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COVID-19: Original Article
Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?
Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
Epidemiol Health. 2023;45:e2023072.   Published online August 3, 2023
DOI: https://doi.org/10.4178/epih.e2023072
  • 2,682 View
  • 110 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined changes in socioeconomic inequalities in mortality in Korea before and after the outbreak of coronavirus disease 2019 (COVID-19).
METHODS
From 2017 to 2020, age-standardized mortality rates were calculated for all-cause deaths, avoidable deaths (preventable deaths, treatable deaths), and unavoidable deaths using National Health Insurance claims data and Statistics Korea’s cause of death data. In addition, the slope index of inequality (SII) and the relative index of inequality (RII) by six income levels (Medical Aid beneficiary group and quintile of health insurance premiums) were computed to analyze the magnitude and change of mortality inequalities.
RESULTS
All-cause and avoidable mortality rates decreased steadily between 2017 and 2020, whereas unavoidable mortality remained relatively stable. In the case of mortality inequalities, the disparity in all-cause mortality between income classes was exacerbated in 2020 compared to 2019, with the SII increasing from 185.44 to 189.22 and the RII increasing from 3.99 to 4.29. In particular, the preventable and unavoidable mortality rates showed an apparent increase in inequality, as both the SII (preventable: 91.31 to 92.01, unavoidable: 69.99 to 75.38) and RII (preventable: 3.42 to 3.66, unavoidable: 5.02 to 5.89) increased.
CONCLUSIONS
In the first year of the COVID-19 pandemic, mortality inequality continued to increase, although there was no sign of exacerbation. It is necessary to continuously evaluate mortality inequalities, particularly for preventable and unavoidable deaths.
Summary
Korean summary
이 연구는 COVID-19 발생 전후 한국에서의 사망률 추이와 사망률 불평등 변화를 조사했다. 2017~2020년 사이에 총사망률과 회피가능사망률은 줄어들었지만, 사망률의 사회경제적 불평등은 더 커지는 경향을 보였다. 특히 예방가능사망과 회피불가능사망에서 불평등이 커져 지속적인 추적과 평가가 필요하다.
Key Message
This study examined the trends in mortality rates and changes in mortality inequality in Korea before and after the onset of COVID-19. Between 2017 and 2020, while the all-cause and avoidable mortality rates decreased, there was a growing trend of inequality in mortality rates based on income levels. Particularly, inequalities in preventable and unavoidable deaths have increased, emphasizing the need for ongoing evaluation.
COVID-19: Original Article
Estimation of the number of working population at high-risk of COVID-19 infection in Korea
Juyeon Lee, Myounghee Kim
Epidemiol Health. 2020;42:e2020051.   Published online July 9, 2020
DOI: https://doi.org/10.4178/epih.e2020051
  • 14,971 View
  • 414 Download
  • 19 Web of Science
  • 15 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to identify occupational groups at high-risk of coronavirus disease 2019 (COVID-19) infection in Korea, to estimate the number of such workers, and to examine the prevalence of protective resources by employment status.
METHODS
Based on the sixth Standard Occupational Classification codes, 2015 census data were linked with data from the fifth Korean Working Conditions Survey, which measured how frequently workers directly come into contact with people other than fellow employees in the workplace.
RESULTS
A total of 30 occupational groups, including 7 occupations from the healthcare and welfare sectors and 23 from other sectors, were classified as high-risk occupational groups involving frequent contact with people other than fellow employees in the workplace (more than half of the working hours). Approximately 1.4 million (women, 79.1%) and 10.7 million workers (46.3%) are employed in high-risk occupations. Occupations with a larger proportion of women are more likely to be at a high-risk of infection and are paid less. For wage-earners in high-risk occupations, protective resources to deal with COVID-19 (e.g., trade unions and health and safety committees) are less prevalent among temporary or daily workers than among those with permanent employment.
CONCLUSIONS
Given the large number of Koreans employed in high-risk occupations and inequalities within the working population, the workplace needs to be the key locus for governmental actions to control COVID-19, and special consideration for vulnerable workers is warranted.
Summary
Korean summary
코로나바이러스감염증-19 (코로나19) 유행 상황에서 감염 고위험 직업군 종사자는 보건의료복지 업종에서 총 140만 명, 그 외 업종에서 총 1,073만 명으로 추정된다. 고위험 사업장에 대해 정부가 안전보건 관리·감독·규제 및 지원 체계를 수립하고, 방역대책의 중심에 노동자의 안전과 건강 보호를 두는 관점의 전환이 필요하다. 우선 당장 역학조사 과정에서 직업관련 요소를 자세히 확인하고, 직업관련 감염에 대한 모니터링과 그에 걸맞는 대책을 마련해야 한다.

Citations

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Epidemiol Health : Epidemiology and Health