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9 "Seung-sik Hwang"
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Brief Report
Utilization of the Unlinked Case Proportion to Control COVID-19: A Focus on the Non-pharmaceutical Interventional Policies of the Korea and Japan
Yeri Jeong, Sanggu Kang, Boeun Kim, Yong Jin Gil, Seung-sik Hwang, Sung-il Cho
J Prev Med Public Health. 2023;56(4):377-383.   Published online June 21, 2023
DOI: https://doi.org/10.3961/jpmph.23.056
  • 2,832 View
  • 83 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Korea and Japan have managed the spread of coronavirus disease 2019 (COVID-19) using markedly different policies, referred to as the “3T” and “3C” strategies, respectively. This study examined these differences to assess the roles of active testing and contact tracing as non-pharmaceutical interventions (NPIs). We compared the proportion of unlinked cases (UCs) and test positivity rate (TPR) as indicators of tracing and testing capacities.
Methods
We outlined the evolution of NPI policies and investigated temporal trends in their correlations with UCs, confirmed cases, and TPR prior to the Omicron peak. Spearman correlation coefficients were reported between the proportion of UCs, confirmed cases, and TPR. The Fisher r-to-z transformation was employed to examine the significance of differences between correlation coefficients.
Results
The proportion of UCs was significantly correlated with confirmed cases (r=0.995, p<0.001) and TPR (r=0.659, p<0.001) in Korea and with confirmed cases (r=0.437, p<0.001) and TPR (r=0.429, p<0.001) in Japan. The Fisher r-to-z test revealed significant differences in correlation coefficients between the proportion of UCs and confirmed cases (z=16.07, p<0.001) and between the proportion of UCs and TPR (z=2.12, p=0.034) in Korea and Japan.
Conclusions
Higher UCs were associated with increases in confirmed cases and TPR, indicating the importance of combining testing and contact tracing in controlling COVID-19. The implementation of stricter policies led to stronger correlations between these indicators. The proportion of UCs and TPR effectively indicated the effectiveness of NPIs. If the proportion of UCs shows an upward trend, more testing and contact tracing may be required.
Summary
Korean summary
“3T”전략과 “3C”전략으로 대표되는 한국과 일본의 코로나 19 유행 시기의 NPI 정책을 비교하고, 접촉자 추적 및 검사 역량의 지표로 감염경로를 알 수 없는 확진자(unlinked case)와 검사 양성률(TPR)의 역할을 평가하였다. 감염경로를 알 수 없는 확진자(UC)는 전체 확진자수 증가 및 검사 양성률의 증가와 관련이 있었으며, 이는 COVID-19 통제에 있어 검사와 접촉자 추적을 적절히 조합하는 것이 중요함을 보여준다.
Original Articles
Annual Endovascular Thrombectomy Case Volume and Thrombectomy-capable Hospitals of Korea in Acute Stroke Care
Eun Hye Park, Seung-sik Hwang, Juhwan Oh, Beom-Joon Kim, Hee-Joon Bae, Ki-Hwa Yang, Ah-Rum Choi, Mi-Yeon Kang, S.V. Subramanian
J Prev Med Public Health. 2023;56(2):145-153.   Published online March 31, 2023
DOI: https://doi.org/10.3961/jpmph.22.318
  • 2,096 View
  • 126 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume.
Methods
From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression.
Results
Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96).
Conclusions
The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.
Summary
Korean summary
급성 허혈성 뇌졸중 환자에서 “혈관 내 혈전제거술(endovascular treatment, EVT)”의 치료효과는 여러 연구를 통해 증명되었으나, EVT 후보군에서 EVT를 제공하기 위한 의료서비스 연구는 부족한 실정이다. 5~7차 뇌졸중 적정성 평가 자료를 활용하여 연간 EVT 시행횟수와 EVT후보군의 30일, 1년 후 치명률 간의 연관성을 다수준 분석을 통해 확인하였다. 연간 15회 이상 EVT를 시행하면서 뇌졸중 전문치료실과 뇌줄중 관련 전문분과(신경과, 신경외과, 재활의학과) 전문의가 모두 있는 병원(TCHs)에서 치료받은 환자는 EVT를 시행하지 않는 병원(PSHs-without-EVT)에서 치료받는 환자에 비해 치명률이 감소하는 경향을 보였다. 이는 뇌졸중 치료체계에서 EVT가능병원을 정의할 필요성을 잘 보여주고, “연간 EVT 시행횟수”는 TCHs를 정의하는 중요한 지표로 사용될 수 있을 것이다.

Citations

Citations to this article as recorded by  
  • Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study
    Dal-Lae Jin, Kyoung-Hoon Kim, Euy Suk Chung, Seok-Jun Yoon
    Journal of Preventive Medicine and Public Health.2024; 57(3): 260.     CrossRef
  • Mortality and Disparities of Acute Myocardial Infarction and Stroke in Korea, 2008–2019
    Ji-Sook Choi, Soomin Kim, Choon-Seon Park, Hyejin Lee, Jin Yong Lee, Sun Min Kim
    Yonsei Medical Journal.2024;[Epub]     CrossRef
The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data
Sanggu Kang, Yeri Jeong, Eun Hye Park, Seung-sik Hwang
J Prev Med Public Health. 2022;55(5):455-463.   Published online September 12, 2022
DOI: https://doi.org/10.3961/jpmph.22.241
  • 3,009 View
  • 124 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Economic hardship has a serious impact on adolescents’ mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents’ suicidal behaviors.
Methods
This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions.
Results
The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively.
Conclusions
ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.
Summary
Korean summary
청소년의 정신건강은 가정의 경제상황에 크게 영향을 받는다. 청소년건강행태조사(KYRBS)(2020)에 참여한 54948명의 중고등학생을 대상으로 가정의 기존 경제적 형편과 코로나19로 인한 가정경제 악화가 자살위험에 미치는 영향을 분석하였다. 그 결과 자살사고, 자살계획, 자살시도 모두 코로나19로 인한 경제상황 악화 정도가 심한 저소득층 가정 청소년에서 위험이 제일 높은 것으로 확인되었다. 코로나19(COVID-19)로 인해 심화된 경제적 불평등이 청소년 정신건강 불평등으로 이어지지 않게 하기 위한 개입이 필요하다.

Citations

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  • Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents
    Mi-Sun Lee, Hooyeon Lee
    Journal of Affective Disorders.2024; 354: 339.     CrossRef
  • Demographic and clinical profile of adolescents suicide attempters admitted to an emergency department during the COVID-19 pandemic – a retrospective cohort study using hospital information system
    Lucyna Tomaszek, Paulina Kurleto, Edyta Turkanik, Ewa Bielec, Irena Milaniak, Wioletta Dąbrowska-Mędrzycka
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
  • Letter to the Editor: Addressing Children’s Mental Health Issues Related to Economic Changes Caused by the COVID-19 Pandemic
    Dalmacito A. Cordero
    Journal of Preventive Medicine and Public Health.2023; 56(1): 95.     CrossRef
  • Effects of COVID-19 outbreak on Korean adolescents: Impact of altered economic perception on physical activity, sedentary behavior, and stress levels in an age-, gender-, and BMI-matched study
    Jisu Kim, In-Whi Hwang, Jeong-Hui Park, Youngdeok Kim, Jung-Min Lee, Sandra Celina Fernandes Fonseca
    PLOS ONE.2023; 18(11): e0294270.     CrossRef
Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea
Eun Hye Park, Yong Jin Gil, Chanki Kim, Beom Joon Kim, Seung-sik Hwang
J Prev Med Public Health. 2021;54(6):385-394.   Published online October 22, 2021
DOI: https://doi.org/10.3961/jpmph.21.329
  • 3,787 View
  • 227 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs).
Methods
This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression.
Results
Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS.
Conclusions
The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.
Summary
Korean summary
혈관 내 재개통술(endovascular thrombectomy, EVT)는 많은 전문인력과 장비등 상당한 자원을 필요로 하는 특성으로 인해 상대적으로 자원이 부족한 지역에 치료 공백이 발생할 수 있다. EVT 가능 병원(Thrombectomy capable stroke center, TSC)를 "연간 EVT 15회 이상 시행, 뇌졸중 전문치료실 운영 그리고 뇌졸중 관련 전문의(신경과, 신경외과, 재활의학과)가 모두 근무하는 병원으로 정의하고 진료권 단위로 분석한 결과 진료권 내 TSC의 존재는 허혈성 뇌졸중 환자군의 치명률를 유의하게 감소시켰다. 그러므로 급성 허혈성 뇌졸중 치료의 지역 간 변이를 줄이기 위해서 진료권 내 TSC 를 정의하고 설치하는 것의 중요하며, 이러한 결과는 향후 70개 진료권 단위 지역책임의료기관을 구축하는 과정에 중요한 근거자료로 활용될수 있을 것이다.

Citations

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  • Prioritization of Injury Prevention and Management Programs and Research and Development (R&D) Projects: Survey Using the Delphi Technique and Analytic Hierarchy Process
    Won Kyung Lee, Minsu Ock, Ju Ok Park, Changsoo Kim, Beom Sok Seo, Jeehee Pyo, Hyun Jin Park, Ui Jeong Kim, Eun Jeong Choi, Shinyoung Woo, Hyesook Park
    Asia Pacific Journal of Public Health.2024; 36(1): 78.     CrossRef
  • Regional variation in access to and quality of acute stroke care: results of Germany’s Health System Performance Assessment pilot, 2014–2020
    P. Hengel, U. Nimptsch, M. Blümel, K. Achstetter, R. Busse
    Research in Health Services & Regions.2024;[Epub]     CrossRef
  • Patterns in the number of interventionalists for endovascular treatment of acute ischemic stroke in the US
    Ankita Tripathi, Laura K. Stein, Mandip S. Dhamoon
    Journal of Stroke and Cerebrovascular Diseases.2023; 32(2): 106943.     CrossRef
  • Thrombectomy-Capable Stroke Centre—A Key to Acute Stroke Care System Improvement? Retrospective Analysis of Safety and Efficacy of Endovascular Treatment in Cardiac Cathlab
    Krzysztof Pawłowski, Artur Dziadkiewicz, Anna Podlasek, Jacek Klaudel, Alicja Mączkowiak, Marek Szołkiewicz
    International Journal of Environmental Research and Public Health.2023; 20(3): 2232.     CrossRef
  • COVID-19 case-fatality variations with application to the Middle East countries
    Sami Khedhiri
    GeoJournal.2022; 88(1): 1127.     CrossRef
Systematic Review
A Systematic Review of Spatial and Spatio-temporal Analyses in Public Health Research in Korea
Han Geul Byun, Naae Lee, Seung-sik Hwang
J Prev Med Public Health. 2021;54(5):301-308.   Published online August 26, 2021
DOI: https://doi.org/10.3961/jpmph.21.160
  • 5,416 View
  • 215 Download
  • 9 Web of Science
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Despite its advantages, it is not yet common practice in Korea for researchers to investigate disease associations using spatio-temporal analyses. In this study, we aimed to review health-related epidemiological research using spatio-temporal analyses and to observe methodological trends.
Methods
Health-related studies that applied spatial or spatio-temporal methods were identified using 2 international databases (PubMed and Embase) and 4 Korean academic databases (KoreaMed, NDSL, DBpia, and RISS). Two reviewers extracted data to review the included studies. A search for relevant keywords yielded 5919 studies.
Results
Of the studies that were initially found, 150 were ultimately included based on the eligibility criteria. In terms of the research topic, 5 categories with 11 subcategories were identified: chronic diseases (n=31, 20.7%), infectious diseases (n=27, 18.0%), health-related topics (including service utilization, equity, and behavior) (n=47, 31.3%), mental health (n=15, 10.0%), and cancer (n=7, 4.7%). Compared to the period between 2000 and 2010, more studies published between 2011 and 2020 were found to use 2 or more spatial analysis techniques (35.6% of included studies), and the number of studies on mapping increased 6-fold.
Conclusions
Further spatio-temporal analysis-related studies with point data are needed to provide insights and evidence to support policy decision-making for the prevention and control of infectious and chronic diseases using advances in spatial techniques.
Summary
Korean summary
본 연구는 국내 시공간 분석을 활용한 역학연구를 체계적 문헌고찰을 통해 검토하였다. 의료이용, 형평성, 건강행동 관련 주제가 가장 많았고, 두 가지 이상의 공간분석 기법을 적용한 사례가 늘었으며, 단순 지도화를 적용한 연구가 가장 많았다. 향후 시공간 분석 결과를 이용해 질병 예방과 관리 정책에 적극적으로 활용할 필요가 있다.

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    Scientific Reports.2024;[Epub]     CrossRef
  • Spatiotemporal models of dengue epidemiology in the Philippines: Integrating remote sensing and interpretable machine learning
    Don Enrico Buebos-Esteve, Nikki Heherson A. Dagamac
    Acta Tropica.2024; 255: 107225.     CrossRef
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    Muhammad Akram Ab Kadir, Rosliza Abdul Manaf, Siti Aisah Mokhtar, Luthffi Idzhar Ismail
    JMIR Research Protocols.2023; 12: e43712.     CrossRef
  • Epidemiological characteristics and spatiotemporal analysis of mumps at township level in Wuhan, China, 2005–2019
    Ying Peng, Peng Wang, De-guang Kong, Wen-zhen Li, Dong-ming Wang, Li Cai, Sha Lu, Bin Yu, Bang-hua Chen, Pu-Lin Liu
    Epidemiology and Infection.2023;[Epub]     CrossRef
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    Zemenu Tadesse Tessema, Getayeneh Antehunegn Tesema, Susannah Ahern, Arul Earnest
    International Journal of Environmental Research and Public Health.2023; 20(13): 6277.     CrossRef
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Climate Change: Original Article
Association Between Air Conditioning Use and Self-reported Symptoms During the 2018 Heat Wave in Korea
Yong-Han Lee, Sanghyuk Bae, Seung-sik Hwang, Jong-Hun Kim, Kyoung-Nam Kim, Youn-Hee Lim, Miji Kim, Sohwa Jung, Ho-Jang Kwon
J Prev Med Public Health. 2020;53(1):15-25.   Published online November 26, 2019
DOI: https://doi.org/10.3961/jpmph.19.171
  • 6,551 View
  • 224 Download
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The purpose of this study was to investigate the health effects of air conditioning use during the 2018 heat wave in Korea, included the highest temperature ever recorded in the nation.
Methods
The participants in this study were 1000 adults aged 19 years and older recruited from across Korea. The participants were asked about their experience of symptoms of various diseases, disruptions of their daily lives, and use of air conditioning during the heat wave. The associations between air conditioning use during the heat wave and health outcomes were analyzed using the chi-square test and multiple logistic regression models.
Results
Among participants who lacked air conditioning in the main space where they spent time outside the home, 33.9%, 8.1%, 43.5%, and 19.4% experienced symptoms of heat-related, cardiovascular, nervous system diseases, and air-conditioningitis, respectively. In comparison, participants who did have air conditioning outside the home experienced the same symptoms at proportions of 21.0%, 1.9%, 26.8%, and 34.2%, respectively (p=0.027, 0.007, 0.007, and 0.023, respectively). Among participants who had no air conditioner at home, 10.0% were absent from school or work due to the heat wave. In contrast, among participants who had an air conditioner at home, only 3.7% were absent as a result of the heat wave (p=0.007).
Conclusions
When air conditioning was not used at home or in the main space where participants spent time outside the home during the 2018 heat wave, adverse health effects were more prevalent, but the risk of air-conditioningitis was reduced.
Summary
Korean summary
본 연구는 한국 기상관측사상 가장 더웠던 2018년 한국의 폭염 기간 동안, 에어컨 사용이 건강에 미치는 영향에 대해 조사하였다. 가정 외 주 생활공간에 에어컨이 가동되지 않거나 가정에 에어컨이 없으면 폭염 기간 동안의 건강 및 일상생활에 좋지 않은 영향을 줄 수 있으나, 냉방병 위험은 낮아질 수 있다.

Citations

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  • Integration and Optimal Control of MicroCSP with Building HVAC Systems: Review and Future Directions
    Mohamed Toub, Chethan R. Reddy, Rush D. Robinett, Mahdi Shahbakhti
    Energies.2021; 14(3): 730.     CrossRef
  • Climate Change and Health: More Research Is Still Needed
    Ho-Jang Kwon
    Journal of Preventive Medicine and Public Health.2020; 53(1): 1.     CrossRef
Original Article
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
DOI: https://doi.org/10.3961/jpmph.18.162
  • 6,477 View
  • 193 Download
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Summary
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.

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Review
Short-term Effect of Fine Particulate Matter on Children’s Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis
Hyungryul Lim, Ho-Jang Kwon, Ji-Ae Lim, Jong Hyuk Choi, Mina Ha, Seung-Sik Hwang, Won-Jun Choi
J Prev Med Public Health. 2016;49(4):205-219.   Published online July 14, 2016
DOI: https://doi.org/10.3961/jpmph.16.037
  • 14,552 View
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  • 52 Crossref
AbstractAbstract PDF
Objectives
No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies.
Methods
Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger’s test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3.
Results
We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM2.5 on children’s hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children’s hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m3 increase in PM2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I2=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe.
Conclusions
We strengthened the evidence on the short-term effect of PM2.5 on children’s hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.
Summary

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Original Article
Deprivation and Mortality at the Town Level in Busan, Korea: An Ecological Study
Min-Hyeok Choi, Kyu-Seok Cheong, Byung-Mann Cho, In-Kyung Hwang, Chang-Hun Kim, Myoung-Hee Kim, Seung-Sik Hwang, Jeong-Hun Lim, Tae-Ho Yoon
J Prev Med Public Health. 2011;44(6):242-248.   Published online November 14, 2011
DOI: https://doi.org/10.3961/jpmph.2011.44.6.242
  • 10,407 View
  • 94 Download
  • 30 Crossref
AbstractAbstract PDF
Objectives

Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality.

Methods

Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation.

Results

The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high.

Conclusions

Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

Summary

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JPMPH : Journal of Preventive Medicine and Public Health