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Systematic Reviews
The effectiveness of protein supplementation combined with resistance exercise programs among community-dwelling older adults with sarcopenia: a systematic review and meta-analysis
Phatcharaphon Whaikid, Noppawan Piaseu
Epidemiol Health. 2024;46:e2024030.   Published online February 14, 2024
DOI: https://doi.org/10.4178/epih.e2024030
  • 4,096 View
  • 282 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The combination of protein supplementation and resistance exercise shows promise for improving and maintaining muscle mass, strength, and performance in older adults with sarcopenia. This systematic review aimed to evaluate the effects of this combination on muscle mass, muscle strength, and physical performance in community-dwelling older adults with sarcopenia.
METHODS
We conducted a comprehensive search of 4 electronic databases: PubMed, Scopus, Embase, and the MEDLINE Library. The search covered literature from January 2013 to January 2023 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed the methodological quality of each study using the standard critical appraisal tool from the Joanna Briggs Institute (JBI). Meta-analysis was performed with the JBI Sumari program.
RESULTS
The review included 7 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 854 participants aged 60 years and above. The study durations ranged from 10 weeks to 24 weeks. An analysis of standardized mean differences (SMDs) showed that protein supplementation combined with resistance exercise significantly increased muscle mass (SMD, 0.95; 95% confidence interval [CI], 0.13 to 1.78; p<0.05) and muscle strength (SMD, 0.32; 95% CI, 0.08 to 0.56; p<0.05).
CONCLUSIONS
Although the limited number of randomized controlled trials restricts the robustness of our conclusions, the evidence suggests that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.
Summary
Key Message
Sarcopenia is a significant health concern. Given the contextual variations and the diverse factors that contribute to the prevalence of sarcopenia, delivering precision interventions to older adults diagnosed with sarcopenia who still reside in the community poses unique challenges. Therefore, precision interventions are vital for proper and feasible treatment planning, especially for early management actions, to reduce the impact of sarcopenia and its associated adverse effects in older adults. Our systematic review and meta-analysis showed that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Citations

Citations to this article as recorded by  
  • The Impact of Protein in Post-Menopausal Women on Muscle Mass and Strength: A Narrative Review
    Katherine Elizabeth Black, Penelope Matkin-Hussey
    Physiologia.2024; 4(3): 266.     CrossRef
Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis
Inhye Kim, Hyunseo An, Sohyeon Yun, Hae Yean Park
Epidemiol Health. 2024;46:e2024013.   Published online January 3, 2024
DOI: https://doi.org/10.4178/epih.e2024013
  • 4,046 View
  • 176 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis.
METHODS
The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions.
RESULTS
Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health.
CONCLUSIONS
This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.
Summary
Korean summary
본 연구는 독거 노인들 대상으로 한 지역사회 기반 중재의 효과에 대하여 탐색하고 그 효과 크기를 확인하기 위하여 체계적고찰 및 메타분석을 실시하였다. 영양 및 복합 중재가 특히 효과적이었으며, 이는 건강 행동과 정신건강에 있어 중요한 긍정적 효과를 나타내어 추후 개별적 맞춤 중재의 잠재적 효과성을 나타낸다. 이러한 발견은 독거노인 집단의 웰빙 향상을 위한 프로그램과 정책 입안에 근거로 활용될 수 있다.
Key Message
This systematic review and meta-analysis evaluated the impact of community-based interventions for older adults living alone, incorporating 9 studies to assess effectiveness in areas like nutrition and combined strategies. Results indicated significant benefits, particularly in health behavior and mental health, demonstrating the potential of tailored interventions. These findings support the development of targeted programs and policy decisions aimed at improving the well-being of this demographic.
COVID-19: Original Article
Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample
Jina Han, Hye Jin Baek, Eunbi Noh, Kyuhyun Yoon, Jung Ae Kim, Sukhyun Ryu, Kay O Lee, No Yai Park, Eunok Jung, Sangil Kim, Hyukmin Lee, Yoo-Sung Hwang, Jaehun Jung, Hun Jae Lee, Sung-il Cho, Sangcheol Oh, Migyeong Kim, Chang-Mo Oh, Byengchul Yu, Young-Seoub Hong, Keonyeop Kim, Sun Jae Jung, Mi Ah Han, Moo-Sik Lee, Jung-Jeung Lee, Young Hwangbo, Hyeon Woo Yim, Yu-Mi Kim, Joongyub Lee, Weon-Young Lee, Jae-Hyun Park, Sungsoo Oh, Heui Sug Jo, Hyeongsu Kim, Gilwon Kang, Hae-Sung Nam, Ju-Hyung Lee, Gyung-Jae Oh, Min-Ho Shin, Soyeon Ryu, Tae-Yoon Hwang, Soon-Woo Park, Sang Kyu Kim, Roma Seol, Ki-Soo Park, Su Young Kim, Jun-wook Kwon, Sung Soon Kim, Byoungguk Kim, June-Woo Lee, Eun Young Jang, Ah-Ra Kim, Jeonghyun Nam, The Korea Community Health Survey Group, Soon Young Lee, Dong-Hyun Kim
Epidemiol Health. 2023;45:e2023075.   Published online August 17, 2023
DOI: https://doi.org/10.4178/epih.e2023075
  • 7,153 View
  • 218 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea.
METHODS
In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.
RESULTS
In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.
CONCLUSIONS
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
Summary
Korean summary
인구집단을 기반으로 하여 대표성 있는 표본을 추출하여 COVID-19 항체유병률 조사를 전국적으로 수행함으로 지역사회 단위에서 지속적으로 모니터링할 수 있는 COVID-19 감시체계 구축의 기반을 마련하였다. 2022년 8월 우리나라 국민의 대부분이 COVID-19에 대한 항체를 보유하고 있었고 인구 3명 중 1명은 미확진 감염자로 추정되었다.
Key Message
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19. In August 2022, most of the Korean people had antibodies to COVID-19, and one in three people was estimated to have an unreported infection. This study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Citations

Citations to this article as recorded by  
  • Infection-mediated immune response in SARS-CoV-2 breakthrough infection and implications for next-generation COVID-19 vaccine development
    Sho Miyamoto, Tadaki Suzuki
    Vaccine.2024; 42(6): 1401.     CrossRef
  • Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
    Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
    BMC Infectious Diseases.2024;[Epub]     CrossRef
Cohort Profile
Integrated database-based Screening Cohort for Asian Nomadic descendants in China (Scan-China): Insights on prospective ethnicity-focused cancer screening
Yuelin Yu, Liying Qiao, Jing Han, Weiwei Wang, Weiwei Kang, Yunjing Zhang, Shu Shang, Ruogu Meng, Lin Zhuo, Siyan Zhan, Yunfeng Xi, Shengfeng Wang
Epidemiol Health. 2023;45:e2023048.   Published online April 18, 2023
DOI: https://doi.org/10.4178/epih.e2023048
  • 4,644 View
  • 91 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Established in 2017, the Screening Cohort for Asian Nomadic descendants in China (Scan-China) has benefited over 180,000 members of a multi-ethnic population, particularly individuals of Mongolian descent compared with the general population (Han ethnicity), in the Inner Mongolia Autonomous Region, China. This cohort study aims to evaluate the effectiveness of cancer screening and serve as a real-world data platform for cancer studies. The 6 most prevalent cancers in China are considered—namely, breast, lung, colorectal, gastric, liver and esophageal cancer. After baseline cancer risk assessments and screening tests, both active and passive follow-up (based on the healthcare insurance database, cancer registry, the front page of hospital medical records, and death certificates) will be conducted to trace participants’ onset and progression of cancers and other prevalent chronic diseases. Scan-China has preliminarily found a disproportionately lower screening participation rate and higher incidence/mortality rates of esophageal and breast cancer among the Mongolian population than among their Han counterparts. Further research will explore the cancer burden, natural history, treatment patterns, and risk factors of the target cancers.
Summary
Key Message
- Scan-China is the first and largest electronic health data (EHD)-integrated cancer screening program for the Mongolian ethnicity in Inner Mongolia. - Scan-China aims to evaluate the effectiveness of screening interventions, particularly on ethnic minorities, portray the natural history, explore risk factors and summarize treatment patterns and updated outcomes of prevalent tumors/other chronic diseases. - Scan-China database comprises baseline cancer risk assessment, screening tests results, active follow-up investigation for participants at high risk and EHD-integrated passive follow-up. Data sources for passive follow-up include healthcare insurance database, cancer registry, front page of hospital medical record and death certificates.

Citations

Citations to this article as recorded by  
  • Higher disease burden and lower utilization in mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China
    Jieying Chen, Liying Qiao, Meng Qi, Yunjing Zhang, Ying Yan, Weiwei Kang, Huziwei Zhou, Yuelin Yu, Yalei Ke, Yuling Jiang, Yingting Rao, Lu Xu, Guohua He, Jing Ren, Xue Yan, Siwei Deng, Xinyu Yang, Yutong Song, Yingzi Yang, Qiaorui Wen, Jing Han, Yiwei Wu
    International Journal of Surgery.2024;[Epub]     CrossRef
COVID-19: Original Article
Effect of socioeconomic disparities on the risk of COVID-19 in 8 metropolitan cities in the Korea: a community-based study
Myung-Jae Hwang, Shin Young Park, Tae-Ho Yoon, Jinhwa Jang, Seon-Young Lee, Myeongsu Yoo, Yoo-Yeon Kim, Hae-Kwan Cheong, Donghyok Kwon, Jong-Hun Kim
Epidemiol Health. 2022;44:e2022107.   Published online November 15, 2022
DOI: https://doi.org/10.4178/epih.e2022107
  • 6,757 View
  • 201 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Socioeconomic disparities have been reported as major risk factors contributing to the spread of coronavirus disease 2019 (COVID-19) at the community level. We conducted an epidemiological study on COVID-19 incidence risk using area-based deprivation indices (DIs) reflecting the characteristics of the susceptible population.
METHODS
A database of the confirmed COVID-19 cases in 8 metropolitan cities in Korea from January 20, 2020 to December 31, 2021 was combined with area-based DI scores and standardized prevalence rates of diabetes and hypertension from the Korean Community Health Survey. Relative risk (RR) levels were estimated using a generalized linear model with a Poisson distribution by age group.
RESULTS
The risk of COVID-19 incidence generally increased with increasing age, especially in patients aged ≥75 years. The RR of COVID-19 incidence per interquartile range increment of the composite deprivation index (composite DI) was 1.54 (95% confidence interval [CI], 1.34 to 1.70). Notably, in the first wave, the risk of COVID-19 incidence was approximately 3 times higher in the region with the lowest socioeconomic status than in the region with the highest status (RR, 3.08; 95% CI, 2.42 to 3.78 based on the the composite DI and RR, 3.13; 95% CI, 2.53 to 3.83 based on the social deprivation index).
CONCLUSIONS
This study provides scientific evidence that socioeconomic deprivation is an important risk factor for the spread of COVID-19. This finding suggests that a mid-term to long-term strategy is needed to protect susceptible populations and reduce the burden of COVID-19 in the community.
Summary
Korean summary
한국의 COVID-19 발생 위험은 지역박탈수준이 높은 지역에서 증가하였고, 특히 유행 초기 75세이상 연령층에서 뚜렷하게 증가하는 것으로 나타났다. 따라서 지역사회수준에서 사회경제적 여건을 고려하여 취약집단에서의 발생위험을 감소시키기 위해 중장기 전략을 세워야 한다는 것을 시사한다.
Key Message
There is a need to develop long-term strategies to reduce the risk of COVID-19 outbreaks in vulnerable populations in areas with poor socioeconomic conditions

Citations

Citations to this article as recorded by  
  • Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
    Doo Woong Lee, Jieun Jang, Jaeyong Shin
    SSM - Population Health.2024; 25: 101580.     CrossRef
  • The current state of graphical abstracts and how to create good graphical abstracts
    Jieun Lee, Jeong-Ju Yoo
    Science Editing.2023; 10(1): 19.     CrossRef
  • Social deprivation and SARS-CoV-2 testing: a population-based analysis in a highly contrasted southern France region
    Jordi Landier, Léa Bassez, Marc-Karim Bendiane, Pascal Chaud, Florian Franke, Steve Nauleau, Fabrice Danjou, Philippe Malfait, Stanislas Rebaudet, Jean Gaudart
    Frontiers in Public Health.2023;[Epub]     CrossRef
Original Articles
Differences in accuracy of height, weight, and body mass index between self-reported and measured using the 2018 Korea Community Health Survey data
Yoonsil Ko, Sunhye Choi, Jisoo Won, Yeon-Kyeng Lee, Dong-Hyun Kim, Seon Kui Lee
Epidemiol Health. 2022;44:e2022024.   Published online February 19, 2022
DOI: https://doi.org/10.4178/epih.e2022024
  • 11,591 View
  • 400 Download
  • 10 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to determine an effective survey method for the accurate calculation of obesity prevalence by comparing the self-reported and measured height, weight, and body mass index (BMI) using the 2018 Korea Community Healthy Survey (CHS) data.
METHODS
Raw data from the 2018 CHS were used to analyze the differences, correlation, and agreement between self-reported and measured height, weight, and BMI.
RESULTS
The self-reported height was over-reported than the measured height (0.59 cm greater for men and 0.71 cm greater for women), while the self-reported weight was under-reported than the measured weight (0.55 kg less for men and 0.67 kg less for women). Subsequently, the self-reported BMI was under-estimated (0.35 kg/m<sup>2</sup> lower for men and 0.49 kg/m<sup>2</sup> lower for women) compared with the measured BMI. The kappa statistic and agreement between measured and self-reported values per BMI category (underweight, normal, overweight, and obesity) were 0.82 and 79.6%, respectively.
CONCLUSIONS
The prevalence of obesity should be calculated using the measured values provided in the CHS in order to promote local health projects based on accurate evidence.
Summary
Korean summary
본 연구는 2018년 지역사회건강조사 원시자료를 이용하여, 자가보고된 신장, 체중, 그리고 체질량지수 값과 실제 측정한 값 간에 차이를 분석하고 상관성과 일치도를 확인하고자 하였으며, 확인결과 자가보고값 체질량지수는 측정값보다 과소측정(남자의 경우 측정값보다 자가보고값이 0.35kg/m2 낮게, 여자는 0.49kg/m2 낮게 측정)된것을 확인하였다.
Key Message
This study aimed to determine an effective survey method for the accurate calculation of obesity prevalence by comparing the self-reported and measured height, weight, and body mass index (BMI) using the 2018 Community Healthy Survey (CHS) data.

Citations

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  • Consistency between self-reported disease diagnosis and clinical assessment and under-reporting for chronic conditions: data from a community-based study in Xi’an, China
    Haobiao Liu, Yanru Zhao, Lichun Qiao, Congying Yang, Ying Yang, Tianxiao Zhang, Qian Wu, Jing Han
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • A cultural models approach to understanding body fatness perceptions and disordered eating in young South Korean men
    Lawrence T. Monocello, Jason M. Lavender, Lauren A. Fowler, Ellen E. Fitzsimmons‐Craft, Denise E. Wilfley
    International Journal of Eating Disorders.2024;[Epub]     CrossRef
  • 고령 여성을 위한 보행 보조차 치수 개선 방안
    진희 박, 길호 정
    Journal of the Korean Society of Clothing and Textiles.2024; 48(1): 108.     CrossRef
  • Validity of Measured vs. Self-Reported Weight and Height and Practical Considerations for Enhancing Reliability in Clinical and Epidemiological Studies: A Systematic Review
    Khadijah Fayyaz, Mo’ath F. Bataineh, Habiba I. Ali, Ali M. Al-Nawaiseh, Rami H. Al-Rifai’, Hafiz M. Shahbaz
    Nutrients.2024; 16(11): 1704.     CrossRef
  • Comparison of self-reported and measured height and weight in patients with psoriasis
    Simona Mastroeni, Francesca Sampogna, Claudia Uras, Mara De Angelis, Roberta Fusari, Nidia Melo Salcedo, Sabatino Pallotta, Damiano Abeni
    Archives of Dermatological Research.2023; 315(7): 2023.     CrossRef
  • Accuracy of Assessing Weight Status in Adults by Structured Observation
    Tânia Jorge, Sofia Sousa, Isabel do Carmo, Nuno Lunet, Patrícia Padrão
    Applied Sciences.2023; 13(14): 8185.     CrossRef
  • Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
    Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
    Epidemiology and Health.2023; 45: e2023018.     CrossRef
  • Tobacco consumption, sales, and output as monitoring indicators in the era of the tobacco endgame
    Hana Kim, Hee-kyoung Nam, Heewon Kang
    Epidemiology and Health.2023;[Epub]     CrossRef
Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data
Eunsu Kim, Min-Ho Shin, Jung-Ho Yang, Soon-Ki Ahn, Baeg-Ju Na, Hae-Sung Nam
Epidemiol Health. 2021;43:e2021062.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021062
  • 10,318 View
  • 273 Download
  • 1 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults.
METHODS
We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index×100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL.
RESULTS
In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26).
CONCLUSIONS
Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
Summary
Korean summary
시군구 단위 스트레스 인지율과 우울 유병률이 개인 단위 건강관련 삶의 질 수준과 연관성을 갖는지 파악하고자 지역사회건강조사 자료를 이용하여 다수준 분석을 수행하였다. 개인 수준에서 인지된 스트레스와 우울은 건강관련 삶의 질 감소와 관련이 있었다. 스트레스와 우울 수준이 높은 시군구일수록 개인의 건강관련 삶의 질은 낮아지는 관계를 보였는데, 이는 남성보다는 여성에서 더 저명하였다.
Key Message
This study examined the associations of regional-level perceived stress and depression with individual HRQOL measured in terms of the EQ-5D using a multilevel model. Individual-level perceived stress and depression were significantly related to individual HRQOL. Regional stress and depression were also significant factors and both had greater negative impacts on HRQOL among women than among men.

Citations

Citations to this article as recorded by  
  • Factors Related to Health-Related Quality of Life across the Life Cycle in One-Person Households among Korean Adults
    Myung-Ock Chae
    Research in Community and Public Health Nursing.2024; 35: 125.     CrossRef
  • Association between seafood intake and depression in Korean adults: analysis of data from the 2014–2020 Korea National Health and Nutrition Examination Survey
    Hyemin Shin, Won Jang, Yangha Kim
    Journal of Nutrition and Health.2023; 56(6): 702.     CrossRef
  • Depression before and during-COVID-19 by Gender in the Korean Population
    Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim
    International Journal of Environmental Research and Public Health.2022; 19(6): 3477.     CrossRef
  • Association Between Regional Levels of Particulate Matter and Recurrent Falls in Korea
    Jung-Ho Yang, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
Factors associated with indoor smoking at home by adults across Korea: a focus on socioeconomic status
Bomgyeol Kim, Yejin Lee, Young Dae Kwon, Tae Hyun Kim, Jin Won Noh
Epidemiol Health. 2020;42:e2020067.   Published online October 28, 2020
DOI: https://doi.org/10.4178/epih.e2020067
  • 10,069 View
  • 190 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea.
METHODS
We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis.
RESULTS
Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher.
CONCLUSIONS
Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.
Summary
Korean summary
이 연구는 가정 실내 흡연과 관련된 다양한 요인들을 파악하였으며, 소득, 교육수준과 같은 사회경제적 요인과 가정 실내 흡연의 연관성을 확인하였다. 이를 통해 가정 실내 흡연 감소를 위한 금연 정책의 근거자료로 활용될 수 있을 것으로 기대된다.

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  • Tobacco usage in the home: a cross-sectional analysis of heated tobacco product (HTP) use and combustible tobacco smoking in Japan, 2023
    Satomi Odani, Takahiro Tabuchi
    Environmental Health and Preventive Medicine.2024; 29: 11.     CrossRef
  • Impacts of smoking ban policies on billiard halls sales in South Korea using objective sales information of a credit card company: A quasi-experimental study (Preprint)
    Jin-Won Noh, Jooyoung Cheon, Hohyun Seong,, Young Dae Kwon, Ki-Bong Yoo
    JMIR Public Health and Surveillance.2023;[Epub]     CrossRef
Gender difference in socioeconomic factors affecting suicidal ideation and suicidal attempts among community-dwelling elderly: based on the Korea Community Health Survey
Jin-Young Jeong
Epidemiol Health. 2020;42:e2020052.   Published online July 13, 2020
DOI: https://doi.org/10.4178/epih.e2020052
  • 12,715 View
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  • 4 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study was performed to explore socioeconomic factors associated with suicidal ideation and suicidal attempts among the local community’s resident elderly.
METHODS
The subjects included 129,277 participants aged 65 years or above of the Korea Community Health Survey conducted in 2013 and 2017. Based on the questions for suicidal ideation and suicidal attempts, the subjects were divided into a no suicidal ideation group (n=111,344), a suicidal ideation group (n=17,487), and a suicidal attempt group (n=446). All analyses were stratified by gender, and a complex sample logistic regression analysis was performed to analyze associated factors. SAS version 9.4 was used for all analyses with a significance level of 0.05.
RESULTS
Common factors associated with suicidal ideation in both genders included marital status, frequency of contact with friends, social activity, and average monthly household income. Economic activity was demonstrated as relevant only to the elderly men subjects. According to the analysis, factors associated with suicidal attempts were the recipients of the National Basic Living Security Act for the elderly men compared to age, frequency of contact with family, frequency of contact with friends, and average monthly household income for the elderly women.
CONCLUSIONS
The study revealed that socioeconomic factors leading to suicidal ideation were similar in the elderly of both genders, while a difference was demonstrated for factors associated with suicidal attempts between the elderly of both genders. It is expected that the results of this study may be used as the basis for screening the local community’s elderly with a high suicidal risk, and in the development of suicide prevention services.
Summary
Korean summary
2013년과 2017년 지역사회건강조사에 참여한 129,277명의 노인을 대상으로 자살시도에 관련된 사회-경제적 요인을 탐색하였다. 분석결과, 남성 노인의 자살시도 관련요인은 국민기초생활수급자, 여성 노인의 자살시도 관련요인은 연령, 가족접촉빈도, 친구접촉빈도, 그리고 월평균가구소득으로 나타났다. 본 결과가 지역사회 거주 노인의 자살 고위험군 선별 및 자살 예방서비스 개발에 기초자료로 활용되기를 기대한다.

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  • A systematic review of psychosocial protective factors against suicide and suicidality among older adults
    Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
    International Psychogeriatrics.2024; 36(5): 346.     CrossRef
  • Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults
    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
    Archives of Public Health.2021;[Epub]     CrossRef
Factors affecting awareness of myocardial infarction symptoms among the general public in Korea
Kyong Sil Park
Epidemiol Health. 2020;42:e2020032.   Published online May 18, 2020
DOI: https://doi.org/10.4178/epih.e2020032
  • 13,647 View
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  • 12 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS).
METHODS
This is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis.
RESULTS
Of a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors.
CONCLUSIONS
In order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.
Summary
Korean summary
2017년 지역사회건강조사 자료를 분석한 결과, 한국의 심근경색증 증상의 인지율은 42%로 낮은 인식을 보였다. 한국의 지역사회 내 일반인들의 심근경색증 증상의 인지율을 제고하기 위해 성별, 연령, 교육수준, 직업을 고려하여 교육 및 홍보를 실시해야 한다. 그리고, 전형적인 심근경색증 증상뿐만 아니라 비전형적인 심근경색증 증상에 대한 인식에 대한 정부, 교육기관, 의료기관 등의 적극적인 노력이 필요하다. 또한, 금연, 금주, 신체활동 증진에 대한 보건정책적 관리방안과 심혈관질환 위험요인을 가진 대상자들의 지속적인 모니터링 및 관리가 필요하다.

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  • Recognition of Early Cardiovascular Disease Symptoms in Hypertensive and Dyslipidemic Individuals of Icheon, Korea: Insights into Educational Levels and Health Literacy
    Jeehye Lee, Dong-Hee Ryu
    Healthcare.2024; 12(7): 736.     CrossRef
  • Awareness of Myocardial Infarction in Nangarhar Residents: A Community Based Study
    Shams Akmal, Ibrahimi Ikramullah , Ahmadzai Hayatullah
    Journal of Cardiology and Cardiovascular Medicine.2024; 9(2): 130.     CrossRef
  • Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study
    Gahyeon Kim, Hyeokjoo Jang, Sebin Kwon, Bumyeol Lee, Suk-Yong Jang, Wonjeong Chae, Sung-In Jang
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • “Recognition of heart attack symptoms and treatment-seeking behaviors: a multi-center survey in Tehran, Iran”
    Elnaz Shahmohamadi, Mojtaba Sedaghat, Arash Rahmani, Farnoosh Larti, Babak Geraiely
    BMC Public Health.2023;[Epub]     CrossRef
  • Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries
    Paul Jie Wen Tern, Amar Vaswani, Khung Keong Yeo
    Korean Circulation Journal.2023; 53(9): 594.     CrossRef
  • Awareness of Myocardial Infarction Symptoms and Risk Factors in Saudi Arabia: A Cross-Sectional Study
    Saad M Alsaab, Ahmed M Almutairi, Ghadi K Alsaadi, Ziyad A Altokhais, Samar H Alabdulqader, Wafa Y Alnofal, Nourah M Alduhaim
    Cureus.2023;[Epub]     CrossRef
  • Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries
    Antonio Daponte-Codina, Emily C. Knox, Inmaculada Mateo-Rodriguez, Amanda Seims, Vera Regitz-Zagrosek, Angela H. E. M. Maas, Alan White, Floris Barnhoorn, Fernando Rosell-Ortiz
    International Journal of Environmental Research and Public Health.2022; 19(3): 1388.     CrossRef
  • Blood Pressure Awareness and Knowledge of Cardio-Cerebrovascular Diseases in South Korean Women with Hypertension
    Yeo Won Jeong
    Healthcare.2021; 9(3): 360.     CrossRef
  • Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis
    Akash Sharma, Karavadi Vidusha, Harshini Suresh, Ajan M. J., Kavinkumar Saravanan, Madhvi Dhamania, Nisha B, Rabbanie Tariq Wani
    Korean Circulation Journal.2021; 51(12): 983.     CrossRef
  • Global Awareness of Myocardial Infarction Symptoms in General Population
    Soo-Joong Kim
    Korean Circulation Journal.2021; 51(12): 997.     CrossRef
  • Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States– and Foreign‐Born Adults in the National Health Interview Survey
    Ivy Mannoh, Ruth‐Alma Turkson‐Ocran, Jasmine Mensah, Danielle Mensah, Stella S. Yi, Erin D. Michos, Yvonne Commodore‐Mensah
    Journal of the American Heart Association.2021;[Epub]     CrossRef
Characteristics of depressive symptoms in middle-aged family members of dementia patients: 2017 Korea Community Health Survey
Jinbeom Park, Won-Chul Lee, Hyunsuk Jeong, Nayoung Hong, BoYoung Bae, Hyeon Woo Yim
Epidemiol Health. 2020;42:e2020031.   Published online May 15, 2020
DOI: https://doi.org/10.4178/epih.e2020031
  • 14,292 View
  • 248 Download
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The characteristics of depressive symptoms in the family members of home-dwelling patients with dementia have not been clearly reported. This study aimed to investigate the characteristics of depressive symptoms in middle-aged family members living with a patient with dementia.
METHODS
This study used the data from the nationwide 2017 Korea Community Health Survey. Among the 228,381 survey participants, 77,276 participants in their 40s and 50s were finally selected for this study. The participants consisted of 760 family members of home-dwelling dementia patients and 76,516 general family members comprising a control group.
RESULTS
The positive rate of Patient Health Questionnaire-9 (PHQ-9)-measured depressive symptoms was significantly higher in the family members of home-dwelling dementia patients (4.4%; control group: 1.9%). After adjusting for potential confounders, the prevalence of PHQ-measured depressive symptoms was 1.72 times (95% confidence interval [CI], 1.03 to 2.85) higher in the family members of home-dwelling dementia patients compared to the control group. The positive rate of depressive symptoms was 2.26 times higher (95% CI, 1.26 to 4.05) in the female middle-aged family members of home-dwelling dementia patients compared to the control group. In addition, those who reported having symptoms almost every day in the PHQ-9 questions had significantly higher positive rates on questions about loss of interest, depression, sleep disturbance, fatigue, poor appetite, and suicidal ideation, and not on questions regarding feelings of worthlessness and psychomotor agitation, compared to the control group.
CONCLUSIONS
Active interventions are needed to relieve depression in the family members of home-dwelling dementia patients.
Summary

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    Sun Young Lee, Shin Hye Yoo, Belong Cho, Kye Hyung Kim, Min Seoul Jang, Jeongmi Shin, Inyoung Hwang, Seok‐Jin Choi, Jung‐Joon Sung, Min Sun Kim
    Muscle & Nerve.2024; 70(3): 306.     CrossRef
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    Rayhanah R. Almutairi, Jaclene A. Zauszniewski
    Issues in Mental Health Nursing.2023; 44(6): 538.     CrossRef
  • Depression before and during-COVID-19 by Gender in the Korean Population
    Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim
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  • A Study on Complementary Policy to Enhance the Effectiveness of National Dementia Policy in Terms of Medical Services
    Su Jeong Seong, Kang Joon Lee, Woo Jung Kim, Kiwon Kim, Dong Woo Lee
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The effects of mental health on recurrent falls among elderly adults, based on Korean Community Health Survey data
Kyung Hee Jo, Jong Park, So Yeon Ryu
Epidemiol Health. 2020;42:e2020005.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020005
  • 15,249 View
  • 300 Download
  • 10 Web of Science
  • 12 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the effect of mental health on frequency of falls (single and recurrent falls) among elderly adults.
METHODS
Data were drawn from the 2015 Korean Community Health Survey. A chi-square test was conducted to compare differences in fall frequency according to health-related behaviors, chronic diseases, and mental health. Subsequently, multinomial logistic regression analysis was used to identify the effects of mental health on single and recurrent falls based on variables found to be significant in the chi-square test.
RESULTS
Recurrent falls were found to be more risky than single falls. Depression was significantly related to single falls (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.12 to 1.44). Depression (OR, 1.56; 95% CI, 1.38 to 1.76), sleep disorder (5 hours or less: OR, 1.12; 95% CI, 1.02 to 1.23; more than 9 hours: OR, 1.24; 95% CI, 1.07 to 1.44, respectively), and subjective stress (OR, 2.30; 95% CI, 1.90 to 2.78) were significantly related to recurrent falls.
CONCLUSIONS
The study’s findings suggest that specialized fall prevention programs are needed to address different types of falls in elderly adults. To prevent recurrent falls, systematic treatment strategies and rehabilitation training must improve physical function and mental health.
Summary
Korean summary
우리나라 노인에서 정신건강이 낙상에 미치는 영향을 확인하였고, 그 결과 단순낙상은 우울감 경험을 한 경우 낙상발생 위험이 증가했으며, 반복낙상은 우울감을 경험하고, 수면장애가 있으며(수면시간 6시간 미만, 9시간 이상), 주관적 스트레스가 커질수록 낙상 위험이 증가하였다. 최종적으로 노인의 정신건강이 반복낙상에 미치는 영향이 더 큰 것을 확인하였다. 본 연구결과를 통해 낙상 예방 및 관리를 위한 보건사업을 제시하고, 반복낙상자의 정신적/신체적 기능 증진을 위한 치료전략과 재활훈련 계획의 근거자료로 활용할 수 있을 것으로 생각된다.

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    Prakasit Tonchoy, Katekaew Seangpraw, Parichat Ong-Artborirak, Supakan Kantow, Nisarat Auttama, Monchanok Choowanthanapakorn, Sorawit Boonyathee
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Individual and regional factors associated with suicidal ideation among Korean elderly: a multilevel analysis of the Korea Community Health Survey
Sang Hee Jeong, Byung Chul Chun
Epidemiol Health. 2019;41:e2019022.   Published online May 26, 2019
DOI: https://doi.org/10.4178/epih.e2019022
  • 12,815 View
  • 275 Download
  • 8 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the individual and regional characteristics that influence suicidal ideation among the Korean elderly population.
METHODS
Using data collected from the 2013 Korea Community Health Survey, a multilevel analysis was performed to establish an understanding of individual behavioral patterns and regional influences on suicidal ideation.
RESULTS
Among the 77,407 individuals sampled, 11,236 (14.5%) elderly people over 60 years of age experienced suicidal ideation. Among individual factors, age, frequency of communication with friends, religious activity, social activity, leisure activity, trust in neighbors, subjective stress level, depressive symptoms, and subjective health status were significantly associated with suicidal ideation. The results showed that the lower the regional deprivation level, the higher the suicidal ideation odds ratio. In terms of regional size, the most significant effects were found in rural areas.
CONCLUSIONS
This study suggested that suicidal ideation in the elderly is associated with community factors, such as the regional deprivation index, as well as personal factors.
Summary
Korean summary
본 연구는 60세 이상 연령의 개인 요인에 따른 자살 생각에 영향을 미치는 요인과 지역 요인을 모두 반영하여 자살 생각에 영향을 미치는 요인을 파악하는 것으로 지역사회건강조사에 응답한 60대 이상 노인 77,407명 중 11,236(14.5%)명을 표본대상으로 선정하여 노인의 자살생각 가능성과 관련된 개인의 행태와 지역 또는 집단에서 영향력을 파악하기 위한 다수준 분석을 실시하였다. 결과적으로 본 연구는 60세이상의 노인에서 자살 생각에 개인적 요인 뿐 아니라 지역박탈지수와 같은 지역 요인이 관여한다는 점을 시사한다.

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  • A systematic review of psychosocial protective factors against suicide and suicidality among older adults
    Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
    International Psychogeriatrics.2024; 36(5): 346.     CrossRef
  • Effects of health-related quality of life and long-term care insurance infrastructure on suicidal ideation among older Korean adults
    Changsook Lee, Sun-Young Heo
    Asia Pacific Journal of Social Work and Development.2023; 33(2): 101.     CrossRef
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    Han Zhou, Dong Han, Haisen Zhou, Xinfeng Ke, Dongdong Jiang
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  • Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
    Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
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    Hyunjin Son, Changhoon Kim
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    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
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Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey
Ji Son Ki, Ho Kim
Epidemiol Health. 2019;41:e2019012.   Published online April 7, 2019
DOI: https://doi.org/10.4178/epih.e2019012
  • 14,216 View
  • 280 Download
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.
METHODS
Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.
RESULTS
With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.
CONCLUSIONS
When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.
Summary
Korean summary
본 연구는 지역사회건강조사와 국민건강영양조사의 2010년부터 2015년까지 6년간의 자료로 각각 6개, 8개 변수의 추정치를 비교하였다. 설문변수 간의 추정치 차이보다 설문변수와 검진변수간의 추정치의 더 차이가 컸고 하위그룹별 시계열 변동은 지역사회건강조사가 더 안정적이었다.

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Ambient air quality and subjective stress level using Community Health Survey data in Korea
Myung-Jae Hwang, Hae-Kwan Cheong, Jong-Hun Kim, Youn Seo Koo, Hui-Young Yun
Epidemiol Health. 2018;40:e2018028.   Published online June 28, 2018
DOI: https://doi.org/10.4178/epih.e2018028
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Air pollution causes various disease in exposed populations, and can lead to premorbid health effects manifested as both physical and psychological functional impairment. The present study investigated the subjective stress level in daily life in relation to the level of air pollution.
METHODS
Data from the Community Health Survey (2013), comprising 99,162 men, and 121,273 women residing in 253 healthcare administrative districts, were combined with air pollutant concentration modelling data from the Korean Air Quality Forecasting System, and were stratified by subjective stress levels into five strata for multiple logistic regression. Levels of exposure were divided into five quintiles according to the annual concentration of nitrogen dioxide (NO2), and were analyzed using a single-pollutant model using NO2 concentration only, and a multi-pollutant model adjusted for the concentration of particulate matter <10 μm in diameter.
RESULTS
Analysis of men and women in various age groups showed the highest odds ratio (OR) for subjective stress level at the highest NO2 concentration quintile in men and women aged 30–64 years (men: 2.91; 95% confidence interval [CI], 2.12 to 4.01; women: 1.82; 95% CI, 1.32 to 2.51). As the NO2 concentration quintile increased, the OR increased. Men showed higher ORs than women in all strata.
CONCLUSIONS
In the present study, annual NO2 concentrations were found to be associated with subjective stress levels. This association was especially clear among socioeconomically active men and women aged 30-64 years.
Summary
Korean summary
2013년 지역사회건강조사를 이용하여 253개 보건행정지역단위로 Korean Air Quality Forecasting System (KAQFS) 대기물질농도 모델링자료를 결합하여 주관적 스트레스 정도에 따라 5분위로 범주화하여 다항로지스틱회귀을 하였다. 본 연구에서는 연평균 NO2농도와 주관적 스트레스 정도가 관련이 있는 것으로 나타났다. 특히, 사회 경제적 활동이 활발한30세 이상 65세 미만의 남성과 여성에서 관련성이 뚜렷하게 나타났다.

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