scholarly journals A national pilot program for chronic diseases and health inequalities in South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rangkyoung Ha ◽  
Dongjin Kim ◽  
Jihee Choi ◽  
Kyunghee Jung-Choi
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Chronic Diseases ◽  
Health Inequalities ◽  
Socioeconomic Position ◽  
Prescription Medication ◽  
Socioeconomic Inequalities ◽  
Pilot Program ◽  
Individual Level ◽  
The Individual

Abstract Background To achieve the health equity, it is important to reduce socioeconomic inequalities when managing chronic diseases. In South Korea, a pilot program for chronic diseases was implemented at the national level. This study aimed to examine its effect on socioeconomic inequalities in chronic disease management at the individual and regional levels. Methods Korean National Health Insurance data from September 2016 to October 2017 were used. Study subjects in the national pilot program for chronic diseases included 31,765 participants and 5,741,922 non-participants. The dependent variable was continuity of prescription medication. Socioeconomic position indicators were health insurance contribution level and the area deprivation index. Covariates were gender, age, and the Charlson Comorbidity Index (CCI). A multilevel logistic regression model was used to address the effects at both the individual and regional levels. This is a cross-sectional study. Results Unlike the group of non-participants, the participants showed no inequality in prescription medication continuity according to individual-level socioeconomic position. However, continuity of prescription medication was higher among those in less deprived areas compared to those in more deprived areas in both the participation and non-participation groups. Conclusions This study found that the pilot program for chronic diseases at the least did not contribute to the worsening of health inequalities at the individual level in South Korea. However, there was a trend showing health inequalities based on the socioeconomic level of the area. These findings suggest that additional policy measures are needed to attain equality in the management of chronic diseases regardless of the regional socioeconomic position.

scholarly journals LOCAL ECONOMIC VOTING AND RESIDENCE-BASED REGIONALISM IN SOUTH KOREA: EVIDENCE FROM THE 2007 PRESIDENTIAL ELECTION

2016 ◽  
Vol 16 (3) ◽  
pp. 349-369 ◽  
Author(s):  
Woo Chang Kang
Keyword(s):  
South Korea ◽  
Presidential Election ◽  
Positive Association ◽  
Economic Voting ◽  
Economic Conditions ◽  
Economic Changes ◽  
Individual Level ◽  
Regional Parties ◽  
National Economic ◽  
The Individual

AbstractRegional bloc voting in South Korea has been ascribed to voters’ psychological attachments to birthplace. This article seeks to expand the existing discussion of regionalism by showing that economic conditions in voters’ places of residence affect vote choices at the individual level and produce clustering of votes at the aggregate level in South Korea. While the idea of residence-based regionalism has previously been suggested, empirical scrutiny of the idea has been limited. Exploiting a Bayesian multilevel strategy, this article provides evidence that short-term economic changes at the province level affected voters’ choices in the 2007 presidential election in South Korea, independent of the long-term political affiliation between regional parties and their constituents. The positive association between local economic conditions and vote choices remains significant, controlling for perceptions of national economic conditions and other individual level covariates such as age and political attitudes.

scholarly journals Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part II: lay perspectives

2007 ◽  
Vol 61 (11) ◽  
pp. 972-977 ◽  
Author(s):  
J. Popay ◽  
U. Kowarzik ◽  
S. Mallinson ◽  
S. Mackian ◽  
J. Barker
Keyword(s):  
Primary Care ◽  
Health Inequalities ◽  
Social Problems ◽  
Individual Level ◽  
Lay Perspectives ◽  
The Individual

scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2020 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Missing Teeth ◽  
Individual Level ◽  
Contextual Variation ◽  
Lower Education ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95%CI: 7.93-11.13) and 6.95 (95%CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI.Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

scholarly journals What medicines do households keep in their cabinets? Understanding the possession and use of medicines at home and the role of health insurance in Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247591
Author(s):  
Hezekiah Olayinka Shobiye ◽  
Oladimeji Akeem Bolarinwa ◽  
Mojirola Martina Fasiku ◽  
Tanimola Makanjuola Akande ◽  
Wendy Janssens
Keyword(s):  
Health Insurance ◽  
Health Facilities ◽  
Correct Match ◽  
Individual Level ◽  
Insurance Program ◽  
Incorrect Match ◽  
Quality Health ◽  
The Individual ◽  
At Home

Background Globally, the possession of medicines stored at home is increasing. However, little is known about the determinants of possessing medicines, their usage according to clinical purpose, which we term ‘correct drug match’, and the role of health insurance. Methods This study uses data from a 2013 survey evaluating a health insurance program in Kwara State, Nigeria, which upgraded health facilities and subsidized insurance premiums. The final dataset includes 1,090 households and 4,641 individuals. Multilevel mixed-effects logistic regressions were conducted at both the individual level and at the level of the medicines kept in respondents’ homes to understand the determinants of medicine possession and correct drug match, respectively, and to investigate the effect of health insurance on both. Results A total of 9,266 medicines were classified with 61.2% correct match according to self-reported use, 11.9% incorrect match and 26.9% indeterminate. Most medicines (73.0%) were obtained from patent proprietary medicine vendors (PPMVs). At 36.6%, analgesics were the most common medicine held at home, while anti-malarial use had the highest correct match at 96.1%. Antihistamines, vitamins and minerals, expectorants, and antibiotics were most likely to have an incorrect match at respectively 35.8%, 33.6%, 31.9%, and 26.6%. Medicines were less likely to have a correct match when found with the uneducated and obtained from public facilities. Enrolment in the insurance program increased correct matches for specific medicines, notably antihypertensives and antibiotics (odds ratio: 25.15 and 3.60, respectively). Conclusion Since PPMVs serve as both the most popular and better channel compared to the public sector to obtain medicines, we recommend that policymakers strengthen their focus on these vendors to educate communities on medicine types and their correct use. Health insurance programs that provide affordable access to improved-quality health facilities represent another important avenue for reducing the burden of incorrect drug use. This appears increasingly important in view of the global rise in antimicrobial resistance.

scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2019 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Relative Index ◽  
Individual Level ◽  
Contextual Variation ◽  
Index Of Inequality ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,979 adults living in 177 Brazilian municipalities were used. Education and household income were used as the individual socioeconomic indicators. At the municipal level, we used the Municipal Human Development Index as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of lost teeth was 9.62 (95%CI: 8.02-11.23) and 7.03 (95%CI: 6.52-7.55) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer lost teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

scholarly journals Socioeconomic position and SARS-CoV-2 infections: seroepidemiological findings from a German nationwide dynamic cohort

2021 ◽  
Author(s):  
Jens Hoebel ◽  
Markus M Grabka ◽  
Carsten Schroeder ◽  
Sebastian Haller ◽  
Hannelore Neuhauser ◽  
...  
Keyword(s):  
Socioeconomic Position ◽  
Adult Population ◽  
Individual Level ◽  
Highly Educated ◽  
Increased Risk ◽  
Pandemic Planning ◽  
Nasal Swabs ◽  
The Individual ◽  
Low Educated ◽  
The Relationship

Background: Evidence on the relationship between socioeconomic position (SEP) and infections with the SARS-CoV-2 coronavirus is still limited as most of the available studies are ecological in nature. This is the first German nationwide study to examine differences in the risk of SARS-CoV-2 infections according to SEP at the individual level. Methods: The 'CORONA-MONITORING bundesweit' (RKI-SOEP) study is a seroepidemiological survey among a dynamic cohort of the German adult population (n=15,122; October 2020 to February 2021). Dried blood samples were tested for SARS-CoV-2 antibodies and oral-nasal swabs for viral RNA. SEP was measured by education and income. Robust logistic regression was used to examine adjusted associations of SARS-CoV-2 infections with SEP. Results: 288 participants were seropositive, PCR-positive, or self-reported a previous laboratory-confirmed SARS-CoV-2 infection. The adjusted odds of SARS-CoV-2 infection were 1.87-fold (95% confidence interval [CI]=1.06–3.29) higher among low-educated than highly educated adults. Evidence was weaker for income differences in infections (odds ratio=1.65; 95% CI=0.89–3.05). Highly educated adults had lower odds of undetected infection. Conclusions: The results indicate an increased risk of SARS-CoV-2 infection in low-educated groups. To promote health equity in the pandemic and beyond, social determinants should be addressed more in infection protection and pandemic planning.

Factors Affecting Consumer Adoption of Broadband in Developing Countries

2008 ◽  
pp. 285-295
Author(s):  
Yogesk K. Dwivedi
Keyword(s):  
Developing Countries ◽  
South Korea ◽  
Developing Nations ◽  
Division I ◽  
The Internet ◽  
Factors Affecting ◽  
Individual Level ◽  
The Individual ◽  
The Uk

This chapter empirically examines factors affecting the adoption of broadband in the developing countries of Bangladesh and the Kingdom of Saudi Arabia (KSA). In the case of Bangladesh, attitudinal, normative, and control factors—discussed in the UK case study in Division I of this book—were used and adapted in order to provide insights about broadband adopters and non-adopters within the developing nations. In order to examine the adoption of broadband in the KSA, a number of variables were employed, which also included some of the variables discussed in the UK case study in Division I. As the Internet was introduced comparatively late in Bangladesh (in 1996), in early 2004 the total penetration of Internet within the country was only 0.25 percent (Totel, 2004). It was suggested that the major obstacles associated with low Internet penetration were the low economic status and still-developing infrastructure within the country (Totel, 2004). A recent media report further emphasised that “Bangladesh is not anywhere on the global broadband map, but it is doing its best to get online. Local service provider, DNS SatComm has started deploying fixed wireless gear from Cambridge Broadband and will offer access to government offices, and other commercial entities” (Malik, 2005). It has also been suggested that Internet connection is slow and costly and not affordable by the general public (Hossain, 2004). Given the situations of Bangladesh in terms of demography, telecommunication infrastructure, and affordability of Internet by people, it was felt that understanding factors including cost of Internet access and subscription affecting consumer adoption might help to encourage further diffusion of high speed Internet. In the KSA, the Internet has taken some time to diffuse and is therefore seen as a relatively new technology. The KSA first started with dial up connections and then moved on to adopt broadband and satellite connections to provide better data communication services to its citizens. However, even with the availability of broadband technology, the rate of adoption is considered to be relatively poor in comparison to other developed countries such as the UK, as well as newly industrialised leading broadband users, such as South Korea (Oh et al., 2003). This poor connectivity is often claimed to be caused by website filtration in the region. Consequently, broadband adoption has been slower than expected in the region. Furthermore, a survey of existing literature on broadband adoption suggests that although both macro and micro level studies were conducted in order to understand the deployment of broadband in the developed world and leading countries such as South Korea, none of these studies focus upon developing countries, such as Bangladesh and the KSA. Although this could be attributed to the slow infrastructure development and low rate of adoption within the two countries, this has provided the motivation for undertaking exploratory research in order to develop an understanding of the perceptions of consumers regarding broadband adoption in these developing nations. Thus, this chapter aims to explore the reasons for the slow adoption of broadband in Bangladesh and the KSA by examining the individual level factors affecting broadband uptake in both cases. The research will thereby seek to adapt the individual level factors from the UK case study (Division I) and attempt to examine if and why the adapted factors affect consumers’ attitudes towards the adoption of broadband in the countries. The chapter begins with a brief discussion of the theoretical basis and variables employed to examine broadband adoption. This is followed by a brief discussion of the utilized research methods. The findings are then presented and discussed. Finally, a conclusion to the chapter is provided.

scholarly journals Does the socioeconomic positioned neighbourhood matter? Norwegian adolescents’ perceptions of barriers and facilitators for physical activity

2022 ◽  
pp. 140349482110666
Author(s):  
Hanne Hennig Havdal ◽  
Elisabeth Fosse ◽  
MEkdes Kebede Gebremariam ◽  
Karien Stronks ◽  
Oddbjørn Klomsten Andersen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Socioeconomic Position ◽  
Physical Activity Behaviour ◽  
Parental Engagement ◽  
Environment Interaction ◽  
Neighbourhood Environment ◽  
Individual Level ◽  
Lower Socioeconomic ◽  
The Individual ◽  
Activity Behaviour

Background and aims: A higher proportion of adolescents from lower socioeconomic position families tend to be less physically active than their counterparts from higher socioeconomic position families. More research is needed to understand the causes of these differences, particularly the influence of the neighbourhood environment. This qualitative study aims to explore how adolescents and their parents from higher and lower socioeconomic neighbourhoods perceive the social, organisational and physical environment influencing adolescents’ physical activity behaviours. Method: We conducted six semi-structured focus groups with 35 13–14-year-olds and eight interviews with some of their parents. The interviewees were recruited from one higher and two lower socioeconomic neighbourhoods in Oslo, Norway. Theme-based coding was used for analysis, and the results discussed in light of an ecological framework. Results: The results indicate that factors like social norms in a neighbourhood could shape adolescents’ physical activity behaviour, and a social norm of an active lifestyle seemed to be an essential facilitator in the higher socioeconomic neighbourhood. Higher availability of physical activity and high parental engagement seemed to facilitate higher physical activity in this neighbourhood. In the lower socioeconomic neighbourhoods, the availability of local organised physical activity and volunteer engagement from parents varied. Programmes from the municipality and volunteer organisations seemed to influence and be essential for adolescents’ physical activity behaviour in these neighbourhoods. Conclusions: The results illustrate the complexity of behaviour and environment interaction, and a limitation in explaining the phenomenon by focusing primarily on the individual level rather than an ecological perspective.

scholarly journals Socioeconomic position and SARS-CoV-2 infections: seroepidemiological findings from a German nationwide dynamic cohort

2021 ◽  
pp. jech-2021-217653
Author(s):  
Jens Hoebel ◽  
Markus M Grabka ◽  
Carsten Schröder ◽  
Sebastian Haller ◽  
Hannelore Neuhauser ◽  
...  
Keyword(s):  
Socioeconomic Position ◽  
Adult Population ◽  
Individual Level ◽  
Highly Educated ◽  
Increased Risk ◽  
Pandemic Planning ◽  
Nasal Swabs ◽  
The Individual ◽  
Low Educated ◽  
The Relationship

BackgroundEvidence on the relationship between socioeconomic position (SEP) and infections with SARS-CoV-2 is still limited as most of the available studies are ecological in nature. This is the first German nationwide study to examine differences in the risk of SARS-CoV-2 infections according to SEP at the individual level.MethodsThe ‘CORONA-MONITORING bundesweit’ (RKI-SOEP) study is a seroepidemiological survey among a dynamic cohort of the German adult population (n=15 122; October 2020–February 2021). Dried blood samples were tested for SARS-CoV-2 antibodies and oral-nasal swabs for viral RNA. SEP was measured by education and income. Robust logistic regression was used to examine adjusted associations of SARS-CoV-2 infections with SEP.Results288 participants were seropositive, PCR positive or self-reported a previous laboratory-confirmed SARS-CoV-2 infection. The adjusted odds of SARS-CoV-2 infection were 1.87-fold (95% CI 1.06 to 3.29) higher among low-educated than highly educated adults. Evidence was weaker for income differences in infections (OR=1.65; 95% CI 0.89 to 3.05). Highly educated adults had lower odds of undetected infection.ConclusionThe results indicate an increased risk of SARS-CoV-2 infection in low-educated groups. To promote health equity in the pandemic and beyond, social determinants should be addressed more in infection protection and pandemic planning.

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