교육수준과 주관적 불건강-매개 요인의 탐색
Educational Attainment and Subjective Unhealthiness-An Exploration of the Mediators
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초록
사회경제적 위치와 건강 불평등의 관계는 비교적 견고하게 입증이 되었으나 사회경제적 위치가 건강 불평등에 어떻게 영향을 미치는지 그 원인이나 기전에 관한 연구는 국내에서는 아직 미흡하다고 할 수 있다. 본 연구의 목적은 사회경제적 위치 중 교육수준에 따른 주관적 건강수준의 차이가 어떤 매개요인을 통해 나타나는지를 파악하는 것이다. 1998년, 2001년, 2005년 국민건강영양조사 자료를 사용하여 (1) 각 연도별로 교육수준이 주관적 불건강에 영향을 미치는지 분석하고, (2) 각 연도별로 교육수준과 주관적 불건강의 매개요인이 무엇이 있는지 분석하고, (3) 각 연도별로 각각의 매개요인이 교육수준에 따른 주관적 불건강의 차이에 얼마나 기여하는가를 파악하고자 하였다. 연구 결과 대체로 교육수준이 낮을수록 주관적 불건강의 비율이 높았으나 1998년 이후로 교육수준별 건강 불평등이 심화되었다는 증거는 불충분하였다. 각 연도별로 교육수준과 주관적 불건강을 매개하는 요인들과 이들이 교육수준에 따른 주관적 불건강의 차이에 기여하는 정도에도 조금씩 차이가 있었다. 남자에서는 질병요인이, 여자에서는 질병요인과 더불어 행태요인이 교육수준과 주관적 건강수준의 관계를 매개하는 것으로 나타나 이러한 매개요인들의 개입을 통해 교육수준에 따른 주관적 건강수준의 격차를 감소시킬 수 있을 것이다.
Abstract
Although the relationship between socioeconomic position and health inequality has been established, studies on how socioeconomic position affects health inequality are not sufficient in Korea. The purpose of the study was to find out those factors that mediate the relationship between education attainment, an indicator of socioeconomic position, and subjective health status. In detail, using the Korea National Health and Nutrition and Examination Survey in 1998, 2001, and 2005, the study (1) checked if educational attainment affected subjective health status, (2) identified the mediators of educational attainment and subjective health status, and (3) analyzed how much each mediator contributed to the difference in subjective health status by educational attainment for each year. The study results showed that lower educational attainment was related to higher rate of subjective unhealthiness. However, the evidence was not sufficient that health inequality by educational attainment has increased since 1998. The mediators between educational attainment and subjective unhealthiness were slightly different across the study years. The extent that each mediator contributed to the difference in subjective unhealthiness by educational attainment was also different across the study years. In general, disease factors for men and women and behavior factors for women were found to mediate educational attainment and subjective unhealthiness. Interventions associated with these mediators could reduce the difference in subjective health status by educational attainment.
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