• Journal of Preventive Medicine and Public Health
• /
• 제47권2호
• /
• pp.94-103
• /
• 2014

Objectives: The present study examined relationships between socioeconomic status (SES) and obesity and body mass index (BMI) as well as the effects of health-related behavioral and psychological factors on the relationships. Methods: A cross-sectional population-based study was conducted on Korean adults aged 20 to 79 years using data from the 2001, 2005, and 2007 to 2009 Korea National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to estimate odds ratios of obesity and mean differences in BMI, respectively, across SES levels after controlling for health-related behavioral and psychological factors. Results: We observed significant gender-specific relationships of SES with obesity and BMI after adjusting for all covariates. In men, income, but not education, showed a slightly positive association with BMI (p<0.05 in 2001 and 2005). In women, education, but not income, was inversely associated with both obesity and BMI (p<0.0001 in all datasets). These relationships were attenuated with adjusting for health-related behavioral factors, not for psychological factors. Conclusions: Results confirmed gender-specific disparities in the associations of SES with obesity and BMI among adult Korean population. Focusing on intervention for health-related behaviors may be effective to reduce social inequalities in obesity.

• Journal of Preventive Medicine and Public Health
• /
• 제53권4호
• /
• pp.266-274
• /
• 2020

Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.

• Journal of Preventive Medicine and Public Health
• /
• 제40권5호
• /
• pp.381-387
• /
• 2007

Objectives: This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. Methods: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). Results: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. Conclusions: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.

• Journal of Preventive Medicine and Public Health
• /
• 제40권6호
• /
• pp.505-511
• /
• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• 한국노년학
• /
• 제36권3호
• /
• pp.611-632
• /
• 2016

노년기 건강문제는 의료적 관점에서뿐만 아니라, 사회경제적 지위와 같은 사회적 조건과의 상호작용 속에서 해법을 찾을 필요가 있다. 이러한 인식 하에, 본 연구에서는 사회경제적 지위가 노인의 건강불평등에 이르는 메커니즘을 파악하고자 하였다. 구체적으로는 사회경제적 지위(소득 및 교육)와 신체적 건강의 세 차원(의료적 건강/기능적 건강/주관적 건강) 간의 사이에서의 중간기제로서 건강행동, 의료시설 접근성, 사회참여, 사회적 관계망의 매개효과를 규명하는 것이다. 연구모형의 검증을 위해 2014년에 실시된 전국노인실태조사 데이터를 2차 분석하였다. 본 연구의 대상은 65세 이상 남녀 노인 10,451명으로, 매개모형 검증을 위해 Baron & Kenny(1986)가 제안하는 절차에 따라 위계적 다중회귀분석을 실시하였고 매개효과의 유의성 검증을 위해 Sobel test를 실시하였다. 분석결과, 노인의 소득수준과 교육수준의 건강에 대한 효과가 동일하지는 않았고 건강의 하위차원에 따라서도 다소 다른 결과가 도출되기는 했지만, 전반적인 결과의 방향은 노인의 사회경제적 지위는 건강격차를 야기하고 있었으며, 그 메커니즘은 건강행동, 의료시설 접근성, 사회참여, 사회적 관계망을 매개한다는 것이다. 특히 본 연구에서 교육은 소득보다도 건강에 대한 보다 강력한 효과를 나타내었다는 점, 사회참여와 같은 사회통합요인의 효과가 부각되었다는 점, 거주지역을 통제한 이후에도 잔존한 의료시설 접근성의 유의미한 매개효과 등은 본 연구의 결과 중에서도 주목할 만하다. 이러한 결과를 바탕으로 사회경제적 조건으로 인한 건강불평등의 메커니즘을 규명하고 이를 완화시킬 수 있는 대안을 모색할 수 있었다는 점에서 본 연구의 의의가 있다.

• 한국치위생학회지
• /
• 제19권4호
• /
• pp.565-575
• /
• 2019

Objectives: In this study, both subjective and objective levels of oral health were used to identify the relationship between oral health inequalities. Methods: Korean National Health and Nutritional Examination Survey data from 2013 to 2015 were combined to create an analysis plan. Oral health questions categorized as subjective oral health conditions and oral health-related diseases used dental tissue disease status as data measured by the Community Periodical Index(CPI) and decayed, missing, filled teeth(DMFT) experience. Other data on oral health behaviors such as toothache experience, the frequency of toothbrush use, chewing problems, oral examination status, and unmet dental care needs were classified and analyzed according to the socioeconomic level. Data were analyzed using frequency and cross analyses, and the statistical significance level was set at 0.05. Results: It was found that higher the economic and educational level, better was the subjective oral health, lower the CPI, lower the experience of toothache, higher the frequency of toothbrush use, lower the number of people having chewing problems, and higher the frequency of oral checkups. Conclusions: Oral health inequality exists among social classes. It is suggested that continuous research and efforts be carried out to promote oral health while considering socioeconomic and educational levels. Further, active government efforts will be needed to address polarization by social class.

• 사회복지연구
• /
• 제42권3호
• /
• pp.267-290
• /
• 2011

본 연구는 인구학적 특성, 사회경제적 특성, 건강위험행동, 가족관계 만족도가 우리나라 노인 인구 집단의 건강 수준 차이에 미치는 요인을 찾고자 한다. 본 연구를 위해 한국복지패널조사 3차 조사(2008년)의 65세 이상 가구를 추출하여 다중회귀분석을 이용하여 건강 수준 차이에 영향을 미치는 요인을 살펴보도록 한다. 분석결과는 다음과 같다. 첫째, 노인의 정신 건강 수준을 가늠하는 지표로서 우울감에 영향을 미치는 요인에 대해 보면, 교육 수준이 낮을수록, 소득이 적을수록, 음주를 하지 않을수록, 가족관계 만족도가 낮을수록 노인의 우울감이 높아지는 것으로 나타났다. 둘째, 노인의 주관적 건강상태에 미치는 요인을 보면, 교육 수준이 낮을수록, 소득이 적을수록, 음주를 하지 않을수록, 가족관계 만족도가 낮을수록 주관적 건강상태가 낮은 것으로 나타났다. 또 가족관계 가운데서도 노인의 배우자와의 관계, 노인의 자녀와의 만족도는 우울감과 주관적 건강상태에 영향을 미쳤다. 이와 같은 결과를 바탕으로 다음과 같은 제언을 할 수 있다. 첫째, 건강 수준의 취약집단인 여성노인을 위한 특화된 정책이 필요하다. 둘째, 건강 수준이 낮은 저소득, 저학력 노인 집단의 건강 수준을 끌어올리기 위한 특화된 정책이 필요하다. 셋째, 노인들의 건강에 영향을 미치는 가정생활 만족도를 높이기 위한 새로운 접근이 요구된다.

• 디지털융복합연구
• /
• 제17권8호
• /
• pp.337-346
• /
• 2019

본 연구에서는 2007년-2017 국민건강영양조사를 이용하여 우리나라의 사회경제적 수준별 당뇨 유병률 격차의 추세 및 당뇨 관리실태 격차의 추세를 살펴보고자 하였다. 사회경제적 수준의 지표로는 가구소득수준을 이용하였으며, 30세 이상 성인을 대상으로 가구소득수준별 당뇨병 연령표준화 유병률, 인지율, 치료율, 혈당조절률을 산출하고 연도별 추세 및 조사연도와 소득수준간의 교호작용을 살펴보았다. 지난 11년간, 우리나라에서 소득수준별 당뇨 유병의 격차는 남녀 모두에서 지속적으로 나타났으며, 남성에서는 소득수준별 격차가 증가하였다 (p for interaction=0.034). 그러나 당뇨의 관리지표인 인지율, 치료율, 혈당조절률은 같은 기간 동안 뚜렷한 소득수준별 격차나 소득수준별 격차의 증감을 보여주지 않았다. 향후 개인의 건강행태, 의료접근성, 지역사회 자원 등 당뇨의 사회경제적 격차를 심화시킬 수 있는 여러 요인들에 대한 생애 전주기적인 심층 연구가 필요하며, 당뇨병 예방관리 정책 수립의 기초자료로서 사회경제적 불평등 추세에 대한 지속적인 모니터링이 필요할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
• /
• 제42권5호
• /
• pp.305-314
• /
• 2009

Objectives : The physical activity of Korean adolescents and its distribution based on social characteristics have not yet been fully assessed. This study intends to reveal the distribution of physical activity by its subgroups and offer possible explanatory variables. Methods : The 3rd Korea Youth Risk Behavior Web-based Survey was analyzed for this study. The appropriateness of physical activity was defined by Korea s Health Plan 2010 and physical inactivity was assessed independently. Family affluence scale, parents education levels, subjective economic status, grade, and school location were considered explanatory variables. All statistical analysis was conducted using SAS ver. 9.1. Results : The proportion of participants engaging in vigorous physical activity was high in males (41.6%), at a low grade (38.5%), within the high family affluence scale group (35.5%). The distribution of participants engaging in moderate physical activity showed similar patterns, but the overall proportion was lower (9.8%). Low family affluence and students with lower subjective economic status reported a higher prevalence of physical inactivity. In multiple logistic regression analysis for physical activity, significant factors included family affluence scale (p<0.05). For physical inactivity, family affluence scale, parents education levels, and subjective economic status were included as significant factors (p<0.05). Conclusions : The results suggest that the physical activity and inactivity of adolescents may be affected by socioeconomic variables, such as family affluence scale. This implies the need to take proper measures to address these socio-economic inequalities.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권11호
• /
• pp.6919-6924
• /
• 2013

Background: Between 1998-2009 South Korea experienced significant progress in reducing the male smoking rate from 66.3% to 46.9%. As part of a significant government effort in the area of smoking cessation intervention, the Korean government implemented the national "Smoking Cessation Clinics (SCC)" program in 2004. Materials and Methods: Data covered 804,334 adult male smokers participating in SCC program at 253 public health centers between 2006-2009. We examined participant cessation rates with the SCC program, their characteristics and program intervention components using health insurance status as a socioeconomic status (SES) indicator. Multivariate logistic regression analyses were performed correcting for intra-class correlations within public health centers. Results: The overall 6-month quit rate was high (46.8%). Higher odds of smoking cessation were positively associated with higher levels of behavioral counseling sessions, but not nicotine replacement therapy (NRT). Cessation rates were lower for Medicaid participants than for regular health insurance participants. Disadvantaged younger smokers were less likely to participate in the program. Older smokers were more likely to quit regardless of SES. Stress was cited as major reason for failure. Conclusions: SES inequalities across different age groups exist in smoking cessation among Korean adult male smokers. There is a need for intervention programs specifically targeting sub-populations of SES by different age groups.