Journal of Preventive Medicine and Public Health

Original Articles

Association Between Parental Marital Status and Types of Suicidal Behavior Among Korean Adolescents: A Cross-sectional Study: Yoon Sik Park, Eun-Cheol Park; J Prev Med Public Health. 2020;53(6):419-428. Published online September 21, 2020; DOI: https://doi.org/10.3961/jpmph.20.004

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Objectives
Adolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior.
Methods
This study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression.
Results
When compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents.
Conclusions
Suicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.

Summary

Citations

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Family Functioning and Suicide Attempts in Mexican Adolescents
Francisco Alejandro Ortiz-Sánchez, Aniel Jessica Leticia Brambila-Tapia, Luis Shigeo Cárdenas-Fujita, Christian Gabriel Toledo-Lozano, María Alejandra Samudio-Cruz, Benjamín Gómez-Díaz, Silvia García, Martha Eunice Rodríguez-Arellano, Edgar Oswaldo Zamora
Behavioral Sciences.2023; 13(2): 120. CrossRef
Childhood adversities and mental health problems: A systematic review
Titik Juwariah, Fendy Suhariadi, Oedojo Soedirham, Agus Priyanto, Erni Setiyorini, Auliasari Siskaningrum, Heni Adhianata, Angelina da Costa Fernandes
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Experiences and needs of parents whose child has attempted suicide
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Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study: Somi Heo, Seyoung Kwon, Yu-Mi Lee, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2020;53(1):45-55. Published online November 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.198

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Abstract Summary PDF Supplementary Material

Objectives
This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.
Methods
This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.
Results
Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.
Conclusions
Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Summary

Korean summary
본 연구에서는 새로운 소아청소년 고혈압 기준을 이용하여, 최근 한국과 미국 소아청소년들의 혈압 및 고혈압 유병률의 변화 추이를 비교하였다. 비만과 고혈압간의 높은 관련성에도 불구하고 한국과 미국 소아청소년의 고혈압 유병률과 비만율은 서로 다른 변화 추이를 나타내었으며, 고혈압 발생에 있어서 한국 소아청소년들이 미국 소아청소년들보다 비만에 더 취약할 가능성을 나타내고 있어 이에 관한 후속연구가 필요하다.

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Melike TELLİOĞLU, Muammer YILMAZ, İnci ARIKAN, Yaşar ÇAKMAKÇI
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Dong Zhao, Jiali Zhou, Danting Su, Yun Li, Weidi Sun, Boren Tan, Shuting Li, Ronghua Zhang, Peige Song
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Association Between Obesity and Blood Pressure Among Iranian Children and Adolescents: A Sub-analysis from the SHED LIGHT Study
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Self-esteem as a Moderator of the Effects of Happiness, Depression, and Hostility on Suicidality Among Early Adolescents in Korea: Yeun-Soon Choi, Hee Kyoung Shin, Dae-Yong Hong, Jang-Rak Kim, Yune-Sik Kang, Baekgeun Jeong, Ki Soo Park, Key Hyo Lee; J Prev Med Public Health. 2019;52(1):30-40. Published online January 2, 2019; DOI: https://doi.org/10.3961/jpmph.18.095

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Abstract Summary PDF Supplementary Material

Objectives
The purpose of this study was to investigate the role of self-esteem as a moderator of the factors influencing suicidality among middle-schoolers.
Methods
Moderated multiple regression analysis was applied to assess the influence of happiness, depression, and hostility on suicidality and to determine the degree to which self-esteem served as a moderator of those relationships. Data were collected from 268 students at a middle school in Busan, Korea, using a self-administered structured questionnaire.
Results
Happiness, depression, and hostility had significant direct effects on suicidality. Self-esteem showed no direct effect, but had a significant moderating effect on the relationship between hostility and suicidal behavior.
Conclusions
These results suggest that various interventions, such as counseling programs, should be designed to alleviate hostility and depression and to enhance happiness and self-esteem among early adolescents.

Summary

Korean summary
본 연구는 중학생의 자살성향에 영향을 주는 주요 요인을 식별하고, 자아존중감의 조절효과를 확인하여 청소년 자살예방 방안 모색을 위한 실마리를 제공하고자 하였다. 실증자료의 분석 결과 자살성향에 행복, 우울, 적대감이 유의한 직접효과, 그리고 조절변수인 자아존중감이 적대감과 상호작용하여 유의한 조절효과를 보였다(p<0.05). 청소년 자살 예방의 실효성을 높이기 위해서는 행복감의 증진, 우울과 적대감의 완화 등 원인변수에 대한 개입과 동시에 조절변수인 자아존중감을 향상시키기 위한 가정과 학교의 체계적인 노력이 필요함을 시사한다.

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Cyberbullying victimization and depression: self-esteem as a mediator and approach coping strategies as moderators
Thi Truc Quynh Ho, MA, Chuanhua Gu, PhD
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Seyed Saeed Hashemi Nazari, Kamyar Mansori, Hajar Nazari Kangavari, Ahmad Shojaei, Shahram Arsang-Jang
Journal of Preventive Medicine and Public Health.2022; 55(2): 164. CrossRef
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International Journal of Environmental Research and Public Health.2021; 18(20): 10623. CrossRef
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Pamukkale Medical Journal.2021;[Epub] CrossRef
Need to establish a new adolescent suicide prevention programme in South Korea
Jiacheng Liu
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Special Article

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome: Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2013;46(4):173-182. Published online July 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.4.173

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Abstract PDF

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Summary

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Original Articles

Preventable Lifestyle Risk Factors for Non-Communicable Diseases in the Pakistan Adolescents Schools Study 1 (PASS-1): Ali Khan Khuwaja, Saleem Khawaja, Komal Motwani, Adeel Akbar Khoja, Iqbal Syed Azam, Zafar Fatmi, Badar Sabir Ali, Muhammad Masood Kadir; J Prev Med Public Health. 2011;44(5):210-217. Published online September 28, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.5.210

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Abstract PDF

Objectives

The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents.

Methods

In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis.

Results

Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07; 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17; 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03; 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had ≥2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57; 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05; 95% CI, 1.29 to 19.78).

Conclusions

Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders.

Summary

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Lipid Profiles and Related Factors in Adolescent.: Moran Ki, Boyoul Choi, Mi Kyung Kim, Ki Rang Kim, Jin Nu Fang, Yun Ju Kang; Korean J Prev Med. 2000;33(1):83-90.

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Abstract PDF: OBJECTIVES
To assess the prevalence rate of dyslipidemia and the level of related factors in adolescents groups in Seoul and Yangpyong area. METHODS: Design; School based survey during May-Jun 1996 in Seoul and Yangpyong county. Subject; 2,453 boys and girls, aged 13 to 19 years; 1,137 Seoul and 1,316 Yangpyong county. Main Outcome Measures; Prevalence rates of raised serum total cholesterol, triglycerides, LDL-cholesterol, decreased HDL-cholesterol, obesity, and levels of energy intake and expenditure RESULTS: Energy intake and fat intake of boys were higher than those of girls and they were higher in Seoul. Energy expenditure per day of boys was bigger than that of girls too. Prevalence rate of obesity was higher in boys of Seoul(15.2%) and girls in Yangpyong county(14.0%). Serum lipid profiles(total cholesterol, triglycerides, LDL-cholesterol) were higher among girls and all prevalence rates of dyslipidemia were higher in boys in Seoul and in girls in Yangpyong county. Especially, girls(29.1%) in Yangpyong had raised serum cholesterol level(> or =170 mg/dl). In contrast, boys in Seoul had higher level of decreased HDL-cholesterol(46.8%) compared to Yangpyong(23.6%). The relationships between serum lipid profiles and relative weights and sex are highly significant. And the relationship between triglycerides and energy intake is significant(p=0.038). But, the associations between serum lipid profiles and energy expenditure had borderline significances. CONCLUSIONS: Hypercholesterolemia rates in girls were higher. Obesity prevalence rate was highest in boys of Seoul. Relative weight and sex are significantly related to lipid profiles. Therefore, Korea is in need of preventive strategies for different obesity and gender groups.; Summary

Twelve-year Study on Body Mass Index Changes of Obese Adolescents.: Yun Ju Kang, Il Suh, Chang Ho Hong, Jong Ku Park; Korean J Prev Med. 1994;27(4):665-676.

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Abstract PDF: The purpose of this study is to observe the longitudinal changes in BMI (Body Mass Index) of obese and non-obese 3rd. grade high school students in Seoul for 12 years and to see the trends of overt weight gain in obese adolescents. The results are as follows; 1. The average annual increasing rates of body mass indices in male students were 1.14kg/m2 in obese group and 0.59 in non-obese group. In female students, the average annual increasing rates of body mass indices were 0.93kg/m2 in obese group and 0.53kg/m2 in non-obese group. 2. The change rate of BMI for 12 years was significantly higher in obese group than non-obese group. 3. Puberty had less influence on the change rate of BMI in obese group compared to non-obese group. 4. In obese group, 71.8% of the variance in BMI at 17 can be predicted by BMI at 16 years in male students. In female students 44.4% can be predicted by BMI at age 16. 5. Among the 17-year-old obese students, 58.8% of the males and 56.2% of females were found not to have been obese at 7 years of age. 6. Among the 17-year-old obese students, those who were obese at 7 years of age were found to have higher BMI at later ages than those who were in the non-obese group. Obese adolescents were more likely to be obese in their childhood than non-obese group. There was no optimal age for the significant weight gain and the increasing rate of BMI was constantly higher in obese group than in non-obese group. Due to the fact that child obesity in early age contributes to obesity in adolescence, close observation is advised on the other hand, a large proportion of obese adolescents can be preventable by early interventions, because about 50% of obese adolescents were not obese in early elementary school age.; Summary

English Abstracts

Estimation of Smoking Prevalence among Adolescents in a Community by Design-based Analysis.: Soon Woo Park, Jong Yeon Kim, Sang Won Lee, Jung Han Park, Yeon Oh Yun, Won Kee Lee; J Prev Med Public Health. 2006;39(4):317-324.

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Abstract PDF: OBJECTIVES
This study was conducted to estimate the unbiased smoking prevalence and its standard errors among adolescents in a large city in Korea, by designbased analysis. METHODS: All the students in Daegu city were stratified by grade, gender and region, and then schools as primary sampling units (PSU) were selected by probability proportional to size (PPS) sampling. One or two classes were sampled randomly from each grade, from 5th grade in elementary schools to the 3rd grade in high schools. The students anonymously completed a standardized selfadministered questionnaire from October to December 2004. The total number of respondents was 8,480 in the final analysis, excluding the third graders in the general high schools because of incomplete sampling. The sampling weight was calculated for each student after poststratification adjustment, with adjustment being made for the missing cases. The data were analyzed with Stata 8.0 with consideration of PSU, weighting and the strata variables. RESULTS: The smoking prevalence (%) and standard errors for male students from the fifth grade in elementary schools to the second grade in high schools were 0.93[0.47, 1.83[ 0.74, 3.16[1.00, 5.12[1.02, 10.86[1.13, 15.63[2.44 and 17.96[2.67, and those for the female students were 0.28[ 0.28, 1.17[0.73, 3.13[0.60, 1.45[0.58, 3.94[0.92, 8.75 [1.86 and 10.04[1.70, sequentially. CONCLUSIONS: The smoking prevalence from this study was much higher than those from the other conventional studies conducted in Korea. The point estimates and standard errors from the design-based analysis were different from those of the model-based analysis. These findings suggest the importance of design-based analysis to estimate unbiased prevalence and standard errors in complex survey data and this method is recommended to apply to future surveys for determining the smoking prevalence for specific population.; Summary

Socioeconomic Differentials in Health and Health Related Behaviors: Findings from the Korea Youth Panel Survey.: Young Ho Khang, Sung Il Cho, Seungmi Yang, Moo Song Lee; J Prev Med Public Health. 2005;38(4):391-400.

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Abstract PDF: OBJECTIVE
This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. METHODS: A nationwide cross-sectional interview survey of 3, 449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on selfreported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. RESULTS: Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. CONCLUSIONS: The perceived economic hardships predicted the health status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.; Summary

Original Article

A Study of the Relationship between Parental Alcohol Problems and Alcohol Use among Adolescent Females in Republic of Korea.: Dong Eok Shin, Jorge Delva; J Prev Med Public Health. 2004;37(3):232-237.

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Abstract PDF: OBJECTIVES
The study was designed to test if alcohol use and alcohol-related problems among adolescent females are related to their parents' level of alcohol problems. METHODS: In 2001, a stratified sample of 2077 adolescent females, grades 10-11, from twelve female-only high schools located in a large metropolitan city in the Republic of Korea completed a questionnaire about alcohol use, parental attention, and parental alcohol consumption, and other risk and protective factors. Data were analyzed with chi-square and regression analyses. RESULTS: Nearly 63% of the student drinkers had experienced at least one to two alcohol-related problems in their lives. Two-thirds of all 2077 students indicated that at least one of their parents had an alcohol-related problem and that approximately 29% had experienced several problems. Results of random effects ordinal logistic regression analyses suggest a dose-response relationship between parental and youth alcohol-related problems. Youth who report having parents with some and many alcohol problems were 30% (Odds Ratios [OR] = 1.30; 95% Confidence Interval [CI] = 1.10 - 1.53) and 55% (OR = 1.55; 95%CI = 1.23 - 1.95) more likely to experience alcoholrelated problems than youth whose parents do not have alcohol problems, respectively, after statistically adjusting for important covariates. CONCLUSIONS: This study presents evidence that alcoholrelated problems among adolescent female students is highly prevalent. Also, the study findings reveal a high percentage of parents with alcohol problems, as reported by students. This study presents evidence of what might be a hidden problem among adults and youths in the Republic of Korea that merits serious attention.; Summary

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