• Journal of Preventive Medicine and Public Health
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• 제53권2호
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• pp.143-148
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• 2020

Objectives: We calculated life expectancy and inequalities therein by income for the period of 2016-2018 across the 253 electoral constituencies of the 20th National Assembly election in Korea. Methods: We obtained population and death data between 2016 and 2018 from the National Health Information Database and constructed abridged life tables using standard life table procedures according to gender and income quintiles for the electoral constituencies of the 20th National Assembly election held in 2016. Results: Life expectancy across the 253 constituencies ranged from 80.51 years to 87.05 years, corresponding to a gap of 6.54 years. The life expectancy difference by income across the 253 constituencies ranged from 2.94 years to 10.67 years. In each province, the difference in life expectancy by income across electoral constituencies was generally greater than the inter-constituency differences. Constituencies in capital and metropolitan areas showed a higher life expectancy and a lower life expectancy difference by income than constituencies in rural areas. Conclusions: Pro-rich inequalities in life expectancy by income existed in every electoral constituency in Korea. Both intra-constituency and inter-constituency socioeconomic inequalities in health should be highlighted in future policy-making in the National Assembly.

• Journal of Preventive Medicine and Public Health
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• 제51권6호
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• pp.289-297
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• 2018

Objectives: Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran. Methods: A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ${\geq}30kg/m^2$. The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity. Results: Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity. Conclusions: Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

• 사회복지연구
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• 제43권1호
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• pp.117-142
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• 2012

본 연구의 목적은 노인의 교육불평등에 따른 건강불평등(주관적 건강상태와 우울)에 대한 사회참여의 매개효과를 검증하는 것이다. 분석을 위한 연구 자료는 강남구 노인복지욕구 실태조사이다. 본 자료는 2009년 7월 30일부터 8월 15일까지 강남구 22개 각 동에서 60세 이상 노인을 대상으로 수집되었으며, 최종 분석에 총 631명의 자료가 사용하였다. 분석방법은 빈도, 백분율, 평균, 표준편차를 통해 대상자의 일반적 특성을 살펴보았으며, 변인간 가설검증을 위해 위계적 회귀분석을 실시하였다. 통계 프로그램은 SPSS 18.0을 이용하였다. 분석 결과 노인의 교육불평등은 노인의 건강불평등에 영향을 미친다는 것이 검증되었다. 또한 교육불평등이 노인의 건강불평등에 영향을 미치는 경로에 있어서 사회참여가 부분매개효과가 있음이 입증되었다. 사회참여 변인이 부분매개효과를 보인다는 것은 노인의 교육불평등이 심할수록 건강불평등(주관적 건강상태, 우울)도 심화된다는 직접적인 경로와 함께, 교육불평등은 사회참여를 통해 더욱 심화된 건강불평등(주관적 건강상태, 우울)을 이끌어낸다는 간접적 경로를 검증해 주는 것이다. 이러한 결과는 한국 사회에서 교육불평등이 건강불평등으로 연결된다는 것을 실증 분석했다는 점과 교육불평등으로 인한 건강불평등을 완화할 수 있는 사회복지적 실천방안으로 사회참여라는 개입방법을 사용할 수 있다는 메커니즘을 검증했다는 점에서 의의를 가진다.

• 간호행정학회지
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• 제21권1호
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• pp.20-31
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• 2015

Purpose: The purpose of this study was to explore ways to define the concept of health inequality. Methods: The concept analysis process by Walker and Avant was used to clarify the meaning of health inequality. Results: Defining attributes of health inequality included differences in health status between individuals or groups, infringement of fundamental rights to health, unfair use of medical services, and social discrimination. The antecedents of health inequality included differences in demographic characteristics (age, gender, education, occupation, residential location), limitations in accessibility to health care, and social exclusion. Consequences of health inequality were increased costs for medical care, decreased health-related quality of life, and lack of ability to cope with health problems resulting in crisis situations, increases in morbidity and mortality, and shortening of life span. The concept was clarified through presentation of model, borderline, related, and contrary cases. Conclusion: Results of this study can be used to guide the direction of future studies through concept analysis in which conceptual attributes in the context of health inequality are examined. Also, based on the result of this study, development of standardized tools to measure health inequality is recommended as well as development of educational programs to reduce health inequalities.

• 보건행정학회지
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• 제30권1호
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• pp.37-49
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• 2020

Background: Unmet healthcare needs have many advantages for measuring inequalities in healthcare use. However, the existing indicator is difficult to capture the reality of unmet healthcare needs sufficiently and is not quite appropriate in comparing regional inequality. The purpose of this study is to critically analyze the utilization of the unmet healthcare need indicator for regional healthcare inequalities research. Methods: We used the level of healthcare accessibility and healthcare need to categorize the regions that are known to cause differences in healthcare utilization between regions and verified how existing unmet healthcare need indicator is distributed at the regional level. Results: Four types of regions were classified according to the high and low levels of healthcare needs and accessibility. The hypothesis about the regional type expected to have the highest unmet healthcare need was not proved. The hypothesis about the lowest expected regional type was proved, but the difference in the average rate of unmet healthcare needs among regional types was not significant. The standard deviation of the rate of unmet healthcare needs among regions within the same type was also higher than the overall regional variation, which also disproved the whole frame of hypothesis. Conclusion: Failure to prove the hypothesis means the gap between the supposed meaning of the indicator and the reality. In order to understand the current state of healthcare utilization of people in various regions of Korea and to resolve inequality, fundamental research on the in-depth structure and mechanisms of healthcare utilization is needed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3411-3417
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• 2013

Over the last 10 years, the number of cancer survivors in South Korea has reached nearly one million with a survival rate of 49.4%. However, integrated supportive care for cancer survivors is lagging. One area in which the current cancer control policy needs updating is in the utilization of information and communication technology (ICT). The remarkable progress in the field of ICT over the past 10 years presents exciting new opportunities for health promotion. Recent communication innovations are conducive to the exchange of meta-information, giving rise to a new service area and transforming patients into active medical consumers. Consequently, such innovations encourage active participation in the mutual utilization and sharing of high-quality information. However, these benefits from new ICTs will almost certainly not be equally available to all, leading to so-called communication inequalities where cancer survivors from lower socioeconomic classes will likely have more limited access to the best means of making use of the health information. Therefore, most essentially, emphasis must be placed on helping cancer survivors and their caregivers utilize such advances in ICT to create a more efficient flow of health information, thereby reducing communication inequalities and expanding social support. Once we enhance access to health information and better manage the quality of information, as a matter of fact, we can expect an alleviation of the health inequalities faced by cancer survivors.

• 보건행정학회지
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• 제26권1호
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• pp.79-91
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• 2016

'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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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.

• 보건행정학회지
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• 제33권2호
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• pp.118-128
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• 2023

Background: Personal socio-economic abilities are crucial as it affects health inequalities. These multidimensional inequalities across the regions have been structured and fixed. This study aimed to analyze health vulnerabilities by regional cluster and identify regional health disparities of self-rated health, using nationally representative cross-sectional data. Methods: This study used personal and regional data. Data from the Community Health Survey 2021 were analyzed. K-means cluster analysis was applied to 250 si-gun-gu using administrative regional data. The clusters were based on three areas: physical environment, health-related behaviors and biological factors, and the psychosocial environment through the conceptual framework for action on the social determinants of health. And binary logistic regression analyses were conducted to examine the differences in self-rated health status by the regional clusters, controlling human biology, environment, lifestyle, and healthcare organization factors. Results: The most vulnerable group was group 3, the moderate vulnerable group was group 1, and the least vulnerable group was group 2. The group 2 was more likely to have high self-rated health status than the moderate vulnerable group (odds ratio [OR], 1.023; p<0.001). And the group 3 showed low self-rated health status than the moderate vulnerable group (OR, 0.775; p<0.001). However, the moderate vulnerable group had significantly higher self-rated health status than the most vulnerable group (group 2: OR, 1.023; p<0.001; group 3: OR, 0.775; p<0.001). Conclusion: These results demonstrate that community members' health status is influenced by regional determinants of health and individual levels. And these contribute to understanding the importance of specific and differentiated interventions like locally tailored support programs considering both individual and regional health determinants.

• 지역사회간호학회지
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• 제31권1호
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• pp.13-23
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• 2020

Purpose: This study explored the contribution of social support resources to the explanation of socioeconomic inequalities in depressive symptoms of older Korean men and women. Methods: Data were derived from Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. The data were analyzed by using multiple logistic regression. The sample consisted of 4,046 men and 6,036 women aged ≥65 years. The Korean version of the Geriatric Depression Scale-Short form (SGDS-K) was employed as an outcome variable. Results: Compared to the older men and women who were in higher socioeconomic status, those in lower socioeconomic status had significantly higher risk of depressive symptoms after adjusting for other covariates. When social support resources were individually included in the base model, each factor contributed to inequalities in depressive symptoms. Social networks explained about 20% of the differential impact of education and 10% to 15% of the differential impact of household income for depressive symptoms in men. Among women, it mitigated 23.6% to 39.0% of education and household income inequalities for depressive symptoms. Social participation contributed to buffer depressive symptom inequalities of 24.0% to 46.3% among men and those of 11.7% to 45.3% among women. Conclusion: Our findings suggest community care nurses acknowledge the value of social support resources to alleviate socioeconomic inequality in depressive symptoms among older men and women.