Journal of Preventive Medicine and Public Health

Original Articles

Are Non-standard Work Schedules Related to Sleep Difficulty and Health-related Quality of Life in Korea? An Examination of Gender Differences: Seowoo Park, Ji Sun Park, Moo Hyuk Lee, Young Kyung Do; J Prev Med Public Health. 2025;58(4):396-405. Published online April 15, 2025; DOI: https://doi.org/10.3961/jpmph.24.378

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Abstract Summary PDF Supplementary Material: Objectives
The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.
Methods
Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.
Results
Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.
Conclusions
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.; Summary

Korean summary
저녁 및 밤 시간대 근무는 수면을 포함한 건강 관련 삶의 질에 부정적 영향을 끼치며, 그 영향은 여성에서 더 크게 나타난다. 비표준시간대 근무는 중요한 공중보건학적 문제이다.

Key Message
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of health-related quality of life, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Exploring the Role of Social Welfare Expenditures in Depressive Symptoms Among Older Adults in Korea: Ji-Su Lee, Eun Sil Yoon, Yeongchae Song, Seowoo Park, Young Kyung Do; J Prev Med Public Health. 2025;58(4):370-378. Published online February 18, 2025; DOI: https://doi.org/10.3961/jpmph.24.403

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Abstract Summary PDF: Objectives
This study aimed to explore the role of community-level social welfare expenditures in depressive symptoms among older adults in Korea, with a particular focus on living arrangements.
Methods
Multi-level data—comprising individual-level data from the 2019 Community Health Survey and regional-level data from the Korean Statistical Information Service—were analyzed using multi-level ordered logistic regression. The dependent variable was the severity of depressive symptoms as measured by the Patient Health Questionnaire-9 score, and the primary independent variables were per capita social welfare expenditure, living arrangements, and their cross-level interaction term.
Results
Older adults living alone exhibited more severe depressive symptoms compared to those living with others (odds ratio [OR], 1.22; p=0.006). Higher community social welfare expenditure was significantly associated with reduced depressive symptom severity (OR, 0.73; p=0.019). Moreover, the protective effect of social welfare expenditure was more pronounced among older adults living alone than among those not living alone (OR, 0.92; p=0.046). Social welfare expenditure was highly correlated with social cohesion, which weakened its independent association with depressive symptoms.
Conclusions
This study highlights the potential of community-level social welfare expenditure to mitigate depressive symptoms among older adults, particularly those who live alone. In light of the rising number of older adults living alone, these findings suggest that non-medical interventions, such as enhanced social welfare programs, may help alleviate depression in this vulnerable population. The strong positive correlation between social welfare expenditure and social cohesion also raises further research questions regarding their interrelationship.; Summary

Korean summary
자치단체의 일인당 사회복지 지출이 증가할수록 해당 지역에 거주하는 노인의 우울 증상이 전반적으로 감소하는 결과를 보였고 이러한 연관성은 특히 독거 노인에게서 더 뚜렷하게 나타났다. 이 결과는 노인인구 규모 및 독거 노인 비율의 증가가 초래할 수 있는 노인 정신 건강의 부정적 영향을 비의료적, 사회적 개입을 통해 완화할 수 있음을 시사한다.

Key Message
Higher community-level social welfare expenditure was associated with lower severity of depressive symptoms among older adults, with this association more pronounced among those living alone. Given the rising number of older adults living alone, these findings highlight the potential of non-medical, social interventions to alleviate depression in this vulnerable population.

Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types: Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee; J Prev Med Public Health. 2025;58(1):83-91. Published online November 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.388

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Abstract Summary PDF Supplementary Material: Objectives
This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications.
Methods
Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as health behavior and healthcare utilization, utilizing individual weights to represent national community residents.
Results
We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types.
Conclusions
This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.; Summary

Korean summary
이 연구는 지방자치단체 층위와 도·농복합시를 포함한 도시화 정도, 인구 규모를 고려한 분류 기준을 사용하여 지역사회건강조사(KCHS)에 대한 새로운 분석틀의 가능성을 검토한다. 기초 지방자치단체 7가지 유형으로 분류했을 때, 연구 대상자 집단은 인구 통계학적 특성에 대해 유의미하게 달랐으며 건강 상태, 건강 행태 및 의료 이용에 뚜렷한 차이를 보였다. 이 연구는 지역보건의료계획 측면에서 지역사회 중심 건강증진사업에 대한 의사 결정에 실질적으로 효과적인 접근 방법이 될 수 있는 기초 지방자치단체의 새로운 유형을 제안한다.

Key Message
This study examines the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size. In comparisons of groups categorized by 7 local government types, populations were significantly different considering demographic characteristics and there were evident differences in health status, health behavior, and healthcare utilization. This study suggests a new typology of local governments which could be a practically effective approach in decision-making for community-centered health projects in terms of community health planning.

The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis: Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee; J Prev Med Public Health. 2025;58(1):60-71. Published online October 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.432

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1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on admission rates and in-hospital mortality among patients with ischemic and hemorrhagic stroke.
Methods
We constructed a dataset detailing the monthly hospitalizations and mortality rates of inpatients with stroke from January 2017 to December 2021. Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients.
Results
The number of ischemic stroke admissions decreased by 18.5%, from 5335 to 4348, immediately following the COVID-19 outbreak (p<0.001). The in-hospital mortality rate for ischemic stroke increased slightly from 3.3% to 3.4% immediately after the outbreak, although it showed a decreasing trend over time. The number of hemorrhagic stroke admissions fell by 7.5%, from 2014 to 1864, immediately following the COVID-19 outbreak. The 30-day in-hospital mortality rate for hemorrhagic stroke initially decreased from 12.9% to 12.7%, but subsequently showed an increasing trend.
Conclusions
We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. The admission rate for both ischemic and hemorrhagic strokes decreased, while in-hospital mortality increased. Specifically, in-hospital mortality from ischemic stroke rose initially after the outbreak before stabilizing. Additionally, our findings indicate variable effects based on sex, age, and socioeconomic status, suggesting that certain groups may be more susceptible. This underscores the need to identify and support vulnerable populations to mitigate adverse health outcomes.

Summary

Korean summary
국민건강보험공단 데이터베이스를 자료원으로 하고 ITS 분석을 실시하여 코로나19가 뇌졸중 환자의 입원 및 30일 내 사망률에 미치는 영향을 조사했습니다. 그 결과 코로나19가 뇌졸중 환자의 입원율과 사망률에 모두 영향을 미친다는 사실을 확인했습니다. 특히, 75세 이상과 의료급여 수급자의 허혈성 및 출혈성 뇌졸중 입원율이 감소한 것으로 나타났습니다.

Key Message
Employing an interrupted time series analysis, we explored the impact of COVID-19 on hospitalizations and 30-day in-hospital mortality among stroke patients using the National Health Insurance Service Database. We confirmed that COVID-19 impacted both the admission and death rates of stroke patients. Specifically, ischemic and hemorrhagic stroke admission rates decreased among individuals over 75 and MA beneficiaries.

Citations

Citations to this article as recorded by

Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea
Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee
Journal of Preventive Medicine and Public Health.2025; 58(2): 218. CrossRef

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