건강형평성의 지역 격차 해소를 위한 접근: 사회생태모형에 의한 지역 간 걷기실천의 영향요인
An approach to reduce the regional gap of health equity : What factors influence walking practices between two districts by social ecological model?
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Since 2008, there have been inequalities in healthcare indices both within and between regions in Korea, and this gap is on the increase. Therefore, this study aims to identify the influencing factors of regional inequalities on walking practices between two districts in Gangwon Province. Methods: Integrated raw data of 2011, 2013, and 2015 from the Korea Community Health Survey, a cross-sectional study, were utilized; this survey included respondents from Yeongwol county and Samcheok city. Based on the reduced Social Ecological Model, walking practices were selected as the dependent variable and other factors, such as individual, interpersonal, and community factors were selected as independent variables. Bivariate (chi-square test, t-test) and logistic regression analyses were performed using SAS statistical software, version 9.4. Results: The rate of walking practices in Yeongwol county was about 10∼20% lower than in Samcheok city in most of the independent variables. Regarding individual variables, female gender, aged between 30 and 40 years, university educational level, and office workers from Yeongwol county were found to be vulnerable categories concerning walking practices, compared to Samcheok city. Additionally, participants who practiced moderate to vigorous physical activities and flexible exercises (more than 5 days per week), attempted weight control, and had social networks with friends were about two times more likely to accomplish walking practices compared to those participants from Yeongwol county, when individual (health-related behavior) and interpersonal variables when considered. Conclusions: Therefore, customized walking programs for vulnerable people should be developed and implemented, in addition to continuous health education campaigns for motivating residents and increasing their awareness. The expansion of the Health+ Village Program for reorganizing communities, and multidisciplinary integration policies and cooperative strategies for community balanced development could produce remarkable improvements in the poor walking practices of Yeongwol county.
Abstract
Since 2008, there have been inequalities in healthcare indices both within and between regions in Korea, and this gap is on the increase. Therefore, this study aims to identify the influencing factors of regional inequalities on walking practices between two districts in Gangwon Province. Methods: Integrated raw data of 2011, 2013, and 2015 from the Korea Community Health Survey, a cross-sectional study, were utilized; this survey included respondents from Yeongwol county and Samcheok city. Based on the reduced Social Ecological Model, walking practices were selected as the dependent variable and other factors, such as individual, interpersonal, and community factors were selected as independent variables. Bivariate (chi-square test, t-test) and logistic regression analyses were performed using SAS statistical software, version 9.4. Results: The rate of walking practices in Yeongwol county was about 10∼20% lower than in Samcheok city in most of the independent variables. Regarding individual variables, female gender, aged between 30 and 40 years, university educational level, and office workers from Yeongwol county were found to be vulnerable categories concerning walking practices, compared to Samcheok city. Additionally, participants who practiced moderate to vigorous physical activities and flexible exercises (more than 5 days per week), attempted weight control, and had social networks with friends were about two times more likely to accomplish walking practices compared to those participants from Yeongwol county, when individual (health-related behavior) and interpersonal variables when considered. Conclusions: Therefore, customized walking programs for vulnerable people should be developed and implemented, in addition to continuous health education campaigns for motivating residents and increasing their awareness. The expansion of the Health+ Village Program for reorganizing communities, and multidisciplinary integration policies and cooperative strategies for community balanced development could produce remarkable improvements in the poor walking practices of Yeongwol county.
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