본문 바로가기
KERD
논문KCI 등재

Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?

Lee Juyeon|김정욱|Oh Rora|Kim Myoung-Hee|Ha Rangkyoung
한국역학회 (Korean Society of Epidemiology)|2023.01|Epidemiology and Health|제45권 |pp. 1-10|DOI 10.4178/epih.e2023072

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

COVID-19KoreaHealth inequalitiesMortality

초록

OBJECTIVES: This study examined changes in socioeconomic inequalities in mortality in Korea before and after the outbreak of coronavirus disease 2019 (COVID-19). METHODS: From 2017 to 2020, age-standardized mortality rates were calculated for all-cause deaths, avoidable deaths (preventable deaths, treatable deaths), and unavoidable deaths using National Health Insurance claims data and Statistics Korea’s cause of death data. In addition, the slope index of inequality (SII) and the relative index of inequality (RII) by six income levels (Medical Aid beneficiary group and quintile of health insurance premiums) were computed to analyze the magnitude and change of mortality inequalities. RESULTS: All-cause and avoidable mortality rates decreased steadily between 2017 and 2020, whereas unavoidable mortality remained relatively stable. In the case of mortality inequalities, the disparity in all-cause mortality between income classes was exacerbated in 2020 compared to 2019, with the SII increasing from 185.44 to 189.22 and the RII increasing from 3.99 to 4.29. In particular, the preventable and unavoidable mortality rates showed an apparent increase in inequality, as both the SII (preventable: 91.31 to 92.01, unavoidable: 69.99 to 75.38) and RII (preventable: 3.42 to 3.66, unavoidable: 5.02 to 5.89) increased. CONCLUSIONS: In the first year of the COVID-19 pandemic, mortality inequality continued to increase, although there was no sign of exacerbation. It is necessary to continuously evaluate mortality inequalities, particularly for preventable and unavoidable deaths.

Abstract

OBJECTIVES: This study examined changes in socioeconomic inequalities in mortality in Korea before and after the outbreak of coronavirus disease 2019 (COVID-19). METHODS: From 2017 to 2020, age-standardized mortality rates were calculated for all-cause deaths, avoidable deaths (preventable deaths, treatable deaths), and unavoidable deaths using National Health Insurance claims data and Statistics Korea’s cause of death data. In addition, the slope index of inequality (SII) and the relative index of inequality (RII) by six income levels (Medical Aid beneficiary group and quintile of health insurance premiums) were computed to analyze the magnitude and change of mortality inequalities. RESULTS: All-cause and avoidable mortality rates decreased steadily between 2017 and 2020, whereas unavoidable mortality remained relatively stable. In the case of mortality inequalities, the disparity in all-cause mortality between income classes was exacerbated in 2020 compared to 2019, with the SII increasing from 185.44 to 189.22 and the RII increasing from 3.99 to 4.29. In particular, the preventable and unavoidable mortality rates showed an apparent increase in inequality, as both the SII (preventable: 91.31 to 92.01, unavoidable: 69.99 to 75.38) and RII (preventable: 3.42 to 3.66, unavoidable: 5.02 to 5.89) increased. CONCLUSIONS: In the first year of the COVID-19 pandemic, mortality inequality continued to increase, although there was no sign of exacerbation. It is necessary to continuously evaluate mortality inequalities, particularly for preventable and unavoidable deaths.

참고문헌 (38)

  1. "Variations in COVID strategies: determinants and lessons" (2020)[URL]
  2. "Which countries have responded best to Covid-19" (2021)[URL]
  3. "The best global responses to the COVID-19 pandemic, 1 year later" (2021)[URL]
  4. "The Covid resilience ranking: the best and worst places to be as world enters next Covid phase" (2022)[URL]
  5. Helleringer S, "Commentary : measuring excess mortality due to the COVID-19 pandemic : progress and persistent challenges", Int J Epidemiol, 51, pp.85~87 (2022)
  6. "Global excess deaths associated with COVID-19 (modelled estimates)" (2022)[URL]
  7. Kontis V, "Lessons learned and lessons missed : impact of the coronavirus disease 2019(COVID-19)pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination", Wellcome Open Res, 6, pp.279~ (2022)
  8. Shin Min Sun, "Estimation of Excess All-cause Mortality during COVID-19 Pandemic in Korea", Journal of Korean Medical Science, 36(39), pp.1~10 (2021), 대한의학회[DOI]
  9. 김진환, "Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020", Epidemiology and Health, 44, pp.1~10 (2022), 한국역학회[DOI]
  10. Oh J, "Excess mortality and the COVID-19 pandemic : causes of death and social inequalities", BMC Public Health, 22, pp.2293~ (2022)
  11. Shiels MS, "Racial and ethnic disparities in excess deaths during the COVID-19 pandemic, March to December 2020", Ann Intern Med, 174, pp.1693~1699 (2021)
  12. Polyakova M, "Racial disparities in excess all-cause mortality during the early COVID-19 pandemic varied substantially across states", Health Aff(Millwood), 40, pp.307~316 (2021)
  13. Luck AN, "The unequal burden of the Covid-19 pandemic : capturing racial", ethnic disparities in US cause-specific mortality, 2022, pp.17, 101012~
  14. Kontopantelis E, "Excess deaths from COVID-19 and other causes by region, neighbourhood deprivation level and place of death during the first 30 weeks of the pandemic in England and Wales : a retrospective registry study", Lancet Reg Health Eur, 7, pp.100144~ (2021)
  15. Kontopantelis E, "Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation, and region in England and Wales during 2020 : a registry-based study", PLoS Med, 19, pp.e1003904~ (2022)
  16. Gadeyne S, "Are we really all in this together? The social patterning of mortality during the first wave of the COVID-19 pandemic in Belgium", Int J Equity Health, 20, pp.258~ (2021)
  17. Kim SY, "The effects of income level on susceptibility to COVID-19 and COVID-19 morbidity", mortality : a nationwide cohort study in South Korea, 2021, pp.10, 4733~
  18. Rutstein DD, "Measuring the quality of medical care. A clinical method", N Engl J Med, 294, pp.582~588 (1976)
  19. "Avoidable mortality: OECD/Eurostat lists of preventable and treatable causes of death (January 2022 version)"[URL]
  20. "Avoidable mortality in the UK" (2019)[URL]
  21. "Assessment of outcomes of innovation in health care delivery system: a conceptual framework and methodology road-map" (2016)[URL]
  22. "Health equity assessment toolkit plus (HEAT Plus): software for exploring and comparing health inequalities in countries. Upload database edition. Version 4.0" (2021)[URL]
  23. "Package ‘PHEindicatormethods’’" (2022)[URL]
  24. Eun SJ, "Avoidable, amenable, and preventable mortalities in South Korea, 2000-2017 : age-period-cohort trends and impact on life expectancy at birth", Soc Sci Med, 237, pp.112482~ (2019)
  25. "Coronavirus pandemic (COVID-19)" (2020)[URL]
  26. "World inequality report 2022"[URL]
  27. Benach J, "Beyond Rose’s strategies : a typology of scenarios of policy impact on population health and health inequalities", Int J Health Serv, 41, pp.1~9 (2011)
  28. Tang KK, "Avoidable mortality risks and measurement of wellbeing and inequality", J Health Econ, 27, pp.624~641 (2008)
  29. Song YM, "Excess mortality from avoidable and non-avoidable causes in men of low socioeconomic status : a prospective study in Korea", J Epidemiol Community Health, 54, pp.166~172 (2000)
  30. Piers LS, "Avoidable mortality in Victoria between 1979 and 2001", Aust N Z J Public Health, 31, pp.5~12 (2007)
  31. "Avoidable mortality: what it means and how it is measured" (2011)[URL]
  32. Han C, "Changes in mortality rate of the general population during the COVID-19 pandemic : an interrupted time series study in Korea", Int J Epidemiol, 51, pp.1396~1407 (2022)
  33. "Health status: causes of mortality" (2023)[URL]
  34. Bahk J, "The contribution of avoidable mortality to the life expectancy gains in Korea between 1998 and 2017", Int J Environ Res Public Health, 17, pp.6499~ (2020)
  35. 박상희, "노인의 불명확한 사망원인진단 관련요인 분석과 개선방안", 보건행정학회지, 21(2), pp.329~348 (2011), 한국보건행정학회
  36. Kim CB, "Characteristics of COVID-19 and future direction of health policy from the human security perspective", Public Health Aff, 5, pp.e12~ (2021)
  37. "A survey on the human rights situation of homeless people in disaster situations in Seoul in 2020" (2020)[URL]
  38. "Cause of death statistics" (2022)[URL]

관련 논문AI추천

Inequality in mortality according to regional deprivation during the COVID-19 pandemic최민혁, Ko Young Gyu, Moon Min Hui한국역학회 · Epidemiology and Health2025 · 제47권 Inequitable distribution of excess mortality during the COVID-19 pandemic in Korea, 2020김새롬, 김진환, 김창엽, Park Eun Hye한국역학회 · Epidemiology and Health2022 · 제44권 Trends and disparities in avoidable, treatable, and preventable mortalities in South Korea, 2001-2020: comparison of capital and non-capital areas은상준한국역학회 · Epidemiology and Health2022 · 제44권 Inequality in Life Expectancy in Korea according to Various Categorizations of the National Health Insurance Premiums as a Marker of Income강영호, 강희연, 박진욱연세대학교의과대학 · Yonsei Medical Journal2020 · 제61권 제7호Worsening of health disparities across COVID-19 pandemic stages in Korea남현우, Jung Hyemin, Lee Hyejin, Lee Jae-ryun, Lee Jin Yong한국역학회 · Epidemiology and Health2024 · 제46권 Changes in Contribution of Causes of Death to Socioeconomic Mortality Inequalities in Korean Adults정최경희, Hong-Jun Cho, Young-Ho Khang대한예방의학회 · 예방의학회지2011 · 제44권 제6호

이 간행물의 다른 논문 (102건)

Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior SurveyChoi Sunhye, Oh Kyungwon, 오창모, Kim Yangha, Yang Ji Eunpp. 1-8Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample황태윤, 오경재, 홍영습, Kim Su Young, 이계오, 윤규현, 김정애, 이혁민, 신민호, 이순영, 이원영, 김동현, 박재현, 이훈재, 조성일, 남해성, 이무식, Lee June-Woo, Kim Sung Soon, 설로마, Kim Byoungguk, 이중정, 오창모, Jung Sun Jae, 오성수, Yim Hyeon Woo, 한미아, 김유미, 조희숙, Lee Ju-Hyung, Jung Jaehun, Kim Ah-Ra, Han Jina, Baek Hye Jin, Noh Eunbi, Ryu Sukhyun, 박노례, Jung Eunok, Kim Sang Il, Hwang Yoo-Sung, Oh Sangcheol, Kim Migyeong, Yu Byengchul, Kim Keonyeop, Hwangbo Young, Lee Joongyub, Kim Hyeongsu, Kang Gilwon, Ryu So Yeon, Park Soon-Woo, Kim Sang Kyu, Park Ki Soo, Kwon Jun-wook, Jang Eun Young, Nam Jeonghyunpp. 1-13Genetically determined alcohol consumption and cancer risk in Korea지선하, 정금지, 백지우, Shin Sang Yoppp. 1-7Self-reported adverse events after 2 doses of COVID-19 vaccine in Korea고미정, 김형준, 황인섭, Kwon Yunhyung, Kim Seontae, Seo Soon-Young, Cho Enhi, Yeon-Kyeng Leepp. 1-7Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in KoreaChoi Jihyun, Choi Yunsang, Kim Jong Mu, 박숙경, Kim Taeyoung, Park Eonjoo, Eun Juk Suk, Lee Eun-young, Mun Ji Won, Lee Sinyoung, Yeom Hansol, Kim Eun Kyoung, Ha Jinhopp. 1-7
원문 보기