• 보건행정학회지
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• 제31권1호
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• pp.5-16
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• 2021

Both access to healthcare services and income security in case of personal illness are being needed to achieve universal health coverage, which is enshrined in the human rights to health and social security and international standards on social protection. Income security acts on both the social determinants and the adverse consequences of ill health and thus would break the vicious disease-poverty cycle. The government is supposed to implement a demonstration project of sickness benefit in 2022 and to publicize its more specific blueprint for all workers. This study is to suggest basic principles and a framework to design a new sickness benefit for universal health coverage, which is based on reviews on previous studies, related issues, and institutional conditions. This is to provide a theoretical basis to promote further discussion and to support its decision-making.

• 성인간호학회지
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• 제12권3호
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• pp.356-368
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• 2000

The purposes of this study were 1) to identify determinants of exercise behavior 2) to determine theoretical frameworks that were used in other research 3) to investigate the limitations of exercise research. seventy six research papers, published between 1984-1999, were selected by searching Medline for this study. Research subjects, determinants of exercise behavior, exercise measurement, the design of studies, statistical method and theoretical background were examined. The results are as follows. 1. On the research subjects, most research papers studied healthy adults. 2. Thirteen variables were identified that were used more than 5 times in various researches were self efficacy, barrier, social support, benefit, physiological characteristics, habit, personality, intention, health status, motivation, subjective norm, attitude, and affect. The most frequently supported determinant was self efficacy, the second one was social support, the third was affect and so on. But few research papers found any significant relationship between subject norms or attitude and exercise. 3. On exercise measurement, only 22.4% of research papers considered intensity, duration, frequency as elements of exercise, and 64.5% of researches were assessed by self-reported questionnaires. 4. In research design, 80.3% of research papers were survey type research. The most frequently used statistcal method was Regression. 5. 44.8% of research papers were done without any theoretical basis. Based on the above findings the following suggestions are made : 1. Research which includes diverse populations with different levels of health status needs to be studied. 2. Determinants of exercise may be dynamic and varing in their influence, therefore, stages of exercise behavior and processes of change need to be studied. 3. In research design, more prospective, longitudinal studies are needed to identify determinants of exercise habits. 4. It is necessary to develop a reliable, valid exercise measurement tool. 5. Studies are needed to develop a theoretical framework for exercise behavior.

• 보건의료산업학회지
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• 제5권2호
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• pp.77-89
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• 2011

This study conducted a secondary analysis by using original data of performed by Korea Institute for Health and Social Affairs to know factors affecting determinants of health using Lalonde model for the adults aged over 19 years living in Korea. The survey was conducted in 2009 and it evaluated finally 5,867 cases by excluding cases with no answer or a wrong answer. This study model adopted two categories of instrument measure health were objective (Average remaining lifetime) and subjective(EQ-5D) health status. The health determinants included in this study could be divided in to four categories, which were human biology, environment, lifestyle, and health care organization. The results were as follows. In the factors affecting average remaining lifetime, human biology were sex, ages, BMI, showed statistically significant difference, environment category were merry status, education showed statistically significant difference, lifestyle category were exercise, drunks showed statistically significant difference and health care organization category were vaccination, health screening showed statistically significant difference. In the factors affecting EQ-5D, human biology category and health care organization category showed with same average remaining lifetime, environment category were merry status, education, income showed statistically significant difference and lifestyle category were exercise, drunks, stress showed statistically significant difference. The results demonstrated that the best powerful factor was life style category and environment category, the least factor was health care organization category. So lifestyle style and environment category should be considered for the future health plan, budget allocation and the priority in the health care.

• Journal of Preventive Medicine and Public Health
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• 제51권6호
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• pp.289-297
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• 2018

Objectives: Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran. Methods: A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ${\geq}30kg/m^2$. The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity. Results: Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity. Conclusions: Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

• 대한예방한의학회지
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• 제22권1호
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• pp.1-14
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• 2018

Objectives : This study aimed to analyze the characteristics of uninsured herbal medicine(UHM) users and the economic and social barriers of UHM utilization. Methods : We used the Korea Health Panel Data, representative national survey on medical utilization and cost, provided by National Health Insurance Service and Korea Institiute of Health and Social Affairs. The frequency analysis was used to identify the characteristics of the respondents, and the cross-analysis (${\chi}^2-test$) was used to verify the relationship between their characteristics and the usage of UHM. In order to analyze the determinants of using the UHM considering the individual's characteristics, logistic regression analysis and multiple regression analysis were conducted for those who used the Korean medicine (KM) outpatient service in 2015. Results : The usage of UHM was significantly lower for those (1) who's age of 20 to 65; (2) who have the university or higher education degree; (3) who live in Jeju province, and (4) who bought the herbal medicine for other health related purposes. On the other hand, the usage of UHM for those (1) who have the first quintile of household income; (2) who have the chronic respiratory disease; (3) who have been taking the medicine for health promotion purpose for more than 3 months and (4) who have purchased the food which has health promotion function was significantly higher than others. The patients who have chronic musculoskeletal diseases accounted the most among the UHM users. Conclusions : There was the considerable inequality in the usage of UHM among household income groups, which provides policy rationale for UHM to be covered by national health insurance. To facilitate the coverage expansion, restrictive covering model can be considered for children and adolescents, or for patients with muskuloskeletal diseases who have the high demand for UHM.

• 보건행정학회지
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• 제29권4호
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• pp.496-501
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• 2019

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities' care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is "government and local government" and "corporation," the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

• 한국콘텐츠학회논문지
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• 제20권2호
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• pp.360-370
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• 2020

필요 치과진료 미수진과 관련된 요인을 파악하고자 지역사회건강조사 원자료를 분석하였다. 21만 4861명의 만 25세이상 인구집단을 대상으로 인구학적 요인, 사회경제적 요인, 사회적지지 및 사회적 환경요인, 사회물리적 환경요인과 필요 치과진료 미수진과의 연관성을 확인하였다. 연구결과, 연령이 낮을수록, 소득분위가 높을수록, 교육수준이 낮을수록, 친척, 친구와 자주 접촉하지 않을수록, 친목, 여가 활동에 참여하지 못할수록, 사회물리적 환경(안전수준, 자연환경, 생활환경, 대중교통, 의료서비스)에 불만족할수록 필요 치과진료 미수진율이 높게 나타났다. 필요 치과진료 미수진에 인구학적 요인, 사회경제적 요인 뿐 아니라 사회적지지 및 사회적 환경요인, 사회물리적 환경요인이 통계적으로 유의한 영향이 있음이 확인되었다. 필요 치과진료 수진율을 높일 수 있는 방안으로 건강의 사회적 결정요인에 정책적 요인을 포함하는 추후 연구가 필요하겠다.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.439-446
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• 2007

In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.

• 보건교육건강증진학회지
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• 제30권1호
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• pp.53-64
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• 2013

Objectives: In this study, a multilevel analysis model has been designed to investigate the effect of personal characteristics associated with smoking cessation on anti-smoking determinants with a goal of finding out the factors which have influence on smoking cessation among the entrants of smoking cessation clinic in a public health center. Methods: A total of 253,136 male smokers who received smoking cessation services for more than six(6) months in a smoking cessation clinic of public health center from July 16, 2007 to July 15, 2008 were examined. For technical analysis, SPSS Version 2.0 has been used. For multilevel analysis on smoking cessation determinants, in addition, HLM 7.0 has been adopted. Results: According to the unconditional model of multilevel analysis, the success rates of smoking cessation among the entrants of a smoking cessation clinic were 47.3%. In an unconditional slope model test to which regional variables were added, a negative effect was observed in average smoking amount, total smoking period, nicotine dependence and services while a positive effect was found in age, stress and type of social security in terms of the log of the odds of smoking cessation. In a conditional model test, a positive effect was observed in Non-Smoking Campaigns (NSC) and Frequency of Counseling (FC) in terms of the log of the odds of smoking cessation in regional variables. Conclusions: It is important to approach smokers individually and, at the same time, build healthy environment for a local community to increase smoking cessation rates among the entrants of smoking cessation clinic in a public health center.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4623-4629
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• 2016

Introduction: Breast cancer is multifactorial therefore more recognition of risk factors is important in its prevention. Objective: This study was conducted in order to determine the factors influencing breast cancer in women referred to health centers in Guilan province in 2015-2016. Method: In a case- control study, 225 women with breast cancer were investigated. The control group consisted of 225 healthy women of the relatives (third-rank) whose phone numbers were obtained from the patients. Data were collected through telephone interviews. Results: The risk of breast cancer raised in women who have a family history of other cancers (OR= 3.5; 95% CI= 1.96-6.6), exposure to X-Ray (OR= 2.5; 95% CI=1.1-5.5), having more than 4 children (OR= 2.695% CI=1.2-4.8), age more than 36 years at first pregnancy(OR=2.3; 95% CI=0.7-5.1),primary levelof education (OR= 5.4;95% CI=2.8-11.2) and inadequate intake of fruit (OR=1.5; 95% CI=1-2.2). Also, presence of the following factors reduced breast cancer risk: regular menstruation (OR= 0.66; CI=0.4-0.9), duration of breastfeeding more than 12 months, less than 6 months and 7-12 months (OR=0.23; 95% CI=0.09-0.59, OR=0.29; 95% CI=0.17-0.49 and OR=0.03; 95% CI=0.01-0.08) and parity (OR=0.4; 95% CI=0.27-0.83) In multiple linear regression analysis of higher education (OR=0.16; 95% CI=0.03-0.77), using contraceptives for more than 16 years (OR=2.3; 95% CI=1.4-3.9), family history of other cancers (OR=6.1; 95% CI=1.9-19.3) and a history of X-Ray exposure (OR=4.4; 95% CI=1.07-18.1) were considered as predictive factors. Conclusion: The results of this study emphasize the importance of informing women about breast cancer risk factors. So, identification of these risk factors is required as important means of prevention and treatment of breast cancer.