Epidemiology and Health

Methods

Plan and operations of the 10th Korea National Health and Nutrition Examination Survey (2025–2027): Sun-Ja Kim, Sihyun Park, Sunja Kim, Suyeon Park, Yoonjung Kim, Yunjung Choi, Sungha Yun, Kyungwon Oh; Epidemiol Health. 2026;48:e2026001. Published online January 2, 2026; DOI: https://doi.org/10.4178/epih.e2026001

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Abstract Summary PDF Supplementary Material: Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th KNHANES (2025–2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea’s transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults’ life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.; Summary

Korean summary
국민건강영양조사는 국민건강증진법 제16조에 근거하여 1998년부터 우리 국민의 건강 및 영양 수준을 파악해 온 국가 단위 건강조사이다. 제10기(2025–2027) 국민건강영양조사는 통계적 대표성을 유지하면서 온라인 조사로의 지속적인 개선·확대, 초고령 사회 등 사회·보건환경 변화에 대응한 신규 조사항목 도입, 추적조사 체계 구축을 통해 국가 건강정책 및 만성질환 예방·관리 전략 수립을 위한 근거 생산을 강화하고자 한다.

Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act that has assessed the health and nutritional status of the Korean population since 1998. The 10th KNHANES (2025–2027) maintains statistical representativeness while further improving and expanding web-based self-administered surveys, incorporating new survey components in response to social and public health changes such as the transition to a super-aged society, and establishing a longitudinal follow-up system to strengthen the evidence base for national health policy development and chronic disease prevention and management.

Systematic Review

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

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Abstract Summary PDF Supplementary 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.

Citations

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Original Article

Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy: Franklin Barbosa da Silva, José Leopoldo Ferreira Antunes, Paulo Frazão; Epidemiol Health. 2021;43:e2021031. Published online May 1, 2021; DOI: https://doi.org/10.4178/epih.e2021031

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Abstract Summary PDF: Abstract
OBJECTIVES
The aim of this study was to determine whether geographic location, socioeconomic status, infant mortality, and mortality from diarrheal disease in health regions are associated with the provision of community water fluoridation (CWF) in Brazilian municipalities.
METHODS
A multilevel ecological study was conducted based on data from the National Survey of Basic Sanitation and Human Development Atlas. A multilevel analysis was carried out considering Brazilian municipalities as the first level and health regions as the second level, comprising sanitation, demographic, socioeconomic, and health characteristics.
RESULTS
The observation units comprised 5,565 municipalities clustered in 438 health regions in Brazil. The lack of CWF provision was positively associated with the following municipal characteristics: a below-median proportion of inhabitants covered by the sewage network, medium to very low human development index, below-median per capita gross domestic product, and an above-median percentage of expenditures on sanitation. In relation to the health regions, the likelihood of a lack of CWF provision was greater in the municipalities belonging to the health regions located in the Northern and Northeastern areas of Brazil and in those where child mortality due to acute diarrheal disease and the proportion of people with low income were higher when adjusted by municipal indicators.
CONCLUSIONS
Information on the characteristics associated with CWF provision constitutes important input for refocusing public policy to reduce inequalities among Brazilian municipalities and health regions. These findings may help policy-makers to understand the challenges facing CWF expansion in low-, middle-, and high-income countries.; Summary

Key Message
Just as the challenges for CWF's expansion in Brazil's most vulnerable areas require firm leadership for refocusing public policy, expansion in low- and middle-income countries demands a continued global collaborative effort.

Lecture

Shared decision making: relevant concepts and facilitating strategies: Jong-Myon Bae; Epidemiol Health. 2017;39:e2017048. Published online October 30, 2017; DOI: https://doi.org/10.4178/epih.e2017048

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Abstract

As the paradigm in healthcare nowadays is the evidence-based, patient-centered decision making, the issue of shared decision making (SDM) is highlighted. The aims of this manuscript were to look at the relevant concepts and suggest the facilitating strategies for overcoming barriers of conducting SDM. While the definitions of SDM were discordant, several concepts such as good communication, individual autonomy, patient participants, and patient-centered decision-making were involved. Further, the facilitating strategies of SDM were to educate and train physician, to apply clinical practice guidelines and patient decision aids, to develop valid measurement tools for evaluation of SDM processes, and to investigate the impact of SDM.

Summary

Korean summary
오늘날 보건의료가 지향하는 목표가 근거에 기반한 환자중심의 의사결정 (Evidence-based Patient-centered Decision Making)인 점에서, 공유된 의사결정 (Shared Decision Making, SDM)의 중요성이 강조되고 있다. 본 원고는 SDM의 관련 개념들을 정리하고, 진료에 적용하는 과정에서의 한계점들과 이를 극복하기 위한 방안들을 살펴보았다.

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Perspective

Suggestions for the promotion of evidence-based public health in South Korea: Jong-Myon Bae; Epidemiol Health. 2017;39:e2017030. Published online July 19, 2017; DOI: https://doi.org/10.4178/epih.e2017030

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Abstract Summary PDF Supplementary Material

Abstract

Evidence-based public health (EBPH) is defined as public health decision-making based on current best evidence. Debates about the latent tuberculosis infection control program suggested by the Korea Centers for Disease Control and Prevention in 2017 highlight the need to promote EBPH. Three strategies have been proposed, including providing necessary evidence by evaluating policy-evidence gaps; delivering high-quality, relevant, and timely evidence by conducting systematic reviews and adapting public health guidelines; and making value-driven decisions by training and educating public health policymakers.

Summary

Korean summary
근거중심 공중보건 (EBPH)는 공중보건영역에서 최신과 최선의 근거에 기반하여 의사결정을 하는 것이다. EBPH를 활성화하기 위해서는 정책-근거 간의 간극을 알아내고, 체계적 고찰을 통한 공중보건지침을 개발하며, 의사결정참여자의 역량을 높이기 위한 교육훈련을 추진하는 것이다.

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