• Health Policy and Management
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• v.27 no.4
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• pp.304-314
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• 2017

Background: This study aimed to analyze effects of postpartum care services to women after birth, identify the factors affecting their use, and examine the extent of income-related inequality in the postpartum care services utilization and expenditures using Korean Health Panel data between 2010 and 2013. Methods: The panel data of the year 2010-2013 of the 247 women after birth were used. First, EuroQoL-5D was used to evaluate the effects of postpartum care service to women's quality of life. Second, multinominal logistic regression analysis was used to identify determinants of the use of the postpartum care services. Finally, concentration index and HIwv (horizontal equity) index were used to find that the concentration index for the inequality in the use of postpartum care services showed negative sign, which implied pro-rich. Results: The estimation results showed that utilization of the postpartum services has a positive effect on women after birth. Also age, area of residence, and number of household members turn out to be the factors of using postpartum services. And there are inequality in the use of postpartum care services whose HIwv index showed positive sign, which implied pro-rich. Conclusion: Therefore, the government's policy of the postpartum care service is necessary to be expanded and diversified considering the personal characteristics and equity of the women after birth.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.113-121
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• 2012

Objectives: This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. Methods: Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. Results: The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women;s educational attainment levels and to their higher status in the labor market. Conclusions: The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.

• Journal of Preventive Medicine and Public Health
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• v.47 no.2
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• pp.104-112
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• 2014

Objectives: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. Methods: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. Results: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. Conclusions: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.389-397
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• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• Iberoamérica
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• v.12 no.1
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• pp.149-186
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• 2010

Community participation in health has been praised as a new way of improving health inequality in developing countries for many decades. This paper is an attempt to evaluate community participation programs in health focusing on two intercultural health hospitals in IX Region of Chile. After exploring the process of program building and its impact on the quality of service, this paper concludes that a community participation program with stronger participation resulted in higher patient satisfaction. The author expects such finding to contribute to more comprehensive understanding of the impact of participation in health programs.

• 한국노년학
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• v.36 no.3
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• pp.611-632
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• 2016

Solutions for elderly health issues need to be found that take into account not only a medical perspective, but also interactions with social conditions such as socioeconomic status. With this in mind, this study aims to understand how socioeconomic status leads to health inequalities for the elderly. Specifically, this study investigates the mediating effects of socioeconomic status(income and education levels), health activities as an intermediary of the three dimensions of physical health(medical health, functional health, subjective health), accessibility of medical facilities, social participation, and social network. To test the research model, a secondary data analysis was conducted on the 2014 National Survey of Senior Citizens. The participants of the study were 10,451 elderly men and women aged 65 and above. To test the mediated model, hierarchical multiple regression analysis was conducted following the procedures suggested by Baron and Kenny(1986). In addition, a Sobel test was conducted to test the mediated model's significance. According to the analysis, the effects of income and educational levels on the health of the elderly were not the same. Additionally, different results were found depending on health dimensions. However, the overall direction of the results showed that the socioeconomic status of the elderly creates health disparities, and health behaviors, accessibility of medical facilities, social participation, and social network had significant mediation effects between socioeconomic status and physical health. Study findings especially worth noting are as follows: education was shown to have a stronger effect on health than income; effects of social integration factors such as social participation were highlighted; and significant mediating effects on the accessibility of medical facilities remained even after taking residential area into account. Results of this study shed light on health inequality mechanisms due to socioeconomic conditions and the need to find alternatives to alleviate these problems.

• 한국노년학
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• v.34 no.2
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• pp.349-367
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• 2014

The purpose of this study is to investigate the relationships between socio-economic position(SEP), environmental exposures, and health of older people in Korea. This study used the data from 'Environmental Exposures and Their Health Effect in Korean Elderly Population'. The sample includes a total of 563 elderly people who were 60 years of age or older. Data on SEP, environmental exposure, and health impact were collected and analyzed using descriptive statistics and multivariate regressions. As a result, study participants' SEP including age, family type, monthly expenditure, type of house, and region was significantly associated with environmental exposure. Also, while adjusting for SEP, environmental exposure such as allowing indoor smoking was associated with self-rated health and depression of study participants. The study findings showed inequality in environmental exposure and health outcomes by SEP in Korean elderly. Environmental exposure was associated with health outcome even after adjusting SEP, and this implied that environmental exposure could be a critical factor in explaining heath inequality by SEP. Further studies are necessary to better understand the causal relationships among SEP, environmental exposure, and health outcomes.

• Journal of dental hygiene science
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• v.23 no.3
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• pp.185-192
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• 2023

Background: The establishment of a strategy for the reduction and prevention of oral disease, a global pervasive disease, is considered one of the important national health policy strategies. In Korea, the 5th Comprehensive National Health Promotion Plan is currently in progress, but there is insufficient research on the transition process or improvement direction in the field of oral health. Methods: Changes in Comprehensive National Health Promotion Plan's Oral health sector in three countries were compared, and the direction of the three countries (Korea, the United States, and Canada) in accordance with the recent Oral health paradigm was confirmed. In this study, we reviewed the existing literature using the narrative review method to draw implications for strategies and directions for oral health promotion in Korea. Results: In Korea, the oral health promotion strategy is included in the 5th Comprehensive National Health Promotion Plan, and the project is being led by the government. The United States prepared a national-led oral health promotion strategy and suggested multi-disciplinary cooperation to improve overall oral health and reduce the oral health inequality. For more active intervention, Canada established an oral health-related department and assigned experts, while emphasizing cooperation between the government and the private sector. Conclusion: As a result of this study, Korea is also making efforts to improve oral health, but more active government intervention is needed to reduce the inequality in oral health by population group. To this end, it is necessary to establish a strong multi-sectoral cooperation system and prepare a strategy for implementation.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.1
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• pp.229-240
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• 2022

This article examines the link between regional disparity and social mobility in India. There has been a steady rise in economic inequality in India. The rapid economic growth coupled with a rise in income inequality is a serious concern in India. While the emphasis is on inclusive growth, it appears difficult to tackle the problem without looking at the intricacies of the problem. The Social Mobility Index is an important tool that focuses on bringing long-term equality by identifying priority policy areas in the country. We used a multivariate statistical approach to construct a social mobility index at the regional level by considering several social and economic variables. Our findings show that while the Union Territory of Delhi ranks first in the social mobility index, Chhattisgarh has the least social mobility. From a policy perspective, a comprehensive examination of the determinants of the social mobility index shows that health, education access, and quality, and equity of education are of great importance in improving social mobility. Considering India's potential economic growth resulting from its 'demographic dividend' and improved access, markets, and technology, increasing social mobility through facilitating equal opportunities in society is key to achieving inclusive growth.