• 보건행정학회지
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• 제28권2호
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• pp.128-137
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• 2018

Background: This study aims to utilize Organization for Economic Cooperation and Development (OECD) data to identify macroscopic determinants of health at national level and to utilize it in health policy development through comparison and analysis with Korea. Methods: The potential years of life lost (PYLL) were used as dependent variables and 19 indicators were selected as health determinants to be independent variables based on the results of previous studies. Data analysis was done using SAS ver. 9.4 package (SAS Institute Inc., Cary, NC, USA) and model used in technical statistics concerning PYLL by countries, multi-linearity test between independent variables and OECD economic studies were modified and used. Results: From 1994 to 2012, the average PYLL for OECD countries was 4,262.9 years, the highest in Estonia and the lowest in Iceland. As a result of the analysis using the fixed effect model, the significant variables affecting PYLL were four variables: gross domestic product, nitric oxide, tobacco consumption, and number of doctors. The health determinants that had more influence on the PYLL of Korean people compared to other OECD countries were tobacco consumption, calorie consumption, fat intake and total health expenditure. Conclusion: In order to effectively reduce unnecessary deaths, we must continue to strengthen our smoking policy and nutrition policies such as calorie and fat intake. It is necessary to prevent the increase of total health expenditure due to the increase in the prevalence of chronic diseases and to strengthen the public health aspect.

• 보건행정학회지
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• 제25권3호
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• pp.152-161
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• 2015

We analyze the determinants of obesity and the chronic diseases using the Korea Health Panel data. Also we analyze the effect of obesity and the chronic diseases on the health care expenditures. Through this study, to reduce the health care expenditures, we suggest the policy implication that might curb the obesity and the chronic diseases. We estimate the determinants of obesity, the chronic diseases, and the health care expenditures using 2SLS (two stage least squares) estimation method under the simultaneous equations framework. Result says that obesity and chronic diseases significantly have positive effects on the health care expenditures. Also the determinants of the health care expenditures that have positive effects are age, income and health care utilization variables.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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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.

• 보건행정학회지
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• 제20권4호
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• pp.114-125
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• 2010

Objectives : This study investigates the determinants of contingent workers' ratio in public health centers. Since the economic crisis in 1997, there have been many studies on contingent workers in Korea. But, previous studies have been not conducted focusing on public health center. Methods : This study used 253 public health centers, installed and operated since December 31, 2008. in Korea as units of analysis. To examine the determinants of contingent workers' ratio, this study uses Pearson correlation and multiple regression analysis. Results : The following appeared as significant variable affecting contingent workers' ratio in public health centers; degree of the local government's financial independence(p<0.001), rate of increase/decrease in ages 65 and over(p<0.001), rate of increase/decrease in basic livelihood security recipients(p<0.01) and rate of increase/decrease in registered disabled persons(p<0.01). In contrast, internal organizational environment characteristics related variables were not statistically significant. Conclusions : Contingent workers' ratio in public health center is significantly affected by financial vulnerability of the local government and increase in demand of health care services.

• Human Ecology Research
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• 제54권5호
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• pp.515-527
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• 2016

This study investigated social determinants and their interaction effects on the health of school-aged children in diverse environmental factors pertaining to the individual, family, and peers from an ecological systematic perspective. Data were drawn from the first wave of the Korean Children and Youth Panel Survey (KCYPS) developed by the National Youth Policy Institute and conducted in 2010. Data were analyzed by descriptive statistics, Cronbach ${\alpha}$, correlation, and hierarchical regression analysis using SPSS ver. 18. The results from this study showed that sex and age were related to the health of school-aged children, as social determinants. Self-rated levels of the health of boys and younger children were more positive than girls and older children; in addition, levels of self-resilience, satisfaction of peer relation, and parenting rearing attitude were found to have a positive impact on self-rated levels of the health of school-aged children as protective factors. Especially, according to the result of interaction analysis between factors, self-resilience, and parenting rearing attitude were moderators of the effects on between sex and household income and self-rated level of the health of school-aged children respectively. The findings from this study suggested the need to expand the social intervention range to improve school-aged children's health.

• Journal of Preventive Medicine and Public Health
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• 제56권1호
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• pp.50-58
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• 2023

Objectives: Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran. Methods: This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middleaged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CI_n) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants. Results: The proportion of MetS in the sample was 41.1%. The CI_n of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%). Conclusions: Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

• 보건의료산업학회지
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• 제5권2호
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• pp.77-89
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• 2011

This study conducted a secondary analysis by using original data of performed by Korea Institute for Health and Social Affairs to know factors affecting determinants of health using Lalonde model for the adults aged over 19 years living in Korea. The survey was conducted in 2009 and it evaluated finally 5,867 cases by excluding cases with no answer or a wrong answer. This study model adopted two categories of instrument measure health were objective (Average remaining lifetime) and subjective(EQ-5D) health status. The health determinants included in this study could be divided in to four categories, which were human biology, environment, lifestyle, and health care organization. The results were as follows. In the factors affecting average remaining lifetime, human biology were sex, ages, BMI, showed statistically significant difference, environment category were merry status, education showed statistically significant difference, lifestyle category were exercise, drunks showed statistically significant difference and health care organization category were vaccination, health screening showed statistically significant difference. In the factors affecting EQ-5D, human biology category and health care organization category showed with same average remaining lifetime, environment category were merry status, education, income showed statistically significant difference and lifestyle category were exercise, drunks, stress showed statistically significant difference. The results demonstrated that the best powerful factor was life style category and environment category, the least factor was health care organization category. So lifestyle style and environment category should be considered for the future health plan, budget allocation and the priority in the health care.

• 보건행정학회지
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• 제20권1호
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• pp.1-18
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• 2010

This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.311-316
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• 2016

Breast cancer is one of the most common causes of cancer mortality in Iran. Social determinants of health are among the key factors affecting the pathogenesis of diseases. This cross-sectional study aimed to determine the social determinants of breast cancer survival time with parametric and semi-parametric regression models. It was conducted on male and female patients diagnosed with breast cancer presenting to the Cancer Research Center of Shohada-E-Tajrish Hospital from 2006 to 2010. The Cox proportional hazard model and parametric models including the Weibull, log normal and log-logistic models were applied to determine the social determinants of survival time of breast cancer patients. The Akaike information criterion (AIC) was used to assess the best fit. Statistical analysis was performed with STATA (version 11) software. This study was performed on 797 breast cancer patients, aged 25-93 years with a mean age of 54.7 (${\pm}11.9$) years. In both semi-parametric and parametric models, the three-year survival was related to level of education and municipal district of residence (P<0.05). The AIC suggested that log normal distribution was the best fit for the three-year survival time of breast cancer patients. Social determinants of health such as level of education and municipal district of residence affect the survival of breast cancer cases. Future studies must focus on the effect of childhood social class on the survival times of cancers, which have hitherto only been paid limited attention.