• 제목/요약/키워드: health disparities

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보건의료 서비스의 공간적 불균등 분포 변이에 대한 연구: 1995년부터 2021년까지 초기진료기관을 대상으로 (Evolution of Healthcare Service Disparities: A Case Study of Primary Care Services in Korea, 1995-2021)

  • 김현;송예나
    • 한국경제지리학회지
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    • 제26권3호
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    • pp.289-309
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    • 2023
  • 우리나라의 국민건강보험은 빠른 시간에 보편적 의료시스템을 정착시키는데 큰 기여를 했다. 하지만 연령대에 따른 의료서비스의 차이는 지속되고 있으며, 내과, 가정의학과, 소아청소년과와 같은 핵심의료 서비스에서 이러한 불평등이 존재하는 것은 큰 우려를 불러일으킬 수 밖에 없다. 진료기관 접근에 대한 불평등은 연령대만이 아니라 지역, 특히 도시와 농촌 사이에도 크게 나타나고 있다. 본 연구는 1995년부터 2021년까지 초기진료기관의 분포를 이용하여 변화하는 경제환경 속에서 의료서비스의 공간적 불평등이 어떻게 변화되어 왔는지를 살핀다. 다양한 불평등 지수와 공간통계분석의 결과를 토대로 볼 때, 1997년 IMF 경제위기, 2008년 금융위기, 그리고 2020년의 COVID-19 공중보건 위기를 겪으며 불평등이 심화 확대된 것을 확인할 수 있었다. 또한 초기의료기관의 불균등 분포에 큰 변화가 온 시기도 밝혀낼 수 있었는데, 이러한 변화에는 유소년이나 전체 인구 분포보다는 고령인구의 분포가 큰 역할을 하고 있었다. 본 연구결과는 인구와 의료서비스의 공간적 분포를 통합적으로 고려하여 핵심적인 의료자원의 불평등을 해소하기 위한 노력이 절실히 필요하다는 것을 강조한다. 특히 이러한 노력은 미래의 경제적 충격에도 적절한 수준의 의료 서비스를 지속할 수 있는 기반이 될 수 있을 것이다.

노인의 일상생활수행능력, 우울 및 주관적 건강상태와 영향요인: 사회경제적 상태와 가족지지를 중심으로 (Activities of Daily Living, Depression, and Self-rated Health and Related Factors in Korean Elderly: Focused on Socioeconomic Status and Family Support)

  • 오세은;고영
    • 지역사회간호학회지
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    • 제26권2호
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    • pp.140-149
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    • 2015
  • Purpose: This study was conducted to identify activities of daily living, depression and self-rated health and related factors for Korean Elderly. Methods: Data from the survey for the Korean Longitudinal Study of Aging in 2010 were used. The data were analyzed using frequencies, weighted proportions, and hierarchical multiple logistic regression. Results: Significant difference was observed in health status induced by socioeconomic status between men and women, but not among age groups. Socioeconomic status was strongly associated with self-rated health among male and female elders. Being unschooled and low net family asset were significantly related with dependency in activities of daily living and depressive symptoms among men. Only low net family asset was significantly related with depressive symptoms among women. Family support provides a slight decrease to the negative relationship between socioeconomic status and health status, especially depressive symptoms. Conclusion: This study suggests that interventions to reduce health inequalities should target elderly with lower socioeconomic status and with poor family support, using a gender-specific approach.

Association Between Socioeconomic Status and Obesity in Adults: Evidence From the 2001 to 2009 Korea National Health and Nutrition Examination Survey

  • Kim, Jihye;Sharma, Shreela V.;Park, Sung Kyun
    • Journal of Preventive Medicine and Public Health
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    • 제47권2호
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    • pp.94-103
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    • 2014
  • Objectives: The present study examined relationships between socioeconomic status (SES) and obesity and body mass index (BMI) as well as the effects of health-related behavioral and psychological factors on the relationships. Methods: A cross-sectional population-based study was conducted on Korean adults aged 20 to 79 years using data from the 2001, 2005, and 2007 to 2009 Korea National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to estimate odds ratios of obesity and mean differences in BMI, respectively, across SES levels after controlling for health-related behavioral and psychological factors. Results: We observed significant gender-specific relationships of SES with obesity and BMI after adjusting for all covariates. In men, income, but not education, showed a slightly positive association with BMI (p<0.05 in 2001 and 2005). In women, education, but not income, was inversely associated with both obesity and BMI (p<0.0001 in all datasets). These relationships were attenuated with adjusting for health-related behavioral factors, not for psychological factors. Conclusions: Results confirmed gender-specific disparities in the associations of SES with obesity and BMI among adult Korean population. Focusing on intervention for health-related behaviors may be effective to reduce social inequalities in obesity.

Primary Care Physicians' Cancer Screening Recommendation Practices and Perceptions of Cancer Risk of Asian Americans

  • Kwon, Harry T.;Ma, Grace X.;Gold, Robert S.;Atkinson, Nancy L.;Wang, Min Qi
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1999-2004
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    • 2013
  • Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.

지역아동센터 이용 아동의 건강 관련 중재연구의 동향 분석 (Trends in Health-related Interventions on Children Attending Community Child Care Centers in South Korea)

  • 박지영;백수연;임미해
    • Child Health Nursing Research
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    • 제24권2호
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    • pp.241-251
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    • 2018
  • Purpose: The purpose of this study was to identify trends in health-related interventions on children attending Community Child Care (CCC) centers, which are part of a health policy to provide after-school care for vulnerable children in South Korea. Methods: From 2007, 109 papers were analyzed using the scoping study method. Results: The number of studies increased steadily between 2007 and 2016. Most studies were based on the social sciences, and the participants were mainly elementary school students. Psychological and social interventions were the most common types of interventions with socio-psychological indicators as measurements. In addition, only a few studies had a clearly defined conceptual framework. The majority of studies did not explicitly indicate that they followed ethical considerations. Conclusion: It is necessary to develop health-related interventions for children attending CCC centers using diverse subjects, types, and evaluation methods, along with improvements in the quality of research methodology. Furthermore, it is essential to clearly articulate and implement ethical considerations in research targeting vulnerable children.

1인 가구 성인 남성 문제음주의 지역 간 변이요인에 관한 연구: 지리적 가중회귀모형을 이용하여 (Determinants of Problem Drinking by Regional Variation among Adult Males in Single-Person Households: Geographically Weighted Regression Model Analysis)

  • 안중근;최희승;김지우
    • 대한간호학회지
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    • 제53권1호
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    • pp.101-114
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    • 2023
  • Purpose: This study aimed to identify regional differences in problem drinking among adult males in single-person households and predict the determinants. Methods: This study used data from the 2019 Community Health Survey. Geographically weighted regression analysis was performed on 8,625 adult males in single-person households who had been consuming alcohol for the past year. The Si-Gun-Gu was selected as the spatial unit. Results: The top 10 regions for problem drinking among adult males in single-person households were located in the Jeju-do and Jeollanam-do areas near the southern coast, whereas the bottom 10 regions were located in the Incheon and northern Gyeonggi-do areas. Smoking, economic activity, and educational level were common factors affecting problem drinking among this population. Among the determinants of regional disparities in problem drinking among adult males in single-person households, personal factors included age, smoking, depression level, economic activity, educational level, and leisure activity, while regional factors included population and karaoke venue ratio. Conclusion: Problem drinking among adult males in single-person households varies by region, and the variables affecting each particular area differ. Therefore, it is necessary to develop interventions tailored to individuals and regions that reflect the characteristics of each region by prioritizing smoking, economic activity, and educational level as the common factors.

Cancer Control and the Communication Innovation in South Korea: Implications for Cancer Disparities

  • Jung, Minsoo
    • 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.

노년기 예방검진에서 사회경제적 불평등 (Socioeconomic Inequalities in Preventive Services among the Elderly: Results from Medical Checkup, Cancer Check, and BP Check)

  • 천희란;김일호
    • Journal of Preventive Medicine and Public Health
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    • 제40권5호
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    • pp.404-410
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    • 2007
  • Objectives: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. Methods: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. Results: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. Conclusions: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.

Factors Affecting Unmet Healthcare Needs of Working Married Immigrant Women in South Korea

  • Yi, Jinseon;Lee, Insook
    • 지역사회간호학회지
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    • 제29권1호
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    • pp.41-53
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    • 2018
  • Purpose: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. Methods: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the 'National Survey of Multicultural Families 2015.' Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. Results: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. Conclusion: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.

Factors Associated with Underscreening for Cervical Cancer among Women in Canada

  • Schoueri-Mychasiw, Nour;McDonald, Paul Wesley
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6445-6450
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    • 2013
  • Background: Cervical cancer is the second most common cancer among women worldwide. Failure to prevent cervical cancer is partly due to non-participation in regular screening. It is important to plan and develop screening programs directed towards underscreened women. In order to identify the factors associated with underscreening for cervical cancer among women, this study examined Pap test participation and factors associated with not having a time-appropriate (within 3 years) Pap test among a representative sample of women in Ontario, Canada using Canadian Community Health Survey (CCHS) data. Materials and Methods: Univariate analyses, cross-tabulations, and logistic regression modeling were conducted using cross-sectional data from the 2007-2008 CCHS. Analyses were restricted to 13,549 sexually active women aged 18-69 years old living in Ontario, with no history of hysterectomy. Results: Almost 17% of women reported they had not had a time-appropriate Pap test. Not having a time-appropriate Pap test was associated with being 40-69 years old, single, having low education and income, not having a regular doctor, being of Asian (Chinese, South Asian, other Asian) cultural background, less than excellent health, and being a recent immigrant. Conclusions: Results indicate that disparities still exist in terms of who is participating in cervical cancer screening. It is crucial to develop and implement cervical cancer screening programs that not only target the general population, but also those who are less likely to obtain a Pap tests.