• Journal of Preventive Medicine and Public Health
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• 제50권3호
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• pp.201-209
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• 2017

Objectives: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.249-259
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• 2011

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.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.214-223
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• 2019

Objectives: Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran. Methods: A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran. Results: The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran. Conclusions: This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.

• Journal of Preventive Medicine and Public Health
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• 제51권6호
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• pp.289-297
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• 2018

Objectives: Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran. Methods: A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ${\geq}30kg/m^2$. The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity. Results: Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity. Conclusions: Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

• 대한토목학회논문집
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• 제31권3B호
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• pp.253-264
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• 2011

일반적으로 가뭄은 기상학적 가뭄, 농업적 가뭄, 수문학적 가뭄, 사회경제학적 가뭄으로 구분하여 정의한 후 정성적 혹은 정량적 평가를 수행한다. 이중 기상학적 가뭄, 농업적 가뭄, 수문학적 가뭄에 관련한 연구는 활발히 진행되고 있으나, 상대적으로 사회경제학적 가뭄평가와 관련한 연구는 미미한 실정이다. 본 연구에서는 우리나라에서 적용가능한 사회경제학적 가뭄을 정의하고 가뭄평가를 수행하였다. 사회경제학적 가뭄을 평가하기 위해서 우리나라의 인구증가와 산업발전을 반영하는 용수수요 현황과 수자원 공급시설의 개발에 따른 가용 수자원의 증가를 반영하는 용수공급 현황을 상대적으로 비교할 수 있는 용수과부족지수(WEDI)를 제안하였다. 본 연구에서 제안된 용수과부족지수의 타당성을 검토하기 위해 기존의 가뭄지수(SPI, PDSI)와 실제 가뭄발생(2001년 봄가뭄)과 비교 분석을 수행하였다. 용수과부족지수를 경상도에 적용하여 용수수요량 대비 용수공급량을 비교 분석한 결과 상대적으로 용수가 부족한 지역과 여유있는 지역을 구분할 수 있었다.

• 보건교육건강증진학회지
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• 제23권2호
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.17-22
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• 2000

목 적: 우리 나라 청소년기 소아의 H. pylori 감염 유병율을 조사하고, 사회경제적 요인이 청소년의 H. pylori 감염에 어떠한 영향을 미치는지 알아보고자 하였다. 대상 및 방법: 1996년 10월 부천시에 살고 있는 10~15세의 532명(남아 285명, 여아 247명)의 소아를 대상으로 채혈을 시행하여 혈청학적인 방법(serum IgG antibody)으로 H. pylori 감염을 진단하였다. 설문지를 통하여 성별, 연령, Hollingshead index에 따라 분류한 사회경제적 수준, 주거형태(전세 또는 자가), 혼잡지수(crowding index)를 조사하였는데, 532명 중 375명(70.5%, 남:여=205:170)의 설문이 회수되었다. Hollingshead index는 부모의 교육정도와 직업을 고려하여 구분하였고 crowding index는 식구수/방수로 구하였다. 각각 단변수 회귀분석 후 의미있는 결과를 모아 다중회귀분석을 시행하였다. 결 과: H. pylori 유병률은 남아에서 17.1% (32/205), 여아에서 16.5% (28/170)로 통계적으로 유의한 차이는 없었다(P=0.88). 10~11세, 12~13세, 14~15세의 세 연령군으로 나누어 비교한 결과, 연령이 증가할수록 H. pylori 유병률은 각각 10.3% (7/68), 15.9% (25/157), 20.7% (31/150)로 유의한 증가를 보였다(P=0.05). 사회경제적 수준을 Hollingshead index로 구하여 세 군으로 나누어 비교한 결과, 사회경제적 수준이 높을수록 H. pylori 양성은 각각 20.0% (23/115), 16.0% (39/244), 6.3% (1/16)로 감소하는 역비례 관계를 보였으나 통계적으로 유의한 차이는 아니었다(P=0.16). 전세와 자가를 비교했을 때 H. pylori 양성은 각각 15.7% (22/140), 17.5% (41/235)로 유의한 차이가 없었다(P=0.66). 혼잡지수(crowding index: 식구수/방수)가 1.5 미만일 때 H. pylori 양성은 16.0% (26/163), 1.5 이상일 때 17.5% (37/212)로 유의한 차이가 없었다(P=0.70). 다중회귀분석 결과 H. pylori 감염에 대해 연령은 odds ratio 2.2 (95% confidence interval 0.9~5.4), Hollingshead index에 의한 사회경제적 수준은 odds ratio 3.6 (95% confidence interval 0.5~28.9)이었다. 결 론: 부천시 청소년기 소아의 H. pylori 감염유병률은 16.8%이며, 부모의 교육정도와 직업에 따른 사회경제적 수준이 가족내 혼잡도, 주거형태보다 감염에 더욱 영향을 미치는 것으로 보인다.

• 한국치위생학회지
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• 제18권6호
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• pp.979-986
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• 2018

Objectives: The purpose of this study was to investigate the relationship between socioeconomic status and periodontal disease. Methods: The data used for the analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (2015). A total of 5,632 adults, aged over 19 years, were included in the study. This study analyzed data relating to socioeconomic status and health behaviors. The socioeconomic status was defined as an exogenous factor. Periodontal disease was the endogenous variable. Health behavior was a mediating variable. The study hypotheses were tested using Structural Equation Modeling analysis with Mplus 7.0 software. Results: According to the model fit test, the associated root-mean-square error was 0.05 (90% CI: 0.046-0.059); comparative fit index was 0.93; Tucker-Lewis index was 0.88; and standardized root-mean-square residual was 0.03. We found that socioeconomic status had significant effects on health behaviors (${\beta}=0.304$, p<0.001) and periodontal disease (${\beta}=-0.289$, p=0.001). Moreover, health behaviors had significant effects on periodontal diseases (${\beta}=0.143$, p<0.001). The analysis of a possible relationship between socioeconomic status and periodontal disease using path analysis demonstrated health behaviors difficulties, along with direct and indirect effects, further increased the risk of periodontal disease. Conclusions: The findings suggest that future interventions for the prevention of periodontal disease should consider health behavior.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• Journal of Nutrition and Health
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• 제35권3호
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• pp.332-351
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• 2002

The purpose of this study was to investigate effect of living condition and aging on food intake in Korea. 98 free-meal receivers and 81 members in well-being center for the aged were asked about their food frequency and food consumption and their socioeconomic status by a questionnaire. All data were analyzed by SPSS (Statistical Packages for the Social Sciences) 10.0 program. There were statistical differences of living condition, marital status, former job and teeth status between free-meal receivers and people with stable lives. Moreover, all age groups of free-meal receivers had lower income, living expenses, educational period and frequency of physical activity than those of people with stable lives. But smoking and drinking was much higher in free-meal receivers. Arthritis was the most prevalent disease in both groups. And free-meal receivers had higher blood pressure and lower Body Mass Index than people with stable lives. Food consumption of free-meal receivers was definitely lower than that of people with stable lives in terms of food frequency and standard amount of food eaten. But noodles, bean sprouts and eggs were very important foods for free-meal receives. Food consumption of the aged was affected by age, educational period, income, blood pressure, duration after retirement, frequency of physical activity and Body Mass Index. Therefore, as various socioeconomic status affects on food intakes of the aged, more effective and practical nutritional programs which consider the receivers'socioeconomic status are needed for the nutritionally at-risk groups like the aging free-meal receivers.