OBJECTIVE: To investigate the relationships of occupational class, educational level and deprivation with mortality in Korea. METHODS: This study used existing South Korean national data on occupation, educational level, and deprivation and death. Mortality was investigated using registered death data from 1993 to 1997 obtained from the Korean National Statistics Office (NSO) with denominators drawn from the 1995 Census. Statistical analysis consisted of poisson regression modeling and multilevel analysis. RESULTS: The lower occupational class (manual workers) group had a higher mortality rate than the higher occupational class (non-manual workers) group. Educational level, and deprivation were both inversely related withand mortality. Occupation was strongly associated with education. Area-based deprivation indicators and individual indices for social class made an independent contribution to the mortality risk. CONCLUSIONS: The findings of this study suggests that the relationships of occupational class, educational level and deprivation with mortality appears to be stronger in Korea than in European countries.
Censuses ; Education ; Korea* ; Mortality* ; Multilevel Analysis ; Occupations ; Social Class

OBJECTIVE: To explore the relationship of social class and health behaviors with self-reported morbidity. METHODS: The 1995 General Household Survey in Korea was used to investigate self-reported morbidity. Logistic regression was used to examine the relationship of social class and health behaviors with self-reported chronic disease and perceived general health. RESULTS: For chronic disease and general perceived health, age adjusted odds ratios were higher for manual workers, lower-educated group as well as those in the lower income group; this held true for both men and women. Health behaviours had little effect on the relationship between social class and morbidity. The relationship between health behaviors and morbidity was very weak. The lower social class expressed higher levels of negative health behaviors, although this relationship appeared to be very weak in Korea. CONCLUSIONS: This study suggests that an understanding of health differentials that addresses the issue of social inequalities in Korea is required.
Chronic Disease ; Family Characteristics ; Female ; Health Behavior* ; Humans ; Korea* ; Logistic Models ; Male ; Odds Ratio ; Social Class* ; Socioeconomic Factors

BACKGROUND: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight and preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. METHODS: In Korea, 8,648,035 births from 1995 to 2010 were studied with respect to social variation in adverse birth outcomes and infant mortality. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. RESULTS: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. CONCLUSION: The social inequality in adverse birth outcomes (low birthweight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequality in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.
Birth Weight ; Cohort Studies ; Education ; Female ; Humans ; Infant ; Infant Mortality* ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Korea ; Logistic Models ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Social Class ; Socioeconomic Factors

BACKGROUNDS: The objective of this study is to explore the relationships of working hours and work intensity with sleep disturbance among 12-hour shift workers in the automobile factory in Korea. METHODS: A questionnaire and a sleep diary were distributed among 2200 (25% of total workers) and 300 workers who were randomly selected in the 8700 workers in one car factory. Among the 300 randomely selected workers, who were randomly selected, 262 workers filled out a sleep diary. For a questionnaire, 2200 (25%) among 8700 workers were randomly selected, 1200 (54% response rate) of whom filled out the questionnaire. The cross-sectional questionnaire and the sleep diary during 14 consecutive days were distributed and collected by workers' representatives, who were trained for the participatory action research in this study. One hundred and sixty workers' sleep diaries and questionnaires were merged by the same worker and used for the analysis in this study. Logistic regression analysis for repeated measurements was modeled using the prevalence of severe sleepiness at work (i.e. Karonlinska Sleepiness Scale 7 or higher) as dependent variable and working hours, sleep pattern, work intensity and health behaviours as independent variables. RESULTS: The prevalence of severe sleepiness at the end of work was more than 60% after finishing night shift in the automobile factory. The main risk factors related to the severe sleepiness at the end of work were the night shift, long working hours more than 10 hours, the higher frequency of night shift per month, less free time between shifts, poor quality of sleep, deficit of sleeping hours and intensified work (reducing tendency of rest time per day and increasing tendency of additional working time) such as increasing tendency of absolute surplus value. DISCUSSION: We suggest that the 12-hour shift system, long working hours, intensified work and poor quantity as well as quality of sleep were the main risk factors for the severe sleepiness among the shift workers in the automobile factory in Korea.
Automobiles* ; Health Services Research ; Korea* ; Logistic Models ; Prevalence ; Questionnaires ; Risk Factors

PURPOSE: The variables (occupation, education, cause of death, age, and sex) on death certificates can be used for health related studies, however, there has been little research on health related studies using death certificates in Korea. Also, the validity of the values of these variables on death certificates is questionable in Korea. Therefore, we compared occupation, data obtained from WELCO(Korea Labour Welfare Corporation) between 1995 and 1997. METHODS: WELCO data on deaths due to workplace injury between 1995-1997 were merged with data from NSO on deaths occurring during the same period, using social security numbers. Out of a total of 7,698 deaths due to workplace injury reported to WELCO between 1995 and 1997, final study population are linked to 6,513 deaths among aged 20-64 between 1995 and 1997. On linking the data sets, two different sources of data are cross-tabulated to determine the percentage of agreement. Expected agreement and Kappa index are also calculated. RESULTS: The results are as follows : Some manual workers are promoted into the non-manual group in the national death data from the National Statistics Office. Educational groups are promoted or demoted between NSO and WELCO death data. The Kappa index for occupational group is 0.49 when the occupational groups are categorised as manual and non-manual workers. The Kappa index is 0.50 in the two-category classification for education : beyond and below university levels; 0.32 in the three-category classification : university, high-school and less than middle-school; 0.25 in the four category classification : university, high-school, middle-school and less than elementary school. The Kappa index is 0.69 for the three-category disease classification : injury, poisoning and certain other consequences of external causes (S00-T98, ICD10), disease of the circulatory system(I00-I99, ICD10) and other disease categories except the two-category classification. The Kappa index for the 5-year age band is 0.99. There is no disagreement for the sex. CONCLUSIONS: The comparison between national workplace injury data and national death data and tells us that occupational and educational variables are not in the range of 'excellent agreement' suggested by Koch(1997). Our comparison study suggests strong prediction of random errors as well as systemic errors. As for the cause of death, injury and cardiovascular disease from the NSO data are well-matched with those from the WELCO workplace injury death data. However, this comparison may have a limitation as the present study is confined to comparing only the categories of infury and cardiovascular disease. This study suggests that national death data as well as workplace injury data need to be improved for use as health indicators in studies relating socio-economic factors and working conditions to mortality in Korea.
Cardiovascular Diseases ; Cause of Death* ; Classification ; Dataset ; Death Certificates* ; Education* ; Humans ; Korea* ; Mortality ; Occupational Groups ; Occupations* ; Poisoning ; Social Security

OBJECTIVES: The aim of this study was to characterize the community health indicators affecting standardized mortality rate of cerebrovascular diseases(CVD) and to identify the relationship between CVD mortality and community health indicators in Gangwon-do. METHODS: The community health indicators included material deprivation index, medical resource, rates of road pavement and local tax. CVD mortality and the material deprivation index were calculated in the registered death data and the 2000 census which were obtained from the Korean National Statistics Office. The community health indicators were measured using 2001 statistical year book of Ganwon-do. Data were analyzed by using Excel 2003, SAS 9.1. CVD mortality and material deprivation index were visualized by Arcview 9.1. RESULTS: CVD mortality varied by region and sex in Gangwon-do. The highest CVD mortality in male and female were noted at Goseong-gun, the lowest CVD mortality in male was at Yangyang-gun as it of female at Pyeongchang-gun. In Taebaek city where material deprivation index was also the highest; in Pyeongchang-gun was the lowest. Also the higher material deprivation index in some regions was the higher CVD mortality was. CVD mortality was not related with community health indicators. CONCLUSIONS: The results showed the regional difference of mortality of CVD among counties and cities in Gangwon-do. It is recommended that other community health indicators besides material deprivation index, road pavement rate, medical resources and local tax affecting CVD mortality need to be considered to improve the preventive strategies.
Censuses ; Female ; Humans ; Male ; Phenothiazines ; Taxes

Objectives: We aimed to identify the factors related to depression and quality of life in patients with hypertension by using multilevel regression analysis. Methods: In 2019, 229 043 participants in the Korean Community Health Survey were selected as the study group. Individual factors were identified using data from the 2019 Community Health Survey. Regional factors were identified using data from the National Statistical Office of Korea. Multilevel regression analysis was conducted to find individual and local factors affecting depression and quality of life in patients with hypertension and to determine any associated interactions. Results: As individual factors in patients with hypertension, women, those with lower education-levels, recipients of basic livelihood benefits, and those with poor dietary conditions showed stronger associations with depression and quality of life. As regional factors and individual-level variables in patients with hypertension, lower gross regional personal income, fewer doctors at medical institutions, and lower rates of participation in volunteer activities presented stronger associations with depression and quality of life. In addition, the associations of depression with gross regional personal income, the number of doctors at medical institutions, and dietary conditions were significantly stronger in patients with hypertension than in patients without hypertension. The associations of gender and employment status with quality of life were also significantly greater. Conclusions Policy interventions are needed to adjust health behaviors, prevent depression, and improve quality of life for patients with hypertension, especially for those with the risk factors identified in this study.

Deprivation indices have been widely used to evaluate neighborhood socioeconomic status and therefore examine individuals within their regional context. Although some studies on the development of deprivation indices were conducted in Korea, additional research is needed to construct a more valid and reliable deprivation index. Therefore, a new deprivation index, named the K index, was constructed using principal component analysis. This index was compared with the Carstairs, Townsend and Choi indices. A possible association between infant death and deprivation was explored using the K index. The K index had a higher correlation with the infant mortality rate than did the other three indices. The regional deprivation quintiles were unequally distributed throughout the country. Despite the overall trend of gradually decreasing infant mortality rates, inequalities in infant deaths according to the deprivation quintiles persisted and widened. Despite its significance, the regional deprivation variable had a smaller effect on infant deaths than did individual variables. The K index functions as a deprivation index, and we may use this index to estimate the regional socioeconomic status in Korea. We found that inequalities in infant deaths according to the time trend persisted. To reduce the health inequalities among infants in Korea, regional deprivation should be considered.
Adult ; Databases, Factual ; Female ; Humans ; Infant ; *Infant Death ; Male ; Parents ; Poverty ; Principal Component Analysis ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; *Social Class

Predicting cancer mortality is important to estimate the needs of cancer-related services and to prevent cancer. Despite its significance, a long-term future projection of cancer mortality has not been conducted; therefore, our objective was to estimate future cancer mortality in Korea by cancer site through 2032. The specially designed Nordpred software was used to estimate cancer mortality. The cancer death data from 1983 to 2012 and the population projection data from 1983 to 2032 were obtained from the Korean National Statistics Office. Based on our analysis, age-standardized rates with the world standard population of all cancer deaths were estimated to decline from 2008-2012 to 2028-2032 (men: -39.8%, women: -33.1%). However, the crude rates are predicted to rise (men: 29.8%, women: 24.4%), and the overall number of the cancer deaths is also estimated to increase (men: 35.5%, women: 32.3%). Several cancer deaths are projected to increase (lung, liver and gallbladder, colon and rectum, pancreas and leukemia in both sexes; prostate cancer in men; and breast and ovarian cancer in women), whereas other cancer deaths are expected to decrease (stomach, esophagus and larynx in both sexes and cervical cancer in women). The largest contribution to increasing cancer deaths is due to the aging of the Korean population. In conclusion, a strategy for primary prevention, early detection, and early treatment to cope with the rapidly increasing death of cancer due to population aging is urgently required.
Age Factors ; Female ; Humans ; Male ; Models, Theoretical ; Neoplasms/*mortality ; Republic of Korea ; Survival Analysis

Forecasting cause-specific mortality can help estimate the future burden of diseases and provide a clue for preventing diseases. Our objective was to forecast the mortality for causes of death in the future (2013-2032) based on the past trends (1983-2012) in Korea. The death data consisted of 12 major causes of death from 1983 to 2012 and the population data consisted of the observed and estimated populations (1983-2032) in Korea. The modified age-period-cohort model with an R-based program, nordpred software, was used to forecast future mortality. Although the age-standardized rates for the world standard population for both sexes are expected to decrease from 2008-2012 to 2028-2032 (males: -31.4%, females: -32.3%), the crude rates are expected to increase (males: 46.3%, females: 33.4%). The total number of deaths is also estimated to increase (males: 52.7%, females: 41.9%). Additionally, the largest contribution to the overall change in deaths was the change in the age structures. Several causes of death are projected to increase in both sexes (cancer, suicide, heart diseases, pneumonia and Alzheimer’s disease), while others are projected to decrease (cerebrovascular diseases, liver diseases, diabetes mellitus, traffic accidents, chronic lower respiratory diseases, and pulmonary tuberculosis). Cancer is expected to be the highest cause of death for both the 2008-2012 and 2028-2032 time periods in Korea. To reduce the disease burden, projections of the future cause-specific mortality should be used as fundamental data for developing public health policies.
Age Factors ; Cause of Death/*trends ; Female ; Forecasting ; Humans ; Male ; Models, Theoretical ; Neoplasms/mortality ; Republic of Korea ; Sex Factors