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Health inequalities of 57,541 prisoners in Korea: a comparison with the general population
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Seohyun Yoon
 , Young-Su Ju, Jaehong Yoon, Ji-Hwan Kim, Bokyoung Choi, Seung-Sup Kim
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Epidemiol Health. 2021;43:e2021033. Published online May 6, 2021
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DOI: https://doi.org/10.4178/epih.e2021033
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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.
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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.
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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
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Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
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Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
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Epidemiol Health. 2018;40:e2018005. Published online February 27, 2018
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DOI: https://doi.org/10.4178/epih.e2018005
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27,616
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423
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24
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Abstract
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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.
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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.
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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
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International Journal of Transgender Health.2023; 24(3): 334. CrossRef - Closing the gap in education: Raising medical professionals' knowledge and attitudes in transgender health
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Clinical Pharmacokinetics.2023; 62(7): 1031. CrossRef - Voices from a Multidisciplinary Healthcare Center: Understanding Barriers in Gender-Affirming Care—A Qualitative Exploration
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International Journal of Environmental Research and Public Health.2023; 20(14): 6367. CrossRef - Does Discrimination Affect Whether Transgender People Avoid or Delay Healthcare?: A Nationwide Cross-sectional Survey in South Korea
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Korean Journal of Women Health Nursing.2022; 28(1): 65. CrossRef - Discrimination keeps transgender people awake at night: A nationwide cross-sectional survey of 583 transgender adults in South Korea
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Yiu Tung Suen, Randolph C. H. Chan, Eliz Miu Yin Wong
Archives of Sexual Behavior.2022; 51(7): 3613. CrossRef - Fertility Preservation and Reproductive Potential in Transgender and Gender Fluid Population
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The Journal of Sexual Medicine.2021; 18(7): 1299. CrossRef - Transgender Adults' Public Bathroom-Related Stressors and Their Association with Depressive Symptoms: A Nationwide Cross-Sectional Study in South Korea
Hyemin Lee, Horim Yi, G. Nic Rider, Don Operario, Sungsub Choo, Ranyeong Kim, Yun-Jung Eom, Seung-Sup Kim
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Alessandra J. Ainsworth, Megan Allyse, Zaraq Khan
Mayo Clinic Proceedings.2020; 95(4): 784. CrossRef - Health Disparities Among Transgender Adults in South Korea
Hyemin Lee, Don Operario, Jacob J. van den Berg, Horim Yi, Sungsub Choo, Seung-Sup Kim
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
International Journal of Transgender Health.2020; 21(2): 182. CrossRef - Gender affirmative care of transgender people: a single center's experience in Korea
Hyun Hye Lim, Yun Ha Jang, Gyu Yeon Choi, Jeong Jae Lee, Eun Sil Lee
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Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
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Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
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Epidemiol Health. 2017;39:e2017046. Published online October 19, 2017
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DOI: https://doi.org/10.4178/epih.e2017046
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49,540
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346
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15
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Abstract
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PDFSupplementary Material
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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.
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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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