The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea
2
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
Objectives: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. Methods: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. Results: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. Conclusions: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.
Abstract
Objectives: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. Methods: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. Results: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. Conclusions: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.
참고문헌 (30)
- Truelsen T, "Stroke incidence and prevalence in Europe: a review of available data", Eur J Neurol, 13(6), pp.581~598 (2006)
- Song IH, "Changing pattern of stroke during the recent 10 years in Korea", Korean J Intern Med, 43(5), pp.637~644 (1992)
- Granger CV, "Functional status measures in a comprehensive stroke care program", Arch Phys Med Rehabil, 58(12), pp.555~561 (1977)
- Centers for Disease Control and Prevention, "State-specific mortality from stroke and distribution of place of death-United States 1999", MMWR Morb Mortal Wkly Rep, 51(20), pp.429~433 (2002)
- Van Rossum CT, "Socioeconomic differences in stroke among Dutch elderly women: the Rotterdam study", Stroke, 30(2), pp.357~362 (1999)
- Hart CL, "The contribution of risk factors to stroke differentials, by socioeconomic position in adulthood: the Renfrew", Paisley study, 2000, pp.90(11), 1788~1791
- Peltonen M, "Social patterning of myocardial infarction and stroke in Sweden: incidence and survival", Am J Epidemiol, 151(3), pp.283~292 (2000)
- Engstrom G, "Geographic distribution of stroke incidence within an urban population: relations to socioeconomic circumstances and prevalence of cardiovascular risk factors", Stroke, 32(5), pp.1098~1103 (2001)
- Jakovljevic D, "Socioeconomic status and ischemic stroke: the FINMONICA Stroke Register", Stroke, 32(7), pp.1492~1498 (2001)
- Jakovljevic D, "Socioeconomic differences in the incidence, mortality and prognosis of intracerebral hemorrhage in Finnish adult population. The FINMONICA Stroke Register", Neuroepidemiology, 20(20), pp.85~90 (2001)
- Jakovljevic D, "Socioeconomic inequalities in the incidence, mortality and prognosis of subarachnoid hemorrhage: the FINMONICA Stroke Register", Cerebrovasc Dis, 12(1), pp.7~13 (2001)
- Wolfe CD, "Incidence and case fatality rates of stroke subtypes in a multiethnic population: the South London Stroke Register", J Neurol Neurosurg Psychiatry, 72(2), pp.211~216 (2002)
- Gillum RF, "Education, poverty, and stroke incidence in whites and blacks: the NHANES I epidemiologic follow-up study", J Clin Epidemiol, 56(2), pp.188~195 (2003)
- Qureshi AI, "Educational attainment and risk of stroke and myocardial infarction", Med Sci Monit, 9(11), pp.466~473 (2003)
- Avendano M, "Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study", Stroke, 37(6), pp.1368~1373 (2006)
- Lisabeth LD, "Neighborhood environment and risk of ischemic stroke: the brain attack surveillance in Corpus Christi (BASIC) project", Am J Epidemiol, 165(3), pp.279~287 (2007)
- Kuper H, "The socioeconomic gradient in the incidence of stroke: a prospective study in middle-aged women in Sweden", Stroke, 38(1), pp.27~33 (2007)
- Avendano M, "Stroke disparities in older Americans: is wealth a more powerful indicator of risk than income and education?", Stroke, 39(5), pp.1533~1540 (2008)
- Li C, "Stroke incidence, recurrence, and case-fatality in relation to socioeconomic position: a population-based study of middle-aged Swedish men and women", Stroke, 39(8), pp.2191~2196 (2008)
- Cesaroni G, "Socioeconomic differences in stroke incidence and prognosis under a universal healthcare system", Stroke, 40(8), pp.2812~2819 (2009)
- Grimaud O, "Incidence of ischaemic stroke according to income level among older people: the 3C study", Age Ageing, 40(1), pp.116~121 (2011)
- "NHI Program: population coverage"[URL]
- Machenbach JP, "Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe", Soc Sci Med, 44(6), pp.757~771 (1997)
- 박보현, "Associations of Income and Wealth with Health Status in the Korean Elderly", 예방의학회지, 42(5), pp.275~282 (2009), 대한예방의학회
- 정연, "소득수준이 주관적 건강상태에 미치는 영향의 연령대별 차이: 2001, 2005년 서울시민보건지표조사 자료의 분석 결과", 예방의학회지, 40(5), pp.381~387 (2007), 대한예방의학회
- Khang YH, "Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measures", J Epidemiol Community Health, 58(4), pp.308~314 (2004)
- 강영호, "경제위기에 따른 사망률 불평등의 변화: 지역의 사회경제적 위치 지표의 활용", 예방의학회지, 38(3), pp.359~365 (2005), 대한예방의학회
- Khang YH, "Health inequalities in Korea: age- and sex-specific educational differences in the 10 leading causes of death", Int J Epidemiol, 33(2), pp.299~308 (2004)
- Kim CW, "Inequalities in cancer incidence and mortality across income groups and policy implications in Korea", Public Health, 122(3), pp.229~236 (2008)
- Park JK, "The accuracy of ICD codes for cerebrovascular diseases in medical insurance claims", Korean J Prev Med, 33(1), pp.76~82 (2000)