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Differences in accuracy of height, weight, and body mass index between self-reported and measured using the 2018 Korea Community Health Survey data
Yoonsil Ko, Sunhye Choi, Jisoo Won, Yeon-Kyeng Lee, Dong-Hyun Kim, Seon Kui Lee
Epidemiol Health. 2022;44:e2022024.   Published online February 19, 2022
DOI: https://doi.org/10.4178/epih.e2022024
  • 4,750 View
  • 347 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to determine an effective survey method for the accurate calculation of obesity prevalence by comparing the self-reported and measured height, weight, and body mass index (BMI) using the 2018 Korea Community Healthy Survey (CHS) data.
METHODS
Raw data from the 2018 CHS were used to analyze the differences, correlation, and agreement between self-reported and measured height, weight, and BMI.
RESULTS
The self-reported height was over-reported than the measured height (0.59 cm greater for men and 0.71 cm greater for women), while the self-reported weight was under-reported than the measured weight (0.55 kg less for men and 0.67 kg less for women). Subsequently, the self-reported BMI was under-estimated (0.35 kg/m2 lower for men and 0.49 kg/m2 lower for women) compared with the measured BMI. The kappa statistic and agreement between measured and self-reported values per BMI category (underweight, normal, overweight, and obesity) were 0.82 and 79.6%, respectively.
CONCLUSIONS
The prevalence of obesity should be calculated using the measured values provided in the CHS in order to promote local health projects based on accurate evidence.
Summary
Korean summary
본 연구는 2018년 지역사회건강조사 원시자료를 이용하여, 자가보고된 신장, 체중, 그리고 체질량지수 값과 실제 측정한 값 간에 차이를 분석하고 상관성과 일치도를 확인하고자 하였으며, 확인결과 자가보고값 체질량지수는 측정값보다 과소측정(남자의 경우 측정값보다 자가보고값이 0.35kg/m2 낮게, 여자는 0.49kg/m2 낮게 측정)된것을 확인하였다.
Key Message
This study aimed to determine an effective survey method for the accurate calculation of obesity prevalence by comparing the self-reported and measured height, weight, and body mass index (BMI) using the 2018 Community Healthy Survey (CHS) data.
Secular trends and related factors in leisure-time sedentary behavior among Koreans: an analysis of data from the 2011-2017 Korea Community Health Survey
Hyun-Ju Seo, Min-Jung Choi, Soon-Ki Ahn
Epidemiol Health. 2022;44:e2022023.   Published online February 14, 2022
DOI: https://doi.org/10.4178/epih.e2022023
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Sedentary behavior has gradually increased and has become a public health problem. Therefore, this study investigated trends in weekday leisure-time sedentary behaviors, as well as characteristic socio-demographic and lifestyle correlates in Korean adults.
METHODS
We analyzed data from 914,946 adults aged ≥19 years who participated in the Korea Community Health Survey (2011, 2013, 2015, and 2017). Leisure-time sedentary behavior was categorized as a binary variable (<4 and ≥4 hr/day). Multivariable regression analysis was used to model the prevalence of sedentary behavior and estimate odds ratios.
RESULTS
The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women between 2011 and 2017, respectively. However, a significant increase was observed in subjects with an education lower than high school in both genders (β coefficient=0.12 for men and 0.08 for women, p for trend <0.001). Women in the lowest household income level (β coefficient=0.08, p for trend=0.001) and with poor subjective health status (β coefficient=0.05, p for trend=0.013) showed an increasing trend. Other factors associated with sedentary behavior were age, education level, body mass index, household income, walking activity, perceived stress level, and subjective health status in both genders.
CONCLUSIONS
Identifying the secular trends and correlates of sedentary behavior by gender and associated factors will provide empirical evidence for developing public health campaigns and promotion programs to reduce sedentary behavior in Koreans.
Summary
Korean summary
본 연구는 지역사회건강조사에서 2011년부터 2017년까지 격년으로 수집된 성인의 좌식행동에 대한 시간적 추세와 관련 요인에 대해 분석한 시계열 단면연구이다. 분석결과, 주중 여가시간에 4시간 이상 앉아 있는 경우는 남성의 경우 15.2%에서 14.4%로, 여성의 경우 16.6%에서 16.0%로 감소되었다. 그러나, 남녀 모두에서 노인인 경우, 중졸 이하의 학력을 가진 경우, 소득수준이 월 100만원 미만인 경우, 주관적 건강상태가 부정적인 경우 좌식행동이 증가하였다. 따라서, 본 연구에서 나타난 좌식행동 관련 요인을 가진 대상자를 목표집단으로 한 건강증진 및 공중보건 캠페인이 개발 및 실행될 필요가 있다.
Key Message
This study is a serial cross-sectional study analyzing the temporal trend and related factors of sedentary behavior of adults using KCHS collected biennially from 2011 to 2017. The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women, respectively. However, elderly, subjects with an education lower than high school, with the lowest household income level, and with poor subjective health status showed an increasing sedentary behavior trend. These findings suggest that health promotion and public health campaigns are need to reduce the prevalence of sedentary behavior in population with related factors.
The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey
Jun Hyun Hwang, Soon-Woo Park
Epidemiol Health. 2022;44:e2022022.   Published online February 14, 2022
DOI: https://doi.org/10.4178/epih.e2022022
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Multiple studies have found that cigarette smokers are more likely to experience sleep disturbances than non-smokers. This study aimed to examine various associations between smoking and sleep quality according to sex and age, which have yet to be sufficiently examined in prior studies.
METHODS
Data analysis was conducted using a nationally representative sample of 224,986 Korean adults who participated in the 2018 Korea Community Health Survey. Sleep quality, as the dependent variable, was measured using the Pittsburgh Sleep Quality Index (PSQI), with PSQI scores indicating either good (≤4 points) or poor (>5 points) sleep quality. Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates.
RESULTS
The overall weighted prevalence of poor sleep quality was 39.4% (95% confidence interval, 39.1 to 39.7). In the multivariate model that excluded psychological factors, poor sleep quality positively correlated to smoking for both sexes and all age groups except for male aged ≥65 years. However, in the full model that included psychological factors, statistically significant odds ratios (approximately 1.5) for poor sleep quality according to smoking status were only observed for female under 65 years of age.
CONCLUSIONS
The relationship between poor sleep quality and smoking status differed according to sex and age. In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.
Summary
Korean summary
한국 성인의 39.4%는 수면의 질(피츠버그 수면의 질 지수(PSQI) 기준)이 낮았다. 성별 및 연령에 따라 흡연과 수면의 질 사이의 관련성은 다르게 나타났다. 구체적으로는 65세 이하의 여성에서 흡연은 수면의 질 악화와 관련성이 있었으나, 남성 또는 65세 이상 여성에서는 흡연과 수면의 질 간 유의한 관련성을 보이지 않았다.
Key Message
In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.
Dairy product consumption and type 2 diabetes among Korean adults: a prospective cohort study based on the Health Examinees (HEXA) study
Jiaqi Zhang, Kyungjoon Lim, Sangah Shin
Epidemiol Health. 2022;44:e2022019.   Published online February 4, 2022
DOI: https://doi.org/10.4178/epih.e2022019
  • 5,427 View
  • 374 Download
  • 3 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
It has been suggested that the consumption of dairy products helps lower the prevalence of type 2 diabetes (T2D). We investigated the association between the consumption of dairy products and T2D events in middle-aged Korean adults.
METHODS
We followed up 53,288 participants (16,895 male and 36,393 female) in the Health Examinees (HEXA) study. The consumption of dairy products was assessed using the self-administered food frequency questionnaire, and T2D was defined according to the 2015 treatment guidelines of the Korean Diabetes Association. Hazard ratios (HRs) and 95% confidence intervals (CIs) between the consumption of dairy products and the risk of T2D were calculated using Cox proportional hazards models after adjusting for potential confounders. Spline regression was used to better represent the association between the consumption of dairy products and the risk of T2D.
RESULTS
Among male, those with higher consumption of dairy products had a significantly lower risk of T2D than those who consumed essentially no dairy products (HR, 0.73; 95% CI, 0.58 to 0.91). In particular, consumption of yogurt (HR, 0.75; 95% CI, 0.60 to 0.93; ptrend=0.035) and cheese (HR, 0.66; 95% CI, 0.49 to 0.89; ptrend=0.005) was negatively associated with the incidence of T2D in male. In female, daily consumption of 1 serving of yogurt decreased the risk of T2D by 11%.
CONCLUSIONS
The association between the consumption of dairy products and the risk of T2D differed by sex and dairy product type. Further prospective studies are needed to confirm these associations.
Summary
Korean summary
본 연구는 한국인유전체역학조사사업의 도시코호트 기반조사와 추적조사에 참여한 40-69세 한국 성인 53 288명의 유제품 섭취와 제2형 당뇨병 발생 위험도를 분석하였다. 요거트와 치즈를 포함한 유제품 섭취가 많을수록 남성의 제2형 당뇨병 위험도가 낮아졌다. 요거트 섭취량을 하루에 한번 증가하면 여성의 제2형 당뇨병 위험도가 감소하다. 유제품 소비와 제2형 당뇨병의 위험도의 연관성은 성별과 유제품에 따라 다르다. 이를 확인하기 위해서는 추가 연구가 필요하다.
Key Message
The study aimed to assess the association between the consumption of dairy products and type 2 diabetes events in Korean adults. Data was from the Health Examinees Study among 53 288 participants. Higher consumption of dairy products including yogurt and cheese was associated with a lower risk of developing type 2 diabetes in men. Increasing yogurt intake by one serving/day reduces the risk of type 2 diabetes in women. The association between the consumption of dairy products and the risk of type 2 diabetes differed by gender and dairy product type. Further studies are needed to confirm this.

Citations

Citations to this article as recorded by  
  • Association of milk consumption with management and incidence of hypertension among South Korean adults: A prospective analysis of the health examinees study cohort
    Hyein Jung, Geongu Lee, Kyungjoon Lim, Sangah Shin
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(11): 2515.     CrossRef
  • Association between dairy consumption and the risk of diabetes: A prospective cohort study from the China Health and Nutrition Survey
    Yucheng Yang, Xiaona Na, Yuandi Xi, Menglu Xi, Haibing Yang, Zhihui Li, Ai Zhao
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Association of dairy consumption patterns with the incidence of type 2 diabetes: Findings from Alberta's Tomorrow Project
    Emad Yuzbashian, Mohammadreza Pakseresht, Jennifer Vena, Catherine B. Chan
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(12): 2760.     CrossRef
The general public’s perspectives on telemedicine during the COVID-19 pandemic in Korea: analysis of a nationwide survey
EunKyo Kang, Hyejin Lee, Ki Jeong Hong, Jieun Yun, Jin Yong Lee, Yun-Chul Hong
Epidemiol Health. 2022;44:e2022020.   Published online February 4, 2022
DOI: https://doi.org/10.4178/epih.e2022020
  • 5,682 View
  • 439 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the awareness, experience, approval, intention to use, and the desired type of telemedicine among Korean general public.
METHODS
From November to December 2020, we conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. A total of 2,097 participants completed the survey.
RESULTS
Of the 2,097 participants, 1,558 (74.3%) were aware of, 1,198 (57.1%) approved of, and 1,474 (70.3%) had the intention to use telemedicine. Participants from regions other than the Seoul metropolitan area and Daegu–Gyeongbuk Province (adjusted odds ratio [aOR], 1.29; 95% confidence interval [CI], 1.02 to 1.63), households with a monthly household income of US$6,000 or more (aOR, 1.44; 95% CI, 1.01 to 2.08), participants who had a college/university or associate’s degree (aOR, 1.35. 95% CI, 1.04 to 1.75) or a master’s degree or above (aOR, 1.73; 95% CI, 1.20 to 2.50), and housewives (aOR, 1.30; 95% CI, 1.03 to 1.64) had higher odds of approval. Elderly participants, those with a chronic disease (aOR, 1.26; 95% CI, 1.04 to 1.54), those who had experienced delays of healthcare services (aOR, 1.94; 95% CI, 1.27 to 2.96), and those who had experience with telemedicine (aOR, 4.28; 95% CI, 1.69 to 10.82) were more likely to intend to use telemedicine services. Regarding types of telemedicine, teleconsultation between doctors showed the highest approval rate (73.1%).
CONCLUSIONS
In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point. Groups with a substantial need for telemedicine were more in favor of telemedicine.
Summary
Korean summary
대표성 있는 대상자에 대해 설문조사를 시행하였을 때, 74.3%가 원격의료에 대해 알고 있었다. 코로나19 유행지역, 소득이 높은 군, 대졸자 혹은 그 이상, 주부는 원격의료에 찬성할 가능성이 높았으며만성질환이 있는 고령자, 의료이용에 지연을 겪었던 사람, 원격의료를 이용해 본 사람은 원격의료 사용 의향이 더 높았다.
Key Message
We conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point.
Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic
Hooyeon Lee, Dongwoo Choi, Jung Jae Lee
Epidemiol Health. 2022;44:e2022018.   Published online January 18, 2022
DOI: https://doi.org/10.4178/epih.e2022018
  • 6,549 View
  • 546 Download
  • 5 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.
RESULTS
In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).
CONCLUSIONS
The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.
Summary
Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.
Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addi­tion, the policies created to prevent its spread have disrupted daily living for the general population. Implement­ing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 cri­sis is of fundamental importance.

Citations

Citations to this article as recorded by  
  • Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study
    Xiaoxu Jiang, Bo Zhao, Eun Woo Nam, Fanlei Kong
    Frontiers in Psychiatry.2022;[Epub]     CrossRef
  • Association of compliance with COVID-19 public health measures with depression
    Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Factors associated with depressive symptomatology during the COVID-19 pandemic in Mexico: A 2021 national survey
    Pablo D. Valencia, Maria A. Torres-Quispe, Sofía Sánchez-Cayo, Ricardo F. Reyes-Aguilar, Alexander G. Acevedo-Cahuana
    Journal of Affective Disorders.2022; 317: 212.     CrossRef
  • Depression and anxiety in later COVID-19 waves across Europe: New evidence from the European COvid Survey (ECOS)
    André Hajek, Sebastian Neumann-Böhme, Iryna Sabat, Aleksandra Torbica, Jonas Schreyögg, Pedro Pita Barros, Tom Stargardt, Hans-Helmut König
    Psychiatry Research.2022; 317: 114902.     CrossRef
  • Socio-economic factors associated with mental health outcomes during the COVID-19 pandemic in South Korea
    Seo Yoon Lee, Jung Jae Lee, Hooyeon Lee
    Frontiers in Public Health.2022;[Epub]     CrossRef
Elder abuse/mistreatment and associated covariates in India: results from the Longitudinal Aging Study in India wave 1, 2017-2018
Thennavan Sathya, Yesuvadian Selvamani, Rangasamy Nagarajan
Epidemiol Health. 2022;44:e2022017.   Published online January 18, 2022
DOI: https://doi.org/10.4178/epih.e2022017
  • 5,423 View
  • 367 Download
  • 2 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Elder abuse has significant adverse consequences for the overall health and well-being of the elderly, including premature mortality. Using cross-sectional data, we assessed the prevalence of elder abuse in India, its variation across states, and associated factors.
METHODS
Nationally representative data from the first wave of the Longitudinal Aging Study in India were analyzed. Bivariate and multivariate analyses were used to study the prevalence, state variations, and associated factors of elder abuse.
RESULTS
Overall, 5.2% of elderly adults (≥60 years) had experienced abuse in the year prior to the survey and 3% had experienced abuse within their own household. Verbal abuse or disrespect was the most common form of abuse. Considerable variation was observed in the prevalence of elder abuse across states and union territories, with the highest prevalence observed in Bihar (11.6%) and Karnataka (10.1%). In regression analysis, education level emerged as a protective factor against elder abuse, particularly among women. Older adults who lived alone, had functional limitations, had multiple morbidities, and had been hospitalized in the past year were more likely to experience abuse. Older adults who experienced abuse were 2 times more likely to experience depressive symptoms.
CONCLUSIONS
Cross-state variation in the prevalence of elder abuse and subgroup differences suggest that state-specific interventions and essential monitoring of older adults with functional limitations, chronic diseases, and recent hospitalization can further reduce the prevalence and consequences of elder abuse in India.
Summary
Korean summary
Key Message
Elder abuse is one of the common forms of violence among the elderly. This study finds a significant proportion (5.2%) of Indian elderly reported elder abuse with considerable state-variations. The prevalence of elder abuse is higher in the states of Bihar (11.6%) and Karnataka (10.1%). Gender differences in elder abuse is notable where women is more likely to experience abuse than men. Education is a key protective factor of abuse. Elderly with multimorbidity and functional limitations are more likely to experience abuse. The elder abuse is positively associated with depressive symptoms.

Citations

Citations to this article as recorded by  
  • Elder Mistreatment as a Risk Factor for Depression and Suicidal Ideation in Korean Older Adults
    Min-So Paek, Mi Jin Lee, Yu-Seon Shin
    International Journal of Environmental Research and Public Health.2022; 19(18): 11165.     CrossRef
  • Understanding Elder Abuse in India: Contributing Factors and Policy Suggestions
    Priya Maurya, Aparajita Chattopadhyay, Smitha Rao, Palak Sharma
    Journal of Population Ageing.2022;[Epub]     CrossRef
Local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area, Korea: a view from a Bayesian perspective
Youngbin Lym, Hyobin Lym, Ki-Jung Kim
Epidemiol Health. 2022;44:e2022016.   Published online January 13, 2022
DOI: https://doi.org/10.4178/epih.e2022016
  • 5,293 View
  • 362 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The purpose of this study was to enhance the understanding of the local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area (GSA), Korea, after its initial outbreak in January 2020.
METHODS
Using the weekly aggregates of coronavirus disease 2019 (COVID-19) cases of 77 municipalities in the GSA, we examined the relative risks of COVID-19 infection across local districts over 50 consecutive weeks in 2020. To this end, we employed a spatiotemporal generalized linear mixed model under the hierarchical Bayesian framework. This allowed us to empirically examine the random effects of spatial alignments, temporal autocorrelation, and spatiotemporal interaction, along with fixed effects. Specifically, we utilized the conditional autoregressive and the weakly informative penalized complexity priors for hyperparameters of the random effects.
RESULTS
Spatiotemporal interaction dominated the overall variability of random influences, followed by spatial correlation, whereas the temporal correlation appeared to be small. Considering these findings, we present dynamic changes in the spread of COVID-19 across local municipalities in the GSA as well as regions at elevated risk for further policy intervention.
CONCLUSIONS
The outcomes of this study can contribute to advancing our understanding of the local-level COVID-19 spread dynamics within densely populated regions in Korea throughout 2020 from a different perspective, and will contribute to the development of regional safety planning against infectious diseases.
Summary
Korean summary
본 논문은 수도권 지역에서 코로나바이러스가 처음 발생한 2020년 1월 이후 12월 말까지 총 50주 동안 수도권 내 지자체 수준에서의 코로나 19 전염병에 대한 시공간적 확산 역동성을 파악하기 위한 연구이다. 데이터 기반의 실증분석을 위한 계층적 베이지언 기법 기반의 시공간 일반화 선형 혼합모형의 결과에 따르면, 확률효과 중 시공간적 상호작용의 영향성이 가장 크게 나타났고, 다음으로는 공간자기상관에 의한 영향 순으로 나타난 반면, 시간에 의한 확률효과는 상대적으로 적게 도출되었다. 연구의 결과를 종합하여, 본 연구에서는 지도 기반의 코로나 19 위험 및 그 위험의 시공간적 변화를 제시하고, 향후 전염병에 대한 정책대응에 활용될 수 있도록 하였다.
Key Message
This study investigates the local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area, Korea, after its initial outbreak in January 2020. We adopt a flexible hierarchical Bayesian method so as to account for latent influences of space and time along with the fixed effects by covariates. The results suggest that spatiotemporal interaction dominates the overall variability of random influences, followed by spatial correlation, while the temporal effect appears to be small. Based on these findings, we present maps that depict dynamic changes of COVID-19 infection as well as regions of elevated risks for further policy consideration.
Socioeconomic inequality in compliance with precautions and health behavior changes during the COVID-19 outbreak: an analysis of the Korean Community Health Survey 2020
Ga Bin Lee, Sun Jae Jung, Yang Yiyi, Jea Won Yang, Hoang Manh Thang, Hyeon Chang Kim
Epidemiol Health. 2022;44:e2022013.   Published online January 9, 2022
DOI: https://doi.org/10.4178/epih.e2022013
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined socioeconomic inequalities in compliance with precautions and health behavior changes during the coronavirus disease 2019 (COVID-19) outbreak using a representative Korean sample.
METHODS
This exploratory study utilized around 210,000 participants aged ≥25 years in the Korean Community Health Survey 2020. Socioeconomic status was measured with educational attainment and household income. Outcomes included non-compliance with 8 precaution measures and deterioration in 6 health behaviors. The relative inequality index (RII) was calculated to quantify the degree of inequality by education and income level. RII values >1.0 indicate that deprived people have a higher frequency of health problems, and RII values <1.0 conversely indicate a higher frequency of health problems in more advantaged groups.
RESULTS
People with lower education or income levels tended to have higher rates of non-compliance with COVID-19 safety precautions (RII range, 1.20 to 3.05). Lower education and income levels were associated with an increased smoking amount (RII=2.10 and 1.67, respectively) and sleep duration changes (RII=1.21 and 1.36, respectively). On the contrary, higher education and income levels were associated with decreased physical activity (RII=0.59 and 0.77, respectively) and increased delivery food consumption (RII=0.27 and 0.37, respectively). However, increased alcohol drinking was associated with lower education and income levels in younger men (RII=1.73 and 1.31, respectively), but with higher levels in younger women (RII=0.73 and 0.68, respectively).
CONCLUSIONS
Our findings suggest the need to develop customized strategies, considering the characteristics of the target population, to decrease the burden and impact of the COVID-19 outbreak.
Summary
Korean summary
코로나19 유행기간 동안 예방지침 준수율과 건강관련 생활습관이 나빠지는 정도는 사회경제적 수준에 따라 차이가 있다. 전반적으로 코로나19 예방지침 준수율은 높았지만, 사회경제수준이 낮을수록 예방지침 준수율도 낮아지는 경향을 보였다. 하지만, 사회경제수준과 생활습관 악화의 관계는 성, 연령, 생활습관의 종류에 따라 달랐다.
Key Message
This study of a representative Korean sample found that socioeconomic inequalities existed in compliance with COVID-19 precautions and in health behavior deterioration. There is a need to develop target group-specific strategies to reduce health inequalities and the long-term health burden of the COVID-19 outbreak.

Citations

Citations to this article as recorded by  
  • Factors associating to the increased smoking time among South Korean male workers during COVID-19 pandemic
    Mi Young Kwon, Myong Sun Cho
    Korean Journal of Health Education and Promotion.2022; 39(2): 53.     CrossRef
  • Trust and compliance: Milieu-specific differences in social cohesion during the COVID-19 pandemic in Germany
    Tim Schröder, Anne Speer, Patrick Sachweh, Olaf Groh-Samberg
    Frontiers in Sociology.2022;[Epub]     CrossRef
Independent predictors of depressive symptoms and social isolation on 2-year all-cause mortality among the Korean elderly in a population-based cohort study: gender differences
Hyunsuk Jeong, Hyeon Woo Yim, Beom-Woo Nam
Epidemiol Health. 2022;44:e2022012.   Published online January 8, 2022
DOI: https://doi.org/10.4178/epih.e2022012
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study.
METHODS
In total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs).
RESULTS
Of the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women.
CONCLUSIONS
The effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.
Summary
Korean summary
본 연구는 지역사회 거주하는 저소득층 노인을 대상으로 한 코호트 연구로 2년 추적조사를 수행하여 사망 원인의 예측인자를 분석하였다. 남성노인에서는 사회적 고립이, 여성노인에서는 우울증상이 2년 모든 사망원인의 독립적인 예측인자였다. 노인의 사망율을 줄이기 위한 지역사회 개입 프로그램은 남성에게는 사회적 고립을 해소를, 여성에게는 우울증상 개선을 위한 프로그램이 요구된다.
Key Message
The effects of depressive symptoms and so¬cial isolation on 2-year all-cause mortality among the elderly dif¬fered according to gender. For elderly men, social isolation increased the risk of 2-year all-cause mortality by 4.6 times compared to those who were not socially isolated. However, the depressive symptoms identified by the GDS-15 were not associated with 2-year all-cause mortality in men. From a public health perspective, these findings suggest that gender-specific community-based interventions are needed to mitigate all-cause mortality among the elderly.
The predictive value of resting heart rate in identifying undiagnosed diabetes in Korean adults: Korea National Health and Nutrition Examination Survey
Dong-Hyuk Park, Wonhee Cho, Yong-Ho Lee, Sun Ha Jee, Justin Y. Jeon
Epidemiol Health. 2022;44:e2022009.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022009
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC).
METHODS
Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM.
RESULTS
RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed.
CONCLUSIONS
Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.
Summary
Korean summary
당뇨병 미인지 또는 미진단은 적절한 치료 시작 시기를 늦추고 당뇨병 합병증 발생의 위험을 높이기 때문에, 각국은 당뇨병 예측 모형을 개발하여 당뇨병을 조기에 예측하고, 치료 시기를 앞당기기 위해 노력하고 있다. 본 연구는 기존의 한국인 당뇨병 예측 모형에 안정시심박수를 추가 변수로 포함시켜, 예측 모형의 성능이 일부개선되는 것을 확인하였고, 더 나아가 나이, 허리 둘레, 그리고 안정시심박수를 포함하여 예측 모형을 개발하고, 그 성능을 확인하였다. 본 연구에서는 간단하게 측정이 가능한 허리 둘레와 안정시심박수 그리고 나이만 포함한 예측 모형이 기존의 예측 모형과 비교해 성능이 열등하지 않은 것을 확인하였다.
Key Message
Higher RHR is associated with increased risk of diabetes. When RHR is added to the Korean undiagnosed diabetes risk score model (Age, Family history of diabetes, Hypertension, Waist circumference, Smoking, Alcohol consumption), the model somewhat increased its predictability of undiagnosed diabetes. Furthermore, the prediction model developed only using age, waist circumference and RHR, which anyone can easily measure or access, had similar predictability to the previous undiagnosed diabetes risk prediction model. The results of this study may help develop future strategies or applications for predicting early undiagnosed diabetes.
Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases
Dahye Baik, Byung-Woo Kim, Moran Ki
Epidemiol Health. 2022;44:e2022010.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022010
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases.
METHODS
Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases).
RESULTS
The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019.
CONCLUSIONS
Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.
Summary
Korean summary
우리나라의 감염병으로 인한 사망률과 의료비용은 증가하고 있다. 특히 고령층에서의 높은 사망률과 과다한 의료비용 지출을 고려하면, 호흡기 감염 관리에 집중하는 것이 중요하며 각 감염병 그룹별로 효과적인 정책과 효율적인 관리가 필요하다. 본 연구는 COVID-19 발생 이전의 우리나라 감염병의 사망률과 발생, 의료비 부담의 장기적인 추세를 분석한 중요한 레퍼런스가 될 것이다.
Key Message
In Republic of Korea, the mortality trends (1997-2019) and costs (2009-2019) of infectious disease have increased and this study is particularly important reference for identifying the long-term trends including mortality, outbreak, financial burden of infectious disease in Korea before COVID-19 outbreak.
Impact of water fluoridation on dental caries decline across racial and income subgroups of Brazilian adolescents
Rafael Aiello Bomfim, Paulo Frazão
Epidemiol Health. 2022;44:e2022007.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022007
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to assess the impact of community water fluoridation (CWF) on differences in dental caries decline across racial and socioeconomic subgroups of Brazilian adolescents.
METHODS
Two nationwide Brazilian population-based oral health surveys were used (Brazilian Oral Health Survey 2003 and 2010). In total, 7,198 adolescents from 15 years to 19 years old living in 50 cities investigated in both surveys were included. The mean numbers of untreated decayed teeth (DT) according to racial (Whites vs. Browns/Blacks) and socioeconomic subgroups (at or above the minimum wage per capita vs. under) were analysed. Difference-in-differences negative binomial regressions were adjusted by schooling, age, and sex. Decayed, missing, and filled teeth and DT prevalence, calculated as a categorical variable, were used in sensitivity analyses.
RESULTS
The adjusted difference of reduction in DT was similar across socioeconomic subgroups (β=-0.05; 95% confidence interval [CI], -0.45 to 0.35) and favoured, but not to a significant degree, Whites (β=-0.34; 95% CI, -0.74 to 0.04) compared to Brown/Blacks in fluoridated areas. In non-fluoridated areas, significant differences were observed in the mean number of DT, favouring the higher socioeconomic subgroup (β=-0.26; 95% CI, -0.53 to -0.01) and Whites (β=-0.40; 95% CI, -0.69 to -0.11) in relation to their counterparts. The sensitivity analyses confirmed the findings.
CONCLUSIONS
The similar reduction in DT across income subgroups suggests that CWF has had a beneficial effect on tackling income inequalities in dental caries within a 7-year timeframe.
Summary
Korean summary
Key Message
Community Water Fluoridation tackled income and racial inequalities in dental caries in adolescents aged 15-19 years between 2003 and 2010 in Brazil.
Evidence of the importance of contact tracing in fighting COVID-19
Okyu Kwon
Epidemiol Health. 2022;44:e2022006.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022006
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We analyzed data to determine whether there are distinguishing characteristics depending on the success or failure of control for coronavirus disease 2019 (COVID-19) by country in the trend of the daily number of confirmed cases and the number of tests.
METHODS
We obtained the number of confirmed cases and tests per day for almost every country in the world from Our World in Data. The Pearson correlation between the two time series was calculated according to the time delay to analyze the relationship between the number of tests and the number of cases with a lag.
RESULTS
For each country, we obtained the time lag that makes the maximum correlation between the number of confirmed cases and the number of tests for COVID-19. It can be seen that countries whose time lag making maximum correlation lies in a special section between about 15 days and 20 days are generally been successful in controlling COVID-19. That section looks like a trench on the battlefield.
CONCLUSIONS
We have seen the possibility that the success in mitigating COVID-19 can be expressed as a simple indicator of the time lag of the correlation between confirmed cases and tests. This time lag indicator is presumably reflected by efforts to actively trace the infected persons.
Summary
Korean summary
일일 신규 확진자 수와 검사자 수 시계열의 상관관계에서의 시간지연 값은 방역의 성공을 평가할 수 있는 지표가 될 수 있음을 여러 국가의 실제 데이터로부터 확인할 수 있었다. 이 시간 지연은 역학 조사에 따른 감염자 발굴의 노력의 결과로 이해할 수 있을 것이다.
Key Message
It was confirmed from actual data from several countries that the time delay value in the correlation between the number of daily new confirmed cases and the number of tests can be an indicator to evaluate the success of quarantine. This time delay can be understood as a result of efforts to discover infected persons according to epidemiological investigations.
Association of participation in the Northern Finland Birth Cohort 1986 with mental disorders and suicidal behaviour
Martta Kerkelä, Mika Gissler, Juha Veijola
Epidemiol Health. 2022;44:e2022005.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022005
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
In prospective follow-up studies, participants are normally contacted during the follow-up period. Even though the idea is not to intervene, the studies conducted during follow-up may affect the target population. Our hypotheses were that participation in the prospective Northern Finland Birth Cohort 1986 study (NFBC 1986) increased the use of mental health services and reduced suicidal behaviour due to participation in follow-up studies.
METHODS
The NFBC 1986 study covered people with an expected date of birth between July 1985 and June 1986 in northern Finland (n=9,396). The participants of the NFBC 1986 were followed since the antenatal period with follow-ups including clinical examinations. The comparison cohort comprised people born in the same area in 1987 (n=8,959), who were not contacted. Registry data on psychiatric treatment, suicide attempts, and suicides were available. Crude risk ratios (RRs) and adjusted (for marital status and education) Mantel-Haenszel RRs were reported.
RESULTS
No increase in mental disorders were found in NFBC 1986 compared to comparison cohort. In the crude RR analysis of female participants, a lower risk for suicide attempts was found (RR, 0.67; 95% confidence interval, 0.49 to 0.92; p=0.011).
CONCLUSIONS
The results did not support our first hypothesis regarding the increased use of mental health services in the NFBC 1986 cohort. However, our second hypothesis gained some support as female participants of the NFBC 1986 had a lower risk of suicide attempts, although it was not due to a higher number of participants receiving psychiatric treatment.
Summary
Korean summary
Key Message
Female members of the longitudinal Northern Finland Birth Cohort 1986 study did have less psychiatric diagnosis in several diagnosis classes than comparison cohort, which may indicate that different follow-up studies conducted in the prospective birth cohort studies may affect to the study population.

Epidemiol Health : Epidemiology and Health