Epidemiology and Health

Original Article

Smoking-attributable mortality among Korean adults in 2019: Yeun Soo Yang, Keum Ji Jung, Heejin Kimm, Sunmi Lee, Sun Ha Jee; Epidemiol Health. 2024;46:e2024011. Published online December 19, 2023; DOI: https://doi.org/10.4178/epih.e2024011

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Abstract Summary PDF: Abstract
OBJECTIVES
Tobacco use ranks among the leading preventable causes of death worldwide. This study was conducted to calculate the mortality rate attributable to smoking in Korea for 2019 and to highlight the importance of tracking and monitoring smoking-related deaths for public health purposes.
METHODS
Population attributable risk (PAR) was used to estimate the number of deaths related to smoking in 2019. PAR percentages were applied to the estimated mortality figures for various diseases, with PAR determined based on relative risk (RR). Levin’s formula was used to calculate PAR, and RR was adjusted for age and alcohol consumption using Cox proportional hazards regression model to derive disease-specific regression coefficients. The analysis incorporated previously determined smoking rates from 1985, and use rates of novel tobacco products were not considered.
RESULTS
The findings revealed a total of 67,982 smoking-attributable deaths in Korea in 2019, 56,993 of which occurred in men and 11,049 in women. The PAR of smoking for various causes of death in adult men was highest for lung cancer at 74.9%, followed by pneumonia (29.4%), ischemic heart disease (42.3%), and stroke (30.2%). For women, the PAR for smoking-related death was highest for lung cancer (19.9%), followed by stroke (7.6%), pneumonia (5.7%), and ischemic heart disease (9.1%).
CONCLUSIONS
In countries experiencing rapid fluctuations in smoking rates, including Korea, regular studies on smoking-related mortality is imperative. Furthermore, it is necessary to investigate smoking-related deaths, including the prevalence of novel tobacco product use, to accurately gauge the risks associated with emerging tobacco products.; Summary

Korean summary
이 연구는 2019년 한국에서 흡연으로 인한 사망률을 계산하고 공중 보건 목적을 위한 흡연 관련 사망추적 및 모니터링의 중요성을 강조합니다. 연구 결과, 2019년 한국에서 흡연으로 인해 총 67,982명이 사망했으며, 이 중 남성이 56,993명, 여성이 11,049명이었습니다. 특히 남성의 경우 폐암(74.9%), 여성의 경우 폐암(19.9%)에서 흡연으로 인한 사망 위험이 가장 높게 나타났습니다.

Key Message
This study analyzed deaths attributable to smoking in Korea in 2019, revealing that a total of 67,982 individuals lost their lives due to smoking. Among these, 56,993 were men and 11,049 were women, with the highest smoking-related mortality rate observed in men due to lung cancer at 74.9%, and in women due to lung cancer at 19.9%. Through these findings, this research emphasizes the importance of tracking and monitoring smoking-related deaths for public health.

Data Profile

Data resource profile: the Korean Community Health Status Indicators (K-CHSI) database: Hye-Eun Lee, Yeon-gyeong Kim, Jin-Young Jeong, Dong-Hyun Kim; Epidemiol Health. 2023;45:e2023016. Published online February 2, 2023; DOI: https://doi.org/10.4178/epih.e2023016

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Abstract Summary PDF Supplementary Material: Abstract
Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants at the municipal level (si/gun/gu-level regions, including mid-sized cities, counties, and districts). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data sources are 71 public databases, including Causes of Death Statistics, Cancer Registration Statistics, Community Health Survey, Population Census, and Census on Establishments and Statistics of Urban Plans. This dataset covers Korea’s 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (si/gun/gu). The current version of the database (DB version 1.3) was built using 12 years of data from 2008 to 2019. All data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do). K-CHSI covers extensive health outcomes and health determinants at the municipal level over a period of more than 10 years, which enables ecological and time-series analyses of the relationships among various health outcomes and related factors.; Summary

Korean summary
지역사회 건강관련요인 데이터베이스는 17개 광역시도와 약 250개 시군구의 건강 결과 및 결정 요인에 대한 연간 데이터를 포함하는 모델 기반 데이터베이스이다. 본 데이터베이스의 건강 결과에는 사망률, 질병 발생률, 유병률, 자가 보고 건강상태 등이 포함되며 건강 결정 요인은 인구사회학적 환경, 건강 행태, 사회적 환경, 물리적 환경, 보건의료 체계의 5개 영역으로 구성되었다. 데이터는 질병관리청 지역사회건강조사 사이트에서 로그인 없이 다운로드할 수 있다(https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).

Key Message
Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants from 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (si/gun/gu). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).

Original Article

Nationwide trends in the incidence of tuberculosis among people with disabilities in Korea: a nationwide serial cross-sectional study: Jinsoo Min, So Young Kim, Jong Eun Park, Yeon Yong Kim, Jong Hyock Park; Epidemiol Health. 2022;44:e2022098. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022098

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Studies on the association between disabilities and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities.

METHODS

We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age-standardized and sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined with a multivariable logistic regression model using data from 2017.

RESULTS

The overall incidence of active TB decreased between 2008 and 2017. The age- and sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (p<0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disabilities (119.9/100,000 vs. 48.5/100,000 person-years, p<0.001), regardless of sex, income level, and place of residence. Compared to those without disabilities, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15 to 1.24). Individuals with mental disabilities (aOR, 1.51; 95% CI, 1.24 to1.84) had the highest odds of active TB incidence, followed by those with developmental disabilities (aOR, 1.30; 95% CI, 1.09 to 1.55).

CONCLUSIONS

People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.

Summary

Korean summary
장애가 있는 사람은 이차적 건강 문제가 발생할 가능성이 더 높고 그들의 건강결정요인은 결핵 발생 위험 요인과 겹친다. 장애인은 비장애인에 비해 연령과 성별에 관계없이 활동성 결핵 발병률이 현저히 높았으며, 장애 유형 중 정신장애와 발달장애가 결핵에 더 취약한 것으로 나타났다. 장애인과 같이 결핵 감염 위험이 있는 취약계층을 파악하고 이들에게 결핵진단 및 항결핵치료의 어려움을 극복할 수 있도록 다학제적 지원을 제공하는 것이 중요하겠다.

Key Message
People with disabilities are more likely to develop secondary health conditions and their social determinants of health overlap with the risk factors for developing TB disease. We found that compared to people without disabilities, a markedly higher incidence of active TB disease among people with disabilities regardless of age and sex, and mental and developmental disabilities among types of disability were more prone to TB disease. It is critical to identify the vulnerable populations, such as people with disabilities, at risk of developing TB infection and provide them with multidisciplinary support to overcome any barriers during TB diagnosis and anti-TB treatment.

Citations

Citations to this article as recorded by

HIV knowledge and access to testing for people with and without disabilities in low‐ and middle‐income countries: evidence from 37 Multiple Indicator Cluster Surveys
Sara Rotenberg, Shanquan Chen, Jill Hanass‐Hancock, Calum Davey, Lena Morgon Banks, Hannah Kuper
Journal of the International AIDS Society.2024;[Epub] CrossRef
The Korea National Disability Registration System
Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin
Epidemiology and Health.2023; 45: e2023053. CrossRef
Nationwide Trends in Osteoporosis in Koreans With Disabilities From 2008 to 2017
Ji Hyoun Kim, So Young Kim, Jong Eun Park, Hyo Jong Kim, Hyun Jeong Jeon, Yeon Yong Kim, Jong‐Hyock Park
JBMR Plus.2023;[Epub] CrossRef
Growing disparity in the prevalence of chronic obstructive pulmonary disease between people with and without disabilities: a Korean nationwide serial cross-sectional study
Jinsoo Min, Jong Eun Park, So Young Kim, Yeon Yong Kim, Jong Hyock Park
Scientific Reports.2023;[Epub] CrossRef

Cohort Profile

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile: Chris Desmond, Gabriella A. Norwitz, Jane D. Kvalsvig, Rachel S. Gruver, Shuaib Kauchali, Kathryn G. Watt, Nonhlanhla P. Myeza, Adele Munsami, Leslie L. Davidson; Epidemiol Health. 2022;44:e2022037. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022037

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Abstract

The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children’s primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.

Summary

Key Message
The Asenze Cohort Study, one of a limited number of population-based studies set in low- and middle-income countries, with a high level of retention, provides an understanding of neuro-developmental, psychosocial, home environmental and economic exposures and outcomes of over 1100 adolescents and their primary caregivers in KwaZulu-Natal, South Africa.

Citations

Citations to this article as recorded by

The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa
Gabriella A. Norwitz, Chris Desmond, Rachel S. Gruver, Jane D. Kvalsvig, Amaleah F. Mirti, Shuaib Kauchali, Leslie L. Davidson, Giulia Ballarotto
PLOS ONE.2023; 18(10): e0290788. CrossRef

Original Articles

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

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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

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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

Preventable causes of cancer in Texas by race/ethnicity: tobacco smoking: Franciska J. Gudenkauf, Aaron P. Thrift; Epidemiol Health. 2021;43:e2021046. Published online July 13, 2021; DOI: https://doi.org/10.4178/epih.e2021046

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Abstract Summary PDF: Abstract
OBJECTIVES
Tobacco smoking is classified as carcinogenic to humans (International Agency for Research on Cancer Group 1). We aimed to estimate the percentage and number of incident cancer cases diagnosed in Texas in 2015 that were attributable to tobacco smoking, and we examined differences in the proportions of smoking-attributable cancers between the major racial/ethnic subgroups of the population.
METHODS
We calculated population-attributable fractions for cancers attributable to tobacco smoking using prevalence data from the Texas Behavioral Risk Factor Surveillance System and relative risks associated with smoking status from pooled analyses of cohort studies or meta-analyses. Cancer incidence data were collected from the Texas Cancer Registry.
RESULTS
We estimated that 19,000 excess cancer cases or 18.4% of all cancers diagnosed in 2015 in Texans aged ≥ 25 years were caused by tobacco smoking. Males had a higher overall proportion of cancers attributable to tobacco smoking than females (male, 23.3%, 11,993 excess cases; female, 13.5%, 7,006 cases). Approximately 20% of cancer cases in non-Hispanic Whites and non-Hispanic Blacks were attributable to tobacco smoking compared to 12.8% among Hispanics.
CONCLUSIONS
Despite ongoing public health campaigns combatting tobacco use, this preventable behavior still contributes significantly to cancer incidence in Texas. Racial/ethnic differences in smoking prevalence and smoking-attributable cancer incidence should be considered when designing cancer prevention programs.; Summary

Key Message
Tobacco smoking remains a major contributor to cancer burden in the United States, particularly among men, non-Hispanic whites and non-Hispanic Blacks due to historically higher smoking rates.

Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea: Su Yeon Kye, Heeyoun Cho, Tran Thi Phuong Thao, Jin-Kyoung Oh, Min Kyung Lim; Epidemiol Health. 2021;43:e2021003. Published online December 29, 2020; DOI: https://doi.org/10.4178/epih.e2021003

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Abstract Summary PDF

Abstract

OBJECTIVES
This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied.

METHODS

From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight.

RESULTS

Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common.

CONCLUSIONS

Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

Summary

Korean summary
신체활동의 종류에 따라 비만에 미치는 영향의 차이가 있는지를 보기 위하여 육체 노동이 많은 농촌지역 성인을 대상으로 직무신체활동과 비만과의 관련성을 다른 잠재요인을 보정하여 분석하였다. 남녀 모두에서 고강도 직무신체활동과 비만과의 역연관성이 확인된 반면 여가신체활동과 비만과의 연관성은 확인되지 않았다. 가구소득이 높은 경우 직무신체활동의 강도가 낮은 경우에도 비만과 역연관성을 보였다. 향후 비만 예방 및 중재 전략 수립 시 대상집단의 특성을 고려하여 다양한 종류의 신체활동에 대한 평가가 고려되어야 할 것이다.

Key Message
Regarding the inverse association of physical activity at work and household income with obesity identified in the study, various type of physical activity including physical activity at work and characteristics of target population might be concerned for assessment and prevention of obesity.

Citations

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The association between different types of physical activity and smoking behavior
Jipeng Zhang, Yiwen Cao, Hongfei Mo, Rui Feng
BMC Psychiatry.2023;[Epub] CrossRef
Efectividad de la actividad física en la prevención y tratamiento de la obesidad: una revisión de la literatura
Yudi Alexandra González, Diana Lucia Vega-Díaz
Revista digital: Actividad Física y Deporte.2023;[Epub] CrossRef
Factors affecting quality of life in low‐income overweight and obese women: The mediating effects of health‐promoting behaviors
Ju‐Hee Nho, Hye Young Kim, Eun Jin Kim
Worldviews on Evidence-Based Nursing.2022; 19(3): 201. CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef

Socio-demographic inequalities in the uptake of Papanicolaou tests in Peru: analysis of the 2015-2017 Demographic and Family Health Survey: Antonio Barrenechea-Pulache, Emmanuel Avila-Jove, Akram Hernández-Vásquez, Fernando M. Runzer-Colmenares; Epidemiol Health. 2020;42:e2020043. Published online June 18, 2020; DOI: https://doi.org/10.4178/epih.e2020043

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Abstract PDF

Abstract

OBJECTIVES
This study was conducted to analyze the inequalities in Papanicolaou test (also referred to as the Pap smear) uptake according to the socio-demographic characteristics of Peruvian women 30 years to 59 years of age using information from the 2015-2017 Demographic and Family Health Survey (ENDES, acronym in Spanish).

METHODS

This is an analytical, cross-sectional study based on information acquired from the 2015-2017 ENDES surveys. Socio-demographic characteristics were reported using absolute frequencies and weighted proportions with 95% confidence intervals, considering results with a p-value <0.05 as statistically significant. Concentration curves (CCs) and concentration indices (IndCs) were created based on the interaction of the wealth index and uptake of Pap smears, taking into account the different characteristics of the population studied for the measure of inequalities.

RESULTS

All the CCs were distributed below the line of equality. Similarly, all the IndCs were higher than zero, indicating inequality in the uptake of Pap smears, favoring those with a higher wealth index. The highest IndC values were obtained from women aged 50-59 (IndC, 0.293), those who lived in the jungle (IndC, 0.230), and those without health insurance (IndC, 0.173).

CONCLUSIONS

We found socio-demographic inequalities in the uptake of Pap smears in Peru, favoring women with a higher wealth index. More funding is needed to promote cervical cancer screening programs and to create systems that ensure equal access to healthcare in Peru.

Summary

Citations

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Ethnic inequalities in coverage and use of women’s cancer screening in Peru
Claudio Intimayta-Escalante
BMC Women's Health.2024;[Epub] CrossRef
Socioeconomic disparities in Papanicolaou test utilization in Western Iran
Bahare Safari-Faramani, Roya Safari-Faramani, Farid Najafi, Davoud Khorasani Zavareh, Ali Kazemi Karyani, Mitra Darbandi
BMC Public Health.2024;[Epub] CrossRef
Reasons for never receiving a pap test among Brazilian women: National health survey
Claudia Fernandes Rodrigues, José Victor Afonso Coutinho, Camila Drumond Muzi, Raphael Mendonça Guimarães
Public Health Nursing.2021; 38(6): 963. CrossRef

Effects of living in the same region as one’s workplace on the total fertility rate of working women in Korea: Yeon-Yong Kim, Hee-Jin Kang, Seongjun Ha, Jong Heon Park; Epidemiol Health. 2019;41:e2019043. Published online October 9, 2019; DOI: https://doi.org/10.4178/epih.e2019043

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Abstract Summary PDF

Abstract

OBJECTIVES
The lowest-low fertility status of Korea has continued for the past 17 years despite governmental efforts to encourage childbirth. As the number of working women has increased, their residence patterns have changed; however, the impact of this factor has yet to be explored. Therefore, this study was conducted to investigate the effects of residence patterns relative to the workplace on the total fertility rate of working women.

METHODS

Information on eligibility and healthcare utilization was obtained from the National Health Information Database between 2011 and 2015. The study participants were working women aged 15-49 years. We classified their residence relative to their workplace into 3 patterns: same municipality, same province, and different province. The total fertility rate was calculated and logistic regression was performed of childbirth according to residence pattern, adjusting for age, insurance contribution quartile, size of the workplace, year of birth, and province of residence.

RESULTS

The total fertility rates of working women from 2011 to 2015 were 1.091, 1.139, 1.048, 1.073, and 1.103, respectively. The total fertility rate by residence pattern was highest in women residing in the same municipality as their workplace. After adjustment, the odds of childbirth in women from the same municipality and the same province were 21.6% and 16.0% higher than those of women residing in a different province, respectively.

CONCLUSIONS

The total fertility rate was higher among women living near their workplace. Therefore, effective policy measures should be taken to promote the proximity of working women’s workplace and residence.

Summary

Korean summary
이 연구를 통하여 직장과 동일한 시군구에 거주하는 직장 여성의 출산율이 타 시군구 및 타 시도에 거주하는 경우보다 더 높게 나타나는 것을 확인하였다. 기존 인구사회학적 특성 위주의 출산 관련 연구에 비해 이 연구에서는 직장과 거주지의 차이의 영향을 확인하였다는 데 의의가 있다. 저출산 대책에 대한 다양한 정책적 접근이 요구되는 시점에 직장 여성의 출산율을 높이기 위하여 거주지 대책 등이 종합적으로 고려될 수 있음을 시사한다.

Citations

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Review Paper

Population data science: advancing the safe use of population data for public benefit: Kerina Helen Jones, David Vincent Ford; Epidemiol Health. 2018;40:e2018061. Published online December 25, 2018; DOI: https://doi.org/10.4178/epih.e2018061

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Abstract

The value of using population data to answer important questions for individual and societal benefit has never been greater. Governments and research funders world-wide are recognizing this potential and making major investments in data-intensive initiatives. However, there are challenges to overcome so that safe, socially-acceptable data sharing can be achieved. This paper outlines the field of population data science, the International Population Data Linkage Network (IPDLN), and their roles in advancing data-intensive research. We provide an overview of core concepts and major challenges for data-intensive research, with a particular focus on ethical, legal, and societal implications (ELSI). Using international case studies, we show how challenges can be addressed and lessons learned in advancing the safe, socially-acceptable use of population data for public benefit. Based on the case studies, we discuss the common ELSI principles in operation, we illustrate examples of a data scrutiny panel and a consumer panel, and we propose a set of ELSI-based recommendations to inform new and developing data-intensive initiatives.We conclude that although there are many ELSI issues to be overcome, there has never been a better time or more potential to leverage the benefits of population data for public benefit. A variety of initiatives, with different operating models, have pioneered the way in addressing many challenges. However, the work is not static, as the ELSI environment is constantly evolving, thus requiring continual mutual learning and improvement via the IPDLN and beyond.

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Original Articles

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran: Shahrzad Nematollahi, Mohammad Ali Mansournia, Abbas Rahimi Foroushani, Mahmood Mahmoodi, Azin Alavi, Mohammad Shekari, Kourosh Holakouie-Naieni; Epidemiol Health. 2018;40:e2018008. Published online March 13, 2018; DOI: https://doi.org/10.4178/epih.e2018008

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Abstract

OBJECTIVES
Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.

METHODS

Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016-2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).

RESULTS

Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).

CONCLUSIONS

Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women’s knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.

Summary

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Waterpipe Tobacco (Hookah) Use in Pregnancy: Associations with Nausea and Vomiting of Pregnancy
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Interventions for waterpipe smoking cessation
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Reproductive outcomes of water pipe smoking: A scoping review
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The effect of quitting water pipe during pregnancy on anthropometric measurements at birth: a population-based prospective cohort study in the south of Iran
Shahrzad Nematollahi, Koroush Holakouie-Naieni, Abdolhossain Madani, Hossein Shabkhiz, Elham Torabi, Samane Lotfi
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Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran: Fatemeh Khosravi Shadmani, Hamid Soori, Kamyar Mansori, Manoochehr Karami, Erfan Ayubi, Salman Khazaei; Epidemiol Health. 2016;38:e2016038. Published online August 29, 2016; DOI: https://doi.org/10.4178/epih.e2016038

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Abstract PDF

Abstract

OBJECTIVES
Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.

METHODS

The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.

RESULTS

Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.

CONCLUSIONS

This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Summary

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Cohort Profile

The Korean social life, health and aging project-health examination cohort: Ju-Mi Lee, Won Joon Lee, Hyeon Chang Kim, Wungrak Choi, Jina Lee, Kiho Sung, Sang Hui Chu, Yeong-Ran Park, Yoosik Youm; Epidemiol Health. 2014;36:e2014003. Published online May 13, 2014; DOI: https://doi.org/10.4178/epih/e2014003

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Abstract

The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr).

Summary

Korean summary
한국인의 사회적 삶, 건강과 노화에 대한 조사(Korean Social Life, Health, and Aging Project, KSHAP) 연구는 노인 건강의 사회적 결정요인과 그 상호작용을 평가하는 것을 목적으로 한다. 이를 위하여 사회연결망분석(social network analysis) 기법을 도입하였다. 사회연결망분석은 개인간의 관계를 네트워크로 파악하는 개념으로, 본 연구에서는 지역사회 전체의 사회연결망 안에서 개인의 특성 및 개인간 상호작용의 특성이 신체적 정신적 건강에 미치는 영향을 연구하고자 한다. 대상인구집단은 인천광역시 강화군 일개 면 지역의 60세 이상 인구 및 그 배우자이며, 전체 860명의 모집단에서 814명(94.7%)의 건강면접조사 및 사회연결망 분석을 완료하였으며, 이 가운데 보건지소(533명) 또는 가정(165명)에서 추가 건강검진을 수행한 698명을 대상으로 KSHAP-Health Examination (KSHAP-HE) 코호트를 구축하였다.

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Original Articles

Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey: Won Joon Lee, Hyeon Chang Kim, Sun Min Oh, Dong Phil Choi, Jaelim Cho, Il Suh; Epidemiol Health. 2013;35:e2013005. Published online June 20, 2013; DOI: https://doi.org/10.4178/epih/e2013005

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet.</sec><sec><title>METHODS</title>This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets.</sec><sec><title>RESULTS</title>Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively.</sec><sec><title>CONCLUSIONS</title>Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.</sec>

Summary

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A Population Health Surveillance Theory: Farouk El Allaki, Michel Bigras-Poulin, Pascal Michel, André Ravel; Epidemiol Health. 2012;34:e2012007. Published online November 30, 2012; DOI: https://doi.org/10.4178/epih/e2012007

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Abstract

<sec><title>OBJECTIVES</title>Despite its extensive use, the term "Surveillance" often takes on various meanings in the scientific literature pertinent to public health and animal health. A critical appraisal of this literature also reveals ambiguities relating to the scope and necessary structural components underpinning the surveillance process. The authors hypothesized that these inconsistencies translate to real or perceived deficiencies in the conceptual framework of population health surveillance. This paper presents a population health surveillance theory framed upon an explicit conceptual system relative to health surveillance performed in human and animal populations.</sec><sec><title>METHODS</title>The population health surveillance theory reflects the authors' system of thinking and was based on a creative process.</sec><sec><title>RESULTS</title>Population health surveillance includes two broad components: one relating to the human organization (which includes expertise and the administrative program), and one relating to the system <italic>per se</italic> (which includes elements of design and method) and which can be viewed as a process. The population health surveillance process is made of five sequential interrelated steps: 1) a trigger or need, 2) problem formulation, 3) surveillance planning, 4) surveillance implementation, and 5) information communication and audit.</sec><sec><title>CONCLUSIONS</title>The population health surveillance theory provides a systematic way of understanding, organizing and evaluating the population health surveillance process.</sec>

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