• Journal of Preventive Medicine and Public Health
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• v.48 no.2
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• pp.84-93
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• 2015

Objectives: The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. Methods: A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ${\geq}50$ years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. Results: There were 8221 osteoporosis patients aged ${\geq}50$ years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p=0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). Conclusions: The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

• Journal of the Korean association of regional geographers
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• v.20 no.2
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• pp.217-229
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• 2014

This study was performed to identify neighborhood deprivation indicators associated with health and to test the contextual effects of those indicators on individual health. This study calculated SMR based on Dong district and see the differences of prediction across deprivation index and indicators. Then, a multi-level analysis using HGLM was conducted to test the contextual effect of neighborhood depreivation indicators on health after controlling for demographic and socioeconomic status of individuals. The results showed that regional SMR had strong correlations with land price, education, welfare recipients, female household proportion in Dong district but failed to show the correlation with individual health and neighborhood deprivation. Individual health was only associated with individual level of demographic and socioeconomic status. That is, spatial dispersion of illness is understood as the distribution of social classes in terms of socioeconomic status of individuals, not the contextual aspects of community.

• Health Policy and Management
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• v.29 no.2
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• pp.146-159
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• 2019

Background: The purpose of this study is to measure the Korean health literacy level and to analyse its gaps according to the factors of socioeconomic and health status and health behaviors. Based on this, policy implications were reviewed to improve the understandability on health information and to reduce the gap among socioeconomic groups. Methods: HLS-EU-Q47, a tool developed by the European Health Literacy Project, was used to conduct a face-to-face interview survey on the health literacy for the samples from general population. Results: The public general health literacy (HL) index was 34.5 out of 50. HL is consisted of three sub-dimensions: healthcare (HC-HL), disease prevention (DP-HL), and health promotion (HP-HL). And a HL analysis found scores of 34.7 points for HC-HL, 35.4 points for DP-HL, and 33.3 points for HP-HL. The level of all HL was different according to socioeconomic characteristics and health behavior. Conclusion: Based on the results of this study, more research activities on health-related literacy need to be conducted, and monitoring system on the HL level needs to be developed and implemented. In addition, a program to improve HL levels needs to be developed in order to strengthen the basis for a more sustainable healthcare system as an agenda with national health policy priority.

• 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.

• Proceedings of the Korea Water Resources Association Conference
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• 2023.05a
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• pp.177-177
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• 2023

The impacts of dams on transboundary flow are complex and challenging to project and manage, given the potential moderating influence of a broad range of anthropogenic and natural factors. This study presents a global meta-analysis of 168 studies that examines the effect magnitude of dams on downstream seasonal, annual flow, and hydrological extremes risk on 39 hotspot transboundary river basins. The study also evaluates the impact of 13 factors, such as climate, basin characteristics, dams' design and types, level of transboundary cooperation, and socioeconomic indicators, on the heterogeneity of outcomes. The findings reveal that moderators significantly influence the impact of dams on downstream flow, leading to considerable heterogeneity in outcomes. Transboundary cooperation emerges as the key factor that determines the severity of dams' effect on both dry and wet season's flows at a significance level of 0.01 to 0.05, respectively. Specifically, the presence of water-supply and irrigation dams has a significant (0.01) moderating effect on dry-season flow across basins with high transboundary cooperation. In contrast, for wet-season flow, the basin's vulnerability to climate extremes is associated with a large negative effect size. The various moderators have varying degrees of influence on the heterogeneity of outcomes, with the aridity index, population density, GDP, and risk level of hydro-political tension being the most significant factors for dry-season flow, and the risk level of hydro-political tension and basin vulnerability to climate extremes being the most significant for wet-season flow. The results suggest that transboundary cooperation is crucial for managing the impacts of dams on downstream flow, and that various other factors, such as climate, basin characteristics, and socioeconomic indicators, have significant moderating effects on the outcomes. Thus, context-specific approaches are necessary when predicting and managing the impacts of dams on transboundary flow.

• Journal of Korean Academy of Rural Health Nursing
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• v.7 no.2
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• pp.51-58
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• 2012

Purpose: to investigate the relationship of between socioeconomic characteristics, and weight perception and lifestyle on body mass index (BMI) in Korea. Method: Participants were 2,405 people recruited from the 2007 Fourth Korea National Health and Nutrition Examination Surveys. Data included weight perception, BMI, and lifestyle factors and was analyzed using ${\chi}$ 2-test, logistic regression Results: Perception of weight was significantly different according to gender, age, education and residence. In the obesity group 21.6% perceived their weight as normal whereas 29.6% of the normal group perceived their weight as obese. In the obesity group, men who were over 70 years old, rural residents and only had elementary education perceived their weight range as normal. In the normal weight group, women who were urban residents and university graduates more frequently perceived their weight as obese. Logistic regression analysis of lifestyle factors, indicated that misperceived obesity was associated with walking (OR=0.703, 95% CI=0.553-0.896), weight control (OR=2.693, 95% CI=2.080-3.485), and health exam (OR=0.730, 95% CI=0.567-0.940) whereas misperceived normal weight was associated with walking (OR=0.696, 95% CI=0.497-0.975), weight control (OR=0.523, 95% CI=0.363-0.749). Conclusion: Results indicate differences in self-perceived weight and life style and provide information that can be used for health promotion program development.

• Journal of Preventive Medicine and Public Health
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• v.47 no.2
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• pp.104-112
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• 2014

Objectives: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. Methods: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. Results: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. Conclusions: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

• Journal of Preventive Medicine and Public Health
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• v.41 no.3
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• pp.173-180
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• 2008

Objectives : The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. Methods : The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The health-related quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. Results : Overall, the mean value of the EQ-5D index was $0.884{\pm}0.140$ and this score was significantly different according to the socioeconomic characteristics, the health-related behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. Conclusions : The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health, A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.

• Journal of the Korean Society of School Health
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• v.20 no.1
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• pp.63-75
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• 2007

Purpose: With economic development and prolonged longevity, the level of health and health disparities have became growing concerns for individual and society as well. Since youth's health status are influenced by households' socioeconomic status and associated with heath status in later stage of life, assessing health inequality in the youth is a significant step toward lessening health disparity and promoting health. We measured health inequality in high school students and decomposed it into health factors. Methods: The subjects included 3,787 high school students of 12th graders from the Korea Education and Employment Panel (KEEP) in 2004. True health status was assumed as a latent variable and estimated by ordered logistic regression model. The predicted health was used as a measure of individual health after rPSraling to [0,1] interval. Total health inequality was then measured by Gini coefficient and was decomposed into health factors. Results: Health inequality in high school students was observed. Of total health inequality, 44% was explained by biological factors such as body mass index (BMI) (32.5%) and gender (13.5%). Behavioral factors such as smoking, drinking, physical activity, hours in bed and hours of computer ussge added to 11.7%. Household income and work experiences explained 5.6% and 8.8%, respectively. School satisfaction explained 14.6%. Other school related factors such as self-assessed achievement and experience of being bullied accounted for 15.5%. Conclusion: Among the health factors, biological factor was the most important contributor in health disparity. Other factors such as health behaviors, socioeconomic factors, school satisfaction and school related factors exhibited somewhat similar magnitude. For policy purposes, it is recommended to look into modifiable factors depending BM, gender and school surroundings.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1034-1040
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• 2018

Purpose: This study aimed to investigate inequalities in colorectal cancer (CRC) screening rates in Korea and trends therein using the slope index of inequality (SII) and relative index of inequality (RII) across income and education groups. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annually conducted, nationwide cross-sectional survey, were utilized. A total of 17174 men and women aged 50 to 74 years were included for analysis. Prior experience with CRC screening was defined as having either a fecal occult blood test within the past year or a lifetime colonoscopy. CRC screening rates and annual percentage changes (APCs) were evaluated. Then, SII and RII were calculated to assess inequality in CRC screening for each survey year. Results: CRC screening rates increased from 23.4% in 2005 to 50.9% in 2015 (APC, 7.8%; 95% CI, 6.0 to 9.6). Upward trends in CRC screening rates were observed for all age, education, and household income groups. Education inequalities were noted in 2009, 2014, and overall pooled estimates in both indices. Income inequalities were inconsistent among survey years, and overall estimates did not reach statistical significance. Conclusion: Education inequalities in CRC screening among men and women aged 50 to 74 years were observed in Korea. No apparent pattern, however, was found for income inequalities. Further studies are needed to thoroughly outline socio-economic inequalities in CRC screening.