Epidemiology and Health

Original Articles

An age-period-cohort analysis of the difference in smoking prevalence between urban and non-urban areas in Japan (2004–2019): Tasuku Okui; Epidemiol Health. 2020;42:e2020072. Published online December 1, 2020; DOI: https://doi.org/10.4178/epih.e2020072

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Abstract

OBJECTIVES
This study aimed to conduct an age-period-cohort (APC) analysis of smoking prevalence trends in urban and non-urban areas in Japan.

METHODS

Data on smoking prevalence from 2004 to 2019 were extracted from the Comprehensive Survey of Living Conditions in Japan. Government ordinance-designated cities and special wards in Tokyo were defined as urban areas. The respondents ranged from 20 years to 79 years old, and were grouped in 5-year intervals. Cohorts were defined for each age group of each year, and those born between 1925-1929 and 1995-1999 were examined. We calculated the estimated smoking prevalence for each age, period, and cohort, as well as the smoking prevalence ratio of non-urban areas compared with urban areas from the APC analysis results.

RESULTS

The magnitude of the decrease in the period effect on smoking prevalence was larger in urban areas than in non-urban areas for both men and women. The smoking prevalence ratio for non-urban areas compared with that of urban areas was above 1 for men at most time points, except in the older age groups. In addition, the prevalence ratio between the areas decreased, particularly as age increased. For women, the smoking prevalence ratio in non-urban areas compared to urban areas was below 1 until cohorts born in the 1970s, but the trend reversed thereafter.

CONCLUSIONS

The results of this study suggest that further smoking control and cessation measures are necessary, particularly for older cohorts in urban women and for younger ages in non-urban men.

Summary

Citations

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The Global, Regional and National Burden of Pancreatic Cancer Attributable to Smoking, 1990 to 2019: A Systematic Analysis from the Global Burden of Disease Study 2019
Wenkai Jiang, Caifei Xiang, Yan Du, Xin Li, Wence Zhou
International Journal of Environmental Research and Public Health.2023; 20(2): 1552. CrossRef
The Usefulness of a Smartphone App–Based Smoking Cessation Program for Conventional Cigarette Users, Heated Tobacco Product Users, and Dual Users: Retrospective Study
Yuko Noda, Ryuhei So, Misaki Sonoda, Takahiro Tabuchi, Akihiro Nomura
Journal of Medical Internet Research.2023; 25: e42776. CrossRef
Pancreatic Cancer and its Attributable Risk Factors in East Asia, Now and Future
Kuiwu Ren, Chunlong Liu, Ziqiang He, Panpan Wu, Jian Zhang, Rui Yang, Tao Cui, Kun Song, Di Cheng, Kui He, Jiangtao Yu
The Oncologist.2023; 28(11): e995. CrossRef
Relationship between physical activity and perceptions of ageing from the perspective of healthy ageing among older people with frailty with chronic disease: a cross-sectional study
Yu-Rung Wang, Huan-Fang Lee, Pei-Lun Hsieh, Chia-Hsiu Chang, Ching-Min Chen
BMC Nursing.2023;[Epub] CrossRef
Regional Differences in the Prevalence of Atopic Dermatitis among Schoolchildren in Japan and Its Associated Factors from 2006 to 2018
Tasuku Okui, Naoki Nakashima
Allergies.2022; 2(2): 33. CrossRef
Association of Esophageal Cancer Mortality with Municipal Socioeconomic Deprivation Level in Japan, 2013–2017: An Ecological Study Using Nationwide Data
Tasuku Okui, Akie Hirata, Naoki Nakashima
International Journal of Environmental Research and Public Health.2022; 19(9): 5483. CrossRef
Trends in Deaths Attributable to Smoking in China, Japan, United Kingdom, and United States From 1990 to 2019
Haoyu Wen, Cong Xie, Fang Shi, Yan Liu, Xiaoxue Liu, Chuanhua Yu
International Journal of Public Health.2022;[Epub] CrossRef
Decreased head circumference at birth associated with maternal tobacco smoke exposure during pregnancy on the Japanese prospective birth cohort study
Tadashi Shiohama, Aya Hisada, Midori Yamamoto, Kenichi Sakurai, Rieko Takatani, Katsunori Fujii, Naoki Shimojo, Chisato Mori, Michihiro Kamijima, Shin Yamazaki, Yukihiro Ohya, Reiko Kishi, Nobuo Yaegashi, Koichi Hashimoto, Chisato Mori, Shuichi Ito, Zenta
Scientific Reports.2021;[Epub] CrossRef
An analysis of health inequalities depending on educational level using nationally representative survey data in Japan, 2019
Tasuku Okui
BMC Public Health.2021;[Epub] CrossRef
Geographical Differences and Their Associated Factors in Chronic Obstructive Pulmonary Disease Mortality in Japan: An Ecological Study Using Nationwide Data
Tasuku Okui, Jinsang Park
International Journal of Environmental Research and Public Health.2021; 18(24): 13393. CrossRef
Trend of asthma prevalence among children based on regional urbanization level in Japan; 2006–2019
Tasuku Okui
Environmental Analysis Health and Toxicology.2021; 36(4): e2021027. CrossRef

Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis: Yongho Jee, Gyuyoung Lee; Epidemiol Health. 2020;42:e2020008. Published online March 3, 2020; DOI: https://doi.org/10.4178/epih.e2020008

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Abstract Summary PDF

Abstract

OBJECTIVES
Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.

METHODS

We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.

RESULTS

The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.

CONCLUSIONS

In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.

Summary

Korean summary
성경험 유병률은 일반적으로 남녀 공히 모든 시기에서 연령대에 따라 증가했다. 공통적으로 최근 연도에서 12-13세 연령군의 성 경험 유병률이 증가한 반면 16-17세 연령군에서 성경험 유병률이 감소했다. 전반적으로 2006 년부터 2017 년까지 청소년들의 성경험률은 소폭 감소했지만, 조기 성경험의 빈도는 증가하고 있다. 따라서 피임이나 순결 교육뿐만 아니라 성적자기결정능력같은 보다 실질적인 성교육이 어릴 때부터 강화되어야 할 것으로 보인다.

Citations

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Human Papillomavirus (HPV) Vaccination Intent among Mothers of Adolescent Sons: A National Survey on HPV Knowledge, Attitudes and Beliefs in South Korea
Jihye Choi, Seyoung Kim, Seung-Ju Lee, Sangrak Bae, Sooyoun Kim
The World Journal of Men's Health.2023; 41(2): 413. CrossRef
Association Between School Bullying Victimization and Sexual Risk-Taking among South Korean Adolescents: The Role of Teacher and Parental Relationships
Jihoon Kim, Yeungjeom Lee, Lindsay Leban, Wesley G. Jennings
Archives of Sexual Behavior.2023; 52(7): 2811. CrossRef
Prevalence and Trends of Sexual Behaviors Among Young Adolescents Aged 12 Years to 15 Years in Low and Middle-Income Countries: Population-Based Study
Zhengyue Jing, Jie Li, Yi Wang, Chengchao Zhou
JMIR Public Health and Surveillance.2023; 9: e45236. CrossRef
Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women
Jhosuny Perez-Fernandez, Diego O. Arroyo-Velasco, Mariella R. Huaman, Sarai G. Chavez-Bustamante, Anita P. Llamo-Vilcherrez, Carolina J. Delgado-Flores, Carlos J. Toro-Huamanchumo
Frontiers in Public Health.2023;[Epub] CrossRef
Sexual-Related Knowledge, School and Family Sexuality Education and Its Association with Experience of Sexual Intercourse among Vocational Secondary School Students in China
Yuhang Fang, Yujia Zheng, Yan Jin, Chunyan Yu, Xiayun Zuo, Qiguo Lian, Chaohua Lou, Lihe Li, Ping Hong, Xiaowen Tu
Children.2022; 9(8): 1206. CrossRef
Factors associated with adolescents’ sexual experience based on the biopsychosocial model: a cross-sectional study using the Korea Youth Risk Behavior Web-based Survey (KYRBS)
Ka Young Kim, Hye Young Shin
BMJ Open.2022; 12(11): e066307. CrossRef

Incidence of varicella in children in Jeju-do, Korea, 2005-2016: age-period-cohort analysis: Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae; Epidemiol Health. 2018;40:e2018054. Published online November 8, 2018; DOI: https://doi.org/10.4178/epih.e2018054

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217 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea.

METHODS

The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2-13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis.

RESULTS

As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do.

CONCLUSIONS

The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.

Summary

Korean summary
2011년 이후 생후 12-15개월 유아에게 수두백신 무상접종을 시행해 오고 있는 제주도에 있어서, 수두발생 신고건수가 증가하는 괴리 현상에 있어, 국민건강보험공단의 수진자료를 확보하여 연령-기간-코호트 (age-period-cohort, APC) 분석을 시행하였다. 그 결과 연령이 증가하고 연도가 최근으로 올수록 수두 발생에 대한 연령과 기간효과는 점점 감소하는 반면, 수두백신 무상접종이 시작된 2011년을 전후해서 코호트 효과는 양에서 음으로 전환하였다. 따라서 현재 접종하고 있는 수두 백신은 수두발생을 예방하는 효과가 있으며, 돌발수두 발생은 이차백신 실패로 볼 수 있다.

Citations

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The comparison of seroconversion rates among different varicella vaccines administered Turkish children; MAV/06 and vOka
Zuhal Umit, Zumrut Sahbudak Bal, Aysin Zeytinoglu, Tansu Gulbahar Aydogan, Ozlem Bag, Gizem Guner Ozenen, Ferda Ozkinay, Zafer Kurugol
Human Vaccines & Immunotherapeutics.2021; 17(11): 4190. CrossRef
Recent increase in pertussis incidence in Korea: an age-period-cohort analysis
Chanhee Kim, Seonju Yi, Sung-il Cho
Epidemiology and Health.2021; 43: e2021053. CrossRef
Incidence of Scarlet Fever in Children in Jeju Province, Korea, 2002-2016: An Age-period-cohort Analysis
Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae
Journal of Preventive Medicine and Public Health.2019; 52(3): 188. CrossRef

Methods

The unrealized potential: cohort effects and age-period-cohort analysis: Jongho Heo, Sun-Young Jeon, Chang-Mo Oh, Jongnam Hwang, Juhwan Oh, Youngtae Cho; Epidemiol Health. 2017;39:e2017056. Published online December 5, 2017; DOI: https://doi.org/10.4178/epih.e2017056

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Abstract Summary PDF Supplementary Material

Abstract

This study aims to provide a systematical introduction of age-period-cohort (APC) analysis to South Korean readers who are unfamiliar with this method (we provide an extended version of this study in Korean). As health data in South Korea has substantially accumulated, population-level studies that explore long-term trends of health status and health inequalities and identify macrosocial determinants of the trends are needed. Analyzing long-term trends requires to discern independent effects of age, period, and cohort using APC analysis. Most existing health and aging literature have used cross-sectional or short-term available panel data to identify age or period effects ignoring cohort effects. This under-use of APC analysis may be attributed to the identification (ID) problem caused by the perfect linear dependency across age, period, and cohort. This study explores recently developed three APC models to address the ID problem and adequately estimate the effects of A-P-C: intrinsic estimator-APC models for tabular age by period data; hierarchical cross-classified random effects models for repeated cross-sectional data; and hierarchical APC-growth curve models for accelerated longitudinal panel data. An analytic exemplar for each model was provided. APC analysis may contribute to identifying biological, historical, and socioeconomic determinants in long-term trends of health status and health inequalities as well as examining Korean’s aging trajectories and temporal trends of period and cohort effects. For designing effective health policies that improve Korean population’s health and reduce health inequalities, it is essential to understand independent effects of the three temporal factors by using the innovative APC models.

Summary

Korean summary
-건강수준 및 건강불평등의 장기적인 추이에 미치는 연령, 기간, 출생 코호트의 독립적인 영향을 분해하는 방법인 연령-기간-코호트 분석법(Age-Period-Cohort analysis)을 국내 보건의료 연구자들에게 체계적으로 소개함 -APC 분석법은 건강수준 및 건강행태, 건강불평등의 추세 분석 및 고령화, 만성질환, 생애주기 연구 등에 있어서 널리 활용될 수 있음 -APC 연구 결과를 바탕으로 향후 보건의료 정책에 있어서도 기간 또는 연령에 따른 정책뿐 아니라 코호트에 특정한 정책들도 고려되어야 할 필요가 있음

Citations

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Decrease in household secondhand smoking among South Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
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Henrik Ekström, Sölve Elmståhl, Lena Sandin Wranker, Hélio J. Coelho-Júnior
Journal of Aging Research.2021; 2021: 1. CrossRef
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Chanhee Kim, Seonju Yi, Sung-il Cho
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Graeme J. Duke, John L. Moran, John D. Santamaria, David V. Pilcher
Journal of Critical Care.2020; 56: 273. CrossRef
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Cancer Research and Treatment.2020; 52(1): 301. CrossRef
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BMJ Open.2020; 10(2): e034098. CrossRef
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Original Article

Age-period-cohort analysis of smoking prevalence among young adults in Korea: Yong Ho Jee, Sung-il Cho; Epidemiol Health. 2016;38:e2016010. Published online March 19, 2016; DOI: https://doi.org/10.4178/epih.e2016010; Correction in: Epidemiol Health 2016;38(0):e2016029

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Abstract Summary PDF

Abstract

OBJECTIVES
Smoking prevalence among Korean men in their thirties is substantially high (approximately 50%). An in-depth analysis of smoking trends among young adults in their twenties is necessary to devise antismoking policies for the next 10 years. This study aimed to identify the contributions of age, period, and birth cohort effects on smoking prevalence in young adults.

METHODS

Subjects comprised 181,136 adults (83,947 men: 46.3%; 97,189 women: 53.7%) aged 19 to 30 years from the 2008-2013 Korea Community Health Survey. Smoking prevalence adjusted with reference to the 2008 population was applied to the age-period-cohort (APC) model to identify the independent effects of each factor.

RESULTS

For men, smoking prevalence rapidly escalated among subjects aged 19 to 22 years and slowed down among those aged 23 to 30 years, declined during 2008 to 2010 but stabilized during 2011 to 2013, and declined in birth cohorts prior to 1988 but stabilized in subjects born after 1988. However, in APC models, smoking prevalence increased with age in the 1988 to 1991 birth cohort. In this birth cohort, smoking prevalence at age 19 to 20 years was approximately 24% but increased to 40% when the subjects turned 23 to 24 years. For women, smoking prevalence was too low to generate consistent results.

CONCLUSIONS

Over the past six years and in recent birth cohorts, smoking prevalence in adults aged 19 to 30 years has declined and is stable. Smoking prevalence should be more closely followed as it remains susceptible to an increase depending on antismoking policies or social conditions.

Summary

Korean summary
우리나라 남자의 30대와 40대의 흡연율은 약 50% 수준으로 매우 높다. 앞으로 10년 뒤에 이들 연령대로 진입하는 20대와 30대 젊은 청년층의 흡연율의 추이를 심층 분석하는 것은 10년 뒤 금연정책 준비에 필요한 기초자료가 될 것이다. 이 연구의 목적은 젊은 청년의 흡연율의 변화추이에 영향을 주는 연령, 연도, 출생코호트 효과를 파악하고자 하였다. 지난 6년 동안 19-30세의 흡연율은 전체적으로 연도가 증가하고 최근 출생코호트로 올수록 감소하는 경향을 보였다. 그러나 최근 출생코호트의 흡연율은 앞으로 금연정책이나 사회적인 상황에 따라 여전히 증가할 여지가 있으므로 주의 깊은 관찰이 필요할 것으로 생각된다.

Citations

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The unrealized potential: cohort effects and age-period-cohort analysis
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Epidemiology and Health.2017; 39: e2017056. CrossRef

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