Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Changes in Mortality Inequality in Relation to the South Korean Economic Crisis: Use of Area-based Socioeconomic Position

경제위기에 따른 사망률 불평등의 변화: 지역의 사회경제적 위치 지표의 활용

  • Yun, Sung-Cheol (Division of Epidemiology and Biostatistics, Clinical Research Center, Asan Medical Center) ;
  • Hwang, In-A (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Lee, Moo-Song (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Lee, Sang-Il (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Jo, Min-Woo (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Lee, Min-Jung (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Khang, Young-Ho (Department of Preventive Medicine, University of Ulsan College of Medicine)
  • 윤성철 (서울아산병원 임상연구센터 역학통계부) ;
  • 황인아 (울산대학교 의과대학 예방의학교실) ;
  • 이무송 (울산대학교 의과대학 예방의학교실) ;
  • 이상일 (울산대학교 의과대학 예방의학교실) ;
  • 조민우 (울산대학교 의과대학 예방의학교실) ;
  • 이민정 (울산대학교 의과대학 예방의학교실) ;
  • 강영호 (울산대학교 의과대학 예방의학교실)
  • Published : 2005.09.01
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Abstract

Objectives : An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001. Methods : Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression). Results : Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period. Conclusions : The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.

Keywords

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