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Original Articles
Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging
Seungju lim, Eunyoung Yoo, Ickpyo Hong, Ji-Hyuk Park
Epidemiol Health. 2023;45:e2023098.   Published online November 2, 2023
DOI: https://doi.org/10.4178/epih.e2023098
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  • 136 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals.
METHODS
We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed.
RESULTS
The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals.
CONCLUSIONS
Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.
Summary
Korean summary
본 연구는 국내 노인인구를 연령대별로 구분하여 연소노인(55-64세), 중고령노인(65-74세), 고령노인(75세+)의 인지저하 기울기를 가속 혹은 감속시키는 라이프스타일 요인을 파악하였다. '흡연'은 연소노인의 인지저하를 가속, '사회활동 참여 빈도'는 중고령노인의 인지저하를 감속시키는 것으로 나타났으며, 고령노인의 경우 유의미한 변수가 나타나지 않았다. 본 결과는 노인의 인지건강에 있어 연령대별 차별화된 라이프스타일 전략이 필요할 것을 시사한다.
Key Message
This study aimed to identify lifestyle factors that accelerate or decelerate the cognitive decline slope in the older population in South Korea, categorized by age groups: young-old adults (55-64), middle-old adults (65-74), and old-old adults (75+). The findings indicated that 'smoking' accelerates cognitive decline in young-old adults, while 'frequency of social activity participation' decelerates cognitive decline in middle-old adults. However, no significant lifestyle variables were identified for old-old adults. These results suggest the necessity of differentiated lifestyle strategies based on age groups for promoting cognitive health in the older population.
Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020
Jin-Hwan Kim, Saerom Kim, Eunhye Park, Chang-yup Kim
Epidemiol Health. 2022;44:e2022081.   Published online September 26, 2022
DOI: https://doi.org/10.4178/epih.e2022081
  • 5,545 View
  • 250 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.
METHODS
We acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression.
RESULTS
An inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm.
CONCLUSIONS
This study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.
Summary

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  • Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in the Republic of Korea?
    Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
    Epidemiology and Health.2023; : e2023072.     CrossRef
Trends and disparities in avoidable, treatable, and preventable mortalities in South Korea, 2001-2020: comparison of capital and non-capital areas
Sang Jun Eun
Epidemiol Health. 2022;44:e2022067.   Published online August 16, 2022
DOI: https://doi.org/10.4178/epih.e2022067
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  • 285 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to describe the regional avoidable mortality trends in Korea and examine the trends in avoidable mortality disparities between the Seoul Capital Area and non-Seoul-Capital areas, thereby exploring the underlying reasons for the trend changes.
METHODS
Age-standardized mortality rates from avoidable causes between 2001-2020 were calculated by region. Regional disparities in avoidable mortality were quantified on both absolute and relative scales. Trends and disparities in avoidable mortality were analyzed using joinpoint regression models.
RESULTS
Avoidable, treatable, and preventable mortalities in Korea decreased at different rates over time by region. The largest decreases were in the non-Seoul-Capital non-metropolitan area for avoidable and preventable mortality rates and the non-Seoul- Capital metropolitan area for treatable mortality rates, despite the largest decline being in the Seoul Capital Area prior to around 2009. Absolute and relative regional disparities in avoidable and preventable mortalities generally decreased. Relative disparities in treatable mortality between areas widened. Regional disparities in all types of mortalities tended to improve after around 2009, especially among males. In females, disparities in avoidable, treatable, and preventable mortalities between areas improved less or even worsened.
CONCLUSIONS
Trends and disparities in avoidable mortality across areas in Korea seem to have varied under the influence of diverse social changes. Enhancing health services to underserved areas and strengthening gender-oriented policies are needed to reduce regional disparities in avoidable mortality.
Summary
Korean summary
2001년부터 2020년까지 회피가능, 예방가능 사망률의 수도권과 비수도권 대도시, 비수도권 비대도시 지역 간 절대적, 상대적 격차는 대체로 감소했지만, 치료가능 사망률의 상대적 격차는 커졌다. 회피가능, 치료가능, 예방가능 사망률의 지역 간 격차는 2009년경 이후에 특히 남성에서 개선됐지만, 여성의 경우 덜 개선되거나 오히려 악화되기도 했다.
Key Message
Regional disparities in avoidable, treatable, and preventable mortalities tended to improve after around 2009, especially among males, but, in females, disparities in all types of mortalities between areas improved less or even worsened.

Citations

Citations to this article as recorded by  
  • Evaluating the effects of the 2017 National Health Insurance coverage expansion on amenable mortality and its disparities between areas in South Korea using Bayesian structural time-series models
    Sang Jun Eun
    Social Science & Medicine.2024; 344: 116574.     CrossRef
  • Regional Health Disparities in Hypertension-Related Hospitalization of Hypertensive Patients: A Nationwide Population-Based Nested Case-Control Study
    Woo-Ri Lee, Jun Hyuk Koo, Ji Yun Jeong, Min Su Kim, Ki-Bong Yoo
    International Journal of Public Health.2023;[Epub]     CrossRef
  • Regional Disparities in the Infant Mortality Rate in Korea Between 2001 and 2021
    Hyeongtaek Woo, Ji Sook Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data
    Woojin Chung
    Healthcare.2022; 10(11): 2243.     CrossRef
The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
Epidemiol Health. 2022;44:e2022044.   Published online May 1, 2022
DOI: https://doi.org/10.4178/epih.e2022044
  • 8,322 View
  • 320 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.
METHODS
A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.
RESULTS
A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.
CONCLUSIONS
During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.
Summary
Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.
Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.

Citations

Citations to this article as recorded by  
  • Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic
    Seung Hee Seo, Sooyoung Cho, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
    Yonsei Medical Journal.2023; 64(7): 463.     CrossRef
  • COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
    Shin-Woo Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
Brief Communication
Occupational inequalities in mortality in Korea: an analysis using nationally representative mortality follow-up data from the late 2000s and after
Eunjeong Noh, Young-Ho Khang
Epidemiol Health. 2022;44:e2022038.   Published online April 6, 2022
DOI: https://doi.org/10.4178/epih.e2022038
  • 6,686 View
  • 350 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Many Korean and international studies have found higher mortality rates and poorer health conditions among manual workers than among non-manual workers. However, a recent study using unlinked data argued that since the economic crisis in Korea in the late 2000s, the mortality estimates of male Korean non-manual workers have been higher than those of manual workers. Our work using individually linked data from the late 2000s and after aimed to examine mortality inequality by occupational class. We analyzed Korea National Health and Nutrition Examination Survey data that were individually linked to cause-of-death data. Cox regression analysis was used to identify the hazard ratios for mortality by occupational class. Of 11,766 males aged between 35 and 64, 397 died between 2007 and 2018: 142 died from cancer, 68 from cardiovascular disease, 88 from external causes, and 99 from other causes. After controlling for age, the mortality estimates for manual workers were 1.85 times higher than those for upper non-manual workers (p<0.05). We observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s; this previously reported finding might have been due to numerator-denominator bias arising from the use of unlinked data.
Summary
Korean summary
개인 단위 연계자료가 아닌 분모(센서스)-분자(사망신고) 집합 자료를 사용하여 2000년대 후반 경제위기 이후 한국 남성 비육체직의 사망률이 육체직보다 높게 나타난다고 기존의 한 연구가 주장했다. 이 연구는 2000년대 이후 개인 단위로 연계된 코호트 자료를 활용하여 여전히 한국에서 육체직의 사망위험이 비육체직보다 높다는 점을 보임으로써, 기존 연구가 비연계자료의 사용으로 인한 분자-분모 바이어스(numerator-denominator bias) 때문에 그와 같은 결과를 보였다고 지적하였다.
Key Message
This paper using individually linked data from the late 2000s and after observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s. The previously reported finding showing reversed occupational mortality inequality might have been due to numerator-denominator bias arising from the use of unlinked data.

Citations

Citations to this article as recorded by  
  • Mortality of Suicide and Cerebro-Cardiovascular Diseases by Occupation in Korea, 1997–2020
    Jungwon Jang, Inah Kim
    International Journal of Environmental Research and Public Health.2022; 19(16): 10001.     CrossRef
Original Articles
Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases
Dahye Baik, Byung-Woo Kim, Moran Ki
Epidemiol Health. 2022;44:e2022010.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022010
  • 11,431 View
  • 511 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases.
METHODS
Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases).
RESULTS
The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019.
CONCLUSIONS
Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.
Summary
Korean summary
우리나라의 감염병으로 인한 사망률과 의료비용은 증가하고 있다. 특히 고령층에서의 높은 사망률과 과다한 의료비용 지출을 고려하면, 호흡기 감염 관리에 집중하는 것이 중요하며 각 감염병 그룹별로 효과적인 정책과 효율적인 관리가 필요하다. 본 연구는 COVID-19 발생 이전의 우리나라 감염병의 사망률과 발생, 의료비 부담의 장기적인 추세를 분석한 중요한 레퍼런스가 될 것이다.
Key Message
In Republic of Korea, the mortality trends (1997-2019) and costs (2009-2019) of infectious disease have increased and this study is particularly important reference for identifying the long-term trends including mortality, outbreak, financial burden of infectious disease in Korea before COVID-19 outbreak.

Citations

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  • Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study
    Hae Suk Cheong, Yoosoo Chang, Yejin Kim, Eun-Jeong Joo, Min-Jung Kwon, Sarah H Wild, Christopher D Byrne, Seungho Ryu
    European Journal of Endocrinology.2023; 188(2): 197.     CrossRef
  • Bacterial biofilm inhibitors: An overview
    Vipin Chandra Kalia, Sanjay K.S. Patel, Jung-Kul Lee
    Ecotoxicology and Environmental Safety.2023; 264: 115389.     CrossRef
  • Determination of Volatile Compounds of Mentha piperita and Lavandula multifida and Investigation of Their Antibacterial, Antioxidant, and Antidiabetic Properties
    Samiah Hamad Al-Mijalli, Eman R. ELsharkawy, Emad M. Abdallah, Munerah Hamed, Nasreddine El Omari, Shafi Mahmud, Mohammed Merae Alshahrani, Hanae Naceiri Mrabti, Abdelhakim Bouyahya, Fernanda Tonelli
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
Risk of COVID-19 transmission in heterogeneous age groups and effective vaccination strategy in Korea: a mathematical modeling study
Youngsuk Ko, Jacob Lee, Yubin Seo, Eunok Jung
Epidemiol Health. 2021;43:e2021059.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021059
  • 8,041 View
  • 146 Download
  • 4 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to analyze the possibility and conditions of maintaining an effective reproductive number below 1 using a mathematical model.
METHODS
The total population was divided into five age groups (0-17, 18-29, 30-59, 60-74, and ≥75 years). Maximum likelihood estimation (MLE) was used to estimate the transmission rate of each age group. Mathematical model simulation was conducted until December 31, 2021, by establishing various strategies for vaccination and social distancing without considering variants.
RESULTS
MLE results revealed that the group aged 0-17 years had a lower risk of transmission than other age groups, and the older age group had relatively high risks of infection. If 70% of the population will be vaccinated by the end of 2021, then simulations showed that even if social distancing was eased, the effective reproductive number would remain below 1 near August if it was not at the level of the third re-spreading period. However, if social distancing was eased and it reached the level of the re-spreading period, the effective reproductive number could be below 1 at the end of 2021.
CONCLUSIONS
Considering both stable and worsened situations, simulation results emphasized that sufficient vaccine supply and control of the epidemic by maintaining social distancing to prevent an outbreak at the level of the re-spreading period are necessary to minimize mortality and maintain the effective reproductive number below 1.
Summary
Korean summary
본 연구에서는 질병관리청에서 제공하는 개별 확진자 데이터에 확률통계적 방법을 적용하여 연령군 간의 감염전파 행렬을 추정하였으며 연령군을 고려한 수리모델에 적용되었다. 본 연구에서 우리는 2020년 10월부터 2021년 5월까지 한국에서의 코로나19 유행상황을 정책 구간에 따라 분석하였으며 이를 토대로 거리두기 완화 수준에 따라 거리두기 완화 상태에서도 지속적으로 유효감염재생산지수가 1보다 작아지는 시점이 달라질 수 있음을 보인다.
Key Message
In this research, we estimated age-group-specified transmission rate matrix by applying maximum likelihood estimation into individual based data which was provided by Korea Disease Control and Prevention Agency. Our model simulation showed the moment, when the effective reproductive number is consistently below 1 even the distancing is eased, is ranged from August to the end of 2021 depending on the intensity of the social distancing during eased phase.

Citations

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  • Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review
    Oscar Espinosa, Laura Mora, Cristian Sanabria, Antonio Ramos, Duván Rincón, Valeria Bejarano, Jhonathan Rodríguez, Nicolás Barrera, Carlos Álvarez-Moreno, Jorge Cortés, Carlos Saavedra, Adriana Robayo, Oscar H. Franco
    Systematic Reviews.2024;[Epub]     CrossRef
  • Mathematical Modeling of COVID-19 Transmission and Intervention in South Korea: A Review of Literature
    Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee
    Yonsei Medical Journal.2023; 64(1): 1.     CrossRef
  • Impact of vaccination and non-pharmacological interventions on COVID-19: a review of simulation modeling studies in Asia
    Karan Thakkar, Julia Regazzini Spinardi, Jingyan Yang, Moe H. Kyaw, Egemen Ozbilgili, Carlos Fernando Mendoza, Helen May Lin Oh
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Effective vaccination strategies to control COVID-19 in Korea: a modeling study
    Youngsuk Ko, Kyong Ran Peck, Yae-Jean Kim, Dong-Hyun Kim, Eunok Jung
    Epidemiology and Health.2023; 45: e2023084.     CrossRef
  • Quantifying the Effects of Non-Pharmaceutical and Pharmaceutical Interventions Against Covid-19 Epidemic in the Republic of Korea: Mathematical Model-Based Approach Considering Age Groups and the Delta Variant
    Youngsuk Ko, Victoria May P. Mendoza, Yubin Seo, Jacob Lee, Yeonju Kim, Donghyok Kwon, Eunok Jung, E. Augeraud, M. Banerjee, J.-S. Dhersin, A. d'Onofrio, T. Lipniacki, S. Petrovskii, Chi Tran, A. Veber-Delattre, E. Vergu, V. Volpert
    Mathematical Modelling of Natural Phenomena.2022; 17: 39.     CrossRef
  • Dietary Behavior and Diet Quality in the Korean Adult Population by Income Level before and after the COVID-19 Pandemic: Using the Korean National Health and Nutrition Examination Survey (2019-2020)
    Hye-Min Na, Bok-Mi Jung
    The Korean Journal of Community Living Science.2022; 33(3): 397.     CrossRef
A small window into the status of malaria in North Korea: estimation of imported malaria incidence among visitors from South Korea
Jisun Sung, Hae-Kwan Cheong, Ah-Young Lim, Jong-Hun Kim
Epidemiol Health. 2020;42:e2020068.   Published online November 21, 2020
DOI: https://doi.org/10.4178/epih.e2020068
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea.
METHODS
The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles.
RESULTS
A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data.
CONCLUSIONS
The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.
Summary
Korean summary
본 연구는 2000-2008년 금강산을 여행한 대한민국 국민과 2005-2015년 개성공단에서 근무한 대한민국 국민에서의 말라리아 발생률을 추정하여 국제사회에 보고된 북한의 말라리아 발생률과 비교 평가하였다. 향후 남북한의 교류가 활성화 되었을 때 북한을 방문하고 돌아온 국민에서의 말라리아 발생률 자료를 사용하여 북한 현지에서의 말라리아 발생률 현황 추이를 살펴볼 수 있을 것으로 보인다.
Ebola virus disease outbreak in Korea: use of a mathematical model and stochastic simulation to estimate risk
Youngsuk Ko, Seok-Min Lee, Soyoung Kim, Moran Ki, Eunok Jung
Epidemiol Health. 2019;41:e2019048.   Published online November 24, 2019
DOI: https://doi.org/10.4178/epih.e2019048
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to the World Health Organization, there have been frequent reports of Ebola virus disease (EVD) since the 2014 EVD pandemic in West Africa. We aim to estimate the outbreak scale when an EVD infected person arrives in Korea.
METHODS
Western Africa EVD epidemic mathematical model SEIJR or SEIJQR was modified to create a Korean EVD outbreak model. The expected number of EVD patients and outbreak duration were calculated by stochastic simulation under the scenarios of Best case, Diagnosis delay, and Case missing.
RESULTS
The 2,000 trials of stochastic simulation for each scenario demonstrated the following results: The possible median number of patients is 2 and the estimated maximum number is 11 when the government intervention is proceeded immediately right after the first EVD case is confirmed. With a 6-day delay in diagnosis of the first case, the median number of patients becomes 7, and the maximum, 20. If the first case is missed and the government intervention is not activated until 2 cases of secondary infection occur, the median number of patients is estimated at 15, and the maximum, at 35.
CONCLUSIONS
Timely and rigorous diagnosis is important to reduce the spreading scale of infection when a new communicable disease is inflowed into Korea. Moreover, it is imperative to strengthen the local surveillance system and diagnostic protocols to avoid missing cases of secondary infection.
Summary
Korean summary
본 연구는 수학적 모델과 확률 시뮬레이션 기법을 이용하여 국내에 유입되지 않았던 에볼라바이러스병(EVD)의 확산 위험도를 정량적으로 예측하는 첫 번째 연구이다. 또한 이 연구를 통해 에볼라바이러스병 환자의 유입 시 발생 가능한 진단 지연 혹은 유입 미인지 상황을 가정하여 발생할 수 있는 2차 감염자 수 및 감염 종식까지의 기간을 계산했고 에볼라바이러스 유입 대비 실시간모니터링의 중요성과 확산 시 상황에 따른 최대 일일 환자수를 합리적으로 제시할 수 있다.

Citations

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  • Estimating the Transmission Risk of COVID-19 in Nigeria: A Mathematical Modelling Approach
    Irany FA, Akwafuo SE, Abah T, Mikler AR
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Editorial
Tuberculosis control in the Republic of Korea
Kyung Sook Cho
Epidemiol Health. 2018;40:e2018036.   Published online August 2, 2018
DOI: https://doi.org/10.4178/epih.e2018036
  • 17,711 View
  • 377 Download
  • 80 Web of Science
  • 95 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The incidence and mortality rates of tuberculosis (TB) in the Republic of Korea are 77 and 5.2 per 100,000 people, respectively (2016), which are the highest among the member countries of the Organization for Economic Cooperation and Development. Recently, the incidence of TB among teens and individuals in their 20s in the Republic of Korea decreased significantly. The decrease is largely attributed to the TB screening and contact investigation efforts targeting schools over the past few years. However, the incidence of TB among elderly individuals remains high, and it is even increasing compared to that in the past 10 years. Older individuals account for 42% of all TB cases and 82% of TB-related deaths. The success rate of TB treatment in the Republic of Korea has gradually increased due to various programs, such as control of non-compliance, insurance coverage for TB diagnosis and treatment, and TB public–private mix models. This study suggests that policy makers should focus their efforts on policies that prioritize a significant reduction in the incidence of TB based on the 2nd National Strategic Plan for Tuberculosis Control (2018–2022).
Summary
Korean summary
2016년 한국의 결핵 발생률은 인구 10만명당 77명이고, 결핵 사망률은 인구 10만명당 5.2명으로 경제협력개발기구(OECD) 회원국 중 가장 높은 수준이다. 본 연구는 지난 수 십 년간 한국의 결핵 발생률, 유병률 및 사망률의 변화 추이와 그간 한국 정부가 시행해 온 다양한 결핵 관리 정책들을 분석하고 향후 개선방안을 제시하고자 하였다.

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Original Articles
The coverage rates for influenza vaccination and related factors in Korean adults aged 50 and older with chronic disease: based on 2016 Community Health Survey data
Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi
Epidemiol Health. 2018;40:e2018034.   Published online July 24, 2018
DOI: https://doi.org/10.4178/epih.e2018034
  • 12,169 View
  • 219 Download
  • 11 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to identify the coverage rates for influenza vaccination and related factors depending on chronic disease in Korean adults aged 50 and older.
METHODS
The 2016 Korea Community Health Survey was used for analysis. Chi-square test was performed to investigate the coverage rates for influenza vaccination depending on chronic disease, and a multiple logistic regression analysis was used to identify the factors associated with influenza vaccination, by chronic disease.
RESULTS
In men with ≥1 chronic disease, 39.8% of 50-64 years of age, and 86.8% of elderly (over 65 years of age) received influenza vaccination. In women with ≥1 chronic disease, 58.7% of 50-64 years of age, and 89.9% of elderly (over 65 years of age) received influenza vaccination (p<0.001). The chronic diseases associated with influenza vaccination were hypertension (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19 to 1.37), diabetes (OR, 1.41; 95% CI, 1.28 to 1.55) in men aged 50-64, hypertension (OR, 1.34; 95% CI, 1.20 to 1.49), diabetes (OR, 1.17; 95% CI, 1.02 to 1.33), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.07 to 1.60) in elderly (over 65 years of age). In women aged 50-64, hypertension (OR, 1.39; 95% CI, 1.30 to 1.49), diabetes (OR, 1.51; 95% CI, 1.35 to 1.68), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.05 to 1.64), and hypertension (OR, 1.55; 95% CI, 1.40 to 1.71), diabetes (OR, 1.27; 95% CI, 1.12 to 1.43) in elderly (over 65 years of age).
CONCLUSIONS
Populations in aged 50-64 are recommendation subject for vaccination or classified as high-risk group in case with chronic disease. Though subject over 60 years old is age close to the elderly, the coverage rates for vaccination was low. It is necessary to devise strategies to raise the coverage rates for vaccination.
Summary
Korean summary
매년 인플루엔자 환자수는 증가하는 추세이며 인플루엔자로 인한 의료이용의 질병부담은 커질 것으로 생각된다. 국내에서는 우선접종 권장대상자들에게 예방접종을 받도록 권고하고 있으며, 예방접종은 인플루엔자를 예방할 수 있는 비용 효과적인 방법이다. 65세 이상 대상자는 국가 무료 예방접종 사업 대상으로 인해 예방접종률이 높은 것으로 확인되었다. 50-64세 인구는 예방접종 권고 대상자임에도 불구하고 낮은 것으로 나타났고, 50-64세 연령에서 만성질환을 동반할 경우 고위험군이지만 여전히 낮은 예방접종률을 보였다. 또한 50-64세 연령에서 1개 이상 만성질환을 동반할 경우 대도시, 중소도시에 거주하는 것보다 군지역에 거주할 경우 높은 예방접종률을 확인함으로써 대도시 및 중소도시에 거주하는 50-64세 연령에 대해 예방접종률을 올릴 수 있는 적극적인 예방접종 홍보가 필요할 것으로 생각한다.

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Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
Epidemiol Health. 2018;40:e2018005.   Published online February 27, 2018
DOI: https://doi.org/10.4178/epih.e2018005
  • 29,560 View
  • 439 Download
  • 28 Web of Science
  • 31 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.
METHODS
In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.
RESULTS
Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.
CONCLUSIONS
Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
Summary
Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.

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  • Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey
    Sav Zwickl, Alex Wong, Ingrid Bretherton, Max Rainier, Daria Chetcuti, Jeffrey D. Zajac, Ada S. Cheung
    International Journal of Environmental Research and Public Health.2019; 16(24): 5088.     CrossRef
Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
Epidemiol Health. 2017;39:e2017046.   Published online October 19, 2017
DOI: https://doi.org/10.4178/epih.e2017046
  • 51,736 View
  • 361 Download
  • 19 Web of Science
  • 18 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.
METHODS
The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).
RESULTS
Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.
CONCLUSIONS
The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Summary
Korean summary
본 연구는 만 19세 이상의 한국 성인 동성애자와 양성애자를 대상으로 이들의 건강상태에 대한 설문조사를 시행하고, 수집한 자료를 분석하여 동성애자·양성애자의 건강불평등 실태를 파악하고자 하였다. 본 연구의 목적은 자가평가건강, 정신건강(우울, 자살생각 및 자살시도), 신체적 건강(근골격계 통증) 및 건강관련행동(흡연율, 위험음주율)을 포함하여 다양한 측면에서 한국 성인 동성애자·양성애자와 일반인구집단의 건강수준을 비교하는 것이다.

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    Hyemin Lee, Don Operario, Madina Agénor, Horim Yi, Sungsub Choo, Seung-Sup Kim
    AIDS Care.2023; 35(5): 672.     CrossRef
  • Experiences of conflict, non-acceptance and discrimination are associated with poor mental well-being amongst LGBTQ-identified individuals in Singapore
    Gerard W. Toh, Wee Ling Koh, Jack Ho, Jackson Chia, Ad Maulod, Irene Tirtajana, Peter Yang, Mathia Lee
    Equality, Diversity and Inclusion: An International Journal.2023; 42(5): 625.     CrossRef
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    Dong-Jin Kim, Na-Hyun Hwang, Ji Yoon Lee, Seung Ha Park, Byung-Il Lee, Eul-Sik Yoon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    International Journal of Transgender Health.2023; : 1.     CrossRef
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    Biao Zhu, Chenchang Xiao, Changmian Ding, Hong Yan, Liyin Wang, Qingqing Jiang, Jiawei Tian, Liqing Wei
    BMC Women's Health.2023;[Epub]     CrossRef
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    Eunha Kim, Haebeen Kim, Kahee Lee
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  • Association between Discrimination and Depressive Symptoms Among 2,162 Lesbian, Gay, and Bisexual Adults in South Korea: Does Community Connectedness Modify the Association?
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    International Journal of Environmental Research and Public Health.2021; 18(4): 2115.     CrossRef
  • Sexual Orientation Change Efforts, Depressive Symptoms, and Suicidality Among Lesbian, Gay, and Bisexual Adults: A Cross-Sectional Study in South Korea
    Hyemin Lee, Carl G. Streed, Horim Yi, Sungsub Choo, Seung-Sup Kim
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    David Adzrago, Ikponmwosa Osaghae, Nnenna Ananaba, Sylvia Ayieko, Pierre Fwelo, Nnabuchi Anikpezie, Donna Cherry
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    Hyemin Lee, Don Operario, Jacob J. van den Berg, Horim Yi, Sungsub Choo, Seung-Sup Kim
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Epidemiologic characteristics of scrub typhus on Jeju Island
Sung Uk Lee
Epidemiol Health. 2017;39:e2017039.   Published online August 18, 2017
DOI: https://doi.org/10.4178/epih.e2017039
  • 12,910 View
  • 211 Download
  • 1 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Scrub typhus is the most common febrile disease in Korea during the autumn. Jeju Island is the largest island in South Korea and has a distinctive oceanic climate. This study aimed to identify epidemiologic characteristics of scrub typhus on Jeju Island.
METHODS
From January 2011 to December 2016, 446 patients were diagnosed with scrub typhus on Jeju Island. The patients’ personal data and the environmental factors that might be related to scrub typhus were investigated and retrospectively analyzed.
RESULTS
The median age of the patients was 58-years-old (range, 8 to 91) and 43% of them worked in the agricultural, forestry or livestock industry. Regardless of their job, 87% of the patients had a history of either working outdoors or of other activities before developing scrub typhus. The south and southeast regions of Jeju Island, especially Namwon-eup, showed the highest incidence of scrub typhus. Workers in mandarin orange orchards seemed to be the highest risk group for scrub typhus infection.
CONCLUSIONS
Scrub typhus on Jeju Island showed unique characteristics. To efficiently prevent scrub typhus, each year individual regional approaches should be developed based on the epidemiologic characteristics of the disease.
Summary
Korean summary
쯔쯔가무시증은 진드기에 의해 감염되는 대표적인 가을철 발열성 질환이다. 제주 지역에서 발생하는 쯔쯔가무시증의 역학적 특성을 분석한 결과 제주도의 남, 남동쪽이 다발생 지역으로 나타났다. 또한 이 지역의 감귤 농업이 쯔쯔가무시증이 발생할 수 있는 주요 위험요인인 것으로 추정된다.

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  • Re-emergence of scrub typhus in Zhejiang Province, southern China: A 45-year population-based surveillance study
    Jiangping Ren, Jimin Sun, Zhengting Wang, Feng Ling, Xuguang Shi, Rong Zhang, Ying Liu, Zhiping Chen, Enfu Chen
    Travel Medicine and Infectious Disease.2019; 32: 101427.     CrossRef
  • Distribution of Chigger Mites as Tsutsugamushi Vectors Sampled in Seogwipo
    Hyeok Jae Lee, Chul Park
    The Korean Journal of Clinical Laboratory Science.2019; 51(3): 344.     CrossRef
  • Epidemiologic characteristics of scrub typhus on Jeju Island
    Sung Uk Lee
    Epidemiology and Health.2018; 39: e2017060r.     CrossRef
  • Awareness and Work-Related Factors Associated with Scrub Typhus: A Case-Control Study from South Korea
    Dong-Seob Kim, Dilaram Acharya, Kwan Lee, Seok-Ju Yoo, Ji-Hyuk Park, Hyun-Sul Lim
    International Journal of Environmental Research and Public Health.2018; 15(6): 1143.     CrossRef
  • Epidemiological characteristics of scrub typhus on the Jeju Island
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Epidemiologic Investigation
Epidemiologic research on lung damage caused by humidifier disinfectants
Moo-Song Lee, Hwa Jung Kim
Epidemiol Health. 2016;38:e2016031.   Published online July 20, 2016
DOI: https://doi.org/10.4178/epih.e2016031
  • 15,687 View
  • 275 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.
Summary
Korean summary
본 역학조사는 일개 병원에서 신고한 질병 유행에 대해 다학제적 연구 결과로써, 질병의 임상적 특성과 역학적 원인 파악 후 정책적 대책으로 이어진 사례이다. 향후 가습기 살균제 이외에도 일반국민의 건강에 영향을 미칠 수 있는 다양한 생활환경요인에 관심을 가지고, 필요 시 적극적인 조사와 대응이 필요할 것이다.

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  • Evaluation of polyhexamethylene guanidine-induced lung injuries by chest CT, pathologic examination, and RNA sequencing in a rat model
    Cherry Kim, Sang Hoon Jeong, Jaeyoung Kim, Ki Yeol Lee, Jaehyung Cha, Chang Hyun Lee, Eun-Kee Park, Ju-Han Lee
    Scientific Reports.2021;[Epub]     CrossRef
  • Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury
    Soyeoun Lim, Jong Han Leem, Young-Seoub Hong, Jungwon Kim, Soyoung Park, Joon-Sung Joh, Woon-Jung Kwon, Yangho Kim
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial cells
    Yong Joo Park, Mi Ho Jeong, In Jae Bang, Ha Ryong Kim, Kyu Hyuck Chung
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    Jae Hong Shin, Byeong Hun Lee, Sung Kwang Lee
    Bulletin of the Korean Chemical Society.2019; 40(8): 819.     CrossRef

Epidemiol Health : Epidemiology and Health