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COVID-19: Original Article
Changes in eating behaviors according to household income in adolescents during the COVID-19 pandemic: findings from the Korea National Health and Nutrition Examination Survey
Hye Ah Lee, Ho Jung Lee, Bomi Park, Yoonhee Shin, Hyunjin Park, Hyesook Park
Epidemiol Health. 2022;44:e2022102.   Published online November 9, 2022
DOI: https://doi.org/10.4178/epih.e2022102
  • 4,247 View
  • 132 Download
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To assess social inequalities in changes in dietary behaviors among adolescents during the coronavirus disease 2019 (COVID-19) pandemic, we compared changes in dietary behavior indicators by household income.
METHODS
Using cross-sectional data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, the prevalence of dietary behaviors in adolescents (12-18 years old) was estimated and changes in dietary behaviors during the COVID-19 pandemic were evaluated. We assessed changes in dietary behaviors with a household income (as a measure of socioeconomic status, SES) disparity.
RESULTS
During the COVID-19 pandemic, the average consumption of vegetables decreased and food insecurity worsened. Adolescents were more likely to skip breakfast than before COVID-19 (33.1 and 37.4%). Soft drink consumption also increased in 2020 from 2019 (7.6 and 14.8%), especially among boys. Average sugar intake and sodium intake showed a tendency to decrease only in girls, but there was no significant difference according to SES level. Skipping breakfast was particularly evident in the low-SES group, and the difference according to household income level (high vs. low) was greater during COVID-19 than before. The prevalence of soft drink consumption increased significantly in the low-SES group, but the rate of increase did not differ by SES level.
CONCLUSIONS
We found that the social disparity in skipping breakfast was further aggravated during the COVID-19 pandemic. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.
Summary
Korean summary
국민건강영양조사 자료를 활용하여, COVID-19 팬데믹 전후 청소년의 식생활 변화 및 가구소득 수준에 따른 차이를 평가하였다. 대체로, 평균 채소 섭취량은 감소하고 탄산음료 소비는 증가한 것으로 나타났으며, 아침식사 결식율도 약간 증가한 것으로 나타났다. 게다가, 가구소득 수준에 따라 평가하였을 때, 아침식사 결식율 증가는 가구소득이 높은 군에 비해 가구소득 수준이 낮은 군에서 두드러진 것으로 나타났다. COVID-19 팬데믹이 장기화됨에 따라, 청소년의 식생활 변화에 대해서는 지속적인 모니터링이 필요하다.
Key Message
Using data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, changes in dietary behaviors of adolescents (12-18 years old) during the COVID-19 pandemic were evaluated. During the COVID-19 pandemic, average consumption of vegetables decreased and consumption of soft drinks increased in 2020 from 2019 (7.6% and 14.8%). In addition, the social disparity in skipping breakfast among adolescents was further aggravated. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.

Citations

Citations to this article as recorded by  
  • Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review
    Nicolas Woods, Jamie A Seabrook, Holly Schaafsma, Shauna Burke, Trish Tucker, Jason Gilliland
    The Journal of Nutrition.2024;[Epub]     CrossRef
  • Analysis of health behavior, mental health, and nutritional status among Korean adolescents before and after COVID-19 outbreak: based on the 2019–2020 Korea National Health and Nutrition Examination Survey
    Misun Lee, Sarang Jeong, Chong-Su Kim, Yoon Jung Yang
    Journal of Nutrition and Health.2023; 56(6): 667.     CrossRef
Original Article
Income-based disparities in the risk of distant-stage cervical cancer and 5-year mortality after the introduction of a National Cancer Screening Program in Korea
Erdenetuya Bolormaa, Seung-Ah Choe, Mia Son, Myung Ki, Domyung Paek
Epidemiol Health. 2022;44:e2022066.   Published online August 11, 2022
DOI: https://doi.org/10.4178/epih.e2022066
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  • 148 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study assessed the socioeconomic gradient in the risk of distant-stage cervical cancer (CC) at presentation and 5-year mortality for new CC patients after the introduction of a national Cancer Screening Program (NCSP) in Korea.
METHODS
All new CC cases from 2007 to 2017 were retrieved from the Korea Central Cancer Registry database linked with the National Health Information Database of the National Health Insurance Service. The age-standardized cumulative incidence of CC, adjusted odds ratios (ORs) of distant metastasis at presentation, and adjusted all-cause mortality hazard ratios (HRs) within 5 years post-diagnosis were assessed according to the income gradient.
RESULTS
The 11-year age-standardized cumulative incidence of CC ranged from 48.9 to 381.5 per 100,000 women, with the richest quintile having the highest incidence. Of 31,391 new cases, 8.6% had distant metastasis on presentation, which was most frequent among Medical Aid beneficiaries (9.9%). Distant-stage CC was more likely when the income level was lower (OR, 1.46; 95% confidence interval [CI]), 1.28 to 1.67 for the lowest compared to the richest) and among Medical Aid beneficiaries (OR, 1.50; 95% CI, 1.24 to 1.82). The 5-year mortality was greater in the lower-income quintiles and Medical Aid beneficiaries than in the richest quintile.
CONCLUSIONS
The incidence of CC was higher in the richest quintile than in the lower income quintiles, while the risk of distant-stage CC and mortality was higher for women in lower income quintiles in the context of the NCSP. A more focused approach is needed to further alleviate disparities in the timely diagnosis and treatment of CC.
Summary
Korean summary
새로이 자궁경부암을 진단받은 여성에서 소득수준에 따른 진단시 원격 전이가 있을 위험도와 진단 이후 5년 사망위험도를 연령과 체질량 지수등의 개인 수준의 위험 요인을 보정하여 구했다. 소득 수준이 낮을수록, 의료급여 환자일수록 진단시 원격 전이가 있을 위험과 5년 내 사망 위험이 높은 것으로 나타났다. 자궁경부암에 대한 전국민 대상 선별 검사가 있지만 여전히 소득 수준에 따른 자궁경부암의 적시 진단과 진단 후 생존의 불평등이 남아 있으며 이에 대한 추가 정책이 필요하다.
Key Message
This study adds empirical evidence for an income-based disparity in the cancer stage at presentation and five-year survival among cervical cancer patients even in the presence of a universal screening program.

Citations

Citations to this article as recorded by  
  • Individual and joint effect of socioeconomic status and lifestyle factors on cancer in Korea
    Chi Lan Tran, Kui Son Choi, Sun‐Young Kim, Jin‐Kyoung Oh
    Cancer Medicine.2023; 12(16): 17389.     CrossRef
  • Menopausal hormone therapy and risk of dementia: health insurance database in South Korea-based retrospective cohort study
    Jin-Sung Yuk, Jin San Lee, Joong Hyun Park
    Frontiers in Aging Neuroscience.2023;[Epub]     CrossRef
  • Disparities in Cancer Incidence across Income Levels in South Korea
    Su-Min Jeong, Kyu-Won Jung, Juwon Park, Nayeon Kim, Dong Wook Shin, Mina Suh
    Cancers.2023; 15(24): 5898.     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
  • 6,928 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
Secular trends and related factors in leisure-time sedentary behavior among Koreans: an analysis of data from the 2011-2017 Korea Community Health Survey
Hyun-Ju Seo, Min-Jung Choi, Soon-Ki Ahn
Epidemiol Health. 2022;44:e2022023.   Published online February 14, 2022
DOI: https://doi.org/10.4178/epih.e2022023
  • 9,407 View
  • 415 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Sedentary behavior has gradually increased and has become a public health problem. Therefore, this study investigated trends in weekday leisure-time sedentary behaviors, as well as characteristic socio-demographic and lifestyle correlates in Korean adults.
METHODS
We analyzed data from 914,946 adults aged ≥19 years who participated in the Korea Community Health Survey (2011, 2013, 2015, and 2017). Leisure-time sedentary behavior was categorized as a binary variable (<4 and ≥4 hr/day). Multivariable regression analysis was used to model the prevalence of sedentary behavior and estimate odds ratios.
RESULTS
The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women between 2011 and 2017, respectively. However, a significant increase was observed in subjects with an education lower than high school in both genders (β coefficient=0.12 for men and 0.08 for women, p for trend <0.001). Women in the lowest household income level (β coefficient=0.08, p for trend=0.001) and with poor subjective health status (β coefficient=0.05, p for trend=0.013) showed an increasing trend. Other factors associated with sedentary behavior were age, education level, body mass index, household income, walking activity, perceived stress level, and subjective health status in both genders.
CONCLUSIONS
Identifying the secular trends and correlates of sedentary behavior by gender and associated factors will provide empirical evidence for developing public health campaigns and promotion programs to reduce sedentary behavior in Koreans.
Summary
Korean summary
본 연구는 지역사회건강조사에서 2011년부터 2017년까지 격년으로 수집된 성인의 좌식행동에 대한 시간적 추세와 관련 요인에 대해 분석한 시계열 단면연구이다. 분석결과, 주중 여가시간에 4시간 이상 앉아 있는 경우는 남성의 경우 15.2%에서 14.4%로, 여성의 경우 16.6%에서 16.0%로 감소되었다. 그러나, 남녀 모두에서 노인인 경우, 중졸 이하의 학력을 가진 경우, 소득수준이 월 100만원 미만인 경우, 주관적 건강상태가 부정적인 경우 좌식행동이 증가하였다. 따라서, 본 연구에서 나타난 좌식행동 관련 요인을 가진 대상자를 목표집단으로 한 건강증진 및 공중보건 캠페인이 개발 및 실행될 필요가 있다.
Key Message
This study is a serial cross-sectional study analyzing the temporal trend and related factors of sedentary behavior of adults using KCHS collected biennially from 2011 to 2017. The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women, respectively. However, elderly, subjects with an education lower than high school, with the lowest household income level, and with poor subjective health status showed an increasing sedentary behavior trend. These findings suggest that health promotion and public health campaigns are need to reduce the prevalence of sedentary behavior in population with related factors.

Citations

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  • Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006–2020)
    Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
    Journal of Epidemiology and Community Health.2023; 77(6): 355.     CrossRef
Gender difference in socioeconomic factors affecting suicidal ideation and suicidal attempts among community-dwelling elderly: based on the Korea Community Health Survey
Jin-Young Jeong
Epidemiol Health. 2020;42:e2020052.   Published online July 13, 2020
DOI: https://doi.org/10.4178/epih.e2020052
  • 11,145 View
  • 231 Download
  • 4 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study was performed to explore socioeconomic factors associated with suicidal ideation and suicidal attempts among the local community’s resident elderly.
METHODS
The subjects included 129,277 participants aged 65 years or above of the Korea Community Health Survey conducted in 2013 and 2017. Based on the questions for suicidal ideation and suicidal attempts, the subjects were divided into a no suicidal ideation group (n=111,344), a suicidal ideation group (n=17,487), and a suicidal attempt group (n=446). All analyses were stratified by gender, and a complex sample logistic regression analysis was performed to analyze associated factors. SAS version 9.4 was used for all analyses with a significance level of 0.05.
RESULTS
Common factors associated with suicidal ideation in both genders included marital status, frequency of contact with friends, social activity, and average monthly household income. Economic activity was demonstrated as relevant only to the elderly men subjects. According to the analysis, factors associated with suicidal attempts were the recipients of the National Basic Living Security Act for the elderly men compared to age, frequency of contact with family, frequency of contact with friends, and average monthly household income for the elderly women.
CONCLUSIONS
The study revealed that socioeconomic factors leading to suicidal ideation were similar in the elderly of both genders, while a difference was demonstrated for factors associated with suicidal attempts between the elderly of both genders. It is expected that the results of this study may be used as the basis for screening the local community’s elderly with a high suicidal risk, and in the development of suicide prevention services.
Summary
Korean summary
2013년과 2017년 지역사회건강조사에 참여한 129,277명의 노인을 대상으로 자살시도에 관련된 사회-경제적 요인을 탐색하였다. 분석결과, 남성 노인의 자살시도 관련요인은 국민기초생활수급자, 여성 노인의 자살시도 관련요인은 연령, 가족접촉빈도, 친구접촉빈도, 그리고 월평균가구소득으로 나타났다. 본 결과가 지역사회 거주 노인의 자살 고위험군 선별 및 자살 예방서비스 개발에 기초자료로 활용되기를 기대한다.

Citations

Citations to this article as recorded by  
  • A systematic review of psychosocial protective factors against suicide and suicidality among older adults
    Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
    International Psychogeriatrics.2024; : 1.     CrossRef
  • Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults
    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
    Archives of Public Health.2021;[Epub]     CrossRef
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
  • 12,607 View
  • 186 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract 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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  • 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
The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)
Mili Dutta, Y Selvamani, Pushpendra Singh, Lokender Prashad
Epidemiol Health. 2019;41:e2019050.   Published online December 18, 2019
DOI: https://doi.org/10.4178/epih.e2019050
  • 14,369 View
  • 304 Download
  • 32 Web of Science
  • 37 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.
METHODS
Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.
RESULTS
The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.
CONCLUSIONS
In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.
Summary

Citations

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  • Variations in adult BMI among Indian men: a quantile regression analysis
    Archana Agnihotri, Brinda Viswanathan
    Journal of Biosocial Science.2024; 56(2): 251.     CrossRef
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    Watchara Pechdin, Pongsun Bunditsakulchai
    Frontiers in Sustainable Food Systems.2024;[Epub]     CrossRef
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    Shivam Dubey
    IP Journal of Nutrition, Metabolism and Health Science.2024; 6(4): 157.     CrossRef
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    M. S. Harish, Axay Bhuker, Bhagirath Singh Chauhan
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    Sourav Chowdhury, Nuruzzaman Kasemi, Aditya Singh, Mahashweta Chakrabarty, Shivani Singh
    Children and Youth Services Review.2023; 145: 106796.     CrossRef
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    Neha Chauhan, Poojan Dogra, Reena Sharma, Shashi Kant, Mridul Soni
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    Melissa F. Young, Emily C. Faerber, Rukshan V. Mehta, Samriddhi Ranjan, Sweekruthi A. Shetty, Usha Ramakrishnan, Kannan Rangiah, Beena Bose, Sarita Devi, Pratibha Dwarkanath, Anura V. Kurpad, Sunita Taneja, Reynaldo Martorell
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    K. C. Megha, Y. A. Nanja Reddy, D. C. Hanumanthappa
    Plant Physiology Reports.2023; 28(2): 199.     CrossRef
  • Burden of tuberculosis & malaria among tribal populations & implications for disease elimination in India
    Jai Prakash Narain, Amar N. Shah, Rajesh Bhatia
    Indian Journal of Medical Research.2023; 157(2&3): 163.     CrossRef
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    Koel Mukherjee, Pulamaghatta N. Venugopal, Kaustav Das
    Human Biology and Public Health.2023;[Epub]     CrossRef
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    Laxmi Kant Dwivedi, Parul Puri, Anjali Pant, Alka Chauhan, Samuel Scott, Shrikant Singh, Sarang Pedgaonker, Phuong H. Nguyen
    Current Developments in Nutrition.2023; 7(9): 101987.     CrossRef
  • Rural-urban disparities in nutritional status among women in Ethiopia based on HIV serostatus: a cross-sectional study using demographic and health survey data
    Hirut Abebe, Anette Agardh, Malachi Ochieng Arunda
    BMC Infectious Diseases.2023;[Epub]     CrossRef
  • Evaluation of a results-based financing nutrition intervention for tuberculosis patients in Madhya Pradesh, India, implemented during the COVID-19 pandemic
    Embry Howell, Rama Rao Dammala, Pratibha Pandey, Darcy Strouse, Atul Sharma, Neeta Rao, Sudheer Nadipally, Amar Shah, Varsha Rai, Russell Dowling
    BMC Global and Public Health.2023;[Epub]     CrossRef
  • Not Hungry, but Still Snacking: The Association Between Hedonic Hunger and Snacking Behaviour Among Young Adults in Vadodara, Gujarat
    Margi Mankad, Devaki Gokhale
    Cureus.2023;[Epub]     CrossRef
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    Saurabh Singh, Neha Shri, Akancha Singh
    Scientific Reports.2023;[Epub]     CrossRef
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    Bina Agarwal
    Economia Politica.2022; 39(1): 31.     CrossRef
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    A. Bose, N. Mondal, J. Sen
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    Geetika Madan Patel, Dhara I Zalavadiya, Ankita Parmar
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  • Factors associated with double burden of malnutrition among mother-child pairs in India: A study based on National Family Health Survey 2015–16
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  • Intra-Individual Double Burden of Malnutrition among Adults in China: Evidence from the China Health and Nutrition Survey 2015
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  • Screening of cardiovascular risk assessment accuracy of anthropometric indices in Indian children and adolescents
    Mohit Aggarwal, Shailendra Singh, Anubhuti Bansal, Bapu Koundinya Desiraju, Anurag Agrawal
    Wellcome Open Research.2020; 5: 273.     CrossRef
Alcohol-related emergency department visits and income inequality in New York City, USA: an ecological study
Kathleen H. Reilly, Katherine Bartley, Denise Paone, Ellenie Tuazon
Epidemiol Health. 2019;41:e2019041.   Published online October 8, 2019
DOI: https://doi.org/10.4178/epih.e2019041
  • 10,511 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.
METHODS
The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.
RESULTS
There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate.
CONCLUSIONS
This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.
Summary

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    He Chen, Jing Ning, Hongwei Hu, Haotian He
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  • Inequality's on Tap: A Longitudinal Study of Area-Level Income Inequality and Alcohol Consumption Among Canadian Adolescents
    Samuel A.J. Lowe, Sujan Basnet, Scott T. Leatherdale, Karen A. Patte, Roman Pabayo
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    Zhen Yu, Keming Yu, Wolfgang K. Härdle, Xueliang Zhang, Kai Wang, Maozai Tian
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Individual and regional factors associated with suicidal ideation among Korean elderly: a multilevel analysis of the Korea Community Health Survey
Sang Hee Jeong, Byung Chul Chun
Epidemiol Health. 2019;41:e2019022.   Published online May 26, 2019
DOI: https://doi.org/10.4178/epih.e2019022
  • 11,148 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the individual and regional characteristics that influence suicidal ideation among the Korean elderly population.
METHODS
Using data collected from the 2013 Korea Community Health Survey, a multilevel analysis was performed to establish an understanding of individual behavioral patterns and regional influences on suicidal ideation.
RESULTS
Among the 77,407 individuals sampled, 11,236 (14.5%) elderly people over 60 years of age experienced suicidal ideation. Among individual factors, age, frequency of communication with friends, religious activity, social activity, leisure activity, trust in neighbors, subjective stress level, depressive symptoms, and subjective health status were significantly associated with suicidal ideation. The results showed that the lower the regional deprivation level, the higher the suicidal ideation odds ratio. In terms of regional size, the most significant effects were found in rural areas.
CONCLUSIONS
This study suggested that suicidal ideation in the elderly is associated with community factors, such as the regional deprivation index, as well as personal factors.
Summary
Korean summary
본 연구는 60세 이상 연령의 개인 요인에 따른 자살 생각에 영향을 미치는 요인과 지역 요인을 모두 반영하여 자살 생각에 영향을 미치는 요인을 파악하는 것으로 지역사회건강조사에 응답한 60대 이상 노인 77,407명 중 11,236(14.5%)명을 표본대상으로 선정하여 노인의 자살생각 가능성과 관련된 개인의 행태와 지역 또는 집단에서 영향력을 파악하기 위한 다수준 분석을 실시하였다. 결과적으로 본 연구는 60세이상의 노인에서 자살 생각에 개인적 요인 뿐 아니라 지역박탈지수와 같은 지역 요인이 관여한다는 점을 시사한다.

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  • A systematic review of psychosocial protective factors against suicide and suicidality among older adults
    Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
    International Psychogeriatrics.2024; : 1.     CrossRef
  • Effects of health-related quality of life and long-term care insurance infrastructure on suicidal ideation among older Korean adults
    Changsook Lee, Sun-Young Heo
    Asia Pacific Journal of Social Work and Development.2023; 33(2): 101.     CrossRef
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    Han Zhou, Dong Han, Haisen Zhou, Xinfeng Ke, Dongdong Jiang
    Heliyon.2023; 9(10): e21141.     CrossRef
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    Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
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    Hyunjin Son, Changhoon Kim
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    Chae Eun Yong, Young Bum Kim, Jiyoung Lyu
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Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues
Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee
Epidemiol Health. 2019;41:e2019005.   Published online February 13, 2019
DOI: https://doi.org/10.4178/epih.e2019005
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.
METHODS
Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.
RESULTS
Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.
CONCLUSIONS
Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.
Summary
Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음. 경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남. 19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.

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    Chi-Young Lee, Eun-Ok Im
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Income-related inequality in completed suicide across the provinces of Iran
Mohammad Hassan Kazemi-Galougahi, Asieh Mansouri, Samaneh Akbarpour, Mahmood Bakhtiyari, Majid Sartipi, Rahmatollah Moradzadeh
Epidemiol Health. 2018;40:e2018012.   Published online April 2, 2018
DOI: https://doi.org/10.4178/epih.e2018012
  • 11,946 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran.
METHODS
This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran.
RESULTS
The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06).
CONCLUSIONS
This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.
Summary

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    International Journal of Environmental Research and Public Health.2023; 20(7): 5256.     CrossRef
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    Taynara Lais Silva, Thatiana Araújo Maranhão, George Jó Bezerra Sousa, Isaac Gonçalves da Silva, José Claudio Garcia Lira Neto, Geovana Almeida dos Santos Araujo
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Decomposing Gender Disparity in Total Physical Activity among Iranian Adults
Ebrahim Rahimi, Seyed Saeed Hashemi-Nazari, Koorosh Etemad, Hamid Soori
Epidemiol Health. 2017;39:e2017044.   Published online October 16, 2017
DOI: https://doi.org/10.4178/epih.e2017044
  • 11,922 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
While gender differences in physical activity (PA) have been reported, their origin is not well understood. The present study aimed to identify factors contributing to this disparity.
METHODS
This was a population-based cross-sectional study based on the 2011 surveillance of risk factors of non-communicable diseases that was conducted among Iranian adults. Multi-staged sampling was performed to obtain the required study sample. The primary outcome was gender differences in the prevalence of sufficient physical activity (SPA). Total physical activity (TPA) was calculated as metabolic equivalents (MET) per minute during a typical week, as recommended by the World Health Organization. On this basis, achieving 600 MET-min/wk or more was defined as SPA. The nonlinear Blinder-Oaxaca decomposition technique was used to explain the disparity.
RESULTS
The predicted gap was 19.50%. About one-third of the gap was due to differences in the level of observable covariates. Among them, work status contributed the most (29.61%). A substantial portion of the gap remained unexplained by such differences, of which about 40.41% was related to unobservable variables. The differential effects of standard of living, ethnicity, and smoking status made the largest contribution, accounting for 37.36, 35.47, and 28.50%, respectively.
CONCLUSIONS
Interventions to reduce the gender gap in PA should focus on increasing TPA among housewives and women with chronic diseases, as well as those with a higher standard of living. In addition, it is essential to explore the impact of ethnicity and smoking status on women’s TPA in order to promote health.
Summary

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  • Perioperative Exercise Intention and Influencing Factors: A Multi-Centered Cross-Sectional Study
    Feng Lv, Yuxi Zhang, Su Min, Ping Li, Lihua Peng, Li Ren, Jian Yu, Bin Wang, Yiwei Shen, Shanshan Tong, Juying Jin, Xi Luo, Jing Chen, Yingrui Chen, Yuanyuan Li, Jin Chen, Xing Zeng, Fuquan Luo, Qiuju Xiong, Lei Zou, Yuanyuan Guo, Jun Cao, Qibin Chen, Bin
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  • Health-Related Quality of Life and Physical Activity in a Community Setting
    Marta Gil-Lacruz, Ana Isabel Gil-Lacruz, Paola Domingo-Torrecilla, Miguel Angel Cañete-Lairla
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    Ebrahim Rahimi, Seyed Saeed Hashemi Nazari
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Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea
Ikhan Kim, Jinwook Bahk, Sung-Cheol Yun, Young-Ho Khang
Epidemiol Health. 2017;39:e2017011.   Published online March 15, 2017
DOI: https://doi.org/10.4178/epih.e2017011
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To examine the income gaps associated with self-rated poor health at the district level in Korea and to identify the geographical correlations between self-rated poor health, life expectancy, and the associated income gaps.
METHODS
We analyzed data for 1,578,189 participants from the Community Health Survey of Korea collected between 2008 and 2014. The age-standardized prevalence of self-rated poor health and the associated income gaps were calculated. Previously released data on life expectancy and the associated income gaps were also used. We performed correlation and regression analyses for self-rated poor health, life expectancy, and associated income gaps.
RESULTS
Across 245 districts, the median prevalence of self-rated poor health was 15.7% (95% confidence interval [CI], 14.6 to 16.8%), with interquartile range (IQR) of 3.1 percentage points (%p). The median interquintile gaps in the prevalence of self-rated poor health was 11.1%p (95% CI, 8.1 to 14.5%p), with IQR of 3.6%p. Pro-rich inequalities in self-rated health were observed across all 245 districts of Korea. The correlation coefficients for the association between self-rated poor health and the associated income gaps, self-rated poor health and life expectancy, and income gaps associated with self-rated poor health and life expectancy were 0.59, 0.78 and 0.55 respectively.
CONCLUSIONS
Income gaps associated with self-rated poor health were evident across all districts in Korea. The magnitude of income gaps associated with self-rated poor health was larger in the districts with greater prevalence of self-rated poor health. A strong correlation between self-rated poor health and life expectancy was also observed.
Summary
Korean summary
본 연구에서는 우리나라 245개 시군구의 자가평가 불건강 유병률의 소득수준 간 격차 크기를 규명하고, 시군구 단위 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 및 기대수명의 소득수준 간 격차의 상관성에 대하여 분석하였다. 연구 결과, 우리나라 245개 모든 시군구에서 자가평가 불건강 유병률에서의 저소득층에 불리한 불평등이 존재하였다. 또한, 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 그리고 자가평가 불건강 유병률의 소득수준 간 격차와 기대수명의 소득수준 간 격차는 높은 상관성이 나타났다. 이 연구는 지방정부 차원에서 건강 형평성 현황에 관한 유의미한 정보를 제공하여 지역별 보건정책 수립의 근거로 활용할 수 있다는데 의의를 찾을 수 있다.

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Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis
Asieh Mansouri, Mostafa Amini Rarani, Mosayeb Fallahi, Iman Alvandi
Epidemiol Health. 2017;39:e2017005.   Published online February 1, 2017
DOI: https://doi.org/10.4178/epih.e2017005
  • 16,386 View
  • 278 Download
  • 15 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS.
METHODS
Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index.
RESULTS
The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (−11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality.
CONCLUSIONS
The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.
Summary

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The burden of infectious and cardiovascular diseases in India from 2004 to 2014
Kajori Banerjee, Laxmi Kant Dwivedi
Epidemiol Health. 2016;38:e2016057.   Published online December 14, 2016
DOI: https://doi.org/10.4178/epih.e2016057
  • 15,213 View
  • 259 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
In India, both communicable and non-communicable diseases have been argued to disproportionately affect certain socioeconomic strata of the population. Using the 60th (2004) and 71st (2014) rounds of the National Sample Survey, this study assessed the balance between infectious diseases and cardiovascular diseases (CVD) from 2004 to 2014, as well as changes in the disease burden in various socioeconomic and demographic subpopulations.
METHODS
Prevalence rates, hospitalization rates, case fatality rates, and share of in-patients deaths were estimated to compare the disease burdens at these time points. Logistic regression and multivariate decomposition were used to evaluate changes in disease burden across various socio-demographic and socioeconomic groups.
RESULTS
Evidence of stagnation in the infectious disease burden and rapid increase in the CVD burden was observed. Along with the drastic increase in case fatality rate, share of in-patients deaths became more skewed towards CVD from 2004 to 2014. Logistic regression analysis demonstrated a significant shift of the chance of succumbing to CVD from the privileged class, comprising non-Scheduled Castes and Tribes, more highly educated individuals, and households with higher monthly expenditures, towards the underprivileged population. Decomposition indicated that a change in the probability of suffering from CVD among the subcategories of age, social groups, educational status, and monthly household expenditures contributed to the increase in CVD prevalence more than compositional changes of the population from 2004 to 2014.
CONCLUSIONS
This study provides evidence of the ongoing tendency of CVD to occur in older population segments, and also confirms the theory of diffusion, according to which an increased probability of suffering from CVD has trickled down the socioeconomic gradient.
Summary

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Epidemiol Health : Epidemiology and Health