Epidemiology and Health

Original Articles

Normal liver enzymes do not indicate safety from alcohol-related liver disease: evidence from a Korean nationwide cohort: Yeon Woo Oh, Jun Young Park, Eun-Cheol Park; Epidemiol Health. 2026;48:e2026004. Published online January 22, 2026; DOI: https://doi.org/10.4178/epih.e2026004

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Abstract Summary PDF: Abstract
OBJECTIVES
This study examined whether individuals with consistently normal liver enzyme levels are protected from alcohol-related liver disease and investigated whether heavy drinking increases liver disease risk independent of normal biomarker status.
METHODS
We conducted a nationwide cohort study using Korean National Health Insurance Service data (2002–2019), including 19,035 participants aged ≥40 years who maintained normal liver enzyme levels (aspartate aminotransferase ≤40 μ/L, alanine aminotransferase ≤40 μ/L, gamma-glutamyl transferase ≤63 μ/L for men and ≤35 μ/L for women) across multiple examinations conducted between 2002 and 2008. Participants were categorized as abstainers (≤1 time/mo), moderate drinkers (≤2 times/wk), and heavy drinkers (≥3 times/wk). Primary outcomes included incident liver disease identified using diagnostic codes. Cox proportional hazards models were used to estimate hazard ratios (HRs), with age-stratified analyses performed.
RESULTS
Heavy drinkers demonstrated a significantly higher risk of liver disease than abstainers (HR, 1.73; 95% confidence interval [CI], 1.40 to 2.14), whereas moderate drinkers showed no significant association (HR, 1.06; 95% CI, 0.94 to 1.19). Consistent patterns emerged for middle-aged adults (40–69 years), with attenuated effects among participants aged ≥70 years. When alcoholic liver disease was analyzed specifically, both moderate (HR, 1.29; 95% CI, 1.05 to 1.58) and heavy drinkers (HR, 2.86; 95% CI, 2.09 to 3.91) exhibited significantly increased hazards.
CONCLUSIONS
Despite normal liver enzyme levels, heavy alcohol consumption was associated with a significantly increased risk of liver disease. These findings challenge current reactive screening paradigms relying solely on biomarker abnormalities and support proactive alcohol counseling regardless of enzyme results. More sensitive strategies are needed for early detection of alcohol-related liver injury.; Summary

Korean summary
간 효소 수치가 지속적으로 정상 범위를 유지한 사람들에게서도 과음은 간 질환 발생 위험을 유의하게 높이는 것으로 나타났다. 이는 정상 간 효소 수치가 간 건강을 보장하지 않음을 의미하며, 간 효소 수치와 무관하게 과음자 모두를 대상으로 한 적극적인 음주 상담과 예방적 개입이 필요하다.

Key Message
Even among individuals who consistently maintain normal liver enzyme levels, heavy alcohol consumption significantly increases the risk of liver disease. These findings challenge the conventional assumption that normal biomarker results reflect hepatic safety. Proactive alcohol counseling should be provided to all heavy drinkers regardless of their liver enzyme status.

Associations between usual source of care characteristics and health outcomes in diabetes mellitus: a focus on medication adherence and healthy behaviors in Korea: Seung Eun Lee, Chul-Woung Kim, Ji Eun Bae, Jee Hyun Choi; Epidemiol Health. 2025;47:e2025063. Published online December 2, 2025; DOI: https://doi.org/10.4178/epih.e2025063

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Abstract Summary PDF: Abstract
OBJECTIVES
This study investigated the associations between usual source of care (USC) characteristics, which incorporate primary care functions, and medication adherence and healthy behaviors in Korean adults with diabetes.
METHODS
We used data from 1,543 adults with diabetes in the 2020 Korea Health Panel Survey. USC was categorized into 5 types based on whether a regular doctor was identified and whether that provider fulfilled comprehensiveness and coordination functions. Multivariable logistic regression was used to assess associations with medication adherence and healthy behaviors.
RESULTS
A significant difference in medication adherence was observed by USC type, although no significant associations emerged for healthy behaviors (smoking, drinking, exercise). Compared to the group without a USC, patients whose regular doctor fulfilled either function were 2.38 times more likely to adhere (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.70 to 3.32), and those whose doctor fulfilled both functions were 1.84 times more likely to adhere (OR, 1.84; 95% CI, 1.31 to 2.59). This association was particularly strong for adherence to medication dosage, frequency, and timing.
CONCLUSIONS
The findings underscore that the functional quality of the USC, particularly the fulfillment of comprehensiveness and coordination, is crucial in improving medication adherence. Simply having a USC is insufficient. The lack of association with healthy behaviors suggests that physicians may focus more on pharmacological control, highlighting the need for multifaceted interventions.; Summary

Korean summary
본 연구는 단순히 주치의가 있는 것만으로는 당뇨병 환자의 복약 순응에 불충분하며, 일차 의료 기능을 충실히 수행하는 상용치료원만이 복약 순응과 유의한 관련이 있음을 입증했습니다. 하지만 상용치료원이 건강 행동 개선과는 관련이 없음을 확인하여, 의료진이 생활 습관 개선에는 영향을 주지 못하고 있음을 시사했습니다. 이러한 결과는 만성질환 관리를 개선하기 위해 상용치료원의 일차 의료 기능을 강화해야 한다는 정책적 근거를 제공합니다.

Key Message
This study shows that simply having a usual source of care (USC) is insufficient; only USCs that fully perform primary care functions are significantly associated with better medication adherence in diabetic patients. However, USC was not linked to improved health behaviors, suggesting providers fail to influence lifestyle changes. The findings provide policy evidence to reinforce the primary care functions of USCs to enhance chronic disease management.

Personal, community, and societal factors associated with mukbang viewing among adolescents: findings from the Korea Youth Risk Behavior Survey: Cynthia Yursun Yoon, Seungha Shin, Haemi Jun, Hyeeun Park, Minseo Kim; Epidemiol Health. 2025;47:e2025055. Published online September 30, 2025; DOI: https://doi.org/10.4178/epih.e2025055

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Mukbang refers to livestreamed videos in which hosts consume large amounts of energy-dense, nutrient-poor foods while interacting with viewers. Mukbang is widely viewed by Korean adolescents and has been associated with adverse health outcomes. To inform efforts to prevent excessive engagement with mukbang content among Korean adolescents, this study examined personal, community, and societal factors associated with excessive mukbang viewing (≥7 times/wk) and explored gender differences in these associations.
METHODS
Data were drawn from the 2022 Korea Youth Risk Behavior Survey (n=36,990; mean age, 15.1±1.7 years; 48.6% girls; 53.2% attending middle school). Self-reported measures included personal (e.g., perceived health, weight, stress, depression, anxiety), community (e.g., living arrangement), and societal factors (e.g., socioeconomic status) and mukbang viewing frequency. Logistic and modified Poisson regression models were used to examine associations with excessive mukbang viewing and to evaluate differences by gender.
RESULTS
Intrapersonal factors—namely perceived health, weight, stress, depression, and anxiety—were associated with excessive mukbang viewing (adjusted prevalence ratios, 1.18 to 1.44), with more pronounced relationships among girls. A community-level factor—living arrangement—displayed a significant association in boys but not in girls. Boys living on campus had 1.42 times the prevalence of excessive mukbang viewing than boys residing with family members (95% confidence interval, 1.08 to 1.88) after adjustment. Further mutual adjustment attenuated estimates toward the null. Societal factors were not significantly associated with excessive mukbang viewing among adolescents.
CONCLUSIONS
Personal and community factors were associated with excessive mukbang viewing. Future research should investigate the mechanisms underlying these associations.; Summary

Korean summary
- 건강 인식 저하, 스트레스, 우울, 불안 등 개인적인 요인은 과도한 먹방 시청과 관련이 있었으며, 특히 여학생에게서 두드러져, 정서적 어려움이 먹방을 정서 조절이나 사회적 연결의 수단으로 활용할 가능성을 시사한다 - 기숙사에 거주하는 남학생이 가족과 거주하는 남학생보다 과도하게 먹방을 시청할 가능성이 높았으며, 이는 또래 영향과 지역사회의 환경이 먹방 시청에 중요한 역할을 함을 보여준다 - 사회경제적 수준은 과도한 먹방 시청과 유의한 관련은 없었으며, 이는 모든 청소년을 대상으로 정서적 건강과 건강한 미디어 사용을 촉진하는 보편적 예방 전략이 필요함을 시사한다

Key Message
- Personal factors such as poor perceived health, stress, depression, and anxiety were strongly related to excessive mukbang viewing, particularly among girls, suggesting that emotional distress may drive girls to engage with mukbang as a form of coping or personal connection - Among boys, those living on campus were more likely to view mukbang excessively than those living with family, indicating that community environment and peer influence may contribute to higher engagement in mukbang - Socioeconomic status was not significantly associated with excessive mukbang viewing, implying that prevention efforts should address emotional well-being and healthy media use across all adolescents, regardless of the background

Systematic Review

Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis: Inhye Kim, Hyunseo An, Sohyeon Yun, Hae Yean Park; Epidemiol Health. 2024;46:e2024013. Published online January 3, 2024; DOI: https://doi.org/10.4178/epih.e2024013

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis.

METHODS

The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions.

RESULTS

Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health.

CONCLUSIONS

This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.

Summary

Korean summary
본 연구는 독거 노인들 대상으로 한 지역사회 기반 중재의 효과에 대하여 탐색하고 그 효과 크기를 확인하기 위하여 체계적고찰 및 메타분석을 실시하였다. 영양 및 복합 중재가 특히 효과적이었으며, 이는 건강 행동과 정신건강에 있어 중요한 긍정적 효과를 나타내어 추후 개별적 맞춤 중재의 잠재적 효과성을 나타낸다. 이러한 발견은 독거노인 집단의 웰빙 향상을 위한 프로그램과 정책 입안에 근거로 활용될 수 있다.

Key Message
This systematic review and meta-analysis evaluated the impact of community-based interventions for older adults living alone, incorporating 9 studies to assess effectiveness in areas like nutrition and combined strategies. Results indicated significant benefits, particularly in health behavior and mental health, demonstrating the potential of tailored interventions. These findings support the development of targeted programs and policy decisions aimed at improving the well-being of this demographic.

Citations

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Original Articles

Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort: Jihun Kang, Taeyun Kim, Kyung-Do Han, Jin-Hyung Jung, Su-Min Jeong, Yo Hwan Yeo, Kyuwon Jung, Hyun Lee, Jong Ho Cho, Dong Wook Shin; Epidemiol Health. 2023;45:e2023101. Published online November 21, 2023; DOI: https://doi.org/10.4178/epih.e2023101

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer.

METHODS

The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer.

RESULTS

Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; ≥10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (≥10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24).

CONCLUSIONS

In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects.

Summary

Korean summary
나이, 여성, 흡연, 그리고 대사 증후군은 조기 발생 폐암의 위험도 증가와 연관이 있었다. 반면에 높은 소득, 신체 활동, 비만은 젊은 성인에서 폐암 발생의 위험도 감소와 연관성을 나타내었다.

Key Message
Age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer. While, high income, physical activity, and obesity displayed protective effects on the development of lung cancer in young adults.

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Zheng Lu, Peilan Zheng, Yi Liao, Haiyan Wang, Keyu Zhu, Yiyang Chen, Zhixin Lin, Xinyan Huang, Yu Wang, Jingrong Yang
International Journal of Surgery.2026; 112(2): 3989. CrossRef
Comprehensive characterization of early-onset lung cancer, in Chinese young adults
Ye Tian, Rui Ma, Wenchang Zhao, Shumin Wang, Chuanjiang Zhou, Weibing Wu, Bo Yang, Hua Xin, Hongyan Wang, Pengfei Li, Ranhua Li, Changhong Liu, Yao Lu, Qian Yu, Chengyang Song, Han Zhang, Ruipu Liang, Lei Zhang, Di Zhou, Xitong Zhao, Zhuo Wu, Yafei Qi, Ru
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Environmental Research.2025; 285: 122667. CrossRef

Higher energy consumption in the evening is associated with increased odds of obesity and metabolic syndrome: findings from the 2016-2018 Korea National Health and Nutrition Examination Survey (7th KNHANES): Sarang Jeong, Hajoung Lee, Sukyoung Jung, Jee Young Kim, Sohyun Park; Epidemiol Health. 2023;45:e2023087. Published online September 19, 2023; DOI: https://doi.org/10.4178/epih.e2023087

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Chrono-nutrition emphasizes meal timing in preventing obesity and metabolic disorders. This study explores the impact of temporal dietary patterns (TDPs) on obesity and metabolic syndrome (MetS) in Korean adults aged 20 years to 65 years.

METHODS

We utilized dynamic time warping method and Kernel k-means clustering to investigate diet quality and the odds ratios (ORs) of obesity and MetS with different TDPs using data from the 7th Korea National Health and Nutrition Examination Survey.

RESULTS

Participants were divided into three groups based on relative energy intake over 24 hours. After adjusting for age and gender, Cluster 3 (with the highest proportion of energy intake in the evening) had the lowest Healthy Eating Index scores compared to other clusters. Following adjustment for key covariates, Cluster 3 showed the highest values for body mass index, waist circumference, blood pressure, total cholesterol, and triglycerides. Compared to Cluster 1 (with a lower proportion of energy intake in the evening), Cluster 2 and Cluster 3 had ORs for obesity of 1.12 (95% confidence interval [CI], 0.97 to 1.30) and 1.19 (95% CI, 1.03 to 1.37), respectively. For MetS, the ORs were 1.26 (95% CI, 1.08 to 1.48) and 1.37 (95% CI, 1.17 to 1.61) when comparing Cluster 2 and Cluster 3 to Cluster 1.

CONCLUSIONS

This study reveals that individuals with higher energy intake in the evening have increased odds of obesity and MetS, even after adjusting for major covariates, including age and total energy intake.

Summary

Korean summary
본 연구는 하루 중 주요 에너지 섭취 사간에 따른 인구사회학적 특징과 건강지표의 상관성을 분석하였다. 제 7기 국민건강영양조사의 20~65세의 한국 성인을 대상으로 Dynamic Time Warping 방법을 이용하여 군집을 나누어 분석한 결과, 하루 중 저녁시간에 에너지 섭취가 높은 그룹이 그렇지 않은 그룹에 비해 연령이 낮고, 흡연자, 음주자, 스트레스를 느끼는 대상자의 비율이 높았다. 또한, 저녁에 에너지 섭취 비율이 높은 그룹이 그렇지 않은 그룹에 비해 체질량지수, 허리둘레, 혈압, 총 콜레스테롤, 중성지방이 높았으며, 식생활 평가 지수가 가장 낮았다. 마지막으로 하루 섭취하는 총 에너지 양과 생활습관 변수를 보정하고도 저녁에 섭취하는 에너지가 많은 그룹은 그렇지 않은 그룹에 비해 비만 및 대사 증후군 유병이 더 높은 것으로 나타났다.

Key Message
• This study examined the relationship between sociodemographic characteristics and health indicators based on the timing of major energy intake during the day. • Using the Dynamic Time Warping method, the analysis revealed that the group with higher evening energy intake was younger and had a higher proportion of smokers, alcohol consumers, and individuals experiencing stress. • Additionally, the group with higher evening energy intake exhibited higher levels of obesity and metabolic syndrome, even after adjusting for total daily energy intake and lifestyle variables.

Citations

Citations to this article as recorded by

Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose–response meta‐analysis of epidemiological studies with GRADE assessment
Roxana Nematbakhsh, Parisa Rouhani, Parvane Saneei
Obesity Reviews.2025;[Epub] CrossRef
2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
Seth S. Martin, Aaron W. Aday, Norrina B. Allen, Zaid I. Almarzooq, Cheryl A.M. Anderson, Pankaj Arora, Christy L. Avery, Carissa M. Baker-Smith, Nisha Bansal, Andrea Z. Beaton, Yvonne Commodore-Mensah, Maria E. Currie, Mitchell S.V. Elkind, Wenjun Fan, G
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Circadian and temporal eating patterns in relation to metabolic syndrome in Iranian women
Azadeh Lesani, Mansooreh Sadat Mojani-Qomi
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Interaction between chronotype and ultra-processed food intake on triglyceride-glucose index in Korean adults
Sarang Jeong, Eunjin Jang, Sukyoung Jung, Jinhyun Kim, Minjeong Jeong, Dahye Han, Sohyun Park
Nutrition Research and Practice.2025; 19(4): 591. CrossRef
Association of Dietary Fiber and Measures of Physical Fitness with High-Sensitivity C-Reactive Protein
Ming-Zhen Su, Suyeon Lee, Dayeon Shin
Nutrients.2024; 16(6): 888. CrossRef
Advances in Gut Microbiota-Targeted Therapeutics for Metabolic Syndrome
Yu Gao, Wujuan Li, Xiaoyu Huang, Yuhong Lyu, Changwu Yue
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Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents: Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023085. Published online September 8, 2023; DOI: https://doi.org/10.4178/epih.e2023085

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP).

METHODS

We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences.

RESULTS

Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent’s physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father’s education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother’s education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05).

CONCLUSIONS

Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.

Summary

Korean summary
본 연구는 2009년부터 2021년까지 청소년의 사회경제적 지위가 신체활동과 좌식생활습관에 미치는 영향을 분석하였다. 청소년의 경제적 상태, 아버지와 어머니의 교육수준이 높을수록 청소년의 신체활동이 증가하고 좌식생활이 감소하였다. 그러나 청소년이 사는 지역의 도시화 정도는 영향을 미치지 않았다.

Key Message
This article analyzes the effects of an adolescent's socio-economic position on their physical activity and sedentary behavior from 2009 to 2021. The higher the adolescent's economic status, father's education, or mother's education, the more they engaged in physical activity and the less time they spent in sedentary behaviors. However, the level of urbanization in the area where the adolescent resided had no effect.

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Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis: Jina Han, Yeong Jun Ju, Soon Young Lee; Epidemiol Health. 2023;45:e2023028. Published online February 22, 2023; DOI: https://doi.org/10.4178/epih.e2023028

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Abstract PDF

Abstract

OBJECTIVES
To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).

METHODS

We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors.

RESULTS

Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90).

CONCLUSIONS

Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

Summary

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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.

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COVID-19: Original Article

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.

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COVID-19: Original Article

The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea: Da-eun Lee, Heewon Kang, Sung-il Cho; Epidemiol Health. 2022;44:e2022087. Published online October 7, 2022; DOI: https://doi.org/10.4178/epih.e2022087

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
It is necessary to investigate tobacco or nicotine product (TNP) use which acts as a risk factor for coronavirus disease 2019 (COVID-19) infection. Especially, wearing a mask is difficult to practice while using TNP. Therefore, this study aimed to examine the association between TNP use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic.
METHODS
The samples of 208,618 Korean adults from 2020 Community Health Survey in Korea were used. As an independent variable, TNP use behaviors such as TNP use status, changes in TNP use after the COVID-19 outbreak, TNP types, and attempt to quit were analyzed. Logistic regression was performed on gender-stratified participants.
RESULTS
Among men, the odds ratio (OR) of current and former TNP users were 2.00 (95% confidence interval [CI], 1.66 to 2.40) and 1.32 (95% CI, 1.09 to 1.60), respectively, compared to never users. In women, OR was 1.50 (95% CI, 1.00 to 2.26) for former users. Cigarette use was more associated with not wearing a mask than non-cigarette tobacco or nicotine product (NCTNP) use (OR, 1.53; 95% CI, 1.12 to 2.08). Men whose TNP use decreased had lower non-compliance (OR, 0.52; 95% CI, 0.36 to 0.74); while women whose TNP use increased had lower non-compliance (OR, 0.13; 95% CI, 0.07 to 0.26).
CONCLUSIONS
Current and former users were less likely to wear masks. Cigarette use was more associated with not wearing a mask than NCTNP use. Changes in TNP use showed association for men and women; however, in the opposite direction. Therefore, more attention should be paid to TNP use prevention and cessation support during the epidemic of respiratory infectious diseases. Moreover, it is necessary to identify risk factors of cigarette users in compliance with mask-wearing.; Summary

Korean summary
담배 또는 니코틴 제품 (Tobacco or Nicotine Products, TNPs) 현재사용자와 과거사용자는 비사용자 대비 마스크 미착용 연관성이 높고, 비궐련 담배 또는 니코틴 제품 (Non-Cigarette Tobacco or Nicotine Products, NCTNPs) 사용자보다는 일반담배 사용자의 마스크 미착용 연관성이 높다. 남성에서는 코로나19 유행 이전 대비 TNPs 사용이 감소했을 때, 여성에서는 증가했을 때 마스크 미착용 연관성이 낮았다. 따라서 호흡기 감염병 유행 시기에는 더욱 TNPs 사용 예방과 금연 지원에 관심을 가질 것을 제안한다.

Key Message
During the epidemic of respiratory infectious diseases, more attention should be paid to tobacco or nicotine products (TNPs) use prevention and cessation support.

Original Articles

The association between fruit and vegetable consumption and metabolic syndrome in Korean adults: does multivitamin use matter?: Jihae Kim, Li-Juan Tan, Hyein Jung, Yumi Roh, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022039. Published online April 19, 2022; DOI: https://doi.org/10.4178/epih.e2022039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Metabolic syndrome (MetS) is closely associated with dietary intake; however, few studies have investigated whether the consumption of fruits and vegetables and multivitamin use affect MetS in the Korean population. This study aimed to examine these effects in Korean adults.

METHODS

This was a cross-sectional study of 89,548 participants aged between 40 years and 69 years selected from the baseline data of the Health Examinees study conducted in Korea. Fresh vegetable and fruit consumption was assessed using a validated 106-item food frequency questionnaire. MetS and its components were defined using the National Cholesterol Education Program, Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to identify associations of fresh vegetable, fruit, and fresh vegetable+fruit consumption and multivitamin use with the prevalence of MetS.

RESULTS

Female in the highest quartile of fresh vegetable, fruit, and fresh vegetable + fruit consumption exhibited a lower prevalence of MetS than those in the lowest quartile. An inverse association with the prevalence of MetS was observed among male with only fresh vegetable consumption. The interaction between the 3 categories and multivitamin intake on the prevalence of MetS was not significant (all pinteraction>0.05), regardless of sex.

CONCLUSIONS

Multivitamin use and consumption of fresh vegetables and fruits had no significant synergistic effects. Although fresh vegetable and fruit consumption showed an inverse association with the prevalence of MetS, this relationship was not altered by multivitamin use.

Summary

Korean summary
본 연구는 한국인 유전체역학조사사업의 도시코호트 조사에 참여한 40-69세 한국 성인 89 548명의 과일과 채소의 섭취와 종합비타민 섭취가 대사증후군에 미치는 영향을 분석하였다. 본 연구에서는 매일 다양한 과일과 채소를 섭취하면, 종합비타민의 섭취와 상관없이 대사증후군 유병 위험도를 낮추는 것을 확인하였다. 따라서, 대사증후군 예방을 위해서는 일상적인 식사에서 충분한 과일과 채소를 섭취하는 것이 권장된다.

Key Message
This study aimed to examine whether the consumption of fruits and vegetables and multivitamin use affect MetS among Korean middle-aged adults. Data was from the Health Examinees Study among 89 548 subjects. Results suggested that fruits and vegetables consumption was related with a decreased prevalence of MetS. However, there was no significant synergistic effect between the consumption of fruits and vegetables and multivitamin use in further reducing MetS prevalence.

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Frontiers in Endocrinology.2023;[Epub] CrossRef

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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Abstract Summary 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.

Citations

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Gender-specific secular trends and related factors of high perceived stress level among Korean older adults: a nation-wide serial cross-sectional study
Eunjeong Choi, Hyun-Ju Seo, Kye Ha Kim, Sun-Young Jung
BMC Public Health.2025;[Epub] CrossRef
Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data
Hyun-Ju Seo, Soon-Ki Ahn, Min-Jung Choi
BMJ Open.2024; 14(4): e081549. CrossRef
Factors related to sedentary behavior in older adult stroke patients in China: a study based on decision tree and logistic regression model
Shuxian Liu, Juan Li, Xi Chen, Xiaowen Jiang, Rong Tang, Yumei Lv
Frontiers in Public Health.2024;[Epub] CrossRef
Evaluation of sedentary lifestyle as a risk factor
Max Ramiro Ochoa Ortega, Bárbara del Rosario Hernández Bravo , Adolfo Miguel Zorrilla Quiñones, Noelvis Ramírez Pérez, Yanet Rodríguez Pérez
Health Leadership and Quality of Life.2024;[Epub] CrossRef
Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006–2020)
Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
Journal of Epidemiology and Community Health.2023; 77(6): 355. CrossRef

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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Abstract Summary PDF Supplementary 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.

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Prevalence and Associated Factors of Poor Sleep Quality Among ‎adults in Qatar
Mueen Al Ansi, Ayman Al-Dahshan, AA Alyafei ‎, Mohamad Chehab, Sami Abdeen, Hanan Khudadad ‎, Nada Adil, Mohamed Aabdien, Mohamed Iheb Bougmiza
Nature and Science of Sleep.2026; Volume 18: 1. CrossRef
Sociodemographic, Clinical and Health-related Behavioural Determinants of Sleep Quality: A Cross-sectional Study Among Malaysian Adults
Admin Admin, Nurul Afiedia Roslim, Siti Maisarah Mohd Noor, Imilia Ismail, Mohamad Izuan Mohd Din, Carmen Piernas, Aryati Ahmad
Malaysian Journal of Medicine and Health Sciences.2026;[Epub] CrossRef
Mediation Effect of CSF Substance P on the Association Between Smoking and Sleep
Xie Zhang, Lingling Chen, Yuyu Wu, Yu‐Hsin Chen, Xingguang Luo, Zeping Xu, Weiming Hu, Yimin Kang, Li Chen, Yanlong Liu, Fan Wang, Danhui Liu
Brain and Behavior.2025;[Epub] CrossRef
Association between consumption of tryptophan with sleep quality in King Saud University students
Nora Alafif
Journal of King Saud University - Science.2024; 36(2): 103046. CrossRef
The Microbiota–Gut–Brain Axis in Metabolic Syndrome and Sleep Disorders: A Systematic Review
Adriano dos Santos, Serena Galiè
Nutrients.2024; 16(3): 390. CrossRef
The association between passive smoking and sleep quality in a Chinese hypertensive population: A cross-sectional study
Niuniu Sun+, Yang Ni+, Yuqian Deng, Jiale Qi, Zhenjie Yu, Chang Wu, Juan He, Yibo Wu
Tobacco Induced Diseases.2024; 22(February): 1. CrossRef
Network analysis of smoking-related sleep characteristics in Chinese adults
Yuting Xie, Peiyuan Sun, Huang Huang, Jianjun Wu, Yue Ba, Guoyu Zhou, Fangfang Yu, Daming Zhang, Yaqun Zhang, Ranran Qie, Zhuolun Hu, Kaiyong Zou, Yawei Zhang
Annals of Medicine.2024;[Epub] CrossRef
Associations between smoking, sex steroid hormones, trouble sleeping, and depression among U.S. adults: a cross-sectional study from NHANES (2013–2016)
Jing Huang, Peiwen Shi, Yuan Zhao, Huinan Zhang, Tian Gao, Xing Wang
BMC Public Health.2024;[Epub] CrossRef
The Interactions between Smoking and Sleep
Ioanna Grigoriou, Serafeim-Chrysovalantis Kotoulas, Konstantinos Porpodis, Dionysios Spyratos, Ioanna Papagiouvanni, Alexandros Tsantos, Anastasia Michailidou, Constantinos Mourelatos, Christina Mouratidou, Ioannis Alevroudis, Alexandra Marneri, Athanasia
Biomedicines.2024; 12(8): 1765. CrossRef
The associations between working conditions and subjective sleep quality among female migrant care workers
I-Ming Chen, Tzu-Yun Lin, Yi-Ling Chien, Jennifer Yi-Ying Chen, Jen-Hui Chan, Shih-Cheng Liao, Po-Hsiu Kuo, Hsi-Chung Chen
Frontiers in Public Health.2023;[Epub] CrossRef

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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667 Download
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Abstract Summary PDF Supplementary 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.

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Trends in overweight and socioeconomic inequality among children and adolescents aged 7–18 years in China from 2010 to 2020
Zhidong Zhou, Jianhua Zhang, Chengyue Li, Yi Wan, Jianwu Liu, Tao He
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Regional Variations in Health Behavior Structures: A Social Determinants of Health Approach
Seungman Lee, Sungho Yoon, Hanbeom Kim
Healthcare.2025; 13(20): 2557. CrossRef
Geriatric health changes during the COVID-19 pandemic: impacts on body composition and vascular aging
Bo Min Kim, Young Jin Tak, Jeong Gyu Lee, Yu Hyeon Yi, Seung-Hun Lee, Gyu Lee Kim, Young Jin Ra, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Young In Lee, Jung In Choi, Sae Rom Lee, Ryuk Jun Kwon, Soo Min Son
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Socioeconomic inequality in organized and opportunistic screening for breast cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Yejin Ha, Xuan Quy Luu, Woorim Kim, Jae Kwan Jun, Mina Suh, Kui Son Choi
Epidemiology and Health.2025; 47: e2025031. CrossRef
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Preventive Medicine Reports.2024; 39: 102617. CrossRef
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Xuan Yao, Zeshui Xu, Marinko Škare, Xindi Wang
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Stefano Tancredi, Bernadette W. A. van der Linden, Arnaud Chiolero, Stéphane Cullati, Medea Imboden, Nicole Probst-Hensch, Dirk Keidel, Melissa Witzig, Julia Dratva, Gisela Michel, Erika Harju, Irene Frank, Elsa Lorthe, Hélène Baysson, Silvia Stringhini,
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Hyerine Shin, Ji-Su Kim, HyunHae Lee
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Communication inequalities in the COVID-19 pandemic: socioeconomic differences and preventive behaviors in the United States and South Korea
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Epidemiology and Health.2022; 44: e2022107. 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.

Accelerometer-measured stepping cadence patterns in Korean adults: an analysis of data from the 2014-2015 Korea National Health and Nutrition Examination Survey: Geon Hui Kim, Hoyong Sung, Yeun Ryu, Jungjun Lim, Joon-Sik Kim, Hak Kyun Kim, Yeon Soo Kim; Epidemiol Health. 2021;43:e2021056. Published online August 17, 2021; DOI: https://doi.org/10.4178/epih.e2021056

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Abstract Summary PDF

Abstract

OBJECTIVES
The aim of this study was to identify the stepping cadence patterns in Korean adults by using objectively measured accelerometer data to analyze the time spent in each cadence category by sex and age.

METHODS

During the 2014-2015 Korean National Health and Nutrition Examination Survey, 1,703 males and females aged 19-64 years provided at least 1 valid day of data (wearing an accelerometer ≥ 10 hr/d). The mean cumulative time and percentage per day in 8 cadence categories (0, 1-19, 20-29, 30-59, 60-79, 80-99, 100-119, and ≥ 120 steps/min) by sex and age group were calculated.

RESULTS

Cumulative time and percentage per day decreased across the incremental cadence categories. Participants spent 360.08± 2.56 min/d in the non-movement cadence category and 361.50± 2.28 min/d in the incidental movement cadence category. However, they spent only about 18.1 min/d (2.1%) at ≥ 100 steps/min. Males spent significantly more time in the cadence categories of sporadic movement, purposeful steps, slow walking, and medium walking, but the other categories, except for brisk walking, had higher values in females (p< 0.001). The older age group spent less time in non-movement cadence categories, and the youngest and oldest groups spent more time at a higher cadence (≥ 100 steps/min) than the other age groups. Similar patterns were found in a subgroup analysis by sex.

CONCLUSIONS

Korean adults spent most of their time at a low cadence and only a few minutes at a high cadence (≥100 steps/min); this trend was consistent across sex and age groups.

Summary

Korean summary
본 연구에서는 2014-2015년도 국민건강영양조사자료의 가속도계 자료를 활용하여 한국 성인의 성별, 연령별 케이던스 패턴을 확인하였다. 한국 성인은 하루 평균 약 12시간(약 87%)을 분당 20보 이하의 낮은 케이던스에서 보냈고, 분당 100보 이상의 높은 케이던스에서는 하루 중 단지 약 18분 (약 2%)의 시간을 보냈다. 성별 및 연령대에 따라 약간의 차이는 있으나, 대부분 유사한 양상을 보였다.

Key Message
Korean adults spent approximately 12 hours per day (about 87%) at a low cadence (<20 steps per minute) while spending only about 18 minutes per day (about 2%) at a high cadence (≥ 100 steps per minute). Even though certain amount of differences between sex and age groups do exist, most have shown similar patterns.

Citations

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Conceptual and Evidence Update on Incidental Physical Activity: A Scoping Review of Experimental and Observational Studies
Daniel Reyes‐Molina, Rafael Zapata‐Lamana, Gabriela Nazar, Igor Cigarroa, Jonatan R. Ruiz, Eva Parrado, Josep‐Maria Losilla, Carlos Celis‐Morales
Scandinavian Journal of Medicine & Science in Sports.2025;[Epub] CrossRef
Normative percentile curves of accelerometer-measured daily step counts in Korean older adults
Seung-Hee Lee, Mihyun Lee, Yonghee Lee, Saejong Park
Physical Activity and Nutrition.2025; 29(3): 46. CrossRef

Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey: Soyeon Kim, Sunhye Choi, Jihee Kim, Suyeon Park, Young-Taek Kim, Ok Park, Kyungwon Oh; Epidemiol Health. 2021;43:e2021026. Published online April 19, 2021; DOI: https://doi.org/10.4178/epih.e2021026

27,709 View
383 Download
40 Web of Science
34 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.

RESULTS

The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).

CONCLUSIONS

Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.

Summary

Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.

Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.

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Methods

Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions: Kyungwon Oh, Yoonjung Kim, Sanghui Kweon, Soyeon Kim, Sungha Yun, Suyeon Park, Yeon-Kyeng Lee, Youngtaek Kim, Ok Park, Eun Kyeong Jeong; Epidemiol Health. 2021;43:e2021025. Published online April 19, 2021; DOI: https://doi.org/10.4178/epih.e2021025

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Abstract Summary PDF Supplementary Material

Abstract

The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.

Summary

Korean summary
국민건강영양조사는 국민건강증진법제16조에 근거하여 1998년부터 우리 국민의 건강수준, 건강행태, 식품 및 영양소 섭취 실태에 대한 국가단위 통계를 산출하는 조사사업이다. 본 연구에서는 건강지표 생산 확대, 조사 자료 활용도 향상 등 20년간의 성과를 요약하고 사회환경과 조사여건 변화를 반영한 건강통계 생산의 발전 방안을 제시하였다.

Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing surveillance system that was initiated in 1998 based on Ar¬ticle 16 of the National Health Promotion Act to produce nationwide statistics regarding the health status, health behaviors, and food and nutrient consumption of the Korean population. In this study, the 20-year accomplishments of the KNHANES including vigorous production of health indicators and improvement of data utilization are summarized, and future plans are presented to improve the health statistics to reflect changes in the social and survey environments.

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The Korean Journal of Internal Medicine.2025; 40(6): 1017. CrossRef
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American Journal of Epidemiology.2025; 194(12): 3520. CrossRef
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Journal of Neurology.2024; 271(3): 1213. CrossRef
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British Journal of Nutrition.2024; 131(5): 894. CrossRef
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Preventive Medicine.2024; 180: 107849. CrossRef
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Preventive Medicine.2024; 180: 107890. CrossRef
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Nutrients.2024; 16(5): 724. CrossRef
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Nutrients.2024; 16(10): 1482. CrossRef
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Nutrients.2024; 16(10): 1516. CrossRef
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Nutrients.2024; 16(23): 4091. CrossRef
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Journal of Clinical Medicine.2024; 13(23): 7402. CrossRef
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Diabetes & Metabolism Journal.2024; 48(6): 1084. CrossRef
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Nutrients.2024; 16(23): 4188. CrossRef
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Journal of Diabetes & Metabolic Disorders.2024;[Epub] CrossRef
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Journal of Nutrition and Health.2024; 57(6): 667. CrossRef
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Epidemiology and Health.2024; 46: e2024089. CrossRef
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Journal of Korean Medical Science.2023;[Epub] CrossRef
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Original Articles

Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults: Kyong Sil Park; Epidemiol Health. 2021;43:e2021006. Published online January 3, 2021; DOI: https://doi.org/10.4178/epih.e2021006

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376 Download
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3 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This cross-sectional study based on the health belief model investigated predictors of anticipated coping behavior at myocardial infarction (MI) symptom onset using secondary data from the 2017 Korea Community Health Survey.

METHODS

Modifying variables (socioeconomic, health knowledge, perceived threat) were selected as independent variables and anticipated coping behavior at MI symptom onset as the dependent variable. Calling 911 was classified as the correct anticipated coping behavior, while visiting a hospital or an oriental hospital, calling family, and others were classified as incorrect.

RESULTS

Of 227,740 participants, 83.2% reported correct anticipated coping behaviors. The likelihood of calling 911 was low if participants experienced atypical symptoms (jaw, neck, back, arm, and shoulder pain), even if they were aware of those symptoms. However, 69.9% of participants who were aware of typical symptoms (chest pain) stated that they would call-911. Sex, age, hypertension, dyslipidemia, obesity, and awareness of MI symptoms affected the correct anticipated coping behavior.

CONCLUSIONS

Correct coping abilities among the general public are vitally important for early treatment of MI patients and reduction of hospitalization time. Members of the general public in their 20s and 30s, 60 years of age or older, with cardiovascular risk factors (male sex, hypertension, dyslipidemia, and obesity), and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Emergency medical services should be called without delay if needed, and public relations activities should be carried out to raise awareness that anyone can use emergency medical services.

Summary

Korean summary
심근경색증 증상 발현 시 올바른 대처 행동을 위해 20-39세, 60세 이상, 남성, 고혈압, 이상지질혈증, 비만이 있는 대상자, 심근경색증 증상을 인지하지 못하는 대상자에게 심근경색증의 전형적, 비전형적 증상에 대해 교육해야 한다. 또한, 환자 발생 시 지체없이 응급의료서비스 신고해야하며, 누구나 응급의료서비스를 이용할 수 있도록 인식 전환을 위한 홍보활동을 시행해야 한다.

Key Message
Those in their 20s and 30s, 60 years of age or older, male, with cardiovascular risk factors, and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Public relations activities should be carried out to raise awareness that anyone can use EMS.

Citations

Citations to this article as recorded by

The Impact of Clusters With Distinct Social Determinants by a Two-Step Cluster Analysis on Cardiovascular Health
Seok Hee Lee, Minsu Ock, Seongmi Moon, Eun Kyeung Song
Journal of Cardiovascular Nursing.2026; 41(2): E77. CrossRef
Application of intensive management of risk awareness combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure
Xiaoli Yin, Cuiping Huang, Binglai Lin
Medicine.2024; 103(20): e37381. CrossRef
Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC
Kyehwan Kim, Moojun Kim, Chang-Ok Seo, Hangyul Kim, Hye Ree Kim, Min Gyu Kang, Jin-Sin Koh, Jeong Rang Park, Rock Bum Kim, Dong Ryeol Ryu, Jang Hoon Lee, Moo Hyun Kim, Tae-Jin Youn, Dae Woo Hyun, Shin-Jae Kim, Sang Jae Rhee, Sang-Don Park, Young Joon Hong
Journal of Clinical Medicine.2024; 13(16): 4840. CrossRef

Prediction of COVID-19 transmission dynamics using a mathematical model considering behavior changes in Korea: Soyoung Kim, Yu Bin Seo, Eunok Jung; Epidemiol Health. 2020;42:e2020026. Published online April 13, 2020; DOI: https://doi.org/10.4178/epih.e2020026

32,880 View
1,350 Download
52 Web of Science
50 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Since the report of the first confirmed case in Daegu on February 18, 2020, local transmission of coronavirus disease 2019 (COVID-19) in Korea has continued. In this study, we aimed to identify the pattern of local transmission of COVID-19 using mathematical modeling and predict the epidemic size and the timing of the end of the spread.

METHODS

We modeled the COVID-19 outbreak in Korea by applying a mathematical model of transmission that factors in behavioral changes. We used the Korea Centers for Disease Control and Prevention data of daily confirmed cases in the country to estimate the nationwide and Daegu/Gyeongbuk area-specific transmission rates as well as behavioral change parameters using a least-squares method.

RESULTS

The number of transmissions per infected patient was estimated to be about 10 times higher in the Daegu/Gyeongbuk area than the average of nationwide. Using these estimated parameters, our models predicts that about 13,800 cases will occur nationwide and 11,400 cases in the Daegu/Gyeongbuk area until mid-June.

CONCLUSIONS

We mathematically demonstrate that the relatively high per-capita rate of transmission and the low rate of changes in behavior have caused a large-scale transmission of COVID-19 in the Daegu/Gyeongbuk area in Korea. Since the outbreak is expected to continue until May, non-pharmaceutical interventions that can be sustained over the long term are required.

Summary

Korean summary
본 논문은 행동변화를 고려한 수학적 모델을 이용하여 코로나바이러스병-19의 유행 양상을 분석하고 총 환자수와 유행기간을 예측하고자 한다. 질병관리본부 확진자 데이터를 이용하여 전국과 대구·경북 지역의 감염전파율과 행동변화율을 추정하였다. 3월 10일까지의 데이터를 기준으로 전국적으로 6월 중순까지 약 13,000명, 대구·경북지역의 경우 5월 말까지 약 11,000명의 환자가 발생할 것으로 예측된다.

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Lifestyle-related predictors affecting prediabetes and diabetes in 20-30-year-old young Korean adults: Kyong Sil Park, Seon Young Hwang; Epidemiol Health. 2020;42:e2020014. Published online March 19, 2020; DOI: https://doi.org/10.4178/epih.e2020014

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20–39 years using data from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

This study is a cross-sectional, secondary analysis using the KNHANES data. Participants were classified into normal group (fasting plasma glucose [FPG] <100 mg/dL and/or hemoglobin A1c [HbA1c] <5.7%), prediabetes group (FPG 100-125 mg/dL and/or HbA1c 5.7-6.4%), and diabetes group (FPG ≥126 mg/dL and/or HbA1c ≥ 6.5%). The data were statistically analyzed using SPSS software.

RESULTS

Out of 4,190 participants, 27.7% of men and 16.3% of women were in the prediabetes group and 1.4% of men and 1.3% of women were in the diabetes group. Logistic regression confirmed that age and obesity are predictors of prediabetes and diabetes in both men and women. Additionally low physical activity and low education level are predictors of prediabetes in men and women, respectively (p<0.05).

CONCLUSIONS

This study has found that age and increased obesity are predictors of elevated blood glucose in young men and women in their 20s and 30s. A strategy to lower obesity by promoting physical activity in men in their 30s is essential to prevent metabolic syndrome and progression to prediabetes.

Summary

Korean summary
20-30대 젊은 성인 남성에서 당뇨전단계 27.7%, 당뇨 1.4%, 여성에서 당뇨전단계 16.4%, 당뇨 1.3%로 확인되었다. 당뇨전단계 및 당뇨의 이환을 예방하기 위해서 비만 관리가 필수적이며, 특히 교육수준이 낮은 젊은 여성과 신체활동이 낮은 30대의 남성에서 신체활동 증진을 통해 효율적으로 비만도를 낮추는 전략 마련이 필요함을 확인하였다.

Citations

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Determinants of Prediabetes in Adolescents: Evidence From Indonesia
Yourisna Pasambo, Ferry Efendi, Ika Yuni Widyawati, Rifky Octavia Pradipta, Fadhaa Aditya Kautsar Murti, Mei‐Chan Chong
Diabetes/Metabolism Research and Reviews.2026;[Epub] CrossRef
Impact of cumulative exposure to a high TG to HDL-C ratio on type 2 diabetes risk in young adults
Jung Heo, Byungpyo Kim, Kyungdo Han, Jae-Hyuk Lee, Seo-Young Sohn, Jiyeon Ahn, Whi-An Kwon, Moon Jung Kim, Eun-Young Doo, Min-Kyung Lee
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Role of oxidative stress in prediabetes development
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Yujin Lee, Jung-Hyun Kim
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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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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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Systematic Review

Risk factors for stomach cancer: a systematic review and meta-analysis: Jalal Poorolajal, Leila Moradi, Younes Mohammadi, Zahra Cheraghi, Fatemeh Gohari-Ensaf; Epidemiol Health. 2020;42:e2020004. Published online February 2, 2020; DOI: https://doi.org/10.4178/epih.e2020004

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1,238 Download
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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.

METHODS

PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.

RESULTS

Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.

CONCLUSIONS

This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Summary

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Review

A systematic review of barriers and motivators to physical activity in elderly adults in Iran and worldwide: Soudabeh Yarmohammadi, Hossein Mozafar Saadati, Mohtasham Ghaffari, Ali Ramezankhani; Epidemiol Health. 2019;41:e2019049. Published online November 29, 2019; DOI: https://doi.org/10.4178/epih.e2019049

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This study was conducted to identify and characterize the barriers and motivations to physical activity (PA) for elderly adults in Iran and other countries.

METHODS

We searched 6 databases (PubMed, Embase, Scopus, Web of Science, Magiran, and the Scientific Information Database) from 2000 to the November 2017, using “aged 60 and over,” “physical activity” or “exercise,” and “motivator” and “barrier” as keywords. Two reviewers independently performed the search, screening, and quality assessment of the studies.

RESULTS

In total, 34 papers were finally included in the study. The most important barriers, based on the frequency of factors, included physical problems, having no companions, and physical barriers to walking. The motivators included improving one’s physical condition, being social, and suitability of the physical environment.

CONCLUSIONS

Important motivators and barriers to PA were more closely related to intrapersonal factors than to the interpersonal and environmental domains. The barriers and motivators to PA in the elderly were not markedly different between Iran and other countries. Therefore, a general strategy could be designed to improve PA in the elderly.

Summary

Citations

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Original Articles

Physical activity level in Korean adults: the Korea National Health and Nutrition Examination Survey 2017: Ki-Yong An; Epidemiol Health. 2019;41:e2019047. Published online November 9, 2019; DOI: https://doi.org/10.4178/epih.e2019047

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated physical activity (PA) participation based on demographic, physical, and psychological variables in Korean adults.

METHODS

Participants were divided into four groups (combined, aerobic only, resistance only, and neither) based on meeting the PA guidelines using moderate and vigorous PA time and resistance exercise frequency from the Korea National Health and Nutrition Examination Survey 2017. The association between meeting the PA guidelines and demographic, medical, fitness, lifestyle, and psychological variables were analyzed using complex samples crosstabs and a general linear model.

RESULTS

Of the 5,820 Korean adults, 66.0% did not meet any of the guidelines. Among demographic factors, sex, age, marital status, income, education level, occupation, and employment status were associated with meeting the PA guidelines. Chronic disease prevalence, weight, waist circumference, body mass index, diastolic blood pressure, glucose, high-density lipoprotein and triglyceride levels, hand-grip strength, resting heart rate, and family history of chronic disease in the medical and fitness variables; frequency of drinking and eating breakfast, total calorie, water, protein, and fat intake in the lifestyle variables; and perceived stress, depression, suicidal thoughts, and quality of life in the psychological variables were associated with meeting PA guidelines.

CONCLUSIONS

Most Korean adults participate in insufficient PA. Moreover, individuals who are socially underprivileged, have low-income or poor physical and mental health conditions participated in relatively less PA. Our findings suggest that government and individual efforts are required to increase PA and resolve health inequality in Korean adults.

Summary

Korean summary
2017년 국민건강영양조사 자료를 분석한 결과, 한국 성인들의 신체활동 실천율은 매우 낮았으며, 특히, 사회적 약자나 저소득층, 신체적, 정신적 건강 위험요인이 높은 사람들에게 더 낮게 나타났다. 신체활동은 건강증진을 위한 가장 경제적이며 효율적인 방법으로써, 신체활동 참여를 늘리고 건강불평등을 해소하기 위한 정부, 의료기관, 교육기관은 물론 국민 개개인의 신체활동에 대한 인식개선과 적극적인 노력이 필요하다.

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Effects of adults’ health behaviors and combinations thereof on health outcomes: an analysis using National Health Insurance Service of Korea cohort data: Hyun-Jung Park, Eun-Jung Kim; Epidemiol Health. 2019;41:e2019042. Published online October 8, 2019; DOI: https://doi.org/10.4178/epih.e2019042

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Abstract Summary PDF

Abstract

OBJECTIVES
The purpose of this study was to estimate the effects of health-risk behaviors, alone and in combination, on health outcomes.

METHODS

This study used sample cohort data provided by the National Health Insurance Service focusing on the use of hospital services, direct medical expenses, length of stay, and re-entry rate according to health-risk behaviors. A frequency analysis and the chi-square test were used to investigate associations between the demographic characteristics of study subjects and their health-risk behaviors. The strength of the association of each factor was calculated as the odds ratio in a crossover analysis.

RESULTS

Obesity had the largest effect, especially in combination with smoking and drinking. In particular, significant associations were shown with the duration of hospitalization and direct medical expenses. After adjustment for sex, age, economic status, and pre-existing medical conditions, the duration of hospitalization was 7.37 times longer and that of medical expenses was 5.18 times higher in the obese group relative to the non-obese group. Drinking showed a statistically significant association with the number of days of hospitalization. After adjusting for the control variables, the number of hospital days was 1.24 longer in the drinking group than in the non-drinking group.

CONCLUSIONS

An analysis of combinations of health risk factors showed obesity had the largest effect.

Summary

Korean summary
본 연구에서는 건강위해행동이 건강결과에 미치는 영향을 추정하고, 건강위해행동 간 상호작용을 분석하여 보다 다차원적 측면에서 건강위해행동과 건강결과 간 관계를 다루었다. 그 결과, 흡연, 비만, 음주 중 1개의 위해행위를 가지고 있는 경우, 흡연 집단에서 모든 건강결과와의 관련성이 통계적으로 유의미하지 않았으나, 비만의 경우, 입원일수와 직접의료비간의 관련성이 유의미하였고, 특히, 비만한 집단의 경우, 성별, 연령, 경제적 수준 및 기저 질환을 보정한 후, 그렇지 않은 집단과 비교하여 입원일수와 의료비의 유의미한 증가가 확인되었다. 건강위험행태요인의 조합을 조사하여, 어떤 경우 건강행태에 영향을 크게 미치는지를 분석한 결과, 비만의 영향이 가장 큰 것으로 분석되었으며, 흡연과 음주, 단일의 건강위험행태보다, 비만과 함께 건강위험행태가 동반되었을 때 그 영향이 증가하였다.

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An analysis of protective health behavior and polypharmacy among older patients: a nationwide cohort study
Zhaoyan Piao, Kyung sun Oh, Euna Han
BMC Geriatrics.2024;[Epub] CrossRef
Risk and protective behaviors for chronic non-communicable diseases among Brazilian adults
R.B.N. de Carvalho, F. Rauber, R.M. Claro, R.B. Levy
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Health behaviors and health status of Korean middleaged men by marital status: Korea Community Health Study, 2015: Yongho Jee, Youngtae Cho; Epidemiol Health. 2019;41:e2019019. Published online May 15, 2019; DOI: https://doi.org/10.4178/epih.e2019019

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208 Download
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Abstract Summary PDF

Abstract

OBJECTIVES
Previous studies have shown that marital status is associated with household composition and living arrangements, which partially explain observed differences in health status according to marital status. However, due to the rapid socioeconomic and demographic transformations of the last few decades, the distribution of marital status among middle-aged adults has become more diverse. Therefore, this study aimed to obtain up-to-date information on the associations between marital status and health and to investigate the implications of these findings for conventional explanations of the health effects of marriage.

METHODS

The data for this study were obtained from the 2015 Korean Community Health Study. We compared 4 modifiable lifestyle behaviors—smoking, alcohol consumption, physical activity, and self-rated health status—as outcome variables in association with marital status in Korean middle-aged men (age 40-44) living in Seoul and other regions.

RESULTS

Married men showed the lowest cigarette smoking prevalence and the highest subjective health status both before and after adjusting for education and income. The odds of engaging in vigorous physical activity did not show a major difference before and after adjustment for income and education.

CONCLUSIONS

In married men, the prevalence of cigarette smoking was lowest and subjective health status was highest, similar to previous studies. However, the prevalence of engaging in physical activity was highest in divorced/widowed/separated men. The health behaviors and health status of Korean middle-aged adults should be more closely followed, since they are representative of demographic changes in the Korean population.

Summary

Korean summary
결혼 상태에 따른 건강을 다룬 이전연구에서 가구구성행태 위주의 연구, 기혼자일수록 일관되게 양호한 건강상태를 보인다는 결과들이 많이 보고되었으나 저출산 고령화의 흐름속에 1인 가구가 증가하고 가구 형태가 다양화되면서 기존의 연구결과들이 오늘날에도 유의한지에 따른 연구가 필요하며, 따라서 본 연구에서는 한국 중년 남성들의 결혼여부에 따른 건강상태를 분석하고자 하였다.

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The association between aggression and risk of Internet gaming disorder in Korean adolescents: the mediation effect of father-adolescent communication style: Eunjin Kim, Hyeon Woo Yim, Hyunsuk Jeong, Sun-Jin Jo, Hae Kook Lee, Hye Jung Son, Hyun-ho Han; Epidemiol Health. 2018;40:e2018039. Published online August 8, 2018; DOI: https://doi.org/10.4178/epih.e2018039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Open and supportive communication between parents and children is known to reduce adolescents’ delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.

METHODS

Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.

RESULTS

Adolescents’ aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.

CONCLUSIONS

Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.

Summary

Korean summary
본 연구는 청소년기의 공격성과 인터넷 게임장애 위험과의 연관성에서 부모와의 의사소통 방식의 매개효과를 알아보고자 하였다. 연구대상자는 인터넷 사용자 코호트 연구(the Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence, iCURE)에 등록된 중학교 1학년 402명을 대상으로 단면조사 연구를 실시하여 구조방정식 모형분석을 하였다. 청소년 시기의 공격성은 인터넷 게임중독과 연관성이 있었고, 이러한 연관성은 아버지와 자녀간의 의사소통을 통해 매개되고 있었다. 아버지가 청소년과 개방적이고 긍정적 의사소통을 하는 경우 청소년의 공격성과 인터넷 게임장애 위험의 연관성을 낮추는 매개효과가 있었다.

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Substance abuse behaviors among university freshmen in Iran: a latent class analysis: Kourosh Kabir, Ali Bahari, Mohammad Hajizadeh, Hamid Allahverdipour, Mohammad Javad Tarrahi, Ali Fakhari, Hossein Ansari, Asghar Mohammadpoorasl; Epidemiol Health. 2018;40:e2018030. Published online July 2, 2018; DOI: https://doi.org/10.4178/epih.e2018030

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215 Download
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Abstract PDF

Abstract

OBJECTIVES
Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.

METHODS

Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup.

RESULTS

The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.

CONCLUSIONS

Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.

Summary

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Effects of human and organizational deficiencies on workers’ safety behavior at a mining site in Iran: Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid Kalatpour, Ali Reza Soltanian, Maryam SeyedTabib; Epidemiol Health. 2018;40:e2018019. Published online May 18, 2018; DOI: https://doi.org/10.4178/epih.e2018019

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Abstract PDF

Abstract

OBJECTIVES
Throughout the world, mines are dangerous workplaces with high accident rates. According to the Statistical Center of Iran, the number of occupational accidents in Iranian mines has increased in recent years. This study investigated and analyzed the human and organizational deficiencies that influenced Iranian mining accidents.

METHODS

In this study, the data associated with 305 mining accidents were analyzed using a systems analysis approach to identify critical deficiencies in organizational influences, unsafe supervision, preconditions for unsafe acts, and workers’ unsafe acts. Partial least square structural equation modeling (PLS-SEM) was utilized to model the interactions among these deficiencies.

RESULTS

Organizational deficiencies had a direct positive effect on workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.23). The effect of unsafe supervision on workers’ violations and workers’ errors was also significant, with path coefficients of 0.14 and 0.20, respectively. Likewise, preconditions for unsafe acts had a significant effect on both workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.21). Moreover, organizational deficiencies had an indirect positive effect on workers’ unsafe acts, mediated by unsafe supervision and preconditions for unsafe acts. Among the variables examined in the current study, organizational influences had the strongest impact on workers’ unsafe acts.

CONCLUSIONS

Organizational deficiencies were found to be the main cause of accidents in the mining sector, as they affected all other aspects of system safety. In order to prevent occupational accidents, organizational deficiencies should be modified first.

Summary

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Differences in agricultural activities related to incidence of scrub typhus between Korea and Japan: Chang-Jin Ma, Gyung-Jae Oh, Gong-Unn Kang, Jeong Mi Lee, Da-Un Lee, Hae-Sung Nam, So Yeon Ryu, Young-Hoon Lee; Epidemiol Health. 2017;39:e2017051. Published online November 9, 2017; DOI: https://doi.org/10.4178/epih.e2017051

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198 Download
20 Web of Science
16 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The purpose of this study was to establish a basis for improving or strengthening the preventive strategy against scrub typhus in Korea by comparing and analyzing the difference of prevention behaviors contributing to the occurrence of scrub typhus in Japan and Korea.

METHODS

The survey was carried out in Jeollabuk-do, which is a high risk and high incidence area, and Fukuoka Prefecture, which is a high risk and low incidence area. The study included 406 Korean farmers and 216 Japanese farmers. Data were collected through face-to-face surveys by interviewers who had completed standardized education.

RESULTS

Korean farmers have a higher percentage of agricultural working posture that involved contact with weeds than Japanese farmers (p<0.05). The frequency and proportion of weeding were lower in Korean farmers than in Japanese farmers (p<0.05). The level of knowledge about scrub typhus was significantly higher among Korean farmers than among Japanese farmers (p<0.05). Mostly, the behavior of agriculture work was more appropriate for Japanese farmers than for Korean farmers (p<0.05). The total average level of agricultural work was lower in Korea than in Japan, lower in men than women, and lower in part-time farmers than full-time farmers (p<0.05).

CONCLUSIONS

This study suggests that it is reasonable to develop and provide a program that can improve the level of preventive behavior taking into consideration the characteristics of the subject in order to reduce the incidence of diseases in high-risk areas for scrub typhus.

Summary

Korean summary
이 연구는 쯔쯔가무시증 발생 위험은 공통으로 존재하나 발생률 및 발생 건수에서는 현저한 차이를 나타내는 한·일 농업인들의 털진드기 매개체에 대한 접촉과 관련된 행태나 환경 관리의 차이를 파악하였다. 연구결과 한국은 일본에 비해 환경관리 수준이 낮고, 풀숲과 접촉할 수 있는 농작업 자세를 더 취하고 있었으며, 쯔쯔가무시증에 대한 지식 수준은 높으나 예방행태 수행 수준은 낮았다. 이 연구는 한국의 농업인들의 쯔쯔가무시증 발생을 억제하기 위해서는 예방행태를 향상시킬 수 있는 프로그램 개발과 제공이 필요함을 제시하고 있다.

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Prediction of monthly occurrence number of scrub typhus in Ganzhou City, China, based on SARIMA and BPNN models
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List of occupational diseases among farmers in Korea: a literature review
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Ann Occup Environ Med.2025; 37: e2. CrossRef
Assessment of influential factors and risk area prediction of scrub typhus in Gannan region, China, based on ecological niche modelling and geographical detector
Fen Lin, Kailun Pan, Jian Li, Chunying Wu, Qingfeng Cai, Hua Xue, Mingpeng Li, Renfa Huang
Acta Tropica.2025; 268: 107726. CrossRef
Distribution and Risk Factors of Scrub Typhus in South Korea, From 2013 to 2019: Bayesian Spatiotemporal Analysis
Jeehyun Kim, Penelope Vounatsou, Byung Chul Chun
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Risk factors for scrub typhus infection in South India: population-based cohort study
Wolf-Peter Schmidt, Neal Alexander, Winsley Rose, Daniel Chandramohan, Mary Cameron, Kundavaram Abhilash, Punam Mangtani, Carol Devamani
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Myeong-Jin Lee, Bok Soon Han, Won-Chang Lee, Young Hwan Kwon
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Hanh Thi Duc Tran, Jan Hattendorf, Hung Manh Do, Thanh Tien Hoang, Hang Thi Hai Hoang, Hoa Ngoc Lam, Mai Kim Huynh, Lan Thi Hoang Vu, Jakob Zinsstag, Daniel Henry Paris, Esther Schelling
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Orientia tsutsugamushi dynamics in vectors and hosts: ecology and risk factors for foci of scrub typhus transmission in northern Thailand
Ivo Elliott, Neeranuch Thangnimitchok, Kittipong Chaisiri, Tri Wangrangsimakul, Piangnet Jaiboon, Nicholas P. J. Day, Daniel H. Paris, Paul N. Newton, Serge Morand
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The estimated burden of scrub typhus in Thailand from national surveillance data (2003-2018)
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PLOS Neglected Tropical Diseases.2020; 14(4): e0008233. CrossRef
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Decomposing economic disparities in risky sexual behaviors among people who inject drugs in Tehran: Blinder-Oaxaca decomposition analysis: Mehdi Noroozi, Hamid Sharifi, Alireza Noroozi, Fatemah Rezaei, Mohammad Rafi Bazrafshan, Bahram Armoon; Epidemiol Health. 2017;39:e2017049. Published online November 5, 2017; DOI: https://doi.org/10.4178/epih.e2017049

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Abstract PDF

Abstract

OBJECTIVES
To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.

METHODS

Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.

RESULTS

Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.

CONCLUSIONS

Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.

Summary

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Prevalence and predictors of condom use among people who inject drugs in Georgia
Maia Kajaia, Maia Butsashvili, Jack A. DeHovitz, George Kamkamidze, Lasha Gulbiani, Tinatin Abzianidze, Mamuka Djibuti
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Aulia Salmaddiina, Almira Nur Hanifah
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Effects of living alone versus with others and of housemate type on smoking, drinking, dietary habits, and physical activity among elderly people: Seungmin Jeong, Sung il Cho; Epidemiol Health. 2017;39:e2017034. Published online August 6, 2017; DOI: https://doi.org/10.4178/epih.e2017034

23,465 View
263 Download
29 Web of Science
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined differences in health behaviors between elderly people living alone and with others; it also investigated whether the effect of living with others differs according to housemate type, namely a spouse and/or younger generations.

METHODS

Gender-stratified data from the 2013 Korea Community Health Survey for individuals aged 60 to 74 living in Seoul were analyzed. Logistic regression modeling was conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of the outcome variables (smoking, drinking, eating salty foods, inactive lifestyle) for the variables of interest (living alone/with others, housemate type). Models were adjusted for confounding variables including history of medical conditions, employment type, and adjusted household income.

RESULTS

Analysis involved 1,814 men and 2,199 women. Risk of smoking was 1.80 times (95% CI, 1.21 to 2.67) higher for men living alone than living with others. Risk of eating salty foods was 0.78 times lower (95% CI, 0.62 to 0.98) for men living with a spouse than a spouse and younger generations. Risk of inactive lifestyle was 1.47 times higher (95% CI, 1.13 to 1.92) for women living alone. Risk of smoking was higher for women living alone (OR, 1.41; 95% CI, 1.03 to 1.92) or with younger generations (OR, 9.12; 95% CI, 2.04 to 40.80) than with a spouse and younger generations.

CONCLUSIONS

Living alone was associated with smoking in men and physical activity in women; housemate type was associated with dietary habits in men and smoking in women. These gender-specific findings can help identify groups of individuals vulnerable to risky health behaviors and to develop policies.

Summary

Korean summary
서울시의 60-74세 노인 남성 1,814명, 여성 2,199명을 대상으로, 노인의 독거 여부와 동거인의 유형이 흡연, 음주, 짜게 먹는 습관, 신체 활동 등 건강 행태에 미치는지 분석한 결과, 독거가 남성의 흡연 및 여성의 신체활동과 연관이 있는 것으로 나타났으며, 동거인의 유형이 남성의 짜게 먹는 습관 및 여성의 흡연과 연관이 있는 것으로 나타났다. 이 결과를 바탕으로 성특이적으로 나타난 노인의 건강 행태를 개선하기 위해 적극적으로 생활 행태를 교정할 수 있도록 영향을 주려는 정책을 만들어야 할 것이다.

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MERS-Original Article

Preventive behaviors by the level of perceived infection sensitivity during the Korea outbreak of Middle East Respiratory Syndrome in 2015: Soon Young Lee, Hee Jeong Yang, Gawon Kim, Hae-Kwan Cheong, Bo Youl Choi; Epidemiol Health. 2016;38:e2016051. Published online November 16, 2016; DOI: https://doi.org/10.4178/epih.e2016051

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study was performed to investigate the relationship between community residents’ infection sensitivity and their levels of preventive behaviors during the 2015 Middle East Respiratory Syndrome (MERS) outbreak in Korea.

METHODS

Seven thousands two hundreds eighty one participants from nine areas in Gyeonggi-do including Pyeongtaek, the origin of the outbreak in 2015 agreed to participate in the survey and the data from 6,739 participants were included in the final analysis. The data on the perceived infection sensitivity were subjected to cluster analysis. The levels of stress, reliability/practice of preventive behaviors, hand washing practice and policy credibility during the outbreak period were analyzed for each cluster.

RESULTS

Cluster analysis of infection sensitivity due to the MERS outbreak resulted in classification of participants into four groups: the non-sensitive group (14.5%), social concern group (17.4%), neutral group (29.1%), and overall sensitive group (39.0%). A logistic regression analysis found that the overall sensitive group with high sensitivity had higher stress levels (17.80; 95% confidence interval [CI], 13.77 to 23.00), higher reliability on preventive behaviors (5.81; 95% CI, 4.84 to 6.98), higher practice of preventive behaviors (4.53; 95% CI, 3.83 to 5.37) and higher practice of hand washing (2.71; 95% CI, 2.13 to 3.43) during the outbreak period, compared to the non-sensitive group.

CONCLUSIONS

Infection sensitivity of community residents during the MERS outbreak correlated with gender, age, occupation, and health behaviors. When there is an outbreak in the community, there is need to maintain a certain level of sensitivity while reducing excessive stress, as well as promote the practice of preventive behaviors among local residents. In particular, target groups need to be notified and policies need to be established with a consideration of the socio-demographic characteristics of the community.

Summary

Korean summary
2015년 한국에서 발생한 메르스 유행 시 지역 주민이 인식하는 민감도와 예방행위 수준을 파악하고 연관성을 밝히고자 2015년 경기도 9개 시의 지역사회건강조사 대상자 6,739명을 대상으로 감염 민감도와 예방행위 등을 조사 분석하였다. 감염 민감도는 성별, 연령, 직업, 건강행위와 연관성이 있었으며, 감염에 대한 민감도가 높을수록 스트레스를 많이 받는 한편, 예방행위 실천에 긍정적인 영향을 미침을 알 수 있었다. 따라서 감염병 유행 시 지나친 스트레스는 줄이되 공중보건 위기에 대한 적정 수준의 민감도를 유지하고, 인구사회학적 특성을 고려한 관리정책이 요구된다.

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Original Articles

Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent: Tantut Susanto, Iis Rahmawati, Emi Wuri Wuryaningsih, Ruka Saito, Syahrul, Rumiko Kimura, Akiko Tsuda, Noriko Tabuchi, Junko Sugama; Epidemiol Health. 2016;38:e2016041. Published online September 30, 2016; DOI: https://doi.org/10.4178/epih.e2016041

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Abstract PDF

Abstract

OBJECTIVES
Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents.

METHODS

A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses.

RESULTS

The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior.

CONCLUSIONS

Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.

Summary

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Happiness and health behaviors in South Korean adolescents: a cross-sectional study: Su Yeon Kye, Jeong Hyun Kwon, Keeho Park; Epidemiol Health. 2016;38:e2016022. Published online May 31, 2016; DOI: https://doi.org/10.4178/epih.e2016022

29,636 View
294 Download
26 Web of Science
23 Crossref

Abstract Summary PDF

Abstract

OBJECTIVES
We examined the associations between happiness and a wide range of health behaviors in South Korean adolescents.

METHODS

Study data were derived from the ninth Korea Youth Risk Behavior Web-based Survey administered from June to July 2013. In addition to happiness levels, the questionnaire included items on sociodemographics and health-related lifestyle factors (smoking, drinking, eating breakfast, fruit and vegetable consumption, physical activity, sedentary behavior, and hours of sleep).

RESULTS

The multivariate analysis revealed that higher levels of happiness were associated with not smoking or drinking, eating breakfast, eating fruits daily, vegetable consumption, participating in at least 60 minutes of physical activity a day, avoiding sedentary behavior, and hours of sleep. Additionally, sex differences were found in relationships between happiness and eating fruit daily, participation in physical activity, and sedentary behavior.

CONCLUSIONS

These results encourage public health professionals to consider the psychological aspects of adolescent life in working to improve their health behaviors and outcomes.

Summary

Korean summary
본 연구는 청소년건강행태온라인조사결과를 활용하여 청소년들의 주관적 행복수준이 여러가지 건강행동과 관련이 있는지를 살펴보았다. 자신이 행복하다고 느끼는 청소년들은 흡연, 음주, 좌식생활을, 그렇지 않다고 느끼는 청소년들보다 더 적게 하고 있었고, 이와 반대로 아침식사, 채소과일섭취, 신체활동, 충분한 수면은 더 많이 하고 있었다. 성별로 보았을 때는, 주관적 행복인지수준과 과일섭취, 신체활동, 좌식생활에 각각 남녀 차이가 있었다. 이러한 결과를 통해 청소년들의 건강행동 증진을 위해서는 이들의 행복인지능력을 강화하는 노력을 할 필요가 있음을 알 수 있었다.

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Relationship between happiness and tobacco smoking among high school students
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Epidemiology and Health.2018; 40: e2018009. CrossRef

Test-retest reliability of health behavior items in the Community Health Survey in South Korea: Soo Jeong Kim, Jin A Han, Young Hwa Kim, Bo Youl Choi, Su Young Kim, Hun Je Lee, In Hwan Oh, Sung-il Cho, Jakyoung Lee, Soon Young Lee; Epidemiol Health. 2015;37:e2015045. Published online October 20, 2015; DOI: https://doi.org/10.4178/epih/e2015045

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Abstract Summary PDF

Abstract

OBJECTIVES
Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale.

METHODS

A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics.

RESULTS

Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted.

CONCLUSIONS

The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.

Summary

Korean summary
이 연구는 지역사회건강조사의 건강행태 문항 중 28개 문항에 대하여 문항의 특성, 준거기간, 보기의 척도에 따라 조사-재조사 신뢰도의 차이를 분석하였다. 전체 문항의 카파값의 범위는 0.44-0.93이었다. 문항의 특성별로는 인지 또는 태도에 비해 습관에 관한 문항의 신뢰도가 높았으며, 보기의 척도가 5점 척도 이상에 비해 2-4점 척도의 신뢰도가 높음을 확인하였다.

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Health Statistics

Trends in health-related behaviors of Korean adults: study based on data from the 2008 - 2014 Community Health Surveys: Yang Wha Kang, Yun Sil Ko, Keon Yeop Kim, Changhyun Sung, Dong Han Lee, Eunkyeong Jeong; Epidemiol Health. 2015;37:e2015042. Published online September 29, 2015; DOI: https://doi.org/10.4178/epih/e2015042

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Abstract

Unhealthy lifestyle behaviors such as smoking, alcohol consumption, and physical inactivity (multiple risks) often lead to serious health consequence and impaired health status. The purpose of this study was to investigate the trend in health-related behavioral factors over time among adults in South Korea (hereafter Korea). The data of 1,595,842 Koreans older than 19 years who participated in the 2008-2014 Korea Community Health Survey were analyzed to assess the trend in the prevalence of behavioral risk factors. Individual or clustering health-related behaviors were assessed according to sex, age, and region among 228,712 adults who participated in the 2014 survey. From 2008 to 2014, the age-adjusted prevalence of obesity and high-risk alcohol use increased the prevalence of male current smoking and marginally decreased walking ability. Over 7 years, the percentage of adults who reported having all three healthy behaviors (i.e., currently not smoking, not consuming alcohol or having high-risk alcohol use, and engaging in walking) decreased from 35.2% in 2008 to 29.6% in 2014. Increased efforts to emphasize multiple health-related behavioral risk factors, including reducing alcohol use and smoking, and to encourage walking are needed in the thirties and forties age groups in Korea.

Summary

Korean summary
본 논문은 지역사회건강조사를 기반으로 한 우리나라 성인의 지난 7년간 주요건강행태변화와 주요 건강위험요인에 대한 결과를 보여주고 있으며, 각 지역간의 차이를 제시함으로써 지역 보건사업의 필요성을 제시하였다.

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Editorial

Monitoring targets and indicators for the prevention and control of non-communicable diseases in Korea: Soon Young Lee; Epidemiol Health. 2015;37:e2015023. Published online May 4, 2015; DOI: https://doi.org/10.4178/epih/e2015023

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Abstract PDF: Abstract
In order to respond to the increasing burden of non-communicable diseases (NCDs) worldwide, the World Health Organization developed the global action plan (GAP), which included nine targets and 25 indicators to monitor the targets. Owing to space constraints, the article reviewed the status of 17 indicators for seven targets out of nine targets in the GAP in Korea. Most of these 17 indicators required additional analysis with existing national data to evaluate the status in Korea. Based on the result from evaluating indicators, the current NCD policy strategy and resources in Korea seemed unlikely to reach the GAP goals, unless innovative policy changes was planned to reduce NCD risk factors particularly focusing on smoking, excessive drinking, and insufficient physical activity.; Summary

Original Articles

The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students: Yoolwon Jeong, Jin Young Kim, Jae Seon Ryu, Ko eun Lee, Eun Hee Ha, Hyesook Park; Epidemiol Health. 2010;32:e2010009. Published online November 24, 2010; DOI: https://doi.org/10.4178/epih/e2010009

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>The objective of this study was to estimate the prevalence of depression in medical students and to evaluate whether interpersonal social support, health-related behaviors, and socio-economic factors were associated with depression in medical students.</sec><sec><title>METHODS</title>The subjects in this study were 120 medical students in Seoul, Korea who were surveyed in September, 2008. The subjects were all women and over the age of 20. Their age, body mass index (BMI), quality of sleep, diet, household income, smoking, alcohol consumption, exercise levels, and self-reported health status were surveyed. The degree of perceived social support was measured using the interpersonal support evaluation list (ISEL). Depression was evaluated using the center for epidemiology studies depression scale (CES-D).</sec><sec><title>RESULTS</title>The mean CES-D score was 14.1±8.6 and 37.1% of the participants appeared to suffer from depression. Low levels of perceived interpersonal support increased the risk of depression by more than 10 times and having higher household income did not necessarily decrease the risk of depression.</sec><sec><title>CONCLUSION</title>Medical students have a relatively high level of depression. Efforts should be made to encourage social support in order to promote mental health in medical students.</sec>

Summary

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Cardiovascular Risk Factors for Incident Hypertension in the Prehypertensive Population: Soo Jeong Kim, Jakyoung Lee, Sun Ha Jee, Chung Mo Nam, Kihong Chun, Il Soo Park, Soon Young Lee; Epidemiol Health. 2010;32:e2010003. Published online May 1, 2010; DOI: https://doi.org/10.4178/epih/e2010003

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>The aim of this study was to investigate the effect of changes in cardiovascular disease (CVD) risk factors on progression from prehypertension (PreHTN) to hypertension (HTN) using an 8-yr prospective Korean Cancer Prevention Study (KCPS) by the National Health Insurance Corporation (NHIC) in Korea.</sec><sec><title>METHODS</title>A total of 16,229 subjects, aged 30 to 54, with new onset preHTN at baseline (1994-1996) in a biennial national medical exam were selected and followed up till 2004 at 2-yr intervals. All subjects underwent a biennial health examination including biochemical measurements and behavior. The log-rank test was performed to assess the relationship between changes in CVD risk factors and progression to HTN. The Cox proportional hazard model was used to identify factors influencing progression to HTN.</sec><sec><title>RESULTS</title>With regards the progression rate in men, ex-smokers (42.9%), abstainers (37.5%), and regular exercisers (37.6%) showed a slower progression rate than continuous smokers (49.5%) and continuous drinkers (50.9%). In women, those who participated in regular exercise (22.6%) had a lower rate of progression than continuous non-exercisers (36.1%). According to the results of the Cox proportional hazard model, improvements in smoking (hazard ratio [HR], 0.756), drinking (HR, 0.669), regular exercise (HR, 0.653), body mass index (HR, 0.715), and total cholesterol (HR, 0.788) played a protective role in progression to HTN in men, while in women, participating in regular exercise (HR, 0.534) was beneficial.</sec><sec><title>CONCLUSION</title>Improvements in CVD-related behaviors diminished the progression rate of HTN. This study suggests that individuals with PreHTN should be targeted for specific health behavioral intervention to prevent the progression of HTN.</sec>

Summary

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Relationship among risk factors related to Human Papillomavirus infection among youth.: Jin Kyoung Oh, Young Hee Ju, Dong Young Yoon, Kap Yeol Jung, Se Il Jung, Hai Rim Shin; Korean J Epidemiol. 2005;27(1):118-128.

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Abstract PDF: Abstract
PURPOSE
To investigate the prevalence and related risk factors of infection with human papillomavirus(HPV) in young adults, and the interrelationships among the risk factors, school-based survey was conducted in Busan.
METHODS
A total of 1,430 male and female students(aged 16~25) participated in the survey that included self-administered questionnaire and, for males, physician-performed collection of exfoliated genital cells, for females, self-collection of vaginal cells. The prevalences of 25 HPV types were evaluated by a polymerase chain reaction-based assay.
RESULTS
HPV DNA detected more frequently in female students(15.2%) than in male students(8.7%). In female students, currently smoking cigarettes(OR=3.8, 95% CI=1.7~8.3) and having had penetrative sexual intercourse(OR=12.7, 95% CI=7.2~22.2) were the significant risk factors for HPV infection; in male students, there was nothing to show statistical significance. Smoking rate was 53.8% in males and 17.7% in females, and 55.6% of male students and 25.9% of female students reported having had a sexual intercourse. Smokers were more likely to have had a sexual intercourse than nonsmokers(OR=4.0, 95% CI=2.5~6.2, males; OR=9.1, 95% CI=5.6~14.7, females).
CONCLUSIONS
According to the strong interrelationship between sexual intercourse and smoking, multilateral behavioral intervention is needed to prevent infection with HPV.; Summary

The Factors Associated with the Abnormal Eating Behavior in University Hospital's Nurses.: Young Geon Ji, Su Jin Kim, Hyung Gon Kang; Korean J Epidemiol. 2005;27(1):108-117.

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Abstract PDF: Abstract
OBJECTIVES
To compare eating behavior according to the shift work and to find the factors associated with the abnormal eating behavior in university hospital's nurses.
METHODS
For this assessment, a cross-sectional study was conducted with 300 university hospital's nurses. Nurses were questioned with self-reported questionnaire forms. After excluding cases with incomplete data, 276 cases are enrolled in the study. To find the factors associated with the abnormal eating behavior, we conducted multiple logistic regression analysis.
RESULTS
The proportions of shift work nurses were 63.77%(176 cases). The proportions of abnormal eating behavior among shift work nurses were 22.73%(40 cases), but only 6.00%(6 cases) among non-shift work nurses had the abnormal eating behavior. Considering the shift work period, the proportions of abnormal eating behavior were 31.25%, 22.92% and 17.50% in case of shift work period were less than 1 year, 1~3 years and more than 3 years, respectively. The abnormal eating behavior was associated with having shift work, doing exercise, more weekly working hours, being on a diet and having perception of overweight. But age and body mass index were not influenced the abnormal eating behavior.
CONCLUSIONS
In this study, we found that the factors associated with the abnormal eating behavior are the shift work, exercise, weekly working hours, perception of overweight and diet.; Summary

Factors Related to Health Behaviors of the People in an Urban Community: Based on the Health Belief Model.: Byung Mann Cho; Korean J Epidemiol. 1999;21(2):151-158.

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Abstract PDF: Abstract
Variables derived from the health belief model were studied in relation to practices of health behavior, which was measured in terms of thoroughness. Data were collected from the sample of 984 adults living in A-Gu of Pusan, during in-home interviews using structured questionnaires. Women practiced more health behaviors than men. The significant negative relationship was found between perceived barriers to health behavior and practices of health behavior in men and women. In addition, emotional support in men and perceived benefits of health behavior in women were also significant predictors of health behaviors. These findings suggest that in the study population, perceived barriers is the most powerful predictor for practices of health behavior and social support is also important for facilitating positive health behaviors.; Summary

The Cross-sectional Study on the Relationship of Health Behavior and Immune Function.: Soon Young Lee, Yeon Sook Yun, Ki Whan Kim, Seon Woo Kim, Ju Won Park; Korean J Epidemiol. 1998;20(2):212-218.

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Abstract PDF: Abstract
To investigate the association of individual health behaviors with imune response against tumor or viral infection, peripheral blood lymphocytes of 185 healthy males in aged from 35 to 44 years for natural killer(NK) cell activity, frequencies of lymphocytes subsets and proliferation response of T and B cell. NK cell activity was determined by Cr release activity assay and lymphocytes subsets were counted using surface antigens(CD4, CD8, CD56) by flow cytometry. The responsiveness of T and B were measured as proliferation stimulated by mitogens. Subjects were classified into four distinct lifestyle patterns, health promotive lifestyle, passive lifestyle, fitness lifestyle and hedonic lifestyle from information on their health behaviors(cigarette smoking, alcohol consumption, and physical activity). Health promotive lifestyle had the highest NK cell activity(Lu30/10(6)CD56) which was significantly higher than hedonic lifestyle)p<0.05). The responsiveness of T cell was significantly lower in passive lifestyle and hedonic lifestyles compared to health promotive lifestyle and fitness lifestyles(p<0.05). However, there was no significant difference in the responsiveness of B cell, CD4, and CD8 among four lifestyles. This cross-sectional study showed the NK cell activity in individuals with desirable health behaviors was lower. The variation of immunity among individuals was not considered in this study, hence the intervention study reflection individual variations is recommended.; Summary

Nationwide Telephone Survey on Leisure Time Physical Activity among Koreans.: Sung Hee Lee, Tae Woo Yoo, Joung Soon Kim; Korean J Epidemiol. 1998;20(1):113-125.

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Abstract PDF: Abstract
Epidemiologic research has demonstrated that varying grade of physical activity has protective effects on several chronic diseases, including coronary heart disease, hypertension, diabetes mellitus, osteporosis, anxiety and depression. Despite the importance of physical activity as an health promotion factor, there have been only a few research data available in Korea. This telephone interview survey on randomly sampled 1,060 adultsaged 15-69 years was carried out to find out the prevalence of self-reported leisure-time physical activity among Korean adults in terms of health promotion practice. The nationwide telephone interview survey was conducted from April through May 1997. Multistage stratified random sampling method was used for sample selection, the respondent was randomly selected from an entire group of adults who lived at the residence connected with the telephone number. A total of 1,060 adults were interviewed and the interviewees' leisure-time physical activity was categorized into four patterns: 'physically inactive', 'irregularly active', 'regularly active, not intensive', and 'regularly active, intensive'. About 53% of the respondents were physically inactive, 15% irregularly active, 14% regularly active, and only 18% were regularly active, intensive. Women were less active than men anc persons of lower socioeconomic status(SES) were less active than higher SES. Physical activity was not significantly associated with smoking status, drinking pattern and overweight, but negatively associated with daily smoking amount and total duration of smoking in smokers. Individuals with higher lever of physical activity were more likely to check blood pressure regularly and have had screening examination for stomach cancer. Conclusively, the proportion of Korean people who perform appropriate level of physical activity in terms of health promotion is still very low, thus an enforced intervention program becomes indispensable to achieve the national health goal by the year 2000.; Summary

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