Epidemiology and Health

Original Articles

Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project: Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023041. Published online April 4, 2023; DOI: https://doi.org/10.4178/epih.e2023041

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Abstract

OBJECTIVES
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.

METHODS

From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.

RESULTS

Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).

CONCLUSIONS

Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.

Summary

Korean summary
본 연구는 “한국인의 사회적 삶, 건강과 노화에 대한 조사”(Korean Social Life, Health and Aging Project, KSHAP)에서 측정한 한 지역 내의 사회적 연결망 자료를 이용하여 사회적 분리와 심혈관 건강 사이의 관계를 살펴보았다. 그 결과, 사회적 분리는 비만, 고혈압, 콜레스테롤, 흡연, 음주 신체적 활동 등을 종합한 ‘라이프 심플 7’ 지표와 부정적인 관련성을 보였으며, 8년 후 추적 조사에서도 이 패턴이 유지되었다. 본 연구 결과는 사회적, 집단적 분리 현상이 신체적 건강에도 악영향을 초래할 수 있음을 시사한다.

Key Message
Using the prospective Korean Social Life, Health, and Aging Project (KSHAP) database, we discovered that group-level segregation was significantly associated with worse cardiovascular health (CVH). Also, we observed a tendency for baseline group-level segregation to be linked to worse CVH after an 8-year follow-up period. These findings emphasize the significance of group-level segregation as a potential contributing factor in the health outcomes of older adults.

Citations

Citations to this article as recorded by

Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey
Shiqi Wang, Hao Zhang, Yiling Lou, Qiqi You, Qingqing Jiang, Shiyi Cao
Journal of Affective Disorders.2024; 349: 577. CrossRef

Reconstructing a COVID-19 outbreak within a religious group using social network analysis simulation in Korea: Namje Kim, Su Jin Kang, Sangwoo Tak; Epidemiol Health. 2021;43:e2021068. Published online September 16, 2021; DOI: https://doi.org/10.4178/epih.e2021068

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Abstract Summary PDF

Abstract

OBJECTIVES
We reconstructed a coronavirus disease 2019 (COVID-19) outbreak to examine how a large cluster at a church setting spread before being detected and estimate the potential effectiveness of complying with mask-wearing guidelines recommended by the government.

METHODS

A mathematical model with a social network analysis (SNA) approach was used to simulate a COVID-19 outbreak. A discrete-time stochastic simulation model was used to simulate the spread of COVID-19 within the Sarang Jeil church. A counterfactual experiment using a calibrated baseline model was conducted to examine the potential benefits of complying with a mask-wearing policy.

RESULTS

Simulations estimated a mask-wearing ratio of 67% at the time of the outbreak, which yielded 953.8 (95% confidence interval [CI], 937.3 to 970.4) cases and was most consistent with the confirmed data. The counterfactual experiment with 95% mask-wearing estimated an average of 45.6 (95% CI, 43.4 to 47.9) cases with a standard deviation of 20.1. The result indicated that if the church followed government mask-wearing guidelines properly, the outbreak might have been one-twentieth the size.

CONCLUSIONS

SNA is an effective tool for monitoring and controlling outbreaks of COVID-19 and other infectious diseases. Although our results are based on simulations and are thus limited, the precautionary implications of social distancing and mask-wearing are still relevant. Since person-to-person contacts and interactions are unavoidable in social and economic life, it may be beneficial to develop precise measures and guidelines for particular organizations or places that are susceptible to cluster outbreaks.

Summary

Korean summary
본 연구는 구조화된 확률적 네트워크 시뮬레이션모형을 이용하여 국내에서 발생했던 사랑제일교회 발 코로나19 집단 감염 사례의 일별 확진자 데이터를 설명하고자, 마스크 착용 비율 추정과 반사실적 실험을 통해 방역지침을 준수한 경우 발생할 수 있었을 확진자의 규모를 추정하였다. 시뮬레이션 결과 추정된 당시 사랑제일교회의 마스크 착용 비율은 약 67% 수준이며, 만약 참석자의 95%가 마스크를 착용한 경우 확진자 규모는 실제의 20분의 1 수준에 그쳤을 것으로 예상된다. 마스크 착용은 예방접종과 함께 코로나 감염증을 극복하기 위한 가장 효과적인 예방활동이며 가장 마지막까지 강조되어야 할 것이다.

Key Message
To better understand the transmission of COVID-19 in a church setting, a stochastic social network analysis with a focus on mask-wearing practice was constructed. The results showed that if mask-wearing were to increase from 67% (at the time of the outbreak) to 95%, the outbreak could have been one-twentieth the size. Among the many measures of non-pharmaceutical intervention which may be withdrawn, mask-wearing is still one of the most effective precautionary measure and should continue to be emphasized.

Citations

Citations to this article as recorded by

Mathematical Modeling of COVID-19 Transmission and Intervention in South Korea: A Review of Literature
Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee
Yonsei Medical Journal.2023; 64(1): 1. CrossRef
A Social Network Analysis Approach to Evaluate the Relationship Between the Mobility Network Metrics and the COVID-19 Outbreak
Sadegh Ilbeigipour, Babak Teimourpour
Health Services Insights.2023; 16: 117863292311738. CrossRef
The effect of shortening the quarantine period and lifting the indoor mask mandate on the spread of COVID-19: a mathematical modeling approach
Jung Eun Kim, Heejin Choi, Minji Lee, Chang Hyeong Lee
Frontiers in Public Health.2023;[Epub] CrossRef
Investigation of Statistical Machine Learning Models for COVID-19 Epidemic Process Simulation: Random Forest, K-Nearest Neighbors, Gradient Boosting
Dmytro Chumachenko, Ievgen Meniailov, Kseniia Bazilevych, Tetyana Chumachenko, Sergey Yakovlev
Computation.2022; 10(6): 86. CrossRef

The anatomy of COVID-19 comorbidity networks among hospitalized Korean patients: Eun Kyong Shin, Hyo Young Choi, Neil Hayes; Epidemiol Health. 2021;43:e2021035. Published online May 7, 2021; DOI: https://doi.org/10.4178/epih.e2021035

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Abstract Summary PDF

Abstract

OBJECTIVES
We aimed to examine how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19).

METHODS

Data were provided by the National Medical Center of the Korea Disease Control and Prevention Agency. These data included the clinical and epidemiological information of all patients hospitalized with COVID-19 who were discharged on or before April 30, 2020 in Korea. We conducted comorbidity network and multinomial logistic regression analyses to identify risk factors associated with COVID-19 disease severity and mortality. The outcome variable was the clinical severity score (CSS), categorized as mild (oxygen treatment not needed), severe (oxygen treatment needed), or death.

RESULTS

In total, 5,771 patients were included. In the fully adjusted model, chronic kidney disease (CKD) (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.19 to 5.61) and chronic obstructive pulmonary disease (COPD) (OR, 3.19; 95% CI, 1.35 to 7.52) were significantly associated with disease severity. CKD (OR, 5.35; 95% CI, 2.00 to 14.31), heart failure (HF) (OR, 3.15; 95% CI, 1.22 to 8.15), malignancy (OR, 3.38; 95% CI, 1.59 to 7.17), dementia (OR, 2.62; 95% CI, 1.45 to 4.72), and diabetes mellitus (OR, 2.26; 95% CI, 1.46 to 3.49) were associated with an increased risk of death. Asthma and hypertension showed statistically insignificant associations with an increased risk of death.

CONCLUSIONS

Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly CKD, COPD, and HF.

Summary

Korean summary
본 연구는 2019 년 코로나 바이러스 질환 (COVID-19)으로 입원 한 환자의 합병증이 결과 (질병 중증도 또는 사망)와 어떤 관련이 있는지를 동반 질환 네트워크 및 다항 로지스틱 회귀 분석을 통해 분석하였다. 기저 질환은 COVID-19의 중증도 및 사망에 차별적으로 영향을 미친다. 제한된 의료 자원을 효율적으로 활용하기 위해서 환자의 기저 동반 질환 중, 특히 만성 신장 질환 (CKD), 만성 폐쇄성 폐 질환 (COPD), 심부전 (HF)을 더욱 면밀히 모니터링해야 한다.

Key Message
We examined how comorbidities were associated with outcomes (illness severity or death) among hospitalized patients with coronavirus disease 2019 (COVID-19), implementing comorbidity network and multinomial logistic regression analyses. Underlying diseases contribute differently to the severity of COVID-19. To efficiently allocate limited medical resources, underlying comorbidities should be closely monitored, particularly chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and heart failure (HF).

Citations

Citations to this article as recorded by

SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses
Muhannad Smadi, Melina Kaburis, Youval Schnapper, Gabriel Reina, Patricio Molero, Marc L. Molendijk
The British Journal of Psychiatry.2023; 223(2): 348. CrossRef
Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis
James Patrick Finnerty, A. B. M. Arad Hussain, Aravind Ponnuswamy, Hafiz Gulzeb Kamil, Ammar Abdelaziz
BMC Pulmonary Medicine.2023;[Epub] CrossRef
The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course—A Narrative Review
Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef

Association of social network size and composition with physical activity in Korean middle-aged adults: Moon Su Kwak, So Mi Jemma Cho, Jee-Seon Shim, Dae Jung Kim, Yoosik Youm, Hyeon Chang Kim; Epidemiol Health. 2020;42:e2020070. Published online November 25, 2020; DOI: https://doi.org/10.4178/epih.e2020070

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members.
METHODS
We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates.
RESULTS
In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA.
CONCLUSIONS
These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.; Summary

Korean summary
이 연구는 30-64세 중년의 한국인 8,092(남자 2,805, 여자 5,207)명에서 사회연결망 특성과 신체활동량의 관련성을 평가했다. 남녀 모두에서 사회연결망의 크기가 클수록, 연결망내 동성인 사람의 비중이 높을수록 신체활동량이 많았다. 사회연결망 크기와 연결망내 동성인 사람의 비중은 권장 신체활동량을 충족률과도 양의 관련성을 보였다. 반면, 연결망내 친족의 비중이 높은 경우는 오히려 권장신체활동량을 충족할 가능성이 낮았다.

Intervention effects in the transmission of COVID-19 depending on the detection rate and extent of isolation: Okyu Kwon, Woo-Sik Son, Jin Yong Kim, Jong-Hun Kim; Epidemiol Health. 2020;42:e2020045. Published online June 23, 2020; DOI: https://doi.org/10.4178/epih.e2020045

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Abstract Summary PDF Supplementary Material

Abstract

Objectives
In 2020, the coronavirus disease 2019 (COVID-19) respiratory infection is spreading in Korea. In order to prevent the spread of an infectious disease, infected people must be quickly identified and isolated, and contact with the infected must be blocked early. This study attempted to verify the intervention effects on the spread of an infectious disease by using these measures in a mathematical model.

Methods

We used the susceptible-infectious-recovery (SIR) model for a virtual population group connected by a special structured network. In the model, the infected state (I) was divided into I in which the infection is undetected and Ix in which the infection is detected. The probability of transitioning from an I state to Ix can be viewed as the rate at which an infected person is found. We assumed that only those connected to each other in the network can cause infection. In addition, this study attempted to evaluate the effects of isolation by temporarily removing the connection among these people.

Results

In Scenario 1, only the infected are isolated; in Scenario 2, those who are connected to an infected person and are also found to be infected are isolated as well. In Scenario 3, everyone connected to an infected person are isolated. In Scenario 3, it was possible to effectively suppress the infectious disease even with a relatively slow rate of diagnosis and relatively high infection rate.

Conclusions

During the epidemic, quick identification of the infected is helpful. In addition, it was possible to quantitatively show through a simulation evaluation that the management of infected individuals as well as those who are connected greatly helped to suppress the spread of infectious diseases.

Summary

Korean summary
본 연구는 행위자 기반 모형의 시뮬레이션 평가를 통해 COVID-19 유행 상황에서 비약물적 중재 효과를 정량적으로 제시하였다. 비약물적 중재에 관한 세 가지 시나리오를 통해 제시한 결과에서, COVID-19 감염자를 신속하게 진단하고, 감염자 본인과 접촉자들을 가능한 한 빨리 모두 격리하여 관리하는 것이 감염병 확산을 억제하는데 있어서 보다 효과적이었다.

Citations

Citations to this article as recorded by

Mathematical Modeling of COVID-19 Transmission and Intervention in South Korea: A Review of Literature
Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee
Yonsei Medical Journal.2023; 64(1): 1. CrossRef
Non-pharmaceutical interventions during the COVID-19 pandemic: A review
Nicola Perra
Physics Reports.2021; 913: 1. CrossRef
Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919. CrossRef

Factors affecting satisfaction with cancer information provided through the social networking services of the National Cancer Information Center in Korea: Su Yeon Kye, Min Hee Lee, Jisu Yoo, Kyung Hee Oh, Jae Kwan Jun; Epidemiol Health. 2017;39:e2017057. Published online December 11, 2017; DOI: https://doi.org/10.4178/epih.e2017057

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Abstract Summary PDF

Abstract

OBJECTIVES
This study aimed to identify the characteristics of social networking service (SNS) users and to assess the relationship of those factors to user satisfaction with the SNSs of the National Cancer Information Center (NCIC) in South Korea.

METHODS

A Web-based survey was completed by 1,670 users of the NCIC SNSs, who provided data on the sources they consulted for information about cancer, determinants of SNS use, sources of NCIC SNS awareness, the time of day they used the SNS, and their satisfaction level.

RESULTS

Facebook users mainly became aware of the NCIC SNSs through an acquaintance’s recommendation, while Twitter was accessed through other SNSs or blogs. Users in their 30s were less satisfied with the NCIC SNSs than those in their teens and 20s. Browsing for cancer-related information on the Internet, prioritizing information quality, and engaging in active use were related to a high level of satisfaction with the NCIC SNSs. Individuals who were exposed to the NCIC SNSs through other SNSs or printed materials were less satisfied with their experience of the NCIC SNSs than those who received a recommendation from an acquaintance.

CONCLUSIONS

These findings may act as a catalyst to guide public health agencies to enhance their use of SNSs.

Summary

Korean summary
본 연구는 소셜네트워크서비스 사용자의 특성을 파악하고 우리나라 국가암정보센터 소셜네트워크서비스 사용자의 만족도에 영향을 주는 요인을 파악하고자 하였다. 국가암정보센터 소셜네트워크서비스 사용자 1,670명을 대상으로 암정보원, 서비스사용동기, 서비스를 알게된 경위, 사용시간대, 서비스 사용 만족도를 조사하였다. 분석결과, 페이스북은 주로 주변 아는 사람들의 권유로 사용하기 시작하였고, 트위터는 다른 사람의 소셜네트워크서비스를 통해 접근하고 있었다. 국가암정보센터에 대한 만족도에 영향을 주는 요인을 살펴보면, 10-20대에 비하여 30대의 만족도가 낮았으며, 인터넷을 통해 암정보를 얻고 있는 경우, 암정보의 질을 중시 여기는 경우, 활발하게 소셜네트워크서비스를 사용하고 있는 경우에 만족도가 높았다. 또한, 다른 사람들의 소셜네트워크서비스나 인쇄물을 통해 국가암정보센터 소셜네트워크서비스를 알게 된 경우 주변 사람들의 권고로 사용하게 된 경우에 비해 만족도가 낮았다. 공공보건의료기관들은 자 기관의 소셜네트워크 서비스 접근도 및 만족도 향상을 위하여 본 결과를 활용할 수 있을 것이다

Citations

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Temporal trends of breast cancer burden in the Western Pacific Region from 1990 to 2044: Implications from the Global Burden of Disease Study 2019
Bing Wu, Ye Li, Baoguo Shi, Xiyu Zhang, Yongqiang Lai, Fuqiang Cui, Xiaodan Bai, Wenjing Xiang, Guihong Geng, Bei Liu, Mingli Jiao, Qunhong Wu, Huiying Yang, Chenxi Zhang, Xinwei Liu, Yulu Tian, Hongyu Li
Journal of Advanced Research.2023;[Epub] CrossRef
Association Between Loneliness and the Frequency of Using Online Peer Support Groups Among Cancer Patients With Minor Children: A Cross-Sectional Web-Based Study
Kazuhiro Kosugi, Yohei Nishiguchi, Tomofumi Miura, Daisuke Fujisawa, Takashi Kawaguchi, Kayo Izumi, Jun Takehana, Yuko Uehara, Yuko Usui, Tatsuto Terada, Yujiro Inoue, Maika Natsume, Midori Yuki Yajima, Yuki Sumazaki Watanabe, Ayumi Okizaki, Eisuke Matsus
Journal of Pain and Symptom Management.2021; 61(5): 955. CrossRef
Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study
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BMJ Open.2021; 11(7): e045168. CrossRef
Factors affecting online health information seeking by channels
Su Yeon Kye, Keeho Park
Korean Journal of Health Education and Promotion.2018; 35(2): 1. CrossRef

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