• 제목/요약/키워드: Social determinants of health

검색결과 307건 처리시간 0.027초

지역의 건강결정요인 취약성 유형화 및 유형별 건강수준의 차이 (Typology of Community Health Vulnerabilities and Their Effects on Health Status by Type-Using Community Health Survey)

  • 박보현;이경희;최숙자;서수경;최선임
    • 지역사회간호학회지
    • /
    • 제32권3호
    • /
    • pp.281-291
    • /
    • 2021
  • Purpose: This study examined health determinants at a community level and put forward to a typology of five different forms of community health vulnerabilities. We also investigated the differences in the prevalence of chronic diseases, self-rated health, and quality of life (EQ-5D) among the five types. Methods: Latent class analysis was applied to material, social capital, and health behavior vulnerability variables across 255 regions of South Korea. The data came from 2017 & 2019 Community Health Survey. Results: We found five types of community health vulnerabilities: Type 1 group had the highest material vulnerabilities compared to Type 5. The typology was found to be significant in all the regression analysis on the prevalence of chronic diseases (hypertension and diabetes), self-rated health status, and quality of life. In the regions with high material vulnerabilities, the material vulnerability appeared the most effective to the health status of individual's. In the other regions with less material vulnerabilities, the social capital and health behavior resources were found to be effective. Conclusion: A comprehensive measure of vulnerability can be helpful to understand community health. Policy makers need to consider the level of material vulnerability when planning for a health promotion project.

저출산 대책에 대한 다학제적 접근 (Multidisciplinary Approach to Low Fertility Issue in Korea)

  • 박정한
    • 보건행정학회지
    • /
    • 제28권3호
    • /
    • pp.233-239
    • /
    • 2018
  • A rapid decrease of total fertility rate to 1.08 in 2005 prompted the Korean government to plan and implement a '5-year plan for ageing society and population policy' starting from 2006. The 1st and 2nd 5-year plans had not shown any discernible impact on the fertility and the 3rd 5-year plan was launched in 2016. However, the fertility rate is going down further. The author reviewed the contents and assessment reports of the fertility promotion plan to suggest ideas for complementing the shortcomings of it. Author defined the major determinants of marriage and child birth as philosophy, politics, sense of value, social norm, culture, healthcare, and education. The plan was examined in view of these determinants. Transformation of Korea from an agricultural society to an industrialized society in a short period of time had brought about changes in most of the determinants of marriage and child birth; in particular philosophy and sense of value. These aspects were not put into consideration in the plan. Author suggested to launch a social education program for the general public to establish a sound philosophy of life, reform the sense of value on family, child birth and education, and cultivate the skill to draw a consensus through discussions on the social issues. A special program to promote marriage of women at the optimum age for child birth was proposed. The government should implement well balanced policy for economic development and labor. Multidisciplinary approach was recommended for these tasks.

성별에 따른 건강불평등 및 관련요인 연구 (Gender Based Health Inequality and Impacting Factors)

  • 송미영;임우연;김증임
    • 여성건강간호학회지
    • /
    • 제21권2호
    • /
    • pp.150-159
    • /
    • 2015
  • Purpose: This study was aimed to identify gender-based health inequality and explore impacting factors on health inequality in one province in Korea. Methods: This was an explanatory study using the secondary data on Chungnam province from the Fifth Community Health Survey from August 16 to Oct 31, 2012. Variables included in this analysis were education level, poverty, marital status, and residential community for socio-cultural characteristics and subjective health status as an indicator of health inequality. Data were analyzed by ${\chi}^2$-test, t-test, ANOVA, and multiple linear regression. Results: There were gender inequalities and disparities in health, and these inequalities were greater in woman than in man (${\chi}^2$=161.8, p<.001). The impacting factors were education level, poverty, marital status, and residential community, which was accounted for 22.6% of variances of health inequality. Among these variables, gender showed the largest influence in health inequalities. Conclusion: To solve health inequalities, it should be considered gender differences based on social determinants of health. It is necessary to develop long term project based on these results and the social determinants model of World Health Organization.

임상치과위생사들의 일가치감 및 그 결정요인에 관한 연구 (A study on perceived value of work among the clinical dental hygienists and its determinants)

  • 윤희숙;김영선
    • 한국치위생학회지
    • /
    • 제7권4호
    • /
    • pp.495-508
    • /
    • 2007
  • This study, to investigate the state of PVW among the clinical dental hygienists and its determinants, has polled 322 clinical dental hygienists working in Daegu, Kyung buk province, and Ulsan. Data were collected by self-administrated questionnaire. A SPSS 12.0 for Windows was used for statistical analysis. The obtained results were as follows: 1. The average of PVW among the respondents was 3.43. 2. The area average of PVW determinants was as follows; job significance, 3.31, process efficiency, 3.42, product usefulness, 3.32, vision realizability, 3.53, social recognition, 3.23 and the total average, 3.36. 3. The married have higher PVW than the unmarried in all areas(p=.012, p=.008, p=.036, p=.007). 4. As for working experience, in the case of perceived self value, those having 1~2 years experience have the highest PVW(p=.000), apart from perceived self value, those having over 6 years experience have the highest PVW in all areas(p=.015, p=.001, p=.002). Relating to the task, those working in the patient consulting and managing part have the highest PVW, relating to the annual salary, those having over 25 million won have the highest PVW(p=.000, p=.000, p=.001, p=.000). 5. The relationship between PVW and PVW determinants, in all respects, is meaningful, so it was found that the higher determinants are, the higher PVW is. 6. The whole explanation variate of PVW determinants was meaningful in PVW, perceived self value, value fulfillment emotion, respectively representing 38.8%, 55.6%, 61.5%(pE.001). PVW of clinical dental hygienists should be considered as a significant criterion of indivisual and organizational effectiveness. To improve effectually PVW of the clinical dental hygienists, there is need to establish culture in a system of hospital that redound to their social recognition.

  • PDF

Social Determinants of Health and Tobacco Use in Five Low - and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012

  • Tee, Guat Hiong;Aris, Tahir;Rarick, James;Irimie, Sorina
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권3호
    • /
    • pp.1269-1276
    • /
    • 2016
  • Background: Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. Materials and Methods: We analysed internationally comparable representative household survey data from 33,482 respondents aged ${\geq}15years$ in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. Results: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Conclusions: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran

  • Moslem Soofi;Farid Najafi;Shahin Soltani;Behzad Karamimatin
    • Journal of Preventive Medicine and Public Health
    • /
    • 제56권1호
    • /
    • pp.50-58
    • /
    • 2023
  • Objectives: Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran. Methods: This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middleaged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants. Results: The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%). Conclusions: Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

건강행동 변화를 위한 보건 커뮤니케이션 전략 개발: 금연을 위한 생태학적 접근전략의 적용 (Development of Health Communication Strategies for Health Behavior Change: Application of Social Ecological Models to Smoking Cessation Intervention)

  • 김혜경
    • 보건교육건강증진학회지
    • /
    • 제27권4호
    • /
    • pp.177-188
    • /
    • 2010
  • Objectives: The aim of this study was to examine factors related to smoking behavior, and to develop multilevel communication strategies for smoking cessation. Methods: This paper reviewed theories and empirical findings with currents ecological models to develop communication strategies. Theory comparison was also performed to identify important mediators in the process of smoking cessation. Results: Factors that have been identified to influence smoking behavior ranges from individual perception, attitudes and self efficacy toward smoking to organizational norms, regulations, community capacity, media advocacy and public smoking regulation policy. In order to address these multi-level determinants of smoking behavior, objectives and strategies for smoking cessation intervention were developed utilizing ecological perspectives to cover intrapersonal, interpersonal(mainly family member and peers), organizational and community/public policy level factors. Conclusion: Multilevel approaches have advanced the existing knowledge on determinants of health behaviors. New direction of research focusing on testing multilevel intervention approaches should be expanded to inform the efficacy of applying social ecological models to health behavior change process.

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

  • Mahumud, Rashidul Alam;Sarker, Abdur Razzaque;Sultana, Marufa;Islam, Ziaul;Khan, Jahangir;Morton, Alec
    • Journal of Preventive Medicine and Public Health
    • /
    • 제50권2호
    • /
    • pp.91-99
    • /
    • 2017
  • Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.