• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.237-240
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• 2005

Social epidemiology is a sub-discipline of epidemiology explicitly investigating social determinants of population distributions of health, disease, and well-being. Persistent pattern of social inequalities in health in spite of the broad improvement in the physical environment over the last centuries necessitated the development of this field as an approach to understand disease etiology that incorporates social experiences as more direct determinant of health. Social epidemiology incorporates theories, measurement tools, and techniques from a wide variety of other social sciences. A population perspective, the social context of behavior, contextual multilevel analysis, a developmental and life-course perspective, and general susceptibility to disease are the most important guiding concepts in social epidemiology.

• Journal of Preventive Medicine and Public Health
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• 제50권2호
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• pp.100-126
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• 2017

Objectives: The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity. Methods: Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence. Results: Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men. Conclusions: This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1259-1275
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• 2015

Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.

• 한국사회정책
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• 제25권2호
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• pp.31-55
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• 2018

돌봄의 경제적 불이익과 성불평등은 서로를 강화한다. 성불평등의 기저에 돌봄의 불평등한 분배와 대우가 자리하고 있다. 돌봄은 성불평등을 심화시키는 경제적 불이익을 초래한다. 돌봄을 수행하는 자는 사회경제적 권력 관계에서 보통 약자의 위치를 점하고 있으며, 사회경제적 약자가 수행하는 돌봄은 그 수행에 대한 공정한 대우와 보상의 목소리를 내기가 어렵다. 그 결과 낮은 경제적 가치를 갖게 된 돌봄을 수행하는 자는 더욱 취약한 사회경제적 지위와 권력 관계에 놓여 불평등한 성별 관계를 지속시킨다. 기본소득 제도는 성불평등을 완화할 수 있는 잠재적 가능성을 지니고 있지만, 돌봄 노동의 특수한 성격이 야기하는 경제적 불이익은 그러한 잠재적 가능성을 희석시킬 수 있다. 기본소득 제도가 여성의 실질적 자유를 실현하기 위해서는 돌봄의 경제적 불이익에 대한 천착과 적극적 개입이 필요하다. 본 논문은 기본소득 지지론자들의 돌봄 노동에 대한 관점을 검토하고, 돌봄노동의 고유한 특성으로 인한 돌봄불이익이 완화 혹은 해소되지 않는다면 기본소득이 도입되어도 돌봄 노동 선택의 성별화를 변화시키는 데 한계가 있다고 주장한다.

• Journal of Preventive Medicine and Public Health
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• 제47권2호
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• pp.104-112
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• 2014

Objectives: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. Methods: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. Results: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. Conclusions: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5845-5851
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• 2014

Reducing fear of cancer is significant in developing cancer screening interventions, but the levels of fear may vary depending on the degrees of media exposure as well as individuals' socioeconomic positions (SEP). However, few studies have examined how the SEP influences the fear of cancer under the moderating process of general and specific forms of media exposure. We investigated the moderating effect of media exposure on the relationship between SEP and the level of fear of cancer by assuming that cancer knowledge is a covariate between those two. In particular, this study examined how exposure to both general and specific media changes the series of processes from SEP to fear of cancer. We conducted path analyses with three types of media - television, radio and the Internet- using data from a health communication survey of 613 adults in Massachusetts in the United States. We found that SEP influences cancer knowledge directly and fear of cancer indirectly, as moderated by the level of media exposure. Health-specific exposure, however, had a more consistent effect than general media exposure in lowering the fear of cancer by increasing knowledge about cancer. A higher level of health-specific exposure and greater amount of cancer knowledge lessened the fear of cancer. In addition, the more people were exposed to health information on television and the Internet, the lower the level of fear of cancer as a result. These findings indicate a relationship between SEP and fear of cancer, as moderated by the level and type of media exposure. Furthermore, the findings suggest that for early detection or cancer prevention strategies, health communication approaches through mass media need to be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1097-1103
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• 2015

Background: Few studies have explored the knowledge and attitudes of adolescents toward cancer prevention and treatment. This lack of research and its potential utility in the development of new educational initiatives and screening methods, or the reconstruction of existing ones, provided the impetus for this study. The primary research aim was to assess secondary school student knowledge of cancer and determine whether or not they possessed basic knowledge of cancer symptoms, risk factors, and treatments and to determine the relationship between cancer knowledge and key demographic factors. Materials and Methods: The Management and Science University conducted a cross-sectional study analyzing responses through cross-tabulation with the socio-demographic data collected. Results: The findings of our quantitative analysis suggest that Malaysian youth generally possess a moderate knowledge about cancer. Quantitative analyses found that socioeconomic inequalities and bias in education present as important factors contributing to cancer awareness, prevention, and treatment among Malaysian adolescents. Conclusions: The findings indicate that Malaysian youth generally possess a moderate knowledge about cancer but the current deficiencies in initiatives directed to cancer awareness continue to hinder the improvement in prevention of cancer among Malaysian adolescents.

• 보건행정학회지
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• 제31권2호
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• pp.188-196
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• 2021

Background: This study purposed to analyze the relationship between extinction risk regions and amenable mortality. Methods: This was a cross-sectional study based on the statistics of 2018 which was extracted from the 228 administrative districts in Korea. Cause of death statistics on each region in 2018 was used to produce the age-adjusted amenable mortality. Regional characteristics were measured by demographic factors, health behavior factors, socioeconomic factors, and medical resources factors. Multiple linear regression model was applied to test their relationship. Results: Results showed that extinction risk regions, crude divorce rates, national cancer screening rates, and independent rate of finance were significantly related to the amenable mortality. Conclusion: The study demonstrated differences in health status by the extinction risks of regions. This study suggests that the use of customized community care program can provide integrated services such as housing, health care or the use of information and communications technology which can make early diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6697-6704
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• 2015

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

• 한국노년학
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• 제30권3호
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• pp.779-791
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• 2010

본 연구는 최근에 증가하고 있는 조손가족의 특징과 손자녀 양육지속의사에 관한 질적인 연구(qualitative approach)이다. 본 연구에서 분석내용은 첫째, 주양육자의 일반적 특성, 손자녀의 특징을 분석하였다. 둘째, 조손가족의 형성배경을 파악하기 위해 양육동기별 형성과정인 조부모가 어떻게 손자녀를 맡아 양육하게 되었는가에 대해 파악한다. 마지막으로 조손가족의 복지욕구를 파악하고, 양육지속의사에 대해 분석하였다. 연구 결과는 다음과 같다. 조손가족의 조사대상자의 주양육자는 조모가 대부분을 차지하였으며 주양육자의 평균 연령은 68.1세로 조사되었다. 대부분의 조부모는 직업이 없는 상태였으며 비교적 건강하였다. 조사대상 손자녀의 일반적 특성 중 성별은 손녀가 51.7%, 손자가 48.3%였고, 평균연령은 11.3세이고 대부분의 손자녀는 건강하였다. 조손가족 형성 배경을 살펴보면, 부모의 이혼으로 인한 조손가족형성이 가장 많았고, 조손가족이 원하는 복지욕구는 경제적 지지를 많이 요구하였다. 조부모의 손자녀 평균양육기간은 평균8년6개월로 나타났다. 양육지속의사에 대한 응답으로 조부모 100%는 손자녀를 양육하겠다고 하였다. 그러나 손가족의 주부양자들은 손자녀 양육에 대한 부담, 혼란스러움, 절망과 같은 부정적인 감정에서부터 희망, 기쁨, 감사에 이르기 까지 다양한 감정을 느끼는 것으로 나타났고 조부모들은 손자녀를 양육하면서 힘든 점도 있었지만, 손자녀와 함께 하면서 인생의 보람과 즐거움을 경험하고 있는 것으로 나타났다. 본 연구는 조손가족 특징과 양육에 대한 어려움을 이해하는데 도움이 되고자하며, 조손가족의 양육기능을 지지할 수 있는 맞춤식 지원 서비스 프로그램 개발 및 개입전략을 모색해 볼 수 있다는 점에서 그 의의를 찾을수 있다.