• Health Policy and Management
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• v.26 no.1
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• pp.12-23
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• 2016

Background: Many studies have explained regional disparities in health by socioeconomic status and healthcare resources, focusing on differences between urban and rural area. However some cities in Korea have the highest cardiovascular mortality, even though they have sufficient healthcare resources. So this study aims to confirm three hypotheses. (1) There are also regional health disparities between cities not only between urban and rural area. (2) It has different regional risk factors affecting cardiovascular mortality whether it is urban or rural area. (3) Besides socioeconomic and healthcare resources factors, there are remnant factors that affect regional cardiovascular mortality such as health behavior and physical environment. Methods: The subject of this study is 227 local authorities (si, gun, and gu). They were categorized into city (gu and si consisting of urban area) and non-city (gun consisting of rural area), and the city group was subdivided into 3 parts to reflect relative different city status: city 1 (Seoul, Gyeonggi cities), city 2 (Gwangyeoksi cities), and city 3 (other cities). We compared their mortalities among four groups by using analysis of variance analysis. And we explored what had contributed to it in whole authorities, city and non-city group by using multiple regression analysis. Results: Cardiovascular mortality is highest in city 2 group, lowest in city 1 group and middle in non-city group. Socioeconomic status and current smoking significantly increase mortality regardless of group. Other than those things, in city, there are some factors associated with cardiovascular mortality: walking practice(-), weight control attempt(-), deficiency of sports facilities(+), and high rate of factory lot(+). In non-city, there are other factors different from those of city: obesity prevalence(+), self-perceiving obesity(-), number of public health institutions(-), and road ratio(-). Conclusion: To reduce cardiovascular mortality and it's regional disparities, we need to consider differentiated approach, respecting regional character and different risk factors. Also, it is crucial to strengthen local government's capacity for practicing community health policy.

• Journal of the Korean Society of School Health
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• v.22 no.2
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• pp.25-36
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• 2009

Purpose: The purpose of this study was to estimate income-related health inequalities among adolescent population across regions in Korea. Methods: Data of 8,456 adolescents from 1998, 2001, 2005, 2007 Korean Health and Nutrition Examination Survey were used for the analysis. True health status was proxied by self-rated health and overweight status. Per capita income was computed from household monthly average income adjusted by consumer price with base year 2005. Adolescent health inequalities were estimated by Concentration Index (CI) across income and space. Results: Ill health score was related with age (p<0.0001), gender (p=0.0155) and income (p<0.0001). Negative relationship between income and ill-health indicated that higher income group tended to enjoy better health and less overweight. These evidences suggested ill health were accumulated on the economically disadvantaged adolescents. The size of health inequalities (ill-health score) were estimated as CI=-0.057 and CI=-0.030 across income groups and regions, respectively. Comparable measures of within region health disparities were also observed. Conclusion: Since health disparity among adolescent population was small compared to adult population, lessening adolescent health inequality could be a helpful way of mitigating health disparities in later stage. Considering life stage of adolescents, school system and local communities could play important roles toward adolescent health distribution. Although health disparity between regions existed, health disparity within a region should not be neglected.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3279-3286
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• 2014

Background: Cancer is one of the leading causes of death in Korea. To reduce cancer incidence, the Korean National Cancer Center (KNCC) has been expanding its organized cancer screening program. In addition, there are opportunistic screening programs that can be chosen by individuals or their healthcare providers. The purpose of this study was to investigate factors associated with participation in organized and opportunistic cancer screening programs, with a particular focus on socioeconomic factors. Materials and Methods: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional nationwide study conducted by the Korean Ministry of Health and Welfare from 2007 to 2011. The study included information from 9,708 men and 12,739 women aged 19 years or over. Multinomial logistic regression analysis was conducted, adjusting for age, year of data collection, residential region, current smoking status, current alcohol consumption status, exercise, marriage status, job status, perceived health status, stress level, BMI, limitation of activities, cancer history, health insurance type, and private insurance status, to investigate the association between education level, economic status, and cancer screening participation. Results: In terms of education level, disparities in attendance were observed only for the opportunistic screening program. In contrast, there was no association between education level and participation in organized screening. In terms of economic status, disparities in opportunistic screening participation were observed at all income levels, but disparities in organized screening participation were observed only at the highest income level. Conclusions: Our findings reveal that socioeconomic factors, including educational level and economic status, were not significantly associated with participation in organized cancer screening, except at the highest level of income.

• Research in Community and Public Health Nursing
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• v.31 no.4
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• pp.514-524
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• 2020

Purpose: The purpose of this study was to examine the relationship between working poverty and health status among Korean workers. Methods: This study is secondary analysis of data extracted from the 2018 Community Health Survey. For the present analysis, 23,575 of the working poor whose household disposable income is below 50.0% of the national median and 111,443 of the working nonpoor were selected. Based on existing literature, a set of variables were chosen from the Community Health Survey. Health status was measured using self-rated health status measure, Patient health Questionnire-9, and EuroQol-5dimension. Results: The proportion of subjective unhealthy status, depressive symptoms, and poor quality of life were significantly higher among the working poor than among the working nonpoor. After adjusting for general characteristics and health behavior factors, the working poverty was a significant predictor of subjective unhealthy status (AOR=1.32, 95% CI=1.25~1.40), depressive symptoms (AOR=1.61, 95% CI=1.38~1.88]), and poor quality of life (β=-0.02, p<.001). Conclusion: The current study confirmed the health disparities between the working poor and the working nonpoor. Therefore, health care programs and policies are required for reducing the health inequalities among the workers.

• Journal of Preventive Medicine and Public Health
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• v.44 no.4
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• pp.141-148
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• 2011

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

• Health Policy and Management
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• v.32 no.1
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• pp.14-20
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• 2022

In this study, we distinguished urban and rural areas in Naju-si, Jeollanam-do, grasped the characteristics of those areas, and investigated the depression-related factors in Naju-si based on this. This study used Community Health Survey data from 2017 to 2019. To investigate the factors affecting the depression in Naju-si local residents, the odds ratio was calculated using a complex sample logistic regression model. As a result of confirming the factors affecting the prevalence of depression in Naju-si residents, the risk of depression was significantly higher at 1.59 (95% confidence interval [CI], 1.02-2.50) for women, 2.14 (95% CI, 1.20-3.83) for recipients of basic livelihoods, 2.35 (95% CI, 1.46-3.79) for those who did not practice walking, and 2.00 (95% CI, 1.23-3.26) for those who slept less than 5 hours. It is necessary to select high-risk groups as a regional-specific project to resolve the mental health disparities in Naju-si and to intervene in early depression prevention through support for mental health support services.

• The Journal of the Korean dental association
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• v.39 no.3 s.382
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• pp.183-188
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• 2001

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7451-7457
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• 2013

Background: Understanding and enhancing change capabilities, including Practice Adaptive Reserve (PAR), of Community Health Centers (CHCs) may mitigate cancer-related health disparities. Materials and Methods: Using stratified random sampling, we recruited 232 staff from seven CHCs serving Asian Pacific Islander communities to complete a self-administered survey. We performed multilevel regression analyses to examine PAR composite scores by CHC, position type, and number of years worked at their clinic. Results: The mean PAR score was 0.7 (s.d. 0.14). Higher scores were associated with a greater perceived likelihood that clinic staff would participate in an evidence-based intervention (EBI). Constructs such as communication, clinic flow, sensemaking, change valence, and resource availability were positively associated with EBI implementation or trended toward significance. Conclusions: PAR scores are positively associated with perceived likelihood of clinic staff participation in cancer screening EBI. Future research is needed to determine PAR levels most conducive to implementing change and to developing interventions that enhance Adaptive Reserve.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7401-7407
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• 2015

Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

• Nutrition Research and Practice
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• v.14 no.6
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• pp.679-690
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• 2020

BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = -0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.