Epidemiology and Health

Original Article

Income-based disparities in the risk of distant-stage cervical cancer and 5-year mortality after the introduction of a National Cancer Screening Program in Korea: Erdenetuya Bolormaa, Seung-Ah Choe, Mia Son, Myung Ki, Domyung Paek; Epidemiol Health. 2022;44:e2022066. Published online August 11, 2022; DOI: https://doi.org/10.4178/epih.e2022066

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Abstract

OBJECTIVES
This study assessed the socioeconomic gradient in the risk of distant-stage cervical cancer (CC) at presentation and 5-year mortality for new CC patients after the introduction of a national Cancer Screening Program (NCSP) in Korea.

METHODS

All new CC cases from 2007 to 2017 were retrieved from the Korea Central Cancer Registry database linked with the National Health Information Database of the National Health Insurance Service. The age-standardized cumulative incidence of CC, adjusted odds ratios (ORs) of distant metastasis at presentation, and adjusted all-cause mortality hazard ratios (HRs) within 5 years post-diagnosis were assessed according to the income gradient.

RESULTS

The 11-year age-standardized cumulative incidence of CC ranged from 48.9 to 381.5 per 100,000 women, with the richest quintile having the highest incidence. Of 31,391 new cases, 8.6% had distant metastasis on presentation, which was most frequent among Medical Aid beneficiaries (9.9%). Distant-stage CC was more likely when the income level was lower (OR, 1.46; 95% confidence interval [CI]), 1.28 to 1.67 for the lowest compared to the richest) and among Medical Aid beneficiaries (OR, 1.50; 95% CI, 1.24 to 1.82). The 5-year mortality was greater in the lower-income quintiles and Medical Aid beneficiaries than in the richest quintile.

CONCLUSIONS

The incidence of CC was higher in the richest quintile than in the lower income quintiles, while the risk of distant-stage CC and mortality was higher for women in lower income quintiles in the context of the NCSP. A more focused approach is needed to further alleviate disparities in the timely diagnosis and treatment of CC.

Summary

Korean summary
새로이 자궁경부암을 진단받은 여성에서 소득수준에 따른 진단시 원격 전이가 있을 위험도와 진단 이후 5년 사망위험도를 연령과 체질량 지수등의 개인 수준의 위험 요인을 보정하여 구했다. 소득 수준이 낮을수록, 의료급여 환자일수록 진단시 원격 전이가 있을 위험과 5년 내 사망 위험이 높은 것으로 나타났다. 자궁경부암에 대한 전국민 대상 선별 검사가 있지만 여전히 소득 수준에 따른 자궁경부암의 적시 진단과 진단 후 생존의 불평등이 남아 있으며 이에 대한 추가 정책이 필요하다.

Key Message
This study adds empirical evidence for an income-based disparity in the cancer stage at presentation and five-year survival among cervical cancer patients even in the presence of a universal screening program.

Citations

Citations to this article as recorded by

Individual and joint effect of socioeconomic status and lifestyle factors on cancer in Korea
Chi Lan Tran, Kui Son Choi, Sun‐Young Kim, Jin‐Kyoung Oh
Cancer Medicine.2023; 12(16): 17389. CrossRef
Menopausal hormone therapy and risk of dementia: health insurance database in South Korea-based retrospective cohort study
Jin-Sung Yuk, Jin San Lee, Joong Hyun Park
Frontiers in Aging Neuroscience.2023;[Epub] CrossRef
Disparities in Cancer Incidence across Income Levels in South Korea
Su-Min Jeong, Kyu-Won Jung, Juwon Park, Nayeon Kim, Dong Wook Shin, Mina Suh
Cancers.2023; 15(24): 5898. CrossRef

Cohort Profile

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

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Abstract

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

Summary

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

Citations

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The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa
Gabriella A. Norwitz, Chris Desmond, Rachel S. Gruver, Jane D. Kvalsvig, Amaleah F. Mirti, Shuaib Kauchali, Leslie L. Davidson, Giulia Ballarotto
PLOS ONE.2023; 18(10): e0290788. CrossRef

COVID-19: Original Article

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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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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Gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural western China: A decomposition analysis
Ruixue Ye, Yuju Wu, Chang Sun, Qingzhi Wang, Yue Ma, Yunwei Chen, Lucy Pappas, Cindy Feng, Scott Rozelle, Huan Zhou
Preventive Medicine Reports.2024; 39: 102617. CrossRef
Aftermath on COVID-19 technological and socioeconomic changes: A meta-analytic review
Xuan Yao, Zeshui Xu, Marinko Škare, Xindi Wang
Technological Forecasting and Social Change.2024; 202: 123322. CrossRef
Association of Depression With Precautionary Behavior Compliance, COVID-19 Fear, and Health Behaviors in South Korea: National Cross-sectional Study
Hyerine Shin, Ji-Su Kim, HyunHae Lee
JMIR Public Health and Surveillance.2023; 9: e42677. CrossRef
Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
Epidemiology and Health.2023; 45: e2023033. CrossRef
Communication inequalities in the COVID-19 pandemic: socioeconomic differences and preventive behaviors in the United States and South Korea
Woohyun Yoo, Yangsun Hong, Sang-Hwa Oh
BMC Public Health.2023;[Epub] CrossRef
Compliance Trajectory and Patterns of COVID-19 Preventive Measures, Japan, 2020–2022
Taro Kusama, Kenji Takeuchi, Yudai Tamada, Sakura Kiuchi, Ken Osaka, Takahiro Tabuchi
Emerging Infectious Diseases.2023;[Epub] CrossRef
COVID-19 in Baghdad, Iraq: adaptive and emotional findings in a household cluster survey
Riyadh Lafta, Sahar Al-Shatari, Meighan Mary, Gilbert Burnham
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Predicting Support for COVID-19 Policies with Partisan Media Use and Negative Emotion: Evidence from the U.S. and South Korea
Dam Hee Kim, Tae Hyun Lim, Yu Jeong Hwang, Seongcheol Kim
Journal of Health Communication.2023; 28(sup2): 32. CrossRef
Factors associating to the increased smoking time among South Korean male workers during COVID-19 pandemic
Mi Young Kwon, Myong Sun Cho
Korean Journal of Health Education and Promotion.2022; 39(2): 53. CrossRef
Trust and compliance: Milieu-specific differences in social cohesion during the COVID-19 pandemic in Germany
Tim Schröder, Anne Speer, Patrick Sachweh, Olaf Groh-Samberg
Frontiers in Sociology.2022;[Epub] CrossRef
Effect of socioeconomic disparities on the risk of COVID-19 in 8 metropolitan cities in the Korea: a community-based study
Myung-Jae Hwang, Shin Young Park, Tae-Ho Yoon, Jinhwa Jang, Seon-Young Lee, Myeongsu Yoo, Yoo-Yeon Kim, Hae-Kwan Cheong, Donghyok Kwon, Jong-Hun Kim
Epidemiology and Health.2022; 44: e2022107. CrossRef

COVID-19: Original Article

Does having various types of fear related to COVID-19 disrupt individuals’ daily life?: Findings from a nationwide survey in Korea: Woorim Kim, Yeong Jun Ju, Soon Young Lee; Epidemiol Health. 2022;44:e2022004. Published online January 3, 2022; DOI: https://doi.org/10.4178/epih.e2022004

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Abstract

OBJECTIVES
Unexpected changes in daily routines caused by the coronavirus disease 2019 (COVID-19) pandemic may affect psychological health. This study investigated the association between various types of COVID-19-related fear and the subjective level of disturbance in daily activities experienced by individuals.

METHODS

This cross-sectional study used the Korea Community Health Survey conducted from August through November 2020. COVID-19-related fear included fear of infection, death, public criticism, family members getting infected, and economic loss. The subjective level of disruption in daily activities was measured using a 0-100 numeric rating scale developed by the Korea Disease Control and Prevention Agency. Multivariable linear regression was used to analyze the associations between the independent and dependent variables. A subgroup analysis was performed based on income level.

RESULTS

Participants who reported fear of infection (β=-3.37, p<0.001), death (β=-0.33, p=0.030), public criticism (β=-1.63, p<0.001), a family member getting infected (β=-1.03, p<0.001), and economic loss (β=-3.52, p<0.001) experienced more disturbances in daily activities. The magnitude of this association was most significant in the lowest-income group.

CONCLUSIONS

Individuals reporting COVID-19-related fear experienced higher levels of subjective disruption in daily activities.

Summary

Korean summary
이 연구는 COVID-19 팬데믹과 관련된 심리적염려가 일상생활 활동에 부정적인 영향을 줄 수 있음을 관찰하였다. COVID-19 감염으로 인한 감염, 사망, 대중의 비판, 가족 중 건강취약자의 감염, 경제적 손실에 대해 염려하는 사람은 그렇지 않은 사람에 비해 일상생활에 더 부정적인 영향을 받고 있는 것으로 관찰되었다. 특히 다양한 유형의 감염염려를 동시에 경험하고 있을수록 일상생활 지장 정도가 더 증가하는 경향이 관찰되었으며 소득수준이 낮을수록 부정적인 영향정도가 더 두드러졌다.

Key Message
Our results revealed that fear related to the COVID-19 pandemic was associated with increased levels of subjective disruptions in daily activities. Compared to individuals without fear, those with fears of COVID-19 infection, dying from infection, public criticism, a family member getting infected, and economic loss reported higher levels of disruption in daily activities. Those who reported fear of COVID-19 infection and economic loss due to infection had particularly higher levels of disturbances. Considering the various types of fear concurrently, the level of disruption experienced tended to increase with the number of reported fears.

Citations

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Is fear of COVID-19 higher in individuals residing in more deprived areas? A nationwide study
Woorim Kim, Soon Young Lee, Yeong Jun Ju
Journal of Public Health.2023; 45(2): 402. CrossRef
Association Between Changes in Family Life Due to COVID-19 and Depressive Mood and Stress Perception
Min-Su Kim, Mi Ah Han, Jong Park, So Yeon Ryu
Asia Pacific Journal of Public Health.2023; 35(1): 14. CrossRef
Public perception of the appropriateness of COVID-19 management strategies and level of disturbances in daily activities: A focus on educational level
Yeong Jun Ju, Woorim Kim, Soon Young Lee, Jordi Gumà
PLOS ONE.2023; 18(6): e0287143. CrossRef

Original Articles

Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence: Paschal Awingura Apanga, Maxwell Tii Kumbeni; Epidemiol Health. 2021;43:e2021092. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021092

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman’s place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.

METHODS

We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.

RESULTS

The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.

CONCLUSIONS

Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.

Summary

Key Message
Our findings suggest that early antenatal care (ANC) was associated with the likelihood of receiving eight or more ANC contacts (ANC8+) among all mothers across low-and middle-income countries. This association was modified by a woman’s place of residence such that mothers living in rural areas who received early ANC had a higher prevalence of ANC8+. Public health programs, which focus on increasing the coverage of ANC8+ should encourage all pregnant women to receive early ANC, particularly those living rural areas.

Citations

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The practice of polygyny on the utilisation of reproductive health services among married women in Ghana
Maxwell Tii Kumbeni, John Ndebugri Alem, Florence Assibi Ziba, Agani Afaya, Paschal Awingura Apanga
Journal of Biosocial Science.2024; : 1. CrossRef
Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region Tanzania
Agatha F. Ngowi, Serafina Mkuwa, Laura Shirima, Frida Ngalesoni, Gasto Frumence
SAGE Open Nursing.2023; 9: 237796082311707. CrossRef
Contents of antenatal care services in Afghanistan: findings from the national health survey 2018
Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari, Abdul Wahed Wasiq, Mohammad Khaled Seddiq, Sheena Currie, Hadia Sayam, Ahmad Haroon Baray, Sayed Ataullah Saeedzai
BMC Public Health.2023;[Epub] CrossRef
The moderating role of partners’ education on early antenatal care in northern Ghana
Paschal Awingura Apanga, Maxwell Tii Kumbeni, James Kotuah Sakeah, Ayokunle A. Olagoke, Olufemi Ajumobi
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef

Income-related inequality in completed suicide across the provinces of Iran: Mohammad Hassan Kazemi-Galougahi, Asieh Mansouri, Samaneh Akbarpour, Mahmood Bakhtiyari, Majid Sartipi, Rahmatollah Moradzadeh; Epidemiol Health. 2018;40:e2018012. Published online April 2, 2018; DOI: https://doi.org/10.4178/epih.e2018012

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Abstract PDF

Abstract

OBJECTIVES
The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran.

METHODS

This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran.

RESULTS

The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06).

CONCLUSIONS

This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.

Summary

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Inequalities in Violent Death across Income Levels among Young Males and Females in Countries of the Americas
Oscar J. Mujica, Dihui Zhang, Yi Hu, Isabel C. Espinosa, Nelson Araneda, Anca Dragomir, George Luta, Antonio Sanhueza
International Journal of Environmental Research and Public Health.2023; 20(7): 5256. CrossRef
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Zakieh Sadat Hosseini, Sedigheh Sadat Tavafian, Omran Ahmadi, Reza Maghbouli
Trials.2023;[Epub] CrossRef
SPATIAL ANALYSIS OF SUICIDE IN NORTHEASTERN BRAZIL AND ASSOCIATED SOCIAL FACTORS
Taynara Lais Silva, Thatiana Araújo Maranhão, George Jó Bezerra Sousa, Isaac Gonçalves da Silva, José Claudio Garcia Lira Neto, Geovana Almeida dos Santos Araujo
Texto & Contexto - Enfermagem.2022;[Epub] CrossRef
Early marriage, stressful life events and risk of suicide and suicide attempt: a case–control study in Iran
Ali Fakhari, Hamid Allahverdipour, Elham Davtalab Esmaeili, Vijay Kumar Chattu, Hamid Salehiniya, Hosein Azizi
BMC Psychiatry.2022;[Epub] CrossRef
Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018
Xiaojing Fan, Min Su, Yaxin Zhao, Yafei Si, Zhongliang Zhou
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Social and economic variables related with Paraquat self-poisoning: an ecological study
Jefferson Antonio Buendía, Gabriel Jaime Restrepo Chavarriaga, Andres F. Zuluaga
BMC Public Health.2020;[Epub] CrossRef

Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea: Ikhan Kim, Jinwook Bahk, Sung-Cheol Yun, Young-Ho Khang; Epidemiol Health. 2017;39:e2017011. Published online March 15, 2017; DOI: https://doi.org/10.4178/epih.e2017011

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Abstract

OBJECTIVES
To examine the income gaps associated with self-rated poor health at the district level in Korea and to identify the geographical correlations between self-rated poor health, life expectancy, and the associated income gaps.

METHODS

We analyzed data for 1,578,189 participants from the Community Health Survey of Korea collected between 2008 and 2014. The age-standardized prevalence of self-rated poor health and the associated income gaps were calculated. Previously released data on life expectancy and the associated income gaps were also used. We performed correlation and regression analyses for self-rated poor health, life expectancy, and associated income gaps.

RESULTS

Across 245 districts, the median prevalence of self-rated poor health was 15.7% (95% confidence interval [CI], 14.6 to 16.8%), with interquartile range (IQR) of 3.1 percentage points (%p). The median interquintile gaps in the prevalence of self-rated poor health was 11.1%p (95% CI, 8.1 to 14.5%p), with IQR of 3.6%p. Pro-rich inequalities in self-rated health were observed across all 245 districts of Korea. The correlation coefficients for the association between self-rated poor health and the associated income gaps, self-rated poor health and life expectancy, and income gaps associated with self-rated poor health and life expectancy were 0.59, 0.78 and 0.55 respectively.

CONCLUSIONS

Income gaps associated with self-rated poor health were evident across all districts in Korea. The magnitude of income gaps associated with self-rated poor health was larger in the districts with greater prevalence of self-rated poor health. A strong correlation between self-rated poor health and life expectancy was also observed.

Summary

Korean summary
본 연구에서는 우리나라 245개 시군구의 자가평가 불건강 유병률의 소득수준 간 격차 크기를 규명하고, 시군구 단위 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 및 기대수명의 소득수준 간 격차의 상관성에 대하여 분석하였다. 연구 결과, 우리나라 245개 모든 시군구에서 자가평가 불건강 유병률에서의 저소득층에 불리한 불평등이 존재하였다. 또한, 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 그리고 자가평가 불건강 유병률의 소득수준 간 격차와 기대수명의 소득수준 간 격차는 높은 상관성이 나타났다. 이 연구는 지방정부 차원에서 건강 형평성 현황에 관한 유의미한 정보를 제공하여 지역별 보건정책 수립의 근거로 활용할 수 있다는데 의의를 찾을 수 있다.

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The Effect of Work Department, Income and Job Status on the Workplace Injury Rates in One Car Manufacturing Factory.: Mi A Son; Korean J Epidemiol. 2001;23(2):52-63.

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Abstract PDF: Abstract
PURPOSE
There has been little research into socio-economic factors and work condition s as risk factors for workplace injuries in Korea. Separating work from social class is difficult as the social division of labour is at the origin of social class (1). The objective of this study is to investigate the relationship of working conditions and socio-economic factors with workplace injury rates.
METHODS
Three year-follow up data sets for workplace injury data analysis for retrospective cohort study were obtained linking the total workforce and workplace injuries between 1995 and 1997. The Proportional Hazards Model (Cox regression) is used to estimate the hazard ratios for workplace injury by different possible risk factors: work department, income, job status, age and tenure.
RESULTS
The press, body and engine departments have higher hazard rates for severe injuries; the press, engine, and supporting departments for lower-back pain; and the assembly line (with wider confidence interval) and supporting departments for Herniated Intervertebral Discs. Lower waged workers have higher rates of workplace injuries, especially for lower-back pain. Workers with low job status have higher rates than foremen or supervisors. Thus, socio-economic factors and work department contribute independently to workplace injury rates.
CONCLUSIONS
Even though this study could not fully investigate the relationship between socio-economic factors and working conditions, the working conditions as well as socioeconomic factors need to be considered as risk factors of workplace injuries in the workplace.; Summary

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