Impacts of Smoking Ban Policies on Billiard Hall Sales in South Korea Using Objective Sales Information of a Credit Card Company: Quasi-Experimental Study

BACKGROUND

Smoking ban policies (SBPs) are potent health interventions and offer the potential to influence antismoking behavior. The Korean government completely prohibited smoking in indoor sports facilities, including billiard halls, since the government revised the National Health Promotion Act in December 2017.

OBJECTIVE

This study aimed to examine the impact of the SBP on the economic outcomes of indoor sports facilities, particularly billiard halls.

METHODS

This study used credit card sales data from the largest card company in South Korea. Data are from January 2017 to December 2018. Monthly sales data were examined across 23 administrative neighborhoods in Seoul, the capital city of South Korea. We conducted the interrupted time series model using the fixed effects model and the linear regression with panel-corrected standard errors (PCSE).

RESULTS

The sales and transactions of billiard halls were not significantly changed after the introduction of the SBP in the full PCSE models. The R2 of the full PCSE model was 0.967 for sales and 0.981 for transactions.

CONCLUSIONS

The introduction of the SBP did not result in substantial economic gains or losses in the sales of billiard halls. In addition to existing price-based policies, the enhanced SBP in public-use facilities, such as billiard halls, can have a positive synergistic effect on reducing smoking prevalence and preventing secondhand smoke. Health policy makers can actively expand the application of SBPs and make an effort to enhance social awareness regarding the necessity and benefits of public SBPs for both smokers and the owners of hospitality facilities.

Current status and needs in the primary healthcare system in Yangon, Myanmar: a mixed-method evaluation

BACKGROUND

Many low- and middle-income countries and international organisations have invested resources to strengthen primary health care (PHC). This study aimed to identify the challenges and unmet needs in the current PHC by assessing the experiences and perceptions of healthcare workers in three townships (Htan Ta Pin, Hmawbi, and Taikkyi) in Yangon, Myanmar.

METHODS

The study was conducted among healthcare professionals and community leaders in three townships. Adopting a mixed-method approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (FGDs) were conducted online for qualitative data.

FINDINGS

Enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5 ratings) while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28) and the impact of the intervention (4.7). The FGDs revealed that while specific infrastructures and equipment were reported insufficient and necessary, the need for financial support has been the recurrent theme throughout the discussions.

INTERPRETATION

Utilising the World Health Organisation's six building block frameworks, our findings suggest that a long-term targeted financial investment in the PHC system is critical in Myanmar through increasing healthcare expenditure per capita.

Association Between Changes in Oral Health-Related Quality of Life and Depressive Symptoms in the Korean Elderly Population

Objectives: The aim of this study was to examine the association between changes in oral health related quality of life (OHRQoL) and depressive symptoms in the elderly South Koreans.

Methods: We used the 2018 and 2020 Korean Longitudinal Study of Ageing data. Our study population was a total of 3,604 participants aged over 65 in 2018. The independent variable of interest was the changes in the Geriatric Oral Health Assessment Index as OHRQoL between 2018 and 2022. The dependent variable was depressive symptoms in 2020. Multivariable logistic regression analyzed the associations between changes in OHRQoL and depressive symptoms.

Results: Participants with improvement in OHRQoL over 2-year period were likely to have fewer depressive symptoms in 2020. Especially, changes in the oral pain and discomfort dimension score was associated with depressive symptoms. A decline in oral physical function, such as difficulty in chewing and speaking, was also associated with depressive symptoms.

Conclusion: Negative change in OHRQoL is a risk factor for depression in elderly. This results suggest the importance of maintaining good oral health in later life, as a protective factor against depression.

Influence of COVID-19-Related Interventions on the Number of Inpatients with Acute Viral Respiratory Infections: Using Interrupted Time Series Analysis

After the first COVID-19 patient was diagnosed, non-pharmaceutical interventions such as social distancing and behavior change campaigns were implemented in South Korea. The social distancing policy restricted unnecessary gatherings and activities to prevent local transmission. This study aims to evaluate the effect of social distancing, a strategy for COVID-19 prevention, on the number of acute respiratory infection inpatients. This study used the number of hospitalized patients with acute respiratory infection from the Infectious Disease Portal of the Korea Centers for Disease Control and Prevention (KCDC) between the first week of January 2018, to the last week of January 2021. Intervention 1t represents the first patient occurrence of COVID-19, Intervention 2t represents the relaxing of the social distancing policy. We used acute respiratory infection statistics from Korea and segmented regression analysis was used. The analysis showed that the trend of the number of acute respiratory infection inpatients decreased after the implementation of the first patient incidence of COVID-19 due to prevention activities. After the relaxing of the social distancing policy, the number of inpatients with acute respiratory infections significantly increased. This study verified the effect of social distancing on the reduction in hospital admissions for acute respiratory viral infections.

Challenges of COVID-19 prevention during protracted conflicts: differential adherence to preventive measures in "contact line" regions in eastern Ukraine

Objectives

Despite the epidemiological importance of social vulnerabilities in compliance with preventive measures, little is known about the disproportional nature of preventive behaviors in crisis-affected populations. We examined adherence to COVID-19 preventive behaviors, focusing on social distancing measures in the conflict-affected regions in eastern Ukraine.

Methods

From a multisectoral needs assessment conducted in 2020 using a household interview of a stratified simple random sample, we included 1,617 rural and urban households located in the government-controlled area. We performed multivariable binary logistic regression analysis with latent class analysis (LCA) to identify unmeasured patterns of classification of preventive measures using data from a cross-sectional survey.

Results

The conflict-affected populations showed difficulty in complying with COVID-19 preventive measures due to losses of housing, partners, and access to food resources due to conflicts. Among the various preventive measures, wearing a face mask (88.1%) and washing hands more regularly (71.4%) were the most frequently reported. Compliance with social distancing was significantly lower in those who experienced the direct impacts of conflicts indicated by damaged accommodation or being widowed. Three different groups who showed distinctive patterns of employing COVID-19 preventive measures were identified via the LCA model, which were "highly complying group", "moderately complying group", and "face masks only group". The group membership was associated with a respondent's poverty status.

Conclusion

The findings show the difficulty in compliance with COVID-19 preventive measures among conflict-affected populations indicating secondary impacts of the conflicts on preventive health behaviors. To mitigate the health impacts of conflicts, immediate attention is needed to address barriers to COVID-19 preventive measures among conflict-affected populations in Ukraine. This study suggests the need for public health strategies to improve preventive health behaviors in conflict-affected populations under pandemics or large-scale outbreaks.

Thoracic spinal angiomyolipoma: case report from an Ethiopian neurosurgical teaching hospital. Illustrative case

BACKGROUND

Angiomyolipoma (AML) of the spine is a rare benign neoplasm (accounting for 0.14%-1.2% of all spine tumors) that is often described along with angiolipoma because of their similarities. They occur almost exclusively in the extradural space, with the thoracic spine being the commonest level.

OBSERVATIONS

The authors present the clinical presentation, diagnosis, and treatment of an extremely rare case of thoracic spine AML in a 47-year-old male patient. The patient underwent laminectomy and gross total resection of the tumor and had an excellent immediate postoperative neurological recovery and long-term functional neurological outcome.

LESSONS

It is always wise to consider rare benign spinal epidural neoplasms such as spinal AMLs in the differential diagnosis of spinal epidural mass, despite metastasis being the commonest epidural tumor with variable modes of treatment, because the management of benign spinal epidural masses such as spine AML is always surgical and associated with an excellent long-term outcome.

Factors influencing injury or death due to traumatic events in Afghanistan's crisis-affected populations: a cross-sectional nationwide study

OBJECTIVE

Afghanistan, with one of the world's largest refugee populations, suffers an enormous burden of injury resulting in loss of life. This study aims to identify the epidemiology of injuries or death in the crisis-affected populations across Afghanistan and to investigate factors associated with injuries or deaths due to traumatic events.

DESIGN

Cross-sectional study.

SETTING

This study analysed Whole Afghanistan Assessment 2019 data. This survey geographically covered all 34 accessible provinces in Afghanistan.

PARTICIPANTS

31 343 displaced and shock-affected households in Afghanistan.

PRIMARY AND SECONDARY OUTCOME MEASURES

Injury or death of household members due to traumatic events.

RESULTS

2561 (8.2%) reported at least one household member had been injured or deceased because of a significant conflict or natural disaster in the past year. Households experienced significant events such as active conflict or violence (prevalence ratio, PR=5.575, p<0.001), earthquake (PR=3.118, p=0.004), flood (PR=1.534, p=0.008) and avalanche or heavy snowfall (PR=3.450, p<0.001) were significantly associated with injury or death. The likelihood of injury or death was significantly higher for long-distance households than for households living within a 5 km radius of the nearest healthcare facilities (6-10 km: PR=1.402, p=0.030; >10 km: PR=1.560, p=0.020).

CONCLUSION

The study provides an epidemiological profile of injuries or death in crisis-affected populations across Afghanistan. Results also suggest that certain factors place the crisis-affected populations in Afghanistan at high risk for injuries or death, which can inform the development of surveillance and prevention programmes, the monitoring of patterns over time and the formulation of healthcare policies.

Effect of COVID-19-Related Interventions on the Incidence of Infectious Eye Diseases: Analysis of Nationwide Infectious Disease Incidence Monitoring Data

Objective: Social distancing has been confirmed to reduce the incidence of not only the COVID-19, but also the incidence of other diseases. Therefore, this study aimed to investigate the effect of social distancing policies on the incidence of infectious eye diseases by monitoring their nationwide incidence data in all age groups.

Methods: In this study, to analyse the impact of COVID-19 policy on IEDSC, the time periods were divided into two interventions. The first intervention was the first COVID-19 patient report in Korea on 19 January 2020. The second intervention was relaxation of the social distancing policy on 6 May 2020. Segmented regression analysis of the interrupted time series was used to assess COVID-19 policies on the IEDSC.

Results: After the first incidence of a COVID-19 patient, IEDSCs decreased significantly in all age groups, while the relaxation of the social distancing policy increased IEDSCs significantly, mostly in all groups.

Conclusion: In the post-COVID-19 era, we hope that national-level interventions such as reducing air pollution and employing precautionary measures will significantly reduce the financial burden of developing infectious ophthalmic diseases.

Factors Related to Oversleeping in Korean Young Adults, with a Focus on Sociodemographic Factors

Young adults the year after high school experience changes in lifestyle and circumstances and tend to experience more oversleeping. However, there are few studies on oversleeping in young adults. This study aims to identify the sociodemographic factors related to oversleeping among young adults in Korea using nationally representative data. This study analyzed self-reported and cross-sectional data in 2016 from a sample of 1876 participants from the Korean Children and Youth Panel Survey, which included respondents one year after high school graduation. Oversleeping was defined as sleeping 9 or more hours a day on average. Logistic regression models were analyzed to test a multivariate association between independent sociodemographic variables and oversleeping. Over one-tenth of young adults reported oversleeping. Oversleeping was associated with household income (OR = 0.99, p = 0.011) and smoking (OR = 1.52, p = 0.041). In addition, when compared to non-working college students, college students who were working (OR = 2.58, p = 0.021), non-students who were working (OR = 1.68, p = 0.048), and non-students who were not working (OR = 3.07, p < 0.001) were more likely to report oversleeping. Oversleeping among young adults was associated with major sociodemographic factors including household income (-), smoking (+), and academic and working status (+). These findings suggest the significant role of sociodemographic factors as predictors of oversleeping and emphasize the importance of examining various factors to achieve a better understanding of oversleeping in young adults.

How public and private health insurance coverage mitigates catastrophic health expenditures in Republic of Korea

Background

The private health insurance (PHI) market in Republic of Korea has instituted indemnity insurance plans that provide partial reimbursements for some medical services or costs that are not covered by the National Health Insurance (NHI). To date, no study has estimated the extent to which PHI coverage lowers the economic burden of households’ access to health care. The current study aims to evaluate the design of Korea’s PHI system in terms of coverage using a catastrophic health expenditure (CHE) indicator and compare it with NHI.

Methods

This study determined the difference between the number of households that were subscribed to PHI and those that received reimbursements from PHI. Additionally, it compared the effects of reduced CHE by NHI benefits with PHI reimbursements. Furthermore, it compared PHI reimbursements based on income class. Finally, it analyzed the contribution of NHI and PHI to CHE reduction through a two-part model with hierarchical regression.

Results

The results indicated that of the 5644 households examined, 3769 subscribed to PHI, but only 246 households received reimbursements. Notably, NHI reduced CHE incidence by 15.17%, whereas PHI only reduced CHE by 1.22%. The NHI scheme indicated reduced inequality as it provided more benefits to the low-income class for their used medical services, whereas PHI paid more reimbursements to the high-income class. Accordingly, NHI coverage has protected households from CHE and improved equality to some extent; however, PHI coverage has had a relatively low effect on relieving CHE and has increased inequality.

Conclusions

The indemnity health insurance plans of PHI companies in Korea only cover partial medical costs or services, and so, most patients do not receive reimbursements. Thus, Korea’s PHI system needs to improve to provide benefits to patients more generously and alleviate their financial burden.

Contributing Factors in Whether Displaced Households Want to Receive Humanitarian Information from Humanitarian Actors: Iraq Multi-Cluster Needs Assessment

Due to political conflict, insurgency, and the COVID-19, the number of displaced households in need of humanitarian support in Iraq has increased. This study investigated factors related to desire of displaced households to receive humanitarian information. Data from the eighth round of the Iraq Multi-Cluster Needs Assessment was used. We classified the household displacement status, identifying levels and types of humanitarian information that the households sought, together with whether the households were impacted by COVID-19. We identified safety and security, housing, water and electricity services, education, health care, and levels of humanitarian assistance resulted in significant differences between internally displaced person (IDP) and returnee households in terms of interest in receiving humanitarian information. The desire to receive humanitarian information was related to whether household members were unemployed due to COVID-19, displacement status, and walking time to reach the nearest health care facility and marketplace. Returnees and IDPs in Iraq are facing a new crisis. Their individual, structural, and environmental vulnerabilities are increasing commensurately. New strategies such as strategies using online or mobile communication that provide humanitarian information are needed to provide humanitarian information to vulnerable groups such as those who have lost jobs due to COVID-19, female heads of households, and those with health problems. In addition to traditional cash and voucher support, the use of the latest technologies such as smartphones and mobile clinics in humanitarian settings would be new strategies.

Association between the Human Development Index and Confirmed COVID-19 Cases by Country

It is important to understand the ultimate control of COVID-19 in all countries around the world in relation to the characteristics of developed countries, LDCs, and the variety of transmission characteristics of COVID-19. Therefore, this study aimed to identify factors associated with confirmed cases of COVID-19 with a focus on the Human Development Index (HDI). The units of analysis used for the current study were countries, and dataset were aggregated from multiple sources. This study used COVID-19 data from Our World in Data, the Global Health Security Index, and the WORLD BANK. A total of 171 countries were included in the analysis. A multi-variable linear regression with a hierarchical framework was employed to investigate whether the HDI is associated with confirmed COVID-19 cases after controlling for the demographic and healthcare system characteristics of the study countries. For Model 2, which controlled for demographic and healthcare system characteristics, HDI (β = 0.46, p < 0.001, 95% CI = 2.64−10.87) and the number of physicians per 1000 people (β = 0.34, p < 0.01, 95% CI = 0.21−0.75) had significant associations with the total number of confirmed COVID-19 cases per million people. Countries with a high HDI level are able to conduct higher per capita testing, resulting in higher numbers of confirmed cases than in countries with lower HDI levels. This study has shown evidence that could be used by governments and international organizations to identify national characteristics and provide the international cooperation necessary to develop effective prevention and intervention methods to deal with the global pandemic.

Financial burden of catastrophic health expenditure on households with chronic diseases: financial ratio analysis

Background

The financial status of households is vulnerable to chronic diseases which entail high medical expenses and income loss. Financial strain can be assessed by four indicators: a household surplus indicator, the liquid asset/debt ratio, a solvency indicator, and a liquidity indicator. We investigated the association between catastrophic health expenditure (CHE) and financial ratio indicators in households with chronic diseases in South Korea.

Methods

This study applied thresholds to the financial ratios to determine the financial strain. We conducted multiple logistic regression analyses to determine whether CHE is associated with financial strain. Furthermore, we analyzed the relationship between CHE and basic financial indicators, absolute finance size, using multiple linear regression.

Results

When CHE occurred, all financial ratio indicators deteriorated. However, this was not due to decreases in the absolute size of wealth and income, but rather the relative balance between finances. In particular, the loss of liquid assets was a major factor in the deterioration. In addition, all types of labor-related income deteriorated; only private transfer income increased.

Conclusions

This study revealed that CHE in households with chronic diseases negatively impacts household finances. It was found that financial coping strategies are only resource consuming.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07922-6.

Association between smokeless tobacco use and cigarette smoking amount by age

BACKGROUND

The use of smokeless tobacco has increased worldwide among young people. This study aimed to investigate the association between smokeless tobacco use and cigarette smoking amount in adult smoker groups stratified by age.

METHOD

2013-2015 National Health Interview Survey was used. A total of 19,635 subjects were included in our analysis. Propensity score matching was used to adjust for selection and any other bias. Generalized estimating equation was used to analyze the association between smokeless tobacco use and cigarette smoking amount by age.

RESULTS

All 580 smokeless tobacco users were matched to 2,900 non-smokeless tobacco users. Among those who were aged under 30, smokeless tobacco use was positively associated with the number of cigarettes used per day. Smokeless tobacco users who were aged under 30 and tried quitting smoking used more cigarettes than those who did non-smokeless tobacco users.

CONCLUSIONS

The present study revealed that among those who were aged under 30, smokeless tobacco use was positively associated with the number of cigarettes used per day. This study could contribute to understand the behaviors and tendencies of smoking in young adulthood and to establish effective smoking cessation methods for their age.

The Impact of Weekday-to-Weekend Sleep Differences on Health Outcomes among Adolescent Students

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the junior high school student panel of the Korean Children and Youth Panel Survey were analyzed. The sleep difference was defined as the difference between the average sleep duration on weekdays and that on weekends in minutes. A series of mixed effect linear regression models for continuous variables or mixed effect logit regression for binary variables was utilized. Korean adolescent students reported from 96.8 min to 133.2 min of sleep duration difference between weekdays and weekends. After controlling for gender, parent work status, and type of housing, the weekday-to-weekend sleep differences were associated with various health-related outcomes including concentration difficulty, aggression, somatic symptoms, and withdrawal. Additionally, adolescent student life satisfaction was associated with sleep difference. The sleep differences among adolescent students were more associated with mental health-related outcomes and emotional symptoms than with physical health-related outcomes. The appropriate intervention to reduce the sleep difference gap is an important key to improve health in the adolescence period.

Factors affecting weekday-to-weekend sleep differences among Korean adolescent students: Focus on extracurricular tutoring time

Objectives

Discrepancy in weekday-weekend sleep induces negative effects on physical health, obesity, psychological disorders, and academic performance; this particularly affects adolescent students through extracurricular tutoring, including evening self-study, private tutoring, and home studies. The present research aimed to clarify sociodemographic and economic factors, including extracurricular tutoring time, associated with weekday-to-weekend sleep differences using longitudinal data.

Study design

Data from the Korean Children and Youth Panel Survey (KCYPS) data were analyzed. Weekday-to-weekend sleep differences and extracurricular tutoring, as well as other covariates, were measured using adolescent’s self-report questionnaires. Multilevel regression and structural equation modeling (SEM) of repeated measures were used to test the hypothesized relationship between variables.

Results

The time spent in weekly extracurricular tutoring was negatively associated with weekday-to-weekend sleep differences. However, increased tutoring time was positively associated with bedtime, and bedtime was in turn positively associated with differences in Korean adolescents’ weekday-to-weekend sleep patterns. The SEM analysis result showed a significant indirect effect of tutoring time on sleep differences via bedtime.

Conclusions

Limiting weekly extracurricular tutoring time is important to early bedtime and reducing weekday-to-weekend sleep pattern differences. Policymakers should develop alternatives to private tutoring to improve the sleep duration and reduce weekday-to-weekend sleep differences among adolescents.

Sociodemographic factors that affect the real treatment rate among patients diagnosed with benign prostatic hyperplasia

BACKGROUND

Real treatment rate among patients diagnosed with benign prostatic hyperplasia (BPH/LUTS) and also its association with sociodemographic factor (SDF) have not been extensively investigated.

METHODS

Data were obtained from the 2006, 2008, 2010, 2012, 2014, and 2016 waves of the Korean Longitudinal Study of Aging (KLoSA). Among 10,254 individuals at the first baseline survey in 2006, a total of 4383 participants were ultimately included for final analysis. For statistical analysis, chi-square tests and generalized estimating equation regression models were conducted.

RESULTS

The prevalence rate of BPH/LUTS was 6.1% (266/4383) and real treatment rate was 58.3 percent (155/266). After adjusting for all confounders, odds ratio (OR) for the treatment of prostate disease in patients ages 55-64 and 65 years or more was 1.884 times higher (95% CI 1.096-3.237; p = .022) and 2.989 times higher (95% CI 1.755-5.091; p < .0001) than patients ages under 55, respectively. The OR for treatment of prostate disease in those residing in urban areas was 0.756 times lower (95% CI 0.573-0.998; p = .048) than those residing in metropolitan areas. The OR for treatment of prostate disease in those with bad self-rated health was 1.886 times higher (95% CI 1.461-2.436; p < .0001), compared to those with good self-rated health.

CONCLUSION

The real treatment rate among patients diagnosed with BPH/LUTS was 58.3%, a larger treatment rate than earlier reports. However, there are still a large proportion of patients who do not seek treatment; and age, residential area, and self-rated health were all found to be associated with real treatment rate.

Factors associated with indoor smoking at home by adults across Korea: a focus on socioeconomic status

OBJECTIVES

Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea.

METHODS

We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis.

RESULTS

Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher.

CONCLUSIONS

Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.

Demographic and Socioeconomic Influences on Sleep Patterns among Adolescent Students

Although proper sleep is an important topic in adolescent health, little is known about the sleep patterns of adolescents from a longitudinal and non-Western perspective. To fill this gap, the present research conducted a longitudinal study of the impact of demographic and socioeconomic factors on sleep patterns among Korean adolescent students. The relationship could positively or negatively affect sleep. Therefore, it is important to understand which demographic and socioeconomic factors are related to sleep patterns. This study used nationally representative panel data from the Korean Children and Youth Panel Survey. A series of descriptive analyses were conducted to provide overall characteristics of the sample. Furthermore, mixed effect regression analysis techniques were employed to test the relationship between demographic and socioeconomic factors and sleep patterns. Paternal employment status was associated with adolescent sleep patterns, while maternal employment status was not. Adolescents with both parents working compared to adolescents with one parent or none working showed different sleep patterns on weekdays but not on weekends. Both parents possessing college degrees, household income, living in an urban area, and family type were associated with adolescent sleep pattern indicators to varying degrees. Some of these associations varied according to adolescent sex. This study provides insight into the impact of demographic and socioeconomic factors on weekend and weekday sleep patterns among adolescent students by sex. These findings provide information for the promotion of healthy sleep in adolescents by addressing demographic and socioeconomic factors.

Association between sodium intake and lower urinary tract symptoms: does less sodium intake have a favorable effect or not?

Background

Sodium intake is known to be related with hypertension (HTN), which could impact lower urinary tracts symptoms (LUTS) indirectly. To date, only limited clinical evidences exist upon the association between sodium preference and LUTS. This cross-sectional study analyzed the association between sodium preference and the severity of LUTS in men.

Methods

A cross-sectional analysis has been performed and a total of 86,637 participants among total registered population of 229,226 in Korean Community Health Survey (KCHS) were included for final analysis. The adjusted odds ratio (OR) or coefficient with 95% confidence interval (CI) estimates were described to show the association between sodium preference and LUTS using negative binomial regression (for the IPSS total, IPSS voiding, and IPSS storage symptoms), ordinal logistic regression (for the IPSS grade), and binomial logistic regression (for the IPSS nocturia symptoms).

Results

Preference of salty taste group (high sodium preference) were significantly associated with higher IPSS total score (Coef =0.31; 95% CI: 0.27, 0.35), increased risk of severe IPSS grade (OR =1.46; 95% CI: 1.35, 1.57), higher IPSS voiding score (Coef =0.38; 95% CI: 0.32, 0.44), higher IPSS storage score (Coef =0.25; 95% CI: 0.22, 0.29), and increased risk of having IPSS nocturia symptoms (OR =1.21; 95% CI: 1.16, 1.27) compared to subjects with neutral group (normal sodium preference). Prediction of IPSS score according to salty taste preference showed u shaped distribution.

Conclusions

Sodium preference for taste were significantly associated with LUTS including voiding symptom, storage symptom and nocturia. Both higher and lower intake of sodium could be unfavorable factor for severity of LUTS.

Impacts of Smoking Ban Policies on Restaurants in Seoul, South Korea: Analysis of Objective Sales Information

BACKGROUND

From July 2013 to January 2015, the smoking ban instituted in restaurants in South Korea gradually expanded to cover all restaurants and bars, moving by size of restaurant (≤99 m2, 100-149 m2, ≥150 m2). This study measured the impacts of the smoking ban for restaurants.

METHODS

This study examined credit, check, or debit card sales data for every September and October from 2012 to 2015 in 711 census tracts in Seoul, South Korea. We accounted for total restaurant sales in each census tract. Our model controlled for the sales amounts for each census tract, type of restaurant, monthly business survey index, number of restaurants, daily average temperature, daily precipitation, and day of the week, and a dummy for census tract.

RESULTS

These were some positive associations with increase in total sales. However, the significance of the coefficients was not consistent over this period. Overall, our results showed no significant negative effects of smoking ban policy on restaurants.

CONCLUSIONS

Smoking ban policies produced benefits in terms of health outcomes, without causing significant negative impacts on sales.

IMPLICATIONS

Although the owners of restaurants anticipated negative impacts on sales from smoking ban policies, the results of this study suggest that restaurants experienced no negative economic impacts on sales from policies with health benefits, which suggest that it would be reasonable to promote and keep on the smoking ban. Also, it is important to apply smoking ban policy to all targets without exclusion.

Association between lower urinary tract symptoms and cigarette smoking or alcohol drinking

Background

Although there have been several studies about the relationship between alcohol or smoking and lower urinary tracts symptoms (LUTS). This study aimed to investigate the association between alcohol or smoking and severity of LUTS in men, as alcohol intake and cigarette smoking is important modifiable lifestyle factors for LUTS.

Methods

A cross-sectional analysis has been performed and a total of 86,707 participants in Korean Community Health Survey were included for final analysis. The adjusted odds ratio (OR) or coefficient with 95% confidence interval (CI) estimates were described to show the association between alcohol consumption or cigarette smoking and LUTS.

Results

Among the total subjects, 77,398 (89.3%), 7,532 (8.7%), and 1,777 (2.0%) had mild, moderate, and severe symptoms, respectively, according to International Prostate Symptom Score (IPSS) grade. Those who drank alcohol at least once per month were significantly associated with decreased risk of having the worst IPSS grade (OR: 0.80, 95% CI: 0.68 to 0.93). Those who smoked in the past but currently quitted and those who were daily smokers showed significantly increased risk of having the worst IPSS grade (past smoker, OR: 1.26, 95% CI: 1.14 to 1.39; daily smoker, OR: 1.21, 95% CI: 1.10 to 1.34). For nocturia, daily smoking showed positive effect (OR: 0.79, 95% CI: 0.75 to 0.84) whereas heavy alcohol drinking showed negative effect (OR: 1.22, 95% CI: 1.14 to 1.32)

Conclusions

Alcohol showed positive effect on LUTS except nocturia whereas cigarette smoking had negative effect on LUTS except nocturia. Daily smoking showed positive effect on nocturia whereas heavy alcohol drinking showed negative effect on nocturia.

Effect of Information Disclosure Policy on Control of Infectious Disease: MERS-CoV Outbreak in South Korea

This study examined the effect of disclosing a list of hospitals with Middle East respiratory syndrome coronavirus (MERS-CoV) patients on the number of laboratory-confirmed MERS-CoV cases in South Korea. MERS-CoV data from 20 May 2015 to 5 July 2015 were from the Korean Ministry of Health & Welfare website and analyzed using segmented linear autoregressive error models for interrupted time series. This study showed that the number of laboratory-confirmed cases was increased by 9.632 on 5 June (p < 0.001). However, this number was significantly decreased following disclosure of a list of hospitals with MERS-CoV cases (Estimate = −0.699; p < 0.001). Disclosing the list of hospitals exposed to MERS-CoV was critical to the prevention of further infection. It reduced the number of confirmed MERS-CoV cases. Thus, providing accurate and timely information is a key to critical care response.

Sex Differences in Factors Affecting Hospital Outpatient Department Visits: Korea Health Panel Survey Data from 2009 to 2016

This study intends to inspect the sex differences in proportion of hospital outpatient department (OPD) visits in overall outpatient (OP) visits using national panel data and to explore factors that influence the proportions by sex. This study analyzed data of the 2009–2016 Korea Health Panel Survey. Fractional logit regression was applied to analyze factors that affect proportion of hospital visits among outpatient visits. Analysis of related factors was carried out first for all analysis subjects and then by sex. The study data were provided by 7470 women (52.2%) and 6846 men (47.8%). The overall average number of OP visits was 13.0, and women showed a much higher frequency of visits (15.8) than men (9.9). The average proportion of hospital OPD visits among overall OP visits was 21.9%, and men showed a higher rate (25.1%) than women (19.5%). The analysis model including sociodemographic factors, economic factors, and health-related factors confirmed that men showed a higher rate of hospital usage than women. Type of medical security, household income, participation in economic activities, disability, and serious illnesses were significant variables for both sexes. Age, education level, marital status, and subscription to voluntary private health insurance were significant only for women, whereas region of residence was significant only for men. This study confirmed that there is a sex difference in proportion of hospital OPD visits and in the factors that affect the proportion of hospital OPD visits. Universal health coverage is provided through social health insurance, but there is a sex difference in hospital OPD visits, and factors related to socioeconomic status have a significant effect, especially on women’s selection of health care institutions. More attention should be given to sex differences in factors affecting health care utilization.

Sex Differences in Factors Associated with General Life Satisfaction among Occupationally Injured Workers in Korea: A Panel Analysis of the 2013-2017 Panel Study of Worker's Compensation Insurance

The majority of previous occupational studies focused on factors affecting life satisfaction among occupationally injured workers have been based on a cross-sectional design, not a sex-aggregated model. This study aimed to identify sex differences in factors related to life satisfaction among workers who experienced work-related injuries using nationally representative panel data from South Korea. Data from the first to fifth (2013-2017) waves of the Panel Study of Worker's Compensation Insurance were analyzed. Of 1514 respondents, those who participated in all five survey waves were included in the final study population. To assess the factors associated with general life satisfaction of the occupationally injured workers, a panel data analysis was conducted using generalized estimating equations. The impacts of education level, return to work, self-rated health, task performance, self-esteem, and self-efficacy were significant in both sexes. On the other hand, the influence of age, marital status, personal labor income, and National Basic Livelihood Act recipient status significantly varied by sex. There were sex differences in factors related to general life satisfaction among occupationally injured workers, highlighting the need for sex-specific intervention programs. Employers, healthcare providers, and other stakeholders need to pay attention to vulnerable groups and investigate the most appropriate financial support.

Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan: a secondary analysis of cross-sectional survey data

OBJECTIVE

Untimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan.

DESIGN

Cross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys.

SETTING

Community-based maternal and child health surveys.

PARTICIPANTS

Among 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included.

OUTCOMES

At the participants' home, an interviewer asked mothers to show their children's vaccination cards, which contained information regarding vaccinations. Children's vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth's penalised likelihood was performed to identify factors associated with timeliness of vaccinations.

RESULTS

238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child's age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate.

CONCLUSIONS

Home-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old.

Is Transient and Persistent Poverty Harmful to Multimorbidity?: Model Testing Algorithms

Multimorbidity, the coexistence of two or more long-term medical conditions in one person, has been known to disproportionally affect the low-income population. Little is known about whether long-term income is more crucial for multimorbidity than income measured in one time point; whether persistent poverty is more harmful than transient one; how changes in wealth affect multimorbidity. This is a longitudinal study on a population representative dataset, the Korean Health Panel (KHP) survey (2010–2015). A multivariate analysis was conducted using logistic regressions. A variety of income and wealth variables was investigated. Low-income Koreans (lowest 20%) were more likely to have multiple disorders; average income was more significantly associated with multimorbidity than the yearly income measured for the same year; persistent episodes of poverty had a greater hazard than transient ones; and income changes appeared to be statistically insignificant. We found that long-term income and persistent poverty are important factors of multimorbidity. These findings support the importance of policies reducing the risk of persistent poverty. Policies to promote public investment in education and create jobs may be appropriate to address multimorbidity.

The Economic Burden of Breast Cancer Survivors in Korea: A Descriptive Study Using a 26-Month Micro-Costing Cohort Approach

Background:

This study analyzed the burden of cancer treatment costs on patients by calculating the monthly amount of medical expenses paid by breast cancer patients for two years after mastectomy.

Methods:

Among those who were diagnosed with breast cancer and had received treatment at one of two academic medical centers in Seoul between 2003 and 2011, 1,087 patients who underwent mastectomy and received follow-up for at least two years were recruited. A micro-costing approach from the provider’s perspective, based on a retrospective review of patient medical claim records, was used to analyze cancer treatment cost of care. The cohort’s number of hospitalizations, total hospitalization duration, and number of outpatient visits were noted, and the total amount of medical expenses, out-of-pocket (OOP) expenditures, uninsured costs, and OOP ratio were calculated.

Results:

The total amount of medical expenses tended to increase by year, whereas the OOP expenditure ratio decreased. The OOP expenditure ratio was highest in the first month post-operation. Around one quarter of the total OOP payments incurred over the course of three months: one month before the operation, the month of the operation, and one month post-operation.

Conclusion:

OOP payment burden on patients was concentrated in the initial phase of treatment, and items not covered by the National Health Insurance caused an additional increase in patients’ burden in the initial phase. The economic burden of cancer treatment varies considerably. In order to alleviate patients’ medical expenses burden, the timing of expenditures and the possible financial burden on cancer survivors, they should be understood more fully and possibly addressed in interventions aimed at reducing the cancer burden.

Relationships between Sleep Patterns, Health Risk Behaviors, and Health Outcomes among School-Based Population of Adolescents: A Panel Analysis of the Korean Children and Youth Panel Survey

Sleep patterns among adolescents are related to health outcomes and health risk behaviors. This study aimed to describe sleep patterns of Korean adolescents and to find the association between sleep patterns and health risk behaviors and health outcomes. Using the junior high school students’ panel data (n = 2351, 12–15 years old) from the Korean Children and Youth Panel Survey, this study described the sleep patterns operationalized as rising time, bedtime, and sleep duration both on weekdays and weekends. The relationships of sleep patterns with health outcomes and/or health risk behaviors were tested using mixed effect linear regression for continuous health variables and using mixed effect logit regression for binary health variables. Obesity status, the number of chronic symptoms, self-rated health status, smoking, and alcohol consumption were associated with rising time on weekdays after controlling for gender, living area, and housing type. The same set of variables except for the number of chronic symptoms were associated with bedtime during the weekdays. Sleep duration during the weekdays was associated with obesity status, smoking, and alcohol consumption. Similar patterns of association between sleep pattern variables during the weekends and health-related outcome variables were found, but were less obvious than those for weekdays. Significant relationships between sleep patterns and various health-related variables were found among adolescents in Korea. The results from this study indicate that helping adolescents change their sleeping times as necessary to ensure adequate sleep should be considered important in diminishing health risk behaviors and promoting positive health outcomes.

Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data

Breastfeeding practices are critical for child health and growth. This paper investigates demographic factors, socioeconomic status, and information sources that affect breastfeeding practices in Sindh Province, Pakistan. A secondary analysis was performed of data on 10,028 women with a birth in the preceding two years who had participated in the 2013-14 Maternal and Child Health Program Indicator Survey. Multiple logistic regressions were used to test the association between breastfeeding status (ever breastfed and still breastfeeding) and age, number of living children, residence, education, wealth, information sources about breastfeeding, assistance during delivery, and place of delivery. Of the 9955 women included in the analysis, 97.9% had breastfed and 83.9% were still breastfeeding at the time of the survey. Being in the second, third, or fourth wealth quintiles and receiving breastfeeding information from relatives and friends were associated with ever breastfeeding. Women who were 35 years or older, living in a town/small city, higher maternal education, middle wealth quintile, and receiving breastfeeding information from the media were associated with still breastfeeding. The findings suggest the need to develop interventions considering maternal socioeconomic status and peer counseling interventions. Mass media campaigns to promote breastfeeding practices should be accompanied by governmental restrictions on the marketing of infant formula.

Factors associated with the use of antenatal care in Sindh province, Pakistan: A population-based study

BACKGROUND

Antenatal care (ANC) is critical to decrease maternal and neonatal mortality. However, little is known about the utilization of ANC services in Pakistan. This study assessed the utilization of ANC in Sindh province, Pakistan, and identified the factors that affect its use.

METHODS

We analysed a subset of data from Maternal and Child Health (MCH) Program Indicator Surveys conducted in Sindh province, Pakistan in 2013 and 2014. Respondents included 10,200 women who had given birth in the past two years. The outcome measure was making at least four ANC visits. Logistic regression models were used to identify demographic, socioeconomic, characteristics of ANC, and informational factors associated with ANC use.

RESULTS

Most women (83.5%) received one or more ANC, mostly by doctors (95%), but only 57.3% of them made the recommended four or more visits, and just 53.7% received their initial ANC care during the first trimester. Making four or more ANC visits was associated with: fewer household occupants (odds ratio [OR] = 0.98; 95% confidence interval [CI] = [0.97, 0.99]), large city residence (OR = 1.92; 95% CI = [1.57, 2.35]), higher women's education (OR = 1.70; 95% CI = [1.33, 2.15]), greater household wealth (OR = 5.66; 95% CI = [4.22, 7.60]), and receiving MCH information from lady health worker (OR = 1.17; 95% CI = [1.00, 1.37]), mother-in-law (OR = 1.17; 95% CI = [1.01, 1.36]), other relatives/friends (OR = 1.19; 95% CI = [1.03, 1.38]), or nurse/midwife (OR = 1.31; 95% CI = [1.06, 1.61]).

CONCLUSIONS

This study demonstrates that both socioeconomic factors and health information sources are associated with women's use of ANC. Therefore, programs should target socially disadvantaged and vulnerable groups, particularly rural, less educated, and poor women, to improve utilization of ANC. In addition, strategies to increase exposure to MCH information sources should be a priority in Sindh, Pakistan.

Gender differences in the impact of retirement on depressive symptoms among middle-aged and older adults: A propensity score matching approach

Background

Retirement is one of the most important later-life status transitions related to changes in workforce participation, lifestyle, and social roles among older adults. The purpose of this study was to investigate the impact of retirement on depressive symptoms by gender in middle-aged and older adult Koreans, using a large, nationally representative sample.

Methods

Using year 2010 and 2012 data from the Korea Longitudinal Study of Aging, we investigated the relationship between adults’ retirement status and depressive symptoms measured by the 10-item Center for Epidemiological Studies–Depression (CES-D10) scale. A series of propensity score matching models were calculated to test the potential retirement effect on adults’ depressive symptoms.

Results

Overall, the level of depressive symptoms of the retired group was not different from that of the employed counterpart. In gender-stratified models, the gain of CES-D10 scores in the retired group was higher than that of the employed group for males, which was in the opposite direction among females. However, the propensity score matching model showed that the relationship between retirement status and CES-D10 score gain was significant for males but not for females.

Conclusions

Our study reinforces the assertion that retirement could worsen depressive symptoms and could differ by gender. Intervention programs focused on the mental health of retired men need to be actively developed and widely implemented.

Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan; A secondary analysis of cross-sectional survey data

BACKGROUND

Pakistan has a high burden of newborn mortality, which would be significantly preventable through appropriate routine immunization. The purpose of this study was to measure the basic timely childhood immunization coverage and to identify determinants of factors influencing childhood immunization coverage in Sindh, Pakistan.

METHODS

Data from Maternal and Child Health Program Indicator Survey 2013-2014 which was conducted in Sindh province of Pakistan was used. Outcome measure was full coverage of the basic immunization schedule from child's vaccination card. The association of receiving basic immunization with demographic factors, socioeconomic status, mother and child health information sources, and perinatal care factors were tested by binary logistic regression.

RESULTS

Among 2,253 children, 1,156 (51.3%) received age-based full basic immunization. The basic immunization rates were 69.1% for under five weeks old, 38.3% for six to nine weeks, 18.8% for 10-13 weeks, 44.0% for 14 weeks-eight months, 60.4% for nine to 11 months, and 59.1% for over one year. Child's age, number of living children, parents' education level, wealth, the source of mother and child health information, number of antenatal care, and assistance during delivery were associated with completing basic immunization.

CONCLUSIONS

The overall full basic immunization coverage in Pakistan was still low. Policy makers should identify children at risk of low immunization coverage and obstacles of receiving antenatal care, implement educational interventions targeting on less educated parents, and conduct mass immunization campaigns for timely and complete immunization.

Association between health-related quality of life and work status in older Korean adults

AIM

Employment status has consistently been associated with health-related quality of life. This study investigated the effect of age on the association between work status and health-related quality of life in Korean adults using a large, nationally representative sample.

METHODS

We used data from the Korean Health Panel, and ran a series of random effects panel models to test the relationship between quality of life as measured by the EuroQol five-dimension questionnaire and work status. The moderation effect of age on the relationship between quality of life and work status was also tested in the same model.

RESULTS

Overall, Korean adults who were employed reported a higher level of quality of life than those who were unemployed. Furthermore, the relationship between quality of life and work status was stronger for those who were aged ≥60 years compared with those who were not.

CONCLUSIONS

Employment status among older people was found to have a greater association on quality of life than among younger people. Thus, it is necessary to carry out further research for employment status of older people about the relationship with quality of life. Geriatr Gerontol Int 2018; 18: 1629-1633.

What Is It to Be Mentally Healthy from the North Korean Refugees' Perspective?: Qualitative Research on the Changes in Mental Health Awareness among the North Korean Refugees

OBJECTIVE

We investigated how mental health awareness among North Korean refugees transformed depending on temporal-spatial context changes.

METHODS

In 2013, we conducted interviews with 10 refugees (eight women) who had been in South Korea for over a year and performed a qualitative analysis of the change in mental health awareness in the differences between living in North Korea, escape (a related period of forced sojourn in a third country), and settlement in South Korea.

RESULTS

We classified 39 concepts into five main categories. The first two categories (while living in North Korea) were "a mindset for the system, but not for individual mental health" and "being confined in a social environment that was indifferent to mental health." A third category appeared during escape: "focusing on survival amid continuity of intense suffering." The final two categories appeared when settling in South Korea: "recognition of mental health amid cultural shock" and "introspection and sorting oneself out."

CONCLUSION

This qualitative study enabled a better multi-dimensional understanding of the social and cultural aspects involved in improving mental health awareness among North Korean refugees in South Korea. It is desirable to integrate mental health as a part of daily life and to expand training for North Korean settlers.

Relationship between body image and weight status in east Asian countries: comparison between South Korea and Taiwan

BACKGROUND

There are many studies examining the relationship between body image and weight status that compare Western and Asian countries. One limitation of these past studies was assuming that all Asian countries are a homogeneous group. To fill the gap in the literature, this study examined the relationship between body image and weight status between participants from two Asian countries.

METHODS

This study utilized data from the 2010 module of the East Asian Social Survey from South Korea (n = 1576) and Taiwan (n = 2199), which contained questions related to body image. Body image was originally measured using a five-point Likert-type question, which was collapsed into three categories for the analysis. Weight status was derived from body mass index scores, which were calculated using self-reported weight and height. A set of multinomial logistic regression analyses were used to investigate the relationship between body image and weight status, stratified by country.

RESULTS

A significant relationship between body image and weight status after controlling for relevant covariates was reaffirmed in this study in the South Korean and Taiwanese. Results indicated that the relationship between body image and weight status of the Taiwanese sample was similar to the relationship in the South Korean sample. However, the results from a further analysis showed that the strength of the relationship across the two Asian countries appeared to be different.

CONCLUSIONS

The weight over-perception was more evident in South Korea than in Taiwan. Females were more vulnerable to societal pressures for thinness and the misperception of the ideal body than males. Interventions to improve distorted body image perception were needed in both countries.

Association between supplementary private health insurance and visits to physician offices versus hospital outpatient departments among adults with diabetes in the universal public insurance system

BACKGROUND

Diabetes mellitus is a chronic disease with a high prevalence across the world as well as in South Korea. Most cases of diabetes can be adequately managed at physician offices, but many diabetes patients receive outpatient care at hospitals. This study examines the relationship between supplementary private health insurance (SPHI) ownership and the use of hospitals among diabetes outpatients within the universal public health insurance scheme.

METHODS

Data from the 2011 Korea Health Panel, a nationally representative sample of Korean individuals, was used. For the study, 6,379 visits for diabetes care were selected while controlling for clustered errors. Multiple logistic regression models were used to examine determinants of hospital outpatient services.

RESULTS

This study demonstrated that the variables of self-rated health status, comorbidity, unmet need, and alcohol consumption significantly correlated with the choice to use a hospital services. Patients with SPHI were more likely to use medical services at hospitals by 1.71 times (95% CI 1.068-2.740, P = 0.026) compared to patients without SPHI.

CONCLUSIONS

It was confirmed that diabetic patients insured by SPHI had more use of hospital services than those who were not insured. People insured by SPHI seem to be more likely to use hospital services because SPHI lightens the economic burden of care.

The Effects of Discrimination Experience on Life Satisfaction of North Korean Refugees: Mediating Effect of Stress

OBJECTIVE

This study investigated the mediation effect of stress between the experience of discrimination and life satisfaction among North Korean refugees who resettled in South Korea. The findings of the current study provide empirical evidence for the need of social interventions to mitigate adverse effects of stress on North Korean refugees who are subject to social discrimination on a daily basis.

METHODS

In this study, we included 500 subjects among 2,138 North Korean refugees who took refuge in South Korea in 2007. The interview started from April 6th 2009 and finished on May 25th 2009. We conducted moderator effect analysis with Path analysis was conducted because we confirm the experience of discrimination was affected by life satisfaction and stress can affected life satisfaction as a moderator.

RESULTS

The experience of discrimination significantly affects stress and stress significantly affects life satisfaction. However, the experience of discrimination was not directly related to life satisfaction. The more stress the study respondents experienced, the lower the life satisfaction they reported.

CONCLUSION

The present finding suggests that the effects of discriminating experiences on the life satisfaction of North Korean refugees in South Korea were mediated by their own perceived stress.

Gender Differences in Suicidal Ideation and Related Factors among North Korean Refugees in South Korea

OBJECTIVE

According to previous social survey, a high number of North Korean refugees (NKRs) in South Korea had suicidal ideation. The purpose of this study is to examine the related factors for suicidal ideation among NKRs by gender in South Korea.

METHODS

We examined the sample of NKRs, 701 subjects (men=160, women=-541) residing in South Korea, the participants were enrolled from October 2008 to May 2014. The related factors with suicidal ideation in NKRs were analyzed via a logistic regression analysis.

RESULTS

Refugee women were more likely to have suicidal ideation than men were. Although thoughts of suicide do not necessarily mean that they will follow through, however, there is an association that the higher rate of suicide also results in a higher rate of attempted suicide. In both genders, they tended to think more frequently about suicide who had stayed in South Korea for more than 5 years. In addition, higher frequencies of suicidal ideation also associated with higher level of perceived stress in both genders.

CONCLUSION

The gender difference should be addressed when designing suicide prevention interventions among the North Korean population in South Korea.

Association between Sleep Duration and Injury from Falling among Older Adults: A Cross-Sectional Analysis of Korean Community Health Survey Data

PURPOSE

While sleeping problems increase with advancing age, there are inherent differences in sleep between males and females. Previous studies have shown inconsistent results of the relationship between sleep duration and risk of injury from falling. While controlling various sociodemographic and health-related factors, national representative data were used in order to analyze the association between sleep duration and injury from falling among older adults.

MATERIALS AND METHODS

The data were obtained from the Korean Community Health Survey of 2011. A total of 55654 individuals aged 65 years and older participated in the study. Multivariable logistic regression analysis was conducted to identify the factors associated with injury from falling.

RESULTS

After adjusting for covariates, such as age, sex, marital status, whether or not an individual is a recipient of benefits from the National Basic Livelihood Act, hypertension, diabetes mellitus, dyslipidemia, stress level, and self-rated health status, those who slept five hours or less per day [odds ratio (OR)=1.26; 95% confidence interval (CI)=1.18-1.34; p<0.001] or eight hours or more per day (OR=1.11; 95% CI=1.04-1.17; p=0.001) presented significantly higher ORs for injury from falling. A similar result was found when we conducted stratification by sex.

CONCLUSION

The current study supports that there is a relationship between short sleep duration and injury from falling and also identified a marginal risk of long sleep in older adults. Therefore, sleep management in older adults with inadequate sleep duration may be necessary.

Relationship of health, sociodemographic, and economic factors and life satisfaction in young-old and old-old elderly: a cross-sectional analysis of data from the Korean Longitudinal Study of Aging

[Purpose] The purpose of the present study was to investigate the relationship of health, sociodemographic, and economic factors and life satisfaction in young-old and old-old elderly groups. [Subjects and Methods] In the 2012 data from the Korean Longitudinal Study of Ageing, 4,134 of the final survey subjects aged 65 or older were analyzed. Multivaribale linear regression was performed to examine the degrees of explanatory power as factors (health, sociodemographic, and economic) in young-old (65 to 79 years) and old-old (80 years or older). [Results] Common variables that affected life satisfaction in both young-old and old-old subjects were health-related factors (depression, moderate to severe cognition, activities of daily living score), sociodemographic factors (level of education, familial communication, social activities), and economic factors (household assets, type of medical insurance). In the old-old group, age was an important associated factor. Mild cognitive impairment did not significantly affect life satisfaction in the old-old group, and only low-intensity social activities had an influence in the old-old group. [Conclusion] Difference in life satisfaction between the young-old and old-old elderly could be explained by gaps in the acceptance of the aging in health. Therefore, a personalized health consultation by life cycle could minimize these differences.

Body mass index and self-rated health in East Asian countries: Comparison among South Korea, China, Japan, and Taiwan

There have been conflicting findings regarding the relationship between body mass index (BMI) and self-rated health (SRH) worldwide. The purpose of this study was to examine the association between BMI and SRH by comparing its relationship in four East Asian countries: South Korea, China, Japan, and Taiwan. Using data from the East Asian Social Survey, the relationship between weight status and SRH status was investigated and compared between four countries, China, Japan, South Korea, and Taiwan. An ordinal logit regression model was estimated for each country, and the results were compared. We found that the relationship between weight status and SRH status differed across the four countries. In China, people who were overweight reported better SRH scores than those of normal weight, whereas in Japan, obese and severely obese people reported poor scores. In contrast, South Koreans who were underweight, obese, or severely obese reported poor ratings of health status than those of normal weight. In Taiwan, however, no differences in respondents' weight status were found across SRH scores. There were notable differences in the relationship between BMI and SRH status in four East Asian countries. Individual countries should consider these relationships when designing and implementing obesity intervention programs.

Gender Differences and Socioeconomic Factors Related to Osteoporosis: A Cross-Sectional Analysis of Nationally Representative Data

BACKGROUND

Osteoporosis has been considered a disease that primarily affects women, but recently male osteoporosis is also attracting attention. This study aims to comparatively analyze socioeconomic and other factors that are related to the prevalence of osteoporosis in both men and women.

MATERIALS AND METHODS

This study used data from the Korean Community Health Survey conducted in 2013. To determine factors related to osteoporosis prevalence, researchers applied a binary logistic regression model, first for all research participants, then separately for male and female participants.

RESULTS

Women were more likely than men to have osteoporosis (odds ratio 12.33, 95% confidence interval 11.55-13.17). Factors related to osteoporosis prevalence included age, education level, region, economic activity, alcohol consumption, salt intake, depression, and body mass index in both genders. Low education and income levels were more highly associated with osteoporosis prevalence in women than in men.

CONCLUSIONS

Most of the factors were not gender specific, but some socioeconomic determinants varied by gender. Future studies that will focus on the effects of socioeconomic factors on osteoporosis, as well as gender-related differences in prevention and control of osteoporosis, are needed.

Relationship between Physical Disability and Depression by Gender: A Panel Regression Model

Background

Depression in persons with physical disabilities may be more common than in the general population. The purpose of this study was to examine the relationship between physical disability and depression by gender among adults, using a large, nationally representative sample.

Methods

This study used data from the Korean Longitudinal Study of Aging, Wave one through four, and ran a series of random effect panel regression models to test the relationship between physical disability status and depression by gender. We tested the moderating effect of gender on the relationship between disability status and depression level by examining the significance of the cross-product term between disability status and gender.

Results

After controlling for self-rated health, marital status, employment status, education, and age, subjects who were female or diagnosed as having any disability presented higher levels of depression scores. Further, the difference in terms of their depression level measured by Center for Epidemiologic Studies Short Depression Scale (CES-D 10) scores between those who were diagnosed as having any disability and those who were not was greater for females than for their male counterparts.

Conclusion

This study reaffirmed that disability is the risk factor of depression, using longitudinal data. In addition, female gender is the effect modifier rather than the risk factor. The effect of gender in the non-disability group, mostly composed of older persons, is limited. On the contrary, the female disability group showed more depressive symptoms than the male disability group. The gender difference in the disability group and the role of culture on these differences need further research.

Age and gender differential relationship between employment status and body mass index among middle-aged and elderly adults: a cross-sectional study

OBJECTIVE

To determine the influence of age and gender, respectively, on the association between employment status and body mass index (BMI) in Korean adults using a large, nationally representative sample.

DESIGN

Cross-sectional study.

SETTING

South Korea.

PARTICIPANTS

7228 from fourth wave of the Korean Longitudinal Study of Aging (KLoSA), the survey's short form and year: 'KLoSA 2012'.

MAIN OUTCOME MEASURES

BMI.

RESULTS

BMI among the employed was higher than among the unemployed for those under 60. In terms of gender, employed men reported higher BMI than their unemployed counterparts, whereas employed women reported lower BMI than did unemployed women.

CONCLUSIONS

Employment status showed varying impacts on obesity by age and gender. Both unemployment at or after 60, as well as unemployment among women, is associated with increased BMI compared with unemployment among younger individuals or men, respectively.