Journal of Preventive Medicine and Public Health

Original Articles

Measuring Trends in Disability-adjusted Life Years and Life Expectancy in Korea: 2008 to 2021: Chung-Nyun Kim, Dawit Urgi Gurmu, Young-Eun Kim, Yoon-Sun Jung, Yongseok Choi, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2026;59(1):25-34. Published online January 29, 2026; DOI: https://doi.org/10.3961/jpmph.25.604

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Abstract Summary PDF Supplementary Material: Objectives
This study, part of the ongoing Korean National Burden of Disease (KNBD) updates, assesses disability-adjusted life years (DALYs) and disability-adjusted life expectancy (DALE) in Korea, taking into account the effects of coronavirus disease 2019 and emphasizing the importance of analyzing these metrics jointly.
Methods
Data were obtained from Statistics Korea, the National Health Insurance Service, and the Korea Disease Control and Prevention Agency. DALYs and DALE were calculated using an incidence-based approach, following disease classification, disability weights, and estimation procedures consistent with prior KNBD research.
Results
Compared with earlier estimates, DALYs showed a slight decline in 2020 followed by an increase in 2021, with this pattern observed across all income quintiles. For DALE, both men and women experienced modest gains relative to earlier studies; however, a decrease occurred across all income levels in 2021 compared with 2020. Regional disparities in DALE also narrowed beginning in 2020, with a more marked reduction among women.
Conclusions
Unlike previous studies, this research presents DALYs and DALE concurrently, offering a more comprehensive perspective on summary measures of population health. The post-2020 rise in DALYs underscores the growing need for effective chronic disease management. Additionally, widening income-based disparities in DALE highlight the urgency of addressing health inequities. Continued monitoring and updates of DALYs and DALE are necessary to understand and respond to these evolving trends.; Summary

Korean summary
한국인의 질병부담과 건강수명을 2021년까지 추가적으로 측정하였다. 그 결과 2021년은 2020년에 비해 질병부담은 증가하였고 건강수명은 감소하였다.

Key Message
The burden of disease and disability-adjusted life expectancy of Korea was measured through 2021. The results showed that the burden of disease increased and disability-adjusted life expectancy decreased, compared to 2020.

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; J Prev Med Public Health. 2025;58(2):188-198. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374

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Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients’ needs and concerns, thereby helping manage the challenges of medication-related burdens.

Summary

Key Message
Older adults with chronic diseases experienced an increasing burden in taking medication with multimorbidity, number of medicines and duration of illness. Motivation and familial support is crucial to minimize these burdens.

Citations

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Medication-related quality of life among individuals utilizing the advanced electronic service for dispensing medications in Saudi Arabia
Ammar Alshamlan, Abdullah Alkattan, Sakinah Alghazal, Manea Almunjem, Ahmed Alkhalifah, Mahdi Almunjem, Eman Alsalameen, Taif Albassri, Asya Alhadad, Amal Alhaqbani
Discover Public Health.2025;[Epub] CrossRef
Latent Profile Analysis and Influencing Factors of Medication-Related Burden in Multidrug-Resistant Tuberculosis Patients in Chengdu, China
Yuanyuan Li, Qiaolin Yu, Rong Yao, Xiaoyi Yang, Bin Wan, Xia Zhao, Yinping Hu, Yan Zhou, Li Dai, Xiaoli Liu, Enchun Xie, Fang Huang, Fanghui Xie, Zhouli Guo
Patient Preference and Adherence.2025; Volume 19: 3387. CrossRef

Global Trends in Childhood Sexual Abuse and Bullying Victimization in 204 Countries: A Comprehensive Analysis From 1990 to 2019: Nasrin Borumandnia, Mohammadamin Sabbagh Alvani, Payam Fattahi, Mahmood Reza Gohari, Yashar Kheirolahkhani, Hamid Alavimajd; J Prev Med Public Health. 2024;57(6):530-539. Published online August 15, 2024; DOI: https://doi.org/10.3961/jpmph.24.007

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Abstract Summary 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-HDI and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high-HDI 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

Key Message
This study analyzes global trends in childhood sexual abuse (CSA) and bullying victimization (BV) from 1990 to 2019 across 204 countries. Results indicate a significant rise in BV rates globally, with boys consistently exhibiting higher rates than girls. While CSA rates among girls show an upward trend, no significant change is observed for boys. These findings highlight the urgent need for targeted interventions to address CSA and BV worldwide.

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Edna Porat-Moeller, Anastasia Keidar, Lee Gafter, Yael Lahav
Child Abuse & Neglect.2025; 163: 107401. CrossRef
Sensory modulation difficulties and complex PTSD among child abuse survivors
Nitzan Avigail Kidra, Lee Gafter, Tami Bar-Shalita, Yael Lahav
European Journal of Psychotraumatology.2025;[Epub] CrossRef
Global burden of noncommunicable diseases attributable to modifiable behavioral risks among adolescents and young adults aged 10–24 years, 1990–2021
Yunfei Feng, Da Sun, Xuren Sun, Qiqiang Guo, Jing Zhang, Yongze Li
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Adverse experiences in childhood and young adulthood, genetic susceptibility, and neurodegenerative disease incidence: a lifespan analysis
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The mediating role of self-esteem in the link between childhood adversities and criminality among North African adult males: A case-control study
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Child Abuse & Neglect.2025; 169: 107718. CrossRef

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea: Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae; J Prev Med Public Health. 2024;57(2):185-196. Published online March 29, 2024; DOI: https://doi.org/10.3961/jpmph.23.514

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Abstract Summary PDF Supplementary Material

Objectives
Excess mortality associated with long-term exposure to fine particulate matter (PM_2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM_2.5 by considering the potential non-linear concentration–response relationship in Korea.
Methods
Daily cause-specific mortality rates and PM_2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM_2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM_2.5 concentrations below 15 μg/m³. Overall deaths attributable to short-term PM_2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM_2.5 exposure.
Results
Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM_2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM_2.5. The estimated number of all-cause excess deaths due to short-term PM_2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472).
Conclusions
Our findings indicate an association between short-term PM_2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM_2.5.

Summary

Korean summary
본 연구는 2010~2019년 한국의 초미세먼지 단기 노출로 인한 사망 부담을 추정하였으며 2010~2019년간, 초미세먼지 단기노출로 인한 전체원인 사망은 10,814명, 비사고 사망은 7,855명, 심혈관 사망은 1,642명, 호흡기 사망은 708명으로 추정하였다. 본 연구 결과는 대기오염 관리, 규제, 정책 수립에 있어 도움을 줄 것으로 예상한다.

Key Message
- We estimated mortality burden attributable to short-term exposure to PM 2.5 in Korea from 2010 to 2019 - Over the 10-years study period, the estimated excess deaths due to short-term exposure to PM 2.5 totaled 10,814 for all-causes, 7,855 for non-accidental, 1,642 for cardiovascular disease, and 708 for respiratory disease. - Our findings can assist in air pollution management, regulation, and policy-making.

Citations

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Wintertime Trends of Fine Particulate Matter (PM2.5) in South Korea, 2012–2022: Response of Nitrate and Organic Components to Decreasing NOx Emissions
Drew C. Pendergrass, Daniel J. Jacob, Yujin J. Oak, Ruijun Dang, Laura Hyesung Yang, Ellie Beaudry, Nadia K. Colombi, Shixian Zhai, Hwajin Kim, Jin‐soo Choi, Jin‐soo Park, Soontae Kim, Ke Li, Hong Liao
Geophysical Research Letters.2025;[Epub] CrossRef
Effects of PM2.5 and particle constituents on overall, cardiovascular, and respiratory mortality in Seoul
Oh Beom Kwon, Eun Ju Lee, Myoung Nam Lim, Young Ji Han, Jun Young Ahn, Hye Jung Shin, Jung Min Park, Jeeyoung Kim, Woo Jin Kim
Scientific Reports.2025;[Epub] CrossRef

Special Articles

Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method: Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock; J Prev Med Public Health. 2023;56(4):291-302. Published online June 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.192

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Abstract Summary PDF Supplementary Material

Objectives
Disability weights require regular updates, as they are influenced by both diseases and societal perceptions. Consequently, it is necessary to develop an up-to-date list of the causes of diseases and establish a survey panel for estimating disability weights. Accordingly, this study was conducted to calculate, assess, modify, and validate disability weights suitable for Korea, accounting for its cultural and social characteristics.
Methods
The 380 causes of disease used in the survey were derived from the 2019 Global Burden of Disease Collaborative Network and from 2019 and 2020 Korean studies on disability weights for causes of disease. Disability weights were reanalyzed by integrating the findings of an earlier survey on disability weights in Korea with those of the additional survey conducted in this study. The responses were transformed into paired comparisons and analyzed using probit regression analysis. Coefficients for the causes of disease were converted into predicted probabilities, and disability weights in 2 models (model 1 and 2) were rescaled using a normal distribution and the natural logarithm, respectively.
Results
The mean values for the 380 causes of disease in models 1 and 2 were 0.488 and 0.369, respectively. Both models exhibited the same order of disability weights. The disability weights for the 300 causes of disease present in both the current and 2019 studies demonstrated a Pearson correlation coefficient of 0.994 (p=0.001 for both models). This study presents a detailed add-on approach for calculating disability weights.
Conclusions
This method can be employed in other countries to obtain timely disability weight estimations.

Summary

Korean summary
이 연구에서는 장애보정생존연수의 산출 방법론 중 발생률 기반 접근법을 이용하여 질병부담 산출에 활용할 질병원인에 대한 장애가중치를 산출하고 한국의 문화사회적 특징을 고려하여 이에 대한 타당성을 검증하였다. 특히, 지난 연구에서 활용한 질병원인에 대한 장애가중치 결과값을 add-on study 방법으로 활용하여 장애가중치를 개정하였다. 이번 연구에서 수행한 add-on study 방법을 활용하여 장애가중치 값을 산출할 경우 다수의 전문가의 누적된 의견을 기반으로 장애가중치를 안정적으로 개정하여 특정 질병원인의 장애보정생존연수를 보다 정확하게 산출할 수 있게 될 것이다.

Citations

Citations to this article as recorded by

Measuring Trends in Disability-adjusted Life Years and Life Expectancy in Korea: 2008 to 2021
Chung-Nyun Kim, Dawit Urgi Gurmu, Young-Eun Kim, Yoon-Sun Jung, Yongseok Choi, Minsu Ock, Seok-Jun Yoon
Journal of Preventive Medicine and Public Health.2026; 59(1): 25. CrossRef
Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2024;[Epub] CrossRef
Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008–2020)
Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2024;[Epub] CrossRef
Korean National Burden of Disease: The Importance of Diabetes Management
Chung-Nyun Kim, Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Diabetes & Metabolism Journal.2024; 48(4): 518. CrossRef
Newly estimated disability weights for 196 health states in Hubei Province, China
Mengge Zhou, Lan Zhang, Tianjing He, Shuzhen Zhu, Yumeng Tang, Qian Li, Miaoyan Shen, Jingju Pan
Population Health Metrics.2024;[Epub] CrossRef

Adjustment for Multimorbidity in Estimations of the Burden of Diseases Using Korean NHIS Data: Yoonhee Shin, Eun Jeong Choi, Bomi Park, Hye Ah Lee, Eun-Kyung Lee, Hyesook Park; J Prev Med Public Health. 2022;55(1):28-36. Published online January 31, 2022; DOI: https://doi.org/10.3961/jpmph.21.583

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Abstract Summary PDF Supplementary Material: The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.; Summary

Korean summary
질병부담 산출 시 몬테카를로 시뮬레이션을 통한 복합질환 보정 방법에 대해 다빈도 질환 실제 데이터 기반으로 검증해 봄으로써 30세 이상 연령에서 추정값에 큰 차이가 없음을 확인하였다. 하지만 30세 미만에서는 포함되는 질환 종류에 따라 실제 데이터 기반으로 복합질환을 보정하는 것이 불가능하거나 시뮬레이션으로 구한 값이 부정확하였다. 따라서, 질환 특성을 반영한 복합질환 보정방법론 개발이 필요함을 제안하며 본 연구 결과는 한국인 질병부담 연구에서 몬테카를로 시뮬레이션을 이용한 복합질환 보정 방법의 활용근거로 사용될 수 있을 것이다.

Measuring the Burden of Disease in Korea, 2008-2018: Yoon-Sun Jung, Young-Eun Kim, Hyesook Park, In-Hwan Oh, Min-Woo Jo, Minsu Ock, Dun-Sol Go, Seok-Jun Yoon; J Prev Med Public Health. 2021;54(5):293-300. Published online September 30, 2021; DOI: https://doi.org/10.3961/jpmph.21.478

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Abstract Summary PDF Supplementary Material

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

Summary

Korean summary
이 논문에서는 장애보정생존년수라는 지표를 활용하여 2008-2018년 한국인의 질병부담 산출결과를 제시하였으며, 성별·연령군별·질환별 질병부담 수준의 차이 뿐만 아니라 지역 및 소득수준의 사회경제적 수준에 따른 질병부담의 격차도 함께 제시하였다.

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Original Article

The Burden of Stroke in Kurdistan Province, Iran From 2011 to 2017: Shahram Moradi, Ghobad Moradi, Bakhtiar Piroozi; J Prev Med Public Health. 2021;54(2):103-109. Published online February 1, 2021; DOI: https://doi.org/10.3961/jpmph.20.335

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Abstract PDF

Objectives
The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017.
Methods
Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs).
Results
The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively.
Conclusions
The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

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Menglan Zhu, Wenyu Jin, Wangbiao He, Lulu Zhang
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Special Article

Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea: Jong-Myon Bae; J Prev Med Public Health. 2017;50(4):217-227. Published online June 16, 2017; DOI: https://doi.org/10.3961/jpmph.17.069

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Abstract PDF Supplementary Material

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

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Original Article

The Economic Burden of Cancers Attributable to Metabolic Syndrome in Korea: Dongwoo Kim, Seok-Jun Yoon, Young-Hoon Gong, Young Ae Kim, Hye-Young Seo, Jihyun Yoon, A-Rim Kim; J Prev Med Public Health. 2015;48(4):180-187. Published online July 20, 2015; DOI: https://doi.org/10.3961/jpmph.15.022

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Abstract PDF

Objectives
Metabolic syndrome is an important etiologic factor in the development of certain types of cancers. The economic cost of the treatment of cancer has been steadily increasing. We therefore estimated the economic burden of cancers attributable to metabolic syndrome in Korea.
Methods
We reviewed metabolic syndrome-related cancers and relative risk and then calculated population attributable fractions. We analyzed insurance claims data for metabolic syndrome-related cancers in 2012 in order to estimate the direct costs associated with these cancers, including hospitalization, outpatient visits, transportation costs, and caregivers’ costs as well as indirect costs such as loss of productivity due to cancer treatment and premature death.
Results
In 2012, 18 070 patients in Korea had cancers attributable to metabolic syndrome. The economic burden was USD 199.8 million and the direct and indirect costs were USD 124.5 million and USD 75.3 million, respectively.
Conclusions
We estimated the economic burden of cancers attributable to metabolic syndrome in Korea and the efforts are necessary to reduce this burden.

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Special Article

Burden of Disease in Japan: Using National and Subnational Data to Inform Local Health Policy: Stuart Gilmour, Yi Liao, Ver Bilano, Kenji Shibuya; J Prev Med Public Health. 2014;47(3):136-143. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.136

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Abstract PDF

The Global Burden of Disease (GBD) study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

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Original Article

Economic Burden of Colorectal Cancer in Korea: Ju-Young Byun, Seok-Jun Yoon, In-Hwan Oh, Young Ae Kim, Hye-Young Seo, Yo-Han Lee; J Prev Med Public Health. 2014;47(2):84-93. Published online March 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.2.84

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Abstract PDF

Objectives

The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service.

Methods

Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs.

Results

The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively.

Conclusions

Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention.

Summary

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Special Article

Overview of the Burden of Diseases in North Korea: Yo Han Lee, Seok-Jun Yoon, Young Ae Kim, Ji Won Yeom, In-Hwan Oh; J Prev Med Public Health. 2013;46(3):111-117. Published online May 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.3.111

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Abstract PDF

This article evaluates the overall current disease burden of North Korea through the recent databases of international organizations. It is notable that North Korea as a nation is exhibiting a relatively low burden from deaths and that there is greater burden from deaths caused by non-communicable diseases than from those caused by communicable diseases and malnutrition. However, the absolute magnitude of problems from communicable diseases like TB and from child malnutrition, which will increase the disease burden in the future, remains great. North Korea, which needs to handle both communicable and nutritional conditions, and non-communicable diseases, whose burden is ever more increasing in the nation, can now be understood as a country with the 'double-burden' of disease.

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English Abstract

Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database.: Seung ji Lim, Han joong Kim, Chung mo Nam, Hoo sun Chang, Young Hwa Jang, Sera Kim, Hye Young Kang; J Prev Med Public Health. 2009;42(4):251-260.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.251

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Abstract PDF

OBJECTIVES
To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. METHODS: We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients' and caregivers' productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. RESULTS: A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. CONCLUSIONS: Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

Summary

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Original Articles

A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life.: Jee Jeon Yi, Hee Na Lee, Heechoul Ohrr, Hye Young Jung, Sang Wook Yi; Korean J Prev Med. 2003;36(4):332-338.

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Abstract PDF: OBJECTIVE
To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. METHODS: The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. RESULTS: 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age at death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. CONCLUSION: An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.; Summary

Burden of Disease in Korea: Years of Life Lost due to Premature Deaths.: Hyejung Chang, Jae Il Myoung, Youngsoo Shin; Korean J Prev Med. 2001;34(4):354-362.

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Abstract PDF: OBJECTIVES
The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life Years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). METHODS: In closely following the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. RESULTS: The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. CONCLUSIONS: Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.; Summary

Estimation of Attributable Burden due to Premature Death from Smoking in Korea.: Seok Jun Yoon, Beom Man Ha, Jong Won Kang, Hye Chung Chang; Korean J Prev Med. 2001;34(3):191-199.

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Abstract PDF: OBJECTIVE
In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL (years of life lost due to premature death) measurement. METHODS: First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost (SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. RESULTS: The following results were obtained in this study:1) Premature death that is attributable to smoking in males could be prevented in 60.9% (513,582 person-year) by non-smoking.2) The burden of premature death by smoking for female was prevented to 17.7% (513,582 person-year) by non-smoking. CONCLUSION: We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.; Summary

Estimating the Disability Weight of Major Cancers in Korea Using Delphi Method.: Seok Jun Yoon, Young Dae Kwon, Byoung Yik Kim; Korean J Prev Med. 2000;33(4):409-414.

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Abstract PDF: OBJECTIVES
To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.; Summary

Measuring the Burden of Major Cancers due to Premature Death in Korea.: Seok Jun Yoon, Yong Ik Kim, Chang Yup Kim, Hyejung Chang; Korean J Prev Med. 2000;33(2):231-238.

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Abstract PDF: OBJECTIVE
To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. METHODS: First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. RESULTS: The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. CONCLUSION: We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.; Summary

A Study on the Family Burden of the Mentally Ill in a Rural Area.: Weon Young Lee, Young Jeon Shin, Jung Hoe Kim, Chung Hyun Nam, Ok Ryun Moon; Korean J Prev Med. 1999;32(3):400-414.

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Abstract PDF: OBJECTIVES
This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. METHODS: Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. RESULTS: Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. CONCLUSIONS: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.; Summary

Burden of disease of major cancers assessment using years of lives with disability in Korea.: Seok Jun Yoon, Hye Jung Chang, Young Soo Shin; Korean J Prev Med. 1998;31(4):801-813.

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Abstract PDF: This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rate, case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer , esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.; Summary

English Abstract

Estimating the Burden of Psychiatric Disorder in Korea.: Jae Hyun Park, Seok Jun Yoon, Hee Young Lee, Hee Sook Cho, Jin Yong Lee, Sang Jun Eun, Jong Hyock Park, Yoon Kim, Yong Ik Kim, Young Soo Shin; J Prev Med Public Health. 2006;39(1):39-45.

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Abstract PDF: OBJECTIVES
This study estimated the burden of disease especially caused by psychiatric disorders in Korea by using DALY, a composite indicator that was recently developed by the Global Burden of Disease study group. METHODS: First, 11 of the major psychiatric disorders in Korea were selected based on the ICD-10. Second, the burden of disease due to premature death was estimated by using YLLs (years of life lost due to premature death). Third, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula: the incidence rate, the prevalence rate and the disability weight of each psychiatric disorder. Last, we estimated the DALY of the psychiatric disorders by adding the YLLs and YLDs. RESULTS: The burden of psychiatric disorder per 100,000 people was attributed mainly to unipolar major depression (1,278 person-years), schizophrenia (638 person-years) and alcohol use disorder (287 person-years). For males, schizophrenia (596 person-years) and alcohol use disorder (491 person-years) caused the highest burden. For females, unipolar major depression (1,749 person-years) and schizophrenia (680 person-years) cause the highest burden. As analyzed by gender and age group, alcohol use disorder causes a higher burden than schizophrenia in men aged 40 years and older. For females, unipolar major depression causes the highest burden in all age groups. CONCLUSIONS: We found that each of the psychiatric disorders that cause the highest burden is different according to gender and age group. This study's results can provide a rational basis to plan a national health policy regarding the burden of disease caused by psychiatric disorders.; Summary

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