Journal of Preventive Medicine and Public Health

Special Article

National Cancer Control Plan of the Korea: Current Status and the Fourth Plan (2021-2025): Kyu-Tae Han, Jae Kwan Jun, Jeong-Soo Im; J Prev Med Public Health. 2023;56(3):205-211. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.115

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Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision of “A Healthy Country with No Concerns about Cancer Anywhere at Any Time,” which aims to build and disseminate high-quality cancer data, reduce preventable cancer cases, and reduce gaps in cancer control. Its main strategies include (1) activation of cancer big data, (2) advancement of cancer prevention and screening, (3) improvement in cancer treatment and response, and (4) establishment of a foundation for balanced cancer control. The fourth NCCP has many positive expectations, similar to the last 3 plans; however, cross-domain support and participation are required to achieve positive results in cancer control. Notably, cancer remains the leading cause of death despite decades of management efforts and should continue to be managed carefully from a national perspective.

Summary

Korean summary
- 기존 1~3차 국가암관리계획의 전반적인 성과를 소개합니다. - 제4차 국가암관리계획의 목표 및 내용을 기존 계획과 비교하여 설명합니다.

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Association between Socioecological Status, Nutrient Intake, and Cancer Screening Behaviors in Adults Aged 40 and Over: Insights from the Eighth Korea National Health and Nutrition Examination Survey (KNHANES, 2019)
Seungpil Jeong, Yean-Jung Choi
Nutrients.2024; 16(7): 1048. CrossRef

Review

A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues: Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2022;55(1):1-9. Published online January 16, 2022; DOI: https://doi.org/10.3961/jpmph.21.580

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Abstract Summary PDF

An index that evaluates the health level of a population group considering both death and loss of function due to disease is called a summary measure of population health (SMPH). SMPHs are broadly divided into life year indices and life expectancy indices, the latter of which comprise healthy life expectancy (HLE). HLE is included as a policy target in various national and regional level healthcare plans, and the term “HLE” is commonly used in academia and by the public. However, the overall level of understanding of HLE—such as the precise definition of HLE and methods of calculating HLE—still seems to be low. As discussed in this study, the types of HLE are classified into disability-free life expectancy, disease-free life expectancy, quality-adjusted life expectancy, self-rated HLE, and disability-adjusted life expectancy. Their characteristics are examined to facilitate a correct understanding and appropriate utilization of HLE. In addition, the Sullivan method, as a representative method for calculating HLE, is presented in detail, and major issues in the process of calculating HLE, such as selection of the population group and age group, estimation of death probability, calculation of life years, and incorporation of health weights, are reviewed. This study will help researchers to select an appropriate HLE type and evaluate the validity of HLE research results, and it is expected to contribute to the vitalization of HLE research.

Summary

Korean summary
건강수명의 유형은 무장애기대수명, 질병 없는 기대수명, 질보정기대수명, 자가평가보정 기대수명, 장애보정기대수명으로 분류된다. 건강수명의 올바른 이해와 적절한 활용을 돕기 위해 이들의 특성을 검토하였다. 이번 연구는 연구자들이 적절한 건강수명 유형을 선택하고 건강수명 연구 결과의 타당성을 평가하는 데 도움이 될 것이며, 건강수명 연구의 활성화에 기여할 것으로 기대된다.

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Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
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Trends of Gaps Between Health-Adjusted Life Expectancy and Life Expectancy at the Regional Level in Korea Using a Group-Based Multi-Trajectory Modeling Approach (2008–2019)
Chung-Nyun Kim, Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Dal-Lae Jin, Seok-Jun Yoon
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Sex/gender-related differences in inflammaging
Fabiola Olivieri, Francesca Marchegiani, Giulia Matacchione, Angelica Giuliani, Deborah Ramini, Francesca Fazioli, Jacopo Sabbatinelli, Massimiliano Bonafè
Mechanisms of Ageing and Development.2023; 211: 111792. CrossRef
Relevance Index Regional Variation by Each Disease and Its Essential Medical Field: A Retrospective Data Analysis From 2016-2020 in Korea
Young-Eun Kim, Jeehee Pyo, Haneul Lee, HyeRan Jeong, Young-Kwon Park, Jeong-Wook Seo, Minsu Ock, Seok-Jun Yoon
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Trends of healthy and unhealthy working life expectancy in Germany between 2001 and 2020 at ages 50 and 60: a question of educational level?
Stefanie Sperlich, Johannes Beller, Jelena Epping, Siegfried Geyer, Juliane Tetzlaff
Journal of Epidemiology and Community Health.2023; 77(7): 430. CrossRef
Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method
Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock
Journal of Preventive Medicine and Public Health.2023; 56(4): 291. CrossRef
The socioeconomic distribution of life expectancy and healthy life expectancy in Chile
Manuel Antonio Espinoza, Rodrigo Severino, Carlos Balmaceda, Tomas Abbott, Baltica Cabieses
International Journal for Equity in Health.2023;[Epub] CrossRef
Comprehensive Measurement of the Burden of Disease due to Adverse Events: A New Analysis of the Cross-Sectional Patient Safety Incident Inquiry
Eun Young Choi, Juyoung Kim, Won Lee, Seung Gyeong Jang, Jeehee Pyo, Minsu Ock
Journal of Korean Medical Science.2023;[Epub] CrossRef
A Scoping Review of Tools and Techniques on Evaluating Population Health and Healthy Life Expectancy
Rui Zhang, Siyuan Wu, Qing Guo, Lizhu Jin, Xuejie Du, Shaoqiong Li, Yujie Meng, Songwang Wang, Xuemei Su, Jing Wu
China CDC Weekly.2023; 5(44): 991. CrossRef
The Primary Process and Key Concepts of Economic Evaluation in Healthcare
Younhee Kim, Yunjung Kim, Hyeon-Jeong Lee, Seulki Lee, Sun-Young Park, Sung-Hee Oh, Suhyun Jang, Taejin Lee, Jeonghoon Ahn, Sangjin Shin
Journal of Preventive Medicine and Public Health.2022; 55(5): 415. CrossRef

Original Articles

Ethnic Variation and Its Association With Malaria Awareness: A Cross-sectional Study in East Nusa Tenggara Province, Indonesia: Robertus Dole Guntur, Jonathan Kingsley, Fakir M. Amirul Islam; J Prev Med Public Health. 2022;55(1):68-79. Published online November 15, 2021; DOI: https://doi.org/10.3961/jpmph.21.367

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Abstract PDF

Objectives
This study investigated associations between ethnicity and malaria awareness in East Nusa Tenggara Province (ENTP), Indonesia.
Methods
A community-based cross-sectional study was conducted upon 1503 adults recruited by multi-stage cluster random sampling. A malaria awareness questionnaire was used to collect data, according to which participants were classified as aware or unaware of malaria. Logistic regression was applied to quantify the strength of associations of factors with malaria awareness.
Results
The participation rate in this study was high (99.5%). The participants were distributed relatively evenly among the Manggarai, Atoni, and Sumba ethnicities (33.0, 32.3, and 30.2%, respectively). Malaria awareness was significantly different amongst these groups; it was most common in the Manggarai ethnicity (65.1%; 95% confidence interval [CI], 59.9 to 70.3) and least common in the Sumba ethnicity (35.0%; 95% CI, 27.6 to 42.4). The most prominent factor influencing the malaria awareness in the Sumba and Manggarai ethnicities was education level, whilst it was socioeconomic status (SES) in the Atoni ethnicity. The likelihood of malaria awareness was significantly higher in adults with an education level of diploma or above (adjusted odds ratio [aOR], 21.4; 95% CI, 3.59 to 127.7 for Manggarai; aOR, 6.94; 95% CI, 1.81 to 26.6 for Sumba). Malaria awareness was significantly more common amongst high-SES adults in the Atoni group (aOR, 24.48; 95% CI, 8.79 to 68.21).
Conclusions
Low education levels and low SES were prominent contributors to lower levels of malaria awareness in rural ENTP. Interventions should focus on improving malaria awareness to these groups to support the Indonesian government’s national commitment to achieve a malaria elimination zone by 2030.

Summary

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The Declined Trend of Malaria over a Ten-year Period in the Rural East Nusa Tenggara Province, Indonesia: A Medical Record Analysis
Maria Lobo, Robertus Dole Guntur, Damai Kusumaningrum, Yulianti Paula Bria
Open Access Macedonian Journal of Medical Sciences.2024; 12(1): 107. CrossRef
The Variation of Malaria Prevention Measures Knowledge and their Associated Factors in Rural East Nusa Tenggara Province, Indonesia
Robertus Dole Guntur, Maria A. Kleden, Damai Kusumaningrum, Fakir M. Amirul Islam
Open Access Macedonian Journal of Medical Sciences.2023; 11(E): 378. CrossRef

Socio-demographic Determinants of Low Physical Activity in Peruvian Adults: Results of a Population-based Survey Performed in 2017-2018: Akram Hernández-Vásquez, Rodrigo Vargas-Fernández; J Prev Med Public Health. 2021;54(6):461-470. Published online November 7, 2021; DOI: https://doi.org/10.3961/jpmph.21.418

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Abstract PDF

Objectives
The objective of this study was to determine the prevalence of low physical activity (PA) in Peruvian adults and to identify associated factors.
Methods
An analytical study was performed using data from the 2017-2018 Nutritional Food Surveillance by Life Stages survey. The outcome variable was low PA (yes or no), assessed using the International Physical Activity Questionnaire-short form. Prevalence ratios were estimated as a measure of association.
Results
Among the 1045 persons included in the analysis, the age-standardized prevalence of low PA was 61.9%. The adjusted model showed that being female and migrating from a rural to an urban area in the last 5 years were associated with a higher probability of having low PA than males and individuals who had not migrated, while residing in rural highlands and jungle areas was associated with a reduced probability of having low PA compared to people residing in other geographic domains.
Conclusions
Being a female and migration from a rural to an urban area in the last 5 years were associated with a higher likelihood of having low PA. Therefore, promotion and prevention strategies related to PA are required, especially in the female and migrant populations.

Summary

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Individualized Biological Age as a Predictor of Disease: Korean Genome and Epidemiology Study (KoGES) Cohort
Seokyung An, Choonghyun Ahn, Sungji Moon, Eun Ji Sim, Sue-Kyung Park
Journal of Personalized Medicine.2022; 12(3): 505. CrossRef
Association between Altitude and the Framingham Risk Score: A Cross-Sectional Study in the Peruvian Adult Population
Akram Hernández-Vásquez, Rodrigo Vargas-Fernández, Manuel Chacón-Diaz
International Journal of Environmental Research and Public Health.2022; 19(7): 3838. CrossRef
Prevalence of Prehypertension and Associated Cardiovascular Risk Profiles among Adults in Peru: Findings from a Nationwide Population-Based Study
Akram Hernández-Vásquez, Rodrigo Vargas-Fernández
International Journal of Environmental Research and Public Health.2022; 19(13): 7867. CrossRef

Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone: Chanki Kim, Eun Jee Chang, Chang-yup Kim; J Prev Med Public Health. 2021;54(6):441-450. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.337

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Abstract Summary PDF Supplementary Material

Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

Summary

Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

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Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
Doo Woong Lee, Jieun Jang, Jaeyong Shin
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Nutritional Risk, Depression, and Physical Function in Older People Living Alone
Jeong-Hye Park, Se-Won Kang
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Urban-Rural Differences in Prevalence of Depressive Symptoms and Its Related Factors Among Older Adults: Findings from the Korean Longitudinal Study of Aging
Bongjeong Kim, Jinseub Hwang, Dohyang Kim, Soo Jin Kang
Research in Community and Public Health Nursing.2024; 35: 51. CrossRef
Global rural health disparities in Alzheimer's disease and related dementias: State of the science
Lisa Ann Kirk Wiese, Allison Gibson, Marc Aaron Guest, Amy R. Nelson, Raven Weaver, Aditi Gupta, Owen Carmichael, Jordan P. Lewis, Allison Lindauer, Samantha Loi, Rachel Peterson, Kylie Radford, Elizabeth K. Rhodus, Christina G. Wong, Megan Zuelsdorff, La
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Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study
Guangjun Zheng, Biying Zhou, Zhenger Fang, Chunxia Jing, Sui Zhu, Mingliang Liu, Xia Chen, Lei Zuo, Haiyan Chen, Guang Hao
BMC Psychiatry.2023;[Epub] CrossRef
Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis
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COVID-19: Original Article

Associations Between Compliance With Non-pharmaceutical Interventions and Social-distancing Policies in Korea During the COVID-19 Pandemic: Yu Seong Hwang, Heui Sug Jo; J Prev Med Public Health. 2021;54(4):230-237. Published online June 16, 2021; DOI: https://doi.org/10.3961/jpmph.21.139

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Abstract Summary PDF Supplementary Material

Objectives
This study explored changes in individuals’ behavior in response to social distancing (SD) levels and the “no gatherings of more than 5 people” (NGM5) rule in Korea during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
Using survey data from the COVID-19 Behavior Tracker, exploratory factor analysis extracted 3 preventive factors: maintenance of personal hygiene, avoiding going out, and avoiding meeting people. Each factor was used as a dependent variable. The chi-square test was used to compare differences in distributions between categorical variables, while binary logistic regression was performed to identify factors associated with high compliance with measures to prevent transmission.
Results
In men, all 3 factors were significantly associated with lower compliance. Younger age groups were associated with lower compliance with maintenance of personal hygiene and avoiding meeting people. Employment status was significantly associated with avoiding going out and avoiding meeting people. Residence in the capital area was significantly associated with higher compliance with personal hygiene and avoiding venturing out. Increasing SD levels were associated with personal hygiene, avoiding going out, and avoiding meeting people. The NGM5 policy was not significantly associated with compliance.
Conclusions
SD levels, gender, age, employment status, and region had explanatory power for compliance with non-pharmaceutical interventions (NPIs). Strengthening social campaigns to inspire voluntary compliance with NPIs, especially focused on men, younger people, full-time workers, and residents of the capital area is recommended. Simultaneously, efforts need to be made to segment SD measures into substrategies with detailed guidance at each level.

Summary

Korean summary
이 연구에서는 대한민국 정부가 COVID-19 방역 정책으로 시행한 ‘사회적 거리두기 단계 조절’과 ‘5인 이상 집합 금지 조치’에 대한 개인의 순응도를 파악하였다. 이를 위해 영국 임페리얼 대학이 2020년 4월부터 2021년 4월까지 24회에 걸쳐 한국인 총 13,300명에게 개인 행동을 조사한 공개 데이터를 분석하였다. 그 결과, 더 높은 수준의 사회적 거리두기 단계 – 특히 다중이용시설들이 폐쇄되는 2.5 단계 -에서 비약물적 중재 조치의 순응도와 더 강한 상관관계를 보였다. 그러나 5인 이상 집합금지는 순응도와 유의한 상관관계를 보이지 않아 사람들이 모임 인원을 제한할 뿐 지속적으로 모임을 하는 것으로 해석된다. 연령, 성별, 직업 구분, 거주지와 같은 인구-사회학적 특성들이 순응도에 영향을 주는 것으로 나타났으므로, 낮은 순응도를 보이는 인구집단의 순응도를 고취시킬 수 있도록 세부적인 전략 (예: 재택근무, 온라인회의, 온라인 수업 권장 등)이 필요하다.

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Gill Hubbard, Chantal den Daas, Marie Johnston, Jennifer Dunsmore, Mona Maier, Rob Polson, Diane Dixon
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Chieh Cheng, Wei-Ming Jiang, Byron Fan, Yu-Chieh Cheng, Ya-Ting Hsu, Hsiao-Yu Wu, Hsiao-Han Chang, Hsiao-Hui Tsou
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Jeong Hyun Ahn, Jin Young Nam
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Vince Fazekas-Pongor, Zsófia Szarvas, Norbert D. Nagy, Anna Péterfi, Zoltán Ungvári, Viktor J. Horváth, Szilvia Mészáros, Adam G. Tabák
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Risk Management and Healthcare Policy.2021; Volume 14: 4765. CrossRef

Original Articles

The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study: Mi-Ji Kim, Sung-Hyo Seo, Ae-Rim Seo, Bo-Kyoung Kim, Gyeong-Ye Lee, Yeun-Soon Choi, Jin-Hwan Kim, Jang-Rak Kim, Yune-Sik Kang, Baek-Geun Jeong, Ki-Soo Park; J Prev Med Public Health. 2019;52(6):405-415. Published online October 24, 2019; DOI: https://doi.org/10.3961/jpmph.19.166

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Abstract Summary PDF Supplementary Material

Objectives
The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas.
Methods
The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants’ frailty.
Results
The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy.
Conclusions
More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

Summary

Korean summary
본 연구는 우리나라 농촌지역 노인들이 인지하는 지역 환경과 노쇠의 연관성을 확인하기 위하여 자기보고식 설문지로 인지된 보행편의성 및 환경오염을 측정하였고, Kaigo-Yobo 평가척도로 노쇠를 평가하였다. 연구 결과, 노쇠에 영향을 미칠 것으로 예상되는 변수들을 통제한 후에도 인지된 보행편의성의 감소와 인지된 환경오염의 증가는 노쇠와 관련성이 있었다.

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Myung Ja Kim, C. Michael Hall
Current Issues in Tourism.2023; 26(2): 171. CrossRef
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Nicola Veronese, Laura Maniscalco, Domenica Matranga, Guido Lacca, Ligia J. Dominguez, Mario Barbagallo
Journal of the American Medical Directors Association.2023; 24(4): 475. CrossRef
Associations of Perceived and Objective Neighborhood Environment Attributes with Walking in Older Adults: A Cross-Sectional Study
Faezeh Behnamifard, Zohre Shafieiyoun, Mostafa Behzadfar
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Herney Rengifo-Reina, Tonatiuh Barrientos-Gutiérrez, Nancy López-Olmedo, Brisa N. Sánchez, Ana V. Diez Roux
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Blood Pressure and the Risk of Death From Non-cardiovascular Diseases: A Population-based Cohort Study of Korean Adults: Jeoungbin Choi, Jieun Jang, Yoonsuk An, Sue K. Park; J Prev Med Public Health. 2018;51(6):298-309. Published online November 14, 2018; DOI: https://doi.org/10.3961/jpmph.18.212

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Abstract Summary PDF Supplementary Material

Objectives
The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases.
Methods
We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model.
Results
Compared to normal levels (SBP <120 or DBP <90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85- 89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ≥160 mmHg) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ≥160 mmHg) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively).
Conclusions
An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.

Summary

Korean summary
2002년 및 2003년 한국 국민건강보험공단 건강검진 수검자 코호트(NHIS-HEALS) 중 506,508명을 대상으로 2013년 말일까지의 통계청 사망자료 기반 심뇌혈관질환을 제외한 기타 사망원인으로의 사망위험을 콕스회귀모형으로 분석한 결과에서 1단계 수축기 고혈압 군과 1단계 이완기 고혈압 군에서 당뇨, 알코올성 간질환, 콩팥부전 사망의 위험도가 통계적으로 유의하게 증가함을 보인 반면, 간질성 폐렴의 사망위험은 유의하게 감소함을 보였다. 2단계 수축기 고혈압 군에서는 폐렴, 간경화 및 허혈성 장질환의 사망위험이 증가하는 것을 보였다. 혈압의 증가가 기존에 알려진 심뇌혈관 질환 이외의 사망위험도에도 연관된 것으로 보이며, 고혈압의 질병부담 연구 및 보건정책 수립시 이 같은 점에 대한 고려가 필요하다.

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Brief Report

Throat Carriage Rate and Antimicrobial Resistance of Streptococcus pyogenes In Rural Children in Argentina: Gastón Delpech, Mónica Sparo, Beatriz Baldaccini, Gisela Pourcel, Sabina Lissarrague, Leonardo García Allende; J Prev Med Public Health. 2017;50(2):127-132. Published online January 4, 2017; DOI: https://doi.org/10.3961/jpmph.15.073

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Abstract PDF

Objectives
The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status.
Methods
Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin.
Results
The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate.
Conclusions
The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.

Summary

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Original Articles

Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults: Peter D. Hart, Gabriel Benavidez, James Erickson; J Prev Med Public Health. 2017;50(1):10-17. Published online December 19, 2016; DOI: https://doi.org/10.3961/jpmph.16.080

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Abstract PDF

Objectives
The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults.
Methods
A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables.
Results
Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker.
Conclusions
In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.

Summary

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C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population: Jung Hyun Lee, Hyungseon Yeom, Hyeon Chang Kim, Il Suh, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin, Sang-Baek Koh, Song Vogue Ahn, Tae-Yong Lee, So Yeon Ryu, Jae-Sok Song, Hong-Soon Choe, Young-Hoon Lee, Bo Youl Choi; J Prev Med Public Health. 2016;49(5):275-287. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.025

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Abstract PDF Supplementary Material

Objectives
C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods
A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results
The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions
Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.

Summary

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Review

Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective: Nina Roswall, Elisabete Weiderpass; J Prev Med Public Health. 2015;48(1):1-9. Published online January 27, 2015; DOI: https://doi.org/10.3961/jpmph.14.052

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Abstract PDF

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization’s prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

Summary

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Original Articles

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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Abstract PDF

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

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Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey.: Geun Yong Kwon, Do Sang Lim, Eun Ja Park, Ji Sun Jung, Ki Won Kang, Yun A Kim, Ho Kim, Sung Il Cho; J Prev Med Public Health. 2010;43(2):174-184.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.174

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OBJECTIVES
This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. METHODS: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. RESULTS: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. CONCLUSIONS: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

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English Abstract

Scientific Basis of Environmental Health Contingency Planning for a Coastal Oil Spill.: Young Min Kim, Hae Kwan Cheong, Jong Ho Kim, Jong Hun Kim, Kumsook Ko, Mina Ha; J Prev Med Public Health. 2009;42(2):73-81.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.73

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Abstract PDF

OBJECTIVES
This study presents a scientific basis for the establishment of an environmental health contingency plan for dealing with accidental coastal oil spills and suggests some strategies for use in an environmental health emergency. METHODS: We reviewed the existing literature, and analyzed the various fundamental factors involved in response strategies for oil spill. Our analysis included data derived from Hebei Spirit oil spill and used air dispersion modeling. RESULTS: Spill amounts of more than 1,000 kl can affect the health of residents along the coast, especially those who belong to vulnerable groups. Almost 30% of South Korean population lives in the vicinity of the coast. The area that is at the highest risk for a spill and that has the greatest number of people at risk is the stretch of coastline from Busan to Tongyeong. The most prevalent types of oil spilt in Korean waters have been crude oil and bunker-C oil, both of which have relatively high specific gravity and contain volatile organic compounds, polycyclic aromatic hydrocarbons, and metals. In the case of a spill of more than 1,000 kl, it may be necessary to evacuate vulnerable and sensitive groups. CONCLUSIONS: The government should establish environmental health planning that considers the spill amount, the types of oil, and the distance between the spot of the accident and the coast, and should assemble a response team that includes environmental health specialists to prepare for the future oil spill.

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