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.
*Health Status Disparities ; Humans ; Korea ; *Research ; *Social Class

OBJECTIVES: Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. METHODS: The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Cancer Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using CoxZs proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. RESULTS: Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09- fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer (Ptrend<0.01). CONCLUSIONS: This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.
Aged ; Cohort Studies ; Female ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Risk-Taking ; Smoking/adverse effects/*epidemiology ; Stomach Neoplasms/*epidemiology/etiology ; Time Factors

OBJECTIVES: The purpose of this study was to examine the determinants of sterilization in South Korea. METHODS: This study was based on the data from the Korea National Fertility Survey carried out in the year 2000 by the Korea Institute of Health and Social Affairs. The subjects of the analysis were 4,604 women and their husbands who were in their first marriage, in the age group of 15-49 years. The data were analyzed by multiple logistic regression analysis. RESULTS: Consistent with the findings of previous studies, the woman's age and the number of total children increased the likelihood of sterilization. In addition, the year of marriage had a strong positive association with sterilization. Interestingly, the number of surviving sons tended to increase the likelihood of sterilization, whereas the woman's education level and age at the time of marriage showed a negative association with sterilization. Religion, place of residence, son preference, and the husband's education level, age and type of occupation were not significant determinants of sterilization. CONCLUSIONS: The sex of previous children and lower level of education are distinct determinants of sterilization among women in South Korea. More studies are needed in order to determine the associations between sterilization rate and decreased fertility.
Adolescent ; Adult ; *Decision Making ; Female ; Health Surveys ; Humans ; Korea ; Male ; Middle Aged ; Spouses/psychology/*statistics & numerical data ; *Sterilization, Reproductive

OBJECTIVES: Obesity is currently an epidemic in Korea, and sleep duration is thought to be one of the risk factors for obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity in Korean adults. METHODS: The data from the 2001 Korean National Health and Nutrition Survey were used, and 6,174 subjects aged 18~80 years were included in the analysis. Sleep duration was measured using information obtained from self-reported questionnaires. Obesity, the main outcome variable, was measured according to body mass index. Multiple regression modeling was used to adjust for potential confounding variables. RESULTS: The study results revealed a negative association between sleep duration and body mass index among Korean adults. These associations persisted after controlling for the potential confounding variables. CONCLUSIONS: These findings support the hypothesis that sleep duration is associated with obesity in Korean adults. In addition, these observations support earlier experimental sleep studies and provide a basis for future studies on weight control intervention by increasing the amount of sleep.
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Obesity/*epidemiology/etiology ; Questionnaires ; Risk Factors ; Sleep Disorders/*epidemiology/physiopathology

Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.
*Health Policy ; Health Promotion ; *Health Status Disparities ; Humans ; Korea ; Policy Making ; Socioeconomic Factors

In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.
Health Planning/*methods ; Health Services Accessibility ; *Health Status Disparities ; Humans ; Korea ; *Urban Health ; Urban Population

OBJECTIVES: The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. METHODS: Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. RESULTS: We found clear inequalities to various degrees in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. CONCLUSIONS: Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations.
Adult ; Female ; *Health Status Disparities ; Humans ; Korea ; Male ; Middle Aged ; Risk Factors ; Risk-Taking ; Social Class

The socioeconomic inequalities in health have recently become an important public health concern in South Korea, and the issue has gained increasing attention from many South Korean researchers due to the increasing income inequality and widening social polarization following its economic crisis in the late 1990s. However, despite the mounting literature on health inequalities published in recent years, the history of research on health inequality in South Korea is premature in comparison to the long histories in several Western countries. Understanding the historical background underlying the issue of health inequality research may aid in establishing and accumulating scientifically solid evidence in South Korea. It may also direct the South Korean research community to develop research agendas that are more politically and academically appropriate for South Korean society. This paper describes the historical development of health inequality research in the West and introduces several important issues contributing to the advancement of health inequality research. Specifically, the major studies conducted before and after the UK Black Report are presented. In addition, the history and current status of health inequality research in South Korea are documented and evaluated. Finally, several research agendas for the quantitative and qualitative improvement of health inequality research in South Korea are proposed.
*Health Status Disparities ; History, 20th Century ; History, 21st Century ; Humans ; Korea ; Public Health ; Research/*history ; Social Class ; Western World

OBJECTIVES: The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. METHODS: Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. RESULTS: Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. CONCLUSIONS: Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.
*Health Status Disparities ; Humans ; Korea ; Public Health/*ethics ; *Social Justice

OBJECTIVES: South Korea has experienced unprecedented ups and downs in the sex ratio at birth (SRB), which has been a unique phenomenon in the last two decades. However, little is known about socioeconomic factors that influence the SRB. Employing the diffusion theory by Rogers, this study was undertaken to examine the trends in social variations in the SRB from 1981 to 2004 in Korea. METHODS: The data was taken from Vital Birth Statistics for the period from 1981-2004. We computed the annual male proportion of live births according to the parental education (university, middle/high school, primary) and occupation (non-manual, manual, others). Logistic regression analysis was employed to estimate the odds ratios of male birth according to social position for the equidistant three time periods (1981-1984, 1991-1994, and 2001-2004). RESULTS: An increased SRB was detected among parents with higher social position before the mid 1980s. Since then, however, a greater SRB was found for the less educated and manual jobholders. The inverse social gradient for the SRB was most prominent in early 1990s, but the gap has narrowed since the late 1990s. The mother's socioeconomic position could be a sensitive indicator of the social variations in the sex ratio at birth. CONCLUSIONS: Changes in the relationship of parental social position with the SRB were detected during the 1980-2004 in Korea. This Korean experience may well be explained by diffusion theory, suggesting there have been socioeconomic differences in the adoption and spread of sex-detection technology.
Abortion, Induced/trends ; Diffusion of Innovation ; Educational Status ; Female ; Humans ; Korea ; Male ; Occupations ; *Parents ; Pregnancy ; Regression Analysis ; *Sex Ratio ; *Socioeconomic Factors