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Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
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Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
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Epidemiol Health. 2024;46:e2024074. Published online September 11, 2024
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DOI: https://doi.org/10.4178/epih.e2024074
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Abstract
Summary
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Abstract
OBJECTIVES Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
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Summary
Korean summary
2006년부터 2015년 한국의 유방암 불평등 추세를 분석하면, 소득수준이 낮은 여성의 발생률은 상대적으로 낮음에도 불구하고 사망률은 높은 양상을 보였다. 유방암 검진과 치료에 있어 보다 형평성을 고려한 정책이 요구된다.
Key Message
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
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Lack of compensation for COVID-19-related overtime work and its association with burnout among EMS providers in Korea
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Ji-Hwan Kim, Jaehong Yoon, Soo Jin Kim, Ja Young Kim, Jinwook Bahk, Seung-Sup Kim
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Epidemiol Health. 2023;45:e2023058. Published online June 15, 2023
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DOI: https://doi.org/10.4178/epih.e2023058
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Abstract
OBJECTIVES This study examined the association between lack of compensation for COVID-19-related overtime work (LCCOW) and burnout among emergency medical service (EMS) providers in Seoul, Korea.
METHODS We conducted a cross-sectional survey of 693 EMS providers in Seoul, Korea. Participants were classified into 3 groups according to their experience of coronavirus disease 2019 (COVID-19)-related overtime work and LCCOW: (1) “did not experience,” (2) “experienced and was compensated,” and (3) “experienced and was not compensated.” Burnout was measured using the Korean version of the Copenhagen Burnout Inventory, which has 3 subdomains: personal burnout (PB), work-related burnout (WRB), and citizen-related burnout (CRB). Multiple linear regression was applied to examine whether LCCOW was associated with burnout after adjusting for potential confounders.
RESULTS In total, 74.2% of participants experienced COVID-19-related overtime work, and 14.6% of those who worked overtime experienced LCCOW. COVID-19-related overtime work showed a statistically non-significant association with burnout. However, the association differed by LCCOW. Compared to the “did not experience” group, the “experienced and was not compensated” group was associated with PB (β=10.519; 95% confidence interval [CI], 3.455 to 17.584), WRB (β=10.339; 95% CI, 3.398 to 17.280), and CRB (β=12.290; 95% CI, 6.900 to 17.680), whereas no association was observed for the “experienced and was compensated” group. Furthermore, an analysis restricted to EMS providers who worked overtime due to COVID-19 showed that LCCOW was associated with PB (β=7.970; 95% CI, 1.064 to 14.876), WRB (β=7.276; 95% CI, 0.270 to 14.283), and CRB (β=10.000; 95% CI, 3.435 to 16.565).
CONCLUSIONS This study suggests that LCCOW could be critical in worsening burnout among EMS providers who worked overtime due to COVID-19.
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Summary
Korean summary
본 연구는 2021년에 진행된 서울시 구급대원 693 명의 설문조사 자료를 이용해서 COVID-19으로 인한 초과근무 경험에 대한 보상 부족과 번아웃의 연관성을 살펴보았다. 초과근무 경험이 없었던 구급대원의 번아웃 점수와 비교할 때, 초과근무 경험이 있고 항상 적절한 보상을 받은 구급대원의 번아웃 점수는 통계적으로 유의한 차이가 관찰되지 않았지만, 초과근무 경험이 있고 적절한 보상을 받지 못한 적이 있는 구급대원의 번아웃 점수는 통계적으로 유의하게 높게 나타났다. 초과근무를 경험한 구급대원으로 한정한 분석에서는 적절한 보상을 항상 받은 구급대원에 비해서 적절한 보상을 받지 못한 적이 있는 구급대원의 번아웃 점수가 통계적으로 유의하게 높았다.
Key Message
Using a survey of 693 EMS providers in Seoul, Korea, we examined the association between lack of compensation for COVID-19-related overtime work (LCCOW) and burnout. Higher scores of burnouts were observed among those with LCCOW, but not among those without LCCOW, compared to the EMS providers who did not experience overtime work due to COVID-19. Furthermore, in the analysis restricted to EMS providers who had worked overtime due to COVID-19, LCCOW was associated with burnout.
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Citations
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- Effects of Post-COVID-19 Syndrome on Quality of Life Among Airline Crew
Jung-Ha Kim, Seunghye Choi Workplace Health & Safety.2024; 72(9): 374. CrossRef - People-Oriented Culture and Its Association With Burnout, Depressive Symptoms, and Sleep Problems During COVID-19 Pandemic Among EMS Providers in Korea
Ji-Hwan Kim, Jaehong Yoon, Soo Jin Kim, Ja Young Kim, Seung-Sup Kim Journal of Occupational & Environmental Medicine.2024; 66(8): e359. CrossRef
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Smoking, drinking, and physical activity among Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
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Sunhye Choi, Jinwook Bahk, Suyeon Park, Kyungwon Oh, Kyunghee Jung-Choi
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Epidemiol Health. 2022;44:e2022043. Published online April 25, 2022
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DOI: https://doi.org/10.4178/epih.e2022043
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14,862
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Abstract
OBJECTIVES This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables.
METHODS This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated.
RESULTS Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group.
CONCLUSIONS In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.
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Summary
Korean summary
코로나 대유행 첫 해인 2020년, 한국 남성에서 고위험음주와 부적절한 신체 활동 수준이 증가하였다. 감염성 질환 대유행 시기, 확산을 차단하기 위한 사회적 노력과 더불어 건강행태에 부정적인 여파가 미치지 않도록 적극적인 대책이 필요함을 시사한다.
Key Message
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. Despite Korea's positive performance in various indicators during the COVID-19 pandemic, the socioeconomic and cultural effects of COVID-19 have affected people's health behaviour. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.
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Hye Young Shin, Ka Young Kim, Purum Kang Public Health Nursing.2024; 41(5): 987. CrossRef - Dose-response risks of all-cause, cancer, and cardiovascular
disease mortality according to sex-specific cigarette smoking
pack-year quantiles
Jieun Hwang, Suyoung Jo, Heewon Kang, Eunsil Cheon, Sung-il Cho Tobacco Induced Diseases.2024; 22(July): 1. CrossRef - A national cross-sectional study on breakfast skipping-related factors and comparison of nutritional status according to breakfast skipping in older adults based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020)
Anna Han, Yean Jung Choi The Journal of nutrition, health and aging.2024; 28(9): 100335. CrossRef - Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)
Hohyun Seong, Sohee Kim, Hyunsook Shin, Chang Won Won, Youn-Jung Kim Geriatric Nursing.2024; 59: 392. CrossRef - Comparison of Food and Nutrient Intake according to the Income Level in Korean Adult Single-Person Households: Using Data from the Korea National Health and Nutrition Examination Survey (2016-2018)
Min-Hee Han, Bok-Mi Jung The Korean Journal of Community Living Science.2024; 35(3): 445. CrossRef - Change in prevalence of smoking during the first year of the COVID-19 pandemic among middle-aged and older adults in Canada: a cohort study of the Canadian Longitudinal Study on Aging
Jayati Khattar, Urun Erbas Oz, Vanessa De Rubeis, Margaret de Groh, Ying Jiang, Lauren Griffith, Laura N Anderson BMJ Public Health.2024; 2(2): e001175. CrossRef - Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey
Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong Epidemiology and Health.2023; 45: e2023015. CrossRef - Factors affecting decreased physical activity during the COVID-19 pandemic: an age-, gender-, and body mass index-matched study
Jhin-Yi Shin, Jaemoo Lee, Jung-Min Lee, Nam Yoon Ho Frontiers in Public Health.2023;[Epub] CrossRef - The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park The Korean Journal of Internal Medicine.2023; 38(5): 714. CrossRef - Association between individuals’ locus of control and mental health during the COVID-19 pandemic
Filiz Eren, Isabelle Kousignian, Solène Wallez, Maria Melchior, Murielle Mary-Krause Journal of Affective Disorders Reports.2023; 14: 100678. CrossRef - Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong Epidemiology and Health.2023; 45: e2023014. CrossRef - Current status of health promotion in Korea
Soo Young Kim Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef - Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
Ji-Young Kwon, Sang-Wook Song Epidemiology and Health.2022; 44: e2022101. CrossRef
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Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
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Jinwook Bahk, Kyunghee Jung-Choi
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Epidemiol Health. 2022;44:e2022110. Published online November 23, 2022
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DOI: https://doi.org/10.4178/epih.e2022110
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Abstract
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Abstract
OBJECTIVES This study aimed to examine the trends in total mortality between 1998 and 2020 and to compare the changes in a wide range of detailed causes of death between 2020 (i.e., during the coronavirus disease 2019 [COVID-19] pandemic) and the previous year in Korea.
METHODS We used registered population and mortality data for the years 1998-2020 obtained from Statistics Korea. The age-standardized all-cause mortality rate and the annual percent change between 1998 and 2020 were determined. The rate ratio and rate difference of the age-standardized mortality rate between 2019 and 2020 were calculated.
RESULTS The age-standardized all-cause mortality rate in Korea has been on a downward trend since 1998, and the decline continued in 2020. In 2020, 950 people died from COVID-19, accounting for 0.3% of all deaths. Mortality decreased for most causes of death; however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020 for both men and women. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This increase was mainly attributed to a higher number of suicide deaths.
CONCLUSIONS This study shed light on the issues of sepsis and aspiration pneumonia despite the successful response to COVID-19 in Korea in 2020. Cases of death from sepsis and aspiration pneumonia should be identified and monitored. In addition, it is necessary to develop a proactive policy to address suicide among young people, especially young women.
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Summary
Korean summary
1998년 이래 한국의 연령표준화 총사망률은 지속적으로 감소하였고, 이러한 경향은 코로나19 대유행 첫해인 2020년에도 관찰되었다. 대부분 사망원인별 사망률이 코로나19 대유행이후에도 감소하였으나, 패혈증 및 흡인성 폐렴으로 인한 사망자가 남성과 여성 모두에서 증가했다. 연령별 사망률에서는 25-29세 여성을 제외한 모든 연령대에서 2019년에 비해 2020년 사망률이 감소하거나 유지되었고, 25-29세 여성의 사망률 증가는 주로 자살 사망의 증가에 기인했다.
Key Message
During 1988-2020, the age-standardized all-cause mortality rate in Korea has been on a downward trend and the decline continued in 2020. In 2020, mortality decreased for most causes of death, however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This was mainly attributed to increased suicide deaths.
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- Suicide mortality rates in Japan before and beyond the COVID‐19 pandemic era
Motohiro Okada, Ryusuke Matsumoto, Eishi Motomura Psychiatry and Clinical Neurosciences Reports.2024;[Epub] CrossRef - Temporal Fluctuations of Suicide Mortality in Japan from 2009 to 2023 Using Government Databases
Ryusuke Matsumoto, Eishi Motomura, Motohiro Okada European Journal of Investigation in Health, Psychology and Education.2024; 14(4): 1086. CrossRef - Unraveling the impact of the COVID-19 pandemic on the mortality trends in Belgium between 2020–2022
Yessika Adelwin Natalia, Johan Verbeeck, Christel Faes, Thomas Neyens, Geert Molenberghs BMC Public Health.2024;[Epub] CrossRef - Evaluation of the effect of the COVID-19 pandemic on the all-cause, cause-specific mortality, YLL, and life expectancy in the first 2 years in an Iranian population—an ecological study
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Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea
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Ikhan Kim, Jinwook Bahk, Sung-Cheol Yun, Young-Ho Khang
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Epidemiol Health. 2017;39:e2017011. Published online March 15, 2017
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DOI: https://doi.org/10.4178/epih.e2017011
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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.
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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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