Journal of Preventive Medicine and Public Health

Special Article

Adjustment for Multimorbidity in Estimations of the Burden of Diseases Using Korean NHIS Data: Yoonhee Shin, Eun Jeong Choi, Bomi Park, Hye Ah Lee, Eun-Kyung Lee, Hyesook Park; J Prev Med Public Health. 2022;55(1):28-36. Published online January 31, 2022; DOI: https://doi.org/10.3961/jpmph.21.583

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Abstract Summary PDF Supplementary Material: The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.; Summary

Korean summary
질병부담 산출 시 몬테카를로 시뮬레이션을 통한 복합질환 보정 방법에 대해 다빈도 질환 실제 데이터 기반으로 검증해 봄으로써 30세 이상 연령에서 추정값에 큰 차이가 없음을 확인하였다. 하지만 30세 미만에서는 포함되는 질환 종류에 따라 실제 데이터 기반으로 복합질환을 보정하는 것이 불가능하거나 시뮬레이션으로 구한 값이 부정확하였다. 따라서, 질환 특성을 반영한 복합질환 보정방법론 개발이 필요함을 제안하며 본 연구 결과는 한국인 질병부담 연구에서 몬테카를로 시뮬레이션을 이용한 복합질환 보정 방법의 활용근거로 사용될 수 있을 것이다.

Brief Report

The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity: Hyejin Han, Bomi Park, Bohyun Park, Namsoo Park, Ju Ok Park, Ki Ok Ahn, Yang Ju Tak, Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2018;51(3):163-168. Published online May 23, 2018; DOI: https://doi.org/10.3961/jpmph.18.027

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Objectives
Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account.
Methods
By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury.
Results
The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high.
Conclusions
The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

Summary

Citations

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Burden of Childhood Injuries in India and Possible Public Health Interventions: A Systematic Review
Mohan Kumar, Vineet Kumar Pathak, Saparya Tripathi, Anita Upadhyay, Vivek V. Singh, Chandrakant Lahariya
Indian Journal of Community Medicine.2023; 48(5): 648. CrossRef
Joinpoint Regression About Injury Mortality and Hospitalization in Korea
Hyun Jin Park, Ui Jeong Kim, Won kyung Lee, Bohyun Park, Yoonhee Shin, Seonhwa Lee, Eun Jeong Choi, Nam-eun Kim, Ju Ok Park, Hyesook Park
Journal of Korean Medical Science.2022;[Epub] CrossRef
Identifying intentional injuries among children and adolescents based on Machine Learning
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BMC Public Health.2021;[Epub] CrossRef
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International Journal of Environmental Research and Public Health.2019; 16(22): 4581. CrossRef

Special Article

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome: Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2013;46(4):173-182. Published online July 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.4.173

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Abstract PDF

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Summary

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Brief Report

Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis: Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2012;45(5):323-328. Published online September 28, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.5.323

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Abstract PDF

Objectives

Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future.

Methods

We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time.

Results

All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women.

Conclusions

The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

Summary

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Original Article

The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence: Hye Ah Lee, Won Kyung Lee, Kyoung-Ae Kong, Namsoo Chang, Eun-Hee Ha, Young Sun Hong, Hyesook Park; J Prev Med Public Health. 2011;44(5):226-233. Published online September 28, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.5.226

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Abstract PDF

Objectives

Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined.

Methods

The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests.

Results

A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2-3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82).

Conclusions

This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.

Summary

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