Journal of Preventive Medicine and Public Health

Perspective

Towards Mental Health Equity: Task Shifting Strategy to Overcome Barriers in Primary Healthcare Services in India: Suganya Panneerselvam, Senthilkumar Ramasamy, Sanjana Agrawal; J Prev Med Public Health. 2025;58(5):548-551. Published online June 13, 2025; DOI: https://doi.org/10.3961/jpmph.25.144

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Abstract Summary PDF: Mental illness remains among the top 10 causes of the global burden of disease. According to the National Mental Health Survey of India, 10.6% of adults exhibit mental disorders. India ideally requires 3 psychiatrists per 100 000 population, yet the current ratio is only 0.7 per 100 000. The country thus faces an urgent need to strengthen mental health infrastructure and expand training programs. Vulnerable groups—particularly residents of rural and remote areas, women, and older adults—are disproportionately affected by this situation. Individuals with mental illness often suffer in silence, enduring human rights violations, stigma, and discrimination. India’s National Mental Health Programme seeks to ensure the availability and accessibility of minimum mental health care for all, with a focus on the most vulnerable and underserved populations. The World Health Organization recommends task shifting or task sharing to improve access and deliver healthcare services in remote areas. Community Health Officers (CHOs) and Accredited Social Health Activists use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders. CHOs then ensure continuity of care through regular follow-up, bridging the gap between diagnosis and ongoing treatment. This practice significantly augments the effectiveness of community-level mental health interventions. Integrating mental health into primary health care should facilitate earlier detection and treatment of mental health disorders.; Summary

Key Message
Mental illness remains among the top 10 causes of the global burden of disease. Stigma associated with these disorders exacerbates the problem, leading to social discrimination. The Ayushman Bharat initiative is a transformative step towards strengthening India’s healthcare system. CHOs and ASHAs use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders within their communities. This task-shifting approach empowers local communities and fosters participation, reducing disease burden and offering a sustainable, effective model.

Original Articles

The Impact of Student-led Community Health Screenings on Clients’ Health Knowledge and Outcomes: A Qualitative Study in New Zealand: JiaRong Yap, Wendy Wenming Zhai, Cindy Seunghee Pak, Sharon Brownie; J Prev Med Public Health. 2025;58(2):167-176. Published online November 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.366

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Abstract Summary PDF: Objectives
This study investigated the impact of community health screenings (CHS) on the Asian community, focussing on the role of a student-led health and wellness centre in promoting and improving health outcomes. The CHS is a collaboration between Te Kotahi Oranga | Health and Wellness Centre and The Asian Network Incorporated, offering free health screenings to Asian migrants in the Waikato region, New Zealand.
Methods
Employing a qualitative approach, we interviewed clients who participated in the CHS to determine their perceptions regarding the effectiveness of the programme, its influence on their health knowledge and actions, and their overall satisfaction with the service. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.
Results
Data analysis utilising reflexive thematic analysis yielded 5 themes: satisfaction and appreciation for the free health screening; strengthened commitment to better personal health; barriers and challenges in accessing public healthcare services; improved knowledge and awareness of health risks; and provision of more health screening tests and health seminars. The findings highlight the significance of culturally tailored health initiatives in addressing healthcare disparities, emphasising the need for innovative strategies to ensure continuity of care and support for underserved populations.
Conclusions
This research contributes to the understanding of how student-led health interventions can enhance public health efforts and improve health outcomes in Asian and migrant communities.; Summary

Key Message
This study explores the impact of a student-led community health screening (CHS) programme on Asian migrants in New Zealand, focusing on its effects on health knowledge and outcomes. Through qualitative interviews, five key themes emerged: participant satisfaction, commitment to personal health, barriers to healthcare access, increased awareness of health risks, and the need for expanded screening services. The findings underscore the value of culturally tailored health initiatives in reducing healthcare disparities and highlight the role of student-led interventions in enhancing preventative care and promoting health equity in underserved populations.

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study: Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul; J Prev Med Public Health. 2025;58(2):156-166. Published online November 21, 2024; DOI: https://doi.org/10.3961/jpmph.24.415

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Abstract Summary PDF Supplementary Material: Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.; Summary

Key Message
- Pb and Cd level was not significant difference between e-waste workers and community-dwelling adults. - Pb and Cd can adversely affect symptoms in the MSD and PSQ affects the CNS in e-waste workers. - E-waste workers had a higher chance of having musculoskeletal disorder, central nervous system disorder, and skin disorder problems than community-dwelling adults but a lower chance of having depression and anxiety than community-dwelling adults.

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.

Perspective

The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Emmanuel Otieno, Josephine Namyalo; J Prev Med Public Health. 2024;57(1):91-94. Published online December 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.110

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Abstract Summary PDF

For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.

Summary

Key Message
For the Ugandans, nearly the last four decades have been years of hope, conflict, and resilience in a myriad of contexts for healthcare reform. Health insurance system has no legal framework and provides benefits not to the entire national population. The 2019 National Health Insurance scheme Bill was passed in 2021. If the President of Uganda assents to the National Health Insurance Bill, it will be a compelling policy in health and health for all policies. But this Bill has several drawbacks. In this perspective, we aimed to provide intricacies and mix of challenges and opportunities for the health sector.

Citations

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Medicina y Ética.2025; 36(3): 858. CrossRef
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Original Articles

The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’: Il-Ho Kim, Cheong-Seok Kim, Min-Hyeok Jeong; J Prev Med Public Health. 2023;56(6):495-503. Published online October 6, 2023; DOI: https://doi.org/10.3961/jpmph.23.022

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Abstract Summary PDF

Objectives
While older adults using community care services are known to be vulnerable for depression, community care utilization (CCU) may help to improve the mental health of these elderly. To date, however, it is much less clear how CCU affects depressive symptoms in the elderly population. This study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea.
Methods
Using the 2006-2019 Korean Welfare Panel Survey, this study is focused on elderly born in 1940 or earlier and selected 3281 persons for baseline interviews in 2006. This consisted of 35 800 person-year observations during a period of 14 years. Panel data analysis were employed to construct years of CCU.
Results
After controlling for covariates, linear term of years using community care was negatively associated with depressive symptoms, but a quadratic term was positively significant. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased. The level of depressive symptoms at the 14th year of using community care remains significantly lower than the level at the outset of its utilization.
Conclusions
This finding implies that CCU could be beneficial for improving mental health among older adults.

Summary

Korean summary
한국복지패널조사(2006-2019년)를 활용하여 지역사회 돌봄서비스의 이용기간(14년 간)에 따른 우울변화궤적을 분석하였다. 분석결과, 지난 14년간 돌봄서비스 이용기간에 따른 우울증상의 궤적은 U자형을 따랐다. 즉 노인은 돌봄서비스를 이용한 첫 해에 가장 높은 우울 수준을 보고하였으며, 이후 9년간 지속적으로 감소하였다가, 점차 증가하는 추세를 보였다.

Key Message
Using the 2006-2019 Korean Welfare Panel Survey, this study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased.

Citations

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Home- and community-based elderly care reform and mental health: evidence from China’s middle-aged and older adults
Shuni Zhang, Cui’e Zhang
Applied Economics.2026; : 1. CrossRef

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program: Joon-Hyeong Kim, Nam-Jun Kim, Soo-Hyeong Kim, Woong-Sub Park; J Prev Med Public Health. 2023;56(6):487-494. Published online August 17, 2023; DOI: https://doi.org/10.3961/jpmph.23.121

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Abstract Summary PDF

Objectives
Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.
Methods
This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.
Results
HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.
Conclusions
The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

Summary

Korean summary
건강주민운동은 지역사회 건강지표 향상에 기여한 것으로 보여진다. 따라서 주민참여형 건강증진사업이 주민들의 건강을 향상하기 위해서는 주민이 주체가 되어 조직화된 힘으로 지역사회의 근본적인 변화를 만들어가는 주민운동의 관점으로 시행될 필요가 있다.

Key Message
The Health Community Organization (HCO) appears to contribute to the enhancement of community health indicators. Therefore, in order to improve the health of residents through community-based participatory health promotion programs, it is necessary to implement them from the perspective of the HCO in which residents organize themselves as a mobilized force to bring about fundamental changes in the community.

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Comparative analysis of oral health behaviour and utilisation of oral health care services in the general population and among patients with non-communicable diseases in Korea: a repeated cross-sectional survey conducted from 2008 to 2022
Jeehee Pyo, Hyeran Jeong, Noor Afif Mahmudah, Young-Kwon Park, Minsu Ock, Pracheth Raghuveer
PLOS One.2025; 20(4): e0321816. CrossRef
Cumulative social-ecological risk factors and health-risk behaviors among Chinese adolescents: A latent class analysis
Xianwei Zhang, Xiaoyang Wang, Fengqin Li, Zhiying Sun, Ke Xu, Zhonghui Liu
Journal of Affective Disorders.2025; 388: 119614. CrossRef
Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung Park, Yoonyoung Jang, Taehwa Kim, Yunsu Choi, Kyoung Hwan Ahn, Jung Ho Kim, Hye Seong, Jun Yong Choi, Hyo Youl Kim, Joon Young Song, Shin-Woo Kim, Hee Jung Choi, Dae Won Park, Young Kyung Yoon, Sang Il Kim
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Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran: Mahdieh Niknam, Nasrin Omidvar, Parisa Amiri, Hassan Eini-Zinab, Naser kalantari; J Prev Med Public Health. 2023;56(1):77-87. Published online January 10, 2023; DOI: https://doi.org/10.3961/jpmph.22.409

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Abstract PDF Supplementary Material

Objectives
It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran.
Methods
A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively.
Results
The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions.
Conclusions
By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Summary

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The Community Readiness Instrument: A Quantitative Measurement Using Statistical Best Practices to Assess Systemic Change Readiness
Natalie M. Ricciutti, Jenny L. Cureton, Sijia Zhang
Behavioral Sciences.2026; 16(1): 153. CrossRef
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Ashley C. Helle, Karla T. Washington, Joan Masters, Kenneth J. Sher, Gregory A. Aarons, Kristin M. Hawley
Journal of Substance Use and Addiction Treatment.2025; 170: 209617. CrossRef
Improving community readiness among Iranian local communities to prevent childhood obesity
Mahdieh Niknam, Nasrin Omidvar, Hassan Eini-Zinab, Naser Kalantari, Keyvan Olazadeh, Parisa Amiri
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“Leisure Life Satisfaction:” Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings in Korea?: Il-Ho Kim, Cheong-Seok Kim; J Prev Med Public Health. 2022;55(4):398-406. Published online July 7, 2022; DOI: https://doi.org/10.3961/jpmph.22.160

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Abstract Summary PDF

Objectives
While the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults.
Methods
This study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older.
Results
After controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization.
Conclusions
The findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.

Summary

Korean summary
본 연구는 2019년 한국복지패널조사의 4,494명의 노인들을 대상으로 돌봄노인의 우울 수준과 여가생활 만족의 조절효과를 검증하였다. 연구결과, 돌봄노인의 우울증상이 일반노인에 비하여 유의하게 높았다(p<0.001). 반면 여가생활 만족은 돌봄서비스 이용노인의 우울 증상을 조절하는 효과가 있었다. 이 연구의 결과는 여가생활 만족이 돌봄노인의 정신건강을 향상시키는데 의미 있는 역할을 할 수 있다는 것을 암시한다.

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The association between self-rated health, number of family members, and cognitive function in community-dwelling older adults: Mediating role of depression
Suyeong Bae, Yumi Ju, Sanghun Nam, Yeonju Jin, Sura Kang, Jeh-Kwang Ryu, Ickpyo Hong, Ali B. Mahmoud
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Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006–2018)
Bo Zhao, Ji Eon Kim, Jiyoung Moon, Eun Woo Nam
SSM - Population Health.2023; 21: 101341. CrossRef
Do the various leisure forms have equal effects on mental health? A longitudinal analysis of self-selected leisure activities
Junyi Bian, Zubing Xiang
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Development of a prediction model for the depression level of the elderly in low-income households: using decision trees, logistic regression, neural networks, and random forest
Kyu-Min Kim, Jae-Hak Kim, Hyun-Sill Rhee, Bo-Young Youn
Scientific Reports.2023;[Epub] CrossRef
The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’
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Journal of Preventive Medicine and Public Health.2023; 56(6): 495. CrossRef

A Multi-level Analysis of Factors Affecting Participation in Health Screenings in Korea: A Focus on Household and Regional Factors: So Yoon Park, Young-jeon Shin; J Prev Med Public Health. 2022;55(2):153-163. Published online October 27, 2021; DOI: https://doi.org/10.3961/jpmph.21.268

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174 Download
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Abstract Summary PDF Supplementary Material

Objectives
This study divided the factors that affect participation in health screenings into individual, household, and regional levels and conducted a multi-level analysis to identify the factors related to participation in health screenings.
Methods
Participants from the 2017 Community Health Survey were classified into 2 groups (under 40 and 40 or older). A multi-level logistic regression analysis was conducted to identify the factors that affected participation in health screenings.
Results
The screening rate of the participants was 69.7%, and it was higher among participants aged 40 and older (80.3%) than it was among participants younger than 40 (49.8%). At the individual level, the factors that influenced participation in health screenings included age, economic activity, smoking status, physician-diagnosed hypertension, and a moderate or high physical activity level. At the household level, the odds ratio of participation in health screenings was high for participants who lived in single-person households, lived with a spouse, earned a high monthly household income, and were not beneficiaries of national basic livelihood security. At the regional level, the odds ratio at the 95% confidence interval level of participation in health screenings was high for participants who had trust in the local community and lived in an area with a proportionally high social welfare budget.
Conclusions
This study analyzed nationalwide data and confirmed that individual, household, and regional characteristics affected participation in health screenings. Therefore, policies that prioritize the improvement of regional level factors and especially household level factors are likely to be the most effective for improving the screening rate.

Summary

Korean summary
이 연구는 건강검진 수검 여부에 영향을 미치는 요인을 개인, 가구, 지역수준으로 나누어 다수준 분석을 통해 분석하였다. 건강검진 수검여부에 개인 특성뿐만 아니라 개인을 둘러싼 가구와 지역의 특성도 영향을 미친다는 것을 확인하였다. 영향요인들의 유의성을 바탕으로, 건강검진 수검률 향상을 위한 정책을 수립할 때 지역수준 요인뿐만 아니라 특별히 가구수준 요인을 개선할 수 있는 정책을 우선하는 것이 효과적일 것이다.

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Factors Related to Regional Variation in the High-risk Drinking Rate in Korea: Using Quantile Regression: Eun Su Kim, Hae-Sung Nam; J Prev Med Public Health. 2021;54(2):145-152. Published online March 16, 2021; DOI: https://doi.org/10.3961/jpmph.20.507

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to identify regional differences in the high-risk drinking rate among yearly alcohol users in Korea and to identify relevant regional factors for each quintile using quantile regression.
Methods
Data from 227 counties surveyed by the 2017 Korean Community Health Survey (KCHS) were analyzed. The analysis dataset included secondary data extracted from the Korean Statistical Information Service and data from the KCHS. To identify regional factors related to the high-risk drinking rate among yearly alcohol users, quantile regression was conducted by dividing the data into 10%, 30%, 50%, 70%, and 90% quantiles, and multiple linear regression was also performed.
Results
The current smoking rate, perceived stress rate, crude divorce rate, and financial independence rate, as well as one’s social network, were related to the high-risk drinking rate among yearly alcohol users. The quantile regression revealed that the perceived stress rate was related to all quantiles except for the 90% quantile, and the financial independence rate was related to the 50% to 90% quantiles. The crude divorce rate was related to the high-risk drinking rate among yearly alcohol users in all quantiles.
Conclusions
The findings of this study suggest that local health programs for high-risk drinking are needed in areas with high local stress and high crude divorce rates.

Summary

Korean summary
본 연구는 quantile regression을 이용하여 high risk drinking 의 지역간 변이 요인을 파악하였습니다. 연구결과, high risk drinking rate 의 지역간 변이가 크고, quanile별로 관련요인을 다르다는 것을 파악하였습니다. 본 연구의 결과는 높은 지역의 스트레스와 조이혼율의 관리와 함께 지역 고위험음주율의 건강프로그램이 필요하다는 것을 암시한다.

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Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly: Kiryong Nam, Eunhye Park, Yuhjin Chung, Chang-yup Kim; J Prev Med Public Health. 2020;53(6):455-464. Published online October 20, 2020; DOI: https://doi.org/10.3961/jpmph.20.341

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Abstract PDF

Objectives
The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals.
Methods
This study used online data on Korean national law to gather information on individual local governments’ regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources.
Results
The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48).
Conclusions
The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

Summary

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Access of older people to primary health care in low and middle-income countries: A systematic scoping review
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COVID-19: Perspective

Unconventional Answers to Unprecedented Challenges: The Swedish Experience During the COVID-19 Outbreak: Giuseppe Valeriani, Iris Sarajlic Vukovic, Richard Mollica; J Prev Med Public Health. 2020;53(4):233-235. Published online July 22, 2020; DOI: https://doi.org/10.3961/jpmph.20.235

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Abstract PDF

Since its early stages, the coronavirus disease 2019 (COVID-19) pandemic has posed immense challenges in meeting the public health and healthcare and social care needs of migrants. In line with other reports from United Kingdom and United States, data from Sweden’s health authority show that migrants have been disproportionately affected by COVID-19. Following the World Health Organization’s statements, as well as the European Public Health Association’s call for action, several centres in Sweden’s most populated areas have activated tools to implement national plans for community outreach through initiatives targeting migrants and ethnic minority groups. Unconventional means should be promoted to mitigate the impact of COVID-19 on migrants and the health of the public at large.

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Original Articles

The Role of Social Support and the Neighborhood Environment on Physical Activity in Low-income, Mexican-American Women in South Texas: Jennifer J. Salinas, Marisol McDaniel, Deborah Parra-Medina; J Prev Med Public Health. 2018;51(5):234-241. Published online July 25, 2018; DOI: https://doi.org/10.3961/jpmph.18.052

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Abstract PDF

Objectives
To determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias.
Methods
The dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale.
Results
Enlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p<0.001) unit increase in sedentary break and a −0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (β=0.296; p=0.002) and PASS scores (β=0.076; p<0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration.
Conclusions
The findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.

Summary

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Factors That Affect Suicidal Attempt Risk Among Korean Elderly Adults: A Path Analysis: Junsoo Ro, Jongheon Park, Jinsuk Lee, Hyemin Jung; J Prev Med Public Health. 2015;48(1):28-37. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.030

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Abstract PDF

Objectives
Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects.
Methods
Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson’s correlation test, and path analysis.
Results
Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts.
Conclusions
Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

Summary

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The Effect of Sleep Duration on the Risk of Unintentional Injury in Korean Adults: Yeon-Yong Kim, Un-Na Kim, Jin-Seok Lee, Jong-Heon Park; J Prev Med Public Health. 2014;47(3):150-157. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.150

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Abstract PDF

Objectives

The decrease or increase in sleep duration has recently been recognized as a risk factor for several diseases, including hypertension and obesity. Many studies have explored the relationship of decreased sleep durations and injuries, but few have examined the relationship between increased sleep duration and injury. The objective of this research is to identify the risk for injury associated with both decreased and increased sleep durations.

Methods

Data from the 2010 Community Health Survey were used in this study. We conducted logistic regression with average sleep duration as the independent variable, injury as a dependent variable, and controlling for age, sex, occupation, education, region (cities and provinces), smoking, alcohol use, body mass index, hypertension, diabetes, arthritis, and depression. Seven categories of sleep duration were established: ≤4, 5, 6, 7, 8, 9, and ≥10 hours.

Results

Using 7 hours of sleep as the reference, the adjusted injury risk (odds ratio) for those sleeping a total of ≤4 h/d was 1.53; 1.28 for 5 hours, for 1.11 for 6 hours, 0.98 for 8 hours, 1.12 for 9 hours, and 1.48 for ≥10 hours. The difference in risk was statistically significant for each category except for the 8 and 9 hours. In this study, risk increased as the sleep duration decreased or increased, except for the 8 and 9 hours.

Conclusions

This research found that either a decrease or increase in sleep duration was associated with an increased risk for injury. The concept of proper sleep duration can be evaluated by its associated injury risk.

Summary

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Implementation and Results of a Survey on Safe Community Programs in Gangbuk-gu, Korea: Focusing on Participants at a Local Public Health Center: Hyun-Joong Kim, Se-Min Hwang, In-Young Lee, Joon-Pil Cho, Myoung-Ok Kwon, Jae-Hun Jung, Ju-Young Byun; J Prev Med Public Health. 2014;47(1):47-56. Published online January 29, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.1.47

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Abstract PDF

Objectives

The purpose of this study was to investigate the current status of and problems with the Safe Community Programs in Gangbuk-gu, one of the 25 districts of the capital city of Korea.

Methods

The study subjects were 396 individuals who were involved in Safe Community Programs between 2009 and 2011. We examined the effectiveness and willingness of respondents to participate as a safety leader of the Safe Community Program with a questionnaire. We examined the injury death rates of Gangbuk-gu by using of the death certificate data of Korea's National Statistical Office. Descriptive statistics and chi-squared tests were used.

Results

The effectiveness of programs did not differ but active participation differed significantly among subjects (p<0.05). The injury death rate of Gangbuk-gu as a whole increased during the implementation period. However, senior safety, in particular, may be a helpful program for reducing injuries in Gangbuk-gu.

Conclusions

This study suggests that the lack of active participation may be a major problem of Safe Community Programs in Gangbuk-gu. Therefore, Safe Community Programs should be expanded to the entire district of Gangbuk-gu and more active participation programs should be developed.

Summary

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English Abstract

Awareness, Treatment and Control of Hypertension and Related Factors in the Jurisdictional Areas of Primary Health Care Posts in a Rural Community of Korea.: Hyung Min Lee, Yu Mi Kim, Cheol Heon Lee, Jin Ho Shin, Mi Kyung Kim, Bo Youl Choi; J Prev Med Public Health. 2011;44(2):74-83.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.74

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OBJECTIVES
This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. METHODS: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP > or =140 mmHg, a diastolic BP > or =90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. RESULTS: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. CONCLUSIONS: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.

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Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea
Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
Korean Journal of Family Medicine.2020; 41(2): 119. CrossRef
Performance of a Community-based Noncommunicable Disease Control Program in Korea: Patients 65 Years of Age or Older
Sun Mi Lim, Sung-Hyo Seo, Ki Soo Park, Young Hwangbo, Yeonok Suh, Sungin Ji, Jeongmook Kang, Hyeonji Hwang, Jose Rene Bagani Cruz, Yoon Hyung Park
Journal of Korean Medical Science.2020;[Epub] CrossRef
The Effect of Special Medical Examination for Night Shift Workers and Follow-Up Management Against Hypertension
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Decrease in Smoking and Related Factor after the Price Raise of Tobacco in Hypertension Patients: Using 2015 Korea National Health and Nutrition Examination Survey
Mi Hyun Joo, Mi Ah Han, Jong Park, Seong Woo Choi, So Yeon Ryu, Jun Ho Shin
Journal of Health Informatics and Statistics.2019; 44(1): 83. CrossRef
Evaluation of Community-based Hypertension Control Programme in South Korea
Sun Mi Lim, Yoon Hyung Park, Won Gi Jhang, Young Taek Kim, Eun Mi Ahn, Ga Hyun Kim, Young Hwangbo
Annals of the Academy of Medicine, Singapore.2018; 47(4): 143. CrossRef
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Hypertension awareness and the related factors by age
Heeran Chun, Il-Ho Kim
Korean Journal of Health Education and Promotion.2016; 33(5): 37. CrossRef
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Yeong Ju Ko, Eunok Park
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Review

Prevention in the United States Affordable Care Act.: Charles M Preston, Miriam Alexander; J Prev Med Public Health. 2010;43(6):455-458.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.455

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Abstract PDF

The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.

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Research Support, Non-U.S. Gov'ts

The Validity and Reliability of a Screening Questionnaire for Parkinson's Disease in a Community.: Jong Hun Kim, Hae Kwan Cheong, Chong Sik Lee, Sung Eun Yi, Kun Woo Park; J Prev Med Public Health. 2010;43(1):9-17.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.9

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OBJECTIVES
Parkinson's disease is one of the most common neurodegenerative diseases in the elderly population. In order to estimate the prevalence of Parkinson's disease in the community, the application of a good screening tool is essential. We evaluated the validity and reliability of a Parkinson's disease screening questionnaire and propose an alternative measure to improve its validity for use in community surveys. METHODS: We designed the study in a three-phase approach consisting of a screening questionnaire, neurologic examination, and confirmatory examination. A repeated survey was administered to patients with disease detected in the community and on 150 subjects. We examined internal consistency using Cronbach's alpha test, test-retest reliability using the kappa statistic, and validity using sensitivity, specificity, and ROC curves. Unadjusted odds ratios were utilized for the estimation of weights for each questionnaire item. RESULTS: The Cronbach's alpha of the questionnaire was 0.708. The kappa statistic for test-retest reliability was good to generally fair in most of the items. When newly proposed weighting scores were used, the optimum cut-off value was 7/8. When cut-off value was 5/6 for surveying prevalence in a community, the sensitivity was 0.98, and the specificity was 0.61, with simultaneous improvement in reliability. CONCLUSIONS: We recommend 5/6 as the ideal cut-off value for the survey of PD prevalence in community. This questionnaire designed for the Korean community could help future epidemiologic studies of PD.

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The rise of Parkinson’s disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and “eat, move, sleep” lifestyle interventions to prevent or slow the rise of non-communicable dise
Roongroj Bhidayasiri, Jirada Sringean, Saisamorn Phumphid, Chanawat Anan, Chusak Thanawattano, Suwijak Deoisres, Pattamon Panyakaew, Onanong Phokaewvarangkul, Suppata Maytharakcheep, Vijittra Buranasrikul, Tittaya Prasertpan, Rotjana Khontong, Priya Jagot
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Severity of Daytime Sleepiness and Parkinsonian-Like Symptoms in Korean Adults Aged 50–64 Years
Chol Shin, Regina E. Y. Kim, Robert J. Thomas, Chang-Ho Yun, Seung Ku Lee, Robert D. Abbott
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K. M. Prasanna Kumar, Bipin Kumar Sethi, Sanjay P. Khare, Mahesh Padsalge, Anadya Prakash Tripathi, Milind Bhole, Dyotona Sen Roy
Thyroid Research and Practice.2021; 18(2): 74. CrossRef
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Nathan A Walker, Jag Sunderram, Peng Zhang, Shou-en Lu, Matthew T Scharf
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Michele K. York, Jared F. Benge, Christine Hunter, Joseph Jankovic
Journal of the Neurological Sciences.2020; 418: 117116. CrossRef
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Ji Won Han, Tae Hui Kim, Kyung Phil Kwak, Kayoung Kim, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Tae Hyun Kim, Seok Woo Moon, Jae Young Park, Joon Hyuk Park, Seonjeong Byun, Seung Wan Suh, Ji Young Seo, Yoonseop So, Seung-Ho Ryu, Jong Chul Youn, Kyoung
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Jose Danilo B. Diestro, Mark Angelo C. Ang, Mark Willy L. Mondia, Paul Matthew D. Pasco
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Assessment of Community Capacity Building Ability of Health Promotion Workers in Public Health Centers.: Jung Min Kim, Kwang Wook Koh, Byeng Chul Yu, Man Joong Jeon, Yoon Ji Kim, Yun Hee Kim; J Prev Med Public Health. 2009;42(5):283-292.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.283

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OBJECTIVES
This study was performed to assess the community capacity building ability of health promotion workers of public health centers and to identify influential factors to the ability. METHODS: The subjects were 43 public officers from 16 public health centers in Busan Metropolitan City. Questionnaire was developed based on 'Community Capacity Building Tool' of Public Health Agency of Canada which consists of 9 feathers. Each feather of capacity was assessed in 4 point rating scale. Univariate analysis by characteristics of subjects and multivariate analysis by multiple regression was done. RESULTS: The mean score of the 9 features were 2.35. Among the 9 feathers, 'Obtaining resources' scored 3.0 point which was the highest but 'Community structure' scored 2.1 which was the lowest. The mean score of the feathers was relatively lower than that of Canadian data. The significant influential factors affecting community capacity building ability were 'Service length', 'Heath promotion skill level', 'Existence of an executive department' and 'Cooperative partnership for health promotion'. According to the result of multiple linear regression, the 'Existence of an executive department' had significant influence. CONCLUSIONS: Community capacity building ability of subjects showed relatively lower scores in general. Building and activating an executive department and cooperative partnerships for health promotion may be helpful to achieve community capacity building ability.

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Community capacity for prevention and health promotion: a scoping review on underlying domains and assessment methods
Vera Birgel, Lea Decker, Dominik Röding, Ulla Walter
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Vesa Saaristo
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Original Articles

A Study on Characteristics of Core Projects Described in 3rd Community Health Plans.: Dong Moon Kim, Weon Young Lee, Chang Yup Kim, Ok Ryun Moon; J Prev Med Public Health. 2004;37(1):88-98.

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Abstract PDF: OBJECTIVE
The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. METHODS: Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k> 0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. RESULTS: The survey was used by 59.8 % of samples as a core project decision-making method. The participants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. CONCLUSION: The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health.; Summary

A Survey on Prenatal Environmental Risk Factors for Mothers of Low Birth Weight Infants in Asan-City.: Heeyoung Lee, Seok Jun Yoon, Hyungsik Ahn, Mina Ha, Kyung Sim Koh, Kyung Ja June; J Prev Med Public Health. 2004;37(1):11-16.

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Abstract PDF: OBJECTIVE
In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. METHODS: In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questions given to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the two groups were compared to calculate the prenatal environmental risk factors of each group. RESULTS: Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio (AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. CONCLUSION: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.; Summary

Factors Associated with Hypertension Control and Antihypertensive Medication among Hypertensive Patients in a Community.: Dong Han Lee, Youn Hee Choi, Kang Hee Lee, Dae Ryong Kang, Sun Ha Jee, Chung Mo Nam, Il Suh; Korean J Prev Med. 2003;36(3):289-297.

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Abstract PDF: OBJECTIVES
The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. METHODS: The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic > or=140 or diastolic > or= 90mmHg) in 1999. We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with x2-test. We also performed logistic regression analysis. RESULTS: The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. CONCLUSIONS: Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.; Summary

Community Based Study for Stress and It's Related Factors.: Gyung Jae Oh, Jeong Mi Lee, Sang Sun Kil, Keun Sang Kwon; Korean J Prev Med. 2003;36(2):125-130.

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Abstract PDF: OBJECTIVES
This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.; Summary

Evaluation of Measles Vaccine Effectiveness in a Community Outbreak.: Byung Chan Park, Hae Kwan Cheong, Sue Kyung Park; Korean J Prev Med. 2002;35(1):33-40.

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Abstract PDF: OBJECTIVE
From an analysis of a community outbreak of measles in Youngju, Gyeongbuk, in March 2000, the authors evaluated the effectiveness of the measles vaccination and its determinants to provide an epidemiologic basis for the establishment of a vaccination policy. METHODS: Information was collected regarding the vaccinations from the health records of four primary schools and through a questionnaire survey of the parents of students in two middle and two high schools (N=4638). Measles cases were surveyed from the patient list of each school and from case reports in the public health center. The attack rate and vaccine effectiveness of measles was evaluated by school; grade; frequency, region, and institution of vaccination. RESULTS: The attack rate of measles, 6.3% among the total subjects, was higher in middle school students (15.8%) than in primary (2.0%, p<0.05) and high school students (8.9%, p<0.05). The attack rate of the unvaccinated group was 4.6-fold higher than the vaccinated group in primary schools (p<0.05). Vaccine effectiveness was 83.2% among lower graders of primary schools, 34.0% among higher graders of primary schools, 26.1% in middle schools, and -7.0% in high schools. In multiple logistic regression analysis, grade in school (odds ratio, 0.77; 95% CI=0.67-0.87) and frequency of vaccination (odds ratio, 0.57; 95% CI=0.37-0.88) were significant predictors of the outcome. CONCLUSIONS: We concluded that the explosive outbreak of measles in this area resulted from both inadequate vaccination coverage and secondary failure of vaccination. There was no evidence of any effect of the cold chain system on the vaccine failure.; Summary

Association of Blood Pressure with the Social Support of Some Rural Residents.: So Yeon Ryu, Chul Gab Lee, Jong Park, Ki Soon Kim; Korean J Prev Med. 2001;34(4):437-443.

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Abstract PDF: OBJECTIVES
This study was performed to assess the association between the social support and blood pressure(BP) in a rural community. METHODS: A cross-sectional survey, comprising a health examination including BP, height and weight and a questionnaire-based interview which investigated social support, demographic factors, smoking, drinking, and etc. was performed between February 10th and March 5th, 1998. The survey included 318 persons who were over than 30-year-old in the rural community of Kwangju, Republic of Korea. We excluded persons who taking antihypertensive medications or who provided incomplete information; we subsequently analyzed the data from 284 persons. In order to test the hypothesis of an association between BP and social support controlling confounders such as age, educational level, working time, body mass index, smoking and drinking, the data was analyzed using multiple linear regression analysis. RESULTS: The subjects were composed of 109(38.4%) males and 175(61.6%) females with mean ages of 62.0 years and 61.1 years, respectively. The hypertension prevalence was 41.3% among males and 45.1% among females. In the correlation analysis, higher total social support scores correlated significantly with lower systolic BP in both males and females. The hypertension prevalence increased significantly with the decreasing of the social support in males. In multiple regression analysis, systolic and diastolic blood pressure showed a negative association with social support in both males and females, although this was not statistically significant. CONCLUSIONS: Larger and broader studies are required in the future in order to identify the association between the social support and BP.; Summary

Development and Evaluation of the Reliability and Validity of the VSSS-82 Korean Version for Measuring Satisfaction with Community-based Mental Health Services in Psychiatric Patients.: Weon Seob Yoo, Young Jeon Shin, Ok Ryun Moon, Jung Hyun Nam; Korean J Prev Med. 2001;34(3):211-218.

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Abstract PDF: OBJECTIVES
To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.; Summary

A Study on the Family Burden of the Mentally Ill in a Rural Area.: Weon Young Lee, Young Jeon Shin, Jung Hoe Kim, Chung Hyun Nam, Ok Ryun Moon; Korean J Prev Med. 1999;32(3):400-414.

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Abstract PDF: OBJECTIVES
This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. METHODS: Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. RESULTS: Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. CONCLUSIONS: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.; Summary

Prevalence Estimation of Several Chronic Diseases through Community Based Health Examination Survey.: Soon Young Lee, Geun Shik Han, Young Ok Kim, Hae Kyung Kim, Byoung Hyun Min; Korean J Prev Med. 1999;32(1):40-47.

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Abstract PDF: OBJECTIVES
The health examination survey was conducted in order to estimate the prevalence of major chronic diseases in a community. METHODS: A multi-stage stratified probability sample of 1,656 persons, aged from 20 to 69 years, was drawn out from Kuri City. All sampled persons were personally informed of the purpose, content and procedures of the survey and mobile examination center was run between 6 AM and 9 PM for the convenience of the participants. RESULTS: 854 persons (339 males and 515 females) completed this survey with a response rate of 53.4%. Prevalent diseases in male were hypertension(19.0%), HBs Ag carrier(9.8%), impaired glucose tolerance(8.7%), diabetes mellitus(6.3%), hypercholesterolemia(3.4%), anemia(2.7%) and degenerative arthritis(2.6%) in order of prevalence rate. Prevalent diseases in female were osteoporosis(22.5%), impaired glucose tolerance(17.3%), anemia(12.8%), hypertension(12.4%), degenerative arthritis (6.6%), HBs Ag carrier(5.8%), diabetes mellitus(5.4%) and hypercholesterolemia(3.5%) in order of prevalence rate. CONCLUSIONS: This results suggest that hypertension was most prevalent in adult male whereas diabetes mellitus including IGT, osteoporosis were most prevalent in adult female, in Kuri City.; Summary

Electrocardiographic findings of a Community People by Computerized Device for Analysis.: Esun Koo, Jae Young Kim, Hae Joon Kim; Korean J Prev Med. 1998;31(2):183-198.

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Abstract PDF: In order to determine the prevalence rate and find out the sexual difference of abnormal electrocardiographic findings manifested by computerized EKG, which is equipped with auto-analyzing function, a total of 2,083 electrocardiograms that were taken from population over 20 years-old from October 1996 to February, 1997 were studied according to their age, gender and blood pressure. l. Using the electrocardiography, with auto-analyzing function, 33 kinds of abnormal findings were manifested. The prevalence rate of abnormal findings was 52.8% in male and 43.7% in female. Among them, the most common finding was sinus bradycardia found in 17.6% of male and 15.4% of female. Left ventricular hypertrophy by voltage criteria, minimal voltage of left ventricular hypertrophy, left axis deviation and atrial fibrillation were more common in male than in female statistically. Both of nospecific T wave and ST segment abnormality were more common in female than in male statistically. 2. Thirty-three kinds of abnormal findings were manifested. They revealed one abnormal finding alone or combined with some other ones making 128 kinds of abnormal findings. The most common abnormal finding that manifested alone was right axis deviation (100%), then myocardial ischemia (95.7%) the next. The most common abnormal finding that complexed with other abnormal findings were left anterior fascicular block(percentage of single manifestation; 26.2%) and nonspecific T wave abnormality(percentage of single manifestation; 32.9%). Also, combination of sinus bradycardia and minimal voltage of left ventricular hypertrophy, and combination of sinus bradycardia and left ventricular hypertrophy were included in 25th sequences of abnormal findings. 3. The prevalence rate of abnormal electrocardiographic findings were higher in older group, hypertensive group, and the group of higher systolic or diastolic pressure in both sexes. 4. Abnormal findings that commonly manifested with sinus bradycardia were voltage criteria or minimal voltage of left ventricular hypertrophy(38.6%): sinus arrhythmia(10.5%); nonspecific T wave or ST segment abnormality(18.4%) and first degree AV block(7.2%) in descending order. 5. The most common site which manifested myocardial ischemia was posterior and inferior wall with equal percentage of 23.4%. And then anterior wall(19.l%), and antero-lateral wall and septum with equal percentage of 10.6% was noted in descending order.; Summary

The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan.: Sang Yi Lee, Chul Woung Kim, Ok Ryun Moon; Korean J Prev Med. 1997;30(4):870-883.

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Abstract PDF: The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. Frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.; Summary

Community screening for stress by using General Health Questionnaire.: Soo Sung Oh, Kwang Seub Lee, Seok Joon Sohn, Jin Su Choi, Jung Ae Rhee; Korean J Prev Med. 1995;28(1):123-140.

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Abstract PDF: This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.; Summary

Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme.: Seung Hum Yu, Woo Hyun Cho, Myongsei Sohn, Chong Yon Park; Korean J Prev Med. 1988;21(2):419-430.

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Abstract PDF: This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 ; secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987 ; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug stores visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 ; and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.; Summary

Case-Control Study on Some Risk Factors of Cerebrovascular Diseases in Rural Community: Matched Analysis with One Control per Case.: Sung Hyun Han, Sung Soo Lee; Korean J Prev Med. 1988;21(1):82-88.

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Abstract PDF: The main objectives of this study were to know the prevalence of cerebrovascular disease, to find the important risk factors of cerebrovascular diseases. This study is a part of Eumseong Community Health Project supportes by GTZ(West German Government). 116 perceived cases of cerebrovascular disease were first screened by health interview and examinations and 80 cases were diagnosed as a cerebrovascular group. For comparison, 80 cases were matched with their neighbor controls of the same sex and the similar age. 1. The prevalence rate for cerebrovascular diseases was 476.3 per 100,000 population which is considered to be very high compared with that of other countries. Age adjusted rate for cerebrovascular diseases was 261.6 per 100,000. 2. Among the risk factors examined for the association with cerebrovascular diseases by case-control study, and analyzed by paired marginal test(McNemar's chi-square-test) and odds ratio, only hypertension showed high significant statistical association.; Summary

English Abstracts

The Resting Electrocardiographic ST Segment Depression and Related Factors at a Rural Adult Community, Korea.: Yu Mi Kim, Mi Kyung Kim, Jin Ho Shin, Heon Kil Lim, Do Myung Paek, Bo Youl Choi; J Prev Med Public Health. 2006;39(6):485-492.

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Abstract PDF: OBJECTIVES
To measure the distribution of electrocardiographic ST segment depression, and evaluate its relationships with cardiovascular risk factors based on the cross-sectional studies within a rural Korean community. METHODS: This study analyzed 1,343 persons, over 40 years old, who participated in a baseline survey during 2002~2005; the exclusion criteria included: a past history of myocardial infarction and angina pectoris, and specific conduction abnormalities. A Standard 12 leads ECG was recorded using an FCP-2101 (Fukuda Denshi Co.). The ST segment depression was retrospectively measured by a physician, according to the Minnesota code classification. RESULTS: ST segment depression was found in 3.6 and 6.4% of male and female participants, respectively. After adjusting for age, gender, smoking, physical activity and obesity differences, high blood pressure showed significant relations with ST depression in females (male ORs=2.67, 95% CI=0.85-8.50; female ORs=2.62, 95% CI=1.29-5.32) CONCLUSIONS: As an ischemic ECG sign, ST depression was related to hypertension in female participants. This relationship remained significant, even after cases with left ventricular hypertrophy were removed.; Summary

Epidemiology and Social Epidemiology.: Yun Mi Song; J Prev Med Public Health. 2005;38(3):237-240.

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Abstract PDF: Social epidemiology is a sub-discipline of epidemiology explicitly investigating social determinants of population distributions of health, disease, and well-being. Persistent pattern of social inequalities in health in spite of the broad improvement in the physical environment over the last centuries necessitated the development of this field as an approach to understand disease etiology that incorporates social experiences as more direct determinant of health. Social epidemiology incorporates theories, measurement tools, and techniques from a wide variety of other social sciences. A population perspective, the social context of behavior, contextual multilevel analysis, a developmental and life-course perspective, and general susceptibility to disease are the most important guiding concepts in social epidemiology.; Summary

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