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Volume 46(4); July 2013
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Special Articles
Burden of Noncommunicable Diseases and National Strategies to Control Them in Korea
Young-Ho Khang
J Prev Med Public Health. 2013;46(4):155-164.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.155
Correction in: J Prev Med Public Health 2013;46(5):292
  • 20,937 View
  • 145 Download
  • 18 Crossref
AbstractAbstract PDF

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.

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Citations

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Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea
Hyeon Chang Kim, Sun Min Oh
J Prev Med Public Health. 2013;46(4):165-172.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.165
  • 16,711 View
  • 267 Download
  • 79 Crossref
AbstractAbstract PDF

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.

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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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AbstractAbstract 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
Drinking Patterns Among Korean Adults: Results of the 2009 Korean Community Health Survey
So Yeon Ryu, Catherine M. Crespi, Annette E. Maxwell
J Prev Med Public Health. 2013;46(4):183-191.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.183
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AbstractAbstract PDF
Objectives

In Korea, the proportion of deaths due to alcohol is estimated at 8.9%, far exceeding the global estimate of 3.8%. Therefore, this study was performed to examine the factors associated with low-risk, moderate-risk, and high-risk drinking patterns in Korean adults and to identify target populations for prevention and control of alcohol-related diseases and deaths.

Methods

We analyzed data from 230 715 Korean adults aged 19 years and older who participated in the 2009 Korean Community Health Survey. Multinomial logistic regression analysis was used to examine associations between socio-demographic and health-related factors and patterns of alcohol use.

Results

A substantially larger proportion of men than women engaged in high risk (21.2% vs. 3.4%) and moderate-risk alcohol use (15.5% vs. 8.2%). In both sexes, moderate- and high-risk uses were associated with younger age, higher income, being currently employed, smoking, being overweight/obese, and good self-rated health.

Conclusions

Given the large proportion of the population that is engaging in moderate- and high-risk drinking and given the social norms that support this behavior, public health policies and campaigns to reduce alcohol consumption targeting the entire population are indicated.

Summary

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Behavioural Determinants for Obesity: A Cross-sectional Study Among Urban Adolescents in India
M. Anitha Rani, B.W.C. Sathiyasekaran
J Prev Med Public Health. 2013;46(4):192-200.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.192
  • 11,868 View
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AbstractAbstract PDF
Objectives

To measure the prevalence of behavioural risk factors for obesity among urban adolescent school children in Chennai, India.

Methods

This study was performed as a cross-sectional study using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for India) among adolescent school children studying in 30 randomly selected secondary and higher secondary schools in Chennai city. 1842 adolescents studying in the VIII to XII standards were randomly selected for the study.

Results

In the present study, 40.7% of the students ate fruit one or more times per day and 74.5% of the students ate vegetables one or more times per day. Nearly 20% of the students ate fast food items on 4 to 7 days during the previous week. Among the students, 30.4% watched television for more than two hours per day. Nearly 68% of the girls and 22% of the boys did not participate in outdoor sports activities. When the pattern of physical activity of the students was assessed, it was observed that 15.6% were inactive, 43.4% were minimally active, and the remaining 41.0% belonged to the category of health enhancing physical activity. Among the students, 6.2% were overweight and 5.2% were obese.

Conclusions

The prevalence of risk factors for obesity was quite high among the adolescents. This study also showed that a great proportion of overweight/obese adolescents had a correct perception of their body weight and they were making efforts to modify risk factors such as television viewing, computer use, a sedentary lifestyle, and unhealthy dietary habits.

Summary

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Use of Drug-eluting Stents Versus Bare-metal Stents in Korea: A Cost-minimization Analysis Using Population Data
Hae Sun Suh, Hyun Jin Song, Eun Jin Jang, Jung-Sun Kim, Donghoon Choi, Sang Moo Lee
J Prev Med Public Health. 2013;46(4):201-209.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.201
  • 8,375 View
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AbstractAbstract PDF
Objectives

The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data.

Methods

We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses.

Results

Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization.

Conclusions

Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

Summary

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Erratums
Erratum: Lessons From Unified Germany and Their Implications for Healthcare in the Unification of the Korean Peninsula
Gun-Chun Ryu
J Prev Med Public Health. 2013;46(4):210-210.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.210
Corrects: J Prev Med Public Health 2013;46(3):127
  • 5,077 View
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PDF
Summary

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    Daniel Karthe, Niklas Rehkopp, Heiko Faust, Tobias Reeh
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Erratum: Fate and Transport of Mercury in Environmental Media and Human Exposure
Moon-Kyung Kim, Kyung-Duk Zoh
J Prev Med Public Health. 2013;46(4):211-211.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.211
Corrects: J Prev Med Public Health 2012;45(6):335
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JPMPH : Journal of Preventive Medicine and Public Health