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Saerom Kim 4 Articles
Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea
Youngsoo Kim, Saerom Kim, Seungmin Jeong, Sang Guen Cho, Seung-sik Hwang
J Prev Med Public Health. 2019;52(1):51-59.   Published online January 23, 2019
  • 6,472 View
  • 192 Download
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated.
Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables.
The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and selfrated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model.
The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.
Korean summary
이 연구에서는 2011년부터 2015년까지의 한국의료패널 자료를 이용하여 미충족의료과 불건강의 관련성을 살펴보고, 불건강을 매개하는 미충족의료의 크기를 추정했다. 미충족의료는 개인고정효과를 보정하였을 때 불건강에 유의한 영향 준다는 것을 확인할 수 있었고, 미충족의료가 매개하는 저소득의 건강 효과는 저소득이 불건강에 미치는 전체 효과 중 일부에 지나지 않았으며, 효과의 크기는 분석 연도 별로 일정하지 않게 나타났다. 이는 건강불평등을 줄이기 위한 정책 개입에서 미충족의료 해소가 유의미한 정책 목표로 가치가 있지만 그 한계 또한 명확하다는 것을 의미한다.


Citations to this article as recorded by  
  • How did unmet care needs during the pandemic affect health outcomes of older European individuals?
    Julien Bergeot, Florence Jusot
    Economics & Human Biology.2024; 52: 101317.     CrossRef
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    Carlota Quintal, Luis Moura Ramos, Micaela Antunes, Óscar Lourenço
    European Journal of Ageing.2023;[Epub]     CrossRef
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    BMC Public Health.2022;[Epub]     CrossRef
  • Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data
    Woojin Chung
    Healthcare.2022; 10(11): 2243.     CrossRef
  • Intergenerational Differences in Factors Affecting Unmet Health Care Needs in South Korea: Comparison of Middle-aged and Older Adults
    Eunjeong Noh
    Journal of Intergenerational Relationships.2021; 19(1): 144.     CrossRef
  • Identification of Unmet Healthcare Needs: A National Survey in Thailand
    Sukanya Chongthawonsatid
    Journal of Preventive Medicine and Public Health.2021; 54(2): 129.     CrossRef
  • Factors affecting unmet healthcare needs of low-income overweight and obese women in Korea: analysis of the Korean National Health and Nutrition Examination Survey 2017
    Ju-Hee Nho, Sook Kyoung Park
    Korean Journal of Women Health Nursing.2021; 27(2): 93.     CrossRef
  • Factors Affecting Unmet Healthcare Needs among Adults with Chronic Diseases
    Ji-Young Han, Hyeon-Sook Park
    Journal of Korean Academy of Community Health Nursing.2021; 32(2): 131.     CrossRef
  • Association between osteoarthritis and unmet medical needs in Korea: limitations in activities as a mediator
    Hooin Jo, Eun-san Kim, Boyoung Jung, Soo-Hyun Sung, In-Hyuk Ha
    BMC Public Health.2020;[Epub]     CrossRef
  • Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study
    Ju Young Kim, Dae In Kim, Hwa Yeon Park, Yuliya Pak, Phap Ngoc Hoang Tran, Truc Thanh Thai, Mai Thi Thanh Thuy, Do Van Dung
    International Journal of Environmental Research and Public Health.2020; 17(17): 6320.     CrossRef
  • Factors Underlying Unmet Medical Needs: A Cross-Sectional Study
    Young Suk Yoon, Boyoung Jung, Dongsu Kim, In-Hyuk Ha
    International Journal of Environmental Research and Public Health.2019; 16(13): 2391.     CrossRef
Civic Participation and Self-rated Health: A Cross-national Multi-level Analysis Using the World Value Survey
Saerom Kim, Chang-yup Kim, Myung Soon You
J Prev Med Public Health. 2015;48(1):18-27.   Published online January 27, 2015
  • 11,188 View
  • 144 Download
  • 4 Crossref
AbstractAbstract PDF
Civic participation, that which directly influences important decisions in our personal lives, is considered necessary for developing a society. We hypothesized that civic participation might be related to self-rated health status.
We constructed a multi-level analysis using data from the World Value Survey (44 countries, n=50 859).
People who participated in voting and voluntary social activities tended to report better subjective health than those who did not vote or participate in social activities, after controlling for socio-demographic factors at the individual level. A negative association with unconventional political activity and subjective health was found, but this effect disappeared in a subset analysis of only the 18 Organization for Economic Cooperation and Development (OECD) countries. Moreover, social participation and unconventional political participation had a statistically significant contextual association with subjective health status, but this relationship was not consistent throughout the analysis. In the analysis of the 44 countries, social participation was of borderline significance, while in the subset analysis of the OECD countries unconventional political participation was a stronger determinant of subjective health. The democratic index was a significant factor in determining self-rated health in both analyses, while public health expenditure was a significant factor in only the subset analysis.
Despite the uncertainty of its mechanism, civic participation might be a significant determinant of the health status of a country.


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    Ebenezer Larnyo, Sharon Tettegah, Brianna Griffin, Jonathan Aseye Nutakor, Natasha Preece, Stephen Addai-Dansoh, Natalia Dubon, Senyuan Liu
    Scientific Reports.2024;[Epub]     CrossRef
  • A bird's eye view of civic engagement and its facets: Canonical correlation analysis across 34 countries
    Kaitlyn Battershill, Victor Kuperman
    Journal of Civil Society.2023; 19(4): 437.     CrossRef
  • Welfare States and the Health Impact of Social Capital: Focusing on the Crowding-Out and Crowding-In Perspectives
    Naoki Akaeda
    Social Indicators Research.2021; 157(3): 841.     CrossRef
  • Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women
    Shervin Assari, James Smith, Mohsen Bazargan
    International Journal of Environmental Research and Public Health.2019; 16(10): 1670.     CrossRef
Association Between Local Government Social Expenditures and Mortality Levels in Korea
Hansoo Ko, Jinseob Kim, Donggil Kim, Saerom Kim, Yukyung Park, Chang-yup Kim
J Prev Med Public Health. 2013;46(1):1-9.   Published online January 31, 2013
  • 8,467 View
  • 73 Download
  • 2 Crossref
AbstractAbstract PDF

We examined the association between social expenditures of the local government and the mortality level in Korea, 2004 to 2010.


We used social expenditure data of 230 local governments during 2004 to 2010 from the Social Expenditure Database prepared by the Korean Institute for Health and Social Affairs. Fixed effect panel data regression analysis was adopted to look for associations between social expenditures and age-standardized mortality and the premature death index.


Social expenditures of local governments per capita was not significantly associated with standardized mortality but was associated with the premature death index (decline of 1.0 [for males] and 0.5 [for females] for each expenditure of 100 000 Korean won, i.e., approximately 100 US dollar). As an index of the voluntary effort of local governments, the self-managed project ratio was associated with a decline in the standardized mortality in females (decline of 0.4 for each increase of 1%). The share of health care was not significant.


There were associations between social expenditures of the local government and the mortality level in Korea. In particular, social expenditures per capita were significantly associated with a decline in premature death. However, the voluntary efforts of local governments were not significantly related to the decline in premature death.



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  • Public health management: systemic analysis of social determinants of health in Brazilian municipalities
    Francisco Carlos Carvalho de Melo, Rodolfo Ferreira Ribeiro da Costa, Jansen Maia Del Corso
    Health Policy and Planning.2020; 35(2): 123.     CrossRef
  • The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey
    Hye Ah Lee, Hyejin Han, Seonhwa Lee, Bomi Park, Bo Hyun Park, Won Kyung Lee, Ju Ok Park, Sungok Hong, Young Taek Kim, Hyesook Park
    BMC Public Health.2018;[Epub]     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health