• 제목/요약/키워드: Population Health

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우리나라 신체활동 및 운동사업에서의 인구집단 전략 (Population Strategy for Physical Activity in Korea)

  • 이무식
    • 농촌의학ㆍ지역보건
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    • 제30권2호
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    • pp.227-240
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    • 2005
  • 현재 건강증진에 대한 다양한 논의가 진행 중으로 학자마다 정의가 다르고 동일한 학자도 문맥에 따라 다르게 사용하고 있는 경우가 많으며, 건강증진 내용의 스펙트럼이 행태변화만을 포함하는 가장 좁은 의미수준부터 지원체계, 질병예방, 건강보호 등을 포괄하는 가장 넓은 의미까지 다양하다. 건강증진의 개념을 어떤 것으로 받아들이든 정책, 개인 기술, 환경변화 등의 측면에서 지역사회(community)가 인간 집단을 포괄하고 있다는 점에서 건강증진의 가장 중요한 장이라는 것은 별로 이론이 없는 것 같다. 건강증진의 개념과 정의가 형성되어가는 시점에서 몇가지 주요한 논란점들이 있는데 그중에서도 건강증진의 접근전략에서 인구집단 전략과 고위험군 접근전략 간의 대립점이 가장 첨예한 논란중의 하나이다. 정부의 정책, 조직의 우선순위, 전문인의 행태 등이 각 개인의 노력과 같이 중요하거나 혹은 더 중요하다는 것이 이러한 입장이며, 건강과 행태에 영호t을 미칠 수 있는 사회체계와 환경에 대해 보다 큰 의사결정권을 가지는 것이 건강증진을 위해 중요하다고 주장한다. 이러한 이유로 건강증진을 논함에 있어 지역사회 전체를 통한 접근이 점점 더 강조하고 있다. 지역사회 건강증진 프로그램은 지역사회자원을 효율적 활용을 통한 보다 강화되고, 통합된, 포괄적, 협력적으로 수행되어져야한다. 이러한 방향은 1986년 오타와 헌장에의 건강증진의 정의에서 살펴볼 수 있으며, 광범위한 건강의 결정요인에 대한 접근이 필수적임을 알 수 있다. 신체활동은 건강의 주요한 결정요인이다. 인구집단 전략은 개인에 대한 신체활동 교육하는 것이 충분하지 않음을 제안한다. 개인 수준의 행태변화도 중요한 것이지만 이에 대한 집단적 변화를 불러줄 환경적 변화를 위한 전략과 균형을 이루어야 한다. 건강증진을 위한 신체활동 인구집단 전략은 사회적, 물리적 지지환경을 강화하고, 국가, 광역 및 기초자치 단체 수준에서 다양한 지역사회자원을 연계, 통합하여야 한다. 지속적인 공공교육 및 사회마케팅이 지역사회 신체활동 조직 및 기관, 산업장, 학교 등을 대상으로 지역사회 모든 주민들이 신체활동에 대한 관심을 증진시킬 수 있도록 협동적으로 이루어져야 한다. 정부와 기관 및 시민들은 지역사회차원의 운동개념으로 주최하고 참여하여 사회적 규범화 작업에 동참하여야한다. 기본적으로 적절하고 충분한 재원의 지원, 인적자원의 개발, 정책 및 입법이 제공되어야한다. 또한 국내외적으로 연구개발과 지식의 공유 및 교환이 요구된다. 한국에서는 전략적 우선순위가 높은 신체활동 프로그램의 범주를 지역 보건소를 기반으로 한 환경적 지원, 생애주기별 접근, 고위험군 및 질환군 접근 등으로 구분하였다. 지역사회에 기반한 신체활동 핵심 프로그램으로 하부구조 구축, 지원적 환경 제공, 지역사회 캠페인, 건강증진 교육 및 홍보, 노인 및 비만인을 위한 신체활동 프로그램, 그리고 운동처방 프로그램 등을 포함하였다. 신체활동증진 및 운동사업은 사회적, 물리적 지원환경 조성 등을 중심으로 전개하며, 보건소를 중심으로 한 운동사업은 지역 공공기관 및 민간기관 등과 연계하여 프로그램을 연동하며, 홍보 및 교육은 지역의 운동단체 및 기관, 각급 학교 등과 협력하여 운동에 대한 관심을 고취하고 신체활동 및 운동을 생활화하는 프로그램을 시행토록 한 전략을 지속, 강화토록 하여야 할 것이다.

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비만이 의료비와 의료이용에 미친 영향 분석 (The Effect of Obesity on Medical Costs and Health Service Uses)

  • 김다양;곽진미;최소영;이광수
    • 보건의료산업학회지
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    • 제11권3호
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    • pp.65-78
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    • 2017
  • Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

Medical Expenditure of National Health Insurance Attributable to Smoking among the Korean Population

  • Lee, Sang-Yi;Jee, Sun-Ha;Yun, Ji-Eun;Kim, Su-Young;Lee, Ja-Kyung;Samet, Jonathan M.;Kim, Il-Soon
    • Journal of Preventive Medicine and Public Health
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    • 제40권3호
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    • pp.227-232
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    • 2007
  • Objectives : The purpose of this study was to determine the population-attributable risk (PAR) and estimate the total medical expenditure of the Korean National Health Insurance (KNHI) due to smoking. Methods : We used data from the Korean Cancer Prevention Study of 1,178,138 Koreans aged 30 to 95. These data were available from 1992 to 2003 and covered a long-term follow-up period among the Korean population. Results : The total medical expenditure of KNHI related to smoking increased by 27% from $324.9 million in 1999 to $413.7 million in 2003. By specific diseases, smoking-attributable KNHI medical expenditure was the highest for lung cancer ($74.2 million), followed by stroke ($65.3 million), COPD ($50.1 million), CHO ($49 million) and stomach cancer ($30 million). A total of 1.3 million KNHI patients were suffering from smoking-related diseases in 2003. We predicted rises in total KNHI medical expenditure related to smoking to $675.1 million (63% increase compared with that of 2003) and in the total number of KNHI patients suffering from smoking-related diseases to about 2.6million (an approximate 100% increase compared with those in 2003) in 2015. Conclusions : We found a substantial economic burden related to the high smoking prevalence in South Korea.

군인과 일반인에서의 우울감과 구강건강관련 삶의 질 비교분석 (Comparison of depression and oral health-related quality of life between the military personnel and public)

  • 김명희;황영선;김태미;백설화;이주현;이경애
    • 대한치과의료관리학회지
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    • 제7권1호
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    • pp.29-38
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    • 2019
  • The goals of this study were to investigate depression and oral health-related quality of life in the military and public and to identify the factors affecting depression. The respondents were 278 soldiers and 228 general people of similar ages. An independent t-test was used to examine the differences between the two groups in the oral health impact profile and Self-rating Depression Scale. A multivariate logistic regression analysis was performed to examine the factors associated with depression in soldiers and the public. The depression level was significantly higher in the general population than in the military personnel (p<0.001). In contrast, the oral health-related quality of life was better in the general population than in the military, but without a statistical significance (p=0.056). Among soldiers, the military rank was the only factor associated with depression, showing a gradient based on the rank. In the general population, the type of work displayed significant associations with depression. As there are some limitations to investigating the factors affecting depression, comparative analyses of the general population groups with similar soldier groups are rare. This study encourages future investigations of the advancements in mental health and improvement programs for oral health in each group.

인구변동 추이와 전망 -2000년대를 향한 국가장기발전 구상을 중심으로- (Trend of Population Change and Future Population in Korea - Korean Future in Year 2000; Long Term National Development -)

  • 고갑석
    • 한국인구학
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    • 제8권1호
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    • pp.87-117
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    • 1985
  • In Principle, the distriction should be understood between projections and forecasts. When the author or user of a projection is willing to describe it as indicating the most likely population at a give date, then he has made a forecast Population change since 1 960 has been reviewed briefly in order to forecast the population of Korea in the year 2,000 which is a leading factor in long term national development plan for which Korea Institute for Population and Health (KIPH) has been participated since 1983. The author of this paper introduced the population forecast prepared for the long term national development plan and an attempt of comparisons with other forecasts such as D.P. Smith's, T. Frejka's, Economic Planning Board's (EPB), UN's and S.B. Lee's was made. Those six forecasts of Korean future population in year 2,000 varried from 48.5 million to 50.0 million due to the base population and assumption of fertility and mortality however the range of total population size is not large enough. Taking four forecasts such as KIPH, EPB, UN, and Lee based on 1980 population census results and latest data of fertility and mortality, KIPH and UN forecast are close in total population size even though there was a slight difference in fertility and mortality assumptions. The smallest size of total population was shown by S.B. Lee (see Table 13) although the difference between KIPH and Lee was approximately one million which is two percent of total population in year 2,000. As a summary of conclusion the author pointed out that one can take anyone of forecasts prepared by different body because size and proportion wise of the Korean population until early I 990s can not be different much and new population projections must be provided by using 1985 population census data and other latest fertility and mortality information coflected by Korea Institute for Population and Health and Economic Planning Board in forth comming year.

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Association of mir-499 and mir-149 Polymorphisms with Cancer Risk in the Chinese Population: Evidence from Published Studies

  • Zhang, You-Gai;Shi, Jian-Xiang;Song, Chun-Hua;Wang, Peng;Dai, Li-Ping;Zhang, Jian-Ying;Shi, Jia-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2337-2342
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    • 2013
  • Meta-analyses have shown that microRNA polymorphisms have variable effects in different population. Yet, no meta-analysis investigated the association of two common polymorphisms of miRNA, mir-499 rs3746444 polymorphism and mir-149 rs2292832 polymorphism, with cancer risk in the Chinese population. We searched the PubMed, Web of Knowledge, MEDLINE, CNKI databases, as well as Cochrane library, updated on December 31, 2012 for assays regarding cancer risk association with these two common polymorphisms in the present meta-analysis. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to explore the strength of associations. The results showed that rs3746444 polymorphism was associated with increased cancer risk (dominant model: GG/AG vs. AA: OR = 1.43, 95% CI: 1.14-1.80; recessive model: GG vs. AG/AA: OR = 1.54, 95% CI: 1.04-2.30; homozygote model: GG vs. AA: OR = 1.69, 95% CI: 1.10-2.60; heterozygote model: AG vs. AA: OR = 1. 35, 95% CI: 1.09-1.67), and rs3746444 was associated with liver cancer in the subgroup of cancer types. For the rs2292832 polymorphism, the results showed no significant risk association in both overall pooled analysis and subgroup of cancer types, smoking status, gender and tea drinking status in the Chinese population. This meta-analysis suggested that the rs3746444 GG genotype is associated with increased cancer risk, especially liver cancer, while the rs2292832 polymorphism showed no association with cancer risk in Chinese.

역학과 사회역학 (Epidemiology and Social Epidemiology)

  • 송윤미
    • Journal of Preventive Medicine and Public Health
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    • 제38권3호
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    • pp.237-240
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    • 2005
  • Social epidemiology is a sub-discipline of epidemiology explicitly investigating social determinants of population distributions of health, disease, and well-being. Persistent pattern of social inequalities in health in spite of the broad improvement in the physical environment over the last centuries necessitated the development of this field as an approach to understand disease etiology that incorporates social experiences as more direct determinant of health. Social epidemiology incorporates theories, measurement tools, and techniques from a wide variety of other social sciences. A population perspective, the social context of behavior, contextual multilevel analysis, a developmental and life-course perspective, and general susceptibility to disease are the most important guiding concepts in social epidemiology.

임상가를 위한 특집3 - 노인 환자의 치과 치료시 고려 사항 (Considerations for the Dental Management of Older Adults)

  • 고홍섭
    • 대한치과의사협회지
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    • 제49권10호
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    • pp.609-617
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    • 2011
  • The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

COVID19 Innate Immunity through Natural Medicine in Palau

  • Christopher U. Kitalong;Tmong Udui;Terepkul Ngiraingas;Pearl Marumoto;Victor Yano
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2020년도 추계국제학술대회
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    • pp.15-15
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    • 2020
  • In an internal document, CORONA-VIRUS DISEASE 2019 (COVID-19) PLAN, release developed stated that "on January 22, 2020, Palau Ministry of Health activated its emergency operations center, and since then has prepared and put in place measures in response to this global pandemic." The actions eventually led to the closure of most flights coming into Palau as a method to protect its population. The population of is at high risk with COVID19 due to the very elevated rate of NCD's, as well as the limited access to proper testing and treatment facilities. Increased use of traditional medicines in the population has reduced the co-morbidities by reducing risk factors. Furthermore, the expansion of tradtional NCD therapies, especially that of DAK reduce pressure due to obesity and diabetes therefore allowing for unimpaired immune systems to combat deadly infectious diseases such as COVID19.

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Use of a Machine Learning Algorithm to Predict Individuals with Suicide Ideation in the General Population

  • Ryu, Seunghyong;Lee, Hyeongrae;Lee, Dong-Kyun;Park, Kyeongwoo
    • Psychiatry investigation
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    • 제15권11호
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    • pp.1030-1036
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    • 2018
  • Objective In this study, we aimed to develop a model predicting individuals with suicide ideation within a general population using a machine learning algorithm. Methods Among 35,116 individuals aged over 19 years from the Korea National Health & Nutrition Examination Survey, we selected 11,628 individuals via random down-sampling. This included 5,814 suicide ideators and the same number of non-suicide ideators. We randomly assigned the subjects to a training set (n=10,466) and a test set (n=1,162). In the training set, a random forest model was trained with 15 features selected with recursive feature elimination via 10-fold cross validation. Subsequently, the fitted model was used to predict suicide ideators in the test set and among the total of 35,116 subjects. All analyses were conducted in R. Results The prediction model achieved a good performance [area under receiver operating characteristic curve (AUC)=0.85] in the test set and predicted suicide ideators among the total samples with an accuracy of 0.821, sensitivity of 0.836, and specificity of 0.807. Conclusion This study shows the possibility that a machine learning approach can enable screening for suicide risk in the general population. Further work is warranted to increase the accuracy of prediction.