• 제목/요약/키워드: health Inequalities

검색결과 140건 처리시간 0.027초

Measuring Out-of-pocket Payment, Catastrophic Health Expenditure and the Related Socioeconomic Inequality in Peru: A Comparison Between 2008 and 2017

  • Hernandez-Vasquez, Akram;Rojas-Roque, Carlos;Vargas-Fernandez, Rodrigo;Rosselli, Diego
    • 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.

한국 청소년의 주관적 건강상태에 영향을 미치는 요인 분석: 가정환경, 건강행태, 심리적 요인 및 식습관 (Self-rated Health Status among Korean Adolescents: Differences in Home Environmental Factors, Health Behaviors, Psychological Factors, and Dietary Habits)

  • 황성희;계승희
    • 한국학교ㆍ지역보건교육학회지
    • /
    • 제19권1호
    • /
    • pp.27-45
    • /
    • 2018
  • 목적: 본 연구는 한국 청소년의 가정환경, 건강행태, 심리적 요인 및 식습관 요인에 따른 주관적 건강상태의 차이를 분석하고, 주요 관련요인을 파악하고자 수행되었다. 방법: 분석자료로서 2015~2016년도 한국 청소년 건강행태 온라인조사 자료를 이용하였으며, 분석대상자 수는 중학생 53,791명, 고등학생 50,959명, 총 104,750명이었다. 학생들의 건강수준은 주관적 건강상태를 기준으로 건강집단과 비건강집단으로 구분하였다. 건강수준에 영향을 미치는 요인으로서 성별, 가정환경, 건강행태, 심리적 요인 및 식습관이 검토되었다. 이들 요인 간 건강집단과 비건강집단의 비율차이 검증을 위해 표본설계 정보를 반영한 Rao-scott 카이제곱검정을 실시하였다. 또한 주관적 건강수준에 영향을 주는 요인을 알아보고자 로지스틱회귀분석을 실시하였다. 결과 및 결론: 주관적 건강수준은 양친부모와 살지 않은 경우, 모의 교육수준이 낮을 때, 주관적 가정경제수준이 낮을수록 낮았다. 음주군, 고강도운동이나 근력운동을 실천하지 않는 군, 과체중이나 비만인군에서 주관적 건강수준이 낮았다. 또한 스트레스나 우울감 등 부정적인 감정이나 행복감을 느끼지 못할 때도 주관적 건강수준은 낮았다. 아침을 결식하거나 탄산음료, 고카페인음료, 패스트푸드 등의 비건강식품을 자주 섭취하는 군에서도 주관적 건강수준은 낮은 것으로 관찰되었다. 한국 청소년들에게서 건강 불평등(health inequalities)은 가정환경, 건강행태, 심리적 요인, 식습관 등 여러 요인들로부터 제기되는 것을 알 수 있었다. 이러한 요인들을 충분히 반영하여 청소년들이 건강해 질 수 있는 다각적 접근 방안이 모색되어야 할 것이다.

사회경제적 위치와 유방암 수술 후 총 사망위험과의 관련성 (Association Between Socioeconomic Status and All-Cause Mortality After Breast Cancer Surgery: Nationwide Retrospective Cohort Study)

  • 박미진;정우진;이선미;박종혁;장후선
    • Journal of Preventive Medicine and Public Health
    • /
    • 제43권4호
    • /
    • pp.330-340
    • /
    • 2010
  • Objectives: This study aims to evaluate and explain the socioeconomic inequalities of all-cause mortality after breast cancer surgery in South Korea. Methods: This population based study included all 8868 females who underwent radical mastectomy for breast cancer between January 2002 and June 2003. Follow-up for mortality continued from January 2002 to June 2006. The patients were divided into 4 socioeconomic classes according to their socioeconomic status as defined by the National Health Insurance contribution rate. The relationship between socioeconomic status and all-cause mortality after breast cancer surgery was assessed using the Cox proportional hazards model with adjusting for age, the Charlson’s index score, emergency hospitalization, the type of hospital and the hospital ownership. Results: Those in the lowest socioeconomic status group had a significantly higher hazard ratio of 2.09 (95% CI =1.50 - 2.91) compared with those in the highest socioeconomic group after controlling for all the identifiable confounding variables. For allcause mortality after radical mastectomy, all the other income groups showed significantly higher 3-year mortality rates than did the highest income group. Conclusions: The socioeconomic status of breast cancer patients should be considered as an independent prognostic factor that affects all-cause mortality after radical mastectomy, and this is possibly due to a delayed diagnosis, limited access or minimal treatment leading to higher mortality. This study may provide tangible support to intensify surveillance and treatment for breast cancer among low socioeconomic class women.

20대 여대생의 양다리길이차이 및 발목관절가동범위가 발목 염좌 발생률에 미치는 영향 (The Effect of Incidence of Ankle Sprains on Both Leg Length Inequalities and Range of Motion of Ankle Joint in 20's Female University Students)

  • 박종항;정연우;김태원
    • 대한정형도수물리치료학회지
    • /
    • 제21권1호
    • /
    • pp.29-35
    • /
    • 2015
  • Background: The purpose of this study was conducted to investigate the effect of incidence of ankle sprains on both leg length inequalities and range of motion of ankle joint in 20's female university students. Methods: 20's female university students were targeting 32 people attending K university in Gwangju. Both leg length inequality was measured using a tape measure, ranges of motion of ankles was measured using a goniometer. Results: The ankle sprain incidence was quite high, with 56.25% (n=18) for the right ankle, 34.38% (n=11) for the left ankle, and 9.38% (n=3) for both. As for the difference between the ankle sprain incidence and both leg length, the average value of the right leg was $83.08{\pm}3.69$, the average value of the left leg was $84.28{\pm}3.27$, making the right leg shorter than the left by 1.2cm with a higher incidence and showing a positive statistical correlation between the two (p<.05). Also showed that there was a negative statistical correlation between ankle sprain incidences and the inversion range of motion spread of the right ankle (p<.05). Conclusion: The incidence of ankle sprains was higher for the larger the difference between both leg length inequality. In addition, the smaller the inversion range of motion spread of the right ankle, the higher the incidence of ankle sprains. Therefore, The evidence suggests that the incidence of ankle sprains can be reduced by recommending stability and efficient exercises that take into consideration the both leg length as well as the ranges of motion of ankle joints.

  • PDF

산업군별 고용형태에 따른 근로자 흡연율 변화 추이: 1992-2006 (Smoking Rate of Workers according to Employment Status and Industry: 1992-2006)

  • 김일호;박기수;천희란
    • 보건교육건강증진학회지
    • /
    • 제28권4호
    • /
    • pp.15-25
    • /
    • 2011
  • Objectives: The present study examined whether smoking rate has declined in 1992-2006 and who the high risk groups were on industry classification and employment type. Methods: Data from 91,263 persons aged 25-64 years were analyzed from three rounds of the Social Statistical Surveys of Korea between 1992 and 2006. Industry indicators were divided by the 9th Korean Standard Industrial Classification. Age-adjusted prevalence of smoking was calculated. Prevalence ratios(PR) and differences(PD) were estimated using log-binomial regression analysis. Results: Age-adjusted prevalence of smoking decreased between 1992 and 2006, specially the smoking prevalence of regular employees decreased most. PD in age-adjusted prevalence of smoking were the biggest between regular and daily employees. PR of the temporary employees', daily employees', self-employed persons' in order was wider than that of regular employees. PR increased significantly increased between 1999 and 2006 for those in manufacturing, construction, wholesale & retail trade, service industries. Increases in PR(regular/irregular) for women in service industry were statistically significant. Conclusions: Despite reducing overall cigarette smoking rates in males, the smoking rate was not reduced equally by industry classification and employment type in both genders. More adjustable antismoking policies and consideration of employment type are requested to reduce inequalities in smoking.

환경보건 스크리닝 툴을 이용한 서울시 누적영향 평가 (Cumulative Impact Assessment Using Environmental Health Screening Tool in Seoul)

  • 임유라;배현주
    • 한국지역지리학회지
    • /
    • 제20권4호
    • /
    • pp.444-453
    • /
    • 2014
  • 환경위험의 피해가 환경불평등과 사회불평등의 상호작용으로 인해 환경약자가 더 많이 피해를 받게 되는 환경 피해 불평등이 심화될 것으로 전망되고 있다. 본 연구는 서울시를 대상으로 미국 캘리포니아 환경보호청에서 개발한 환경보건 스크리닝 툴을 적용하여 통합적인 지역 규모의 누적영향을 평가하였다. 환경보건 취약지역을 스크리닝하기 위하여 환경노출과 건강영향의 환경부담, 민감집단과 사회경제적 요인의 인구특성에 따라 10개 지표를 선정하였다. 환경보건 스크리닝 툴을 통하여 2009~2011년 서울시 누적영향평가를 실시한 결과, 서울의 강서와 강남지역에서 위험요인이 높게 나타났며 강서지역은 환경부담과 인구특성 모두에서 위험요인이 높았고, 강남지역은 환경부담요인이 높은 것으로 나타났다. 연구결과는 민감 취약계층 등 환경약자를 고려한, 공정하고 효율적인 환경정책을 추진하기 위한 과학적인 근거를 제공할 수 있다.

  • PDF

강원도 일부 농촌지역 노인의 사회경제적 위치와 구강건강관련 삶의 질과의 연관성 (The association between oral health related quality of life(OHRQoL) and socio-economic position in the elderly in rural area of Gangwon province)

  • 이민선;신선정;정세환
    • 한국치위생학회지
    • /
    • 제11권5호
    • /
    • pp.707-715
    • /
    • 2011
  • Objectives : The objective of this study was to assess a level of oral health related quality of life(OHRQoL) for rural communities elderly and to determine the association between OHRQoL and socio-economic position. Methods : The study population was elderly(60+year-old) residents of PyeongChang county, Jeongseon county, Yeongwol county, Gangwon province. A total of 171 people were invited to participate. Oral health related quality of life was measured using the GOHAI. The data were analyzed with Mann-Whitney U test or Kruskal-Wallis test and to assess socio-economic inequalities in OHRQoL(GOHAI), we used multi-variable logistic regression models. We used models adjusting for age, sex, family status factors(Model I) and compared them to models additionally adjusting for stress level(Model II). Results : There were significant differences in lower score of GOHAI at lower age group and live alone group. And we found that lower SES was significantly associated with lower score of OHRQoL. Social gradient in the score of OHRQoL persisted when adjusted for age, sex, family status, stress level. Conclusions : We recommend that oral health promotion program should be developed after due consideration SES for rural communities elderly because OHRQoL of rural communities elderly was low and association between SES and OHRQoL for rural communities elderly.

Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model

  • Kang, Jung Hun;Jung, Chang Yoon;Park, Ki-Soo;Huh, Jung Sik;Oh, Sung Yong;Kwon, Jung Hye
    • Journal of Hospice and Palliative Care
    • /
    • 제24권4호
    • /
    • pp.226-234
    • /
    • 2021
  • Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

비정규직 근로가 건강에 미치는 영향 (Employment inequalities in health among South Korea)

  • 김일호
    • 한국조사연구학회:학술대회논문집
    • /
    • 한국조사연구학회 2007년도 춘계학술대회 발표논문집
    • /
    • pp.109-122
    • /
    • 2007
  • o 비정규직근로에 영향을 미치는 요인 - 남성의 경우 낮은 사회계급(육체노동근로자, 낮은 소득수준, 낮은 교육수준, 낮은 주관적인 생활수준) - 여자의 경우 낮은 사회계급(육체노동근로자, 낮은 소득수준), 특히 연령이 높을수록, 교육수준이 높을수록 비정규직화 될 가능성이 남성보다 월등하게 높음. o 비정규근로가 건강지표에 미치는 영향 - 남자 : 자가건강수준, 근골격계질환, 간질환 - 여자 : 자가건강수준, 호흡기 질환, 정신질환, 사회, 심리적 건강(우울증, 자살사고) o 고용불평등 추이(1995년${\sim}$2003년) IMF 이후 - 남자육체직에서 유의하게 증가 - 여자비육체직에서 증가 양상

  • PDF

The Impact of Capital Account Openness on Income Inequality: Empirical Evidence from Asia

  • ULLAH, Imran;TUNIO, Fayaz Hussain;ULLLAH, Zia;NABI, Agha Amad
    • The Journal of Asian Finance, Economics and Business
    • /
    • 제9권2호
    • /
    • pp.49-59
    • /
    • 2022
  • The relationship between income inequality and capital account openness is empirically investigated in this study, where macroeconomic variables have opposing effects. Panel data used in the study from the KAOPEN Index and World Bank consists of 28 Asian countries and has been examined; it contains annual observations from 1970 to 2018. The data is examined using a random-effect model based on GMM estimates. Income inequality and capital account openness are positively and significantly related, according to our findings. Overall, the findings imply that increasing income gaps reduced capital investment in nations with large discrepancies. The growing economic discrepancy is being caused by the rich's increasing income share at the expense of the poor. In Asia, inward capital account openness exacerbates income inequality, while outward capital account openness exacerbates it. As a result, income inequality slows economic growth, leading to inflation, unemployment, and increased government spending in several Asian countries. Our control factors, GDP, and other secondary school enrolments, all had a statistically significant negative relationship with income inequality. Income disparity has a positive and statistically significant association with government spending, inflation, population, trade openness, and unemployment. Income disparity has a negative association with capital account openness, gross domestic product, and secondary school enrollment.