Journal of Preventive Medicine and Public Health

Original Articles

Effects of Marital Status and Income on Hypertension: The Korean Genome and Epidemiology Study (KoGES): Mia Son, Yeon Jeong Heo, Hye-Jin Hyun, Ho Jong Kwak; J Prev Med Public Health. 2022;55(6):506-519. Published online October 7, 2022; DOI: https://doi.org/10.3961/jpmph.22.264

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Objectives
This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea.
Methods
The data were derived from the Korean Genome and Epidemiology Study (KoGES; 4851-302) which included 211 576 participants. To analyze the relationships of income, marital status, and health behaviors with hypertension in male and female over 40 years of age, multiple logistic regression was conducted with adjustments for these variables.
Results
The prevalence of hypertension increased linearly as income decreased. The odds ratio for developing hypertension in people with an income of <0.5 million Korean won (KRW) compared to ≥6.0 million KRW was 1.55 (95% confidence interval [CI], 1.25 to 1.93) in the total population, 1.58 (95% CI, 1.27 to 1.98) in male, and 1.07 (95% CI, 0.35 to 3.28) in female. The combined effect of income level and marital status on hypertension was significant. According to income level and marital status, in male, low income and divorce were most associated with hypertension (1.76 times; 95% CI, 1.01 to 3.08). However, in female, the low-income, married group was most associated with hypertension (1.83 times; 95% CI, 1.71 to 1.97).
Conclusions
The results of this study show that it is necessary to approach male and female marital status separately according to income in health policies to address inequalities in the prevalence of hypertension.

Summary

Korean summary
이 연구는 한국의 40세 이상 성인 남녀를 대상으로 소득수준, 결혼, 건강행태요인이 고혈압에 미치는 영향을 분석하였다. 이 연구는 한국인유전체역학조사사업조사(KoGES; 4851-302, 2001-2011)에서 구축한 211576명을 대상으로 다중 로지스틱회귀모델을 이용하여 분석했다. 소득이 고혈압에 미치는 영향은 역의 선형으로 소득이 적을수록 고혈압이 증가하는 경향이 뚜렷하게 나타났다. 소득수준과 혼인상태, 고혈압과의 연관성은 여성보다 남성이 더 강하게 나타났다. 소득수준과 혼인상태가 상호작용하여 고혈압에 미치는 영향에서, 저소득층에서 별거 상태가 고혈압에 미치는 전반적인 영향이 가장 강하게 나타났으며, 남성의 경우 이혼 상태, 여성의 경우 결혼을 유지하고 있는 상태가 고혈압과 가장 강하게 연관되어, 남녀사이에 차이가 존재함을 보여주었다. 이 연구는 소득, 결혼이 고혈압에 중요하게 영향을 미치는 것으로 나타나, 고혈압예방대책에 저소득과 별거 이혼등의 결혼상태를 고려하는것이 필요하다는 것을 제안한다.

Citations

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The impact of retirement on blood pressure: evidence from a nationwide survey in China
Jiarun Mi, Xueyan Han, Man Cao, Hanchao Cheng, Zhaoyang Pan, Jian Guo, Wei Sun, Yuanli Liu, Congyi Zheng, Xin Wang, Xue Cao, Zhen Hu, Yixin Tian, Zengwu Wang, Tianjia Guan
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Shapely additive values can effectively visualize pertinent covariates in machine learning when predicting hypertension
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Effects of Income Level on the Association Between Hypertension and Depression: 2010-2017 Korea National Health and Nutrition Examination Survey: San Kang, Hyeon Chang Kim; J Prev Med Public Health. 2020;53(6):439-446. Published online October 8, 2020; DOI: https://doi.org/10.3961/jpmph.20.337

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Abstract PDF Supplementary Material

Objectives
This study analyzed the associations of hypertension (HTN) with symptoms and diagnosis of depression by income level among Korean adults.
Methods
This study was based on the 2010-2017 Korea National Health and Nutrition Examination Survey data; a total of 29 425 adults (aged 20 years or older) were analyzed. HTN was defined as a systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of hypertensive medications. Depression symptoms were evaluated based on a questionnaire about depression-related symptoms. A depression diagnosis was defined based on questionnaire responses indicating that a participant had been diagnosed with depression. Household income was divided into higher or lower income ranges based on the median income of the participants. Multiple logistic regression analyses were performed to assess the associations between HTN and depression symptoms/diagnosis in the higher-income and lower-income groups.
Results
In the higher-income group, the odds ratio (OR) for the association between HTN and depression symptoms was 1.15 (95% confidence interval [CI], 0.97 to 1.37), and the OR for the association between HTN and depression diagnosis was 1.41 (95% CI, 1.13 to 1.76). In the lower-income group, the OR for the association between HTN and depression symptoms was 1.18 (95% CI, 1.04 to 1.34), whereas the OR for the association between HTN and depression diagnosis was 0.82 (95% CI, 0.70 to 0.97).
Conclusions
The associations of HTN with symptoms and diagnosis of depression differed by income level.

Summary

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Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults
Rohan M. Shah, Sahil Doshi, Sareena Shah, Shiv Patel, Angela Li, Joseph A. Diamond
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Chiyoung Lee, Heewon Kim, Gennady S. Cymbalyuk
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Review

A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework: Marita Mohammadshahi, Shahrooz Yazdani, Alireza Olyaeemanesh, Ali Akbari Sari, Mehdi Yaseri, Sara Emamgholipour Sefiddashti; J Prev Med Public Health. 2019;52(2):72-81. Published online December 31, 2018; DOI: https://doi.org/10.3961/jpmph.18.238

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Objectives
The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions.
Methods
This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework.
Results
The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians’ incentive for pecuniary profit or meeting their target income, physicians’ current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients’ observable characteristics, patients’ non-clinical characteristics, and insurance coverage.
Conclusions
A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians’ behavior, particularly in the field of health economics.

Summary

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Original Articles

Trends in Inequality in Cigarette Smoking Prevalence by Income According to Recent Anti-smoking Policies in Korea: Use of Three National Surveys: Youngs Chang, Sanghyun Cho, Ikhan Kim, Jinwook Bahk, Young-Ho Khang; J Prev Med Public Health. 2018;51(6):310-319. Published online October 30, 2018; DOI: https://doi.org/10.3961/jpmph.18.225

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Abstract PDF Supplementary Material

Objectives
This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea.
Methods
The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator.
Results
Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015.
Conclusions
The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.

Summary

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Soo Kyung Jeong, Gye Ae Kim, Min Kyung Lim, Youn Hee Kim, Cho Hee Choi, Sang Mi Lee, Hun Jae Lee
Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(1): 20. CrossRef
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Sung Yeol Son, Seo Young Kang, Hong-Jun Cho
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Trends in Alcohol Consumption for Korean Adults from 1998 to 2018: Korea National Health and Nutritional Examination Survey
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Tobacco price increases in Korea and their impact on socioeconomic inequalities in smoking and subsequent socioeconomic inequalities in mortality: a modelling study
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Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992–2016
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Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys
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Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014): Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh; J Prev Med Public Health. 2018;51(3):140-147. Published online May 14, 2018; DOI: https://doi.org/10.3961/jpmph.17.153

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Abstract PDF

Objectives
Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures.
Methods
This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships.
Results
Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term.
Conclusions
The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

Summary

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Effects of Iranian Economic Reforms on Equity in Social and Healthcare Financing: A Segmented Regression Analysis: Hamed Zandian, Amirhossein Takian, Arash Rashidian, Mohsen Bayati, Telma Zahirian Moghadam, Satar Rezaei, Alireza Olyaeemanesh; J Prev Med Public Health. 2018;51(2):83-91. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.050

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Abstract PDF

Objectives
One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households’ income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

Summary

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Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
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Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
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Ehsan Aghapour, Mehdi Basakha, Seyed Hossein Mohaqeqi Kamal, Abolghasem Pourreza
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Farhad Pourfarzi, Satar Rezaei, Reza Malekzadeh, Arash Etemadi, Telma Zahirian Moghadam, Hamed Zandian
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Income Differences in Smoking Prevalences in 245 Districts of South Korea: Patterns by Area Deprivation and Urbanity, 2008-2014: Ikhan Kim, Jinwook Bahk, Tae-Ho Yoon, Sung-Cheol Yun, Young-Ho Khang; J Prev Med Public Health. 2017;50(2):100-126. Published online February 9, 2017; DOI: https://doi.org/10.3961/jpmph.16.069

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Abstract PDF Supplementary Material

Objectives
The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity.
Methods
Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence.
Results
Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men.
Conclusions
This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.

Summary

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Socioeconomic Disparities in Osteoporosis Prevalence: Different Results in the Overall Korean Adult Population and Single-person Households: Jungmee Kim, Joongyub Lee, Ju-Young Shin, Byung-Joo Park; J Prev Med Public Health. 2015;48(2):84-93. Published online March 6, 2015; DOI: https://doi.org/10.3961/jpmph.14.047

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Abstract PDF

Objectives
The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households.
Methods
A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ≥ 50 years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area.
Results
There were 8221 osteoporosis patients aged ≥ 50 years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p= 0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43).
Conclusions
The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

Summary

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The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea: Su Ra Seo, Su Young Kim, Sang-Yi Lee, Tae-Ho Yoon, Hyung-Geun Park, Seung Eun Lee, Chul-Woung Kim; J Prev Med Public Health. 2014;47(2):104-112. Published online March 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.2.104

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Abstract PDF

Objectives

To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea.

Methods

Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated.

Results

In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels.

Conclusions

The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.

Summary

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Has Income-related Inequity in Health Care Utilization and Expenditures Been Improved? Evidence From the Korean National Health and Nutrition Examination Survey of 2005 and 2010: Eunkyoung Kim, Soonman Kwon, Ke Xu; J Prev Med Public Health. 2013;46(5):237-248. Published online September 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.5.237

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Abstract PDF

Objectives

The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea.

Methods

We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners.

Results

The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010.

Conclusions

We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

Summary

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English Abstract

Management of Diabetic Mellitus in Low-income Rural Patients.: Hye Yeon Kim, Woo Jun Yun, Min Ho Shin, Sun Seong Kweon, Hye Ran Ahn, Seong Woo Choi, Young Hoon Lee, Dong Hyeok Cho, Jung Ae Rhee; J Prev Med Public Health. 2009;42(5):315-322.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.315

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Abstract PDF

OBJECTIVES
Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS: We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS: The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS: DM management in low income patients is very poor and requires further work to improve.

Summary

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Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea
Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
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The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes
Jihye Jeong, Namhee Park, So Young Shin
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Group Classification on Management Behavior of Diabetic Mellitus
Sung-Hong Kang, Soon-Ho Choi
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Research Support, Non-U.S. Gov't

Associations of Income and Wealth with Health Status in the Korean Elderly.: Bo Hyun Park, Minsoo Jung, Tae Jin Lee; J Prev Med Public Health. 2009;42(5):275-282.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.275

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Abstract PDF

OBJECTIVES
This study aimed to verify the association between wealth or income level and health status after adjusting for other socio-economic position (SEP) indicators among Korean adults aged 45 and over. METHODS: Data were obtained from the 1st wave of Korean Longitudinal Study of Ageing (households: 6,171, persons: 10,254). We used self-rated health status and activities of daily living (ADLs) as dependent variables. Explanatory variables included both net wealth measured by savings, immovables, the other valuated assets and total income including pay, transfer, property and so on. Binary logistic regression was conducted to examine the relationships. Also, in order to determine the relative health inequality across economic groups, we estimated the relative index of inequality (RII). RESULTS: The inequality of health status was evident among various wealth and income groups. The wealthiest group (5th quintile) was much healthier than the poorest group, and this differential increased with age. Likewise, higher income was associated with better health status among the elderly. However, these effects, as measured by the odds ratio and RII, showed that wealth was more important in determining health status of elderly people. CONCLUSIONS: This study suggests that economic capability plays a significant role in determining the health status and other health-related problems among the elderly. Particularly, our results show that health status of the aged is related more closely to the individual's wealth than income.

Summary

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Review

A Review on Socioeconomic Position Indicators in Health Inequality Research.: Yong Jun Choi, Baek Geun Jeong, Sung Il Cho, Kyunghee Jung-Choi, Soong Nang Jang, Minah Kang, Young Ho Khang; J Prev Med Public Health. 2007;40(6):475-486.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.475

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Abstract PDF

OBJECTIVES
Socioeconomic position (SEP) refers to the socioeconomic factors that influence which position an individual or group of people will hold within the structure of a society. In this study, we provide a comprehensive review of various indicators of SEP, including education level, occupation-based SEP, income and wealth, area SEP, lifecourse SEP, and SEP indicators for women, elderly and youth. METHODS AND RESULTS: This report provides a brief theoretical background and discusses the measurement, interpretation issues, advantages and limitations associated with the use of each SEP indicator. We also describe some problems that arise when selecting SEP indicators and highlight the indicators that appear to be appropriate for health inequality research. Some practical information for use in health inequality research in South Korea is also presented. CONCLUSIONS: Investigation into the associations between various SEP indicators and health outcomes can provide a more complete understanding of mechanisms between SEP and health. The relationship between specific SEP indicators and specific health outcomes can vary by country due to the differences in the historical, socioeconomic, and cultural contexts of the SEP indicators.

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English Abstract

Differential Effects of Family Income on Self-rated Health by Age: Analysis of Seoul Citizens Health Indicators Survey 2001, 2005.: Youn Jung, Youngtae Cho, Juhwan Oh; J Prev Med Public Health. 2007;40(5):381-387.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.381

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37 Download
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Abstract PDF

OBJECTIVES
This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. METHODS: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). RESULTS: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. CONCLUSIONS: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.

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Original Article

Social Support and Self-rated Health Status in a Low Income Neighborhood of Seoul, Korea.: Min Kyoung Lim, Myoung Hee Kim, Young Jeon Shin, Weon Seob Yoo, Bong Min Yang; Korean J Prev Med. 2003;36(1):54-62.

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Abstract PDF: OBJECTIVES
To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.; Summary

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