한국 청소년의 주관적 건강상태에 영향을 미치는 요인 분석: 가정환경, 건강행태, 심리적 요인 및 식습관 Self-rated Health Status among Korean Adolescents: Differences in Home Environmental Factors, Health Behaviors, Psychological Factors, and Dietary Habits원문보기
목적: 본 연구는 한국 청소년의 가정환경, 건강행태, 심리적 요인 및 식습관 요인에 따른 주관적 건강상태의 차이를 분석하고, 주요 관련요인을 파악하고자 수행되었다. 방법: 분석자료로서 2015~2016년도 한국 청소년 건강행태 온라인조사 자료를 이용하였으며, 분석대상자 수는 중학생 53,791명, 고등학생 50,959명, 총 104,750명이었다. 학생들의 건강수준은 주관적 건강상태를 기준으로 건강집단과 비건강집단으로 구분하였다. 건강수준에 영향을 미치는 요인으로서 성별, 가정환경, 건강행태, 심리적 요인 및 식습관이 검토되었다. 이들 요인 간 건강집단과 비건강집단의 비율차이 검증을 위해 표본설계 정보를 반영한 Rao-scott 카이제곱검정을 실시하였다. 또한 주관적 건강수준에 영향을 주는 요인을 알아보고자 로지스틱회귀분석을 실시하였다. 결과 및 결론: 주관적 건강수준은 양친부모와 살지 않은 경우, 모의 교육수준이 낮을 때, 주관적 가정경제수준이 낮을수록 낮았다. 음주군, 고강도운동이나 근력운동을 실천하지 않는 군, 과체중이나 비만인군에서 주관적 건강수준이 낮았다. 또한 스트레스나 우울감 등 부정적인 감정이나 행복감을 느끼지 못할 때도 주관적 건강수준은 낮았다. 아침을 결식하거나 탄산음료, 고카페인음료, 패스트푸드 등의 비건강식품을 자주 섭취하는 군에서도 주관적 건강수준은 낮은 것으로 관찰되었다. 한국 청소년들에게서 건강 불평등(health inequalities)은 가정환경, 건강행태, 심리적 요인, 식습관 등 여러 요인들로부터 제기되는 것을 알 수 있었다. 이러한 요인들을 충분히 반영하여 청소년들이 건강해 질 수 있는 다각적 접근 방안이 모색되어야 할 것이다.
목적: 본 연구는 한국 청소년의 가정환경, 건강행태, 심리적 요인 및 식습관 요인에 따른 주관적 건강상태의 차이를 분석하고, 주요 관련요인을 파악하고자 수행되었다. 방법: 분석자료로서 2015~2016년도 한국 청소년 건강행태 온라인조사 자료를 이용하였으며, 분석대상자 수는 중학생 53,791명, 고등학생 50,959명, 총 104,750명이었다. 학생들의 건강수준은 주관적 건강상태를 기준으로 건강집단과 비건강집단으로 구분하였다. 건강수준에 영향을 미치는 요인으로서 성별, 가정환경, 건강행태, 심리적 요인 및 식습관이 검토되었다. 이들 요인 간 건강집단과 비건강집단의 비율차이 검증을 위해 표본설계 정보를 반영한 Rao-scott 카이제곱검정을 실시하였다. 또한 주관적 건강수준에 영향을 주는 요인을 알아보고자 로지스틱회귀분석을 실시하였다. 결과 및 결론: 주관적 건강수준은 양친부모와 살지 않은 경우, 모의 교육수준이 낮을 때, 주관적 가정경제수준이 낮을수록 낮았다. 음주군, 고강도운동이나 근력운동을 실천하지 않는 군, 과체중이나 비만인군에서 주관적 건강수준이 낮았다. 또한 스트레스나 우울감 등 부정적인 감정이나 행복감을 느끼지 못할 때도 주관적 건강수준은 낮았다. 아침을 결식하거나 탄산음료, 고카페인음료, 패스트푸드 등의 비건강식품을 자주 섭취하는 군에서도 주관적 건강수준은 낮은 것으로 관찰되었다. 한국 청소년들에게서 건강 불평등(health inequalities)은 가정환경, 건강행태, 심리적 요인, 식습관 등 여러 요인들로부터 제기되는 것을 알 수 있었다. 이러한 요인들을 충분히 반영하여 청소년들이 건강해 질 수 있는 다각적 접근 방안이 모색되어야 할 것이다.
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문제 정의
This study aimed to identify home environmental factors, health behaviors, psychological factors, and dietary habits affecting self-rated health status among Korean adolescents. The factors affecting self-rated health status were family structure, maternal educational level, and subjective family economic status in home environmental factors, drinking, vigorous physical activities, musclestrengthening exercise, and weight status in health behaviors, perceived stress, experience of sadness or hopelessness, suicidal ideation, subjective happiness, and subjective academic achievement in psychological factors, skipping breakfast, soft drinks consumption, highcaffeine beverage consumption, and fast food consumption in dietary habits.
제안 방법
Analysis was performed considering the complex sample design information (strata, clusters, and weighted values) by year of the combined data, and all analyzed results, except frequency, reflected weighted values by year. A Rao-Scott chi-square test considering the sampling design information was performed to test the percent differences by self-rated health status among home environmental factors, health behaviors, psychological factors, and dietary habits. In addition, logistic regression analysis was performed to investigate the factors influencing health levels.
A number of studies have been conducted on adult subjects, but there is still a lack of research verifying the factors that determine the health level of adolescents and not that many studies have been conducted from the perspective of health inequality. Furthermore, unlike many studies in general that are conducted with a restricted number of study subjects with limited variables that have only attempted to identify factors affecting the health of adolescents, this study utilized data from the Korea Youth Risk Behavior Web-based Survey that was conducted at the national level among about 100,000 middle and high school students in Korea to analyze the difference in subjective health status by incorporating a broader range of variables, such as home environmental factors, health behaviors, psychological factors, and dietary habits, and to further identify the major related factors affecting health inequality.
A Rao-Scott chi-square test considering the sampling design information was performed to test the percent differences by self-rated health status among home environmental factors, health behaviors, psychological factors, and dietary habits. In addition, logistic regression analysis was performed to investigate the factors influencing health levels.
To investigate differences in the self-rated health status according to home environmental factors, health behavior, psychological factors, and dietary habits, and to identify the influences of the contributing factors, a logistic regression analysis was performed. Model 1 was adjusted for gender and school grade (middle or high school).
대상 데이터
The general characteristics of the participants are shown in Table 1. A total of 104,750 participants were included in our analysis. The distribution of the adolescents was 51.
Students who responded “so-so” to a question inquiring about their self-rated health status (n=28,821) were excluded, and the data for the remaining 104,750 students (53,791 middle school students, and 50,959 high school students) were analyzed.
이론/모형
Health behaviors included current smoking status, current drinking status, moderate physical activity, vigorous physical activity, muscle-strengthening exercise, and weight status. Height and weight measurements were used to calculate BMI (BMI: weight [kg] / height [m2]). Psychological factors included degree of perceived stress, experience of sadness or hopelessness, suicidal ideation, subjective happiness, and subjective academic achievement.
성능/효과
Analysis of perceived levels of stress showed that the proportion of participants experiencing high levels of stress was 29.9% in the healthy group, and 69.3% in the unhealthy group, indicating that the unhealthy group was more sensitive to stress. The rate of experiencing sadness or despair, and the proportion of participants who responded they had seriously considered committing suicide were higher in the unhealthy group.
In this study, self-rated health status was higher among participants who performed vigorous physical activities or muscle-strengthening exercise more than three days per week.
Differences in self-rated health status according to home environmental factors, health behaviors, psychological factors, and dietary habits, as well as the main contributing factors of self-rated heath status among Korean adolescents were investigated. Our results showed that in relation to the home environment factors, participants who lived with both biological parents, and participants with a high family economic status had a higher self-rated health status. In relation to the health behavior factors, the non-drinking group, and the group that performed vigorous physical activities and muscle-strengthening exercise had a higher health status than the non-drinking group, and non-exercise groups, respectively.
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