• Health Policy and Management
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• v.30 no.3
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• pp.355-365
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• 2020

Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

• Health Policy and Management
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• v.32 no.1
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• pp.63-72
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• 2022

Background: Depression is a common disease around the world. Many studies are showing that mental health can be improved through physical activity, and daily regular exercise can reduce the negative effects of depression or depressive symptoms. In order to promote individual physical activity, a physical activity-friendly environment must precede. Therefore, this study attempted to confirm whether the number of sports facilities for all affects individual depression. Methods: Among the respondents to the 2018 Community Health Survey, data from 181,086 people excluding missing value were used. Descriptive and chi-square tests were performed to understanding the general characteristics of individual level variables. A multilevel logistic regression was conducted to confirm the effect of individual and regional level variables on depressive symptoms. Results: As a result of confirming the effect of individual characteristics on depressive symptoms, it was confirmed that both socioeconomic and health behavior factors had an effect. Similar results were shown in a model that considered regional level variables, and in the case of the number of sports facilities per population, people who belongs to smaller areas were more likely to have depressive symptoms (odds ratio, 0.98; 95% confidence interval, 0.97-0.99). Conclusion: As a result of the analysis, it was confirmed that both individual level and regional level variables had a significant effect on depressive symptoms. This suggests that not only individual level approaches but also regional level approaches are needed to improve individual depressive symptoms In particular, it may be possible to consider to increase the number of sports facilities in areas where the prevalence of depressive symptoms is high and the number of sports facilities is insufficient.

• Health Policy and Management
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• v.27 no.2
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• pp.177-185
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• 2017

Background: The mental problems of the elderly are at issue as a serious social phenomenon. The purpose of this study is to identify risk factors affecting the mood disorders of the elderly. Methods: The subjects were 1,779,236 aged ${\geq}65$ and participated in health screening. Dependent variable was mood disorders. Independent variables were consisted of community level (regional deprivation index and healthcare resources) and individual level (sex, age, insurance type, disability, smoking, alcohol, physical activity, body mass index, and healthcare utilization). Multilevel logistic regression was performed. Results: At the individual level, women, employed insured, severely disabled people, heavy alcohol drinkers, high-intensity physical activity, body mass index, and patients who had chronic disease and severe disease were significantly associated with mood disorders. As the age has increased, it has let increase of mood disorders. At the community level, as the regional deprivation index has increased by 1, mood disorders has been increased by 1.005 times. The intra-class coefficient was 7.04%. Conclusion: We found individual and community level factors are associated with mood disorders. Systematic approach is essential to reduce mood disorders.

• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Journal of the Korean association of regional geographers
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• v.19 no.4
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• pp.712-736
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• 2013

Since the 1990s, the international married couple, who were transnational migration has increased. therefore, there has been many studies on this approaches in the meanwhile, but enough analysis is not being done on the background of female marriage migrant and the adaptation of international marriage couples, because there is limits of the approach method. With the awareness of these issues, this study is about the analysis on the background and adaptation of them, based the data of surveys and in-depth interviews targeted international marriage couples in the area of Daegu and Gyeongbuk. The result of analysis survey on background of international migration was very high level about the recognition of the international marriage couple's global thinking, and analyzed this macro-background does not affect much about the international marriage couple's adaptation. However, this study were analyzed that the advance cognition degree to the other side, which are expected affect directly to the life and adaptation of all the couples is very low level.

• Health Policy and Management
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• v.27 no.4
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• pp.296-303
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• 2017

Background: This study purposed to analyze regional factors related to gastric cancer screening rate provided by national cancer screening program in Korea. Methods: The unit of analysis was administrative districts of si gun gu level. Dependent variable was regional gastric cancer screening rate provided by national cancer screening program, and regional variables were selected to represent the regional characteristics such as demographic, health behavior and status, socioeconomic, and health resource. Tobit regression was applied for the analysis. Results: Analysis results showed that gastric cancer screening rate was varied depending on regions from 47.8% to 69.1%. Tobit regression showed that gastric cancer screening rate had negative relationships with smoking rate, financial independence rate, and National Health Insurance premium per capita. And regional gastric cancer screening rate had positive relationships with sex ratio and number of gastric cancer screening center. Conclusion: Regional characteristics should be considered in establishing regional policies for increasing the gastric cancer screening rate.

• Health Policy and Management
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• v.30 no.1
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• pp.37-49
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• 2020

Background: Unmet healthcare needs have many advantages for measuring inequalities in healthcare use. However, the existing indicator is difficult to capture the reality of unmet healthcare needs sufficiently and is not quite appropriate in comparing regional inequality. The purpose of this study is to critically analyze the utilization of the unmet healthcare need indicator for regional healthcare inequalities research. Methods: We used the level of healthcare accessibility and healthcare need to categorize the regions that are known to cause differences in healthcare utilization between regions and verified how existing unmet healthcare need indicator is distributed at the regional level. Results: Four types of regions were classified according to the high and low levels of healthcare needs and accessibility. The hypothesis about the regional type expected to have the highest unmet healthcare need was not proved. The hypothesis about the lowest expected regional type was proved, but the difference in the average rate of unmet healthcare needs among regional types was not significant. The standard deviation of the rate of unmet healthcare needs among regions within the same type was also higher than the overall regional variation, which also disproved the whole frame of hypothesis. Conclusion: Failure to prove the hypothesis means the gap between the supposed meaning of the indicator and the reality. In order to understand the current state of healthcare utilization of people in various regions of Korea and to resolve inequality, fundamental research on the in-depth structure and mechanisms of healthcare utilization is needed.

• Health Policy and Management
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• v.24 no.2
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• pp.128-135
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• 2014

Background: With ageing and growing importance of disease management system, it is necessary to investigate the extent of regional difference in service utilization for chronic diseases among the elderly and to reflect it in designing the system. Methods: A multiple regression analysis and descriptive statistics analyses were employed using patient survey, which covers nationwide health facilities and their users. Results: While the differences in the rate of service utilization/utilization outside living area between urban and rural areas or between income levels are not large, considerable variations are observed within urban or rural areas and within income groups. Conclusion: This results suggest that it is important to subsidize economically disadvantaged segments of the population and residents of less-favored areas to be better-equipped for chronic disease management in order to prevent the development of severe ailments and the need for treatment at higher-level medical institutions. Improvements to the service infrastructure in vulnerable regions are essential.

• Architectural research
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• v.25 no.2
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• pp.19-27
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• 2023

London's BID, introduced in the early 2000s, has grown significantly to fill the gap between government services which have been decreased by the global recession and localism, and the demand for better services to strengthen competitiveness on a global level. Based on this background, this study comparatively analysed two BIDs in London with contrasting regional characteristics to find how BID works differently for the regeneration and sustainable development of regional business districts according to regional characteristics. As a result, the two BIDs ultimately had the goal of improving the local business environment and strengthening the competitiveness of local businesses and had a common point of working in close partnership with the public sector such as the local government. However, depending on the local situation and characteristics, it has been observed that there are differences in the strategies of work and the roles and relationships in the partnership with the public sector.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1913-1917
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• 2015

Background: Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region. Materials and Methods: The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods. Results: The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC. Conclusions: The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.