• Nutrition Research and Practice
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• 제18권4호
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• pp.554-566
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• 2024

BACKGROUND/OBJECTIVES: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea. SUBJECTS/METHODS: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural). RESULTS: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed. CONCLUSION: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.

• 한국학교ㆍ지역보건교육학회지
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• 제6권
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• pp.1-16
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• 2005

This study was conducted to the middle and high school students in some Seoul and Kyunki areas to identify the smoking behavior characteristics among adolescences. A self-administered survey was conducted to the 2nd grad students in 4 middle schools and 6 high schools and the survey Questionnaire included general characteristics, smoking and drug use history, the close people's smoking and drug use, smoking and drug abuse prevention education, smoking intention, and smoking attitude. A total of 2,452 youths finished the survey (1,182 middle school students and 1,270 high school students). Current smoking students were 14.6%, the ex-smokers were 5.5%, and the never smokers were 85.4%. Majority of students smoked less than 5 bars of cigarettes and their first smoking experiences were related to their family members (siblings, parents, and relatives), friends, advertisement in order. Other GYTS countries reported the similar sources of the smoking start and friend was prior smoking start factor to the other sources. The students who wanted to Quit smoking were 6.7% and the students who ever had tried to Quit smoking were 9.1%. The major reasons of Quitting smoking were for their health and for their financial burden. Approximately 60% learned about smoking and drug abuse in their regular school classes, 8.4% were in the special school activities, and 7.9% were in the class closing time sometimes in order. The students who learned in any regular class were smaller in the high school students than in the middle school students. The learning experiences in school of other GYTS countries were similar to that of Korea. In conclusion, students' smoking was affected not only by the preventive activities in school but also by the close people's behaviors and care in this study; therefore, the active partnership between school and family must be a strong strategy for youth's smoking prevention.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.234-241
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• 2019

Objectives: To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status. Methods: This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status. Results: Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight. Conclusions: These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.

• 보건의료산업학회지
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• 제8권4호
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• pp.199-207
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• 2014

Family type is not only an important sociodemographic variable for health studies but also influences the health behavior and health condition of individuals. This study assessed a representative sample to see whether family type is associated with health behavior in Korean adults age 65 and older. This is a cross-sectional study of 9,535 Korean elderly who participated in the 2010-2012 Korean National Health and Nutrition Examination Survey. The subjects were classified as couple cohabitation, couple-offspring cohabitation, alone, or alone-offspring cohabitation. We assessed the relationship between family type and six health behaviors (smoking, high risk drinking, walking, oral examinations, health screenings, and influenza vaccinations) after controlling covariates. The "alone" classification had a significantly higher risk of no health screening, but was more likely to have an influenza vaccination than couples. Significant interactions between family type and healthy behavior were observed with oral health screening, influenza vaccination, and smoking {Odds ratio (95% confidence interval), 1.452 (1.066-1.980), 1.375 (1.083-1.747), 2.246 (1.604-3.146)}. There is a significant association between family type and healthy behaviors.

• 보건교육건강증진학회지
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• 제33권5호
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• pp.13-21
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• 2016

Objectives: The present study aims to examine associations between job demands and problem drinking, smoking, and practice of regular exercise among middle-aged and older male employees. Methods: Analyses were based on 239 employees aged 50+ and participated the 1st(2006) and the 4th(2012) waves of the Korean Longitudinal Study of Ageing(KLoSA). Panel logit regression analyses were performed to explore longitudinal associations between physical and cognitive job demands and the health behaviors when effects of demographic characteristics and objective job conditions were controlled. Results: Results suggested that first, workers who reported greater cognitive job demands were less likely to engage in problem drinking over the 6-year-period. Second, increased physical demands of the job were associated with greater odds of smoking, while physical demands predicted a reduced likelihood of practicing regular exercise. Conclusions: Results from the present analyses emphasize job demands could lead workers to problem health behaviors and suggest areas for health promotion efforts at the workplace that are sensitive to the needs of aging workers.

• 지역사회간호학회지
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• 제16권4호
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• pp.517-526
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• 2005

Purpose: The purpose of this study is to find taxi drivers' smoking behavior, self-efficacy and expectation level of success in smoking cessation. It will provide useful information for developing nursing interventions in health promotion programs. Method: The subjects of this study were 271 taxi drivers in Seoul and its metropolitan area. Data were collected using a self-reported questionnaire asking smoking history, smoking behaviors, health problem, stages of change for smoking cessation, self-efficacy and the expectation level of success in smoking cessation. Data were analyzed through descriptive statistics. Pearson's correlation, Mann-Whitney U test, Kruskal-Wallis test and Cronbach's a. Results: Of the taxi drivers, 83.8% were current smokers. Stages of change were as follows: 45.8% were in the precontemplation stage, 26.2% in the contemplation stage, 13.7% in the maintenance stage, 12.2% in the preparation stage and 1.5% in the action stage. In addition. 20.3% of the subjects reported health problems such as hypertension, heart disease, diabetes mellitus and respiratory disease. The expectation level of success in smoking cessation was positively related with self-efficacy. There were statistically significant differences in the expectation level of success in smoking cessation according to the number of cigarettes per day and nicotine dependency. In addition. there were statistically significant differences in self-efficacy according to the number of cigarettes per day, duration of smoking (years) and nicotine dependency. Conclusion: The results of this study suggest that taxi drivers' health problems and smoking rate were serious. Therefore more systematic health promotion programs for smoking cessation should be developed and executed by health care specialists at individual taxi companies.

• 한국직업건강간호학회지
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• 제24권3호
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• pp.245-257
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• 2015

Purpose: This study was performed to investigate the present condition of drug abuse and its association with depression, self-rated health and health behaviors by job status in Korean adults. Methods: Data were derived from the study on four addiction problem and suicide in 2014. Multiple logistic regression was used to analyze patterns of drug abuse according to depression, self-rated health and health behaviors. Results: The prevalence of drug abuse during the past year was 17.1% of the 4,018 subjects. About 3.3 times risk for drug abuse was found among individuals who had high depression scores. The risk of drug abuse was higher among those who were smoking (OR:1.46, 95% CI:1.17~1.83), drinking more frequently (OR:1.30, 95% CI:1.07~1.58), sleeping insufficiently (OR:1.31, 95% CI:1.03~1.67), eating irregularly (OR:1.45, 95% CI:1.19~1.76). Drug abuse problem was detected more seriously among employed than unemployed adults. Conclusion: Health-related behaviors, such as smoking, drinking, sleeping, eating should be considered simultaneously when designing strategies to deal with drug abuse problem, and it is important to understand the interaction between drug abuse and mental health. Furthermore, workplace based intervention can be effective in solving drug abuse problem.

• 한국학교보건학회지
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• 제32권2호
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• pp.105-115
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• 2019

Purpose: The purpose of this study was to compare the mental health factors related to health risk behaviors between multicultural and monocultural adolescents. Methods: The study subjects were selected from the 2018 Korea Youth Risk Behavior Web-Based Survey Dataset. A total of 60,040 multicultural and monocultural adolescents were included in the analysis. A $x^2$ test and logistic regression were conducted, using SPSS 18.0, to compare the general characteristics, mental health, and health risk behaviors of the multicultural and monocultural adolescents. This process involved a complex sample design. Results: There was a significant difference in the rates of suicidal behaviors. Multicultural adolescents showed a significantly higher rate of suicidal ideation (8.6% vs. 8.5%, p=.004), suicidal plan (3.2% vs. 2.4%, p=.004), and suicidal attempt (5.0% vs 3.1%, p=.04) than monocultural adolescents. Perceived stress had a significant impact only on monocultural adolescents. Monocultural adolescents with high levels of perceived stress were at a greater risk of drinking (high stress=reference; low stress OR=0.91, p=.025) and smoking (high stress=reference; low stress OR=0.90, p=.029) than those with low stress. Multicultural adolescents who had made suicide attempts were at a higher risk of drinking (multicultural OR=7.879, p<.001; monocultural OR=2.481, p<.001) and smoking (multicultural OR=4.011, p=.015; monocultural OR=2.800, p<.001) than monocultural adolescents. Conclusion: To implement an effective smoking and drinking prevention program, it is necessary to consider how we can reduce the risk factors. Stress management is important for monocultural adolescents and a proactive suicide-screening program and a suicide prevention program should be included in the program for both multicultural and monocultural adolescents.

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.6-14
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• 2018

Objectives: To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners. Methods: We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners' corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ${\geq}65\;years$) and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife. Results: Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49) was highest when the participant's partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66), eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62); and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98). In comparison to non-housewives, housewives had higher odds of eating salty food. Conclusions: The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.

• 보건교육건강증진학회지
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• 제21권1호
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• pp.153-170
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• 2004

Objectives： This study was performed to develop a smoking prevention program for Korean high school students, and to evaluate the effects of the program. Methods： A smoking prevention program, composed of five-session curriculum, was developed by modifying several smoking prevention and cessation programs based on the Social Influence Model. The program was applied to the freshmen of a technical high school. We surveyed with a questionnaire one week before education, one week after education, and two months after education. The number of participants for data analysis were 282(181 males, 101 females). Among those, 162(97 males, 65 females) students were allocated to the education group, and the other 120(84 males, 36 females) students were allocated to the control group. The effect of education was analyzed by multiple logistic regression analysis adjusted by potential confounders. Results： Among smokers, those who had education were more likely to quit smoking (OR＝2.99, 95% confidence interval(CI) 0.84-10.64), and to decrease smoking frequency(OR＝2.29, 95% CI 0.95-5.53) in borderline significance one week after education. However, the effect of education disappeared two months after education. The effect of education was significant(OR＝9.11, 95% CI 3.22-25.76) for the increase of smoking cessation intention one week after education, and it persisted until two months after education(OR＝2.94, 95% CI 1.18-7.35). Education was also a significant predictor(OR＝1.97, 95% CI 0.89-4.37) for the increase of smoking cessation stage one week after education and it persisted(OR＝6.39, 95% CI 2.42-16.86) after two months. Among non-smokers, those who had education were more likely to decrease smoking intention one week after education(OR＝4.71, 95% CI 1.63-13.58). However, the statistical significance of education disappeared two months after education. Conclusions： The results showed that the smoking prevention program developed in this study changed smoking behaviors immdeiately after education even though the effect did not persist. However, this program was successful in increasing smoking cessation intention and stage of smoking cessation among smokers.