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Original Articles
Health inequalities of 57,541 prisoners in Korea: a comparison with the general population
Seohyun Yoon, Young-Su Ju, Jaehong Yoon, Ji-Hwan Kim, Bokyoung Choi, Seung-Sup Kim
Epidemiol Health. 2021;43:e2021033.   Published online May 6, 2021
DOI: https://doi.org/10.4178/epih.e2021033
  • 10,819 View
  • 366 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to examine health disparities between prisoners and the general population in Korea.
METHODS
We sought to estimate the prevalence of 17 physical and mental diseases using the nationwide medication prescription dataset among the total population of prisoners (n=57,541) in Korea. Age- and sex- standardized prevalence ratios (SPRs) were estimated to compare the disease prevalence between the prisoners and the general population. The disease prevalence for the general population was calculated from the prescription dataset for a representative of the Korean population (n=926,246) from the 2013 Korean National Health Insurance Service-National Sample Cohort. Furthermore, the prevalence of these diseases was compared between prisoners and a low-income segment of the general population (n=159,781).
RESULTS
Compared to the general population, prisoners had higher prevalence of almost all physical and mental diseases, including hyperlipidemia (SPR, 20.18; 95% confidence interval [CI], 19.43 to 20.94), pulmonary tuberculosis (SPR, 9.58; 95% CI, 7.91 to 11.50), diabetes (SPR, 6.13; 95% CI, 5.96 to 6.31), cancer (SPR, 2.36; 95% CI, 2.07 to 2.68), and depression (SPR, 46.73; 95% CI, 44.14 to 49.43). When compared with the low-income population segment, higher prevalence were still found among prisoners for most diseases, including pulmonary tuberculosis (SPR, 6.39; 95% CI, 5.27 to 7.67) and depression (SPR, 34.71; 95% CI, 32.79 to 36.72).
CONCLUSIONS
We found that prisoners were more likely to be unhealthy than the general population, even in comparison with a low-income segment of the general population in Korea.
Summary
Korean summary
이 연구는 대한민국 재소자 전수(전국 총 52개 정부운영 교정시설 재소자 57,541명)를 대상으로 법무부 전체 구금시설 의료실태 현황조사 자료를 이용해 신체적∙정신적 건강상태를 파악하고자 하였다. 그 결과를 성∙연령별 표준화율을 적용해 일반인구집단의 국민건강보험공단 표본 코호트 자료와 비교했을 때 재소자들은 고지혈증, 폐결핵, 우울증 등 대부분의 질병에서 일반인구집단보다 더 높은 유병률을 보였다. 이러한 결과는 저소득 일반인구집단과의 비교에서도 유사하게 나타났다.
Key Message
This study aimed to assess mental and physical health conditions among the total population of 57,541 prisoners in all 52 government correctional facilities. And we sought to estimate age- and sex- standardized prevalence ratios to compare the disease prevalence between the prisoners and the general population. Prisoners were more likely to have most of physical and mental diseases (including hyperlipidemia, pulmonary tuberculosis, and depression) than the general population in Korea.

Citations

Citations to this article as recorded by  
  • Prevalence of latent tuberculosis infection among participants of the national LTBI screening program in South Korea – A problem of low coverage rate with current LTBI strategy
    Hyung Woo Kim, Jinsoo Min, Joon Young Choi, Ah Young Shin, Jun-Pyo Myong, Yunhee Lee, Hyeon Woo Yim, Hyunsuk Jeong, Sanghyuk Bae, Hoyong Choi, Hyekyung In, Ahyoung Park, Miri Jang, Hyeon-Kyoung Koo, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Frontiers in Public Health.2023;[Epub]     CrossRef
Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
Epidemiol Health. 2018;40:e2018005.   Published online February 27, 2018
DOI: https://doi.org/10.4178/epih.e2018005
  • 29,964 View
  • 441 Download
  • 30 Web of Science
  • 31 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.
METHODS
In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.
RESULTS
Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.
CONCLUSIONS
Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
Summary
Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.

Citations

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  • Situational Avoidance and Its Association with Mental Health Among Transgender Adults in South Korea: A Nationwide Cohort Study
    Yun-Jung Eom, Hyemin Lee, Sungsub Choo, Ranyeong Kim, Horim Yi, Rockli Kim, Seung-Sup Kim
    LGBT Health.2024; 11(2): 122.     CrossRef
  • Invisibility and Stigma: Experiences of Transgender and Gender Non-Conforming Individuals in South Korea
    Eunha Kim, Hyun Park, YeJi Cho, KyungAh Jeon, Hyunju An
    Archives of Sexual Behavior.2024; 53(1): 77.     CrossRef
  • Βarriers and Gaps to Medical Care for Transgender Individuals: A TRANSCARE Scoping Review with a Focus on Greece
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    BMC Psychology.2024;[Epub]     CrossRef
  • Gender Identity Change Efforts Are Associated with Depression, Panic Disorder, and Suicide Attempts in South Korean Transgender Adults
    Hyemin Lee, Don Operario, Arjee J. Restar, Sungsub Choo, Ranyeong Kim, Yun-Jung Eom, Horim Yi, Seung-Sup Kim
    Transgender Health.2023; 8(3): 273.     CrossRef
  • Transgender-specific COVID-19-related stressors and their association with depressive symptoms among transgender adults: A nationwide cross-sectional survey in South Korea
    Hyemin Lee, Arjee J. Restar, Don Operario, Sungsub Choo, Carl G. Streed Jr, Horim Yi, Ranyeong Kim, Yun-Jung Eom, Seung-Sup Kim
    International Journal of Transgender Health.2023; 24(3): 334.     CrossRef
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    Best Practice & Research Clinical Obstetrics & Gynaecology.2023; 89: 102339.     CrossRef
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    International Journal of Environmental Research and Public Health.2023; 20(14): 6367.     CrossRef
  • Does discrimination prevent transgender and gender diverse people from seeking healthcare?: A nationwide cohort study in South Korea
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    International Journal of Transgender Health.2023; : 1.     CrossRef
  • An Analysis of the Demographics and Clinical Characteristics of Transgender and Intersex Populations in Korea: A Retrospective Study Using HIRA Database
    Dong-Jin Kim, Na-Hyun Hwang, Ji Yoon Lee, Seung Ha Park, Byung-Il Lee, Eul-Sik Yoon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Job-Seeking Experiences of Trans Adults in South Korea
    Jimin Sung, Jaehee Yi, Min Ah Kim, Gaben Sanchez
    Journal of Homosexuality.2023; : 1.     CrossRef
  • Does Discrimination Affect Whether Transgender People Avoid or Delay Healthcare?: A Nationwide Cross-sectional Survey in South Korea
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    Journal of Immigrant and Minority Health.2022; 24(1): 170.     CrossRef
  • Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective
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    Yun-Jung Eom, Hyemin Lee, Ranyeong Kim, Sungsub Choo, Horim Yi, Seung-Sup Kim
    Sleep Health.2022; 8(6): 580.     CrossRef
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    Archives of Sexual Behavior.2022; 51(7): 3613.     CrossRef
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    Biomedicines.2022; 10(9): 2279.     CrossRef
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    Jeong-Won OH, Yeoul Yun, Eun Sil Lee
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    Journal of Asian and African Studies.2021; 56(2): 364.     CrossRef
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    Sa Ra Lee, Min-A Kim, Mun Nyeong Choi, Suyeon Park, Jaehyun Cho, Chulmin Lee, Eun Sil Lee
    Sexual Medicine.2021; 9(1): 100278.     CrossRef
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    The Journal of Sexual Medicine.2021; 18(7): 1299.     CrossRef
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    LGBT Health.2021; 8(7): 486.     CrossRef
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    Asia Pacific Journal of Public Health.2020; 32(2-3): 103.     CrossRef
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Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
Epidemiol Health. 2017;39:e2017046.   Published online October 19, 2017
DOI: https://doi.org/10.4178/epih.e2017046
  • 52,167 View
  • 366 Download
  • 19 Web of Science
  • 18 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
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.
Summary
Korean summary
본 연구는 만 19세 이상의 한국 성인 동성애자와 양성애자를 대상으로 이들의 건강상태에 대한 설문조사를 시행하고, 수집한 자료를 분석하여 동성애자·양성애자의 건강불평등 실태를 파악하고자 하였다. 본 연구의 목적은 자가평가건강, 정신건강(우울, 자살생각 및 자살시도), 신체적 건강(근골격계 통증) 및 건강관련행동(흡연율, 위험음주율)을 포함하여 다양한 측면에서 한국 성인 동성애자·양성애자와 일반인구집단의 건강수준을 비교하는 것이다.

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    AIDS Care.2023; 35(5): 672.     CrossRef
  • Experiences of conflict, non-acceptance and discrimination are associated with poor mental well-being amongst LGBTQ-identified individuals in Singapore
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  • Sexual Orientation Change Efforts, Depressive Symptoms, and Suicidality Among Lesbian, Gay, and Bisexual Adults: A Cross-Sectional Study in South Korea
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    Asia Pacific Journal of Public Health.2020; 32(2-3): 103.     CrossRef
  • Internalized transphobia and mental health among transgender adults: A nationwide cross-sectional survey in South Korea
    Hyemin Lee, Kevin K. Tomita, Janice M. Habarth, Don Operario, Horim Yi, Sungsub Choo, Seung-Sup Kim
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  • Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in South Korea: An Age-Stratified Analysis
    Hyemin Lee, Don Operario, Horim Yi, Sungsub Choo, Seung-Sup Kim
    LGBT Health.2019; 6(8): 393.     CrossRef
  • Association between workplace discrimination and depressive symptoms among firefighters in South Korea
    Nagyeong Lee, Ji‐Hwan Kim, Ja Young Kim, Seung‐Sup Kim
    American Journal of Industrial Medicine.2018; 61(9): 741.     CrossRef
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