Epidemiology and Health

Original Articles

Can resident registration expiration statistics due to death be used for near-real-time mortality tracking? A validation study using 2023 data from Korea: Jin-Hwan Kim; Epidemiol Health. 2025;47:e2025042. Published online August 3, 2025; DOI: https://doi.org/10.4178/epih.e2025042

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Abstract Summary PDF: Abstract
OBJECTIVES
Real-time mortality tracking is essential for public health surveillance, especially during emergencies such as the coronavirus disease 2019 (COVID-19) pandemic. In Korea, delayed availability of vital statistics (VS) data has hindered timely mortality monitoring. This study evaluates whether National Administrative Data (NAD) on resident registration expiration due to death, provided by the Ministry of Interior and Safety, could serve as a reliable alternative for near real-time mortality surveillance.
METHODS
We compared mortality counts between VS and NAD for 2023 at multiple geographic levels (county, province, and nation) and across demographic strata (sex and age groups). The analysis was conducted in 3 stages: comparing overall mortality counts, analyzing county-level distributions, and assessing equivalence through correlation analyses, scatter plots, and density plots.
RESULTS
NAD showed strong agreement with VS at the national level, reporting only 0.4% more deaths overall (0.2% for male, 0.6% for female). Notable differences were observed in early childhood mortality, with NAD showing 16.8% fewer deaths for neonates (age 0) and 14.8% more for ages 1-4, as well as in monthly variations (5-9%). Correlation analyses indicated extremely high consistency between the 2 data sources across all geographic levels (correlation coefficients ≥0.999), especially at the national and provincial levels.
CONCLUSIONS
NAD provides a reliable alternative to VS for real-time mortality surveillance in Korea, providing comparable accuracy with much-improved timeliness. Although some variations are present in specific age groups and monthly trends, these can be addressed through appropriate analytical strategies. The recent availability of sex-specific and age-specific data in NAD since 2023 establishes it as a valuable infrastructure for mortality surveillance.; Summary

Korean summary
- 행정자료(NAD)는 통계청 사망통계(VS)와 높은 일치도를 보여 신속한 사망 감시체계 구축에 활용할 수 있다. - 2023년부터 NAD에 성별·연령별 정보가 포함됨에 따라, 한국의 공중보건 위기 대응을 위한 핵심적인 사망 감시 인프라로 발전할 수 있게 되었다.

Key Message
- National Administrative Data (NAD) demonstrates high concordance with Vital Statistics (VS), making it applicable for establishing rapid mortality surveillance systems. - With the inclusion of sex- and age-specific information since 2023, NAD has evolved into a critical mortality surveillance infrastructure for South Korea's public health emergency response.

Effects of student human rights ordinances on mental health among middle and high school students in South Korea: a difference-in-differences analysis: Sang Jun Eun; Epidemiol Health. 2025;47:e2025011. Published online March 1, 2025; DOI: https://doi.org/10.4178/epih.e2025011

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
To actively protect and enhance students’ human rights, student human rights ordinances (SHROs) have been enforced in seven provinces in South Korea at different times since 2010. Although human rights are closely linked to mental health, there has been no research on the effectiveness of human rights legislation on adolescent mental health. This study evaluated the effects of SHROs on the mental health of middle and high school students.
METHODS
Repeated cross-sectional data were used, including 1,148,257 respondents from the Korea Youth Risk Behavior Web-based Survey between 2006 and 2023. Probabilities of perceived stress, sleep insufficiency, depressive mood, suicide ideation, and suicide attempt in treated provinces were estimated through a difference-in-differences approach that accounts for treatment effect heterogeneity across groups over time.
RESULTS
SHROs had no consistently significant effects on any mental health outcomes, except for slightly increased suicide ideation in total students (0.7%, 95% confidence interval 0.3% to 1.1%). Suicide attempts in total and male students and perceived stress and sleep insufficiency in female students tended to decrease, while other mental health outcomes tended to increase. Uncertainty in the effect estimates of SHROs increased for all mental health outcomes with possible violations of parallel trends, rendering originally significant effects insignificant.
CONCLUSIONS
SHROs failed to improve mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.; Summary

Korean summary
학생의 인권을 포괄적으로 보장하기 위해 학생인권조례가 시행되었지만 학생인권조례 시행 지역에서 중고등학생의 정신건강은 향상되지 않았는데, 이는 조례에 벌칙 조항 같은 강제성 기전이 없었기 때문이었을 수 있다. 학생인권조례는 중고등학생의 정신건강에 대해 효과가 없었지만 이 연구는 인권 법제의 청소년 정신건강에 대한 효과를 처음으로 평가했다. 인권증진을 위한 법적 수단의 청소년 정신건강에 대한 효과성과 효과 기전에 관하여 추가 연구가 필요하다.

Key Message
Although student human rights ordinances have been enforced in South Korea to comprehensively guarantee human rights for students, they failed to improve the mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms such as penalty provisions. Despite the ineffectiveness of student human rights ordinances, this study first estimated the effects of human rights legislation on adolescent mental health. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.

Sex-specific associations between dietary legume subtypes and type 2 diabetes in a prospective cohort study: Hye Won Woo, Sangmo Hong, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024083. Published online October 17, 2024; DOI: https://doi.org/10.4178/epih.e2024083

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Dietary soy, known for its high phytoestrogen content, has been suggested to exhibit a sex-specific association with type 2 diabetes. However, evidence regarding the sex-specific associations of different legume subtypes with type 2 diabetes remains scarce. We aimed to evaluate whether habitual consumption of soy and non-soy legumes (beans and peanuts) was prospectively and sex-specifically associated with the risk of type 2 diabetes incidence, taking into considering significant sex-specific genetic factors beyond legume consumption.
METHODS
A total of 16,666 participants (96,945 person-years) were followed and 945 incident cases were observed. Cumulative intake of legume subtypes was calculated using a food frequency questionnaire administered at baseline and during the revisit surveys.
RESULTS
Non-soy legumes are inversely associated with type 2 diabetes in both men and women. Dietary soy intake, however, demonstrated a unilaterally interacting sex-specific association with type 2 diabetes risk (pinteraction for sex=0.017). Specifically, there was a significant inverse association with type 2 diabetes risk in women (incidence rate ratio, 0.66; 95% confidence interval, 0.48 to 0.80; ptrend=0.007), but no such association was observed in men. This sex-specific association persisted and even appeared antagonistic in minor allele carriers of 2 novel single nucleotide polymorphisms, rs10196939 (LRRTM4) and rs11750158 (near GFPT2) (pinteraction for sex=0.001 and 0.011, respectively).
CONCLUSIONS
Habitual consumption of legumes shows protective impacts against type 2 diabetes, although these benefits vary by sex. Non-soy legumes provide health advantages for both men and women, whereas soy consumption seems to be beneficial exclusively for women.; Summary

Korean summary
콩류 섭취는 제2형 당뇨병 예방에 도움이 되는데, 대두를 제외한 콩류와 땅콩은 남녀 모두에게 건강상의 이점이 있는 반면, 대두는 여성에게만 보호적 이점이 있는 것으로 관찰되었다. 대두 섭취는 남성과 여성에서 서로 다른 영향을 미치는 것으로 관찰되었으며, 이는 대두 섭취의 건강상의 영향이 성별에 따라 다르게 나타날 수 있음을 시사하였다.

Key Message
Our findings showed that while legume consumption was protective against type 2 diabetes, beans and peanuts demonstrated health benefits in both sexes, whereas soy's protective benefits were observed only in women. Soy consumption was observed to have different effects between men and women, suggesting that the health impact of soy intake may differ by sex.

A prospective association between dietary mushroom intake and the risk of type 2 diabetes: the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study: Yu-Mi Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024017. Published online January 8, 2024; DOI: https://doi.org/10.4178/epih.e2024017

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Mushrooms, known for their nutritious and functional components, are considered healthy and medicinal. This study investigated the prospective association between dietary mushroom consumption and the incidence of type 2 diabetes among Korean adults aged ≥40 years.

METHODS

In total, 16,666 participants who were not taking anti-diabetic medication or insulin and had normal fasting blood glucose (FBG; <126 mg/dL) were included. We used the cumulative average dietary consumption of mushrooms as an exposure metric, calculated from food frequency questionnaires at every follow-up, along with covariates collected during a baseline survey. To estimate incidence rate ratios (IRRs) for type 2 diabetes, a modified Poisson regression model with a robust error estimator was applied.

RESULTS

In multivariable models, dietary mushroom consumption was inversely associated with type 2 diabetes incidence in both genders (men: IRR, 0.65; 95% confidence interval [CI], 0.47 to 0.90; plinearity=0.043 in the highest quartile (Q4) vs. the lowest quartile (Q1); women: IRR, 0.70; 95% CI, 0.54 to 0.93; plinearity=0.114 in Q4 vs. Q1). The inverse association remained after adjustment for dietary factors instead of dietary quality index, the baseline FBG, and the exclusion of incidence within the first year. Additionally, no significant interaction was found regarding the risk of type 2 diabetes between dietary mushroom consumption and participants’ gender or other factors.

CONCLUSIONS

Dietary mushroom consumption was inversely linked with the risk of type 2 diabetes incidence in both genders, indicating the beneficial role of mushrooms in preventing the disease.

Summary

Korean summary
- 흔히 사용하는 버섯의 식이 섭취량이 증가함에 따라 한국 40세 이상 성인에서 제2형 당뇨병 발생 위험이 낮았다. - 이러한 역관계는 성별과 다양한 식이 배경에서도 일관성을 유지하였고, 이는 버섯이 제2형 당뇨병 예방에 있어 잠재적인 식이요소로서의 가능성을 보여주는성을 보여주는 보여주는 결과이다.

Key Message
• Increased dietary consumption of commonly used mushrooms is associated with a lower risk of type 2 diabetes incidence among adults aged 40 years or older in Korea. • This inverse relationship remains consistent across genders and various dietary backgrounds, underscoring the potential of mushrooms as a preventive dietary component against.

Citations

Citations to this article as recorded by

Integrative Roles of Functional Foods, Microbiotics, Nutrigenetics, and Nutrigenomics in Managing Type 2 Diabetes and Obesity
Hong Nhung Lam, Shih-Ping Lin, Dang Hien Ngan Nguyen, Chiao-Ming Chen, Chien-Tien Su, Te-Chao Fang, Sing-Chung Li
Nutrients.2025; 17(4): 608. CrossRef
Protective Properties of the White Button Mushroom, Agaricus bisporus, in a Mouse Model of Colitis
Elaine Dempsey, Aaron M. Walsh, Supriya Yadav, Jude Wilson, Frederick J. Sheedy, Sinead C. Corr
Molecular Nutrition & Food Research.2025;[Epub] CrossRef

Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys: Thi Tra Bui, Thi Huyen Trang Nguyen, Jinhee Lee, Sun Young Kim, Jin-Kyoung Oh; Epidemiol Health. 2024;46:e2024014. Published online January 4, 2024; DOI: https://doi.org/10.4178/epih.e2024014

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Abstract Summary PDF Supplementary Material

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.

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.

Citations

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A Community-Based, Lifestyle Behavioral Intervention Based on the Extended Theory of Planned Behavior for Postmenopausal Women at Cardiometabolic Risk: A Randomized Controlled Trial
Sooyeon Park, Jina Choo
Western Journal of Nursing Research.2025; 47(7): 573. CrossRef
Feasibility of Using the EuroQol-5 Dimensions to Identify Masticatory Discomfort in Community-Dwelling Older Adults
Han-Nah Kim, Nam-Hee Kim
Journal of Dental Hygiene Science.2025; 25(3): 237. CrossRef

Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging: Seungju lim, Eunyoung Yoo, Ickpyo Hong, Ji-Hyuk Park; Epidemiol Health. 2023;45:e2023098. Published online November 2, 2023; DOI: https://doi.org/10.4178/epih.e2023098

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Abstract Summary PDF

Abstract

OBJECTIVES
Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals.

METHODS

We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed.

RESULTS

The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals.

CONCLUSIONS

Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.

Summary

Korean summary
본 연구는 국내 노인인구를 연령대별로 구분하여 연소노인(55-64세), 중고령노인(65-74세), 고령노인(75세+)의 인지저하 기울기를 가속 혹은 감속시키는 라이프스타일 요인을 파악하였다. '흡연'은 연소노인의 인지저하를 가속, '사회활동 참여 빈도'는 중고령노인의 인지저하를 감속시키는 것으로 나타났으며, 고령노인의 경우 유의미한 변수가 나타나지 않았다. 본 결과는 노인의 인지건강에 있어 연령대별 차별화된 라이프스타일 전략이 필요할 것을 시사한다.

Key Message
This study aimed to identify lifestyle factors that accelerate or decelerate the cognitive decline slope in the older population in South Korea, categorized by age groups: young-old adults (55-64), middle-old adults (65-74), and old-old adults (75+). The findings indicated that 'smoking' accelerates cognitive decline in young-old adults, while 'frequency of social activity participation' decelerates cognitive decline in middle-old adults. However, no significant lifestyle variables were identified for old-old adults. These results suggest the necessity of differentiated lifestyle strategies based on age groups for promoting cognitive health in the older population.

Citations

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A rapid scoping review on operationalizing cognitive and social activities in research on dementia risk reduction
Jeroen Bruinsma, Ruud Roodbeen, Giselle G. A. Menting, Kay Deckers, Stevie Hendriks, Rik Crutzen
Aging & Mental Health.2025; 29(10): 1788. CrossRef
Genetic association of social participation with cognitive function: A bidirectional Mendelian randomization study
Aoqiang Zhai, Ruiqi Zou, Tianrun Lv, Siqi Yang, Yanjie Zhong, Yang Xiong, Fuyu Li, Haijie Hu
Journal of Alzheimer’s Disease.2025; 106(1): 259. CrossRef
The prevalence and the correlates of mental disorders among the elderly population: results from China Mental Health Survey
Jingjuan Pang, Minghui Li, Zhaorui Liu, Yueqin Huang, Xiaofei Hou, Guoli Yan, Xiangdong Xu, Limin Wang, Yongping Yan, Shuiyuan Xiao, Lingjiang Li, Jie Yan, Yaqin Yu, Xiufeng Xu, Zhizhong Wang, Yifeng Xu, Tao Li, Tingting Zhang, Huifang Yin, Guangming Xu
BMC Public Health.2025;[Epub] CrossRef
Social activities in multidomain dementia prevention interventions: insights from practice and a blueprint for the future
Jeroen Bruinsma, Leonie N. C. Visser, Alara Abaci, Anna Rosenberg, Ana Diaz, Sten Hanke, Rik Crutzen, Francesca Mangialasche, Miia Kivipelto, Charlotta Thunborg
Frontiers in Psychiatry.2024;[Epub] CrossRef
Association between dietary quality and accelerated aging: a cross-sectional study of two cohorts
Yue Chen, Xin Zheng, Yiming Wang, Chenan Liu, Jinyu Shi, Tong Liu, Shiqi Lin, Hailun Xie, Heyang Zhang, Xiaoyue Liu, Zhaoting Bu, Li Deng, Shouling Wu, Hanping Shi
Food & Function.2024; 15(15): 7837. CrossRef
Independent and Joint Associations of Socioeconomic Status and Lifestyle behaviors with Cognitive Impairment among Elderly Chinese Population
Y. Feng, S. Jia, W. Zhao, X. Wu, Y. Zuo, S. Wang, L. Zhao, M. Ma, X. Guo, C.S. Tarimo, Y. Miao, Jian Wu
The Journal of Prevention of Alzheimer's Disease.2024; 11(5): 1513. CrossRef

Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020: Jin-Hwan Kim, Saerom Kim, Eunhye Park, Chang-yup Kim; Epidemiol Health. 2022;44:e2022081. Published online September 26, 2022; DOI: https://doi.org/10.4178/epih.e2022081

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This study analyzed inequities in excess mortality according to region and socioeconomic position to explain the distribution of excess mortality in Korea in 2020.

METHODS

We acquired weekly all-cause mortality data from January 2015 to December 2020 from (1) the National Health Insurance Database and (2) Vital Statistics. Excess mortality for 2020 was calculated by comparing the weekly observed and expected deaths from the same period (2015-2019) using quasi-Poisson regression.

RESULTS

An inequitable distribution of excess mortality was identified. The estimated excess mortality in Korea was -29,112 (95% confidence interval, -29,832 to -28,391), corresponding to -55 per 100,000, and the ratio of observed deaths to expected deaths was 0.91. Negative excess mortality was observed except for females in the 0-14 age group. Male Medical Aid beneficiaries showed positive excess mortality, while non-disabled and disabled groups showed similar negative values. When the standardized mortality ratio was calculated for the top 10 causes of death, deaths from Alzheimer’s disease and septicemia increased, whereas those from diabetes mellitus and cerebrovascular disease decreased. The decrease in mortality was primarily concentrated in older adults, while the mortality of young females increased due to increased intentional self-harm.

CONCLUSIONS

This study adds essential evidence regarding the overall performance of Korea. The observed inequalities according to various socioeconomic variables indicate that the results of strict measures to control coronavirus disease 2019 were not distributed equitably. Efforts should be made to properly evaluate the current and future problems related to the pandemic.

Summary

Citations

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Excess mortality during and after the COVID-19 emergency in Japan: a two-stage interrupted time-series design
Ganan Devanathan, Paul LC Chua, Shuhei Nomura, Chris Fook Sheng Ng, Nasif Hossain, Akifumi Eguchi, Masahiro Hashizume
BMJ Public Health.2025; 3(1): e002357. CrossRef
The impact of a medical residents' walkout on mortality rates in South Korea, 2024
Jin-Hwan Kim, Saerom Kim
Health Policy.2025; 159: 105375. CrossRef
The Power of ‘Publicness’ Discourse: An Analysis of Counter‐Hegemonic Formation Against Health System Privatisation
Jiwoo Ha, Chang‐yup Kim
Sociology of Health & Illness.2025;[Epub] CrossRef
The political effect of medical dominance in South Korea’s COVID-19 response
Seohwa Park, Jungmin Seo
Cambridge Review of International Affairs.2025; 38(5): 654. CrossRef
The Predestined Failure of the Market Mechanism in Ensuring Health for all in Times of a Pandemic: The Case of the Republic of Korea
Jin-Hwan Kim
International Journal of Social Determinants of Health and Health Services.2025; 55(4): 465. CrossRef
Can resident registration expiration statistics due to death be used for near-real-time mortality tracking? A validation study using 2023 data from Korea
Jin-Hwan Kim
Epidemiology and Health.2025; 47: e2025042. CrossRef
Universal health coverage saves more lives among severely ill COVID-19 patients: A difference-in-differences analysis of individual patient data in South Korea
Daseul Moon, Jeangeun Jeon, Jieun Park, Min-Hyeok Choi, Myoung-Hee Kim, Hongjo Choi
Health Research Policy and Systems.2024;[Epub] CrossRef
Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022
So-Jin Im, Ji-Yeon Shin, Duk-Hee Lee
Journal of Preventive Medicine and Public Health.2024; 57(5): 480. CrossRef
Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?
Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim
Epidemiology and Health.2023; 45: e2023072. 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.

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The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care: Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin; Epidemiol Health. 2022;44:e2022044. Published online May 1, 2022; DOI: https://doi.org/10.4178/epih.e2022044

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Abstract

OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.

METHODS

A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.

RESULTS

A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.

CONCLUSIONS

During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.

Summary

Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.

Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.

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Impact of the COVID-19 Pandemic on Hemato-Oncology Services: A Retrospective Dual-Center Cohort Study in Kazakhstan
Maral Yerdenova, Aigulsum Izekenova, Akbope Myrkassymova, Gaukhar Mergenova, Mohammed Merzah, Balday Issenova, Maksat Mamyrkul, Aliya Atabayeva, Vytenis Kalibatas, Dejan Nikolic, Yineng Chen
Healthcare.2025; 13(19): 2520. CrossRef
Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea
Young Su Park, Ock-Joo Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu
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Brief Communication

Occupational inequalities in mortality in Korea: an analysis using nationally representative mortality follow-up data from the late 2000s and after: Eunjeong Noh, Young-Ho Khang; Epidemiol Health. 2022;44:e2022038. Published online April 6, 2022; DOI: https://doi.org/10.4178/epih.e2022038

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Abstract

Many Korean and international studies have found higher mortality rates and poorer health conditions among manual workers than among non-manual workers. However, a recent study using unlinked data argued that since the economic crisis in Korea in the late 2000s, the mortality estimates of male Korean non-manual workers have been higher than those of manual workers. Our work using individually linked data from the late 2000s and after aimed to examine mortality inequality by occupational class. We analyzed Korea National Health and Nutrition Examination Survey data that were individually linked to cause-of-death data. Cox regression analysis was used to identify the hazard ratios for mortality by occupational class. Of 11,766 males aged between 35 and 64, 397 died between 2007 and 2018: 142 died from cancer, 68 from cardiovascular disease, 88 from external causes, and 99 from other causes. After controlling for age, the mortality estimates for manual workers were 1.85 times higher than those for upper non-manual workers (p<0.05). We observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s; this previously reported finding might have been due to numerator-denominator bias arising from the use of unlinked data.

Summary

Korean summary
개인 단위 연계자료가 아닌 분모(센서스)-분자(사망신고) 집합 자료를 사용하여 2000년대 후반 경제위기 이후 한국 남성 비육체직의 사망률이 육체직보다 높게 나타난다고 기존의 한 연구가 주장했다. 이 연구는 2000년대 이후 개인 단위로 연계된 코호트 자료를 활용하여 여전히 한국에서 육체직의 사망위험이 비육체직보다 높다는 점을 보임으로써, 기존 연구가 비연계자료의 사용으로 인한 분자-분모 바이어스(numerator-denominator bias) 때문에 그와 같은 결과를 보였다고 지적하였다.

Key Message
This paper using individually linked data from the late 2000s and after observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s. The previously reported finding showing reversed occupational mortality inequality might have been due to numerator-denominator bias arising from the use of unlinked data.

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Mortality of Suicide and Cerebro-Cardiovascular Diseases by Occupation in Korea, 1997–2020
Jungwon Jang, Inah Kim
International Journal of Environmental Research and Public Health.2022; 19(16): 10001. CrossRef

Original Articles

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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3D-Printable Polylactic Acid Composites with Hydrochar-Stabilized Silver Nanoparticles for Antimicrobial Photodynamic Therapy
Michael A. Oluwagbemiga, Jesús Gómez, Sonam Bhattarai, Omnia Ahmed, Bernd Zechmann, Nathaniel F. Adegboyega, Andrés M. Durantini
ACS Applied Engineering Materials.2025; 3(8): 2638. CrossRef
Air pollution and health burden: a generalized additive mixed model approach to PM2.5, life Expectancy, and respiratory infections and tuberculosis in Thailand, Malaysia, and Singapore
Wong Ming Wong, Wunhong Su
Air Quality, Atmosphere & Health.2025;[Epub] CrossRef
Validation of operational definitions of mortality in a nationwide hemodialysis population using the Health Insurance Review and Assessment Service databases of Korea
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
Bacterial biofilm inhibitors: An overview
Vipin Chandra Kalia, Sanjay K.S. Patel, Jung-Kul Lee
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Samiah Hamad Al-Mijalli, Eman R. ELsharkawy, Emad M. Abdallah, Munerah Hamed, Nasreddine El Omari, Shafi Mahmud, Mohammed Merae Alshahrani, Hanae Naceiri Mrabti, Abdelhakim Bouyahya, Fernanda Tonelli
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef

Risk of COVID-19 transmission in heterogeneous age groups and effective vaccination strategy in Korea: a mathematical modeling study: Youngsuk Ko, Jacob Lee, Yubin Seo, Eunok Jung; Epidemiol Health. 2021;43:e2021059. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021059

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aims to analyze the possibility and conditions of maintaining an effective reproductive number below 1 using a mathematical model.

METHODS

The total population was divided into five age groups (0-17, 18-29, 30-59, 60-74, and ≥75 years). Maximum likelihood estimation (MLE) was used to estimate the transmission rate of each age group. Mathematical model simulation was conducted until December 31, 2021, by establishing various strategies for vaccination and social distancing without considering variants.

RESULTS

MLE results revealed that the group aged 0-17 years had a lower risk of transmission than other age groups, and the older age group had relatively high risks of infection. If 70% of the population will be vaccinated by the end of 2021, then simulations showed that even if social distancing was eased, the effective reproductive number would remain below 1 near August if it was not at the level of the third re-spreading period. However, if social distancing was eased and it reached the level of the re-spreading period, the effective reproductive number could be below 1 at the end of 2021.

CONCLUSIONS

Considering both stable and worsened situations, simulation results emphasized that sufficient vaccine supply and control of the epidemic by maintaining social distancing to prevent an outbreak at the level of the re-spreading period are necessary to minimize mortality and maintain the effective reproductive number below 1.

Summary

Korean summary
본 연구에서는 질병관리청에서 제공하는 개별 확진자 데이터에 확률통계적 방법을 적용하여 연령군 간의 감염전파 행렬을 추정하였으며 연령군을 고려한 수리모델에 적용되었다. 본 연구에서 우리는 2020년 10월부터 2021년 5월까지 한국에서의 코로나19 유행상황을 정책 구간에 따라 분석하였으며 이를 토대로 거리두기 완화 수준에 따라 거리두기 완화 상태에서도 지속적으로 유효감염재생산지수가 1보다 작아지는 시점이 달라질 수 있음을 보인다.

Key Message
In this research, we estimated age-group-specified transmission rate matrix by applying maximum likelihood estimation into individual based data which was provided by Korea Disease Control and Prevention Agency. Our model simulation showed the moment, when the effective reproductive number is consistently below 1 even the distancing is eased, is ranged from August to the end of 2021 depending on the intensity of the social distancing during eased phase.

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Woo-Sik Son, Min-Kyung Chae, Dong-Uk Hwang, Kyeongah Nah, Minsoo Kim, Jong-Hoon Kim, Jonggul Lee
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Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee
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Karan Thakkar, Julia Regazzini Spinardi, Jingyan Yang, Moe H. Kyaw, Egemen Ozbilgili, Carlos Fernando Mendoza, Helen May Lin Oh
Frontiers in Public Health.2023;[Epub] CrossRef
Effective vaccination strategies to control COVID-19 in Korea: a modeling study
Youngsuk Ko, Kyong Ran Peck, Yae-Jean Kim, Dong-Hyun Kim, Eunok Jung
Epidemiology and Health.2023; 45: e2023084. CrossRef
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Youngsuk Ko, Victoria May P. Mendoza, Yubin Seo, Jacob Lee, Yeonju Kim, Donghyok Kwon, Eunok Jung, E. Augeraud, M. Banerjee, J.-S. Dhersin, A. d'Onofrio, T. Lipniacki, S. Petrovskii, Chi Tran, A. Veber-Delattre, E. Vergu, V. Volpert
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A small window into the status of malaria in North Korea: estimation of imported malaria incidence among visitors from South Korea: Jisun Sung, Hae-Kwan Cheong, Ah-Young Lim, Jong-Hun Kim; Epidemiol Health. 2020;42:e2020068. Published online November 21, 2020; DOI: https://doi.org/10.4178/epih.e2020068

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Abstract Summary PDF

Abstract

OBJECTIVES
This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea.

METHODS

The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles.

RESULTS

A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data.

CONCLUSIONS

The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.

Summary

Korean summary
본 연구는 2000-2008년 금강산을 여행한 대한민국 국민과 2005-2015년 개성공단에서 근무한 대한민국 국민에서의 말라리아 발생률을 추정하여 국제사회에 보고된 북한의 말라리아 발생률과 비교 평가하였다. 향후 남북한의 교류가 활성화 되었을 때 북한을 방문하고 돌아온 국민에서의 말라리아 발생률 자료를 사용하여 북한 현지에서의 말라리아 발생률 현황 추이를 살펴볼 수 있을 것으로 보인다.

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Development of a Plasmodium vivax malaria model for evaluating the effects of control strategies on the malaria burden in Democratic People’s Republic of Korea
Hye Seong, Jiyeon Suh, Jun Yong Choi, Jeehyun Lee, Joon-Sup Yeom
Frontiers in Public Health.2024;[Epub] CrossRef

Ebola virus disease outbreak in Korea: use of a mathematical model and stochastic simulation to estimate risk: Youngsuk Ko, Seok-Min Lee, Soyoung Kim, Moran Ki, Eunok Jung; Epidemiol Health. 2019;41:e2019048. Published online November 24, 2019; DOI: https://doi.org/10.4178/epih.e2019048

21,555 View
223 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
According to the World Health Organization, there have been frequent reports of Ebola virus disease (EVD) since the 2014 EVD pandemic in West Africa. We aim to estimate the outbreak scale when an EVD infected person arrives in Korea.

METHODS

Western Africa EVD epidemic mathematical model SEIJR or SEIJQR was modified to create a Korean EVD outbreak model. The expected number of EVD patients and outbreak duration were calculated by stochastic simulation under the scenarios of Best case, Diagnosis delay, and Case missing.

RESULTS

The 2,000 trials of stochastic simulation for each scenario demonstrated the following results: The possible median number of patients is 2 and the estimated maximum number is 11 when the government intervention is proceeded immediately right after the first EVD case is confirmed. With a 6-day delay in diagnosis of the first case, the median number of patients becomes 7, and the maximum, 20. If the first case is missed and the government intervention is not activated until 2 cases of secondary infection occur, the median number of patients is estimated at 15, and the maximum, at 35.

CONCLUSIONS

Timely and rigorous diagnosis is important to reduce the spreading scale of infection when a new communicable disease is inflowed into Korea. Moreover, it is imperative to strengthen the local surveillance system and diagnostic protocols to avoid missing cases of secondary infection.

Summary

Korean summary
본 연구는 수학적 모델과 확률 시뮬레이션 기법을 이용하여 국내에 유입되지 않았던 에볼라바이러스병(EVD)의 확산 위험도를 정량적으로 예측하는 첫 번째 연구이다. 또한 이 연구를 통해 에볼라바이러스병 환자의 유입 시 발생 가능한 진단 지연 혹은 유입 미인지 상황을 가정하여 발생할 수 있는 2차 감염자 수 및 감염 종식까지의 기간을 계산했고 에볼라바이러스 유입 대비 실시간모니터링의 중요성과 확산 시 상황에 따른 최대 일일 환자수를 합리적으로 제시할 수 있다.

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Editorial

Tuberculosis control in the Republic of Korea: Kyung Sook Cho; Epidemiol Health. 2018;40:e2018036. Published online August 2, 2018; DOI: https://doi.org/10.4178/epih.e2018036

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Abstract Summary PDF Supplementary Material

Abstract

The incidence and mortality rates of tuberculosis (TB) in the Republic of Korea are 77 and 5.2 per 100,000 people, respectively (2016), which are the highest among the member countries of the Organization for Economic Cooperation and Development. Recently, the incidence of TB among teens and individuals in their 20s in the Republic of Korea decreased significantly. The decrease is largely attributed to the TB screening and contact investigation efforts targeting schools over the past few years. However, the incidence of TB among elderly individuals remains high, and it is even increasing compared to that in the past 10 years. Older individuals account for 42% of all TB cases and 82% of TB-related deaths. The success rate of TB treatment in the Republic of Korea has gradually increased due to various programs, such as control of non-compliance, insurance coverage for TB diagnosis and treatment, and TB public–private mix models. This study suggests that policy makers should focus their efforts on policies that prioritize a significant reduction in the incidence of TB based on the 2nd National Strategic Plan for Tuberculosis Control (2018–2022).

Summary

Korean summary
2016년 한국의 결핵 발생률은 인구 10만명당 77명이고, 결핵 사망률은 인구 10만명당 5.2명으로 경제협력개발기구(OECD) 회원국 중 가장 높은 수준이다. 본 연구는 지난 수 십 년간 한국의 결핵 발생률, 유병률 및 사망률의 변화 추이와 그간 한국 정부가 시행해 온 다양한 결핵 관리 정책들을 분석하고 향후 개선방안을 제시하고자 하였다.

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Original Articles

The coverage rates for influenza vaccination and related factors in Korean adults aged 50 and older with chronic disease: based on 2016 Community Health Survey data: Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi; Epidemiol Health. 2018;40:e2018034. Published online July 24, 2018; DOI: https://doi.org/10.4178/epih.e2018034

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aims to identify the coverage rates for influenza vaccination and related factors depending on chronic disease in Korean adults aged 50 and older.

METHODS

The 2016 Korea Community Health Survey was used for analysis. Chi-square test was performed to investigate the coverage rates for influenza vaccination depending on chronic disease, and a multiple logistic regression analysis was used to identify the factors associated with influenza vaccination, by chronic disease.

RESULTS

In men with ≥1 chronic disease, 39.8% of 50-64 years of age, and 86.8% of elderly (over 65 years of age) received influenza vaccination. In women with ≥1 chronic disease, 58.7% of 50-64 years of age, and 89.9% of elderly (over 65 years of age) received influenza vaccination (p<0.001). The chronic diseases associated with influenza vaccination were hypertension (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19 to 1.37), diabetes (OR, 1.41; 95% CI, 1.28 to 1.55) in men aged 50-64, hypertension (OR, 1.34; 95% CI, 1.20 to 1.49), diabetes (OR, 1.17; 95% CI, 1.02 to 1.33), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.07 to 1.60) in elderly (over 65 years of age). In women aged 50-64, hypertension (OR, 1.39; 95% CI, 1.30 to 1.49), diabetes (OR, 1.51; 95% CI, 1.35 to 1.68), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.05 to 1.64), and hypertension (OR, 1.55; 95% CI, 1.40 to 1.71), diabetes (OR, 1.27; 95% CI, 1.12 to 1.43) in elderly (over 65 years of age).

CONCLUSIONS

Populations in aged 50-64 are recommendation subject for vaccination or classified as high-risk group in case with chronic disease. Though subject over 60 years old is age close to the elderly, the coverage rates for vaccination was low. It is necessary to devise strategies to raise the coverage rates for vaccination.

Summary

Korean summary
매년 인플루엔자 환자수는 증가하는 추세이며 인플루엔자로 인한 의료이용의 질병부담은 커질 것으로 생각된다. 국내에서는 우선접종 권장대상자들에게 예방접종을 받도록 권고하고 있으며, 예방접종은 인플루엔자를 예방할 수 있는 비용 효과적인 방법이다. 65세 이상 대상자는 국가 무료 예방접종 사업 대상으로 인해 예방접종률이 높은 것으로 확인되었다. 50-64세 인구는 예방접종 권고 대상자임에도 불구하고 낮은 것으로 나타났고, 50-64세 연령에서 만성질환을 동반할 경우 고위험군이지만 여전히 낮은 예방접종률을 보였다. 또한 50-64세 연령에서 1개 이상 만성질환을 동반할 경우 대도시, 중소도시에 거주하는 것보다 군지역에 거주할 경우 높은 예방접종률을 확인함으로써 대도시 및 중소도시에 거주하는 50-64세 연령에 대해 예방접종률을 올릴 수 있는 적극적인 예방접종 홍보가 필요할 것으로 생각한다.

Citations

Citations to this article as recorded by

Disentangling behavioral determinants of seasonal influenza vaccination in post-corona era: An integrated model approach
So-Hyun Kim, Minsoo Jung, Hani Amir Aouissi
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2025 Clinical Practice Guidelines for Diabetes Management in Korea: Recommendation of the Korean Diabetes Association
Shinae Kang, Seon Mee Kang, Jong Han Choi, Seung-Hyun Ko, Bo Kyung Koo, Hyuk-Sang Kwon, Mi Kyung Kim, Sang Yong Kim, Soo-Kyung Kim, Young-eun Kim, Eun Sook Kim, Jae Hyeon Kim, Chong Hwa Kim, Ji Min Kim, Hae Jin Kim, Min Kyong Moon, Sun Joon Moon, Jun Sung
Diabetes & Metabolism Journal.2025; 49(4): 582. CrossRef
Influenza vaccine hesitancy in the elderly: Where do we stand?
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Vaccine.2025; 66: 127831. CrossRef
Barriers to influenza vaccination in older adults with chronic diseases: Insights from a COM-B model–based meta-analysis
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Human Vaccines & Immunotherapeutics.2025;[Epub] CrossRef
Factors Associated with Influenza Vaccination Among Urban Community-Dwelling Chinese Elderly: Results from a Multicity Cross-Sectional Study
Jiayue Guo, Xitong Jiao, Shuai Yuan, Lili You
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All-Cause and Cause-Specific Mortality Attributable to Seasonal Influenza: A Nationwide Matched Cohort Study
Heeseon Jang, Jaelim Cho, Seong-Kyung Cho, Donghan Lee, Sung-il Cho, Sang-Baek Koh, Dong-Chun Shin, Changsoo Kim
Journal of Korean Medical Science.2023;[Epub] CrossRef
Cost-Effectiveness of Influenza Vaccination Strategies in Adults: Older Adults Aged ≥65 Years, Adults Aged 50–64 Years, and At-Risk Adults Aged 19–64 Years
Min Joo Choi, Gyeongseon Shin, Daewon Kang, Jae-Ok Lim, Yun-Kyung Kim, Won Suk Choi, Jae-Won Yun, Ji Yun Noh, Joon Young Song, Woo Joo Kim, Sang-Eun Choi, Hee Jin Cheong
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Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery: Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim; Epidemiol Health. 2018;40:e2018005. Published online February 27, 2018; DOI: https://doi.org/10.4178/epih.e2018005

46,263 View
480 Download
42 Web of Science
43 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.

METHODS

In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.

RESULTS

Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.

CONCLUSIONS

Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.

Summary

Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.

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Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I: Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim; Epidemiol Health. 2017;39:e2017046. Published online October 19, 2017; DOI: https://doi.org/10.4178/epih.e2017046

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.

METHODS

The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).

RESULTS

Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.

CONCLUSIONS

The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.

Summary

Korean summary
본 연구는 만 19세 이상의 한국 성인 동성애자와 양성애자를 대상으로 이들의 건강상태에 대한 설문조사를 시행하고, 수집한 자료를 분석하여 동성애자·양성애자의 건강불평등 실태를 파악하고자 하였다. 본 연구의 목적은 자가평가건강, 정신건강(우울, 자살생각 및 자살시도), 신체적 건강(근골격계 통증) 및 건강관련행동(흡연율, 위험음주율)을 포함하여 다양한 측면에서 한국 성인 동성애자·양성애자와 일반인구집단의 건강수준을 비교하는 것이다.

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Epidemiologic characteristics of scrub typhus on Jeju Island: Sung Uk Lee; Epidemiol Health. 2017;39:e2017039. Published online August 18, 2017; DOI: https://doi.org/10.4178/epih.e2017039

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Abstract Summary PDF

Abstract

OBJECTIVES
Scrub typhus is the most common febrile disease in Korea during the autumn. Jeju Island is the largest island in South Korea and has a distinctive oceanic climate. This study aimed to identify epidemiologic characteristics of scrub typhus on Jeju Island.

METHODS

From January 2011 to December 2016, 446 patients were diagnosed with scrub typhus on Jeju Island. The patients’ personal data and the environmental factors that might be related to scrub typhus were investigated and retrospectively analyzed.

RESULTS

The median age of the patients was 58-years-old (range, 8 to 91) and 43% of them worked in the agricultural, forestry or livestock industry. Regardless of their job, 87% of the patients had a history of either working outdoors or of other activities before developing scrub typhus. The south and southeast regions of Jeju Island, especially Namwon-eup, showed the highest incidence of scrub typhus. Workers in mandarin orange orchards seemed to be the highest risk group for scrub typhus infection.

CONCLUSIONS

Scrub typhus on Jeju Island showed unique characteristics. To efficiently prevent scrub typhus, each year individual regional approaches should be developed based on the epidemiologic characteristics of the disease.

Summary

Korean summary
쯔쯔가무시증은 진드기에 의해 감염되는 대표적인 가을철 발열성 질환이다. 제주 지역에서 발생하는 쯔쯔가무시증의 역학적 특성을 분석한 결과 제주도의 남, 남동쪽이 다발생 지역으로 나타났다. 또한 이 지역의 감귤 농업이 쯔쯔가무시증이 발생할 수 있는 주요 위험요인인 것으로 추정된다.

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Epidemiologic Investigation

Epidemiologic research on lung damage caused by humidifier disinfectants: Moo-Song Lee, Hwa Jung Kim; Epidemiol Health. 2016;38:e2016031. Published online July 20, 2016; DOI: https://doi.org/10.4178/epih.e2016031

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Abstract

In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.

Summary

Korean summary
본 역학조사는 일개 병원에서 신고한 질병 유행에 대해 다학제적 연구 결과로써, 질병의 임상적 특성과 역학적 원인 파악 후 정책적 대책으로 이어진 사례이다. 향후 가습기 살균제 이외에도 일반국민의 건강에 영향을 미칠 수 있는 다양한 생활환경요인에 관심을 가지고, 필요 시 적극적인 조사와 대응이 필요할 것이다.

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Original Articles

The prevalence and risk factors for pterygium in South Korea: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010: Eun-Young Pyo, Gui Hyeong Mun, Kyung Chul Yoon; Epidemiol Health. 2016;38:e2016015. Published online April 29, 2016; DOI: https://doi.org/10.4178/epih.e2016015

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Abstract Summary PDF

Abstract

OBJECTIVES
To determine the prevalence and risk factors for pterygium in the adult Korean population of South Korea.

METHODS

Data were analyzed from 9,193 participants who were 40 years of age or older from the Korea National Health and Nutrition Examination Survey (KNHANES), conducted from 2009 to 2010. Standardized slit-lamp examinations were performed by study ophthalmologists to examine the anterior segment for evidence of pterygium. Pterygium was graded clinically as T1 (atrophic), T2 (intermediate), or T3 (opaque). Every participant underwent ocular and systemic examinations, as well as interviewer-administered questionnaires. Any evidence of pterygium and observed association between the risk factors were recorded.

RESULTS

The mean age of the subjects was 55.7 (±0.2) years. Of the 9,193 eligible subjects, 935 had pterygium in at least one eye. In a multivariate logistic regression analysis adjusted for age and sex, pterygium was significantly associated with rural vs. urban residence (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.4 to 2.0), lower level of education (OR, 4.5; 95% CI, 3.1 to 6.6), low income (OR, 1.3; 95% CI, 1.0 to 1.8), smoking (OR, 0.7; 95% CI, 0.5 to 1.0), and more hours of sun exposure (OR, 1.5; 95% CI, 1.2 to 1.8). After adjusting for all variables, the prevalence of pterygium was significantly associated with age, sex, residence, education level, and smoking.

CONCLUSIONS

This is a nationwide epidemiologic study in South Korea to assess the prevalence of and risk factors for pterygium. The overall prevalence of pterygium was 8.8% among Koreans aged 40 years or older. Older age, male gender, rural residence, lower level of education, and non-smoking were associated with the development of pterygium.

Summary

Korean summary
이 연구는 40세이상 한국인의 군날개 유병률과 위험요인을 파악하기 위해 2009년부터 2010년까지 조사된 국민건강영양조사 자료를 이용하여 분석하였다. 한국인의 40세이상 군날개 유병률은 8.8%이었으며, 다중로지스틱 회귀분석을 통해 분석된 관련 위험요인으로는 연령, 성, 거주지역, 교육수준, 흡연이었다.

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Changes in seroprevalence of hepatitis B surface antigen and epidemiologic characteristics in the Republic of Korea, 1998-2013: Hyerin Lee, Hyungmin Lee, Yumi Cho, Kyungwon Oh, Moran Ki; Epidemiol Health. 2015;37:e2015055. Published online December 23, 2015; DOI: https://doi.org/10.4178/epih/e2015055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.

METHODS

HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.

RESULTS

HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.

CONCLUSIONS

While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.

Summary

Korean summary
한국 국민건강영양조사 자료로 본 HBsAg 양성률은 1998 년 4.6%에서 2008 년에 2.9%로 감소한 이후 5 년간 증감없이 2013 년에 2.9%로 나타났다. 한국 HBsAg 양성률을 더욱 감소시키기 위해서는 예방접종사업뿐 아니라 B형 간염 환자 치료를 보다 적극적으로 해야 될 것으로 보인다. 또한 HBsAg 양성자는 간경화나 간암 예방을 위해 건강한 생활습관을 가지도록 노력하는 것이 필요하다.

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Current Oncology Reports.2022; 24(2): 187. CrossRef
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Zhuo-Zhi Lim, Jau Shya Teo, Ah Choon Tan, Teck-Onn Lim
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Martin C. S. Wong, Jason L. W. Huang, Jacob George, Junjie Huang, Colette Leung, Mohammed Eslam, Henry L. Y. Chan, Siew C. Ng
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Byung-Woo Kim, Chang-Mo Oh, Hwa Young Choi, Joong-Won Park, Hyunsoon Cho, Moran Ki
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MERS-Epidemiologic Investigation

Epidemiological investigation of the 119th confirmed Middle East Respiratory Syndrome coronavirus case with an indefinite mode of transmission during the Pyeongtaek outbreak in Korea: Jong Hyuk Choi, Byoungin Yoo, Soon Young Lee, Eun Gyu Lee, Moran Ki, Woncheol Lee, Jong Rak Jung, Kyujin Chang; Epidemiol Health. 2015;37:e2015054. Published online December 10, 2015; DOI: https://doi.org/10.4178/epih/e2015054

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Abstract

Since the first case was diagnosed on May 20, 2015, there were 186 confirmed cases of Middle East Respiratory Syndrome (MERS) until the end of outbreak in South Korea. Although medical institutions were the most identifiable sources of MERS transmission in South Korea, similar to other countries, in-depth epidemiological investigation was required for some confirmed cases with indefinite contact history or hospital visit records. The subject of epidemiological investigation in the present study was a 35 year-old male patient diagnosed with MERS (#119) who lived in Asan-city and worked in Pyeongtaek-city. Various potential sources of transmission were carefully investigated. While he could have been exposed to MERS through a friend from Saudi Arabia or confirmed MERS cases in his workplace, neighboring areas, and medical institutions, as well as contacts in his home, the chances of transmission were low; however, the potential for transmission through his local community could not be excluded. Practically, it was difficult to determine the modes of transmission for all outbreak cases in communicable disease that occurred in this short period of time. The investigation to identify the mode of transmission in this case was ultimately unsuccessful. However, the various data collected and analyzed to reveal modes of transmission provided detailed information that could not be collected using only interview surveys.

Summary

Korean summary
2015년 한국에서 유행한 메르스 환자들 중, 감염 경로가 불분명한 119번째 환자에 대한 심층 역학조사를 통해 다양한 감염경로의 가능성을 검토하였다. 감염경로를 명확하게 밝혀내지 못한 한계점이 있지만, 지역사회 전파에 대한 가능성을 제시하였다. 감염병 대유행시 효율적인 감염경로 파악을 위해서는 다방면의 자료에 대한 확보체계와 이를 신속히 분석하고 판단할 수 있는 전문 인력 확충이 필요하다.

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A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences
Rebecca E. Ramshaw, Ian D. Letourneau, Amy Y. Hong, Julia Hon, Julia D. Morgan, Joshua C. P. Osborne, Shreya Shirude, Maria D. Van Kerkhove, Simon I. Hay, David M. Pigott
Scientific Data.2019;[Epub] CrossRef

Editorial

A new strategy for tuberculosis control in North Korea: Young-jeon Shin, Moran Ki, Nackmoon Sung; Epidemiol Health. 2015;37:e2015053. Published online November 22, 2015; DOI: https://doi.org/10.4178/epih/e2015053

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Abstract

Tuberculosis is one of the most prevalent diseases in North Korea. Despite some positive accomplishments by current aid projects, it is still necessary to investigate the existing aid system. The following are necessary for improvement: sustaining a high degree of expertise, cooperation among various related parties including the international community, mediation to induce this cooperation, a more active role of the South Korean government, and encouragement of North Korea to more actively participate. Achieving these will help solve the issues of current tuberculosis aid projects in North Korea and lead to more successful outcomes.

Summary

Korean summary
결핵은 북한의 주요 질병 중 하나이다. 기존 사업이 이루어낸 일부 긍정적인 성과에도 불구하고 북한 결핵사업의 문제들을 해결하고 성공적인 성과를 거두기 위해서는 기존 지원체계에 대한 반성과 함께 고도 전문성의 지속유지, 국제사회를 포함한 다양한 관련자들간의 협력, 이러한 협력을 이끌어낼 수 있는 조정능력, 남한정부의 보다 적극적인 역할, 북한 당사자의 참여유도가 필요하다.

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Original Articles

Handwashing with soap and national handwashing projects in Korea: focus on the National Handwashing Survey, 2006-2014: Moo-Sik Lee, Su Jin Hong, Young-Taek Kim; Epidemiol Health. 2015;37:e2015039. Published online August 31, 2015; DOI: https://doi.org/10.4178/epih/e2015039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Handwashing is the most fundamental way to prevent the spread of infectious diseases. Correct handwashing can prevent 50 to 70% of water-infections and foodborne-infections. We report the results of a fact-finding study on general handwashing attitude and practice in the Republic of Korea by analyzing habits and awareness among adults and students (grades 4 to 12) based on the 2006 to 2014 National Handwashing Surveys and observational surveys.

METHODS

The awareness survey was performed by telephone interviews with adults and students in 16 municipalities and provinces sampled by quota for region, sex and age. The observational survey was performed in subway, railway, and other public restrooms in seven municipalities selected through systematic sampling.

RESULTS

Adults and students washed their hands with soap/sanitizer an average of 6.6 and 5.2 times daily, respectively, in 2014, an increase and decrease compared to 2006 (4.8) and 2013 (6.8). Their average daily handwashing frequency in 2014, 9.8 and 8.3, was higher than in 2006 (7.6), but lower than in 2013 (10.3).The percentage of participants handwashing with soap after using the restroom (29.5%) has been increasing since 2009, but remain slower than in other countries (42% to 49%). The percentages of participants handwashing with water in 2014, 2013, and 2011 were 57.5%, 72.6%, and 71.4%, respectively.

CONCLUSIONS

Handwashing with soap is an important national public health issue, and national projects promoting it should be given high priority. Research support is necessary to provide scientific evidence of the importance of handwashing with soap and to develop and implement evidence-based policies.

Summary

Korean summary
우리나라(한국)의 2006년부터 2014년 사이에 수행된 손씻기 실태조사 결과분석을 통하여 성인과 초•중•고등학생들의 평소 손씻기 실태 및 인식, 공공화장실 이용시 손씻기 행동의 수준 및 추세를 파악함으로써 추후 비누로 손씻기 사업의 근거와 정책 및 전략 개발의 기초자료를 제공하고자 하였다.

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The costs of hepatitis A infections in South Korea: Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo; Epidemiol Health. 2014;36:e2014011. Published online August 18, 2014; DOI: https://doi.org/10.4178/epih/e2014011

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies.

METHODS

We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008.

RESULTS

There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group.

CONCLUSIONS

This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate.

Summary

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Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey: Won Joon Lee, Hyeon Chang Kim, Sun Min Oh, Dong Phil Choi, Jaelim Cho, Il Suh; Epidemiol Health. 2013;35:e2013005. Published online June 20, 2013; DOI: https://doi.org/10.4178/epih/e2013005

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Abstract

<sec><title>OBJECTIVES</title>The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet.</sec><sec><title>METHODS</title>This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets.</sec><sec><title>RESULTS</title>Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively.</sec><sec><title>CONCLUSIONS</title>Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.</sec>

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