Abstract

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

주제어

#Socioeconomic Differential   #Stroke   #Cardiovascular Disease   #Mortality  

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참고문헌 (36)

1. 보건복지부. 만성병관리법 공청회 및 정책 워크샵 개최 보도자료. 서울: 보건복지부, 2003 
2. 송윤미. 사회경제적 수준과 사망의 연관성-한국 남성 759,665명에서의 코호트 연구. 한국역학회지 1998;20(2):219-25 
3. 조홍준. 공교 의료보험 피보험자의 사회계층별 사망률 차이에 관한 연구 [박사학위논문]. 서울: 서울대학교 대학원, 1997 
4. Bishop JA, Formby JP, Smith WJ. Working Paper no.26, Luxemburg Income Group, 1989 
5. Ichiro K. Income Inequality and Health In: Lisa FB, Ichiro K, editors. Social Epidemiology. New York: Oxford, 2000. pp.76-94 
6. Keil JE, Sutherland SE, Knapp RG, Tyroler HA. Does equal socioeconomic status in black and white men mean equal risk of mortality? Am J Public Health 1992;82:1133-1136 
7. Mulchay R, Daly L, Grahan I, Hickey N. Level of education, coronary risk factors, and cardiovascular disease. Ir Med J 1984;77:316-318 
8. Song YM, Byeon JJ. Excess mortality from avoidable and no-avoidable causes in men of low socioeconomic status: a prospectiv study in Korea. J Epidemiol Community Health 2000;54:166-72 
9. Vagero D, Lundberg O. Health indqualities in British and Sweden. Lancet 1939;2:35-36 
10. 강영호. 한국에서의 빈곤, 불평등, 건강. 김창엽 편, 빈곤과 건강. 서울: 한울아카데미, 2003. 쪽 92-120 
11. Rogat E, Sorlie PD, Johnson NJ, Schmitt A mortality study of 1.3million persons by demographic, social and economic factors: 1979-1985 Follow-up. National Institueds of Health. 1992. NIH Publication No. 92-3297:1-5 
12. 손미아. 직업, 교육수준, 그리고 물질적 결핍이 사망률에 미치는 영향. 예방의학회지 2002;35(1):76-82 
13. Macintyre S. Socioeconomic inequalities in health: some key contemporary issues, Working Paper Series, No 93-6, Boston: The Health Institute, New England Medical Center. 1996 
14. Liu K, et al. Relation of education to major risk factors and death from coronary heart disease, cardiovascular disease, and all causes: findings of three Chicago epidemiologic studies. Circulation 1982;66;1308-1314 
15. Khang YH, Lynch JW, Kaplan GA. Health inequalities in Korea: Age- and sex-specific educational differences in th 10 leading causes of death. Int J Epidemiol 2004a;(33)2:299-308 
16. Khang YH, Lynch JW, Woon SC, Lee SI. Trends in socioeconomic health inequalities in Korea: Use of mortality and morbidity measures. J Epidemiol Community Health 2004b;53:308-314 
17. Lilienfeld AM. Variation in mortality from heart disease: race, sex, and socioeconomic status. Pub Health Rep 1956;71:545-552 
18. Wilkinson RG. The Epidemiological Transition: from Marerial Scarcity to Social Disadvantage? Journal of The American Academy of Arts and Sciences 1994;123(4):61-77 
19. Sawyer D. Income distribution in OECD Countries. OECD Economic Outlook, Occasional Studies. Paris: OECD. 1976 
20. Hart N. The Social and Economic Envirment and Human Health. In : Holland WW, Detels R, Knox RG, editors, Oxford Textbook of Public Health, Oxford; Oxford University Press, 1991 
21. Kunst AE. del Rios ME, Groenhof F, Mackenbach JP. Socioeconomic Inequalities in Stroke Mortality Among Middle-Aged Men: AnInternational Overview. Stroke 1998;29(1):2285-2291 
22. Kaplan GA, Keil JE. Special Report: Socioeconomic Factors and Cardiovascular Disease: A Review of the Literature. Circulation 1993;88(4):1973-1993 
23. Blaxter M. Health service as a defence against the consequence of poverty industrialized societies. Soc Sci Med 1983;16:1139-48 
24. 김공현. 건강증진사업의 세계적 동향. 한국보건행정학회 후기 학술대회 연제집.1997년 10월 
25. Pappas G, Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States 1960 and 1986. N Eng J Med 1993;329:103-9 
26. Rose G, Marmot MG. Social class and coronary heart disease. Br Heart J 1931;45: 13-19 
27. Illsley R. Comparative Review of Sources, Methodology and Knowledge. Soc Sci Med 1990;31(3):229-236 
28. 통계청. 2004년 사망원인통계연보. 서울: 통계청, 2005 
29. Abel-Smith B. An Introduction to Health: Policy Planning and Financing. 1st ed. Longman, 1994 
30. Neser WB, Tyroler HA, Cassel JC. Social disorganization and stroke mortality in the black population of North Carolina. Am J Epidemio 1971;93:166-175 
31. Davey Smith G, Neaton JD, Stamler J. Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: 1.White Men. Am J of Public HeaIth 1996;86:489-496 
32. Keil JE, Loadholt CB, Weinrich MC, Sandifer, SH, Boyle E Jr. Incidence of coronary heart disease in blacks in Charleston, South Carolina. Am Heart J 1984;108:779-786 
33. Salonen JT. Socioeconomic status and risk of cancer, cerebral stroke, and death due to coronary Heart disease and any disease: a longitudinal study in eastern Finland. J Epidemiol Community Health 1982;36:294-297 
34. O'Connel O, Propper C. Equity and the Distribution of National Health Service Resources. J of Health Economics 1990;10:1-20 
35. 윤태호. 우려나라의 사회계층간 건강행태 차이 [석사학위논문]. 서울: 서울대학교 보건대학원, 2000 
36. 한국보건사회연구원. 건강수준의 사회적계층간 차이와 정책 방향. 서울: 한국보건사회연구원, 2004 

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