• 한국산학기술학회논문지
• /
• 제19권2호
• /
• pp.561-574
• /
• 2018

본 논문에서는 건강 불평등의 해소를 위하여 지리적 가중 회귀를 이용한 대사증후군 유병률의 지역별 변이 요인 및 관련 요인을 파악하고, 이를 통하여 지역의 효율적인 대사증후군 관리 사업 개발을 위한 적용방안을 마련하였다. 국민건강 보험공단 2015년 건강보험 통계연보 및 지역사회건강조사 등 기타 국가 기관 자료를 통하여 대사증후군 유병률과 사회경제적 수준의 사회구조적 요인, 그리고 물리적 환경, 건강행태, 이환, 정신건강, 예방관리, 의료이용의 중재 요인 지표를 수집하였다. 먼저 수집된 데이터를 바탕으로 대사증후군 유병률의 변이수준을 측정하는 지표인 EQ (Extremal Quotient)와 CV(Coefficient of Variations)를 이용하여 지역 간 변이가 존재함을 확인한 후, 공간적 이질성 및 의존성 등의 공간적 변이 고려가 가능한 지리적 가중 회귀(Geographically Weighted Regression)를 이용하여 대사증후군 유병률의 지역 간 변이 관련 요인을 분석하였다. 지리적 가중 회귀 분석 결과 대사증후군 유병률의 수준에 따라 주요 요인의 크기와 관리의 우선순위가 다름을 알 수 있었으며, 향후 지역별 대사증후군 관리의 목표와 우선순위 설정을 통한 관리 사업의 효과를 증대시킬 수 있는 방안마련이 가능함을 확인하였다.

• 지역사회간호학회지
• /
• 제26권2호
• /
• pp.140-149
• /
• 2015

Purpose: This study was conducted to identify activities of daily living, depression and self-rated health and related factors for Korean Elderly. Methods: Data from the survey for the Korean Longitudinal Study of Aging in 2010 were used. The data were analyzed using frequencies, weighted proportions, and hierarchical multiple logistic regression. Results: Significant difference was observed in health status induced by socioeconomic status between men and women, but not among age groups. Socioeconomic status was strongly associated with self-rated health among male and female elders. Being unschooled and low net family asset were significantly related with dependency in activities of daily living and depressive symptoms among men. Only low net family asset was significantly related with depressive symptoms among women. Family support provides a slight decrease to the negative relationship between socioeconomic status and health status, especially depressive symptoms. Conclusion: This study suggests that interventions to reduce health inequalities should target elderly with lower socioeconomic status and with poor family support, using a gender-specific approach.

• Journal of Preventive Medicine and Public Health
• /
• 제53권4호
• /
• pp.266-274
• /
• 2020

Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.

• Journal of Preventive Medicine and Public Health
• /
• 제38권4호
• /
• pp.443-448
• /
• 2005

Objectives : This study was done to evaluate the reliability of education and occupational class between using the health survey and the death certificate data. Methods : The 1998 National Health and Nutrition Examination Survey (NHANES) was conducted on a cross-sectional probability sample of South Korean households, and it contained unique 13-digit personal identification numbers that were linked to the data on mortality from the Korean National Statistical Office. The data from 263 deaths were used to estimate the agreement rates and the Kappa indices of the education and occupational class between using the NHANES data and the death certificate data. Results : The simple and weighted Kappa indices for education were 0.60 (95% CI=0.53-0.68) and 0.73 (95% CI=0.67-0.79) respectively, if the educational level was grouped into five categories: no-formal-education, elementary-school, middle-school, high-school and college or over. The overall agreement rate was 71.9% for these educational groups. The magnitude of reliability, as measured by the overall agreement rates and Kappa indices, tended to increase with a decrease in the educational class. The number of non-educated people with using the death certificate data was smaller than that with using the NHANES data. For the occupational class (manual workers, non-manual workers and others), the Kappa index was 0.40 (95% CI=0.30-0.51), which was relatively lower than that for the educational class. Compared with the NHANES, the number of non-manual workers for the deceased who were aged 30-64 tended to be increased (8 to 12) when using the death certificate data, whereas the number of manual workers tended to be decreased (59 to 41). Conclusions : The socioeconomic inequalities in the mortality rates that were based on the previous unlinked studies in South Korea were not due to a numerator/denominator bias. The mortality rates for the manual workers and the no-education groups might have been underestimated.