• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.455-460
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• 2014

Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

• Korean Journal of Community Nutrition
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• v.26 no.6
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• pp.495-507
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• 2021

Objectives: This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region. Methods: This study included 13,926 adults (≥ 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression. Results: Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas. Conclusions: Regional differences in total fat and SFA intakes and their food sources were observed among Korean adults. Our findings may help plan nutritional strategies to ameliorate regional health disparities.

• Journal of dental hygiene science
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• v.16 no.3
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• pp.225-234
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• 2016

The purpose of this study was to determine the oral health condition and behavioral status of Korean adults according to occupational status. The subjects were 7,676 adults, aged between 19 and 64 years, who completed both oral examination and questionnaire survey, among those who indicated that they were currently participating in economic activities, according to the data from the Fourth Korea National Health and Nutrition Examination Survey. Occupational class and employment status were selected as measures of occupational status. Complex-samples logistic regression models were used to assess the associations among oral health, behavioral, and occupational statuses. We found a significant occupational class-related difference in the oral health and behavioral statuses of both the men and women. In particular, the prevalence odds ratios of untreated dental caries in manual workers were 1.19 and 1.67 times higher than in non-manual workers, for men and women, respectively. As for oral health condition and behavioral status according to employment status, the health risk in temporary employment workers was higher than that in permanent employment workers. As for the prevalence odds ratios of the risk of dental caries, the highest values were observed for tooth brushing fewer than 3 times per day, not undergoing oral examinations, and chewing difficulty complaints. The risk of dental caries for agricultural, forestry, and fishing workers for both men and women was found to be the highest among other workers. Thus, strategies to promote workplace oral health in the microscopic and macroscopic perspectives should be developed to constantly monitor oral health problems, and to identify vulnerable social groups within occupational groups and the related factors that mediate oral health differences.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of agricultural medicine and community health
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• v.49 no.1
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• pp.37-49
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• 2024

Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

• Health Policy and Management
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• v.34 no.2
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• pp.211-221
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• 2024

Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.1
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• pp.119-130
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• 2000

The purpose of this study was to serve as a basis for more effective sex education, by examining the influence of obscene media on elementary school student's sex consciousness. For attaining the purpose, the research questions were posed as follows: 1) What's general characteristics of elementary school students? 2) How much are elementary school students exposed to obscene media? 3) Is their sex consciousness different according to the degree of being exposed to obscene media and the appearance of secondary sex characteristic? The subject of study were the 400 male and female students who were in the sixth grade at elementary school in the city of Paju. The questionnaire survey was conducted to find out their general characteristics, sex consciousness and degree of being exposed to obscene media. The conclusions were as follows; 1) Basic Information 94% of the students investigated were living with their parents. The greatest number of their parents were in their fourties. Concerning the religion of their families, 47.5% belonged to Christianity or Catholicism. 47.3% got in touch with obscene media, which indicated that the harmful influence of that media was great. Their basic knowledge of pregnancy was very poor, as 27.2% weren't sure whether being pregnant could be caused only by shaking hands, hugging or kissing. 34.7% considered it a natural behavior to contact the other sex. Regarding their practice of sexual behavior, they'd have an experience of hugging or kissing. 2) Group Comparison The female students underwent the appearance of secondary sex characteristic faster than the male students. As a result of examining if their degree of being exposed to obscene media was affected by the presence or absence of secondary sex characteristic, no statistically significant difference existed in all the groups: the entire group, male student group and female student group. There appeared, however, statistically significant differences between male and female students, as the number of male student who hadn't yet been exposed to obscene media was less than that of female student who hadn't. And the number of male student who had been much exposed to obscene media was more than that of female student who had. 3) Sex Knowledge, Sex Attitude and Sex Practice The extent of making contact with obscene media didn't make statistically significant difference to the sex knowledge of all the groups. But more extent of getting in touch with obscene media led to more sex attitude and sex practice in the entire group. However, as a result of analyzing these things by the presence or absence of secondary sex characteristic, it's found in general that the group that had secondary sex characteristic possessed statistically better sex knowledge than the other group that hadn't. For the male students, there appeared little disparities in three subareas of sex knowledge, sex attitude and sex practice. For the female students, however, the group that had secondary sex characteristic owned better sex knowledge than the other group that hadn't, and the former group looked upon sex attitude as more natural.

• Journal of the Korean Institute of Landscape Architecture
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• v.42 no.3
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• pp.76-89
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• 2014

The functions of urban park including health related benefit and climate adaptation and mitigation are expanding. However, in-depth research and discourse on the equitable distribution of expanded park function has been limited so far. Following research suggests Green Welfare concept to reflect distributive equity and multifunctionality in the process of urban park policy development and execution. This study developed park welfare indices to analyze disparities of neighborhood urban park(NUP) distribution viewed from green welfare by literature review. The findings analyzed through the Correlation Analysis and Cluster Analysis by SPSS 18.0. The results of the study are as follows. First, green welfare is defined as "to receive equitable benefits and participate in the delivery process of green services which are promoting health and securing safety from climate change risks for every citizen by life cycle regardless of socioeconomic status". Second, NUP per person in Seoul indicate meaningful differences by socioeconomic and environmental status of Seoul administrative districts. Park welfare indices correlated to NUP per person were shown population density(negative), percentage of individuals $aged{\geq}65$(positive), percentage of self-reliance of local finance(positive), flood and air pollution vulnerability by climate change(negative). Third, the cluster analysis identifies three significant clusters that indicate differences of park welfare level. Thus, it was found that NUP in Seoul from a green welfare perspective was provided disproportionately. Future urban park policy in Seoul was required equitable distribution of multifunctionality of park beyond quantitative expansion, and priority consideration should be given to park service consumer.

• Nutrition Research and Practice
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• v.11 no.2
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• pp.139-146
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• 2017

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing "very difficult" or "difficult", were combined to form the chewing difficulty group. Similarly, those who found chewing "moderately difficult", "easy", and "very easy" were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.

• Journal of Korean society of Dental Hygiene
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• v.15 no.2
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• pp.343-352
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• 2015

Objectives: The purpose of this study was to compare the liberal arts curricula of domestic 3 year and 4 year dental hygiene departments and to obtain the basic data for the development of a standardized dental hygiene curriculum. Methods: The liberal arts curricula of fifteen 3 year and 4 year dental hygiene departments in Korea and other countries were analyzed. A survey was conducted on 801 selected dental hygiene majors from December 8 to 12, 2014. A self-reported questionnaire was completed by 750 dental hygiene students and 150 dental hygiene professors. The questionnaire consisted of 5 questions of general characteristics and 13 questions including curricula change, usability of curricula, awareness of the suitability of dental hygiene curricula, and validity of curricula. Cronbach'a alpha was 0.71 in this study. Results: The grade point average in the liberal arts courses in Korean 4 year dental hygiene departments were 29, which was higher than that in 3 year dental hygiene departments of 13.2. There were large disparities among the colleges in the credits of these courses. The most common liberal arts courses in 4 year dental hygiene departments were foreign languages, man, society and communication, and natural science. In 3 year dental hygiene departments, English and foreign languages were the most common courses, followed by computer, man and society, philosophy and ethics. Foreign languages were considered to be the liberal arts course that should be most strengthened according to the job environment change of dental hygienist in globalizing society, followed by social psychology and pedagogy. Conclusions: Liberal arts courses were offered in the 4 year dental hygiene departments than in the 3 year dental hygiene departments in Korea, but there were a great deal of differences between colleges. The preparation of standardized guidelines on liberal arts courses are necessary. Liberal arts courses should support the performance skill and knowledge of the dental hygienists.