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Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data
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Eunsu Kim, Min-Ho Shin, Jung-Ho Yang, Soon-Ki Ahn, Baeg-Ju Na, Hae-Sung Nam
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Epidemiol Health. 2021;43:e2021062. Published online September 8, 2021
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DOI: https://doi.org/10.4178/epih.e2021062
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Abstract
OBJECTIVES We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults.
METHODS We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index×100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL.
RESULTS In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26).
CONCLUSIONS Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
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Summary
Korean summary
시군구 단위 스트레스 인지율과 우울 유병률이 개인 단위 건강관련 삶의 질 수준과 연관성을 갖는지 파악하고자 지역사회건강조사 자료를 이용하여 다수준 분석을 수행하였다. 개인 수준에서 인지된 스트레스와 우울은 건강관련 삶의 질 감소와 관련이 있었다. 스트레스와 우울 수준이 높은 시군구일수록 개인의 건강관련 삶의 질은 낮아지는 관계를 보였는데, 이는 남성보다는 여성에서 더 저명하였다.
Key Message
This study examined the associations of regional-level perceived stress and depression with individual HRQOL measured in terms of the EQ-5D using a multilevel model. Individual-level perceived stress and depression were significantly related to individual HRQOL. Regional stress and depression were also significant factors and both had greater negative impacts on HRQOL among women than among men.
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Citations
Citations to this article as recorded by
- Factors Related to Health-Related Quality of Life across the Life Cycle in One-Person Households among Korean Adults
Myung-Ock Chae Research in Community and Public Health Nursing.2024; 35: 125. CrossRef - Association between seafood intake and depression in Korean adults: analysis of data from the 2014–2020 Korea National Health and Nutrition Examination Survey
Hyemin Shin, Won Jang, Yangha Kim Journal of Nutrition and Health.2023; 56(6): 702. CrossRef - Depression before and during-COVID-19 by Gender in the Korean Population
Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim International Journal of Environmental Research and Public Health.2022; 19(6): 3477. CrossRef - Association Between Regional Levels of Particulate Matter and Recurrent Falls in Korea
Jung-Ho Yang, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin Journal of Korean Medical Science.2022;[Epub] CrossRef
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Time-variant reproductive number of COVID-19 in Seoul, Korea
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Seong-Geun Moon, Yeon-Kyung Kim, Woo-Sik Son, Jong-Hoon Kim, Jungsoon Choi, Baeg-Ju Na, Boyoung Park, Bo Youl Choi
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Epidemiol Health. 2020;42:e2020047. Published online June 28, 2020
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DOI: https://doi.org/10.4178/epih.e2020047
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14,293
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Abstract
OBJECTIVES To estimate time-variant reproductive number (R<sub>t</sub>) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies.
METHODS Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated R<sub>t</sub> using program R’s package “EpiEstim”. For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date.
RESULTS Based on the information of 313 confirmed cases, the epidemic curve was shaped like ‘propagated epidemic curve’. The daily R<sub>t</sub> based on R<sub>t_c</sub> peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both R<sub>t</sub> from R<sub>t_c</sub> and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of R<sub>t</sub> was greater when using R<sub>t_c</sub>. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable.
CONCLUSIONS R<sub>t</sub> can be estimated based on R<sub>t_c</sub> which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of R<sub>t</sub> would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.
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Summary
Korean summary
우리나라 전체와 각 시도별 일별 증상 발현자 수 또는 확진자 수를 이용하여 추정한 Rt로 방역정책의 효과를 국가 및 시도 수준에서 지속적으로 모니터링 할 필요가 있다.
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Citations
Citations to this article as recorded by
- Reproduction Factor Based Latent Epidemic Model Inference: A Data-Driven Approach Using COVID-19 Datasets
Sujin Ahn, Minhae Kwon IEEE Journal of Biomedical and Health Informatics.2023; 27(3): 1259. CrossRef - 코로나19 핵심 지표 산출체계 국제 비교 및 활용도 제고 방안 연구
나애 이, 연경 김, 승필 정, 우주 이, 주환 오, 승식 황 Public Health Weekly Report.2023; 16(29): 973. CrossRef - The Impacts of Compact City Characteristics on COVID-19 Spreading Force : Focused on the Seoul Metropolitan Area
Haejun Hyun, Myungje Woo Journal of Korea Planning Association.2023; 58(7): 5. CrossRef - COVID-19 early-alert signals using human behavior alternative data
Anasse Bari, Aashish Khubchandani, Junzhang Wang, Matthias Heymann, Megan Coffee Social Network Analysis and Mining.2021;[Epub] CrossRef
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