Journal of Preventive Medicine and Public Health

Perspective

Polypharmacy and Therapeutic Inertia in Extreme Longevity: A Potential Clinical Ageism Scenario Secondary to Important Gaps in Clinical Evidence: María Viviana Pantoja, Ivan David Lozada-Martinez; J Prev Med Public Health. 2024;57(5):508-510. Published online September 27, 2024; DOI: https://doi.org/10.3961/jpmph.24.364

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Abstract PDF: Population aging is a global health priority due to the dramatic increase in the proportion of older persons worldwide. It is also expected that both global life expectancy and disability-free life expectancy will increase, leading to a significant rise in the proportion of individuals with extreme longevity, such as non-agenarians and centenarians. The inaccuracy of clinical evidence on therapeutic interventions for this demographic could lead to biased decision-making, influenced by age-related beliefs or misperceptions about their therapeutic needs. This represents a potential clinical ageism scenario stemming from gaps in clinical evidence. Such biases can result in 2 significant issues that adversely affect the health status and prognosis of older persons: polypharmacy and therapeutic inertia. To date, documents on polypharmacy in non-agenarians and centenarians account for less than 0.35% of the overall available evidence on polypharmacy. Furthermore, evidence regarding therapeutic inertia is non-existent. The purpose of this letter is to discuss polypharmacy and therapeutic inertia as potential clinical ageism scenarios resulting from the clinical evidence gaps in extreme longevity.; Summary

Original Article

A Comparison of Green, Delta, and Monte Carlo Methods to Select an Optimal Approach for Calculating the 95% Confidence Interval of the Population-attributable Fraction: Guidance for Epidemiological Research: Sangjun Lee, Sungji Moon, Kyungsik Kim, Soseul Sung, Youjin Hong, Woojin Lim, Sue K. Park; J Prev Med Public Health. 2024;57(5):499-507. Published online September 6, 2024; DOI: https://doi.org/10.3961/jpmph.24.272

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Abstract PDF: Objectives
This study aimed to compare the Delta, Greenland, and Monte Carlo methods for estimating 95% confidence intervals (CIs) of the population-attributable fraction (PAF). The objectives were to identify the optimal method and to determine the influence of primary parameters on PAF calculations.
Methods
A dataset was simulated using hypothetical values for primary parameters (population, relative risk [RR], prevalence, and variance of the beta estimator ) involved in PAF calculations. Three methods (Delta, Greenland, and Monte Carlo) were used to estimate the 95% CIs of the PAFs. Perturbation analysis was performed to assess the sensitivity of the PAF to changes in these parameters. An R Shiny application, the “GDM-PAF CI Explorer,” was developed to facilitate the analysis and visualization of these computations.
Results
No significant differences were observed among the 3 methods when both the RR and p-value were low. The Delta method performed well under conditions of low prevalence or minimal RR, while Greenland’s method was effective in scenarios with high prevalence. Meanwhile, the Monte Carlo method calculated 95% CIs of PAFs that were stable overall, though it required intensive computational resources. In a novel approach that utilized perturbation for sensitivity analysis, was identified as the most influential parameter in the estimation of CIs.
Conclusions
This study emphasizes the necessity of a careful approach for comparing 95% CI estimation methods for PAFs and selecting the method that best suits the context. It provides practical guidelines to researchers to increase the reliability and accuracy of epidemiological studies.; Summary

Review

Potential Increasing Trend in Schizophrenia Relapse Prevention in the Past 40 Years: A Bibliometric Analysis: Isymiarni Syarif, Hasnawati Amqam, Saidah Syamsuddin, Veni Hadju, Syamsiar Russeng, Yusran Amir; J Prev Med Public Health. 2024;57(5):421-434. Published online August 26, 2024; DOI: https://doi.org/10.3961/jpmph.24.201

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Abstract PDF: Objectives
Schizophrenia is an organic disease and a severe mental disorder with a relatively high risk of relapse. The rising rate of schizophrenia relapse has motivated researchers and academics to innovate and develop interventions aimed at relapse prevention. This bibliometric study sought to examine the publication trends in schizophrenia relapse prevention from 1973 to 2023, assess the contribution of international collaborations across various journals, identify the most influential authors and articles, and forecast future developments in this field.
Methods
The study included 683 articles obtained from the Scopus database, analyzed using VOSviewer software, and visualized with Tableau.
Results
Reports of schizophrenia relapse prevention strategies have increased significantly over the last 3 decades. However, fluctuations persist, as evidenced by the annual number of publications ranging from 25 to 40 within the past 5 years. Nevertheless, this increasing trend underscores the sustained interest in this area of research. Regarding contribution size, the United States produced the largest volume of publications on this subject. John M. Kane authored the most articles, while Stefan Leucht exhibited the highest h-index. Frequently used keywords in this field include “relapse AND schizophrenia” AND “prevention.”
Conclusions
These results represent an important reference for determining the current state of research on schizophrenia relapse prevention and future research directions.; Summary

Original Articles

Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022: So-Jin Im, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2024;57(5):480-489. Published online August 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.254

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Abstract PDF: Objectives
Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic’s impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method.
Methods
Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented.
Results
The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with “endocrine, nutritional, and metabolic diseases” and “symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified.”
Conclusions
Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.; Summary

Healthcare Utilization and Discrepancies by Income Level Among Patients With Newly Diagnosed Type 2 Diabetes in Korea: An Analysis of National Health Insurance Sample Cohort Data: Eun Jee Park, Nam Ju Ji, Chang Hoon You, Weon Young Lee; J Prev Med Public Health. 2024;57(5):471-479. Published online August 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.165

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Abstract PDF: Objectives
The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D.
Methods
A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care.
Results
From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99).
Conclusions
Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.; Summary

Global Trends in Childhood Sexual Abuse and Bullying Victimization: A Comprehensive Analysis from 1990 to 2019: Nasrin Borumandnia, Mohammadamin Sabbagh Alvani, Payam Fattahi, Mahmood Reza Gohari, Yashar Kheirolahkhani, Hamid Alavimajd; Received January 1, 2024 Accepted June 18, 2024 Published online August 15, 2024; DOI: https://doi.org/10.3961/jpmph.24.007 [Accepted]

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Abstract PDF: Objectives
No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.
Methods
CSA and BV rates were extracted from the Global Burden of Disease study, spanning the years 1990 to 2019 across 204 countries. Trends by gender, region, and human development index (HDI) were examined.
Results
For both boys and girls, and in both high- and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high- and low-HDI countries for both genders (p<0.001). Subsequently, we analyzed trends separately by gender across all countries, without considering development level. In this analysis, CSA rates among girls decreased from 1990 to 2000, followed by an increasing tendency after 2000; overall, an upward trend was evident between 1990 and 2019 (p=0.029). In contrast, no significant pattern was observed for boys. Notably, BV demonstrated an increasing trend across all regions when HDI was not considered (p<0.05), with African populations experiencing the most pronounced rise (p<0.001). Globally, boys consistently exhibited higher BV rates than girls.
Conclusions
Our research indicates that, on a global scale, rates of CSA among girls have been rising. Additionally, BV rates have increased in all regions for both boys and girls. Notably, this trend in BV rates is occurring irrespective of HDI. These findings underscore the necessity for targeted interventions in areas with high rates of CSA and BV.; Summary

Factors Associated With Coverage in Community-directed Treatment With Ivermectin for Onchocerciasis Control in Savanah and Forest Areas in Central African Republic: A Cross-sectional Study: Sylvain Honoré Woromogo, Stéphanie Inesse Garoua-Adjou, Ange Donatien Ngouyombo, Rodrigue Herman Doyama-Woza, Henri Saint Calvaire Diemer, Jean de Dieu Longo; J Prev Med Public Health. 2024;57(5):490-498. Published online August 14, 2024; DOI: https://doi.org/10.3961/jpmph.24.280

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Abstract PDF: Objectives
The aim of this study was to identify factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in savannah and forest areas in the Central African Republic.
Methods
A cross-sectional study was conducted in 2 districts where onchocerciasis is endemic. We employed a pretested and validated questionnaire that included questions about the socio-demographic characteristics of the respondents and variables relevant to coverage assessment. Multivariate logistic regression analyses were performed to identify the associations between surveyed mass drug administration (MDA) coverage and the variables considered, while accounting for potential confounding factors. A p-value <0.05 was considered statistically significant.
Results
At the district level, the MDA program achieved a reach of 87.29% (95% confidence interval [CI], 86.03 to 88.55) in Bossangoa and 61.74% (95% CI, 59.56 to 63.92) in Kémo, compared to the reported rates of 90.02% and 91.70%, respectively. Women in both Bossangoa and Kémo were 1.28 times more likely to have taken ivermectin than men (95% CI, 1.12 to 1.47; p=0.008; 95% CI, 1.09 to 2.00; p=0.041, respectively). The age groups of 5-14, 15-24, and 25-34 were statistically associated with better distribution coverage in both districts. Individuals with knowledge of onchocerciasis were more likely to receive ivermectin compared to those without knowledge, with adjusted odds ratios of 1.41 (95% CI, 1.11 to 2.01; p=0.030) and 3.19 (95% CI, 2.91 to 4.08; p=0.001), respectively.
Conclusions
The authors recommend implementing measures to improve MDA coverage in future campaigns. These measures should include allocating sufficient time for MDA activities, providing health education, and mobilising the entire population.; Summary

Case Report

Pseudoephedrine-induced Fixed Drug Eruption in a Scuba Diver With Recurrent Palmoplantar Exfoliation: Pimpreeya Kajornchaikul, Pattarawat Thantiworasit, Jettanong Klaewsongkram; Received June 24, 2024 Accepted August 1, 2024 Published online August 8, 2024; DOI: https://doi.org/10.3961/jpmph.24.319 [Accepted]

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Abstract PDF: Objectives
This report presents a case of pseudoephedrine-induced nonpigmented bullous fixed drug eruption (NBFDE) manifesting as recurrent palmoplantar exfoliation in a scuba diver. It emphasizes the importance of considering drug allergies in the differential diagnosis when divers present with peeling hands and soles.
Methods
A 38-year-old female scuba diver experiencing recurrent palmoplantar exfoliation underwent a clinical evaluation, patch testing, an interferon-gamma enzyme-linked immunospot (ELISpot) assay, and graded drug challenges with pseudoephedrine and phenylephrine.
Results
Patch testing yielded negative results; however, the ELISpot assay indicated a strong immune response to pseudoephedrine. A graded challenge involving pseudoephedrine successfully reproduced the symptoms, confirming a diagnosis of pseudoephedrine-induced NBFDE. Subsequently, a challenge with phenylephrine elicited a milder reaction, suggesting it as a potential alternative medication for the patient.
Conclusions
This case highlights NBFDE as a potential cause of skin peeling in scuba divers who are allergic to pseudoephedrine. It emphasizes the importance of considering drug allergies when diagnosing palmoplantar exfoliation in divers and underscores the need for a thorough evaluation of medication use in this group. Alternative medications and management strategies should be considered for divers with a pseudoephedrine allergy to prevent ear barotrauma while minimizing the risk of adverse skin reactions.; Summary

Original Articles

The Influence of Family Adversities on Longitudinal Changes in Physical Inactivity Among Korean Adolescents During the COVID-19 Pandemic: Tae Kyoung Lee, Jing Zhu, Young Mi Kim, Ze-Kai Jiang, Meilin Zhang, Won Ha Choi, Tae-Young Pak, Hana Song; J Prev Med Public Health. 2024;57(5):443-450. Published online August 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.236

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Abstract PDF: Objectives
Lack of physical activity has a critical effect on the physical and mental health of adolescents. This study examined the influence of family adversities on the longitudinal changes in physical inactivity among adolescents during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
The study used multi-wave data from the Korean Children and Youth Panel Survey, including 2590 Korean adolescents aged 12-14 years. The longitudinal trajectory of physical inactivity among adolescents and the effects of related factors were estimated using a latent growth modeling method.
Results
Our results revealed a significant increase in physical inactivity among adolescents over time. At the onset of the pandemic, approximately one-seventh of Korean middle schoolers reported a lack of physical activity. However, 3 years later, during the quarantine, nearly one-fifth of these adolescents reported a significant increase in their physical inactivity. Initially, low level parental education was predictive of adolescents’ physical inactivity, but this effect diminished over time, becoming statistically insignificant by the end of the 3-year period. Moreover, the increase in physical inactivity over the 3 years was significantly influenced by parental rejection.
Conclusions
These findings suggest that adolescents who experience parental rejection are more likely to report an increase in sedentary behaviors in contexts such as the COVID-19 pandemic.; Summary

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

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Abstract PDF: Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.; Summary

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia: Tofan Agung Eka Prasetya, Nurul Izzah Abdul Samad, Aisy Rahmania, Dian Afif Arifah, Ratih Andhika Akbar Rahma, Abdullah Al Mamun; J Prev Med Public Health. 2024;57(5):451-460. Published online July 25, 2024; DOI: https://doi.org/10.3961/jpmph.24.214

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Abstract PDF: Objectives
This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia.
Methods
A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance.
Results
The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032).
Conclusions
Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.; Summary

HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-related Stigma in Health Services in West Sumatra, Indonesia: An Empirical Evaluation Using PLS-SEM

Vivi Triana, Nursyirwan Effendi, Brian Sri Pra Hastuti, Cimi Ilmiawati, Dodi Devianto, Afrizal Afrizal, Adang Bachtiar, Rima Semiarty, Raveinal Raveinal

J Prev Med Public Health. 2024;57(5):435-442.   Published online July 15, 2024

DOI: https://doi.org/10.3961/jpmph.23.503

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Abstract PDF

Objectives
The aim of this study was to investigate the significance of associations between knowledge, professional ethics, institutional support, perceptions regarding HIV/AIDS, and HIV/AIDS-related stigma among health workers in West Sumatra, Indonesia.
Methods
We conducted a cross-sectional study involving health workers at public hospitals and health centers in West Sumatra in June 2022. The Health Care Provider HIV/AIDS Stigma Scale was employed to assess the stigma associated with HIV/AIDS. To estimate and evaluate the model’s ability to explain the proposed constructs, we utilized the standardized partial least squares structural equation model (PLS-SEM).
Results
In total, 283 individuals participated in this study (average age, 39 years). The majority were female (91.2%), nearly half were nurses (49.5%), and 59.4% had been working for more than 10 years. The study revealed that HIV/AIDS-related stigma persisted among health workers. The PLS-SEM results indicated that all latent variables had variance inflation factors below 5, confirming that they could be retained in the model. Knowledge and professional ethics significantly contributed to human immunodeficiency virus (HIV)-related stigma, with an effect size (f²) of 0.15 or greater. In contrast, perceived and institutional support had a smaller impact on HIV-related stigma, with an effect size (f²) of at least 0.02. The R 2 value for health worker stigma was 0.408, suggesting that knowledge, professional ethics, institutional support, and perceived support collectively explain 40.8% of the variance in stigma.
Conclusions
Improving health workers’ understanding of HIV, fostering professional ethics, and strengthening institutional support are essential for reducing HIV-related stigma in this population.

Summary

The Associations Between Physical Activity and Mental Health Problems in Middle-aged Indonesians

Sri Handayani, Siti Isfandari, Diyan Ermawan Effendi, Rozana Ika Agustiya, Irfan Ardani, Arief Priyo Nugroho, Yunita Fitrianti

J Prev Med Public Health. 2024;57(4):379-387.   Published online July 12, 2024

DOI: https://doi.org/10.3961/jpmph.24.003

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Abstract Summary PDF

Objectives
Mental health issues have become a growing concern worldwide. Research has shown that regular physical activity (PA) can positively affect mental health. This study investigated the associations between PA and mental health problems (MHPs) in middle-aged Indonesians.
Methods
The study utilized data from the 2018 Indonesian Basic Health Research Survey and used a cross-sectional approach. The participants included individuals aged 40-60 years who completed the 20-question Self-Reporting Questionnaire. A logistic regression was performed to analyze a sample of 263 930 data points.
Results
Nearly 10.4% of the participants suffered from mental health issues. Notably, among those who did not engage in moderate and vigorous PA, a sign of MHPs was found in 12.5% of participants. Those who met World Health Organization standards for PA were less likely to experience MHPs (10.1%). This study found a significant association between PA and mental health. After adjusting for smoking, alcohol consumption, non-communicable diseases, and socio-demographic variables like age, sex, education, occupation, marital status, and residence, the connection between PA and mental health became even stronger (adjusted odds ratio, 0.81; 95% confidence interval, 0.78 to 0.85; p<0.001).
Conclusions
Regular PA has been shown to affect mental health positively. Therefore, it is important to improve health education and efforts to raise awareness among middle-aged Indonesians about the importance of PA in maintaining good mental health.

Summary

Key Message
This study revealed a significant association between physical activity (PA) and mental problems (MHPs) among middle-aged Indonesians. Individuals who engaged in moderate to vigorous PA were less likely to experience MHPs compared to those who did not meet recommended PA levels. This association remained strong after adjusting confounding variables such as smoking, alcohol consumption, non-communicable diseases, and socio- demographic factors. Therefore, promoting regular physical activity could be a beneficial strategy for improving mental health status in this population.

Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases

Eunsil Cheon, Yeun Soo Yang, Suyoung Jo, Jieun Hwang, Keum Ji Jung, Sunmi Lee, Seong Yong Park, Kyoungin Na, Soyeon Kim, Sun Ha Jee, Sung-il Cho

J Prev Med Public Health. 2024;57(4):327-338.   Published online July 3, 2024

DOI: https://doi.org/10.3961/jpmph.23.471

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Abstract Summary PDF Supplementary Material

Objectives
Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020.
Methods
Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020.
Results
The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths.
Conclusions
Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

Summary

Korean summary
한국의 흡연율은 상당 수준 감소하였지만 흡연의 장기적인 건강영향은 지속적으로 나타나고 있다. 4개의 대규모 코호트와 1995년 흡연율을 사용하여 2020년 한국의 흡연기인 사망자수를 산출한 결과 남성 53,930명, 여성 6283명으로 총 60,213명이였다. 효과적인 담배규제와 금연 정책을 위하여 장기적인 사망자수 모니터링이 필요할 것이다.

Key Message
Despite the significant decrease in smoking rates in South Korea, the long-term health effects of smoking continue to manifest. Our analysis using four large-scale cohorts and 1995 smoking prevalence revealed that in 2020, the number of smoking-attributable death in South Korea was 53,930 for men and 6,283 for women, totaling 60,213. Long-term monitoring is necessary for effective tobacco control and smoking cessation policies.

Citations

Citations to this article as recorded by

The economic cost of direct smoking in South Korea
Kristine Namhee Kwon, Kangyeon Lee, Wankyo Chung
Preventive Medicine Reports.2024; 46: 102865.     CrossRef

Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors

Minsoo Jung

J Prev Med Public Health. 2024;57(4):370-378.   Published online June 24, 2024

DOI: https://doi.org/10.3961/jpmph.24.196

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Abstract Summary PDF

Objectives
Comorbidities increase susceptibility to severe coronavirus disease 2019 (COVID-19) infections, but limited information has been published regarding human immunodeficiency virus (HIV) and COVID-19 co-infections. This study explored the relationships among socioeconomic characteristics, sexual behaviors, and COVID-19 infection rates among Korean men who have sex with men (MSM) who are also living with HIV.
Methods
Data were collected through a web survey aimed at members of the largest gay portal site in Korea, supported by the National Research Foundation of Korea (n=1005). The primary independent variables included COVID-19-related vaccinations and sexual behaviors. The dependent variable was the incidence of COVID-19 infection among respondents during the pandemic. For statistical analysis, hierarchical multiple logistic regression was performed, controlling for potential confounding variables.
Results
Model I indicated that older MSM were less likely to contract COVID-19 (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.96 to 0.99). Model II demonstrated that HIV-positive MSM were nearly twice as likely to be infected with COVID-19 compared to their HIV-negative counterparts (aOR, 1.97; 95% CI, 1.14 to 3.41). Furthermore, even after accounting for COVID-19 vaccination status in model III, HIV-positive MSM continued to show a higher risk of infection (aOR, 1.93; 95% CI, 1.12 to 3.35).
Conclusions
The findings of this study indicate that HIV-positive MSM are at an increased risk of contracting COVID-19, even when their vaccination status is considered. Therefore, it is essential to prioritize the prevention of COVID-19 infections in HIV-positive individuals by administering appropriate antiretroviral therapy and ensuring adherence to public health guidelines.

Summary

Korean summary
이 연구는 한국의 HIV 양성인 남성 동성애자(MSM)가 코로나-19 백신접종을 했어도 HIV 음성인 MSM에 비하여 COVID-19에 감염될 위험이 더 높다는 것을 보여주었다. 이러한 결과는 항레트로바이러스 요법의 준수나 촉진과 더불어 이들 취약 계층을 위한 COVID-19 예방조치 강화와 맞춤형 공중보건 전략의 필요성을 강조한다.

Key Message
This study found that HIV-positive men who have sex with men (MSM) in Korea are at a heightened risk of contracting COVID-19 compared to HIV-negative individuals, even when vaccination status is accounted for. This finding underscore the necessity of targeted public health strategies, including the promotion of adherence to antiretroviral therapy and the reinforcement of COVID-19 prevention measures for this vulnerable population.

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