Objective : This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. Methods : A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Results : Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. Conclusions : The perceived economic hardships predicted the health status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.
Objectives: There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. Methods: This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. Results: Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. Conclusions: Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.
Kim, Chang-Seok;Yun, Sung-Cheol;Kim, Hye-Ryun;Khang, Young-Ho
Journal of Preventive Medicine and Public Health
/
v.39
no.1
/
pp.30-38
/
2006
Objectives: We examined whether the neighborhood socioeconomic position predicts the smoking rates after adjusting for individual socioeconomic position indicators. Methods: Data were obtained from the 2001 Seoul Health Indicators Survey. The neighborhood socioeconomic position was the residential distribution of the high class (power elites), as measured by the location quotients (LQ) for each administrative dong (district). A high LQ denotes a high neighborhood socioeconomic status. The individual socioeconomic position included education, occupation and income. Age-adjusted smoking rates according to the LQ level were computed with the direct method. The total number of subjects in this study (26,022 men and 28,007 women) was the reference. A multilevel logistic regression analysis was conducted with the individuals at the first level and the neighborhoods at the second level to estimate the odds ratios of smoking with 95% confidence intervals. Results: For men, the age-adjusted smoking rates increased with a decrease in the LQ. For women, the relationship between the age-adjusted smoking rate and the LQ was not clear. The odds of smoking for both genders were greater among those subjects with lower incomes and lower education. The manual occupational class had greater odds of smoking than the non-manual class for the males, while the odds ratio of smoking among females with a manual occupation tended to be lower than those females with a non-manual occupation. For the males, the LQ levels independently predicted smoking after adjustment for individual income. However, this relation between the LQ and smoking in males was explained by full adjustment for the individual socioeconomic position indicators (education, occupation and income). Conclusions: A low level of neighborhood socioeconomic position was associated with higher smoking rates among the men residing in Seoul. This association between the neighborhood socioeconomic position and smoking in men was explained by the individual socioeconomic position. Anti-smoking efforts to reduce geographical inequality in smoking should be directed at reducing the smoking rates between the individuals with different socioeconomic backgrounds in the metropolitan city of Seoul, South Korea.
Objectives: This study was to examine the independent and mediating effect of socioeconomic position and social relationship on depression. Methods: The study analyzed the data from the 2014 Korea Welfare Panel Study(n=9,172) using descriptive statistics, Kendall's rank correlation analysis, multiple regression analysis and the Sobel test. Results: Much of the connection between parental socioeconomic position and respondent depression was explained by respondent educational attainment in men but was not in women. A large portion of the association between educational attainment and depression was explained by type of household and satisfaction with social relationship among men. The effect of educational attainment on depression was fully mediated by type of household among women. The effect of type of household on depression was partly mediated by satisfaction with social relationship in men and women. Lastly, educational attainment, type of household and satisfaction with social relationship had an independent association with depression among men, but educational attainment was not statistically significant among women. Conclusions: Our study illuminated the importance of the independent and mediating effect of parental and respondent socioeconomic position and social relationship in the production of depression for South Korean adults.
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.
Objectives: It has been well documented that people on the lower socioeconomic position are significantly more likely to smoke cigarettes. The purposes of this study were (a) to identify a potential difference of socioeconomic factors, and (b) to compare a smoking rate, one of the most representative health behavior between people with/without disabilities after the controlling socioeconomic factors. Methods: The Korea Panel Survey of Employment for People of Disabilities (2012) and the Korea National Health and Nutrition Survey (2012) were employed for calculating the smoking rates of persons with/without disabilities. Results: The results demonstrated that the socioeconomic position indicators (education, occupation and household equivalent income) of persons with disabilities were lower than persons without disabilities. The smoking rates of the persons with/without disabilities were 35.9% and 19.0% respectively before propensity score matching. After propensity score matching with the socioeconomic factors, however, ATT of people with disabilities was 0.201 which is lower than ATT of people without disabilities (0.227). Conclusions: Our findings indicated that the socioeconomic level of persons with disabilities is important to improve the smoking rates and health level regardless of their disabilities.
In order to develop practical implications for depression among the elderly, this study examines socioeconomic and health-behavioral risk factors of geriatric depression diagnosis. Sample consists of 964 elders aged 65 and over, living in an urban community. Using the Short-form Geriatric Depression Scale(SGDS), study subjects were screened for geriatric depression to those who presented 10 points and over in SGDS. Descriptive statistics shows that about 22.2% elders are estimated to suffer from geriatric depression. Predictors of geriatric depression diagnosis were examined through logistic regression. Results show that elders who live with family, who have medical insurance, who have higher education, who don't smoke, and who do more physical activities were less likely to suffer from geriatric depression. These findings indicate that socioeconomic position such as health insurance, education and health behaviors such as smoking, physical activities are closely related to geriatric depression, suggesting that interventions on socioeconomic position and health behaviors may be effective to reduce depression among the elderly.
While health information-seeking behavior as an indicator of health communication of patients including cancer survivors has been researched, few studies have focused on how socioeconomic position and media use combine to influence health-related information seekers. This study examined social characteristics of health information-seeking behavior taking into account an individual's socioeconomic position and their media use in Korea, a developed country. The data for this study came from a survey of 1,010 respondents drawn from a nationally representative sample in the Republic of Korea. We conducted multivariate logistic regression analyses for gender-specific effects. We found that men who reported high household income were one and half times more likely to seek health information than those with low income status. We also found that women who performed Internet searches by computer at home were almost two times more likely to seek health information than those who did not. Similar results were found for men as well. Our analyses revealed that socioeconomic position and media use are associated with health information-seeking behavior by gender. Studies on information seekers may bring us more effective health promotion and relevant intervention for people with chronic conditions including cancer survivors.
This study examined the effect of parental socioeconomic position on the association between birth outcomes and infant mortality in early and late 2000's. Linked Birth and Infant Death data sets from 2001 to 2003 (T1) and from 2006 to 2008 (T2), provided by the Korea National Statistical Office, were used for analysis. Birth outcomes were categorized into four groups: normal term, small-for-gestational age (SGA), large-for-gestational age (LGA) and intrauterine growth retardation (IUGR). Infant death was defined as the death of a live-born child under one year of age; indicators of parental socioeconomic position were limited to parental education and occupation. The results showed that T2 infant mortality hazard ratios of SGA and IUGR have increased compared to T1. Particularly, preterm and low birth weight babies with shorter gestational age and lighter birth weight than T1 have elevated in T2, possibly indicating that population quality might be continuously aggravated. Moreover, the effect of maternal age on infant mortality has disappeared, rather that of parents' socioeconomic position has increased during the periods, which entailed growing disparities in infant mortality by their social class. Further studies should be therefore done to estimate the effect of parental socioeconomic position on the relationship between birth outcomes and infant mortality in the near future.
Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.
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