OBJECTIVES: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. METHODS: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. RESULTS: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. CONCLUSIONS: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.
Aged ; *Blood Pressure ; Chronic Disease ; Female ; Health Services Accessibility/*statistics & numerical data ; Health Status ; Humans ; Korea/epidemiology ; Male ; Neoplasms/*diagnosis ; Physical Examination/*statistics & numerical data ; Preventive Health Services/*statistics & numerical data ; Residence Characteristics ; Sex Factors ; Socioeconomic Factors

The objective of this study is to investigate gender differences of obesity on major chronic diseases in elderly Korean males and females. This study applied a cross sectional design using the 2005 Korean National Health and Nutrition Examination Survey (KNHNES). We selected 508 elderly males and 830 elderly females who were 60 or more years old. Obesity was defined using Body Mass Index (BMI) (> or = 25) or Waist Circumference (WC) (> or = 90 for men and > or = 85 for women). We applied a surveylogistic regression to determine gender differences in relation to the effect of obesity on eleven major chronic diseases. Using WC, 46.2% of females were obese compared to 34.3% for males. Similarly, using BMI, 42.2% of females were obese compared to 31.7% for males. While obese males and females had similar profiles for developing metabolic syndrome components including hypertension, dyslipidemia, and diabetes (odds ratios [ORs] were 1.8-2.6 for males and 1.7-2.5 for females), obese elderly females had additional risks for arthritis and urinary incontinence (ORs 1.5-1.8 for females) as well as higher prevalence for these diseases. A clearer understanding of gender differences in relation to the association between obesity and chronic diseases would be helpful for reducing the social burden of chronic diseases in the elderly.
Aged ; *Asian Continental Ancestry Group ; Body Mass Index ; *Chronic Disease ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity/*epidemiology/physiopathology ; Odds Ratio ; Sex Factors ; Waist Circumference

OBJECTIVES: The aim of this study was to investigate whether working married women in different occupational classes affected diverse health outcomes. METHODS: We used data for married women aged 25-59 (N=2,273) from the 2005 National Health and Nutritional Examination Survey. Outcome measures included physical/mental and subjective/objective indicators (self-rated poor health, chronic diseases, depression, and suicidal ideation from reported results; metabolic syndrome and dyslipidemia from health examination results). Age-standardized prevalence and logistic regression were employed to assess health status according to three types of working groups (housewives, married women in manual jobs, married women in non-manual jobs). Sociodemographic factors (age, numbers of children under 7, education, household income) and health behaviors (health examination, sleep, rest, exercise, smoking, drinking) and a psychological factor (stress) were considered as covariates. RESULTS: Non-manual married female workers in Korea showed better health status in all five health outcomes than housewives. The positive health effect for the non-manual group persisted in absolute (age-adjusted prevalence) and relative (odds ratio) measures, but multivariate analyses showed an insignificant association of the non-manual group with dyslipidemia. Manual female workers showed significantly higher age-adjusted prevalence of almost all health outcomes than housewives except chronic disease, but the associations disappeared after further adjustment for covariates regarding sleep, rest, and stress. CONCLUSIONS: Our results suggest that examining the health impact of work on married women requires the consideration of occupational class.
Adult ; Employment/*statistics & numerical data ; Female ; Health Behavior ; *Health Status ; Humans ; Korea/epidemiology ; Marital Status/*statistics & numerical data ; Middle Aged ; Occupations/*statistics & numerical data ; Stress, Psychological ; *Women's Health

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

OBJECTIVES: This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. METHODS: Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. RESULTS: The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market. CONCLUSIONS: The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
Adult ; Age Factors ; Data Collection ; Educational Status ; Employment/classification/economics ; Female ; *Health Status Disparities ; Humans ; Male ; Middle Aged ; Republic of Korea ; Sex Factors ; *Social Change ; Social Class ; Women's Health/*trends ; Women's Rights/*trends

OBJECTIVES: We examined gender differential changes in employment-related health inequalities according to occupational position (professional/nonprofessional) in South Korea during the last decade. METHODS: Data were taken from four rounds of Social Statistical Surveys of South Korea (1995, 1999, 2003, and 2006) from the Korean National Statistics Office. The total study population was 55435 male and 33 913 female employees aged 25-64. Employment arrangements were divided into permanent, fixed-term, and daily employment. RESULTS: After stratification according to occupational position (professional/nonprofessional) and gender, different patterns in employment - related health inequalities were observed. In the professional group, the gaps in absolute and relative employment inequalities for poor self-rated health were more likely to widen following Korea's 1997 economic downturn. In the nonprofessional group, during the study period, graded patterns of employment-related health inequalities were continuously observed in both genders. Absolute health inequalities by employment status, however, decreased among men but increased among women. In addition, a remarkable increase in relative health inequalities was found among female temporary and daily employees (p = 0.009, < 0.001, respectively), but only among male daily employees (p = 0.001). Relative employment-related health inequalities had clearly widened for female daily workers between 2003 and 2006 (p = 0.047). The 1997 Korean economic downturn, in particular, seemingly stimulated a widening gap in employment health inequalities. CONCLUSIONS: Our study revealed that whereas absolute health inequalities in relation to employment status increased in the professional group, relative employment-related health inequalities increased in the nonprofessional group, especially among women. In view of the high concentration of female nonstandard employees, further monitoring of inequality should consider gender specific patterns according to employee's occupational and employment status.
Adult ; Economic Recession ; Employment/classification/economics/*trends ; Female ; *Health Status Disparities ; Humans ; Male ; Middle Aged ; Prejudice ; Republic of Korea ; Sex Factors ; Women's Health/*economics

OBJECTIVES: Obesity is a well-recognized risk factor for type 2 diabetes mellitus (DM) among young and middle-aged adults in South Korea. To elaborate on the association between obesity and Diabetes mellitus (DM), subjective data from self-reporting survey or objective data from health examination is generally used. This study was conducted to validate the change of association from using these different measurements. METHODS: Community Health Survey data and Korea National Health and Nutrition Examination Survey data, as subjective and objective data respectively, were used. Population, resident in Seoul and over 45 aged, were selected for the study and the association between obesity and DM were defined by using multivariate logistic regression model. RESULTS: In subjective data, DM prevalence was 12.4% (male, 14.7; female, 10.6) and obesity prevalence was 26.0% (male, 29.2; female, 23.4). Whereas, in objective data, DM prevalence was 15.0% (male, 17.8; female, 12.9), and obese population was 32.4% (male, 34.4; female, 30.8). Based on the effect of obesity on DM prevalence from each data, using objective data increased the impact of obesity. Difference of relative risk of obesity between from subjective data and from objective was bigger in female than male and statistically significant. CONCLUSIONS: The differences of association pattern between subjective and objective data were found, due to higher obesity prevalence in objective data, and discrepancies of socio-economic status. These discrepancies could be inevitable Therefore we have to face them proactively, and understand the different aspect of various variables from different measurement.
Adult ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Female ; Health Surveys* ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys* ; Obesity* ; Prevalence ; Risk Factors ; Seoul

BACKGROUND: The purpose of this study was to investigate the association between number of sleep hours and obesity based on body mass index (BMI) after adjusting for socioeconomic position, health behaviors, and clinical factors. METHODS: Data from subjects aged 20-64 years (n=12,688) in the Korea National Health and Nutrition Examination Survey in 2007-2009 was analyzed. Subjects were divided into two groups according to age: 20-44 (young adults) and 45-64 years (middle-aged adults). With respect to sleep time, subjects were classified as short sleepers (<6 hr/day), long sleepers (≥9 hr/day), and normal sleepers (6-8.9 hr/day). Obesity was defined as a BMI ≥25. RESULTS: The proportion of patients who were obese was 27.8%. The distribution of short sleepers, long sleepers, and normal sleepers was 6.4%, 13.7%, and 79.9%, respectively. The adjusted short sleeper and long sleeper odds ratios (OR) for obesity in young adults were significantly different from that in middle-aged adults after adjustment for confounding factors. In women, the adjusted short sleeper OR for obesity was 1.56 (95% CI, 1.02-2.37). CONCLUSION: This community-based random sample of Korean adults showed that women with short sleep duration may be at significant risk of obesity.
Adult ; Body Mass Index ; Female ; Health Behavior ; Humans ; Korea ; Nutrition Surveys ; Obesity ; Odds Ratio ; Young Adult