Journal of Preventive Medicine and Public Health

Original Articles

Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries: Miftahul Arsyi, Besral Besral, Milla Herdayati, Revati Phalkey; J Prev Med Public Health. 2022;55(6):559-567. Published online November 13, 2022; DOI: https://doi.org/10.3961/jpmph.22.316

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Objectives
This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN).
Methods
Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017.
Results
The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers’ demographic/socioeconomic factors, health behaviors, and other factors.
Conclusions
In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.

Summary

Citations

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Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries
Vishnu Khanal, Sangita Bista, Shiva Raj Mishra
BMC Public Health.2024;[Epub] CrossRef
The association of Chinese and American antenatal care utilization indices with birth outcomes
Haibo Zhou, Yi Yang, Peihan Chi, Haoyue Cheng, Xialidan Alifu, Yiwen Qiu, Ye Huang, Libi Zhang, Diliyaer Ainiwan, Yan Zhuang, Hui Liu, Zhi Chen, Yunxian Yu
Frontiers in Public Health.2024;[Epub] CrossRef
Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial
Y Mekonnen, E Wolde, A Bekele, Z Mehari, S Abebe, T Hagos, Y Tadesse, T Taye, G Asire, T Nigatu, S Kumar, S Girma, M Salasibew
BMC Pregnancy and Childbirth.2023;[Epub] CrossRef
Compliance with the World Health Organization’s 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana
Leticia Achangebe Akum, Eunice Amina Offei, Mary Rachael Kpordoxah, Daudi Yeboah, Abdul-Nasir Issah, Michael Boah, Sanjoy Kumer Dey
PLOS ONE.2023; 18(6): e0285621. CrossRef

Non-linear Relationship Between Body Mass Index and Lower Urinary Tract Symptoms in Korean Males: Chang Kyun Choi, Sun A Kim, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin; J Prev Med Public Health. 2019;52(3):147-153. Published online March 29, 2019; DOI: https://doi.org/10.3961/jpmph.18.259

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Abstract Summary PDF

Objectives
The purpose of this study was to evaluate the association between body mass index (BMI) and severe lower urinary tract symptoms (LUTS) in Korean males.
Methods
This study was conducted on males aged ≥50 years who participated in the 2011 Korean Community Health Survey. LUTS severity was assessed using the Korean version of the International Prostate Symptom Score (IPSS) questionnaire, and was dichotomized as severe (IPSS >19) and non-severe (IPSS ≤19). BMI was divided into 6 categories: <18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2. To evaluate the relationship between BMI and LUTS, a survey-weighted multivariate Poisson regression analysis was performed to estimate prevalence rate ratios (PRRs). Age, smoking status, alcohol intake, physical activity, educational level, household income, and comorbidities were adjusted for in the multivariate model.
Results
A U-shaped relationship was detected between BMI and severe LUTS. Compared with a BMI of 23.0-24.9 kg/m2, the PRR for a BMI <18.5 kg/m2 was 1.65 (95% confidence interval [CI], 1.35 to 2.02), that for a BMI of 18.5-22.9 kg/m2 was 1.25 (95% CI, 1.09 to 1.44), that for a BMI of 25.0-27.4 kg/m2 was 1.20 (95% CI, 1.00 to 1.45), that for a BMI of 27.5-29.9 kg/m2 was 1.11 (95% CI, 0.83 to 1.47), and that for a BMI ≥30.0 kg/m2 was 1.85 (95% CI, 1.18 to 2.88).
Conclusions
This study showed that both high and low BMI were associated with severe LUTS.

Summary

Korean summary
이 연구는 2011 지역사회건강조사를 기반으로 하였다. 한국인 남성에서 체질량지수와 하부요로증상 간에는 U자형 관련성이 있었으며, 저체중과 비만 모두 높은 하부요로증상 유병률을 보였다. 따라서 전립선 질환의 건강서비스 제공에 있어서 비만 뿐만 아니라 저체중 또한 위험인자로 함께 고려할 필요가 있다.

Citations

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Metabolic syndrome and male lower urinary tract symptoms
Gallus B. INEICHEN, Fiona C. BURKHARD
Panminerva Medica.2022;[Epub] CrossRef

High Level Physical Activity and Prevalence of Cardiovascular Disease Using the Korea National Health and Nutrition Examination Survey Data, 2007-2013: Kyounghoon Park, Byung-Joo Park; J Prev Med Public Health. 2017;50(5):320-327. Published online September 5, 2017; DOI: https://doi.org/10.3961/jpmph.17.073

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Abstract PDF

Objectives
The purpose of our study was to evaluate the association between the intensity of physical activity (PA) and prevalence of cardiovascular disease (CVD) using Korean representative data. Methods: We analyzed 39 804 participant data from the Korea National Health and Nutrition Examination Survey, 2007-2013. Exposure variable was three levels of PA (low, medium, and high) in a week, and outcome variable was prevalence of CVD based on patient self-recognition and doctor’s diagnosis. Complex logistic regression analysis was performed to evaluate the relationship between level of PA and CVD adjusted by body mass index, hypertension, hypercholesterolemia, diabetes mellitus, stress recognition, household income, smoking, and current drinking. The indices of association w ere estimated as crude prevalence odds ratio (POR), adjusted POR, and their 95% confidence interval (CI). All statistical analyzes were performed using complex sample analysis procedure of the SPSS version 23.0. Results: When all variables were adjusted, only high level PA in women showed a significant association with stroke (adjusted POR by patient’s self-recognition, 0.57; 95% CI, 0.32 to 0.99, adjusted POR by doctor’s diagnosis, 0.55; 95% CI, 0.34 to 0.87) and CVD (adjusted POR by doctor’s diagnosis, 0.68; 95% CI, 0.48 to 0.96). Conclusions: High level PA in women has a significant reverse association with prevalence of stroke and CVD in Korea. Further study for elucidating the mechanism will be needed.

Summary

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Role of regular physical activity in modifying cardiovascular disease risk factors among elderly Korean women
Seunghui Baek, Youngmee Kim, Lorraine S. Evangelista
IJASS(International Journal of Applied Sports Scie.2018; 30(1): 20. CrossRef

The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data: Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon; J Prev Med Public Health. 2016;49(5):308-322. Published online September 7, 2016; DOI: https://doi.org/10.3961/jpmph.16.035

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Abstract PDF

Objectives
The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
Methods
The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables.
Results
Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to “financial burden” (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to “service not available when needed.” There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to “financial burden” (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to “service not available when needed.”
Conclusions
Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.

Summary

Citations

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Risk of all-cause mortality is associated with multiple health-related lifestyle behaviors and does not differ between urban and rural areas in Korea
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Purity Njagi, Jelena Arsenijevic, Wim Groot
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BMJ Open Diabetes Research & Care.2020; 8(1): e000729. CrossRef
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Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon, Dongjin Kim, Jihee Choi
Osong Public Health and Research Perspectives.2019; 10(5): 295. CrossRef
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Regional Disparity and Factors Influencing Unmet Medical Needs: A Study Based on the Sixth Korea National Health and Nutrition Examination Survey (2015)
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Dental Care Utilization for Examination and Regional Deprivation: Cheol-Sin Kim, Sun-Young Han, Seung Eun Lee, Jeong-Hee Kang, Chul-Woung Kim; J Prev Med Public Health. 2015;48(4):195-202. Published online July 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.026

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Abstract PDF

Objectives
Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization.
Methods
Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258).
Results
Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model.
Conclusions
This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination.

Summary

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Hosung Shin, Han-A Cho, Bo-Ra Kim
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Relationship between Subjective Oral Discomfort and Health-Related Quality of Life in the South Korean Elderly Population
Kyung-Yi Do, Sook Moon
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Change over a period of 9 years in self-reported oral health of a middle-aged population using 4-6th KNHANES data
Song-Yi Kim, Nam-Hee Kim
Journal of Korean Academy of Oral Health.2019; 43(2): 50. CrossRef
The role of healthcare system in dental check‐ups in 27 European countries: multilevel analysis
Shiho Kino, Eduardo Bernabé, Wael Sabbah
Journal of Public Health Dentistry.2017; 77(3): 244. CrossRef
The Association Among Individual and Contextual Factors and Unmet Healthcare Needs in South Korea: A Multilevel Study Using National Data
Seung Eun Lee, Miyeon Yeon, Chul-Woung Kim, Tae-Ho Yoon
Journal of Preventive Medicine and Public Health.2016; 49(5): 308. CrossRef
Dental care utilization in the west of Iran: a cross-sectional analysis of socioeconomic determinants
Satar Rezaei, Esmail Ghahramani, Mohammad Hajizadeh, Bijan Nouri, Sheno Bayazidi, Fatemah Khezrnezhad
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Research Support, Non-U.S. Gov't

Test-Retest Reliability of a Questionnaire for the Korea Youth Risk Behavior Web-Based Survey.: Jisuk Bae, Hyojee Joung, Jong Yeon Kim, Kyoung Nam Kwon, Young Taek Kim, Soon Woo Park; J Prev Med Public Health. 2010;43(5):403-410.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.403

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Abstract PDF

OBJECTIVES
A web-based survey has been administered annually since 2005 throughout Korea to assess the prevalence of adolescent health risk behaviors among middle and high school students. The aim of this study was to evaluate the test-retest reliability of the Korea Youth Risk Behavior Web-based Survey (KYRBWS) questionnaire. METHODS: A convenience sample of 2298 middle and high school students participated in self-administered questionnaire surveys twice, approximately two weeks apart, in 2008. The percent agreement, kappa statistics, and prevalence rates at the first and second surveys were computed for the core subset of 39 self-reported health risk behavior indices of the KYRBWS. RESULTS: Among 39 indices, seven indices had kappas > or = 0.81 and all of the indices had kappas > or = 0.41. Based on non-overlapping 95% confidence intervals, three indices had significantly different prevalence rates between the first and second surveys. In the subgroup analyses by school grade and gender, two indices had significantly different reliability estimates between middle and high school students. There were no significantly different reliability estimates between male and female students, except for one index. CONCLUSIONS: This study demonstrated that the reliability estimates for the KYRBWS questionnaire are varied, but generally reliable over time. The indices with low reliability estimates need to be evaluated further in order to determine whether the indices should be modified or deleted from future versions of the KYRBWS.

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Original Article

Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey.: Geun Yong Kwon, Do Sang Lim, Eun Ja Park, Ji Sun Jung, Ki Won Kang, Yun A Kim, Ho Kim, Sung Il Cho; J Prev Med Public Health. 2010;43(2):174-184.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.174

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Abstract PDF

OBJECTIVES
This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. METHODS: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. RESULTS: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. CONCLUSIONS: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

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English Abstract

Association between the Physical Activity of Korean Adolescents and Socioeconomic Status.: In Hwan Oh, Goeun Lee, Chang Mo Oh, Kyung Sik Choi, Bong Keun Choe, Joong Myung Choi, Tai Young Yoon; J Prev Med Public Health. 2009;42(5):305-314.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.305

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Abstract PDF

OBJECTIVES
The physical activity of Korean adolescents and its distribution based on social characteristics have not yet been fully assessed. This study intends to reveal the distribution of physical activity by its subgroups and offer possible explanatory variables. METHODS: The 3rd Korea Youth Risk Behavior Web-based Survey was analyzed for this study. The appropriateness of physical activity was defined by Korea's Health Plan 2010 and physical inactivity was assessed independently. Family affluence scale, parents' education levels, subjective economic status, grade, and school location were considered explanatory variables. All statistical analysis was conducted using SAS ver. 9.1. RESULTS: The proportion of participants engaging in vigorous physical activity was high in males (41.6%), at a low grade (38.5%), within the high family affluence scale group (35.5%). The distribution of participants engaging in moderate physical activity showed similar patterns, but the overall proportion was lower (9.8%). Low family affluence and students with lower subjective economic status reported a higher prevalence of physical inactivity. In multiple logistic regression analysis for physical activity, significant factors included family affluence scale (p<0.05). For physical inactivity, family affluence scale, parents education levels, and subjective economic status were included as significant factors (p<0.05). CONCLUSIONS: The results suggest that the physical activity and inactivity of adolescents may be affected by socioeconomic variables, such as family affluence scale. This implies the need to take proper measures to address these socio-economic inequalities.

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