Regional disparities in healthy eating and nutritional status in South Korea: Korea National Health and Nutrition Examination Survey 2017
0
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = −0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.
Abstract
BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = −0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.
참고문헌 (36)
- Arcaya MC, "Inequalities in health : definitions, concepts, and theories", Glob Health Action, 8, pp.27106~ (2015)
- Murray CJ, "Health inequalities and social group differences: what should we measure?", Bull World Health Organ, 77, pp.537~543 (1999)
- Braveman P, "Social inequalities in health within countries : not only an issue for affluent nations", Soc Sci Med, 54, pp.1621~1635 (2002)
- Sen A, "Why health equity", Health Econ, 11, pp.659~666 (2002)
- Kim S, "Disparities in the utilisation of preventive health services by the employment status : an analysis of 2007-2012 South Korean national survey", PLoS One, 13, pp.e0207737~ (2018)
- 김기랑, "한국 식품 미보장 현황 및 특성", 보건사회연구, 29(2), pp.268~292 (2009), 한국보건사회연구원[DOI]
- Lee SH, "Income disparities in the use of health screening services among university students in Korea: a cross-sectional study of 2479 participants in a university", Medicine (Baltimore), 95, pp.e3681~ (2016)
- 이효, "Physical activity disparities by socioeconomic status among metabolic syndrome patients: The Fifth Korea National Health and Nutrition Examination Survey", Journal of exercise rehabilitation, 12(1), pp.10~14 (2016), 한국운동재활학회
- Zhang Q, "Using concentration index to study changes in socio-economic inequality of overweight among US adolescents between 1971 and 2002", Int J Epidemiol, 36, pp.916~925 (2007)
- Kim S, "Assessment of trends in socioeconomic inequalities in cancer screening services in Korea, 1998-2012", Int J Equity Health, 15, pp.30~ (2016)
- Hwang J, "Measuring socioeconomic inequalities in obesity among Korean adults, 1998-2015", Int J Environ Res Public Health, 16, pp.1617~ (2019)
- "Korea Health Promotion Institute" (2020)[URL]
- "Health Plan" (2020)[URL]
- Developing Strategies for the National Health Plan 2020, "Choi EJ", Korea Institute for Health and Social Affairs, ~ (2016)
- Kweon S, "Data resource profile : the Korea National Health and Nutrition Examination Survey(KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)
- "Korea National Health and Nutrition Examination Survey Selection of Target People" (2020)[URL]
- World Health Organization, "Western Pacific Country Health Information Profiles" (2011), World Health Organization Western Pacific Region
- Rural Development Administration (KR), "Food Composition Table. 5th rev. ed", Rural Development Administration, ~ (1996)
- Rural Development Administration(KR), "Food Composition Table. 6th rev. ed", Rural Development Administration, ~ (2001)
- Rural Development Administration(KR), "Food Composition Table. 7th rev. ed", Rural Development Administration, ~ (2006)
- Rural Development Administration (KR), "Standard Food Composition Table. 8th rev. ed", Rural development Administration, ~ (2012)
- Ministry of Health and Welfare (KR), "Dietary Reference Intakes for Koreans 2015", The Korean Nutrition Society, ~ (2015)
- Pearcy JN, "A summary measure of health disparity", Public Health Rep, 117, pp.273~280 (2002)
- Analyzing Health Equity Using Household Survey Data: a Guide to Techniques and Their Implementation, "O'Donnell O", The World Bank, ~ (2007)
- Clarke PM, "On the measurement of relative and absolute income-related health inequality", Soc Sci Med, 55, pp.1923~1928 (2002)
- O'Donnell O, "conindex : Estimation of concentration indices", Stata J, 16, pp.112~138 (2016)
- 김미영, "일부 농촌주민을 대상으로 한 사회경제적 및 심리사회적 요인과 비만의 관련성", Journal of Obesity & Metabolic Syndrome, 21(1), pp.18~28 (2012), 대한비만학회[DOI]
- Korea Health Statistics 2018: Korea National Health and Nutrition Examination Survey (KNHANES VII-3), "Korea Centers for Disease Control and Prevention", Korea Centers for Disease Control and Prevention, ~ (2019)
- 이원준, "Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey", Epidemiology and Health, 35, pp.1~7 (2013), 한국역학회
- Kyung Won Lee, "Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults", Nutrition Research and Practice, 10(3), pp.294~304 (2016), 한국영양학회
- Wagstaff A, "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality", Health Econ, 14, pp.429~432 (2005)
- Xu Y, "Explaining income-related inequalities in dietary knowledge : evidence from the China Health and Nutrition Survey", Int J Environ Res Public Health, 17, pp.532~ (2020)
- Yazdi-Feyzabadi V, "Socio-economic inequality in unhealthy snacks consumption among adolescent students in Iran : a concentration index decomposition analysis", Public Health Nutr, 22, pp.2179~2188 (2019)
- Mostafavi F, "The association of unhealthy diet with socioeconomic inequality in children : a study in Kurdistan. West of Iran", Health Scope, 8, pp.e58336~ (2019)
- Shan Z, "Association between healthy eating patterns and risk of cardiovascular disease", JAMA Intern Med, 180, pp.1090~1100 (2020)
- Hu EA, "Adherence to the Healthy Eating Index-2015 and other dietary patterns may reduce risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality", J Nutr, 150, pp.312~321 (2020)