Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지

Differential Effects of Family Income on Self-rated Health by Age: Analysis of Seoul Citizens Health Indicators Survey 2001, 2005

소득수준이 주관적 건강상태에 미치는 영향의 연령대별 차이: 2001, 2005년 서울시민보건지표조사 자료의 분석 결과

  • Jung, Youn (School of Public Health, Seoul National University) ;
  • Oh, Ju-Hwan (School of Public Health, Seoul National University) ;
  • Cho, Young-Tae (School of Public Health, Seoul National University)
  • 정연 (서울대학교 보건대학원) ;
  • 오주환 (서울대학교 보건대학원) ;
  • 조영태 (서울대학교 보건대학원)
  • Published : 2007.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. Methods: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). Results: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. Conclusions: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.

Keywords

References

  1. Gruenberg EM. The failure of success. Milbank Memo Fund Q 1977; 55(1): 3-24 https://doi.org/10.2307/3349592
  2. Manton KG. Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q 1982; 60(2): 183-244 https://doi.org/10.2307/3349767
  3. Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med 1980; 303(3): 130-135 https://doi.org/10.1056/NEJM198007173030304
  4. House JS, Lepkowski JM, Kinney AM, Mero RP, Kessler RC, Herzog AR. The social stratification of aging and health. J Health Soc Behav 1994; 35(3): 213-234 https://doi.org/10.2307/2137277
  5. House JS, Lantz PM, Herd P. Continuity and change in the social stratification of aging and health over the life course: Evidence from a nationally representative longitudinal study from 1986 to 2001/2002. J Gerontol B Psycol Sci Soc Sci 2005; 60 (Spec No 2): 15-26 https://doi.org/10.1093/geronb/60.Special_Issue_2.S15
  6. Miech RA, Shanahan MJ. Socioeconomic status and depression over the life course. J Health Soc Behav 2000; 41(2): 162-175 https://doi.org/10.2307/2676303
  7. Lynch SM. Cohort and life-course patterns in the relationship between education and health : A hierarchical approach. Demography 2003; 40(2): 309-331 https://doi.org/10.1353/dem.2003.0016
  8. Kim HR, Khang YH, Yoon KG, Kim CS. Socioeconomic Health Inequalities and Counter Policies in Korea. Korea Institute for Health and Social Affairs; 2004. p. 137-256 (Korean)
  9. Kim HR. The relationship of socioeconomic position and health behaviors with morbidity in Seoul, Korea. Health Social Affair 2005; 25(2): 1-35 (Korean)
  10. Khang YH, Lynch JW, Yun SC, Lee SI. Trends in socioeconomic health inequalities in Korea: Use of mortality and morbidity measure. J Epidemiol Community Health 2004; 58(4): 308-314 https://doi.org/10.1136/jech.2003.012989
  11. Yoon TH, Moon OR, Lee SY, Jeong BG, Lee SJ, Kim NS, Jhang WK. Differences in health behaviors among the social strata in Korea. Koreans J Prev Med 2000; 33(4): 469-476 (Korean)
  12. Son M. The relationship of social class and health behaviors with morbidity in Korea. Koreans J Prev Med 2002; 35(1): 57-64 (Korean)
  13. Lee MS. Health inequalities among Korean adults. Korean Sociol 2005; 39(6): 183-209 (Korean)
  14. Lee SG. Social contextual effects on regional mortality and self-rated health status [dissertation]. Korea: Yonsei Univ; 2002 (Korean)
  15. Cho HJ, Khang YH, Yun SC. Occupational differences in cigarette smoking in South Korea: Findings from the 2003 Social Statistics Survey. J Prev Med Public Health 2006; 39(4): 365-370 (Korean)
  16. Khang YH, Kim HR. Socioeconomic mortality inequality in Korea: Mortality follow-up of the 1998 National Health and Nutrition Examination Survey(NHANES) data. J Prev Med Public Health 2006; 39(2): 115-122 (Korean)
  17. Khang YH, Yun SC, Hwang IA, Lee SM, Lee SI, Jo MW, Lee MJ. Changes in mortality inequality in relation to the South Korean economic crisis: Use of area-based socioeconomic position. J Prev Med Public Health 2005; 38(3): 359-365 (Korean)
  18. Khang YH, Lynch JW and Kaplan GA. Health inequalities in Korea: Age- and sex-specific educational differences in the 10 leading causes of death. Int J Epidemiol 2004; 33(2): 299-308 https://doi.org/10.1093/ije/dyg244
  19. Khang YH, Cho HJ. Socioeconomic inequality in cigarette smoking: Trends by gender, age, and socioeconomic position in South Korea, 1989-2003. Prev Med 2006; 42(6): 415-422 https://doi.org/10.1016/j.ypmed.2006.02.010
  20. Khang YH, Khang MA, Kim MH, Shin YJ, Yoo YS, Yoon TH, Jang SR, Jung BG, Jung KH, Cho SI, Cho HJ, Choi YE, Choi YJ. Developing Indicators of Equity in Health and Monitoring Magnitude of Socioeocnomic Inequality in Health. University of Ulsan College of Medicine, Management Center for Health Promotion; 2006, p. 69-78 (Korean)
  21. Harper S, Lynch J. Methods for Measuring Cancer Disparities: Using Data Relevant to Healthy People 2010 Cancer-Related Objectives. NCI Cancer Surveillance Monograph Series, Number 6. Bethesda: National Cancer Institute; 2005. p. 36-41
  22. Sergeant JC. Relative index of inequality: Definition, estimation and inference. Biostatistics 2005; 7(2): 213-224 https://doi.org/10.1093/biostatistics/kxj002
  23. Hayes LJ, Berry G. Sampling variability of the Kunst-Mackenbach relative index of inequality. J Epidemid Community Health 2002; 56(10): 762-765 https://doi.org/10.1136/jech.56.10.762
  24. Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grotvedt L, Helmert U, Lahelma E, Lundberg O, Matheson J, Mielck A, Mizrahi A, Rasmussen NK, Regidor E, Spuhler T, Mackenbach JP. Differences in self reported morbidity by educational level: A comparison of 11 western European countries. J Epidemiol Community Health 1998; 52(4); 219-227 https://doi.org/10.1136/jech.52.4.219
  25. Kunst AE, Bos V, Lahelma E, Bartley M, Lissau I, Regidor E, Mielck A, Cardano M, Dalstra JA, Geurts JJ, Helmert U, Leunartsson C, Ramm J, Spadea T, Stronegger WJ Mackenbach JP. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int J Epidemiol 2005; 34(2): 295-305 https://doi.org/10.1093/ije/dyh342
  26. Mackenbach JP, Martikainen P, Looman CW, Dalstra JA, Kunst AE, Lahelma E; SEdHA working group. The shape of the relationship between income and self-assessed health: An international study. Int J Epidemiol 2005; 34(2): 286-293 https://doi.org/10.1093/ije/dyh338
  27. Becket M. Converging health inequalities in later life-an artifact of mortality selection? J Health Soc Behav 2000; 41 (1): 106-119 https://doi.org/10.2307/2676363
  28. Yeo YJ, Kim TW. The trends of inequality and policy implications in Korea. Health Social Affair 2006; 26(1): 95-134 (Korean)
  29. Macintyre S. The Black Report and beyond: What are the issues? Soc Sci Med 1997; 44(6): 723-745 https://doi.org/10.1016/S0277-9536(96)00183-9
  30. Ministry of Health and Welfare, Korea Institute for Health and Social Affairs. Health Plan 2010. Ministry of Health and Welfare, 2005. p. 28- 31 (Korean)