Journal of Preventive Medicine and Public Health

Tae Ho Yoon

8 Articles

Comparisons of Health Inequalities in Small Areas with Using the Standardized Mortality Ratios in Korea.: Ji Hyun Kim, Tae Ho Yoon; J Prev Med Public Health. 2008;41(5):300-306.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.300

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OBJECTIVES
This study was performed to compare the standardized mortality ratios among different small areas and to explore the usefulness of standardized mortality ratios in South Korea. METHODS: To calculate the standardized mortality ratio (SMR), we obtained the national deaths certificate data (2004-2006) and national registration population data (2003-2006), and these were provided by the National Statistical Office. The small areas (Eup.Myoun.Dong) were based on the subdivisions of counties. Among the 3,580 small areas classified by the National Statistical Office, 3,571 areas were included in this study. The basic statistics and decile distributions of the SMRs for all the regional levels were calculated, and the small area maps were also produced for some selected regions. To evaluate the precision of SMR, we calculated the 95% confidence intervals of the SMR in selected small areas. RESULTS: The mean and the standard deviation of the SMRs among all small areas were 100.8 and 17.0, respectively. The range was 30.6-211.7 and the inter-quartile range was 20.7. Seoul metropolitan city displayed the lowest mean SMR among 16 regions in South Korea, and 34.6 percent of the small area SMRs belonged to the first decile(the lowest group). On the contrary, the mean SMR of Gyeongsangnam province was highest, and 26.1 percent of the small area SMRs belonged to the tenth decile(the highest group). In some areas, the precision of the SMR, which was calculated by the 95% confidence intervals, remained questionable, yet it was quite stable for almost areas. CONCLUSIONS: The standardized mortality ratios can be useful for allocating health resources at the small area level in Korea.

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Comparison of three small-area mortality metrics according to urbanity in Korea: the standardized mortality ratio, comparative mortality figure, and life expectancy
Ikhan Kim, Hwa-Kyung Lim, Hee-Yeon Kang, Young-Ho Khang
Population Health Metrics.2020;[Epub] CrossRef
Life Expectancy in Areas around Subway Stations in the Seoul Metropolitan Area in Korea, 2008–2017
Ikhan Kim, Hee-Yeon Kang, Young-Ho Khang
Journal of Korean Medical Science.2020;[Epub] CrossRef
Use of the National Health Information Database for Estimating Town-Level Mortality in Korea: Comparison with the National Administrative Data, 2014–2017
Ikhan Kim, Youngs Chang, Hee-Yeon Kang, Yeon-Yong Kim, Jong Heon Park, Young-Ho Khang
Journal of Korean Medical Science.2019;[Epub] CrossRef
Trends in health-related behaviors of Korean adults: study based on data from the 2008 - 2014 Community Health Surveys
Yang Wha Kang, Yun Sil Ko, Keon Yeop Kim, Changhyun Sung, Dong Han Lee, Eunkyeong Jeong
Epidemiology and Health.2015; 37: e2015042. CrossRef
Changes and determinants affecting on geographic variations in health behavior, prevalence of hypertension and diabetes in Korean
Yoo-Mi Kim, Sung-Hong Kang
Journal of Digital Convergence.2015; 13(11): 241. CrossRef
Factors Affecting Diabetic Screening Behavior of Korean Adults: A Multilevel Analysis
Hyeongsu Kim, Minjung Lee, Haejoon Kim, Kunsei Lee, Sounghoon Chang, Vitna Kim, Jun Pyo Myong, Soyoun Jeon
Asian Nursing Research.2013; 7(2): 67. CrossRef
Socioeconomic inequalities in health status in Korea
Kyunghee Jung-Choi, Yu-Mi Kim
Journal of the Korean Medical Association.2013; 56(3): 167. CrossRef
A Comparison of Community Health Status by Region and an Investigation of related Factors using Community Health Indicators
Eunok Park
Journal of Korean Academy of Community Health Nursing.2012; 23(1): 31. CrossRef
〈 Field Action Report 〉 The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects
Baek-Geun Jeong, Jang-Rak Kim, Yune-Sik Kang, Ki-Soo Park, Jin-Hyang Lee, Sun-Rae Jo, Gi-Deok Seo, Sang-Jun Joo, Eun-Suk Oh, Seung-Jin Kim, Seong-Jin Jo, Seung-Mi Kim, Dong-Mun Yeum, Mi-Young Sim
Journal of agricultural medicine and community health.2012; 37(1): 36. CrossRef
Adherence to Physical Activity Among Older Adults Using a Geographic Information System: Korean National Health and Nutrition Examinations Survey IV
Hye-A Yeom, Dukyoo Jung, Mona Choi
Asian Nursing Research.2011; 5(2): 118. CrossRef
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
Journal of Preventive Medicine and Public Health.2010; 43(2): 174. CrossRef
Development of Composite Deprivation Index for Korea: The Correlation with Standardized Mortality Ratio
Hosung Shin, Suehyung Lee, Jang Min Chu
Journal of Preventive Medicine and Public Health.2009; 42(6): 392. CrossRef

The Proposal of Policies Aimed at Tackling Health Inequalities in Korea.: Tae Ho Yoon; J Prev Med Public Health. 2007;40(6):447-453.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.447

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Abstract PDF

Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.

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The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty
Sun Ok Eom, Insook Lee
Journal of Korean Academy of Nursing.2017; 47(3): 380. CrossRef
Health Behaviors, Health Status, and Utilization Patterns of Health Care Institutions for homeless shelter residents: Comparison of Younger and Older male residents
Hee Sang Yoon, Young Ran Han, Mi Sook Song
Journal of Korean Public Health Nursing.2013; 27(3): 578. CrossRef
Current status of policy developments in tackling health inequalities and the next steps to be taken in Korea
Myoung-Hee Kim, Joohee Lee
Journal of the Korean Medical Association.2013; 56(3): 206. CrossRef
Health Inequalities Policy in Korea: Current Status and Future Challenges
Young-Ho Khang, Sang-il Lee
Journal of Korean Medical Science.2012; 27(Suppl): S33. CrossRef
Task Analysis of Managers in the Customized Visiting Health Services
Young Ran Han, Young Rye Park, Young Hee Kim, Hee Chung Choi, Mi Ja Chung
Journal of Korean Academy of Community Health Nursing.2012; 23(2): 165. CrossRef
The Effect of a Health Promotion Program through Multi-level Health Promotion
Gyung-Hee Kim, Hee Sang Yoon
Journal of Korean Academy of Community Health Nursing.2010; 21(1): 92. CrossRef

Educational Differences in Health Care Utilization in the Last Year of Life among South Korean Cancer Patients.: Soo Young Choo, Sang Yi Lee, Chul Woung Kim, Su Young Kim, Tae Ho Yoon, Hai Rim Shin, Ok Ryun Moon; J Prev Med Public Health. 2007;40(1):36-44.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.36

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OBJECTIVES
There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. METHODS: To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. RESULTS: The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. CONCLUSIONS: This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.

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Cross-national differences in wealth inequality in health services and caregiving used near the end of life
Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina Suzuki
eClinicalMedicine.2023; 58: 101911. CrossRef
Socioeconomic differences in the perception of inequalities in healthcare utilization and health in South Korea
Nayeon Kim, Hye-won Yun, Juwon Park, Fatima Nari, Hee Jin Wang, Jae Kwan Jun, Kui Son Choi, Mina Suh
Preventive Medicine Reports.2023; 36: 102445. CrossRef
Cross-National Differences in Wealth Inequality in Health Services and Caregiving Used Near the End of Life
Jennifer A. Ailshire, Cristian A. Herrera, Eunyoung Choi, Margarita Osuna, Elina M. Suzuki
SSRN Electronic Journal .2022;[Epub] CrossRef
Socioeconomic position and use of healthcare in the last year of life: A systematic review and meta-analysis
Joanna M. Davies, Katherine E. Sleeman, Javiera Leniz, Rebecca Wilson, Irene J. Higginson, Julia Verne, Matthew Maddocks, Fliss E. M. Murtagh, Holly Gwen Prigerson
PLOS Medicine.2019; 16(4): e1002782. CrossRef
Joint Symposium of Korean Cancer Association & UICC-ARO—Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia
Eun-Cheol Park, Norie Kawahara, Shinjiro Nozaki, Hasbullah Thabrany, Shunya Yoshimi, Sohee Park, Duk Hyoung Lee, Hideyuki Akaza, Jae Kyung Roh
Japanese Journal of Clinical Oncology.2017; 47(9): 889. CrossRef
Medical Costs and Healthcare Utilization among Cancer Decedents in the Last Year of Life in 2009
Inuk Hwang, Dong Wook Shin, Kyoung Hee Kang, Hyung Kook Yang, So Young Kim, Jong-Hyock Park
Cancer Research and Treatment.2016; 48(1): 365. CrossRef
Barriers to Cancer Care, Perceived Social Support, and Patient Navigation Services for Korean Breast Cancer Patients
Jung-won Lim
Social Work in Health Care.2015; 54(1): 47. CrossRef
Equity in health care: current situation in South Korea
Hong-Jun Cho
Journal of the Korean Medical Association.2013; 56(3): 184. CrossRef
Inequalities in Medical Care Utilization by South Korean Cancer Patients According to Income: A Retrospective Cohort Study
Tae Ho Yoon, Sang-Yi Lee, Chul-Woung Kim, Su Young Kim, Baek-Geun Jeong, Hyeung-Keun Park
International Journal of Health Services.2011; 41(1): 51. CrossRef
Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data
Min Young Kim, Jong Ku Park, Sang Baek Koh, Chun-Bae Kim
Journal of Preventive Medicine and Public Health.2010; 43(6): 513. CrossRef

Developing the Predictive Model for the Group at High Risk for Colon Cancer.: Ae Kyoung Lee, Sang Yi Lee, Il Soo Park, Su Young Kim, Tae Ho Yoon, Baek Geun Jeong; J Prev Med Public Health. 2006;39(5):438-446.

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Abstract PDF: OBJECTIVES
We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. METHODS: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. RESULTS: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). CONCLUSIONS: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.; Summary

The Relationship between Regional Material Deprivation and the Standardized Mortality Ratio of the Community Residents Aged 15-64 in Korea.: Baek Geun Jeong, Kap Yeol Jung, Joon Youn Kim, Ok Ryun Moon, Yong Hwan Lee, Young Seoub Hong, Tae Ho Yoon; J Prev Med Public Health. 2006;39(1):46-52.

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Abstract PDF: OBJECTIVES
This study was performed to investigate the relationship between regional material deprivation and the standardized mortality ratios(SMRs) of community residents aged 15-64 in Korea. METHODS: SMRs were investigated using the registered death data from 1995 to 2000 that was obtained from the Korean National Statistics Office with the denominators being drawn from the 1995 to 2000 census. Material deprivation was measured using the Townsend score that was calculated from the 1995 to 2000 census. The relationship between the regional material deprivation and the SMRs of the community residents aged 15-64 was investigated by using ANOVA, Spearman's rank correlation analysis and Pearson's correlation analysis. The trends in mortality inequality were investigated using the concentration index. RESULTS: On the ANOVA, the SMRs of the men and women residents in the least deprived areas were the smallest and those in the most deprived areas were the largest. Spearman's rank correlation analysis, Pearson's correlation analysis and the concentration index revealed that significant positive relationships exist between the regional material deprivation and the SMRs of the community residents aged 15-64. CONCLUSIONS: This study suggests that there are mortality inequalities among the communities in Korea and part of this difference is due to the material deprivation of the community. Strategies aimed at reducing mortality inequalities among the communities will be needed to address economic inequalities. Further studies are needed to explore the mechanisms of how the regional deprivation influences on health and how the other factors of the community influence on the health of the community residents.; Summary

Socioeconomic Costs of Obesity for Korean Adults.: Baek Geun Jeong, Ok Ryun Moon, Nam Soon Kim, Jae Heon Kang, Tae Ho Yoon, Sang Yi Lee, Sin Jae Lee; Korean J Prev Med. 2002;35(1):1-12.

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Abstract PDF: OBJECTIVE
To estimate the socioeconomic costs of obesity in Korea, 1998. METHODS: The 1998 National Health and Nutrition Examination Survey (1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM (non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF (Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. RESULTS: The direct costs of obesity were 2,126 billion~965 billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion~1,086 billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4,225 billion~2,050 billion Won, which corresponded to about 0.094% ~0.046% of GDP and 1.88%~0.91 of total health care costs in Korea. CONCLUSIONS: Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. Further studies are needed to caculate socioeconomic costs of obesity more exactly.; Summary

Increasing Prevalence of Obesity Related Disease for Koreans Associated with Overweight and Obesity.: Nam Soon Kim, Ok Ryun Moon, Jae Heon Kang, Sang Yi Lee, Baek Geun Jeong, Sin Jae Lee, Tae Ho Yoon, Kyung Hwa Hwang; Korean J Prev Med. 2001;34(4):309-315.

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Abstract PDF: OBJECTIVE
To develop a better understanding of the relationship between weight status and the prevalence of obesity related diseases in the Korean population. METHODS: The 1998 Korean National Health and Nutrition Survey was used and 10,880 persons who had previously taken health examinations were selected for study. The Korean Society for the Study of Obesity's classification of weight status was used. Hypertension, diabetes mellitus, dyslipidemia, osteoarthritis, chronic heart disease, stroke were included as obesity related disease. A logistic regression model was developed to estimate the prevalence odds ratio by obesity class adjusted for demographic and socio-economic factors and we converted the odds ratio to a prevalence ratio using the base line prevalence of disease to aid in the interpretation of the ratios. RESULTS: The prevalence of obesity was 26.3% based on the KSSO classification (BMI> or =25). A graded increase in the prevalence ratio was observed with increasing severity of overweight and obesity for all health outcomes with the exception of chronic heart disease in men and stroke in both men and women. With normal weight individuals as the reference, for men who were younger than 50 years, the prevalence ratios were highest for hypertension BMI<23-25: 1.70(95% CI=1.41-2.05), 25 or =30: 4.83(95% CI=3.78-5.84). The prevalence ratios for dyslipidemia were as high as hypertension, but were lower than hypertension for diabetes mellitus and osteoarthritis. Prevalence ratios generally were greater in younger adults. The prevalence of having 2 or more obesity related diseases increased with weight status category, except in people who were older than 50 years. CONCLUSIONS: Based on results, obesity is an increasingly important health problem in Korea and the disease burden increases according to weight status. For Korean adults, the strongest relationship was seen between weight status and hypertension and dyslipidemia. In older people the impact of excess weight and obesity is stronger than that seen in younger people. Increased efforts in the study of obesity and prevention and treatment of obesity and obesity related disease are required.; Summary

Differences in Health Behaviors among the Social Strata in Korea.: Tae Ho Yoon, Ok Ryun Moon, Sang Yi Lee, Baek Geun Jeong, Sin Jae Lee, Nam Sun Kim, Won Ki Jhang; Korean J Prev Med. 2000;33(4):469-476.

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Abstract PDF: OBJECTIVES
To analyze differences in health behaviors among the social strata in Korea by using the 1995 National Health and Health Behavior Survey Data. METHODS: Study participants numbered 2,352 men and 1,016 women aged between 15-64 years old, with housewives, students and non-waged family workers excluded. Health behaviors in this study were defined according to the recommendations of the Alameda 7 study. The measure of health behaviors was based on the Health Practices Index(HPI; 0-5 range, with the exclusion of snacking between meals and regularly eating breakfast) developed by the Alameda County research. The significance of the relationship between social strata and HPI was assessed by considering the adjusted means from the multi-variate model. RESULTS: For men, incidence rates of never having smoked, no/moderate use of alcohol, regular exercise, and regular 7-8 hours sleep per night were higher in the upper social strata. Meanwhile, for women, incidence rates of never having smoked, no/moderate use of alcohol, appropriate weight, regular exercise, and regular 7-8 hours sleep per night were higher in the upper strata. HPI varied significantly among social strata in both sexes (p<0.001), a result which held true when adjusted for age, education, income, social insurance type, marital status and region. CONCLUSIONS: Health behaviors assessed by Health Practices Index(HPI) varied significantly among social strata for both sexes. Therefore, the existing gap in health behaviors among social strata can be corrected more effectively by target oriented health promotional activities.; Summary

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