• 보건행정학회지
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• 제28권4호
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• pp.378-391
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• 2018

Background: People who were born in different years, that is, different birth cohorts, grow in varying socio-historical and dynamic contexts, which result in differences in social dispositions and physical abilities. Methods: This study used age-period-cohort analysis method to establish explanatory models on healthcare expenditure in Korea reflecting birth cohort factor using intrinsic estimator. Based on these models, we tried to investigate the effects of ageing population on future healthcare expenditure through simulation by scenarios. Results: Coefficient of cohort effect was not as high as that of age effect, but greater than that of period effect. The cohort effect can be interpreted to show 'healthy ageing' phenomenon. Healthy ageing effect shows annual average decrease of -1.74% to 1.57% in healthcare expenditure. Controlling age, period, and birth cohort effects, pure demographic effect of population ageing due to increase in life expectancy shows annual average increase of 1.61%-1.80% in healthcare expenditure. Conclusion: First, since the influence of population factor itself on healthcare expenditure increase is not as big as expected. Second, 'healthy ageing effect' suggests that there is a need of paradigm shift to prevention centered-healthcare services. Third, forecasting of health expenditure needs to reflect social change factors by considering birth cohort effect.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.323-328
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• 2012

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

• Journal of Preventive Medicine and Public Health
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• 제53권3호
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• pp.198-204
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• 2020

Objectives: This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis. Methods: We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects. Results: The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later. Conclusions: The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8589-8594
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• 2016

Background: Liver cancer is one of the most common causes of death in the world. In Korea, hepatitis B virus (HBV) is a major risk factor for liver cancer but infection rates have been declining since the implementation of the national vaccination program. In this study, we examined the secular trends in liver cancer mortality to distinguish the effects of age, time period, and birth cohort. Materials and Methods: Data for the annual number of liver cancer deaths in Korean adults (30 years and older) were obtained from the Korean Statistical Information Service for the period from 1984-2013. Joinpoint regression analysis was used to study the shapes of and to detect the changes in mortality trends. Also, an age-period-cohort model was designed to study the effect of each age, period, and birth cohort on liver cancer mortality. Results: For both men and women, the age-standardized mortality rate for liver cancer increased from 1984 to 1993 and decreased thereafter. The highest liver cancer mortality rate has shifted to an older age group in recent years. Within the same birth cohort group, the mortality rate of older age groups has been higher than in the younger age groups. Age-period-cohort analysis showed an association with a high mortality rate in the older age group and in recent years, whereas a decreasing mortality rate were observed in the younger birth cohort. Conclusions: This study confirmed a decreasing trend in liver cancer mortality among Korean men and women after 1993. The trends in mortality rate may be mainly attributed to cohort effects.

• 한국지역지리학회지
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• 제17권1호
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• pp.75-95
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• 2011

이 연구는 생애주기에 따른 주거이동 모형의 횡단면적 접근과 분석이 가지는 한계의 대안으로서 출생코호트 접근을 하였다. 1970년부터 2005년까지 진주시를 사례로 5세 연령 간격으로 출생코호트를 구분하고 각각의 주거이동을 탐색하고 비교하였다. 그리고 주거수요로서 인구변천과 출산력, 주거공급으로서 주택재고와 주거지역 입지 등 변화도 함께 살펴보았다. 그 결과 모형이 강조하고 있는 연령효과 이외에도 코호트효과와 기간효과가 확인되며, 이로 인해 각 출생코호트의 주거이동 궤적에 차이가 있었다. 한편 모형이 제시하고 있는 것과는 달리 가구주의 연령이 증가하면서 연령효과가 감소하였고 이동은 감소, 안정되었다. 이에 대한 해석은 출생코호트 간의 주거승계가 미약하거나 단절되고 있고, 결과적으로 연령집단이 주거를 서로 달리하는 가족지위보다 출생코호트를 주거분화 요인 중 하나로 제시할 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.409-418
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• 2020

Objectives: This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan. Methods: We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort. Results: Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women. Conclusions: Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

• 한국경제지리학회지
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• 제23권2호
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• pp.166-181
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• 2020

본 논문은 수도권과 비수도권 거주자를 대상으로 1998~2018년 한국노동패널(KLIPS) 조사자료의 APC(Age-Period-Cohort) 모형 분석을 통해 지역별 소득 불평등의 강도와 추세 및 소득 불평등의 지역 간 격차 추세를 비교·분석한다. 주요 분석 결과는 다음과 같다. 첫째, 코호트와 연령효과 양자의 경우 수도권에 거주하는 소위 베이비붐 및 '386세대'를 포함하는 50~60대는 비수도권의 다른 연령대 및 코호트와 비교해 상대적인 소득 불평등 완화 효과가 있다. 둘째, 소득 불평등의 지역 간 격차를 설명하는 데에 미시적인 개인 특성도 무시할 수 없지만, 그보다는 누락변수의 구조적·제도적 요인과 특성변수의 사회적인 차별 효과가 더 의미가 있다. 전반적으로 코호트 내 및 코호트 간 소득 불평등이 중첩되어 나타나고 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4501-4504
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• 2012

In recent decades, decreasing trends in esophageal cancer mortality have been observed across China. We here describe esophageal cancer mortality trends in Linzhou city, a high-incidence region of esophageal cancer in China, during 1988-2010 and make a esophageal cancer mortality projection in the period 2011-2020 using a Bayesian approach. Age standardized mortality rates were estimated by direct standardization to the World population structure in 1985. A Bayesian age-period-cohort (BAPC) analysis was carried out in order to investigate the effect of the age, period and birth cohort on esophageal cancer mortality in Linzhou during 1988-2010 and to estimate future trends for the period 2011-2020. Age-adjusted rates for men and women decreased from 1988 to 2005 and changed little thereafter. Risk increased from 30 years of age until the very elderly. Period effects showed little variation in risk throughout 1988-2010. In contrast, a cohort effect showed risk decreased greatly in later cohorts. Forecasting, based on BAPC modeling, resulted in a increasing burden of mortality and a decreasing age standardized mortality rate of esophageal cancer in Linzhou city. The decrease of esophageal cancer mortality risk since the 1930 cohort could be attributable to the improvements of socialeconomic environment and lifestyle. The standardized mortality rates of esophageal cancer should decrease continually. The effect of aging on the population could explain the increase in esophageal mortality projected for 2020.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.188-194
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• 2019

Objectives: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. Methods: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ${\leq}14years$ residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. Results: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. Conclusions: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

• 분석과 대안
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• 제8권2호
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• pp.31-64
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• 2024

최근 한국 국민의 통일필요 의식의 하락 추세는 선명하다. 통일필요 의식 하락 추세에 있어 출생 코호트 효과는 존재하는가? 본 연구의 목적은 통일필요 의식에 있어 출생 코호트가 통계적으로 유의미한 영향을 미치는지 분석하는 것이다. 이를 위해 분석모형으로 위계적 연령-기간-코호트(HAPC) 모형을 채용하였으며 2007~2021년 기간 서울대학교 통일평화연구원의 통일의식조사 데이터를 사용하였다. 분석 결과, 출생 코호트 수준에서 경제불평등의 진행이 통일 필요성 인식 하락에 영향을 미쳤다는 증거가 관찰되었다. 소득과 자산의 양극화 진행으로 인해 사회 진출 과정에서 사회경제적 어려움을 겪은 1980년대 출생 코호트는 막대한 재원이 투입되는 남북통일에 대해, 1960년대와 1970년대 출생 코호트와 비교해 선명하게 부정적인 인식을 가지는 것으로 판단된다.