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Comparison of chronic disease risk by dietary carbohydrate energy ratio in Korean elderly: Using the 2007-2009 Korea National Health and Nutrition Examination Survey (한국 노인 식사의 탄수화물 에너지비에 따른 만성질환 위험성 비교: 2007~2009년 국민건강영양조사 자료 이용)

  • Park, Min Seon;Suh, Yoon Suk;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.47 no.4
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    • pp.247-257
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    • 2014
  • Purpose: It is reported that most senior people consume a high carbohydrate diet, while a high carbohydrate diet could contribute to the risk of chronic disease. The aim of this study is to determine whether a high carbohydrate diet can increase the risk of chronic disease in elderly Koreans. Methods: Using the 2007-2009 Korean National Health Nutrition Examination Survey data, out of a total of 3,917 individuals aged 65 and above, final 1,535 subjects were analyzed, divided by dietary carbohydrate energy ratio into two groups of moderate carbohydrate ratio (MCR, 55-70%) and excessive carbohydrate ratio (ECR, > 70%). All data were processed after the application of weighted value, using a general linear model or logistic regression. Results: Eighty one percent of elderly Koreans consumed diets with carbohydrate energy ratio above 70%. The ECR group included more female subjects, rural residents, lower income, and lower education level. The ECR group showed lower waist circumference, lower diastolic blood pressure, and lower frequency of consumption of meat and egg, milk, and alcohol. The intake of energy and most nutrients, with the exception of fiber, potassium, vitamin A, and carotene, was lower in the ECR group compared to the MCR group. When analyzed by gender, the ECR group showed lower risk of dyslipidemia in male and obesity in female subjects, even though the ECR group showed low intake of some nutrients. No difference in the risk of hypertension, diabetes, and anemia was observed between the two groups in male or female subjects. Conclusion: This result suggested that a high carbohydrate diet would not be a cause to increase the risk of chronic disease in the elderly. Further study is needed in order to determine an appropriate carbohydrate energy ratio for elderly Koreans to reduce the risk of chronic disease.

Associations of Metabolic Syndrome with Glaucoma in Korean - Based on the Korean National Health and Nutrition Examination Survey 2005, 2007-9, 2010 (한국인의 대사증후군과 녹내장 간의 상관관계 -2005, 2007-9, 2010국민건강영양조사 이용)

  • Park, Sang Shin;Kim, Taehun;Pak, Yun-Suk;Lee, Sang-Yoon;Lee, Hae Jung;Lee, Eun-Hee
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.2
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    • pp.241-247
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    • 2012
  • Purpose: This study was conducted to assess the association of metabolic syndrome and its components with glaucoma. Methods: We investigated the associations of metabolic syndrome and its components (abdominal obesity, impaired fasting glucose, high blood pressure, and dyslipidemia) with glaucoma using data from 19,162 adults aged 40 or above among the Korean National Health and Nutrition Examination Survey III (2005), IV (2007-9), V (2010). The logistic regression analysis was used for assessing those associations after adjusting demographic, lifestyle, and social economic status and for assessing the association of metabolic medication intakes with glaucoma risks. Results: After adjusting for age and sex, the risk of glaucoma was significantly higher in the subjects with impaired fasting glucose(Odds Ratio (95% confidence interval): 1.78 (1.25, 2.53)) and metabolic syndrome (1.45 (1.01, 2.08)) than subjects without those. These associations increased when additional adjusting for smoking, alcohol use, regular physical activity, income, education status(impaired fasting glucose: 1.89 (1.29, 2.77), metabolic syndrome: 1.52 (1.03, 2.25)). Glaucoma prevalence was borderline significantly increased according to the number of metabolic abnormalities(age and sex adjusted p for trend = 0.055). Use of antihypertensive medication was significantly associated with the risk of glaucoma. Conclusions: Metabolic syndrome and impaired fasting glucose were significantly associated with the increased glaucoma risk. Use of antihypertensive medication was also significantly associated with the increased glaucoma risk.

Clinical Significance of Tumor Markers in Gastric Cancer Patients after Curative Resection (근치적 절제술을 시행한 위암 환자에서 종양 표지자의 임상적 의미)

  • Kim, Sa-Young;Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.136-142
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    • 2009
  • Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.

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Effect of Phenolic Extract of Dry Leaves of Lespedeza cuneata G. Don on Antioxidant Capacity and Tyrosinase Inhibition (야관문 잎 페놀 추출물의 항산화능 및 미백 효과)

  • Cho, Eun-Jung;Ju, Hyun-Mi;Jeong, Chang-Ho;Eom, Seok-Hyun;Heo, Ho-Jin;Kim, Dae-Ok
    • Horticultural Science & Technology
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    • v.29 no.4
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    • pp.358-365
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    • 2011
  • Lespedeza cuneata G. Don is a plant commonly grown in Asian countries, which has been widely used as an oriental medicinal herb to treat diabetes, diarrhea and various other inflammatory diseases. The phenolics of dry leaves of L. cuneata G. Don were extracted by using 80% (v/v) aqueous methanol in assistance with homogenization and sonification. The phenolic extract and its five different fractions (n-hexane, chloroform, ethyl acetate, n-butanol, and water) were used to evaluate the levels of total phenolics, total flavonoids, and antioxidant capacity as well as the inhibitory effect of tyrosinase activity. Ethyl acetate fraction (1 g) had the highest levels of total phenolics at 240.8 mg gallic acid equivalents (GAE), total flavonoids as 90.4 mg catechin equivalents (CE) as well as antioxidant capacity at 523.4 mg vitamin C equivalents (VCE) on ABTS assay and 329.5 mg VCE on DPPH assay among fractions. One g of water fraction contained total phenolics at 133.1 mg GAE, total flavonoids at 34.5 mg CE, and antioxidant capacity at 333.4 mg VCE for ABTS assay and 313.2 mg VCE for DPPH assay. Inhibition of tyrosinase activity of water fraction at 300 ${\mu}g{\cdot}mL^{-1}$ was at 47.2% and 21.1% for L-tyrosine and L-DOPA as its substrate, respectively. On the other hand, ethyl acetate fraction at 300 ${\mu}g{\cdot}mL^{-1}$ showed tyrosinase inhibition of 10.2% for L-tyrosine and 11.9% for L-DOPA. These results suggested that the phenolics from dry leaves of L. cuneata G. Don may be utilized as a potent source of antioxidants and skin whitening agents.

The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

The Study on the Contents and Satisfaction of Oriental Medicine Examination Program (한방건강검진 프로그램의 내용과 참가자들의 만족도에 관한 연구)

  • Lee Eun-Kyoung;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.51-95
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    • 2002
  • 1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

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The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine - (30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 -)

  • Yoon, Jinwon;Choi, Sungyong;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.1
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

Prevalence and Related Factors of Knee Osteoarthritis in Rural Women (농촌여성의 무릎 골관절염 유병률 및 관련요인)

  • Seo, Joong-Hwan;Kang, Pock-Soo;Lee, Kyeong-Soo;Yun, Sung-Ho;Hwang, Tae-Yoon;Park, Jong-Seo
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.167-182
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    • 2005
  • Objectives: This study was performed to investigate the prevalence of knee osteoarthritis according to the criteria of diagnosing knee osteoarthritis in rural women and the factors related with this disease. Methods: The data obtained from 200 women older than 40 years of age residing in 5 Ri's in Goryeong-gun. Gyeongsanbuk-do by random cluster sampling from September to October 2002. Knee osteoarthritis was determined positive according to the Kellgren and Lawrence classification and knee pain. Results: Among these subjects, 71.0% showed more than grade 2 in radiologic finding and the rate of knee pain according to the survey was 67.0%. The rate of subjects meeting the criteria of knee osteoarthritis was 54.0%. According to univariate analysis, the prevalence of knee osteoarthritis increased with age and those farming people and people working in household industry was significantly high at 58.9% compared with others. The prevalence of knee osteoarthritis showed a significant relationship with the family history and past history of knee injury and knee surgery(p<0.01), and diabetes mellitus(p<0.05). The score of ADL was significantly different in the subjects with knee osteoarthritis compared with normal group(p<0.05). When the presence of knee osteoarthritis and the period of the life style of seating down on the floor were compared, a significant difference was present between the osteoarthritis group and normal group. As for metabolic factors, the blood sugar level, bone density, and body mass index(BMI) were significantly different in the osteoarthritis group compared with normal group. When multiple logistic regression analysis was performed with the presence of knee osteoarthritis as the dependent variable, the prevalence of knee osteoarthritis was significantly affected by older age, subjects farming or working in household industry, the history of knee injury, the history of surgery, higher blood sugar level, and higher BMI. Conclusions: These subjects need an intervention through self-care programs such as exercise for preventing osteoarthritis, weight control programs, other exercise programs strengthening knee joints, and guidelines when working in vinyl houses.

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The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Comparisons of Health Status and Health Behaviors among the Elderly between Urban and Rural Areas (도시와 농촌지역 노인의 건강행태 및 건강수준 비교)

  • Chun, Jong-Duk;Ryu, So Yeon;Han, Mi Ah;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.38 no.3
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    • pp.182-194
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    • 2013
  • Objectives: To identify and compare the health behaviors and health status of the elderly between urban and rural areas using the data of the Korean National Health and Nutrition Examination Survey (KNHANES). Methods: The study population comprised 3,823 elderly people aged 65 years or older who participated in the $4^{th}$ KNHANES (2007-2009). The areas were classified into "large cities," "cities," and "rural areas" using the administrative and residential areas. The health behaviors and health status of the elderly between the rural and urban areas were compared using a complex sample design with the Rao-Scott chi-square test and weighted multiple logistic regression analysis. Results: Compared to large cities, the odds ratios (ORs) (95% confidence interval [CI]) of rural areas were as high as 1.58 (1.25-2.01) for the influenza vaccination and as low as 0.47 (0.37-0.59) for flexibility exercises, 0.56 (0.38-0.81) for muscular exercises, and 0.76 (0.62-0.92) for obesity. The ORs (CI) for osteoarthritis and diabetes mellitus were as low as 0.81 (0.66-0.99) and 0.70 (0.55-0.89), respectively. Conclusions: The health behaviors and health status of the elderly are better in rural areas than in urban areas despite the fact that the socioeconomic conditions in rural areas are poorer that those in urban areas. These findings suggest that programs suitable for residential areas should be developed and that studies to explain the differences in residential areas are needed.