• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.297-306
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• 2022

Objectives: The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran. Methods: This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality. Results: The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model. Conclusions: The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.330-340
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• 2010

Objectives: This study aims to evaluate and explain the socioeconomic inequalities of all-cause mortality after breast cancer surgery in South Korea. Methods: This population based study included all 8868 females who underwent radical mastectomy for breast cancer between January 2002 and June 2003. Follow-up for mortality continued from January 2002 to June 2006. The patients were divided into 4 socioeconomic classes according to their socioeconomic status as defined by the National Health Insurance contribution rate. The relationship between socioeconomic status and all-cause mortality after breast cancer surgery was assessed using the Cox proportional hazards model with adjusting for age, the Charlson’s index score, emergency hospitalization, the type of hospital and the hospital ownership. Results: Those in the lowest socioeconomic status group had a significantly higher hazard ratio of 2.09 (95% CI =1.50 - 2.91) compared with those in the highest socioeconomic group after controlling for all the identifiable confounding variables. For allcause mortality after radical mastectomy, all the other income groups showed significantly higher 3-year mortality rates than did the highest income group. Conclusions: The socioeconomic status of breast cancer patients should be considered as an independent prognostic factor that affects all-cause mortality after radical mastectomy, and this is possibly due to a delayed diagnosis, limited access or minimal treatment leading to higher mortality. This study may provide tangible support to intensify surveillance and treatment for breast cancer among low socioeconomic class women.

• Korean Journal of Health Education and Promotion
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• v.27 no.1
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• pp.61-69
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• 2010

Objectives: The aim of this study was to examine socioeconomic inequalities in oral health and to investigate the extent to which socioeconomic disparities in oral health are attenuated by oral health related consciousness and behaviors. Methods: We used data from the third 2006 Korea National Oral Health Survey(KNOHS) and a total of 3,457 subjects aged over 18 years were analyzed. The dependent variable was periodontal conditions which is devided into dichotomy, that is, health and ill-health, using the Community Periodontal Index(CPI) in KNOHS. Socioeconomic status(SES) were measured by educational attainment, income and residential area. Age, gender, oral health consciousness(self-assessed oral health status, concern about oral health and self-perceived dental treatment needs and behaviors(brushing, use of dental floss and dental visits) were adjusted in binary logistic regression analysis. Results and Conclusion: The results show that oral health consciousness and behaviors do not mediate the relationship between SES and periodontal health and there might be limitations to attenuate socioeconomic disparities in oral health only by changing of either oral health consciousness or(and) behaviors. Our findings suggest that more definite oral health policies and dental health education among adults with lower education will need in order to improve oral health.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.431-438
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• 2007

Objectives : The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. Methods : Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. Results : We found clear inequalities to various degrees?in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. Conclusions : Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations.

• Korean Journal of Remote Sensing
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• v.22 no.5
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• pp.325-335
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• 2006

This paper evaluates and maps the quality of life in the Atlanta, Georgia metropolitan area in 2000. Three environmental variables from Landsat TM data, four socioeconomic variables from census data, and a hazard-related variable from toxic release inventory (TRI) database were integrated into a geographic information system (GIS) environment for the quality of life assessment. To solve the incompatibility problem in areal units among different data, the four socioeconomic variables aggregated by zonal units were spatially disaggregated into individual pixels. Principal components analysis (PCA) was employed to integrate and transform environmental, socioeconomic, and hazard-related variables into a resultant quality of life score for each pixel. Results indicate that the highest quality of life score was found around Sandy Springs, Roswell, Alphretta, and the northern parts of Fulton County along Georgia 400 whereas the lowest quality of life score was clustered around Smyma of Cobb County, the inner city of Atlanta, and Hartsfield-Jackson International Airport. The results also reveals that normalized difference vegetation index (NDVI) and relative risk from TRI facilities are two versatile indicators of environmental and socioeconomic quality of an urban area in the United States.

• Health Policy and Management
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• v.7 no.1
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• pp.155-182
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• 1997

Objectives : This study was designed to compare North Korea and South Korea in measures of the quality of life (physical quality of life index and human development index) and to investigate the impact of selected medical and socioeconomic factors on PQL variables. Data and Methods : The World Bank, the United Nations Development Programme, and Population Reference Bureau were the principal sources of statistical data of 121 countries. Variables included infant mortality, life expectancy at birth, literacy rate, secondary school enrollment (male and female), GNP per capita, population per doctor, daily calorie supply per capita, and a composite PQL index. The Ordinary Least Square model was employed for cross-countries analysis. Findings : Both countries under quite different political and economic systems saw big improvememts in the quality of life, reducing mortality and prolonging life expectancy during the past three decades. In recent decad, however, North Korea has experienced abrupt exacerbation in the quality of life. Significant improvements in infant mortality of the population wer attributable mainly to GNP per capita and the secondary school enrollemt of female. The principal predictors of life expectancy at birth were population per doctor, infant mortality, and literacy rate. The secondary school enrollment of female and population per doctor were significantly associated with improvements in the physical quality of life index (PQLI). Conclusion : The results of this study confirmed a point illustrated by other studies : The association between quality of life as a measure of health status and socioeconomic factors was strong and positive. The important contribution of educational attainment in general, female education level in particular to improvements in the quality of life deserves good news for building an integrated health care system in the reunified Korea, taking into account the high level of education two koreas are enjoying. Meanwhile, when a sharp drop in the quality of life has been observed in North Korea under serious economic difficulties and food shortage in recent decade, the significant contribution of economic development to improvements in the quality of life poses bad nows for reunifying Korean health care in economic terms.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.31 no.3B
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• pp.243-252
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• 2011

The change of rainfall pattern due to recent climate change increases the occurrence probability of drought in Korea. Unlike other natural disasters, a drought has long duration, extensive area subject to damage, and greater socioeconomic damage than other disasters. In order to evaluate drought severity, meteorological drought indices are mainly used in practice. This study presents a more realistic method to evaluate drought severity considering drought climate factors as well as socioeconomic factors which are vulnerable to disaster. To perform a spatial evaluation of drought risk in Gyeongsang-do, drought risk was defined and analyzed through the hazard index and the vulnerability index. The drought hazard index was spatially assessed using the drought index and GIS. The drought vulnerability index was also spatially assessed using the 5 socioeconomic factors. As a result, the drought risks were compared and used for evaluating regional drought risk considering regional characteristics of Gyeongsang-do.

• Journal of Preventive Medicine and Public Health
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• v.41 no.3
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• pp.186-194
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• 2008

Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.

• Journal of Acupuncture Research
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• v.28 no.1
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• pp.117-124
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• 2011

Objectives : Bell's palsy is the most common acute facial paralysis but its causes still unclear. At present, one of the most widely accepted cause is viral infections, and generally socioeconomic factors influence the viral infections. The purpose of this study is to investigate the relationship of incidence of facial palsy with socioeconomic factors. Methods : Seventeen patients with a acute facial palsy, who volunteered and completed all of the assessment measures participated. Using data on 17 participants, we examined the independent contribution of education, income, and occupation to a risk factor of severe facial palsy. Severity of global facial impairment was assessed by the facial disability index (FDI), the house-brackmann facial nerve grading system, WHO quality of life - bref (WHOQOL-BREF) and visual analogue scale (VAS) about discomfort of life. Results : There was no correlation between severity of facial palsy and gender, marriage, education, or occupation. Age greater than 60 years (p<0.05), and low monthly income(p<0.05), poor self-rated health was associated with greater severity of idiopathic facial paralysis. Conclusions : The number of subjects with facial palsy in our study (n-17) was small, and therefore generalization to larger patient populations might be unwarranted. But according to the outcome, we suggest that socioeconomic factors, especially low monthly income influence severity of bell's palsy.

• Health Policy and Management
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• v.22 no.1
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• pp.85-108
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• 2012

One of the ways to achieve the principle of equal access for equal needs, availability and geographical accessibility of health care resources regardless of resident sites is important. The purpose of this paper is to measure socioeconomic inequities in distribution of health care resources among regions in the Republic of Korea (hereafter Korea). Data were extracted from regional statistics of National Health Insurance, Community Health Survey, Korea Social Science Data Archive, and Korean Statistical Information Services at the same period of 2009. The dependent variables were the number of health workforce and health care facilities in each region. The proxy indicator of regional socioeconomic status was local tax per person. To identify whether inequalities among regions, we examined the concentration index(CI) and indirectly standardized CI by controlling each region's demographics and need factors. Total observations were 232 districts in nationwide, and we analyzed separately Seoul(25 districts) and non-Seoul areas(207 districts). The standardized CI values of health care resources were positive(favoring the rich region) across the nation in almost all kinds of resources. Especially the number of specialist, dentist, dental clinics, clinics, oriental medical clinics, pharmacists, and pharmacies were statistically significantly favoring the rich region. But the CI for the number of long-term care hospitals, public health centers were negative(favoring the poor region). The tendency of CI presenting positive values were increased in Seoul area. But in the case of non-Seoul, the CI indexes were nearly zero. The results suggest that except the Seoul area, little regional socioeconomic-related inequalities were observed in the distribution of health care resources in Korea.