• Title/Summary/Keyword: health Inequalities

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Determinants of Health Information-Seeking Behavior: Implications for Post-Treatment Cancer Patients

  • Jung, Minsoo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6499-6504
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    • 2014
  • Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post-treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

Income Differences in Smoking Prevalences in 245 Districts of South Korea: Patterns by Area Deprivation and Urbanity, 2008-2014

  • Kim, Ikhan;Bahk, Jinwook;Yoon, Tae-Ho;Yun, Sung-Cheol;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.2
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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.

Geographic Disparities in Prostate Cancer Outcomes - Review of International Patterns

  • Baade, Peter D.;Yu, Xue Qin;Smith, David P.;Dunn, Jeff;Chambers, Suzanne K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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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.

The Relationship between Regional Material Deprivation and the Standardized Mortality Ratio of the Community Residents Aged 15-64 in Korea (우리나라에서의 지역의 물질적 결핍수준과 15-64세 인구 표준화사망비의 관계)

  • Jeong, Baek-Geun;Jung, Kap-Yeol;Kim, Joon-Youn;Moon, Ok-Ryun;Lee, Yong-Hwan;Hong, Young-Seoub;Yoon, Tae-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.1
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    • pp.46-52
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    • 2006
  • Objectives: This study was performed to investigate the relationship between regional material deprivation and the standardized mortality ratios(SMRs) of community residents aged 15-64 in Korea. Methods: SMRs were investigated using the registered death data from 1995 to 2000 that was obtained from the Korean National Statistics Office with the denominators being drawn from the 1995 to 2000 census. Material deprivation was measured using the Townsend score that was calculated from the 1995 to 2000 census. The relationship between the regional material deprivation and the SMRs of the community residents aged 15-64 was investigated by using ANOVA, Spearman's rank correlation analysis and Pearson's correlation analysis. The trends in mortality inequality were investigated using the concentration index. Results: On the ANOVA, the SMRs of the men and women residents in the least deprived areas were the smallest and those in the most deprived areas were the largest. Spearman's rank correlation analysis, Pearson's correlation analysis and the concentration index revealed that significant positive relationships exist between the regional material deprivation and the SMRs of the community residents aged 15-64. Conclusions: This study suggests that there are mortality inequalities among the communities in Korea and part of this difference is due to the material deprivation of the community. Strategies aimed at reducing mortality inequalities among the communities will be needed to address economic inequalities. Further studies are needed to explore the mechanisms of how the regional deprivation influences on health and how the other factors of the community influence on the health of the community residents.

Changes in Mortality Inequality in Relation to the South Korean Economic Crisis: Use of Area-based Socioeconomic Position (경제위기에 따른 사망률 불평등의 변화: 지역의 사회경제적 위치 지표의 활용)

  • Yun, Sung-Cheol;Hwang, In-A;Lee, Moo-Song;Lee, Sang-Il;Jo, Min-Woo;Lee, Min-Jung;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.3
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    • pp.359-365
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    • 2005
  • Objectives : An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001. Methods : Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression). Results : Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period. Conclusions : The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.

Health Literacy and Health Behaviors among Older Adults with Cardio-cerebrovascular Disease Residing in Rural Areas (농촌 지역 심뇌혈관질환 노인의 건강정보이해능력과 건강행위)

  • Lee, Myung Suk
    • Korean Journal of Adult Nursing
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    • v.29 no.3
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    • pp.256-265
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    • 2017
  • Purpose: The aim of this study was to identify levels of health literacy and reported health behaviors among older adults with cardio-cerebrovascular disease residing in rural areas. Methods: A cross-sectional survey was conducted with a convenience sample of 134 older people (mean age=75.5 years, 71.6% Female) registered at seven health centers. The structured questionnaires were used to measure levels of health literacy and health behaviors. Results: The average functional health literacy score was $6.08{\pm}3.04$, and the health behavior score was $62.92{\pm}6.45$. Respectively health behavior was positively associated with health literacy. Education, economic status, number of family members, number of social activities and health literacy were contribution factors explaining 40.64% of the variance in health behavior. Health literacy specifically explained 12.5% of health behavior. Conclusion: These findings suggest that strategies for improving health behaviors and reducing health inequalities may benefit from adopting a stronger focus on health literacy within prevention, patient education, and other public health interventions. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health behaviors.

Epidemiology and Social Epidemiology (역학과 사회역학)

  • Song, Yun-Mi
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.3
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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.

The effect of Health Inequality Factors on Health Level of the Rural Elderly (건강불평등 요인이 농촌노인의 건강수준에 미치는 영향)

  • Choi, Dong Hee;Chae, Young Ran
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.98-106
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    • 2017
  • Purpose: This study aimed to analyze the relationships between the factors affecting health levels of the elderly in rural areas. Methods: Subjects were 257 elderly people residing in rural areas of six cities and Gangwon Province. Data was collected through questionnaires (demographic and socioeconomic status, social resources, health behaviors, physical environment, psychological tendency and general health levels) and was analyzed by using multiple regression and Sobel test. Results: The demographic and socioeconomic characteristics of the subjects exerted statistically significant influence on their social resources, health behaviors, physical environment, and psychological tendencies. The demographic and socioeconomic characteristics, social resources, health behaviors, physical environment, and psychological tendencies, in turn, exerted a statistically significant influence on the health level. The social resources had mediating effects on the relationship between income, one of the demographic and socioeconomic characteristics, and health level. The residential environments had mediating effects on the relationship between income and health level. The psychological tendency had mediating effects on the relationship between income and health level. Conclusion: This study suggests that income is an important factor affecting health level among rural elderly people. In addition, social resources, health behaviors, physical environment, and psychological tendencies among them also affect health level, so it is necessary to make strategies to improve these factors.

Research Trend Analysis of Health and Mental Health Literacy in Korea : 2007-2017 (건강정보이해능력·정신건강정보이해능력 국내연구경향분석 : 2007년-2017년)

  • Baik, Jeong?Won;Lee, Hee-Yun;Nam, Hee-Eun
    • The Korean Journal of Health Service Management
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    • v.12 no.3
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    • pp.95-106
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    • 2018
  • Objectives: The purpose of this study was to analyze the recent research trends in health and mental health literacy and suggest their implications for future research. Methods: Ninety six articles on the topics of health literacy and mental health literacy that were published in journals in Korea during the last 10 years analyzed. Results: The majority of articles were published in medical journals, whereas the articles published in social and natural sciences journals were conducted by multidisciplinary research teams and seemed to be increasing generally. The participants studied in the selected articles were mostly older adults followed by adults aged 18 and over, and other various groups including health professionals and immigrant groups. More than 97% of the articles used quantitative research methods. Conclusions: Health literacy mirrors other health inequalities. To increase the level of understanding of health information, studies should be conducted using various variables. It is also necessary to develop a community education program that can be implemented in the community. Futher, the results highlighted the importance of interdisciplinary research. It is hoped that this effort will help solve t health inequality.

An Exploratory Study of Health Inequality Discourse Using Korean Newspaper Articles: A Topic Modeling Approach

  • Kim, Jin-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.6
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    • pp.384-392
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    • 2019
  • Objectives: This study aimed to explore the health inequality discourse in the Korean press by analyzing newspaper articles using a relatively new content analysis technique. Methods: This study used the search term "health inequality" to collect articles containing that term that were published between 2000 and 2018. The collected articles went through pre-processing and topic modeling, and the contents and temporal trends of the extracted topics were analyzed. Results: A total of 1038 articles were identified, and 5 topics were extracted. As the number of studies on health inequality has increased over the past 2 decades, so too has the number of news articles regarding health inequality. The extracted topics were public health policies, social inequalities in health, inequality as a social problem, healthcare policies, and regional health gaps. The total number of occurrences of each topic increased every year, and the trend observed for each theme was influenced by events related to its contents, such as elections. Finally, the frequency of appearance of each topic differed depending on the type of news source. Conclusions: The results of this study can be used as preliminary data for future attempts to address health inequality in Korea. To make addressing health inequality part of the public agenda, the media's perspective and discourse regarding health inequality should be monitored to facilitate further strategic action.