• Communications for Statistical Applications and Methods
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• v.26 no.6
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• pp.557-573
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• 2019

Mortality study is an essential component of actuarial risk management for life insurance policies, annuities, and pension plans. Life expectancy has drastically increased over the last several decades; consequently, longevity risk associated with annuity products and pension systems has emerged as a crucial issue. Among the various aspects of mortality study, a consideration of the cause-of-death mortality can provide a more comprehensive understanding of the nature of mortality/longevity risk. In this case study, the cause-of-mortality data in Korea and the US were analyzed along with a multinomial logistic regression model that was constructed to quantify the impact of mortality reduction in a specific cause on actuarial values. The results of analyses imply that mortality improvement due to a specific cause should be carefully monitored and reflected in mortality/longevity risk management. It was also confirmed that multinomial logistic regression model is a useful tool for analyzing cause-of-death mortality for actuarial applications.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.38-44
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• 2005

Objective : To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. Methods : The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea s National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61,164 medical doctors with a follow-up period of 473,932 person-years. Standardized mortality ratios(SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. Results : We confirmed 1,150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47(95% CI : $0.44{\sim}0.50$). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : $0.38{\sim}0.68$). Conclusions : The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.

• Safety and Health at Work
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• v.13 no.1
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• pp.117-125
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• 2022

Background: External-cause mortality is an important public health issue worldwide. Considering its significance to workers' health and inequalities across industries, we aimed to describe the state of external-cause mortality and investigate its difference by industry in Republic of Korea based on data for 2018. Methods: Data obtained from the Statistics Korea and Korean Employment Information System were used. External causes of death were divided into three categories (suicide, transport accident, and others), and death occurred during employment period or within 90 days after unemployment was regarded as workers' death. We calculated age- and sex-standardized mortalities per 100,000, standardized mortality ratios (SMRs) compared to the general population and total workers, and mortality rate ratios (RRs) across industries using information and communication as a reference. Correlation analyses between income, education, and mortality were conducted. Results: Age- and sex-standardized external-cause mortality per 100,000 in all workers was 29.4 (suicide: 16.2, transport accident: 6.6, others: 6.6). Compared to the general population, all external-cause and suicide SMRs were significantly lower; however, there was no significant difference in transport accidents. When compared to total workers, wholesale, transportation, and business facilities management showed higher SMR for suicide, and agriculture, forestry, and fishing, mining and quarrying, construction, transportation and storage, and public administration and defense showed higher SMR for transport accidents. A moderate to strong negative correlation was observed between education level and mortality (both age- and sex-standardized mortality rates and SMR compared to the general population). Conclusion: Inequalities in external-cause mortalities from suicide, transport accidents, and other causes were found. For reducing the differences, improved policies are needed for industries with higher mortalities.

• Korea journal of population studies
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• v.8 no.2
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• pp.46-67
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• 1985

In this paper, an attempt has been made to examine the pattern of mortality in Korea during 1970~80. By applying the age-sex specific mortality rates quoted from 1978~79 life tables for Korea published by NBOS, EPB to those of the West pattern of regional model life tables and the far eastern pattern of model life tables for developing countries, life expectancy at birth were calculated. Also the author reviewed the trends of death rates, life expectancy and cause of death using vital registration data and other materials. Summarized results are as follows; 1. Crude death rates in Korea was reduced to one fifth in the 1983 compared to that in 1920's. Life expectancy also improved to almost double in 1985 compared to 1920's. But the difference in the life expectancy between male and female increased during that period and it was recorded as 6.4 years in 1985. This discrepancy was mainly due to the different tempo of decreasing in mortality level by sex, particularly, for the age 40 and above. 2. For the pattern of mortality in Korea, it showed that female mortality could accounted closer to the West pattern model life tables. There were high similarity between actual pattern prevalent in Korea and West pattern. And its coefficient of variance was also very low. However for the case of male, it was difficult to find the exact model life tables for explaining the actual situation on the male mortality pattern which means exist considerable dissimilarity in older ages. The Far eastern pattern of U.N. model life tables show better results than West pattern, however, the deviation of the pattern to actual was severe. Also in Far eastern pattern, high coefficient of variance was existed. Furthermore it was found in the paper that the mortality level of Korean male for the age 40 and above were much higher than that of Far eastern pattern which was reflected the high mortality of the male adult in Far east region. 3. The analysis of cause of death showed that circulatory disease such as cerebrovascular disease and hypertensive disease accounted for the leading cause of death in Korea for the age 40 and above. There should he paid special attention to chronic retrogressive diseases for the older age groups. For younger age groups, injury and poisoning were reported as important cause of death.

• Journal of Korean Neurosurgical Society
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• v.59 no.5
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• pp.485-491
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• 2016

Objective : The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. Methods : From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group. Results : The frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant. Conclusion : Using the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.

• Korea journal of population studies
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• v.15 no.2
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• pp.15-59
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• 1992

After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

• Korea journal of population studies
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• v.26 no.2
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• pp.1-32
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• 2003

An analysis on cause-specific mortality at the provincial level provides essential information for policy formulation and makes it possible to draw hypotheses regarding various diseases and causes of death. Although the mortality level and causes of death at the provincial level are determined by the multiple effects of socioeconomic, cultural, medical and ecological factors, this study primarily intends to examine similarities and differences of cause-specific mortality at the provincial level. Utilizing the registered death and the registered population as of 1998, the delayed death registration and unreported infant deaths were supplemented at the provincial level and age-standardized death rates and life tables were calculated. Regarding the mortality level due to all causes, major findings were as follow: (1) For both sexes as a whole, Seoul showed the lowest mortality level, and Jeonnam showed the highest mortality level; and (2) The differences of the mortality level among provinces were greater for males than females and for those less than 65 years than those 65 years and over. Regarding the cause-specific mortality level revealed in all indicators (cause-specific age-standardized mortality rates and the probability of dying at birth due to a specific cause for males, females, and both sexes combined respectively), the major findings were as follow: (1) The mortality level due to heart diseases was the highest in Busan and the lowest in Gangweon; (2) The mortality level due to liver diseases was the highest in Chonnam; and (3) The mortality level due to traffic accidents was the highest in Chungnam and the lowest in Inchon. As the mortality differentials at the provincial level are related to various factors, exploratory statistical analysis is attempted for the 25 explanatory variables including socioeconomic variables and 90 mortality variables. Mortality due to all causes are related to socioeconomic variables. Among cause-specific mortality, mortality due to liver diseases and traffic accidents is related to socioeconomic variables. Finally, the need to improve the quality of death certificate is discussed.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.515-518
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• 2000

The mortalities of the gorals (Nemorhaedus goral raddeanus) that have been raised in Everland Zoological Gardens were retrospectively analyzed based on the clinical charts and autopsy reports from 1976 to 1999. During that Period a total of 17 gorals were died. Infectious factos (35.2%), digestive (23.5%) and respiratory disorders (17.6%) account feta the majority of cause of death. The The mortality of newborn gorals (50%) were significantly higher than that of adult (20%) and juvenile gorals (0%) due to infectious disease. 83.5% of the infectious disease were found in the garals younger than 5 months old. The cause of death of 5 newborn gorals died by infectious disease were as follows: 1aryngeal diphtheria, 2 (40%); actinobacillosis,2 (40%): coccidiosis. 1 (20%). It was considered that proper hygenic epic precautions in goral Pens ir feeding Places together with avoidance of rough feed are needed for the prevention of death of infectious cause at the goral raising in zoo-logical gardens.