Journal of Preventive Medicine and Public Health

Perspective

The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Emmanuel Otieno, Josephine Namyalo; J Prev Med Public Health. 2024;57(1):91-94. Published online December 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.110

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Abstract Summary PDF: For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.; Summary

Key Message
For the Ugandans, nearly the last four decades have been years of hope, conflict, and resilience in a myriad of contexts for healthcare reform. Health insurance system has no legal framework and provides benefits not to the entire national population. The 2019 National Health Insurance scheme Bill was passed in 2021. If the President of Uganda assents to the National Health Insurance Bill, it will be a compelling policy in health and health for all policies. But this Bill has several drawbacks. In this perspective, we aimed to provide intricacies and mix of challenges and opportunities for the health sector.

Original Article

Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study: Hyo-jung Lee, Jeong Pil Choi, Kunhee Oh, Jin-Young Min, Kyoung-Bok Min; J Prev Med Public Health. 2023;56(6):552-562. Published online November 15, 2023; DOI: https://doi.org/10.3961/jpmph.23.313

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Abstract Summary PDF: Objectives
Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.
Methods
This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).
Results
The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.
Conclusions
These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.; Summary

Korean summary
이 연구는 신체활동이 한국 청소년들사이에서 불안과 불건강행태간의 관계에 어떠한 영향을 미치는지 조사하였다. 이 연구에서 신체활동을 하지 않는 청소년에서만 흡연 및 불안전한 성행위와 같은 불건강행태와 불안 간의 유의미한 연관성을 보였음에도 불구하고, 이러한 불건강행태와 운동 간에는 같은 방향의 유의미한 상호작용이 관찰되지 않았다. 따라서 이 연구는 신체 활동이 청소년들의 불건강행태와 불안간의 관계에 직접 미치는 영향에 대해 명확하게 결론을 내릴 수 없었다.

Key Message
Among Korean adolescents, this study found that significant associations between unhealthy behaviors such as smoking and unsafe sex, and anxiety were only observed in adolescents who did not engage in physical activity. Despite this, no significant interaction was observed between these unhealthy behaviors and exercise. Contrary to popular belief, this study concludes that the evidence is insufficient to definitively say that physical activity influences the relationship between adolescent unhealthy behaviors and anxiety.

Perspective

Epidemiological Model for Conventional Tobacco Control Measures and Tobacco Endgame Policies: Heewon Kang, Sung-il Cho; J Prev Med Public Health. 2023;56(5):481-484. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.239

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Abstract Summary PDF Supplementary Material

Epidemiological models, also known as host-agent-vector-environment models, are utilized in public health to gain insights into disease occurrence and to formulate intervention strategies. In this paper, we propose an epidemiological model that incorporates both conventional measures and tobacco endgame policies. Our model suggests that conventional measures focus on relationships among agent-vector-host-environment components, whereas endgame policies inherently aim to change or eliminate those components at a fundamental level. We also found that the vector (tobacco industry) and environment (physical and social surroundings) components were insufficiently researched or controlled by both conventional measures and tobacco endgame policies. The use of an epidemiological model for tobacco control and the tobacco endgame is recommended to identify areas that require greater effort and to develop effective intervention measures.

Summary

Korean summary
이 연구는 기존의 담배규제와 관련된 역학 모형을 확장하여 담배 수요를 줄이기 위한 조치인 MPOWER 정책과 담배 종결전의 주요 정책을 아우르는 개념적 모형을 제시하였다. 각 정책을 개념적 모형 내 배치한 결과, MPOWER 정책은 모형 내 구성요소 간의 연결을 끊는 것을 목표로 하는 반면, 종결전 정책은 모형 내 요소들을 영구적으로 변화시키거나 제거하려는 특성을 가지고 있는 것으로 나타났다. 담배규제정책이 개체, 병원체, 벡터 및 환경 요소에 대한 균형 잡힌 포트폴리오를 갖추고 있는지 평가하기 위해 이 개념적 모형을 활용할 수 있다.

Key Message
We extended the conceptual epidemiological model for tobacco control by incorporating measures to reduce the demand for tobacco (MPOWER measures) and key endgame policies. The model suggests that MPOWER measures focus on disconnecting the relationships between model components, while endgame policies aim to permanently change or eliminate the components themselves. This model can be used to examine whether a country or jurisdiction's tobacco control policy maintains a balanced portfolio across agent, host, vector, and environmental factors.

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Public support for tobacco endgame policies in South Korea: Findings from the 2020 International Tobacco Control Korea Survey
Heewon Kang, Wonjeong Yoon, Hong Gwan Seo, Sungkyu Lee, Sujin Lim, Gil-yong Kim, Su Young Kim, Steve S Xu, Mi Yan, Anne C K Quah, Janet Chung-Hall, Lorraine V Craig, Coral E Gartner, Geoffrey T Fong, Sung-il Cho
Tobacco Control.2024; : tc-2023-058454. CrossRef
Decrease in household secondhand smoking among South Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Hana Kim, Heewon Kang, Sung-il Cho
Epidemiology and Health.2023; : e2024009. CrossRef

Original Article

Health-related Quality of Life in Elderly Asian American and Non-Hispanic White Cancer Survivors: Suzanne Vang; J Prev Med Public Health. 2023;56(5):440-448. Published online September 13, 2023; DOI: https://doi.org/10.3961/jpmph.22.464

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Abstract Summary PDF: Objectives
The purpose of this study was to assess predictors of health-related quality of life (HRQoL) in elderly Asian American and non-Hispanic White cancer survivors.
Methods
We conducted cross-sectional secondary data analyses using the combined datasets from the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey.
Results
Elderly Asian American cancer survivors reported a lower mental HRQoL but a comparable physical HRQoL relative to elderly non-Hispanic White cancer survivors. Stress factors, such as comorbidities, difficulties with activities of daily living, and a history of depressive symptoms, along with coping resources like self-rated health and the ability to take the survey in English, were significantly associated with mental and physical HRQoL. Among elderly Asian American cancer survivors, a significantly lower mental HRQoL was observed among those taking the survey in the Chinese language.
Conclusions
The findings suggest that race exerts a differential impact on HRQoL. Interventions should be designed to address the distinct cultural, linguistic, and systemic needs of elderly Asian American cancer survivors. Such an approach could assist in reducing cancer-related health disparities.; Summary

Key Message
Secondary data analyses of the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey combined datasets reveal that elderly Asian American cancer survivors had poorer mental health-related quality of life (HRQoL) compared to their non-Hispanic White counterparts. Elderly Asian American cancer survivors who did not complete the survey in English had significantly worse mental HRQoL than their Asian American counterparts who did. These findings point to the need for increased research to identify and address the distinct cultural, linguistic, and system-related needs of elderly Asian American cancer survivors in order to optimize HRQoL in this population.

Special Article

National Cancer Control Plan of the Korea: Current Status and the Fourth Plan (2021-2025): Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im; J Prev Med Public Health. 2023;56(3):205-211. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.115

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Abstract Summary PDF

Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision of “A Healthy Country with No Concerns about Cancer Anywhere at Any Time,” which aims to build and disseminate high-quality cancer data, reduce preventable cancer cases, and reduce gaps in cancer control. Its main strategies include (1) activation of cancer big data, (2) advancement of cancer prevention and screening, (3) improvement in cancer treatment and response, and (4) establishment of a foundation for balanced cancer control. The fourth NCCP has many positive expectations, similar to the last 3 plans; however, cross-domain support and participation are required to achieve positive results in cancer control. Notably, cancer remains the leading cause of death despite decades of management efforts and should continue to be managed carefully from a national perspective.

Summary

Korean summary
- 기존 1~3차 국가암관리계획의 전반적인 성과를 소개합니다. - 제4차 국가암관리계획의 목표 및 내용을 기존 계획과 비교하여 설명합니다.

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Association between Socioecological Status, Nutrient Intake, and Cancer Screening Behaviors in Adults Aged 40 and Over: Insights from the Eighth Korea National Health and Nutrition Examination Survey (KNHANES, 2019)
Seungpil Jeong, Yean-Jung Choi
Nutrients.2024; 16(7): 1048. CrossRef

Original Articles

Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia: Thresya Febrianti, Ngabila Salama, Inggariwati , Dwi Oktavia; J Prev Med Public Health. 2023;56(3):231-237. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.008

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Abstract PDF

Objectives
This study aimed to identify risk factors associated with coronavirus disease 2019 (COVID-19) mortality in pre-elderly and elderly individuals in Jakarta, Indonesia.
Methods
We employed a case-control study design, utilizing secondary data from the Epidemiology Surveillance, Immunization Prevention, and Disease Control Sections of the DKI Jakarta Provincial Health Office, collected from December 2020 to January 2021. The study included 188 cases and an equal number of controls. Cases were COVID-19 patients confirmed to have died, as reported by hospitals and communities and subsequently verified by healthcare workers. Control subjects were patients who completed a 14-day isolation period and had been officially declared recovered by healthcare professionals. The dependent variable was the mortality of COVID-19 patients in the January 2021 period. The independent variables consisted of demographic data (age and sex), clinical symptoms (cough, runny nose, anosmia, diarrhea, headaches, abdominal pain, muscle pain, and nausea/vomiting), and comorbidities (hypertension, heart disease, and diabetes). Multivariate analysis was conducted using multiple logistic regression.
Results
The multiple logistic regression analysis revealed several factors associated with COVID-19 fatalities in Jakarta: age of 60 years or older (odds ratio [OR], 4.84; 95% CI, 3.00 to 7.80), male (OR, 2.38; 95% CI, 2.41 to 3.68), dyspnea (OR, 3.93; 95% CI, 2.04 to 7.55), anosmia (OR, 0.13; 95% CI, 0.04 to 0.46), and heart disease (OR, 4.38; 95% CI, 1.04 to 18.46).
Conclusions
The control and prevention of COVID-19 among elderly individuals require particular vigilance. When a COVID-19 case is detected within this demographic, prompt treatment and medication administration are crucial to mitigate the presenting symptoms.

Summary

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Tuberculosis Coinfection among COVID-19 Patients: Clinical Presentation and Mortality in a Tertiary Lung Hospital in Indonesia
Heni Muflihah, Fajar A. Yulianto, Rina, Edi Sampurno, Astri Ferdiana, Santun B. Rahimah
The International Journal of Mycobacteriology.2024; 13(1): 58. CrossRef

Teleworking Survey in Saudi Arabia: Reliability and Validity of Arabic Version of the Questionnaire: Heba Yaagoub AlNujaidi, Mehwish Hussain, Sama’a H. AlMubarak, Asma Saud AlFayez, Demah Mansour AlSalman, Atheer Khalid AlSaif, Mona M. Al-Juwair; J Prev Med Public Health. 2022;55(6):578-585. Published online November 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.242

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Abstract PDF Supplementary Material: Objectives
This study aimed to adapt the survey questionnaire designed by Moens et al. (2021) and determine the validity and reliability of the Arabic version of the survey in a sample of the Saudi population experiencing teleworking.
Methods
The questionnaire includes 2 sections. The first consists of 13 items measuring the impact of extended telework during the coronavirus disease 2019 (COVID-19) crisis. The second section includes 6 items measuring the impact of the COVID-19 crisis on self-view of telework and digital meetings. The survey instrument was translated based on the guidelines for the cultural adaptation of self-administrated measures.
Results
The reliability of the questionnaire responses was measured by Cronbach’s alpha. The construct validity was checked through exploratory factor analysis followed by confirmatory factor analysis (CFA) to further assess the factor structure. CFA revealed that the model had excellent fit (root mean square error of approximation, 0.00; comparative fit index, 1.0; Tucker-Lewis index, 1; standardized root mean squared residual, 0.0).
Conclusions
The Arabic version of the teleworking questionnaire had high reliability and good validity in assessing experiences and perceptions toward teleworking. While the validated survey examined perceptions and experiences during COVID-19, its use can be extended to capture experiences and perceptions during different crises.; Summary

SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan: Lyudmila Yermukhanova, Zhanar Buribayeva, Indira Abdikadirova, Anar Tursynbekova, Meruyert Kurganbekova; J Prev Med Public Health. 2022;55(6):539-548. Published online October 11, 2022; DOI: https://doi.org/10.3961/jpmph.22.360

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Abstract PDF: Objectives
The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan.
Methods
The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires.
Results
The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners.
Conclusions
The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees’ working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.; Summary

Brief Report

Effects of Forest Therapy on Psychological Improvement in Middle-aged Women in Korea: Bum-Jin Park, Won-Sop Shin, Chang-Seob Shin, Poung-Sik Yeon, Chung-Yeub Chung, Si-Hyung Lee, Dong-Jun Kim, Youn-Hee Kim, Chang-Eun Park; J Prev Med Public Health. 2022;55(5):492-497. Published online September 20, 2022; DOI: https://doi.org/10.3961/jpmph.22.086

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Abstract Summary PDF Supplementary Material

Objectives
Women experience more stress in middle age than in other periods of their lives. Therefore, health management programs that enable middle-aged women to cope with and manage stress are needed. This study investigated the psychological effects of a meditation-focused forest therapy program among 53 middle-aged women living in urban areas in Korea.
Methods
Participants were divided into 2 groups: one group underwent the program for 3 days in a forest, followed by 3 days in an urban environment, and the other group underwent the program for 3 days in the urban environment, followed by 3 days in the forest. The psychological effects of the forest therapy program were evaluated using the Profile of Mood States-Brief (POMS-B). Differences in mood state before and after the program conducted in the forest (experimental group) and in the urban environment (control group) were evaluated using the paired-samples t-test.
Results
The program in the forest significantly reduced tension, depression, anger, fatigue, and confusion among the domains of the POMS-B. The program in the urban area significantly reduced tension, but not depression, anger, fatigue, or confusion.
Conclusions
Meditation-focused forest therapy programs are expected to contribute to promoting psychological health and enhancing the quality of life of middle-aged women.

Summary

Korean summary
중년 여성이 건강을 관리할 수 있는 프로그램이 필요하다. 이 연구는 명상 중심의 산림치유 프로그램이 중년 여성의 심리적 건강 증진에 효과적인지 검증하기 위해 프로그램 시행 전후에 참가자의 기분상태(POMS-B)를 측정하여 비교하였다. 결과에 의하면 긴장, 우울, 분노, 피곤, 혼돈이 통계적으로 유의하게 감소하였다.

Citations

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Effect of Anti-Aging Standard Forest Healing Program With Multiple Visits to a Forest Facility on Cognition in Older Age Patients
Jinseok Park, Sheng-Min Wang, Dong Woo Kang, Beom Lee, Hojin Choi
Dementia and Neurocognitive Disorders.2024; 23(1): 44. CrossRef
Supporting Wellness, Resilience, and Community With Forest Therapy
Susan A Abookire, Sujata G Ayala, Nancy A Shadick
Global Advances in Integrative Medicine and Health.2024;[Epub] CrossRef
The Impact of Forest Therapy Programs on Stress Reduction: A Systematic Review
Yawei Zhang, Lu Feng, Wenjie Duan
Forests.2023; 14(9): 1851. CrossRef

Special Article

Statin Intake and Gastric Cancer Risk: An Updated Subgroup Meta-analysis Considering Immortal Time Bias: Jong-Myon Bae; J Prev Med Public Health. 2022;55(5):424-427. Published online August 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.209

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Abstract Summary PDF

A retrospective record-linkage study (RLS) based on medical records containing drug prescription histories involves immortal time bias (ITB). Thus, it is necessary to control for this bias in the research planning and analysis stages. Furthermore, a summary of a metaanalysis including RLSs that did not control for ITB showed that specific drugs had a preventive effect on the occurrence of the disease. Previous meta-analytic results of three systematic reviews evaluating the association between statin intake and gastric cancer risk showed that the summary hazard ratio (sHR) of the RLSs was lower than 1 and was statistically significant. We should consider the possibility of ITB in the sHR of RLSs and interpret the results carefully.

Summary

Korean summary
이차자료를 활용하여 구축한 코호트 추적연구는 immortal time bias가 개입될 개연성을 염두에 두어야 한다. 이들 연구결과들을 제외한 메타분석 결과 스타닌 복용에 따른 위암발생 위험 감소는 관련성이 없다는 결과를 도출하였다.

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Sodium-glucose cotransporter-2 inhibitors use and the risk of gout: a systematic review and meta-analysis
Shih-Wei Lai, Bing-Fang Hwang, Yu-Hung Kuo, Chiu-Shong Liu, Kuan-Fu Liao
Frontiers in Endocrinology.2023;[Epub] CrossRef

Brief Report

Analysis of a Targeted Intervention Programme on the Risk Behaviours of Injecting Drug Users in India: Evidence From the National Integrated Biological and Behavioural Surveillance Survey: Damodar Sahu, Varsha Ranjan, Nalini Chandra, Saritha Nair, Anil Kumar, Elangovan Arumugam, Mendu Vishnu Vardhana Rao; J Prev Med Public Health. 2022;55(4):407-413. Published online July 19, 2022; DOI: https://doi.org/10.3961/jpmph.22.150

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Abstract PDF

Objectives
This study provides insights on the impact of a targeted intervention (TI) programme on behaviour change among injecting drug users (IDUs) in India.
Methods
This paper examined the data from the Integrated Biological and Behavioural Surveillance 2014-2015 for IDUs in India. Logistic regression was performed to understand the factors (TI programme services) that affected injecting risk behaviours by adjusting for covariates. Propensity score matching was conducted to understand the impact of the TI programme on using new needles/syringes and sharing needles/syringes in the most recent injecting episode by accounting for the covariates that predicted receiving the intervention.
Results
Participants who received new needles and syringes from peer educators or outreach workers were 1.3 times (adjusted odds ratio, 1.29; 95% confidence interval [CI], 1.09 to 1.53) more likely to use new needles/syringes during most recent injecting episode than participants who did not receive needles/syringes. The matched-samples estimate (i.e., average treatment effect on treated) of using new needles in the most recent injecting episode showed a 2.8% (95% CI, 0.0 to 5.6) increase in the use of new needles and a 6.5% (95% CI, -9.7 to -3.3) decrease in needle sharing in the most recent injecting episode in participants who received new needles/syringes. There was a 2.2% (95% CI, -3.8 to -0.6) decrease in needle sharing in the most recent injecting episode among participants who were referred to other services (integrated counselling and testing centre, detox centres, etc.).
Conclusions
The TI programme proved to be effective for behaviour change among IDUs, as substantiated by the use of new needles/syringes and sharing of needles/syringes.

Summary

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Effectiveness of targeted intervention program under the national AIDS control program among Hijra and transgender population: Evidence from Integrated Biological and Behavioral Surveillance, 2014-15
Nishakar Thakur, Sanjay Rai, Shashi Kant, Arvind Pandey, Damodar Sahu, Puneet Misra, Partha Haldar, Shreya Jha, Pradeep Kumar, Chinmoyee Das
International Journal of STD & AIDS.2024; 35(5): 337. CrossRef

Special Article

Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database: Dawoon Jeong, Hee-Yeon Kang, Jinsun Kim, Hyewon Lee, Bit-Na Yoo, Hee-Sun Kim, Hongjo Choi; J Prev Med Public Health. 2022;55(3):253-262. Published online April 22, 2022; DOI: https://doi.org/10.3961/jpmph.21.635

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Abstract Summary PDF Supplementary Material

We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

Summary

Korean summary
TB Post 코호트(Korean Tuberculosis and Post-Tuberculosis Cohort)는 한국의 결핵 모니터링 및 관리에 대한 인구집단 수준에서의 새로운 근거를 마련하고자 구축한 우리나라 결핵 환자 코호트입니다. 국가 결핵감시체계의 일환으로 구축된 질병관리청의 결핵신고자료와 국민건강보험공단의 국민건강정보DB 자료, 통계청 사망원인 자료의 연계로 구축되었으며, 각 자료원이 보유한 정보를 활용하여 통합적인 결핵 환자 연구가 가능할 것으로 기대하고 있습니다. 결핵의 정책 효과 연구뿐만 아니라, 치료 성공, 실패, 중단 등 치료결과에 대한 영향 요인 및 환자들의 건강 관련 행태에 대한 역학 연구 등 향후 다양한 연구에 활용될 수 있을 것으로 기대됩니다.

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Systematic Review

Challenges to Achieving Universal Health Coverage Throughout the World: A Systematic Review: Alireza Darrudi, Mohammad Hossein Ketabchi Khoonsari, Maryam Tajvar; J Prev Med Public Health. 2022;55(2):125-133. Published online March 8, 2022; DOI: https://doi.org/10.3961/jpmph.21.542

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Abstract PDF Supplementary Material

Objectives
No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC.
Methods
A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables.
Results
Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported.
Conclusions
This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.

Summary

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Original Article

Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone: Chanki Kim, Eun Jee Chang, Chang-yup Kim; J Prev Med Public Health. 2021;54(6):441-450. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.337

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Abstract Summary PDF Supplementary Material

Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

Summary

Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

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COVID-19: Perspective

New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic: Seung Mi Yoo, Seol Hee Chung, Won Mo Jang, Kyoung Chang Kim, Jin Yong Lee, Sun Min Kim; J Prev Med Public Health. 2021;54(1):17-21. Published online January 26, 2021; DOI: https://doi.org/10.3961/jpmph.20.594

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Abstract Summary PDF

In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

Summary

Korean summary
건강보험심사평가원은 전 국민과 전체 요양기관의 축적된 정보, 전체 요양기관과 연결된 네트워크, 실시간 데이터 공유를 통해 이번 코로나19 위기 대응에 기여했다. 건강보험심사평가원은 1) 진단검사∙약제 등재, 2) 요양기관 내 고위험군 감지, 3) 마스크 중복구매 방지 시스템 구축, 4) 주요 보건의료자원 가동현황 모니터링 시스템 구축, 5) 환자관리 정보시스템 구축 및 익명화된 환자 데이터 공개로 국제협력연구 촉진의 다섯 가지 전략을 성공적으로 수행했다. 건강보험심사평가원은 현재의 보건위기 상황을 극복하고, 코로나19 시대 이후로도 새롭게 주어진 위기대응의 역할과 소명을 다할 것이다.

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