- Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022
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So-Jin Im, Ji-Yeon Shin, Duk-Hee Lee
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J Prev Med Public Health. 2024;57(5):480-489. Published online August 20, 2024
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DOI: https://doi.org/10.3961/jpmph.24.254
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 Abstract
Summary
 PDF Supplementary Material
- Objectives
Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic’s impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method.
Methods
Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented.
Results
The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with “endocrine, nutritional, and metabolic diseases” and “symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified.”
Conclusions
Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.
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Summary
Korean summary
초과 사망은 팬데믹 영향을 종합적으로 평가하는 핵심 지표로 잘 알려져 있으나, 추정 방법에 따라 결과가 다양한 것으로 보고되고 있다. 코로나19 팬데믹동안 흔하게 사용된 3가지 방법 – 단순 평균, 연령보정 평균, 연령 보정 선형 회귀식-을 이용하여 초과사망을 추정하였을 때, 추정 방법에 따라서 초과사망에 큰 차이가 있었다. 3가지 방법 중 인구 고령화와 사망률 감소 추이를 고려한 연령 보정 선형 회귀식이 가장 적절한 것으로 판단되었으며, 이 방법을 이용한 한국의 초과 사망은 2020년 0.3%, 2021년 4.0%, 2022년 20.7%로 추정되었다. 또한 팬데믹 전 기간 동안 20대 초과 사망이 급증했는데 이는 주로 자해와 자살의 증가로 인한 것이었으며, '내분비, 영양 및 대사 질환' 및 ' 달리 분류되지 않은 증상, 징후와 임상 및 검사의 이상소견”으로 인한 초과사망도 급증하였다.
Key Message
● Excess deaths, a comprehensive indicator of the pandemic’s impact, varied by estimation method.
● Using an age-adjusted linear regression approach, which considers an aging population and declining mortality rates, excess deaths in Korea during the COVID-19 pandemic were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022.
● Excess deaths surged among individuals in their 20s throughout the pandemic, mainly due to increased self-harm and suicide, alongside a sharp rise in deaths related to ‘endocrine, nutritional, and metabolic diseases’, and ‘symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified’.
- Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study
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Somi Heo, Seyoung Kwon, Yu-Mi Lee, Ji-Yeon Shin, Duk-Hee Lee
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J Prev Med Public Health. 2020;53(1):45-55. Published online November 20, 2019
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DOI: https://doi.org/10.3961/jpmph.19.198
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Abstract
Summary
PDFSupplementary Material
- Objectives
This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.
Methods
This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.
Results
Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.
Conclusions
Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.
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Summary
Korean summary
본 연구에서는 새로운 소아청소년 고혈압 기준을 이용하여, 최근 한국과 미국 소아청소년들의 혈압 및 고혈압 유병률의 변화 추이를 비교하였다. 비만과 고혈압간의 높은 관련성에도 불구하고 한국과 미국 소아청소년의 고혈압 유병률과 비만율은 서로 다른 변화 추이를 나타내었으며, 고혈압 발생에 있어서 한국 소아청소년들이 미국 소아청소년들보다 비만에 더 취약할 가능성을 나타내고 있어 이에 관한 후속연구가 필요하다.
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Citations
Citations to this article as recorded by  - Association Between Obesity and Blood Pressure Among Iranian Children and Adolescents: A Sub-analysis from the SHED LIGHT Study
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