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Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys
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Thi Tra Bui, Thi Huyen Trang Nguyen, Jinhee Lee, Sun Young Kim, Jin-Kyoung Oh
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Epidemiol Health. 2024;46:e2024014. Published online January 4, 2024
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DOI: https://doi.org/10.4178/epih.e2024014
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 Abstract
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Abstract
OBJECTIVES
We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts.
METHODS For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities.
RESULTS The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women.
CONCLUSIONS Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.
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Summary
Korean summary
- 시군구 지역단위의 불건강생활(흡연, 음주, 비만, 신체활동 부족 각 0-2점, 합 4점 이상 불건강) 유병률은 여자보다 남자에서 높고, 연령이 높아지면서 감소한다.
- 지역사회 환경개선(술집 개수, 패스트푸드점 밀도, 공원 면적, 병상밀도)과 사회경제적 수준 강화(교육수준, 가구소득, 고용)를 통해 생활습관적 건강행태의 지역 격차를 줄일 수 있다.
- 이러한 향상 노력의 효과는 지역의 건강상태 수준이나 사회인구학적 특성에 따라 다를 수 있다.
Key Message
• District prevalence rates of unhealthy living were higher among men than women and decreased with advancing age.
• Efforts to reduce regional disparities in lifestyle behaviors could benefit from enhancements to the neighborhood environment and the socioeconomic status of the area.
• The effectiveness of such improvements may vary based on socio-demographic characteristics and health conditions.
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Survival Rate and Prognostic Factors of Cancer Patients Diagnosed in a University Hospital.
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Un Je Park, Tae Yong Lee, Sug Gu Lee, Sun Young Kim
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Korean J Epidemiol. 2000;22(2):136-147.
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Abstract
PURPOSE
This study was conducted to investigate case-fatality rates and survival rates, prognostic factors of prevalent five cancers(stomach, lung, liver, cervix, colon) in a university hospital located in Taejon City.METHODS 2,158 cancer patients who have admitted the hospital from Jan. 1, 1991 to Dec. 31, 1998 were analysed.
The higher ratio of outbreak and growing were selected among the investigated cancer data for over 100 of subjects in Korean cancer patient was examined into two method. The one is medical record and the other is affirm a government office for existence or not.RESULTS The lung cancer was discovered for the highest fatality rate. The crude 5-year survival rate of all cancer patients was 43.9% and that in male was higher than that in female. The 5-year survival rate of stomach cancer patients were 49.7%, that treated with combined(operation and chemotherapy) were 66.2%, that with metastasis to lymph node were 48.1%, and distant metastasis were 31.9%. Lung cancer patients were 25.9%, that treated with operation were 42.7%, and that with metastasis to lymph node were 29.3%. Hepatoma patients were 25.5%, that treated with operation were 37.8%.
Uterine cervix cancer patients were 74.8%, that treated with operation were 95.0%, that with metastasis to lymph node were 83.3%, and distant metastasis 74.8%. Colon cancer patients were 41.8%, that treated with operation were 50.2%, that with metastasis to lymph node were 33.4%. Prognostic factors affecting survival rate among stomach cancer patients were age, operation, operation with cancer chemotherpy, and metastais to lymph node and distant matastasis. Prognostic factors of uterine cervix cancer was age, and that of colon cancer were operation with radiotherapy, metatasis to lymph node and distant metastasis.CONCLUSION case-fatality rate in male were higher than that in female, and increased with age. The cancer survival rate of female is high, the high in over 40 years group, and operation is exposed in the highest survival rate, also significant difference in metastasis level.
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