Epidemiology and Health

Original Article

Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020: Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023033. Published online March 7, 2023; DOI: https://doi.org/10.4178/epih.e2023033

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study investigated recent trends in the prevalence of obesity among Korean adolescents and explored socioeconomic disparities in obesity.
METHODS
This study used annual self-reported data on height, weight, and socioeconomic information from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2020. With a 95.8% response rate, the sample consisted of 818,210 adolescents. Obesity prevalence was calculated according to 4 socioeconomic indicators (household income, father’s educational attainment, mother’s educational attainment, and urbanicity). Socioeconomic inequality was quantified using the relative index of inequality (RII).
RESULTS
The overall prevalence of obesity increased, doubling from 5.9% in 2006 to 11.7% in 2020. Boys and high school students showed a higher prevalence. The RIIs in household income and parental educational attainments significantly increased with time, indicating a growing inequality in obesity. Socioeconomic disadvantages had a greater influence on obesity among girls. The most recent RII values for boys were 1.25 for income, 1.79 for the father’s education, and 1.45 for the mother’s education, whereas the corresponding values for girls were 2.49, 3.17, and 2.62, respectively.
CONCLUSIONS
These findings highlight growing inequalities in adolescent obesity according to household income and parental educational attainments, especially for girls and middle schoolers.; Summary

Korean summary
2006년부터 2020년까지 청소년 비만의 유병은 증가 추세에 있을 뿐 아니라, 가정의 경제상태, 부모의 학력수준에 따른 비만의 위험 격차도 점점 심해지는 추세를 보였다. 특히, 남학생과 고등학생의 비만 유병률이 높게 나타났으나, 사회경제적 지표에 따른 비만의 불평등 격차는 여학생과 중학생에서 높게 나타났다.

Key Message
Not only the prevalence but also socioeconomic inequality in adolescent obesity increased between 2006 and 2020. The potential impact of socioeconomic disparity on obesity was greater in girls and middle school students than their counterparts.

COVID-19: Special Article

Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey: Bomi Park, Jihee Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh; Epidemiol Health. 2023;45:e2023019. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023019

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.

METHODS

We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.

RESULTS

In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.

CONCLUSIONS

The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.

Summary

Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.

Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.

Citations

Citations to this article as recorded by

Excess mortality during the Coronavirus disease pandemic in Korea
Changwoo Han, Hoyeon Jang, Juhwan Oh
BMC Public Health.2023;[Epub] CrossRef

COVID-19: Special Article

Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey: Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh; Epidemiol Health. 2023;45:e2023018. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023018

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to investigate changes in health behaviors, including cigarette smoking, alcohol drinking, physical activity, dietary behaviors, and obesity, before and during the coronavirus disease 2019 (COVID-19) pandemic using the Korea Youth Risk Behavior Survey (KYRBS) database.
METHODS
KYRBS data from 2015 to 2021 were used in this study. Differences in health behaviors between before (pre-pandemic period: 2018-2019) and during (pandemic period: 2020-2021) the pandemic were examined. Differences were compared using linear regression and the chi-square test considering the complex survey design after adjusting for grade level.
RESULTS
The prevalence of current cigarette smoking and current alcohol drinking significantly decreased in both male and female students during the pandemic compared to the pre-pandemic period. However, the prevalence of obesity significantly increased in both male and female students during the same period. When examining physical activity and dietary behaviors closely related to obesity, fast food consumption increased and fruit consumption decreased during the pandemic in both male and female students, whereas no significant changes in physical activity were observed in either male or female students.
CONCLUSIONS
The deterioration of adolescent dietary behaviors and an increase in the prevalence of obesity can increase the future disease burden, and concerted efforts at the individual and national levels are needed to reduce obesity and promote healthy dietary behaviors.; Summary

Korean summary
이 연구는 한국 청소년건강행태조사자료(KYRBS)를 사용하여 코로나19 유행 전후의 우리나라 청소년들의 흡연, 음주, 신체활동, 식습관, 비만 등의 건강행태의 변화에 대하여 살펴보고자 하였다. 이 연구에서는 2015년부터 2021년까지의 청소년건강행태조사자료를 사용하여, 코로나19 유행 이전 (2018-2019년)과 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화에 대하여 조사하였다. 학년레벨을 보정한 후, 복합표본설계를 고려하여 로지스틱 회귀분석과 카이제곱검정을 이용하여 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화가 있었는지에 대하여 확인하였다. 그 결과, 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나19 유행 기간(2020-2021년) 동안에 현재흡연율과 현재음주율이 유의하게 감소하였다. 그러나 동일한 기간 동안에 남학생과 여학생 모두에서 비만율이 유의하게 증가하였는데, 비만율과 관련된 신체활동 및 식습관에 대하여 살펴보았을 때, 신체활동에서는 유의한 변화가 없었던 반면, 남학생과 여학생 모두에서 패스트푸드 섭취는 증가하고 과일섭취가 감소한 것으로 나타났다. 따라서 코로나19 유행기간 동안 흡연율 및 음주율 등의 청소년 건강에 유익한 변화도 있었으나, 비만율도 같이 증가한 것을 확인할 수 있었다. 청소년기의 식습관의 악화 및 비만율의 증가는 미래 우리나라의 질병부담을 증가시킬 수 있기 때문에, 청소년의 비만율을 낮추고 건강한 식습관을 증진시키기 위한 개인 및 사회 차원의 노력이 필요하다.

Key Message
-The current cigarette smoking and current alcohol drinking rates significantly decreased among Korean adolescents during the pandemic period compared to the pre-pandemic period. -On the other hand, the obesity rate increased significantly especially among Korean male adolescents, which is accompanied by changes in dietary habits such as an increase in fast food intake and a decrease in fruit intake.

Original Articles

Associations between digital media use and lack of physical exercise among middle-school adolescents in Korea: Gyeongmin Kim, Hyunsuk Jeong, Hyeon Woo Yim; Epidemiol Health. 2023;45:e2023012. Published online January 10, 2023; DOI: https://doi.org/10.4178/epih.e2023012

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The reported effects of digital media overuse on physical activity among adolescents are inconsistent. This study examined the association between hours of digital media use and lack of moderate-intensity physical exercise (mPE) according to the type of digital media.
METHODS
This study included 1,837 middle school students from the iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) study conducted in Korea. Hours spent using digital media were measured by self-reported daily usage time for Internet games, messengers, social media, and watching game streaming on weekdays. Lack of mPE was defined as performing a minimum of 30 minutes at a time less than twice weekly. Multivariable logistic regression analysis stratified by sex was performed.
RESULTS
Among male students, the group with the highest hours of using either Internet games or watching game streaming was more likely to lack mPE than each non-user group. In contrast, among male students, the group using either messengers or social media had a higher rate of mPE compared to each non-user group. Female students showed no association between hours spent using Internet games, messengers, social media, or watching game streaming and a lack of mPE.
CONCLUSIONS
Among male middle school students in Korea, the excessive use of Internet games or watching game streaming was associated with a lack of mPE. Thus, guidelines should be established regarding adolescent use of internet games and watching game streaming.; Summary

Korean summary
한국에서 남, 여 중학생을 대상으로 4개 인터넷 매체(인터넷 게임, 메신저, 소셜미디어, 게임 스트리밍 시청) 과다사용과 신체 운동 부재와의 연관성을 알아보기 위한 단면조사 연구를 시행하였다. 남자 중학생에서 인터넷 게임 사용 또는 게임 스트리밍 시청 시간이 가장 높은 사분위 그룹은 비이용 그룹보다 중간 강도의 신체운동 부재율이 유의하게 높았다.

Key Message
A cross-sectional study was conducted to find out the relationship between excessive use of four Internet media (internet games, messengers, social media, and game streaming) and lack of physical exercise targeting male and female middle school students in Korea. Among male middle school students, the upper quartile group with the highest Internet game use or game streaming viewing time had a significantly higher moderate-intensity physical exercise absence rate than the non-use group.

Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication: Hye-Kyung Cho, Hyunju Lee, Young June Choe, Shinkyeong Kim, Sujin Seo, Jiwon Moon, Eun Hwa Choi, Geun-Yong Kwon, Jee Yeon Shin, Sang-Yoon Choi, Mi Jin Jeong, Myoungsoon You; Epidemiol Health. 2023;45:e2023004. Published online December 13, 2022; DOI: https://doi.org/10.4178/epih.e2023004

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Abstract Summary PDF

Abstract

OBJECTIVES
Vaccination is one of the most important strategies to contain the spread of coronavirus disease 2019 (COVID-19). Vaccination in children is dependent on their parents, making it important to understand parents’ awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children.

METHODS

A web-based nationwide survey was conducted among Korean parents of 7-year-old to 18-year-old children in August 2021 to estimate parents’ intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy through regression analysis.

RESULTS

Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were being a mother (adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.25 to 0.52), a lower education level (aOR, 0.83; 95% CI, 0.70 to 0.97), hesitancy to other childhood vaccines (aOR, 0.78; 95% CI, 0.64 to 0.96), and refusal to vaccinate themselves (aOR, 0.08; 95% CI, 0.02 to 0.20). Having older children (aOR, 1.20; 95% CI, 1.13 to 1.28), trusting the child’s doctor (aOR, 1.19; 95% CI, 1.07 to 1.32), positive perceptions of the COVID-19 vaccine’s effectiveness (aOR, 2.60; 95% CI, 1.90 to 3.57) and perceiving the COVID-19 vaccine as low-risk (aOR, 1.68; 95% CI, 1.27 to 2.24) were associated with COVID-19 vaccine acceptance. Concerns about adverse reactions were the most common cause of hesitancy.

CONCLUSIONS

Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase COVID-19 vaccine uptake in children. Differential or targeted approaches to parents according to gender, age, and their children’s age are necessary for effective communication about vaccination in children.

Summary

Korean summary
부모에게 백신 효과와 안전성에 대한 정확하고 믿을만한 정보를 제공하는 것이 소아 코로나19 백신 접종률을 높이는데 중요하다. 자녀의 백신 접종에 대한 의사소통을 효율적으로 하기 위해서는 부모의 성별과 연령, 자녀의 연령을 고려한 차별적인 접근 방법이 필요하다.

Key Message
To improve COVID-19 vaccine uptake in children, it's crucial to provide parents with reliable and precise information about vaccine safety and effectiveness. Targeted communication strategies that consider factors such as the age of the parents and their children, as well as gender, may be necessary to effectively convey this information.

Citations

Citations to this article as recorded by

Willingness and hesitancy of parents to vaccinate against COVID-19 their children ages 6 months to 4 years with frail conditions in Italy
Grazia Miraglia del Giudice, Giorgia Della Polla, Mario Postiglione, Italo Francesco Angelillo
Frontiers in Public Health.2023;[Epub] CrossRef

Changes in eating behaviors according to household income in adolescents during the COVID-19 pandemic: findings from the Korea National Health and Nutrition Examination Survey: Hye Ah Lee, Ho Jung Lee, Bomi Park, Yoonhee Shin, Hyunjin Park, Hyesook Park; Epidemiol Health. 2022;44:e2022102. Published online November 9, 2022; DOI: https://doi.org/10.4178/epih.e2022102

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
To assess social inequalities in changes in dietary behaviors among adolescents during the coronavirus disease 2019 (COVID-19) pandemic, we compared changes in dietary behavior indicators by household income.
METHODS
Using cross-sectional data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, the prevalence of dietary behaviors in adolescents (12-18 years old) was estimated and changes in dietary behaviors during the COVID-19 pandemic were evaluated. We assessed changes in dietary behaviors with a household income (as a measure of socioeconomic status, SES) disparity.
RESULTS
During the COVID-19 pandemic, the average consumption of vegetables decreased and food insecurity worsened. Adolescents were more likely to skip breakfast than before COVID-19 (33.1 and 37.4%). Soft drink consumption also increased in 2020 from 2019 (7.6 and 14.8%), especially among boys. Average sugar intake and sodium intake showed a tendency to decrease only in girls, but there was no significant difference according to SES level. Skipping breakfast was particularly evident in the low-SES group, and the difference according to household income level (high vs. low) was greater during COVID-19 than before. The prevalence of soft drink consumption increased significantly in the low-SES group, but the rate of increase did not differ by SES level.
CONCLUSIONS
We found that the social disparity in skipping breakfast was further aggravated during the COVID-19 pandemic. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.; Summary

Korean summary
국민건강영양조사 자료를 활용하여, COVID-19 팬데믹 전후 청소년의 식생활 변화 및 가구소득 수준에 따른 차이를 평가하였다. 대체로, 평균 채소 섭취량은 감소하고 탄산음료 소비는 증가한 것으로 나타났으며, 아침식사 결식율도 약간 증가한 것으로 나타났다. 게다가, 가구소득 수준에 따라 평가하였을 때, 아침식사 결식율 증가는 가구소득이 높은 군에 비해 가구소득 수준이 낮은 군에서 두드러진 것으로 나타났다. COVID-19 팬데믹이 장기화됨에 따라, 청소년의 식생활 변화에 대해서는 지속적인 모니터링이 필요하다.

Key Message
Using data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, changes in dietary behaviors of adolescents (12-18 years old) during the COVID-19 pandemic were evaluated. During the COVID-19 pandemic, average consumption of vegetables decreased and consumption of soft drinks increased in 2020 from 2019 (7.6% and 14.8%). In addition, the social disparity in skipping breakfast among adolescents was further aggravated. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.

Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019: Chandrashekhar T. Sreeramareddy, Anusha Manoharan; Epidemiol Health. 2022;44:e2022103. Published online November 8, 2022; DOI: https://doi.org/10.4178/epih.e2022103

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.
METHODS
We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.
RESULTS
Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.
CONCLUSIONS
The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.; Summary

Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.

Cohort Profile

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile: Chris Desmond, Gabriella A. Norwitz, Jane D. Kvalsvig, Rachel S. Gruver, Shuaib Kauchali, Kathryn G. Watt, Nonhlanhla P. Myeza, Adele Munsami, Leslie L. Davidson; Epidemiol Health. 2022;44:e2022037. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022037

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Abstract Summary PDF: Abstract
The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children’s primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.; Summary

Key Message
The Asenze Cohort Study, one of a limited number of population-based studies set in low- and middle-income countries, with a high level of retention, provides an understanding of neuro-developmental, psychosocial, home environmental and economic exposures and outcomes of over 1100 adolescents and their primary caregivers in KwaZulu-Natal, South Africa.

Original Articles

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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Abstract Summary PDF Supplementary 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

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.

Age-specific effects of ozone on pneumonia in Korean children and adolescents: a nationwide time-series study: Kyoung-Nam Kim, Youn-Hee Lim, Sanghyuk Bae, In Gyu Song, Soontae Kim, Yun-Chul Hong; Epidemiol Health. 2022;44:e2022002. Published online December 28, 2021; DOI: https://doi.org/10.4178/epih.e2022002

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The aim of this study was to estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents.

METHODS

We performed quasi-Poisson regression analyses for individuals of 0-4 years, 5-9 years, 10-14 years, and 15-19 years of age using nationwide time-series data from the Korea (2011-2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants.

RESULTS

A 10.0-parts per billion increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0-4 (relative risk [RR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 5-9 years of age (RR, 1.06; 95% CI, 1.04 to 1.08), but not at 10-14 (RR, 1.01; 95% CI, 0.98 to 1.04) or 15-19 years of age (RR, 1.01; 95% CI, 0.97 to 1.06). The association between ozone and hospital admissions due to pneumonia was stronger in cool seasons (from November to April) than in warm seasons (from May to October), but was similar between boys and girls.

CONCLUSIONS

Short-term exposure to ozone was associated with a higher risk of pneumonia at 0-4 years and 5-9 years of age, but not at 10-14 years or 15-19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.

Summary

Korean summary
-어린이와 청소년에서 대기오염물질인 오존에 단기 노출되었을 때 폐렴으로 인한 입원 위험이 증가하는지를 건강보험공단 청구자료를 이용하여 구축한 시계열자료로 분석하였다. -0-4세, 5-9세 군에서는 오존 단기 노출 시 폐렴으로 인한 입원 위험이 증가하였으나 10-14세, 15-19세 군에서는 입원 위험 증가가 관찰되지 않았다.

Key Message
• The effects of ozone levels on hospital admissions for pneumonia were evaluated. • We used quasi-Poisson time-series models and a difference-in-differences method. • Ozone levels increased hospital admissions for pneumonia at ages 0–4 and 5–9 years. • Evidence for the effects of ozone levels on pneumonia was not found at older ages.

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Intraday exposure to ambient ozone and emergency department visits among children: a case-crossover study in southern China
Jiahong Ren, Lifeng Zhu, Yachen Li, Haiyi Li, Qian Hu, Jian Zhu, Qingyan Zhang, Yunquan Zhang
Environmental Science and Pollution Research.2023; 30(30): 74853. CrossRef

Social competence, leisure time activities, and smoking trajectories among adolescent boys: data from the Korean Children & Youth Panel Survey: Eunjung Park, Min Kyung Lim, Jinju Park, Tran Thi Phuong Thao, Sukyung Jeong, Eun Young Park, Jin-Kyoung Oh; Epidemiol Health. 2021;43:e2021066. Published online September 9, 2021; DOI: https://doi.org/10.4178/epih.e2021066

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The purpose of this study was to identify the trajectories and potential predictors of tobacco use during adolescence in Korea and to develop appropriate strategies for the implementation of tobacco use prevention programs.
METHODS
The trajectory of tobacco use and associated predictors were analyzed for 1,169 male students from grade 6 (age 11-12) to grade 10 (age 15-16) in the Korean Children & Youth Panel Survey from 2012 to 2016.
RESULTS
Three trajectories of smoking experience were identified: non-smokers (class 1: n=775, 82.3%), temporary users (class 2: n=32, 3.4%), and regular users (class 3: n=135, 14.3%). When compared to non-smokers, temporary users had a higher likelihood of living with a single parent, dissatisfaction with grades, having a girlfriend, having been victimized at least once, and having at least 1 delinquent friend in grade 7 (when smoking experimentation was at its peak). Significant factors associated with regular use included having a girlfriend, committing at least 1 type of delinquent behavior, and being a non-reader. Committing at least 1 type of delinquent behavior and having at least 1 delinquent friend were associated with regular users, distinguishing them from temporary users.
CONCLUSIONS
Understanding why adolescents exhibit different trajectories of tobacco use by identifying the factors associated with each trajectory can contribute to the development of tailored prevention strategies and early cessation programs for adolescents.; Summary

Korean summary
2010-2016년 한국아동청소년패널에 포함된 남학생 흡연경험 분석을 통해 3개의 주요 흡연유형이 확인되었다 (비흡연자 82.3%, 일시 흡연자 3.4%, 지속 흡연자 14.3%). 한부모 가정, 학업성적에 대한 불만족, 이성친구를 사귀는 경우, 또래로부터 괴롭힘을 당한 경험, 1명 이상의 비행 친구가 있는 경우 일시 흡연자가 될 가능성이 높고, 비행 경험이 있는 경우, 이성 친구를 사귀는 경우, 독서를 하지 않는 경우 지속 흡연자가 될 가능성이 높았다. 청소년기 성장단계에 따른 흡연유형의 변화와 관련 요인에 대한 분석 결과는 청소년 대상 맞춤형 흡연예방 및 금연 프로그램 마련에 기여할 수 있을 것이다.

Key Message
In adolescence, significant life changes such as increasing academic workloads and various societal influences combined with growing recognition can affect their interest in trying smoking. The current study suggested that societal influence such as living with a single parent, dissatisfaction with grades, having been victimized at least once, and having at least 1 delinquent friend initiates smoking experimentation. Adolescents having a girlfriend, committing at least 1 type of delinquent behavior, and never reading have a greater possibility of smoking continuation for regular use. These findings might contribute to development of tailored prevention and early cessation programs for adolescents.

Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression: Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Leili Tapak, Iman Dianat, Akram Karimi-Shahanjarini, Rashid Heidarimoghadam; Epidemiol Health. 2020;42:e2020039. Published online June 2, 2020; DOI: https://doi.org/10.4178/epih.e2020039

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8 Citations

Abstract PDF

Abstract

OBJECTIVES
This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students.

METHODS

In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used.

RESULTS

In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP.

CONCLUSIONS

A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.

Summary

Citations

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Prevalence of chronic pain and contributing factors: a cross-sectional population-based study among 2,379 Iranian adolescents
Maryam Shaygan, Azita Jaberi, Marziehsadat Razavizadegan, Zainab Shayegan
The Korean Journal of Pain.2023; 36(2): 230. CrossRef
Association between Physical Fitness and Low Back Pain: The Pepe Cross-Sectional Study
Aina M. Galmés-Panadés, Josep Vidal-Conti
Children.2022; 9(9): 1350. CrossRef
Prevalence of Low Back Pain among Primary School Students from the City of Valencia (Spain)
Vicente Miñana-Signes, Manuel Monfort-Pañego, Antonio Hans Bosh-Bivià, Matias Noll
Healthcare.2021; 9(3): 270. CrossRef
Identification of factors related to behaviors associated with musculoskeletal pain among elementary students
Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Akram Karimi-Shahanjarini, Leili Tapak, Rashid Heidarimoghadam, Iman Dianat
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef
Parents' knowledge and attitudes when choosing their children's school bag: An introductory study
Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Dubravko Bokonjić
Scripta Medica.2021; 52(2): 124. CrossRef
Designing School Tables and Chairs based on Anthropometry of Elementary School Students in Surabaya
Riska Ayu Yulianingtyas, Dani Nasirul Haqi
The Indonesian Journal Of Occupational Safety and Health.2021; 10(1): 97. CrossRef
Unconventional seats for students returning to school during the worldwide COVID-19 pandemic: has Italy taken the right direction?
Massimiliano Polastri, Julie Swann
International Journal of Therapy and Rehabilitation.2020; 27(11): 1. CrossRef
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Fabíola Unbehaun Cibinello, Jessica Caroliny de Jesus Neves, Mônica Yosino Leão Carvalho, Paola Janeiro Valenciano, Dirce Shizuko Fujisawa
Motriz: Revista de Educação Física.2020;[Epub] CrossRef

Relationship between the experience of online game genre and high risk of Internet gaming disorder in Korean adolescents: Hyunho Han, Hyunsuk Jeong, Sun-Jin Jo, Hye Jung Son, Hyeon Woo Yim; Epidemiol Health. 2020;42:e2020016. Published online April 7, 2020; DOI: https://doi.org/10.4178/epih.e2020016

55,208 View
271 Download
7 Citations

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined the association between high risk of Internet gaming disorder (IGD) and online game genres used by adolescents.

METHODS

The data derived from the baseline data of the Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence. A total 1,532 middle school students who use online games included. The participants reported the names of the online games they used during the past year. Game genres were categorized into role playing games (RPGs), shooting, multiplayer online battle arena (MOBA), simulation, arcade, sports and action games. The risk of IGD was measured using the Internet Gaming Use-Elicited symptom Screen. The relationship between the experience of online game genre and high risk of IGD was analyzed using multiple logistic regression model.

RESULTS

The game time of a student was longer if he or she had an experience of RPGs, shooting games, MOBA games, simulation games, and action games. The direct and independent association between high risk of IGD in adolescents and the genres of RPGs, simulation games and MOBA were found to be odds ratios 1.52 (95% confidence interval [CI], 1.03 to 2.26); 1.59 (95% CI, 1.03 to 2.45); and 1.51 (95% CI, 1.03 to 2.21), respectively after adjusted the potential confounding variables and the use of other online game genres.

CONCLUSIONS

The present cross-sectional study has found an association between online game genres and the risk of IGD in adolescents attending a school. A cohort study should verify the causal association in future.

Summary

Korean summary
본 연구에서는 전향적 코호트 연구인 iCURE의 기저시점에 등록된 2,319명 중, 연구목적상 필요한 중학생 1,532명의 자료를 활용하여 온라인 게임장르 이용경험과 인터넷게임장애 위험의 연관성을 살펴보았다. 이는 추후, 온라인 게임장애의 위험요인을 규명하는 연구에 기초자료를 제시하는데 목적을 두었다. 이에, 롤플레잉게임, 시뮬레이션게임, MOBA의 이용경험이 있는 자는 인터넷게임장애 고위험자가 될 가능성이 각각 1.52배, 1.59배, 1.51배 높은 것으로 나타났다. 따라서, 추후, 청소년들이 이용하는 온라인 게임장르와 인터넷게임장애의 관련성을 알아보기 위한 관찰연구에서, 위험요인이 되는 장르로 롤플레잉게임과 시뮬레이션게임, MOBA 장르에 주목할 필요성이 있다. 또한, 대상자들의 연령수준과 해당 시점에 유행적인 요소의 파악이 필요할 것이다.

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Correlates of internet gaming among violent and nonviolent gamers and comparison of their psychological well-being with nongamers in a university student population
Maliha Ansari, NisheetM Patel, AnkurN Mahida, AjayG Phatak, Anusha Prabhakaran, JagdishR Varma
Indian Journal of Psychiatry.2022; 64(1): 98. CrossRef
Escapism-Based Motivation Affected the Psychological Performances of High-Risk Internet Gaming Disorder Individuals
Shuai Wang, Jialing Li, Siyu Wang, Can Mi, Wei Wang, Zhengjia Xu, Wenjing Xiong, Longxing Tang, Yanzhang Li
Frontiers in Psychiatry.2022;[Epub] CrossRef
The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses
Yuan-Xia Gao, Jiang-Yang Wang, Guang-Heng Dong
Journal of Psychiatric Research.2022; 154: 35. CrossRef
Prevalence of gaming disorder in East Asia: A comprehensive meta-analysis
Zhenjiang Liao, Xinxin Chen, Qiuping Huang, Hongxian Shen
Journal of Behavioral Addictions.2022; 11(3): 727. CrossRef
Children’s mobile-gaming preferences, online risks, and mental health
Chun-Yin Hou, Ru Rutherford, Hsi Chang, Fong-Ching Chang, Liu Shumei, Chiung-Hui Chiu, Ping-Hung Chen, Jeng-Tung Chiang, Nae-Fang Miao, Hung-Yi Chuang, Chie-Chien Tseng, Taro Matsuki
PLOS ONE.2022; 17(12): e0278290. CrossRef
Contribution of Game Genre and Structural Game Characteristics to the Risk of Problem Gaming and Gaming Disorder: a Systematic Review
Florian Rehbein, Daniel L. King, Andreas Staudt, Tobias Hayer, Hans-Jürgen Rumpf
Current Addiction Reports.2021; 8(2): 263. CrossRef
The Impact of Online Game Addiction on Adolescent Mental Health: A Systematic Review and Meta-analysis
Eni Purwaningsih, Ira Nurmala
Open Access Macedonian Journal of Medical Sciences.2021; 9(F): 260. CrossRef

Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis: Yongho Jee, Gyuyoung Lee; Epidemiol Health. 2020;42:e2020008. Published online March 3, 2020; DOI: https://doi.org/10.4178/epih.e2020008

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5 Citations

Abstract Summary PDF

Abstract

OBJECTIVES
Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.

METHODS

We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.

RESULTS

The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.

CONCLUSIONS

In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.

Summary

Korean summary
성경험 유병률은 일반적으로 남녀 공히 모든 시기에서 연령대에 따라 증가했다. 공통적으로 최근 연도에서 12-13세 연령군의 성 경험 유병률이 증가한 반면 16-17세 연령군에서 성경험 유병률이 감소했다. 전반적으로 2006 년부터 2017 년까지 청소년들의 성경험률은 소폭 감소했지만, 조기 성경험의 빈도는 증가하고 있다. 따라서 피임이나 순결 교육뿐만 아니라 성적자기결정능력같은 보다 실질적인 성교육이 어릴 때부터 강화되어야 할 것으로 보인다.

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Jihye Choi, Seyoung Kim, Seung-Ju Lee, Sangrak Bae, Sooyoun Kim
The World Journal of Men's Health.2023; 41(2): 413. CrossRef
Association Between School Bullying Victimization and Sexual Risk-Taking among South Korean Adolescents: The Role of Teacher and Parental Relationships
Jihoon Kim, Yeungjeom Lee, Lindsay Leban, Wesley G. Jennings
Archives of Sexual Behavior.2023;[Epub] CrossRef
Prevalence and Trends of Sexual Behaviors Among Young Adolescents Aged 12 Years to 15 Years in Low and Middle-Income Countries: Population-Based Study
Zhengyue Jing, Jie Li, Yi Wang, Chengchao Zhou
JMIR Public Health and Surveillance.2023; 9: e45236. CrossRef
Sexual-Related Knowledge, School and Family Sexuality Education and Its Association with Experience of Sexual Intercourse among Vocational Secondary School Students in China
Yuhang Fang, Yujia Zheng, Yan Jin, Chunyan Yu, Xiayun Zuo, Qiguo Lian, Chaohua Lou, Lihe Li, Ping Hong, Xiaowen Tu
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Factors associated with adolescents’ sexual experience based on the biopsychosocial model: a cross-sectional study using the Korea Youth Risk Behavior Web-based Survey (KYRBS)
Ka Young Kim, Hye Young Shin
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Review

The global prevalence of dental healthcare needs and unmet dental needs among adolescents: a systematic review and meta-analysis: Mahin Ghafari, Samira Bahadivand-Chegini, Tayebeh Nadi, Amin Doosti-Irani; Epidemiol Health. 2019;41:e2019046. Published online October 27, 2019; DOI: https://doi.org/10.4178/epih.e2019046

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6 Citations

Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.

METHODS

PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.

RESULTS

The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).

CONCLUSIONS

The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.

Summary

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Ana Carla Souza COSTA, Djessyca Miranda e PAULO, Maria Tereza Campos VIDIGAL, Walbert de Andrade VIEIRA, Andres Felipe Millan CARDENAS, Luiz Renato PARANHOS
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Wan Nurazreena Wan Hassan, Mohd Zambri Mohamed Makhbul, Zamros Yuzadi Mohd Yusof
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Maria Tereza Campos Vidigal, Caio Melo Mesquita, Murilo Navarro de Oliveira, Walbert de Andrade Vieira, Cauane Blumenberg, Gustavo G Nascimento, Matheus Melo Pithon, Luiz Renato Paranhos
European Journal of Orthodontics.2022; 44(4): 359. CrossRef
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Wan Nurazreena Wan Hassan, Mohd Zambri Mohamed Makhbul, Zamros Yuzadi Mohd Yusof, Siti Adibah Othman
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Association between malocclusion in the mixed dentition with breastfeeding and past nonnutritive sucking habits in school-age children
Glauber S. Belitz, Lara J. N. Furlan, Jessica K. Knorst, Luana C. Berwig, Thiago M. Ardenghi, Vilmar A. Ferrazzo, Mariana Marquezan
The Angle Orthodontist.2022; 92(5): 669. CrossRef
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Eeva Torppa‐Saarinen, Mimmi Tolvanen, Satu Lahti, Anna Liisa Suominen
Community Dentistry and Oral Epidemiology.2021; 49(2): 158. CrossRef

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