An Assessment of Magnitudes and Patterns of Socioeconomic Inequalities across Various Health Problems: A Large National Cross-Sectional Survey in Korea

Magnitudes of health inequalities present consequences of socioeconomic impact on each health problem. To provide knowledge on the size of health problems in terms of socioeconomic burden, we examined the magnitudes and patterns of health inequalities across 12 health problems. A total of 17,292 participants older than 30 years were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010–2012). The age-adjusted prevalence ratios were compared across socioeconomic positions (SEPs) based on income, education, and occupation. The magnitudes of socioeconomic inequalities varied across 12 health problems and, in general, the patterns of socioeconomic inequalities were similar among groups of health problems (i.e., non-communicable diseases (NCDs), mental health, and subjective health states). Significant health inequalities across NCDs, such as diabetes, hypertension, ischemic heart disease, and arthritis, were observed mainly in women. Socioeconomic inequalities in mental health problems, such as depression, suicidal ideation, and suicide attempts, were profound for both genders and across SEP measures. Significant socioeconomic inequalities were also observed for subjective health. No or weak associations were observed for injury and HBV infection. The patterns of socioeconomic inequalities were similar among groups of health problems. Mental illnesses appeared to require prioritization of socioeconomic approaches for improvement in terms of absolute prevalence and relative socioeconomic distribution

Characterization of Rotavirus Infection in Hospitalized Children under 5 with Acute Gastroenteritis 5 Years after Introducing the Rotavirus Vaccines in South Korea

We herein characterized rotavirus infection in hospitalized children under 5 years of age with gastroenteritis after introducing rotavirus vaccines in South Korea from 20 February 2012, to 31 March 2013. Enzyme-linked fluorescent immunoassay was performed to detect rotavirus antigens. G and P genotyping was performed using nested multiplex PCR. For the failed PCR samples, sequencing was conducted. We performed a test-negative case-control study to estimate vaccine effectiveness. Vaccine effectiveness was measured using a multivariate logistic regression model. Rotavirus was detected in 16 (13.2%) of the 121 patients, with a seasonal peak in April 2012. The dominant genotypes detected were G3P[8] (33.3%) and G4P[6] (26.7%), and vaccine effectiveness against rotavirus hospitalization was 84.9% [95% CI: 23.2–97.0] in the complete vaccinated group. A higher prevalence of rotavirus infection was observed among children with siblings than those without siblings (p p < 0.001). In conclusion, the prevalence of rotavirus followed a decreasing trend, and there was no evidence of emergences of nonvaccine-type strains. Vaccine effectiveness against rotavirus hospitalization was 84.9%. Although children with siblings were more susceptible to rotavirus infection, they were less likely to receive vaccination against rotavirus

Socioeconomic inequalities in health in the context of multimorbidity:A Korean panel study

<div><p>Socioeconomic inequalities in health are commonly known to decrease at late age. Yet, it remains unclear whether socioeconomic inequalities in health at late age appear in relation to multimorbidity, particularly in Korea where social support remains unsatisfactory for older people. Using three waves of Korea Health Panel, data of 19,942 observations with repeated measure were constructed to ensure a temporal sequence between three socioeconomic measures (i.e., poverty, employment status, and education) and multimorbidity with a <i>t</i> to <i>t</i>+1 year transition. A multilevel multinomial model was applied to quantify the socioeconomic impact across different age, diseases and disease groups, both separately and in combination. There were associations between socioeconomic position (SEP) and multimorbidity, and increasing trends of socioeconomic inequalities not only with greater number of morbidity but also with age. The latter result was only observed with employment status through mid-to-early old age; i.e., between the 40s (odds ratio (OR) = 2.45, 95% confidence interval (CI):1.08–5.57) and 70s (OR = 3.48, 95%CI: 1.24–9.74). The patterns of socioeconomic inequalities in multimorbidity varied for particular pairs of diseases and were stronger in the disease pairs co-occurring with mental and cardiovascular diseases but weaker in the disease pairs co-occurring with cancer. Accumulation of adversity tended to intensify with increase in number of diseases and older age, though this finding was not consistently supported. The labour market should be encouraged to actively participate in actions to promote healthy aging needs to be complemented by the provision of more generous and universal income support to the elderly in Korea.</p></div

Age, Period, and Cohort Effects on Suicide Mortality in South Korea, 1992–2015

Although the effects of age, period, and cohort (APC) on suicide are important, previous work in this area may have been invalid because of an identification problem. We analyzed these effects under three different scenarios to identify vulnerable groups and thus overcame the identification problem. We extracted the annual numbers of suicides from the National Death Register of Korea (1992&ndash;2015) and estimated the APC effects. The annual average suicide rates in 1992&ndash;2015 were 31.5 and 14.7 per 100,000 males and females, respectively. The APC effects on suicide were similar in both sexes. The age effect was clearly higher in older subjects, in contrast to the minimal changes apparent during earlier adulthood. The birth cohort effect showed an inverted U shape; a higher cohort effect was evident in females born in the early 1980s when period drift was larger than 3.7%/year. Period effect increased sharply during the early 1990s and 2000s. We found that elderly and young females may be at a particularly high risk of suicide in Korea

The Epidemiological Influence of Climatic Factors on Shigellosis Incidence Rates in Korea

Research has shown the effects of climatic factors on shigellosis; however, no previous study has evaluated climatic effects in regions with a winter seasonality of shigellosis incidence. We examined the effects of temperature and precipitation on shigellosis incidence in Korea from 2002&ndash;2010. The incidence of shigellosis was calculated based on data from the Korean Center for Disease Control and Prevention (KCDC, Cheongju, Korea), and a generalized additive model (GAM) was used to analyze the associations between the incidence and climatic factors. The annual incidence rate of shigellosis was 7.9 cases/million persons from 2002&ndash;2010. During 2007&ndash;2010, high incidence rates and winter seasonality were observed among those aged &ge;65 years, but not among lower age groups. Based on the GAM model, the incidence of shigellosis is expected to increase by 13.6% and 2.9% with a temperature increase of 1 &deg;C and a lag of two weeks and with a mean precipitation increase of 1 mm and a lag of five weeks after adjustment for seasonality, respectively. This study suggests that the incidence of shigellosis will increase with global climate change despite the winter seasonality of shigellosis in Korea. Public health action is needed to prevent the increase of shigellosis incidence associated with climate variations

Odds ratio (95% confidence interval)^*of socioeconomic factors (t year) for predicting number of chronic multimorbidity (t+1 year) from multinomial multilevel models fitted to Korea Health Panel (2009–2011), stratified by each socioeconomic measures and age groups.

<p>Odds ratio (95% confidence interval)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0173770#t003fn002" target="_blank">*</a>}of socioeconomic factors (t year) for predicting number of chronic multimorbidity (t+1 year) from multinomial multilevel models fitted to Korea Health Panel (2009–2011), stratified by each socioeconomic measures and age groups.</p

Odds ratio (95% confidence interval)^*of socioeconomic factors for each disease groups and pairs between six disease groups from multinomial multilevel models fitted to Korea Health Panel (2009–2011).

<p>Odds ratio (95% confidence interval)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0173770#t004fn002" target="_blank">*</a>}of socioeconomic factors for each disease groups and pairs between six disease groups from multinomial multilevel models fitted to Korea Health Panel (2009–2011).</p

Bivariate association between socio-demographic factors(t year) and number of chronic disease (t+1 year)in the Korea Health Panel members (2009–2011).

<p>Bivariate association between socio-demographic factors(t year) and number of chronic disease (t+1 year)in the Korea Health Panel members (2009–2011).</p

Socio-demographic and health behavioural characteristics of study participants from the Korea Health Panel members (2009–2011) by age groups.

<p>Socio-demographic and health behavioural characteristics of study participants from the Korea Health Panel members (2009–2011) by age groups.</p