• 제목/요약/키워드: Social determinants of health

검색결과 313건 처리시간 0.027초

Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran

  • Pourfarzi, Farhad;Moghadam, Telma Zahirian;Zandian, Hamed
    • Journal of Preventive Medicine and Public Health
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    • 제55권3호
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    • pp.297-306
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    • 2022
  • Objectives: The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran. Methods: This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality. Results: The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model. Conclusions: The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.

보육교사의 건강증진행위 영향요인 (Factors Affecting Health Promotion Behavior of Child Care Teachers)

  • 이영란;박선남;이미란
    • 한국보건간호학회지
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    • 제33권1호
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    • pp.123-135
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    • 2019
  • Purpose: The purpose of this study was to identify the factors of the health promotion behavior of child care center teachers. Methods: This study conducted a survey of 200 child day care center teachers in Seoul from January to February, 2017. This study examined the actual condition of health promotion behavior, perceived health status and the determinants of health promotion behavior of child care center teachers. Results: The factors affecting the health promotion behaviors of the child care teachers were age, working time, perceived benefit, barrier, and social support. Conclusion: These findings suggest that it is necessary to develop and apply a health promotion program for child care teachers.

Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis

  • Zandian, Hamed;Takian, Amirhossein;Rashidian, Arash;Bayati, Mohsen;Moghadam, Telma Zahirian;Rezaei, Satar;Olyaeemanesh, Alireza
    • Journal of Preventive Medicine and Public Health
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    • 제51권2호
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    • pp.83-91
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    • 2018
  • Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

노인의 사회적 자본 의식에 영향을 미치는 요인: 사회참여의식을 중심으로 (Determinants of the Social Capital Awareness of the Elderly with a Focus on Social Participation Awareness)

  • 홍성희
    • 가족자원경영과 정책
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    • 제20권2호
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    • pp.19-41
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    • 2016
  • This study examines the human capital, economic capital, and psychological factors that influence social participation among the elderly in the future. The data, 'Survey on the Elderly in 2014', were collected from 'The Ministry of Health & Welfare' and the 'Korea Institute for Health and Social Affairs'. The samples included 10,279 elderly people who were over 65 years of age. Multiple regression analysis was used to analyze the research model. The findings are as follows. First, the highest participation awareness level of all was for the hobbies and leisure activities, and the lowest participation awareness level was for volunteer activities. Second, human capital factors such as age, education level, and health status, and economic capital factors such as household consumption expenditure and standard of living signigicant affected social participation awareness among the elderly. Psychological factors such as self-esteem, depression, and the subjective age of becoming elderly, also affected the social participation awareness. Third, awareness differed by sex. In particular, age and depression were restrictions of social participation awareness that were more common among elderly women than among elderly men, although single women were more likely to participate in religious, learning, and hobby and leisure activities. In contrast, chronic diseases and household consumption expenditures were more restrictive of social participation awareness among elderly men compared to elderly women. These results show that human capital, economic capital, and psychological factors heavily influence the social participation awareness of the elderly, although the degree of influence of these factors differs by sex.

한국 대학생의 건강행위 예측모형 (Structural Equation Model for the Health Behaviors of University Students in Korea)

  • 이성은;오가실;박영주;김정아;김희순;오경옥;이숙자;전화연;정추자;최상순;강현철
    • 대한간호학회지
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    • 제34권6호
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    • pp.903-912
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    • 2004
  • Purpose: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. Method: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. Data collection: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. Results: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effecton health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status; a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. Recommendation: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.

대학생의 건강증진 실천의지가 자기효능감, 행복, 생활만족, 여가만족에 미치는 영향 (The Effects of the College Students' will for the Improvement of Health Playing on Self-Efficacy, Happiness, Life Satisfaction and Leisure Satisfaction)

  • 백정원;남희은;류지선
    • 보건의료산업학회지
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    • 제6권1호
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    • pp.173-183
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    • 2012
  • This study is designed to look into the relations between college students' will for the improvement of their health and self-efficacy, happiness, life satisfaction and leisure satisfaction. To achieve this, a survey was carried out from November 2011 to December 2011, targeting 876 college students in 10 different regions in Busan and Gyeongsangnam-do area. From the questionnaires, undependable and inappropriate questionnaires were excluded and 812 questionnaires were used for analysis data in descriptive statistics, variance analysis and simple regression analysis. The results are as follows. The groups with the strong show higher self-efficacy, have more happiness and express better life satisfaction. It has been empirically proved that those college students with a strong will to improve their health love themselves more and value themselves higher, which has positive influences on their happiness, life satisfaction and leisure satisfaction.

대학생의 건강증진 생활양식 결정요인에 관한 연구 (Determinants of Health Promoting Lifestyle of College Students)

  • 이미라
    • 대한간호학회지
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    • 제27권1호
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    • pp.156-168
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    • 1997
  • This study was undertaken in order to examine the relationship of self-efficacy, control, perceived health status. self-esteem, social support, and demographic characteristics to health promoting lifestyle of college students, and to determine factors affecting health promoting lifestyle of college students. The subjects were 92 students of one university in Taejon. The instruments used for this study were a survey of general characteristics, health promoting lifestyle(44 items), self-efficacy (28 items), self-esteem(10 items). control(8 items), perceived heath status(1 item), and social support(12 items). Analysis of data was done by use of mean, percentage, t-test. ANOVA, Pearson correlation coefficient and stepwise regression with SAS program. The results of this study are as follows. 1) The average item score for the health promoting lifestyles was low at 2.30. In the sub-categories, the highest degree of performance was interpersonal support(2.90), and the lowest degree was exercise(1.67). 2) Male students showed a significant higher score in exercise subscale than female students. Students who had more income had higher scores in self actualization subscale. Students who's family had experienced severe disease had higher scores in health responsibility and interpersonal support subscale. Students who had experienced exercise had higher scores in total health promoting lifestyle, exercise, interpersonal support, and stress management subscale. 3) Significant correlation between perceived health status and self-efficacy, perceived health status and self-esteem, control and self-efficacy, control and self-esteem, control and social support, self-esteem and self-efficacy was found. 4) Self-efficacy and control revealed significant correlations with total health promoting lifestyle and all subscales of health promoting lifestyle except self actualization, A significant correlation between perceived health status and self actualization subscale was found. Self-esteem revealed significant correlations only with self actualization and interpersonal support subscale. 5) Significant correlations were found between most of the subscales of total health promoting lifestyle. 6) Self-efficacy was the highest factor predicting health promoting lifestyles of college students (30.55%). Self-efficacy and control accounted for 36.55% in health promoting lifestyle of college students.

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노인 삶의 만족도 변화: 전국노인생활실태 및 복지욕구조사 3개년도(1994, 2004, 2008년) 결과비교 (Change in Life Satisfaction of Korean Elderly: Comparisons of 1994, 2004, 2008 National Survey Results on the Elderly Life Conditions and Welfare Need)

  • 정순둘;이선희
    • 한국노년학
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    • 제31권4호
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    • pp.1229-1246
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    • 2011
  • 본 연구는 고령화 사회 진입시기를 전후로 노인 삶의 만족도 변화 및 영향요인을 분석함으로써 이들 삶의 만족도를 향상시키기 위한 사회복지적 함의를 찾고자 하는 목적에서 이루어졌다. 연구의 분석을 위해 한국보건사회연구원 및 계명대학교산학협력단에서 실시한 전국노인생활실태 및 복지욕구조사 3개년도 자료(1994, 2004, 2008년)를 이용하였다. 분석대상은 각 연도별 65세 이상 노인으로 1994년 1,371명, 2004년 3,278명, 2008년 3,009명이다. 자료분석은 다중회귀분석을 실시하여 이루어졌으며, 다양한 요인들이 삶의 만족도에 미치는 영향을 살펴보았다. 분석결과 첫째, 삶의 만족도는 평균보다 높았으나 고령화 사회 진입 이후 최근으로 올수록 점차 감소하였다. 둘째, 삶의 만족도에 영향을 미치는 요인은 주관적 경제 및 건강상태와 같은 공통요인과 배우자 유무, 취업유무, 노후인식 등의 가변요인으로 나타났다. 본 연구결과를 통해 다양한 노인가구 형태에 따른 서비스 제공, 사회활동 참여 기회 확대 등의 제도적 기반 마련이 필요함을 제언하였다.

Social Determinants of Smoking Behavior: The Healthy Twin Study, Korea

  • Kim, Youn-Sik;Ko, Han-Soo;Yoon, Chang-Gyo;Lee, Dong-Hun;Sung, Joo-Hon
    • Journal of Preventive Medicine and Public Health
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    • 제45권1호
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    • pp.29-36
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    • 2012
  • Objectives: The purpose of this study was to identify any influence of socioeconomic status on smoking and smoking cessation in a situation where genetic factors are controlled. Methods: The sample for this study was 2502 members of the twins and families cohort who participated in the Korean Healthy Twins Study from 2005 to 2009. Groups of brothers or sisters, including twins and fraternal twins, were compared in terms of smoking and smoking cessation behaviors according to differences in socioeconomic status and gender. Results: In a situation with complete control of genetic factors, results showed that the daily smoking amount, cumulative smoking amount, and dependence on nicotine decreased with higher-status occupations, and the rate of smoking and amount of cumulative smoking decreased with higher levels of education. Regarding smoking cessation behavior, a higher level of education was associated with a lower smoking cessation rate, and no significant gender differences were found. Conclusions: Environmental factors had a stronger influence on smoking behavior than did genetic factors. Genetic factors had greater influence on smoking cessation than did environmental factors; however, this requires verification in further studies.

중.고령자의 민간의료보험 가입 여부의 결정 요인 (The determinants of purchasing private health insurance among middle-aged and elderly Korean adults)

  • 유기봉;조우현;이민지;권정아;박은철
    • 한국병원경영학회지
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    • 제17권3호
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    • pp.23-36
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    • 2012
  • Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

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