Epidemiology and Health

Original Articles

Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis: Jina Han, Yeong Jun Ju, Soon Young Lee; Epidemiol Health. 2023;45:e2023028. Published online February 22, 2023; DOI: https://doi.org/10.4178/epih.e2023028

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Abstract

OBJECTIVES
To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).

METHODS

We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors.

RESULTS

Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90).

CONCLUSIONS

Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

Summary

Citations

Citations to this article as recorded by

Effects of physical activity and sedentary behaviors on cardiovascular disease and the risk of all-cause mortality in overweight or obese middle-aged and older adults
Yongqiang Zhang, Xia Liu
Frontiers in Public Health.2024;[Epub] CrossRef
Modulating the Expression of Exercise-induced lncRNAs: Implications for Cardiovascular Disease Progression
Li-Hua Yu, Ge-Lin Zhang
Journal of Cardiovascular Translational Research.2024;[Epub] CrossRef

Trends and all-cause mortality associated with multimorbidity of non-communicable diseases among adults in the United States, 1999-2018: a retrospective cohort study: Mengzi Sun, Ling Wang, Xuhan Wang, Li Tong, Lina Jin, Bo Li; Epidemiol Health. 2023;45:e2023023. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023023

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. However, the patterns, temporal trends, and all-cause mortality associated with NCD multimorbidity over time have not been well described in the United States.

METHODS

All adult participants were sourced from nationally representative data from the National Health and Nutrition Examination Survey. In total, 55,081 participants were included in trend analysis, and 38,977 participants were included in Cox regression.

RESULTS

The 5 NCDs with the largest increases over the study period were diabetes, osteoporosis, obesity, liver conditions, and cancer. The estimated prevalence of multimorbidity increased with age, especially for middle-aged participants with 5 or more NCDs; in general, the prevalence of NCD multimorbidity was higher among females than males. Participants with 5 or more NCDs were at 4.49 times the risk of all-cause mortality of participants without any diseases. Significant interactions were found between multimorbidity and age group (p for interaction <0.001), race/ethnicity (p for interaction<0.001), and educational attainment (p for interaction=0.010).

CONCLUSIONS

The prevalence of multiple NCDs significantly increased from 1999 to 2018. Those with 5 or more NCDs had the highest risk of all-cause mortality, especially among the young population. The data reported by this study could serve as a reference for additional NCD research.

Summary

Key Message
This study included a series-cross sectional study and a retrospective cohort study, utilizing nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. This study aimed to explore the patterns, temporal trends, and all-cause mortality of multimorbidity of NCDs in the United States from 1999 to 2018, by gender-specific and age-specific. The data reported by this study could serve as a reference for additional NCD research.

Citations

Citations to this article as recorded by

Association of poverty-income ratio with cardiovascular disease and mortality in cancer survivors in the United States
Vidhushei Yogeswaran, Youngdeok Kim, R. Lee Franco, Alexander R. Lucas, Arnethea L. Sutton, Jessica G. LaRose, Jonathan Kenyon, Ralph B. D’Agostino, Vanessa B. Sheppard, Kerryn Reding, W. Gregory Hundley, Richard K. Cheng, Hamid Reza Baradaran
PLOS ONE.2024; 19(7): e0300154. CrossRef

Trends and disparities in avoidable, treatable, and preventable mortalities in South Korea, 2001-2020: comparison of capital and non-capital areas: Sang Jun Eun; Epidemiol Health. 2022;44:e2022067. Published online August 16, 2022; DOI: https://doi.org/10.4178/epih.e2022067

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to describe the regional avoidable mortality trends in Korea and examine the trends in avoidable mortality disparities between the Seoul Capital Area and non-Seoul-Capital areas, thereby exploring the underlying reasons for the trend changes.

METHODS

Age-standardized mortality rates from avoidable causes between 2001-2020 were calculated by region. Regional disparities in avoidable mortality were quantified on both absolute and relative scales. Trends and disparities in avoidable mortality were analyzed using joinpoint regression models.

RESULTS

Avoidable, treatable, and preventable mortalities in Korea decreased at different rates over time by region. The largest decreases were in the non-Seoul-Capital non-metropolitan area for avoidable and preventable mortality rates and the non-Seoul- Capital metropolitan area for treatable mortality rates, despite the largest decline being in the Seoul Capital Area prior to around 2009. Absolute and relative regional disparities in avoidable and preventable mortalities generally decreased. Relative disparities in treatable mortality between areas widened. Regional disparities in all types of mortalities tended to improve after around 2009, especially among males. In females, disparities in avoidable, treatable, and preventable mortalities between areas improved less or even worsened.

CONCLUSIONS

Trends and disparities in avoidable mortality across areas in Korea seem to have varied under the influence of diverse social changes. Enhancing health services to underserved areas and strengthening gender-oriented policies are needed to reduce regional disparities in avoidable mortality.

Summary

Korean summary
2001년부터 2020년까지 회피가능, 예방가능 사망률의 수도권과 비수도권 대도시, 비수도권 비대도시 지역 간 절대적, 상대적 격차는 대체로 감소했지만, 치료가능 사망률의 상대적 격차는 커졌다. 회피가능, 치료가능, 예방가능 사망률의 지역 간 격차는 2009년경 이후에 특히 남성에서 개선됐지만, 여성의 경우 덜 개선되거나 오히려 악화되기도 했다.

Key Message
Regional disparities in avoidable, treatable, and preventable mortalities tended to improve after around 2009, especially among males, but, in females, disparities in all types of mortalities between areas improved less or even worsened.

Citations

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Evaluating the effects of the 2017 National Health Insurance coverage expansion on amenable mortality and its disparities between areas in South Korea using Bayesian structural time-series models
Sang Jun Eun
Social Science & Medicine.2024; 344: 116574. CrossRef
Residential mobility according to health status in South Korea's largest metropolitan city during the COVID-19 pandemic using generalized estimating equations for longitudinal data
Ikhan Kim, Duwon Kim
Health & Place.2024; 88: 103265. CrossRef
Determinants of internal migration to smaller cities: local public goods, job opportunities, and lifecycle stages
Hemin Choi
Local Government Studies.2024; 50(3): 617. CrossRef
Avoidable Mortality in Korea 1997–2001: Temporal Trend and its Contribution to All-cause Mortality
Yoolwon Jeong, Sunghyo Seo
International Journal of Public Health.2024;[Epub] CrossRef
Association between residing in municipalities facing population decline and satisfaction with neighboring healthcare infrastructure in older aged adults
Yeong Jun Ju, Woorim Kim, Kyujin Chang, Tae Hoon Lee, Soon Young Lee
BMC Public Health.2024;[Epub] CrossRef
Regional Health Disparities in Hypertension-Related Hospitalization of Hypertensive Patients: A Nationwide Population-Based Nested Case-Control Study
Woo-Ri Lee, Jun Hyuk Koo, Ji Yun Jeong, Min Su Kim, Ki-Bong Yoo
International Journal of Public Health.2023;[Epub] CrossRef
Regional Disparities in the Infant Mortality Rate in Korea Between 2001 and 2021
Hyeongtaek Woo, Ji Sook Kim
Journal of Korean Medical Science.2023;[Epub] CrossRef
Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data
Woojin Chung
Healthcare.2022; 10(11): 2243. CrossRef

Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases: Dahye Baik, Byung-Woo Kim, Moran Ki; Epidemiol Health. 2022;44:e2022010. Published online January 3, 2022; DOI: https://doi.org/10.4178/epih.e2022010

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Abstract

OBJECTIVES
In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases.

METHODS

Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases).

RESULTS

The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019.

CONCLUSIONS

Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.

Summary

Korean summary
우리나라의 감염병으로 인한 사망률과 의료비용은 증가하고 있다. 특히 고령층에서의 높은 사망률과 과다한 의료비용 지출을 고려하면, 호흡기 감염 관리에 집중하는 것이 중요하며 각 감염병 그룹별로 효과적인 정책과 효율적인 관리가 필요하다. 본 연구는 COVID-19 발생 이전의 우리나라 감염병의 사망률과 발생, 의료비 부담의 장기적인 추세를 분석한 중요한 레퍼런스가 될 것이다.

Key Message
In Republic of Korea, the mortality trends (1997-2019) and costs (2009-2019) of infectious disease have increased and this study is particularly important reference for identifying the long-term trends including mortality, outbreak, financial burden of infectious disease in Korea before COVID-19 outbreak.

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Dong Hee Lee, Ye-Jee Kim, Hyangkyoung Kim, Hyung Seok Lee
Kidney Research and Clinical Practice.2024; 43(2): 156. CrossRef
Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea
Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae
Journal of Preventive Medicine and Public Health.2024; 57(2): 185. CrossRef
Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study
Hae Suk Cheong, Yoosoo Chang, Yejin Kim, Eun-Jeong Joo, Min-Jung Kwon, Sarah H Wild, Christopher D Byrne, Seungho Ryu
European Journal of Endocrinology.2023; 188(2): 197. CrossRef
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Vipin Chandra Kalia, Sanjay K.S. Patel, Jung-Kul Lee
Ecotoxicology and Environmental Safety.2023; 264: 115389. CrossRef
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Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef

Geographical distribution of health indicators related to snake bites and envenomation in Morocco between 1999 and 2013: Faiçal El hattimy, Fouad Chafiq, Hinde Hami, Abdelghani Mokhtari, Abdelmajid Soulaymani, Soulaymani Bencheikh Rachida; Epidemiol Health. 2018;40:e2018024. Published online June 16, 2018; DOI: https://doi.org/10.4178/epih.e2018024

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Abstract PDF

Abstract

OBJECTIVES
Envenomation from snake bites is a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the epidemiological features of snake bites in Morocco and to evaluate time-space trends in snake bite incidence, the mortality rate, and the case-fatality rate.

METHODS

This is a retrospective study of snake bite cases reported to the Moroccan Poison Control Center between 1999 and 2013.

RESULTS

During the study period, 2,053 people were bitten by snakes in Morocco. Most victims were adults (55.4%). The average age of the patients was 26.48±17.25 years. More than half of the cases (58.1%) were males. Approximately 75% of snake bites happened in rural areas, and 85 deaths were recorded during this period. The incidence of snake bites remained generally steady over the 15-year period of this study, with a marked increase noted since 2012. The mortality rate has increased slightly, from 0.02 deaths per 100,000 inhabitants in 1999 to 0.05 in 2013. The geographical distribution of snake bite cases in the regions of Morocco showed that Tanger-Tétouan had the highest annual incidence of snake bites (1.41 bites per 100,000 inhabitants). However, the highest annual mortality rates were recorded in the Guelmim-Es Semara and Souss-Massa-Drâa regions (0.09 deaths per 100,000 inhabitants for both regions).

CONCLUSIONS

The geographical distribution of the incidence, mortality, and case-fatality rates of snake bites in Morocco showed large disparities across regions during the three 5-year periods included in this study, meaning that certain areas can be considered high-risk for snake bites.

Summary

Citations

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Isuru Jayathilaka, Eranthi Weeratunga, Timothy Omara
PLOS ONE.2024; 19(4): e0299814. CrossRef
From fangs to antidotes: A scoping review on snakebite burden, species, and antivenoms in the Eastern Mediterranean Region
Ali Alshalah, David J. Williams, Alessandra Ferrario, Stuart Robert Ainsworth
PLOS Neglected Tropical Diseases.2024; 18(7): e0012200. CrossRef
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Towards achievement of Universal Health Coverage: a qualitative inquiry among health stakeholders and snakebite victims on community and health system factors influencing snake envenomation management in Oti Region, Ghana
Martin Ayanore, Mabel Worlasi Dzenu, Robert Kokou Dowou, Agani Afaya
Journal of Global Health Science.2023;[Epub] CrossRef
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Jairo Alfonso Mendoza-Roldan, Viviane Noll Louzada-Flores, Nouha Lekouch, Intissar Khouchfi, Giada Annoscia, Andrea Zatelli, Frédéric Beugnet, Julia Walochnik, Domenico Otranto, Eric HY Lau
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Esteban Ortiz-Prado, Justin Yeager, Felipe Andrade, Camila Schiavi-Guzman, Paola Abedrabbo-Figueroa, Enrique Terán, Lenin Gómez-Barreno, Katherine Simbaña-Rivera, Juan S. Izquierdo-Condoy
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Andrei N. Savu, Anna R. Schoenbrunner, Rachel Politi, Jeffrey E. Janis
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Faiçal El Hattimy, Chafiq Fouad, Hermann-Désiré Lallié, Abdelrhani Mokhtari, Abdelmajid Soulaymani, Rachida Soulaymani, S. Bourekkadi, H. Hami, A. Mokhtari, K. Slimani, A. Soulaymani
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Mohd Zaki Fadzil Senek, So Yeon Kong, Sang Do Shin, Kyong Min Sun, Jungeun Kim, Young Sun Ro
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PLOS Neglected Tropical Diseases.2019; 13(8): e0007221. CrossRef

Trends in gastrointestinal cancer incidence in Iran, 2001-2010: a joinpoint analysis: Mehdi Darabi, Mohsen Asadi Lari, Seyed Abbas Motevalian, Ali Motlagh, Shahram Arsang-Jang, Maryam Karimi Jaberi; Epidemiol Health. 2016;38:e2016056. Published online December 5, 2016; DOI: https://doi.org/10.4178/epih.e2016056

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Abstract PDF

Abstract

OBJECTIVES
The main purpose of this study was to evaluate changes in the time trends of stomach, colorectal, and esophageal cancer during the past decade in Iran.

METHODS

Cancer incidence data for the years 2001 to 2010 were obtained from the cancer registration of the Ministry of Health. All incidence rates were directly age-standardized to the world standard population. In order to identified significant changes in time trends, we performed a joinpoint analysis. The annual percent change (APC) for each segment of the trends was then calculated.

RESULTS

The incidence of stomach cancer increased from 4.18 and 2.41 per 100,000 population in men and women, respectively, in 2001 to 17.06 (APC, 16.7%) and 8.85 (APC, 16.2%) per 100,000 population in 2010 for men and women, respectively. The corresponding values for colorectal cancer were 2.12 and 2.00 per 100,000 population for men and women, respectively, in 2001 and 11.28 (APC, 20.0%) and 10.33 (APC, 20.0%) per 100,000 in 2010. For esophageal cancer, the corresponding increase was from 3.25 and 2.10 per 100,000 population in 2001 to 5.57 (APC, 12.0%) and 5.62 (APC, 11.2%) per 100,000 population among men and women, respectively. The incidence increased most rapidly for stomach cancer in men and women aged 80 years and older (APC, 23.7% for men; APC, 18.6% for women), for colorectal cancer in men aged 60 to 69 years (APC, 24.2%) and in women aged 50 to 59 years (APC, 25.1%), and for esophageal cancer in men and women aged 80 years and older (APC, 17.5% for men; APC,15.3% for women) over the period of the study.

CONCLUSIONS

The incidence of gastrointestinal cancer significantly increased during the past decade. Therefore, monitoring the trends of cancer incidence can assist efforts for cancer prevention and control.

Summary

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Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database: Hyungseon Yeom, Dae Ryong Kang, Seong Kyung Cho, Seung Won Lee, Dong-Ho Shin, Hyeon Chang Kim; Epidemiol Health. 2015;37:e2015022. Published online May 1, 2015; DOI: https://doi.org/10.4178/epih/e2015022

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Abstract Summary PDF

Abstract

OBJECTIVES
The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea.

METHODS

The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database.

RESULTS

Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%).

CONCLUSIONS

The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.

Summary

Korean summary
급성심근경색 환자의 급성기 의료이용행태를 조사하기 위해 2007년부터 2011년까지 급성심근경색증 진단명(ICD-10 코드 I21.x)을 포함하는 입원 청구자료 513,886건을 분석하였다. 총 295,001건의 독립된 입원 에피소드를 추출하여 분석한 결과, 5년동안 전체 입원건수와 응급실 경유 입원건수는 감소한 반면, 진단 또는 치료 목적의 침습적 시술을 동반한 입원은 증가하였다. 건강보험청구자료를 이용하여 급성심근경색증 발생 규모를 파악할 때, 진단명만으로는 정확한 추계가 어려우며 관련 시술 등의 의료이용 정보를 추가하는 것이 필요할 것이다.

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Epidemiologic Transition of Communicable Diseases in Korea: Academia's Contributions to the National Communicable Disease Prevention and Control Programs.: Joung Soon Kim, Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):4-21.

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Abstract PDF: Abstract
This paper describes the transition of communicable diseases in Korea since 1970s. Some of Korean's general living background and health indicators are introduced, followed by trends in the changes during the last several decades in socioeconomic, demographic, and living environmental status, which are closely associated with the transition of communicable diseases. The current incidence of classified, notifiable disease, the incidence by year, and the transition of communicable diseases are presented. Governmental responses to prevent and control communicable diseases, including both emerging and re-emerging infectious diseases, which have become recognized as having public health importance are described. Finally, the role played by academia during the last several decades in the successful control of communicable diseases is analyzed.; Summary

Secular Trends of Suicide Mortality in Korea.: Jongsoon Park, Soonduck Kim, Seonmi Ji, Jesuk Lee; Korean J Epidemiol. 2003;25(2):84-91.

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Abstract PDF: Abstract
PURPOSE
This study was conducted to analysis the trends and states of suicide mortality in Korea from 1983 to 2001.
METHODS
This study was based on data published in 1983-2001 from the annual report of the cause of death statistics of National Statistical Office.
RESULTS
First, both of annual suicide rate and adjusted suicide rate rapidly went up in 1996 and hit the highest in 1998. Second, since 1983 only when the suicide rate was the highest in the ages 20-24 rather than other age groups, the suicides have been continuously shown to be the highest in the old age group. Third, the seasonal percentages of suicides were generally high in spring and summer, the seasons when the percentage of sunshine is relatively high, in both results for men and women. Fourth, men have most frequently committed suicide through hanging while their suicide through falling from a high site have least frequently occurred but currently tends to gradually increase. Meanwhile, women have most frequently done suicide generally by using insecticide.
CONCLUSION
In Korea, the suicide rate and suicide percentage of the old people have been yearly increasing, and their suicide rate is also shown to the highest rather than those of other age groups. Therefore, it is necessary to prevent the suicide of the old people through a systematic analysis. Moreover, it is necessary to verify the risk factors and defensive factors for the suicide impulse and suicide attempt. On the basis of this, the construction of a nationwide social safety network for the national mental health is very important to find and treat the problems of the mental health to lead the people to suicide.; Summary

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