Seasonal influenza leads to a significant disease burden, and older people infected with influenza are susceptible to various complications. Influenza immunization can prevent infection effectively and significantly reduce the risk of complications and severe cases. Creating a supportive environment for vaccination is crucial in advancing the influenza vaccination rate among the elderly population. In China, the present environment for supporting influenza vaccinations among the elderly is primarily comprised of policies for free vaccination and expense reimbursement, which exhibit noteworthy regional variations across cities and regions. This study systematically analyses the supportive environment and regional disparities associated with influenza vaccination among the elderly in China. It aims to comprehend the opportunities for influenza prevention and control resulting from the current background of influenza vaccination and to identify potential health inequality challenges caused by regional differences. The findings should inform the introduction of relevant national policies and programs to protect the health and well-being of the elderly population.
Humans ; Aged ; Health Status Disparities ; Influenza, Human/prevention & control* ; China ; Cities ; Vaccination

Seasonal influenza leads to a significant disease burden, and older people infected with influenza are susceptible to various complications. Influenza immunization can prevent infection effectively and significantly reduce the risk of complications and severe cases. Creating a supportive environment for vaccination is crucial in advancing the influenza vaccination rate among the elderly population. In China, the present environment for supporting influenza vaccinations among the elderly is primarily comprised of policies for free vaccination and expense reimbursement, which exhibit noteworthy regional variations across cities and regions. This study systematically analyses the supportive environment and regional disparities associated with influenza vaccination among the elderly in China. It aims to comprehend the opportunities for influenza prevention and control resulting from the current background of influenza vaccination and to identify potential health inequality challenges caused by regional differences. The findings should inform the introduction of relevant national policies and programs to protect the health and well-being of the elderly population.
Humans ; Aged ; Health Status Disparities ; Influenza, Human/prevention & control* ; China ; Cities ; Vaccination

Objective: Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed. Methods: The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT. Results: Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality. Conclusion Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.
Adult ; Health Status Disparities ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal/pathology* ; Prognosis ; Risk Factors ; SEER Program/statistics & numerical data* ; Seminoma/pathology* ; Survival Rate/trends* ; Testicular Neoplasms/pathology* ; United States/ethnology*

OBJECTIVES: The validity of instruments measuring socioeconomic position (SEP) has been a major area of concern in research on cardiovascular health disparities. The purpose of this systematic review is to identify the current status of the methods used to measure SEP in research on cardiovascular health disparities in Korea and to provide directions for future research. METHODS: Relevant articles were obtained through electronic database searches with manual searches of reference lists and no restriction on the date of publication. SEP indicators were categorized into compositional, contextual, composite, and life-course measures. RESULTS: Forty-eight studies published from 2003 to 2018 satisfied the review criteria. Studies utilizing compositional measures mainly relied on a limited number of SEP parameters. In addition, these measures hardly addressed the time-varying and subjective features of SEP. Finding valid contextual measures at the organizational, community, and societal levels that are appropriate to Korea’s context remains a challenge, and these are rarely modeled simultaneously. Studies have rarely focused on composite and life-course measures. CONCLUSIONS: Future studies should develop and utilize valid compositional and contextual measures and appraise social patterns that vary across time, place, and culture using such measures. Studies should also consider multilevel influences, adding a focus on the interactions between different levels of intertwined SEP factors to advance the design of research. More attention should be given to composite and life-course measures.
Cardiovascular Diseases ; Health Status Disparities ; Korea ; Publications ; Socioeconomic Factors

PURPOSE: This study attempted to identify regional disparities of self-rated health among Korean wage workers and to investigate the influencing factors on them. METHODS: The study subjects were 25,069 workers in 16 regions who were extracted from the 2014 Korean Working Condition Survey (KWCS). A multilevel analysis was conducted by building hierarchical data at individual and regional level. RESULTS: In this study, ‘financial autonomy rate’ and ‘current smoking rate’ were identified as regional factors influencing the workers' self-rated health. When the socio-demographic and occupational factors of the workers were controlled, ‘current smoking rate’, a health policy factor, explained the regional disparity of workers' health status. CONCLUSION: We found that the health status of workers can be affected by the health behavior level of the whole population in their residential area. In order to improve the health status of working population and to alleviate their regional health inequalities, it is necessary to strengthen macro and structural level interventions.
Health Behavior ; Health Policy ; Health Status Disparities ; Multilevel Analysis ; Occupational Health ; Residence Characteristics ; Salaries and Fringe Benefits ; Smoke ; Smoking ; Socioeconomic Factors

OBJECTIVES: This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. METHODS: This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. RESULTS: The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. CONCLUSIONS: We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
Adult ; Body Mass Index ; Cross-Sectional Studies ; Health Status Disparities ; Humans ; Iran* ; Life Style ; Obesity ; Prevalence ; Quality of Life* ; Smoke ; Smoking ; Social Class ; Socioeconomic Factors*

PURPOSE: The purpose of this study was to examine changes in the self-rated health of adolescents and to identify its predictors using longitudinal data from the KCYPS. METHODS: A sample of 2,351 adolescents who were in the first grade of middle school in 2010 was analyzed. The study employed latent growth analysis using data from 2010 to 2016. RESULTS: Results indicated that self-rated health of adolescents increased, following the form of a linear function. The analyses revealed that adolescent self-perception of health were conceptualized not only by their health-related behaviors, but also by personal, socioeconomic and psychological factors. Specifically, physical activity, passive leisure time activities, gender (initial: b=−.060, slope: b=.030), place of residence (initial: b=−.079), self-rated economic condition (b=.098), working status of mother (b=.016), monthly family income (b=−.001), aggression (b=.061), depression (initial: b=−.104, slope: b=.012), stress (initial: b=−.172, slope: b=.014, ego-resiliency (initial: b=.197, slope: b=−.021), and self-esteem (initial: b=.106, slope: b=−.017) had significant effects on the overall linear change of self-rated health (p < .05 for all estimators above). CONCLUSION: The findings of this study suggest that adolescents' self evaluation of their health is shaped by their total sense of functioning, which includes individual, health-related behavioral, socioeconomic, and psychological factors.
Adolescent Health ; Adolescent* ; Aggression ; Depression ; Diagnostic Self Evaluation ; Health Status Disparities ; Humans ; Leisure Activities ; Longitudinal Studies ; Mothers ; Motor Activity ; Psychology ; Self Concept

PURPOSE: The purpose of this study was to identify trends in health-related interventions on children attending Community Child Care (CCC) centers, which are part of a health policy to provide after-school care for vulnerable children in South Korea. METHODS: From 2007, 109 papers were analyzed using the scoping study method. RESULTS: The number of studies increased steadily between 2007 and 2016. Most studies were based on the social sciences, and the participants were mainly elementary school students. Psychological and social interventions were the most common types of interventions with socio-psychological indicators as measurements. In addition, only a few studies had a clearly defined conceptual framework. The majority of studies did not explicitly indicate that they followed ethical considerations. CONCLUSION: It is necessary to develop health-related interventions for children attending CCC centers using diverse subjects, types, and evaluation methods, along with improvements in the quality of research methodology. Furthermore, it is essential to clearly articulate and implement ethical considerations in research targeting vulnerable children.
Child Care* ; Child* ; Health Policy ; Health Status Disparities ; Humans ; Korea* ; Methods ; Research Design ; Social Sciences

OBJECTIVES: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities. METHODS: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women). RESULTS: Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men. CONCLUSIONS: The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Adult* ; Bisexuality* ; Dataset ; Depression ; Drinking ; Female ; Health Status Disparities ; Homosexuality* ; Homosexuality, Female* ; Humans ; Korea* ; Male ; Minority Health ; Musculoskeletal Pain ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicidal Ideation

OBJECTIVES: The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran. METHODS: The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters. RESULTS: There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p < 0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p < 0.001). CONCLUSIONS: Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.
Bayes Theorem ; Breast Neoplasms* ; Breast* ; Female* ; Health Status Disparities ; Humans ; Incidence* ; Iran ; Residence Characteristics* ; Resource Allocation ; Socioeconomic Factors* ; Spatial Analysis