Journal of Preventive Medicine and Public Health

Original Article

Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data: Joo Youn Seo, Jae Hee Seo, Myoung Hee Kim, Moran Ki, Hee Suk Park, Bo Youl Choi; J Prev Med Public Health. 2012;45(3):164-173. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.164

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Objectives

Over the past several years, the incidence of hepatitis A infection has been increasing rapidly in the young-adult population in Korea. We examined the effects of area-level socioeconomic status and environmental hygiene on the incidence of hepatitis A.

Methods

This study is based on the registered national population of Korea and the national health insurance data from 2004 to 2008. A total of 73 459 individuals were confirmed to have had hepatitis A. The standardized incidences of hepatitis A in 232 districts adjusted for sex and age of people were calculated for each year, and the rate ratios of the incidence rates were estimated according to area-level socioeconomic status and environmental hygiene using multiple Poisson regression models.

Results

The incidence rates of hepatitis A infection were 15.6 (per 100 000) in 2004, 19.0 (per 100 000) in 2005, 27.2 (per 100 000) in 2006, 25.1 (per 100 000) in 2007, and 61.7 (per 100 000) in 2008. The analysis of the area-level effects showed that residential areas of the less deprived than other regions, areas with higher levels of education, and heavily populated areas were significantly associated with increased risk.

Conclusions

There is a very strong possibility that both area-level socioeconomic status and environmental hygiene play a role in increasing the risk of hepatitis A infection in Korea. Therefore, to reduce hepatitis A infection, we need a nationwide strategy that considers these area-level characteristics.

Summary

Citations

Citations to this article as recorded by

Trends of Hepatitis A Virus Infection in Poland: Assessing the Potential Impact of the COVID-19 Pandemic and War in Ukraine
Piotr Rzymski, Dorota Zarębska-Michaluk, Agnieszka Genowska, Piotr Tyszko, Birute Strukcinskiene, Robert Flisiak
Viruses.2024; 16(3): 469. CrossRef
Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
Jaehong Jeong, Mijeong Kim, Jungsoon Choi
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Impact of urbanization on morbidity of hepatitis A: a national panel study in China during 2005–2018
Bo-Wen Ming, Zhou Yang, Ze-Lin Yan, Chen Shi, Xiao-Han Xu, Li Li, Chun-Quan Ou
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The Korean Journal of Internal Medicine.2019; 34(6): 1297. CrossRef
Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012
Joo Yeon Seo, Sungyong Choi, BoYoul Choi, Moran Ki
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Low Compliance with National Guidelines for Preventing Transmission of Group 1 Nationally Notifiable Infectious Diseases in Korea
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Changes in the seroprevalence of IgG anti-hepatitis A virus between 2001 and 2013: experience at a single center in Korea
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Clinical and Molecular Hepatology.2014; 20(2): 162. CrossRef
Risk Factors for Acute Hepatitis A Infection in Korea in 2007 and 2009: A Case-Control Study
Joo Youn Seo, Bo Youl Choi, Moran Ki, Hye Lim Jang, Hee Suk Park, Hyun Jin Son, Si Hyun Bae, Jin Han Kang, Dae Won Jun, Jin-Woo Lee, Young Jin Hong, Young Seok Kim, Chang-Hwi Kim, U Im Chang, Jong-Hyun Kim, Hyeon Woong Yang, Hong Soo Kim, Kyeong Bae Park,
Journal of Korean Medical Science.2013; 28(6): 908. CrossRef
Letter to the Editor: The Increasing Hepatitis A Incidence in Korea: Is It Possible Within a Limited Time?
Pegah Karimi Elizee, Seyed Moayed Alavian, Seyyed Mohammad Miri
Journal of Preventive Medicine and Public Health.2012; 45(5): 329. CrossRef
Author Response: The Increasing Hepatitis A Incidence in Korea: Is It Possible Within a Limited Time?
Joo Youn Seo, Moran Ki, Bo Youl Choi
Journal of Preventive Medicine and Public Health.2012; 45(5): 331. CrossRef

English Abstracts

The Association Between Public Social Expenditure and Suicides: Evidence from OECD Countries.: Yoojin Park, Myoung hee Kim, Soonman Kown, Young jeon Shin; J Prev Med Public Health. 2009;42(2):123-129.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.123

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Abstract PDF

OBJECTIVES
This study aimed to examine the association between public social expenditure (PSE) and suicides in the 27 countries of the Organization for Economic Cooperation and Development (OECD) from 1980 to 2003. METHODS: The age-standardized suicide rates and their annual change (%) were obtained from the OECD Health Data 2007. As a measure of social protection, the PSE (% GDP) was used. The covariates included the annual divorce rate (/100,000 population), fertility rate (number of children/woman aged 15 to 49 years), GDP per capita (US$PPP), male unemployment rate (%), life expectancy (years) and alcohol consumption (liter/capita) for each country, which were all obtained from the OECD Health Data 2007 and the OECD Social Indicators 2006. Using hierarchical linear models that included these covariates, the effects of PSE on suicides (Model 1) and the annual percent change (Model 2) were examined (Model 3). Also, sub-sample analyses were done for six countries that experienced political/economic transition. RESULTS: We could not find significant effects of PSE on suicides (Model 1), but we observed significantly negative effects on the annual percent change for men and women (Model 2). Such findings were replicated in the sub-sample analysis, and moreover, the effect size was much larger (Model 3). CONCLUSIONS: Our finding suggests that social welfare protection can be a pivotal factor for suicide epidemiology, and especially in countries experiencing a social crisis or transition.

Summary

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Strengthening Causal Inference in Studies using Non-experimental Data: An Application of Propensity Score and Instrumental Variable Methods.: Myoung Hee Kim, Young Kyung Do; J Prev Med Public Health. 2007;40(6):495-504.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.495

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Abstract PDF

OBJECTIVES
This study attempts to show how studies using non-experimental data can strengthen causal inferences by applying propensity score and instrumental variable methods based on the counterfactual framework. For illustrative purposes, we examine the effect of having private health insurance on the probability of experiencing at least one hospital admission in the previous year. METHODS: Using data from the 4th wave of the Korea Labor and Income Panel Study, we compared the results obtained using propensity score and instrumental variable methods with those from conventional logistic and linear regression models, respectively. RESULTS: While conventional multiple regression analyses fail to identify the effect, the results estimated using propensity score and instrumental variable methods suggest that having private health insurance has positive and statistically significant effects on hospital admission. CONCLUSIONS: This study demonstrates that propensity score and instrumental variable methods provide potentially useful alternatives to conventional regression approaches in making causal inferences using non-experimental data.

Summary

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Reviews

Health Inequalities in Korea: Current Conditions and Implications.: Yu Mi Kim, Myoung Hee Kim; J Prev Med Public Health. 2007;40(6):431-438.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.431

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Abstract PDF

OBJECTIVES
The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. METHODS: Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. RESULTS: We found clear inequalities to various degrees in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. CONCLUSIONS: Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations.

Summary

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Why Do Health Inequalities Matter?.: Young Jeon Shin, Myoung Hee Kim; J Prev Med Public Health. 2007;40(6):419-421.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.419

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Abstract PDF

OBJECTIVES
The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. METHODS: Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. RESULTS: Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. CONCLUSIONS: Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.

Summary

Citations

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Original Articles

Social Support and Self-rated Health Status in a Low Income Neighborhood of Seoul, Korea.: Min Kyoung Lim, Myoung Hee Kim, Young Jeon Shin, Weon Seob Yoo, Bong Min Yang; Korean J Prev Med. 2003;36(1):54-62.

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Abstract PDF: OBJECTIVES
To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.; Summary

The Association between the Psychosocial Well-being Status and Adverse Lipid Profiles in a Rural Korean Community.: Chang Hoon Kim, Myoung Hee Kim, Sung Il Cho, Jung Hyun Nam, Bo Youl Choi; Korean J Prev Med. 2003;36(1):24-32.

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Abstract PDF: OBJECTIVES
To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.; Summary

Prevalence of Congenital Heart Disease from the Elementary Student Heart Disease Screening Program.: Hong Jue Lee, Myoung Hee Kim, Jo Won Jung, Seong Ho Kim, Bo Youl Choi; Korean J Prev Med. 2001;34(4):427-436.

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Abstract PDF: OBJECTIVE
To estimate the prevalence of congenital heart disease from the 1998 student heart disease screening program. METHODS: The heart disease screening program for elementary students was conducted in Kyonggi-do, in 1998. The subjects of the present study comprised the 40,402 students who attended the schools in the catchment area of a collaborative university hospital and who participated in the primary examination. The congenital heart disease (CHD) patients were initially identified through a questionnaire about prior medical history, and further through diagnostic tests & medical examinations in the secondary & the tertiary examinations. Certain assumptions were used in the estimation of the number of CHD cases among non-participants of the secondary & tertiary examinations. The overall prevalence of CHD was estimated by adding the CHD detection rates of the participants and the estimated prevalence of the non-participants. RESULTS: Among the 40,402 primary participants, 1,655 were referred further, of whom 79.1% (1,309) participated in the secondary examination. Of these, 121 were referred to the tertiary examination, with a participation rate at this last stage of 80.2%. The positive predictive value (PPV) of the screening tools was the highest when the results of both EKG and the questionnaire were positive. Because 85.9% of the detected cases had a past history of CHD, PPV was higher when the selection criteria in the questionnaire included past CHD history than when it didnt. The CHD detection rate among the participants was 1.76 cases/1,000 and the presumed number of cases among the non-participants was 31; giving an estimated final CHD prevalence of 2.52 cases/1,000 (95% CI : 2.06-3.06). Among the identified cases of CHD, VSD (52.8%) was the most common, followed by PDA (9.7%), TOF (9.7%) & PS (9.7%). CONCLUSION: Because the characteristics of the non-participants differed from those of the participants, the estimation of prevalence was influenced by the participation rate. Of the detected cases, 85.9% had a past history of diagnosis or operation for CHD. These findings suggested that the prevalence estimated in this study may be an underestimation of the actual condition. Therefore, a birth cohort study is required in order to more accurately estimate the prevalence and the effects of the program.; Summary

Evaluation of the Completeness of Case Reporting during the 1998 Cheju-do Mumps Epidemic, Using Capture-recapture Methods .: Myoung Hee Kim, Jin Kyoung Park, Mo Ran Ki, Young Joo Hur, Bo Youl Choi, Joung Soon Kim; Korean J Prev Med. 2000;33(3):313-322.

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Abstract PDF: OBJECTIVES
To estimate mumps incidence during the study period and to evaluate the completeness of case reporting. METHODS: Capture-recapture methods, originally developed for counting wildlife animals, were used. The data sources were 1) the National Notifiable Communicable Disease Reporting System (NNCDRS; 848 cases), 2) the School Health Reporting System, temporarily administered by the Division of Education (SHRS; 1,026 cases), and 3) a survey of students (785 cases). We estimated the number of unobserved mumps cases by matching the three data sources and fitting loglinear models to the data. We then determined the estimated total number of mumps cases by adding this to the number of observed cases. Completeness was defined as the proportion of observed cases from each source to the total of estimated cases. RESULTS: The total number of observed cases was 1,844 and the total number of estimated cases was 1,935 (95% CI: 1,878-2,070). The overall completeness was 43.8% of the NNCDRS, 53.0% of the SHRS, and 40.6% of the survey. However, completeness varied by area and age. CONCLUSION: Although the completeness of NNCDRS data appeared higher than in the past, it is difficult to generalize this result. In Korea, it is possible to estimate the size of health hazards relatively cheaply and quickly, by applying capture-recapture methods to various data using a multiple data collection system.; Summary

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