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Original Articles
Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
Epidemiol Health. 2024;46:e2024074.   Published online September 11, 2024
DOI: https://doi.org/10.4178/epih.e2024074
  • 996 View
  • 65 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS
We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS
When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
Summary
Korean summary
2006년부터 2015년 한국의 유방암 불평등 추세를 분석하면, 소득수준이 낮은 여성의 발생률은 상대적으로 낮음에도 불구하고 사망률은 높은 양상을 보였다. 유방암 검진과 치료에 있어 보다 형평성을 고려한 정책이 요구된다.
Key Message
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
Jinwook Bahk, Kyunghee Jung-Choi
Epidemiol Health. 2022;44:e2022110.   Published online November 23, 2022
DOI: https://doi.org/10.4178/epih.e2022110
  • 6,870 View
  • 172 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to examine the trends in total mortality between 1998 and 2020 and to compare the changes in a wide range of detailed causes of death between 2020 (i.e., during the coronavirus disease 2019 [COVID-19] pandemic) and the previous year in Korea.
METHODS
We used registered population and mortality data for the years 1998-2020 obtained from Statistics Korea. The age-standardized all-cause mortality rate and the annual percent change between 1998 and 2020 were determined. The rate ratio and rate difference of the age-standardized mortality rate between 2019 and 2020 were calculated.
RESULTS
The age-standardized all-cause mortality rate in Korea has been on a downward trend since 1998, and the decline continued in 2020. In 2020, 950 people died from COVID-19, accounting for 0.3% of all deaths. Mortality decreased for most causes of death; however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020 for both men and women. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This increase was mainly attributed to a higher number of suicide deaths.
CONCLUSIONS
This study shed light on the issues of sepsis and aspiration pneumonia despite the successful response to COVID-19 in Korea in 2020. Cases of death from sepsis and aspiration pneumonia should be identified and monitored. In addition, it is necessary to develop a proactive policy to address suicide among young people, especially young women.
Summary
Korean summary
1998년 이래 한국의 연령표준화 총사망률은 지속적으로 감소하였고, 이러한 경향은 코로나19 대유행 첫해인 2020년에도 관찰되었다. 대부분 사망원인별 사망률이 코로나19 대유행이후에도 감소하였으나, 패혈증 및 흡인성 폐렴으로 인한 사망자가 남성과 여성 모두에서 증가했다. 연령별 사망률에서는 25-29세 여성을 제외한 모든 연령대에서 2019년에 비해 2020년 사망률이 감소하거나 유지되었고, 25-29세 여성의 사망률 증가는 주로 자살 사망의 증가에 기인했다.
Key Message
During 1988-2020, the age-standardized all-cause mortality rate in Korea has been on a downward trend and the decline continued in 2020. In 2020, mortality decreased for most causes of death, however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This was mainly attributed to increased suicide deaths.

Citations

Citations to this article as recorded by  
  • Suicide mortality rates in Japan before and beyond the COVID‐19 pandemic era
    Motohiro Okada, Ryusuke Matsumoto, Eishi Motomura
    Psychiatry and Clinical Neurosciences Reports.2024;[Epub]     CrossRef
  • Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases
    Ryusuke Matsumoto, Eishi Motomura, Motohiro Okada
    European Journal of Investigation in Health, Psychology and Education.2024; 14(4): 1086.     CrossRef
  • Unraveling the impact of the COVID-19 pandemic on the mortality trends in Belgium between 2020–2022
    Yessika Adelwin Natalia, Johan Verbeeck, Christel Faes, Thomas Neyens, Geert Molenberghs
    BMC Public Health.2024;[Epub]     CrossRef
  • Evaluation of the effect of the COVID-19 pandemic on the all-cause, cause-specific mortality, YLL, and life expectancy in the first 2 years in an Iranian population—an ecological study
    Zahra Pirayesh, Seyed Mohammad Riahi, Ali Bidokhti, Toba Kazemi
    Frontiers in Public Health.2023;[Epub]     CrossRef
COVID-19: Special Article
Smoking, drinking, and physical activity among Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Sunhye Choi, Jinwook Bahk, Suyeon Park, Kyungwon Oh, Kyunghee Jung-Choi
Epidemiol Health. 2022;44:e2022043.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022043
  • 14,877 View
  • 597 Download
  • 10 Web of Science
  • 13 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables.
METHODS
This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated.
RESULTS
Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group.
CONCLUSIONS
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.
Summary
Korean summary
코로나 대유행 첫 해인 2020년, 한국 남성에서 고위험음주와 부적절한 신체 활동 수준이 증가하였다. 감염성 질환 대유행 시기, 확산을 차단하기 위한 사회적 노력과 더불어 건강행태에 부정적인 여파가 미치지 않도록 적극적인 대책이 필요함을 시사한다.
Key Message
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. Despite Korea's positive performance in various indicators during the COVID-19 pandemic, the socioeconomic and cultural effects of COVID-19 have affected people's health behaviour. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

Citations

Citations to this article as recorded by  
  • Association between handgrip strength and physical activity: A nationwide population‐based study in Korea
    Hye Young Shin, Ka Young Kim, Purum Kang
    Public Health Nursing.2024; 41(5): 987.     CrossRef
  • Dose-response risks of all-cause, cancer, and cardiovascular disease mortality according to sex-specific cigarette smoking pack-year quantiles
    Jieun Hwang, Suyoung Jo, Heewon Kang, Eunsil Cheon, Sung-il Cho
    Tobacco Induced Diseases.2024; 22(July): 1.     CrossRef
  • A national cross-sectional study on breakfast skipping-related factors and comparison of nutritional status according to breakfast skipping in older adults based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020)
    Anna Han, Yean Jung Choi
    The Journal of nutrition, health and aging.2024; 28(9): 100335.     CrossRef
  • Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)
    Hohyun Seong, Sohee Kim, Hyunsook Shin, Chang Won Won, Youn-Jung Kim
    Geriatric Nursing.2024; 59: 392.     CrossRef
  • Comparison of Food and Nutrient Intake according to the Income Level in Korean Adult Single-Person Households: Using Data from the Korea National Health and Nutrition Examination Survey (2016-2018)
    Min-Hee Han, Bok-Mi Jung
    The Korean Journal of Community Living Science.2024; 35(3): 445.     CrossRef
  • Change in prevalence of smoking during the first year of the COVID-19 pandemic among middle-aged and older adults in Canada: a cohort study of the Canadian Longitudinal Study on Aging
    Jayati Khattar, Urun Erbas Oz, Vanessa De Rubeis, Margaret de Groh, Ying Jiang, Lauren Griffith, Laura N Anderson
    BMJ Public Health.2024; 2(2): e001175.     CrossRef
  • Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey
    Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023015.     CrossRef
  • Factors affecting decreased physical activity during the COVID-19 pandemic: an age-, gender-, and body mass index-matched study
    Jhin-Yi Shin, Jaemoo Lee, Jung-Min Lee, Nam Yoon Ho
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
    Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park
    The Korean Journal of Internal Medicine.2023; 38(5): 714.     CrossRef
  • Association between individuals’ locus of control and mental health during the COVID-19 pandemic
    Filiz Eren, Isabelle Kousignian, Solène Wallez, Maria Melchior, Murielle Mary-Krause
    Journal of Affective Disorders Reports.2023; 14: 100678.     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023014.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
    Ji-Young Kwon, Sang-Wook Song
    Epidemiology and Health.2022; 44: e2022101.     CrossRef
Original Articles
Employment status and mortality among Korean men over a 13-year period
Dohee Lim, Kyoung Ae Kong, Hyesook Park, Kyunghee Jung-Choi
Epidemiol Health. 2021;43:e2021055.   Published online August 18, 2021
DOI: https://doi.org/10.4178/epih.e2021055
  • 9,932 View
  • 263 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study explored the effect of employment status on mortality over a 13-year period in Korean men.
METHODS
Data were used from the Korean Labor and Income Panel Study from 1999 to 2012. This study started with 2,737 subjects and included employed men in good health, aged 30-69 years. Deaths were tracked for 13 years from 2000 to 2012. Employment status classifications were: (1) regular employees, (2) precarious employees, (3) petty bourgeoisie, and (4) employers. Hazard ratios (HRs) were calculated using a Cox proportional hazards model, and were adjusted for age, education, income, and occupation, with regular employees as the reference category. To examine the effect of employment status and include employment history, the risk ratios of mortality were measured using the Poisson regression model, considering the duration of each employment and using 0 years as the reference category.
RESULTS
Over the course of the 13-year study, being a precarious employee (HR, 1.84) or petty bourgeoisie (HR, 1.87) at a particular point in time had a negative effect on mortality when compared with regular employees. Furthermore, working as precarious employees or petty bourgeoisie had no positive effect on mortality. A positive effect was observed, however, on the overall mortality risk for regular employees.
CONCLUSIONS
These results suggest that a healthy social policy is needed for precarious employees and petty bourgeoisie to avoid disadvantages in the workplace and the social safety net.
Summary
Korean summary
13년간 추적한 결과, 비정규직 노동자와 고용원이 없는 자영업자가 정규직 노동자에 비해 사망위험이 유의하게 높았다. 정규직 노동자에서는 일하는 것이 사망위험을 낮추는 긍정적인 효과를 관찰할 수 있었으나, 비정규직 노동자나 고용원이 없는 자영업자에서는 일하는 것의 긍정적인 효과를 관찰할 수 없었다. 이는 비정규직 노동자와 고용원이 없는 자영업자에 대한 건강한 사회 정책이 필요함을 시사한다.
Key Message
Over the course of the 13-year study, being a precarious employee or petty bourgeoisie had a negative effect on mortality when compared with regular employees. No positive effect of working was found for precarious employees or petty bourgeoisie, whereas cumulative work as a regular employee was observed to have a positive effect on mortality. These results suggest that a healthy social policy is needed for precarious employees and petty bourgeoisie to avoid disadvantages in the workplace and the social safety net.

Citations

Citations to this article as recorded by  
  • Temporary Employment Is Associated with Poor Dietary Quality in Middle-Aged Workers in Korea: A Nationwide Study Based on the Korean Healthy Eating Index, 2013–2021
    Seong-Uk Baek, Myeong-Hun Lim, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon
    Nutrients.2024; 16(10): 1482.     CrossRef
  • Inequality in Mortality and Cardiovascular Risk Among Young, Low-Income, Self-Employed Workers: Nationwide Retrospective Cohort Study
    Byungyoon Yun, Heejoo Park, Jaesung Choi, Juyeon Oh, Juho Sim, Yangwook Kim, Jongmin Lee, Jin-Ha Yoon
    JMIR Public Health and Surveillance.2024; 10: e48047.     CrossRef
The effect of community-level smoke-free ordinances on smoking rates in men based on Community Health Surveys
Hye Ah Lee, Hyesook Park, Ho Kim, Kyunghee Jung-Choi
Epidemiol Health. 2014;36:e2014037.   Published online December 26, 2014
DOI: https://doi.org/10.4178/epih/e2014037
  • 19,295 View
  • 154 Download
  • 12 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
As one of smoke-free policies, communities have established the smoke-free ordinances since August 2010. Thus, this study aimed to evaluate the effects of community-level smoke-free ordinances (SFO) on smoking rates in men using multiyear Community Health Survey (CHS) data.
METHODS
Data on community-level SFO were collected from a website on Enhanced Local Laws and Regulation Information System. Regional smoking-related data were obtained from CHS data from 2008 to 2012 and the age-standardized rates of current smoking in men, attempts to quit smoking, and smoke-free campaign experiences including the mean number of cigarettes smoked (smoking amount) were calculated. Repeated measures analysis of variance was performed to evaluate the effects of regional implementation of SFO and the duration on change of smoking rates.
RESULTS
Overall current smoking rates and daily mean cigarettes smoked were lower in community where SFO had been implemented compared to those without implementation, and there was a significant difference in smoking rates between 2010 and 2008. Cross-sectional analysis of the effects of regional SFO revealed clear difference in rate of current smoking, but longitudinal analysis showed no significant differences. Stratifying by age groups, however, showed that groups less than 30 years of age had low smoking rates in community with ordinance compared to those without SFO since 2010. Yearly surveys measuring the number of cigarettes smoked, attempts to quit smoking, and experiences of smoke-free campaigns showed regional differences in the duration of implementation, but these differences were not significant in longitudinal analysis. Furthermore, there was a difference in regional socioeconomic characteristics between community with and without SFO implementation.
CONCLUSIONS
For effective smoking control, it is necessary to evaluate current policies and develop indices to evaluate the practical implementation of ordinances. As more communities to pass the SFO, long-term observation and assessments required.
Summary
Korean summary
2008년부터 2012년까지 조사된 지역사회건강조사 자료를 이용하여, 지역별 금연 조례 시행에 대한 효과를 평가한 연구 결과로, 종단적 분석을 통해 접근하였을 때 시간에 따른 흡연율 감소 폭은 조례 시행/미시행 지역간에 차이를 보이지 않았으며, 지역의 사회경제적 특성 요인에 차이가 존재하는 것으로 나타났다. 효과적인 흡연 규제를 위해, 현 시행중인 정책에 대한 효과 평가 및 장기적인 평가가 필요하다.

Citations

Citations to this article as recorded by  
  • Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea
    Siwoo Kim, Yuri Lee, Changwoo Han, Min Kyung Kim, Ichiro Kawachi, Juhwan Oh
    Frontiers in Public Health.2023;[Epub]     CrossRef
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    BMJ Open.2019; 9(8): e025298.     CrossRef
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    Japan Journal of Nursing Science.2018; 15(3): 210.     CrossRef
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    Hye Ah Lee, Hyejin Han, Seonhwa Lee, Bomi Park, Bo Hyun Park, Won Kyung Lee, Ju Ok Park, Sungok Hong, Young Taek Kim, Hyesook Park
    BMC Public Health.2018;[Epub]     CrossRef
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    A-Reum Ryu, Do Hyun Kim, Eunjoo Kim, Mi Young Lee, Ji C. Bihl
    Oxidative Medicine and Cellular Longevity.2018;[Epub]     CrossRef
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