• Health Policy and Management
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• v.31 no.1
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• pp.114-124
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• 2021

Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivation on the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients. Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954 patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patients into six groups according to individual income level and neighborhood deprivation: 'high in advantaged,' 'high in disadvantaged,' 'middle in advantaged,' 'middle in disadvantaged,' 'low in advantaged,' and 'low in disadvantaged.' We calculated hazard ratios (HR) of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the reference group as diabetes patients with high income in advantaged regions. Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same low individual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset of diabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00-1.08) compared to the 'low in disadvantaged' group (HR, 1.10; 95% CI, 1.05-1.16). In addition, the 'high in advantaged' group showed slightly higher HRs for the onset of diabetes complication (HR, 1.06; 95% CI, 1.00-1.11) compared to the 'low in advantaged' and it appeared to be associated with slight mitigation of the risk of diabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-related hospitalization (HR, 1.29; 95% CI, 1.19-1.41) compared to the other groups. Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effects individual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.

• Journal of the Korean Regional Science Association
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• v.36 no.3
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• pp.3-16
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• 2020

The causes and effects of intra-urban spatial inequality have received much scholarly attention. However, the effects of urban spatial inequality on resident perceptions and the mechanisms through which it is sustained and reproduced remain mostly unknown. This study aimed to investigate whether regional deprivation, the relative socioeconomic standing of a region, affects the residents' perceptions of upward social mobility. By employing the ordinal logistic multilevel model to analyze nested data collected from Seoul, South Korea, this study found that the regional deprivation has a significant negative effect on residents' perception of upward social mobility. The results of this study suggest that one way in which spatial inequality is sustained and reproduced is by the effects of regional deprivation, having negative impacts on the aspirations and socioeconomic activities of residents. This study is expected to provide meaningful implications for planning and policy aimed to combat spatial inequality.

• Journal of Preventive Medicine and Public Health
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• v.42 no.6
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• pp.392-402
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• 2009

Objectives : The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). Methods : The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. Results : The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. Conclusions : The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

• The Journal of Asian Finance, Economics and Business
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• v.8 no.3
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• pp.821-832
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• 2021

Economic deprivation of households remains a significant economic issue in the world. Researchers have shown great concern in identifying crucial factors to enhance poor households' socio-economic performance. Therefore, this paper aims to develop a new conceptual framework to investigate the influence of different microfinance services on households' socioeconomic performance using moderated mediation analysis of various crucial factors. Focus-group interviews with managements of the microfinance institution, i.e. Amanah Ikhtiar Malaysia (AIM), and a systematic literature review were conducted for this purpose, and a new framework for the future study has been developed. The result from focus-group interviews and systematic literature review propose microfinance financial services, training programs, and business coaching as independent factors, whereas household socioeconomic performance as a dependent factor in the proposed model. Specifically, this study provides the direction to scholars to empirically test the direct relationship between financial services and household socioeconomic performance and the indirect relationship between training programs, business coaching, and household socioeconomic performance. Further, microfinance institutions' service efficiency is also included as a moderator that can strengthen microfinance services' effectiveness. The study also provides useful implications for policymakers, financial institutions, households, micro-enterprises, and researchers to better understand microfinance interventions and household economic mechanisms.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.100-126
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• 2017

Objectives: The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity. Methods: Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence. Results: Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men. Conclusions: This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.

• Journal of the Korean Data and Information Science Society
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• v.28 no.6
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• pp.1257-1260
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• 2017

Single-person households recently have been rapidly increasing and one reason may be the increment in elderly single-person. Since the change of living patterns is relevant to the government policy direction, it is important to understand how single-person households are clustered and which factors have influence on them. In this study, we tried to detect spatial clusters of single-person households and low-income elderly single-person households after adjusting for deprivation index. A recently developed fused lasso for Poisson data was used for data analysis and we provided the details on how to use it in R. From these analysis results, we observed the effect of socioeconomic level on the clusters and explained the reason why spatial clusters are shown after adjusting for deprivation index.

• Journal of dental hygiene science
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• v.17 no.4
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• pp.375-381
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• 2017

The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.

• The Journal of Korean Society for School & Community Health Education
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• v.20 no.1
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• pp.69-84
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• 2019

Objectives: The purpose of this study is to examine change in adolescent depression across time and to determine the relation between individual and neighborhood socioeconomic status (SES) and depression. Methods: This study employed multilevel latent growth analysis using longitudinal data from Korea Children and Youth Panel Survey. A sample of this study consists of 2,351 adolescents who were in first grade of middle school in 2010. Results: Results showed that both initial level and downward trajectory of depression varied significantly across individuals as well as across neighborhoods. On the individual level, self-rated economic condition(b=-0.203, p<.001) was related to the initial level of depression. Adolescents whose father had a high educational level(b=0.028, p<.001) or whose mother had a low educational level(b=-0.022, p=.011) had lower rates of decline in adolescent depression. On the neighborhood level, neighborhood deprivation index (b=0.003, p=.019) and gini coefficient(b=0.124, p=.040) were associated with lower rates of decline in depression. Conclusions: Low SES in adolescence is correlated with worse mental health, especially depression. Social disparities in depression likely originate before adulthood. The findings argue for the importance of understanding depression in adolescence from a multilevel or ecological framework.

• Journal of Nutrition and Health
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• v.26 no.5
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• pp.593-602
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• 1993

As part of the Nutrition CRSP Mexico project conducted in rural villages in highland Mexico, this study examined whether nutritional factors, family characteristics, and the duration of schooling were associated with cognitive performances in 107 schoolers(53 boys and 54 girls) aged 8~10. Food intake was measured by recall, direct observation and weighment twice monthly over the course of a year. Families were characterized in terms of socioeconomic status and parental cognitive performance, education and aspiration. Dietary quality, but not energy intake, and anthropometry (wt-for-age, ht-for-age, head circumference) were significantly associated with cognitive test results for both verbal and performance measures. When the effect of SES is controlled using partial correlation, the relationships were substantially weakened. Sex differences were also found in response to nutritional deprivation. Among boys, dietary quality was the most important indicator of cognitive performance, while household economic conditions were more importantly associated with cognitive performance among girls. Participation in schooling was important for cognitive skille as it related to nutritional status.