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Original Articles
Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Hana Kim, Heewon Kang, Sung-il Cho
Epidemiol Health. 2024;46:e2024009.   Published online December 13, 2023
DOI: https://doi.org/10.4178/epih.e2024009
  • 1,751 View
  • 86 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011.
METHODS
Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign.
RESULTS
For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively).
CONCLUSIONS
A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.
Summary
Korean summary
지난 15년 동안 한국 청소년의 가정 내 간접흡연 노출은 감소했다. 가정 내 간접흡연 노출에 대하여 중학교 입학 코호트 효과가 존재하였다. 또한, 청소년의 가정 내 간접흡연 노출 감소는 2011년 12월 공공장소에서의 금연구역 규제와 2008년 시행된 캠페인과 연관되어 있었다.
Key Message
Household secondhand smoke (SHS) exposure among Korean adolescents has decreased over the past 15 years. There was a school admission cohort effect on household SHS exposure. A complete smoking ban in public space with increased penalties in December 2011 and a campaign in 2008 to avoid SHS exposure were associated with reduced household SHS exposure among adolescents.
Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea
Kyoung Hoon Kim, Sang Min Lee, Minha Hong, Kyu-Man Han, Jong-Woo Paik
Epidemiol Health. 2023;45:e2023022.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023022
  • 6,290 View
  • 275 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.
METHODS
Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.
RESULTS
The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.
CONCLUSIONS
Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.
Summary
Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.
Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.

Citations

Citations to this article as recorded by  
  • Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions
    Jackson Newberry-Dupé, Wanyu Chu, Simon Craig, Rohan Borschmann, Gerard O’Reilly, Paul Yates, Glenn Melvin, Kylie King, Harriet Hiscock
    Psychiatric Quarterly.2024; 95(1): 33.     CrossRef
Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey
Ji Son Ki, Ho Kim
Epidemiol Health. 2019;41:e2019012.   Published online April 7, 2019
DOI: https://doi.org/10.4178/epih.e2019012
  • 12,584 View
  • 279 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.
METHODS
Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.
RESULTS
With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.
CONCLUSIONS
When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.
Summary
Korean summary
본 연구는 지역사회건강조사와 국민건강영양조사의 2010년부터 2015년까지 6년간의 자료로 각각 6개, 8개 변수의 추정치를 비교하였다. 설문변수 간의 추정치 차이보다 설문변수와 검진변수간의 추정치의 더 차이가 컸고 하위그룹별 시계열 변동은 지역사회건강조사가 더 안정적이었다.

Citations

Citations to this article as recorded by  
  • Variability Test of Estimates of Korea Community Health Survey Data in Gyeongsangnam-do (2008-2018)
    Youngjun Seon, Baekgeun Jeong, Boyeong Jin, Zunghun Lim, Changjin Cho, Youngeun Son, Dong Wook Kim
    Journal of Health Informatics and Statistics.2023; 48(3): 281.     CrossRef
  • Measurement of physical activity and sedentary behavior in national health surveys, South America
    Danilo R. Silva, Luciana L. Barboza, Se-Sergio Baldew, Cecilia Anza-Ramirez, Robinson Ramírez-Vélez, Felipe B. Schuch, Thayse N. Gomes, Kabir P. Sadarangani, Antonio García-Hermoso, Ramfis Nieto-Martinez, Gerson Ferrari, J. Jaime Miranda, André O. Werneck
    Revista Panamericana de Salud Pública.2022; 46: 1.     CrossRef
  • Differences in accuracy of height, weight, and body mass index between self-reported and measured using the 2018 Korea Community Health Survey data
    Yoonsil Ko, Sunhye Choi, Jisoo Won, Yeon-Kyeng Lee, Dong-Hyun Kim, Seon Kui Lee
    Epidemiology and Health.2022; 44: e2022024.     CrossRef
Forecasting and prediction of scorpion sting cases in Biskra province, Algeria, using a seasonal autoregressive integrated moving average model
Schehrazad Selmane, Mohamed L’Hadj
Epidemiol Health. 2016;38:e2016044.   Published online October 14, 2016
DOI: https://doi.org/10.4178/epih.e2016044
  • 13,195 View
  • 281 Download
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aims of this study were to highlight some epidemiological aspects of scorpion envenomations, to analyse and interpret the available data for Biskra province, Algeria, and to develop a forecasting model for scorpion sting cases in Biskra province, which records the highest number of scorpion stings in Algeria.
METHODS
In addition to analysing the epidemiological profile of scorpion stings that occurred throughout the year 2013, we used the Box-Jenkins approach to fit a seasonal autoregressive integrated moving average (SARIMA) model to the monthly recorded scorpion sting cases in Biskra from 2000 to 2012.
RESULTS
The epidemiological analysis revealed that scorpion stings were reported continuously throughout the year, with peaks in the summer months. The most affected age group was 15 to 49 years old, with a male predominance. The most prone human body areas were the upper and lower limbs. The majority of cases (95.9%) were classified as mild envenomations. The time series analysis showed that a (5,1,0)×(0,1,1)12 SARIMA model offered the best fit to the scorpion sting surveillance data. This model was used to predict scorpion sting cases for the year 2013, and the fitted data showed considerable agreement with the actual data.
CONCLUSIONS
SARIMA models are useful for monitoring scorpion sting cases, and provide an estimate of the variability to be expected in future scorpion sting cases. This knowledge is helpful in predicting whether an unusual situation is developing or not, and could therefore assist decision-makers in strengthening the province’s prevention and control measures and in initiating rapid response measures.
Summary

Citations

Citations to this article as recorded by  
  • Epidemiological aspects of scorpion stings in Algeria: A monocentric retrospective study
    Mohamed Amine Kerdoun
    Toxicologie Analytique et Clinique.2022; 34(1): 4.     CrossRef
  • Terrestrial venomous animals, the envenomings they cause, and treatment perspectives in the Middle East and North Africa
    Timothy P. Jenkins, Shirin Ahmadi, Matyas A. Bittenbinder, Trenton K. Stewart, Dilber E. Akgun, Melissa Hale, Nafiseh N. Nasrabadi, Darian S. Wolff, Freek J. Vonk, Jeroen Kool, Andreas H. Laustsen, Jean-Philippe Chippaux
    PLOS Neglected Tropical Diseases.2021; 15(12): e0009880.     CrossRef
  • Time Series Analysis of Tuberculosis in Medea Province in Algeria
    Mohamed L'HADJ, Schehrazad SELMANE
    Journal of Engineering Technology and Applied Sciences.2019; 4(2): 85.     CrossRef
  • Predictive determinants of scorpion stings in a tropical zone of south Iran: use of mixed seasonal autoregressive moving average model
    Vahid Ebrahimi, Esmael Hamdami, Mohammad Djaefar Moemenbellah-Fard, Shahrokh Ezzatzadegan Jahromi
    Journal of Venomous Animals and Toxins including Tropical Diseases.2017;[Epub]     CrossRef
Modeling and forecasting of the under-five mortality rate in Kermanshah province in Iran: a time series analysis
Mehran Rostami, Abdollah Jalilian, Behrooz Hamzeh, Zahra Laghaei
Epidemiol Health. 2015;37:e2015003.   Published online January 22, 2015
DOI: https://doi.org/10.4178/epih/e2015003
  • 17,499 View
  • 213 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The target of the Fourth Millennium Development Goal (MDG-4) is to reduce the rate of under-five mortality by two-thirds between 1990 and 2015. Despite substantial progress towards achieving the target of the MDG-4 in Iran at the national level, differences at the sub-national levels should be taken into consideration.
METHODS
The under-five mortality data available from the Deputy of Public Health, Kermanshah University of Medical Sciences, was used in order to perform a time series analysis of the monthly under-five mortality rate (U5MR) from 2005 to 2012 in Kermanshah province in the west of Iran. After primary analysis, a seasonal auto-regressive integrated moving average model was chosen as the best fitting model based on model selection criteria.
RESULTS
The model was assessed and proved to be adequate in describing variations in the data. However, the unexpected presence of a stochastic increasing trend and a seasonal component with a periodicity of six months in the fitted model are very likely to be consequences of poor quality of data collection and reporting systems.
CONCLUSIONS
The present work is the first attempt at time series modeling of the U5MR in Iran, and reveals that improvement of under-five mortality data collection in health facilities and their corresponding systems is a major challenge to fully achieving the MGD-4 in Iran. Studies similar to the present work can enhance the understanding of the invisible patterns in U5MR, monitor progress towards the MGD-4, and predict the impact of future variations on the U5MR.
Summary

Citations

Citations to this article as recorded by  
  • Predicting the detection of leprosy in a hyperendemic area of Brazil: Using time series analysis
    Vera Gregório, Dinilson Pedroza, Celivane Barbosa, Gilberto Bezerra, Ulisses Montarroyos, Cristine Bonfim, Zulma Medeiros
    Indian Journal of Dermatology, Venereology and Leprology.2021; 87: 651.     CrossRef
  • Forecasting Malaysia Under-5 Mortality Using State Space Model
    N F Abd Nasir, A N Muzaffar, S N E Rahmat, W Z Wan Husin, N S Zainal Abidin
    Journal of Physics: Conference Series.2020; 1496: 012001.     CrossRef
  • Multivariate Long Memory Cohort Mortality Models
    Hongxuan Yan, Gareth Peters, Jennifer Chan
    SSRN Electronic Journal .2018;[Epub]     CrossRef
  • Forecast analysis of any opportunistic infection among HIV positive individuals on antiretroviral therapy in Uganda
    John Rubaihayo, Nazarius M. Tumwesigye, Joseph Konde-Lule, Fredrick Makumbi
    BMC Public Health.2016;[Epub]     CrossRef
A Time Series Analysis of the Death Rates and Rectangularization of the Survival Curve, 1970-2010.
Yong Gyu Park, Kyung Hwan Cho
Korean J Epidemiol. 1997;19(2):210-219.
  • 4,738 View
  • 13 Download
AbstractAbstract PDF
Abstract
As the population of senior people has been increased rapidly during the past 30 years in Koera, the health policy and related research in this field are strongly demanded to manage various problems which can be derived from the gerontic phenomenon. We estimated the death rates up to 2010 using the annual mortality data published by the National Statistical Office from 1970 to 1995 by time series analysis and calculated the survival curves, life expectancy by life table method with modified Graville's formular and proposed several measures which can be used in describing the theory of retangularization of survival curves and compression of mortality hypothesis. According to the results, the relative and absolute rectangularization and the convergency of survival curves were observed, and all the Keyfitz's H, NH, SD, and CV decreased while the life expectancy increased in the period of 1970 to 2010. So we conclude that the hypothesis of mortality compression suggested by Fries explains the changing pattern of aged population in Korea very well.
Summary
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