표준사망비를 활용한 우리나라 소지역별 건강불평등 비교
Comparisons of Health Inequalities in Small Areas with Using the Standardized Mortality Ratios in Korea
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참고문헌
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초록
Objectives : This study was performed to compare the standardized mortality ratios among different small areas and to explore the usefulness of standardized mortality ratios in South Korea. Methods : To calculate the standardized mortality ratio (SMR), we obtained the national deaths certificate data (2004-2006) and national registration population data (2003- 2006), and these were provided by the National Statistical Office. The small areas (Eup.Myoun.Dong) were based on the subdivisions of counties. Among the 3,580 small areas classified by the National Statistical Office, 3,571 areas were included in this study. The basic statistics and decile distributions of the SMRs for all the regional levels were calculated, and the small area maps were also produced for some selected regions. To evaluate the precision of SMR, we calculated the 95% confidence intervals of the SMR in selected small areas. Results : The mean and the standard deviation of the SMRs among all small areas were 100.8 and 17.0, respectively. The range was 30.6-211.7 and the inter-quartile range was 20.7. Seoul metropolitan city displayed the lowest mean SMR among 16 regions in South Korea, and 34.6 percent of the small area SMRs belonged to the first decile(the lowest group). On the contrary, the mean SMR of Gyeongsangnam province was highest, and 26.1 percent of the small area SMRs belonged to the tenth decile(the highest group). In some areas, the precision of the SMR, which was calculated by the 95% confidence intervals, remained questionable, yet it was quite stable for almost areas. Conclusions : The standardized mortality ratios can be useful for allocating health resources at the small area level in Korea.
Abstract
Objectives : This study was performed to compare the standardized mortality ratios among different small areas and to explore the usefulness of standardized mortality ratios in South Korea. Methods : To calculate the standardized mortality ratio (SMR), we obtained the national deaths certificate data (2004-2006) and national registration population data (2003- 2006), and these were provided by the National Statistical Office. The small areas (Eup.Myoun.Dong) were based on the subdivisions of counties. Among the 3,580 small areas classified by the National Statistical Office, 3,571 areas were included in this study. The basic statistics and decile distributions of the SMRs for all the regional levels were calculated, and the small area maps were also produced for some selected regions. To evaluate the precision of SMR, we calculated the 95% confidence intervals of the SMR in selected small areas. Results : The mean and the standard deviation of the SMRs among all small areas were 100.8 and 17.0, respectively. The range was 30.6-211.7 and the inter-quartile range was 20.7. Seoul metropolitan city displayed the lowest mean SMR among 16 regions in South Korea, and 34.6 percent of the small area SMRs belonged to the first decile(the lowest group). On the contrary, the mean SMR of Gyeongsangnam province was highest, and 26.1 percent of the small area SMRs belonged to the tenth decile(the highest group). In some areas, the precision of the SMR, which was calculated by the 95% confidence intervals, remained questionable, yet it was quite stable for almost areas. Conclusions : The standardized mortality ratios can be useful for allocating health resources at the small area level in Korea.
참고문헌 (24)
- General Register Office, "England and Wales 1951, Part Ì. Occupational Mortality" (1958), HMSO
- Yule GU, "On some points relating to the vital statistics of occupational mortality", J R Statist Soc, 97(1), pp.1~84 (1934)
- Julious SA, "Why do we continue to use standardized mortality ratios for small area comparisons?", J Pub Health Med, 23(1), pp.40~46 (2001)
- Rothman KJ, "Modern epidemiology" (1998), Lippincott-Raven
- Gordis L, "Epidemiology" (2004), Elsevier Saunders
- Black D, "The Black report in:Inequalities in Health", pp.202~ (1992), Penguin Books
- 정백근, "우리나라에서의 지역의 물질적 결핍수준과 15-64세 인구 표준화사망비의 관계", 예방의학회지, 39(1), pp.46~52 (2006), 대한예방의학회
- Kim HK, "A SMR study of Korean public servants", J Prev Med Public Health, 30(2), pp.293~307 (1997)
- 신유철, "통계청 사망 자료를 이용한 우리나라 의사들의 사망률에 관한 연구 1992-2002", 예방의학회지, 38(1), pp.38~44 (2005), 대한예방의학회
- "statistical standards"[URL]
- Vandenbroucke JP, "A shortcut method for calculating the 95 percent confidence interval of the standardized mortality ratio", Am J Epidemiol, 115(2), pp.303~304 (1982)
- "Annual report of life table statistics 2005"[URL]
- "Annual Report of Births and Deaths Statistics 2005/URL:"[URL]
- Janes GR, "Descriptive epidemiology: analysing and interpreting surveillance data in:Principles and Practice of Public Health Surveillance", pp.112~167 (1994), Oxford University Press
- Checkoway H, "Research Methods in Occupational Epidemiology" (1989), Oxford University Press
- Hennekens CH, "Epidemiology in Medicine" (1987), Little Brown & Company
- Goldman DA, "Are standardized mortality ratios valid for public health data analysis?", Stat Med, 19(8), pp.1081~1088 (2000)
- "Standardized Mortality Ratios for Wards in England and Wlaes, 1999-2003: Results for those aged under 85 for males, females and all persons"[URL]
- Carstairs V, "Deprivation and mortality: An alternative to social class?", Community Med, 11(3), pp.210~219 (1989)
- Raleigh VS, "Life expectancy in England: Variations and trends by gender, health authority, and level of deprivation", J Epidemiol Community Health, 51(6), pp.649~658 (1997)
- Woods LM, "Geographical variation in life expectancy at birth in England and Wales is largely explained by deprivation", J Epidemiol Community Health, 59(2), pp.115~120 (2005)
- Williams ES, "Impact of nursing home deaths on life expectancy calculations in small areas", J Epidemiol Community Health, 58(11), pp.958~962 (2004)
- Mays N, "Relation between all cause standardised mortality ratios and two indices of deprivation at regional and district level in England", J Epidemiol Community Health, 43(2), pp.191~199 (1989)
- Townsend P, "Individual or social responsibility for premature death? Current controversies in the British debate about health", Int J Health Serv, 20(3), pp.373~392 (1990)
