawing upon some decompositions oi Gross Regional Domestic Product(GRDP) per head and labor productivity, the overall trend of inequalities in Korea has been revealed and the trajectory of the Honam region's economic change has been identified by examining how the region's economic performance changed relative to that of Korea in the 1990s. There are some findings. First of all, Korea is characterized by strong divergence in the development of its region economies, in terms o\ulcorner per capita GRDP, which relies upon productivity differentials rather than differences in employment rates. Second, the Honam region has displayed poor economic performances in terms of GRDP per head except for Jeonnam. Third, the dramatic fall in cumulative population growth relative to the national average has been an important factor in the Jeonnam's overwhelming economic performance measured by per capita GRDP. Fourth, the decline in the relative productivity of the Honam region is mostly explained by falling relative regional productivity growth in construction, transport and manufacturing, although it should be noted that the latter sector has made positive contribution to raising relative regional productivity of Jeonnam. Fifth, overall the shift in employment to service sector, especially to social, personal, public, health, education, other services other than distribution, hotels, catering has tended to support relative regional productivities, along with the positive contribution being made oi agriculture, forestry and fishing to relative regional productivity growth in the Honam region.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.53-59
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• 2016

Background: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. Methods: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities. Results: Survey participants responded that South Korea needs governmental policies to alleviate the concentration of cardiovascular surgery patients in large metropolitan hospitals. Participants agreed that the freedom to choose medical institutions and improved accessibility to metropolitan hospitals due to advanced transportation systems were some of the causes for the concentration. A majority (98.7%) of respondents thought establishing thoracic and cardiovascular surgery centers in provinces was an appropriate solution to alleviate the concentration. Thoracic and cardiovascular surgery specialists were ranked as the number one group on which to focus development. Conclusion: Developing and carrying out policies to establish thoracic and cardiovascular surgery centers in provinces will alleviate the regional imbalance in available heart surgery services and an overall improvement in cardiovascular disease treatment in South Korea.

• Korean Journal of Community Nutrition
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• v.26 no.1
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• pp.37-47
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• 2021

Objectives: The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years. Methods: Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan (4th: n=5,977, 7th: n=6,651), urban (4th: n=4,511, 7th: n=5,512) and rural (4th: n=3,566, 7th: n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression. Results: In urban and rural areas, the obesity rate increased in the 7th survey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7th survey compared to the 4th survey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4th survey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject's residential area, but in the 7th survey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, P=0.044). Conclusions: This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.