scholarly journals The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis

2020 ◽  
Author(s):  
Young-Eun Kim ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-beom Kim ◽  
Dun-Sol Go ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Outcome ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability

Abstract Background: This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods: The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.Results: The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.Conclusions: Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis

2020 ◽  
Author(s):  
Seok-Jun Yoon ◽  
Young-Eun Kim ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-beom Kim ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Outcome ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability

Abstract Background: This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods: The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.Results: The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.Conclusions: Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis

2020 ◽  
Author(s):  
Young-Eun Kim ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-beom Kim ◽  
Dun-Sol Go ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Outcome ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability

Abstract Background This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country. Results The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase. Conclusions Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals The Gaps in Health-Adjusted Life Years (HALE) by Income and Region in Korea: A National Representative Bigdata Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3473
Author(s):  
Young-Eun Kim ◽  
Yoon-Sun Jung ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-Beom Kim ◽  
...  
Keyword(s):  
Low Income ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability ◽  
Municipal Level

This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability (YLD) from the national claims data, as well as to identify the differences and inequalities in income level and region. The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based YLD for 260 disease groups, and used it as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 Korean municipal-level administrative districts. Our results revealed that HALE increased from 2008 to 2018. HALE in males increased faster than that in females. HALE was higher in higher income levels. In 2018, the gap in HALE between Q1 and Q2, the lower income group, was about 5.57 years. The gap in females by income level was smaller than that in males. Moreover, the gap in HALE by region was found to increase. Results suggest that there is an inequality in YLD in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals Widening or narrowing income inequalities in myocardial infarction? Time trends in life years free of myocardial infarction and after incidence

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Juliane Tetzlaff ◽  
Fabian Tetzlaff ◽  
Siegfried Geyer ◽  
Stefanie Sperlich ◽  
Jelena Epping
Keyword(s):  
Myocardial Infarction ◽  
Low Income ◽  
Income Group ◽  
Federal State ◽  
Men And Women ◽  
Mortality Risks ◽  
Income Inequalities ◽  
Life Years ◽  
Incidence And Mortality ◽  
Over Time

Abstract Background Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. Methods The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006–2008 and 2015–2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. Results MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. Conclusions Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.

Educational activities on language and behavioural outcomes at school entry are more important for socioeconomically disadvantaged children: a prospective observational study of Australian children

2020 ◽  
pp. jech-2020-213856
Author(s):  
Angela Gialamas ◽  
Dandara G Haag ◽  
Murthy N Mittinty ◽  
John W Lynch
Keyword(s):  
Low Income ◽  
Income Group ◽  
Receptive Vocabulary ◽  
Self Report ◽  
School Entry ◽  
Educational Activities ◽  
Disadvantaged Children ◽  
Lower Income Group ◽  
Effect Measure Modification ◽  
Independent Effects

BackgroundTo investigate whether time spent in educational activities at 2–3 years and developmental outcomes at school entry differ among children from different socioeconomic backgrounds.MethodsParticipants were from the Longitudinal Study of Australian Children (n=4253). Time spent in educational activities was collected using 24-hour time-use diaries. Income was measured using parent self-report. Receptive vocabulary was assessed using the Peabody Picture Vocabulary Test, and problem behaviours were measured by the Strengths and Difficulties Questionnaire. Marginal structural models were used to test whether the effects of educational activities on outcomes differed by income.ResultsChildren exposed to both <30 min/day in educational activities and being in a low-income household were at greater risk of poorer outcomes at school entry than the simple sum of their independent effects. Compared with children who spent ≥30 min/day in educational activities from high-income households, children who experienced <30 min/day in educational activities from low-income households had a 2.30 (95% CI 1.88 to 2.80) higher risk of having a receptive vocabulary score in the lowest quartile at school entry. The Relative Excess Risk due to Interaction of 0.15 (95% CI −0.38 to 0.67) was greater than 0, indicating a super-additive effect measure modification by income. These patterns were similar for behavioural outcomes.ConclusionsOur findings suggest that if there was an intervention of sufficient dose to increase the amount of time spent in educational activities to at least 30 min/day for children in the lower-income group, the risk of children having sub-optimal receptive vocabulary would be reduced by 45% and the risk of teacher-reported conduct and hyperactivity problems reduced by 67% and 70%, respectively.

scholarly journals Life Satisfaction Predicts Perceived Social Justice: The Lower Your Life Satisfaction, the Less Just You Perceive Society to Be

2020 ◽  
Vol 11 ◽  
Author(s):  
Qifan Jia ◽  
Jie Zhou ◽  
Mingquan Huang
Keyword(s):  
Life Satisfaction ◽  
Social Justice ◽  
Low Income ◽  
Group Analysis ◽  
Income Group ◽  
Income Level ◽  
Moderation Effect ◽  
Multiple Group ◽  
Random Intercept ◽  
Lagged Effect

It has been well established that life satisfaction is related to perceived social justice. However, current theories provide contrary assumptions on the direction of the influence. In this research, we use data from two longitudinal surveys collected in China to test the reciprocal relations between life satisfaction and perceived social justice over time. With a random intercept cross-lagged panel model, we disaggregate the between-person effect and the within-person effect of the relationship. To specify the conditions of the effect, we consider income levels as the moderator. Study 1 (N = 119) showed that on the between-person level, life satisfaction, and perceived social justice are positively correlated. On the within-person level, cross-lagged effect results showed that an individuals’ deviations from their expected score in life satisfaction predict deviations from their expected perceived social justice at the next time point, while deviations from expected perceived social justice does not predict subsequent deviations from expected life satisfaction. In study 2 (N = 637), we divided participants into three groups based on their household income and conducted a multiple group analysis to test its moderation effect. We found that the between-person correlation of life satisfaction and perceived social justice is not moderated by income level, and it is significant in all the three groups. However, the within-person cross-lagged effect is moderated by income level, and the effect of life satisfaction on perceived social justice only exists in the low income group. This research confirms the unidirectional relationship between life satisfaction and perceived social justice across time, and clarifies the effect in different levels and income groups, providing new insights on the formation of justice perception. It is recommended that future studies apply experimental designs to reach causal effects and explore more possible moderators and mediators.

scholarly journals Long-Term Effect of Income Level on Mortality after Stroke: A Nationwide Cohort Study in South Korea

2020 ◽  
Vol 17 (22) ◽  
pp. 8348
Author(s):  
Seungmin Jeong ◽  
Sung-il Cho ◽  
So Yeon Kong
Keyword(s):  
Low Income ◽  
Income Group ◽  
Income Level ◽  
High Income ◽  
High Income Group ◽  
Stroke Mortality ◽  
Stroke Event ◽  
Middle Income ◽  
Medical Aid ◽  
Post Stroke

We investigated whether income level has long-term effects on mortality rate in stroke patients and whether this varies with time after the first stroke event, using the National Health Insurance Service National Sample Cohort data from 2002 to 2015 in South Korea. The study population was new-onset stroke patients ≥18 years of age. Patients were categorized into Category (1) insured employees and Category (2) insured self-employed/Medical Aid beneficiaries. Each category was divided into three and four income level groups, retrospectively. The study population comprised of 11,668 patients. Among the Category 1 patients (n = 7720), the low-income group’s post-stroke mortality was 1.15-fold higher than the high-income group. Among the Category 2 patients (n = 3948), the lower income groups had higher post-stroke mortality than the high-income group (middle-income, aOR (adjusted odds ratio) 1.29; low-income, aOR 1.70; Medical Aid beneficiaries, aOR 2.19). In this category, the lower income groups’ post-stroke mortality risks compared to the high-income group were highest at 13–36 months after the first stroke event(middle-income, aOR 1.52; low-income, aOR 2.31; Medical Aid beneficiaries, aOR 2.53). Medical Aid beneficiaries had a significantly higher post-stroke mortality risk than the high-income group at all time points.

scholarly journals 511Effects of educational activities prior to school entry are more important for socioeconomically disadvantaged children

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Angela Gialamas ◽  
Dandara Haag ◽  
Murthy Mittinty ◽  
John Lynch
Keyword(s):  
Low Income ◽  
Income Group ◽  
Language Ability ◽  
Self Report ◽  
School Entry ◽  
Lower Income ◽  
Educational Activities ◽  
Disadvantaged Children ◽  
Lower Income Group ◽  
Effect Measure Modification

Abstract Background We examined whether time in educational activities at 2-3 years and language ability at school entry differed among children from diverse socioeconomic backgrounds. Methods Data were drawn from the Longitudinal Study of Australian Children (n = 4253). Educational activities were collected using time-use diaries. Household income was measured using parent self-report. Language ability was assessed using the Peabody Picture Vocabulary Test. Marginal structural models with inverse probability of treatment weights were used to assess modification of the effect of time spent in educational activities on language ability by income. Results Children exposed to both &lt;30 minutes/day in educational activities and being in a low-income household were at greater risk of poorer outcomes than the simple sum of their independent effects. Compared with children who spent ≥30 minutes/day in educational activities and from higher-income households, children who experienced &lt;30 minutes/day from low-income households had a 2.30 (95% CI: 1.88, 2.80) higher risk of having lower language ability. The Relative Excess Risk Due to Interaction of 0.15 (95% CI:-0.15, 0.67) was greater than zero indicating a super-additive effect measure modification by income. Conclusions Our results suggest that boosting time in educational activities to 30 minutes/day would benefit the lower-income group relatively more than the higher-income group. Key messages If there was an intervention of sufficient dose to increase the amount of time spent in educational activities to 30 minutes/day for children in the lower-income group, the risk of children having lower language ability at school entry could be reduced by 45%.

scholarly journals 4499 A look at motivation and income level for families in obesity treatment

2020 ◽  
Vol 4 (s1) ◽  
pp. 121-122
Author(s):  
Melissa Ramel ◽  
Denise Wilfley ◽  
Rachel Tabak
Keyword(s):  
Low Income ◽  
Income Group ◽  
Income Level ◽  
Income Groups ◽  
Significant Difference ◽  
High Motivation ◽  
The Mean ◽  
Level Of Motivation ◽  
Children In The Middle ◽  
The Relationship

OBJECTIVES/GOALS: An evidence-based approach for childhood obesity is family-based treatment (FBT). Research supports that motivation and income level may impact treatment success; however, the relationship between the two is understudied. Therefore, the objective of this study was to examine whether motivation for beginning FBT is associated with income levels. METHODS/STUDY POPULATION: 459 parent and child dyads from the PLAN (Pediatric, Learning, Activity, Nutrition) with Families multisite study were included in this study. PLAN consists of FBT through personalized health coaching over the course of two years, focusing on nutrition, physical activity, and parenting skills. Parent and child also attend height and weight assessments every 6 months in the study. Outcomes of the study include weight change and mastery of behavioral skills. Motivation and income level were provided by self-report at the beginning of the study. Motivation was based on a scale from 1-10 (1 = no motivation, 10 = high motivation). Income levels were grouped into one of three broader categories- low income ($80,000/year). RESULTS/ANTICIPATED RESULTS: The mean level of motivation for the parent was 8.76 and for the child was 7.87. There was a significant difference in the mean level of motivation for the child and parent, t = 7.73, p = < .001. Post-hoc multiple comparisons using Tukey’s HSD test indicated that children in the high-income group had lower levels of motivation (M = 7.29, SD = 2.07) compared to children in the middle (M = 8.18) and low (M = 8.70) income groups. Level of motivation did not differ for children in the middle and low-income groups. Finally, parent motivation level did not differ significantly by income group. While there were significant differences between parent and child motivation levels, the motivation remained high for both groups. DISCUSSION/SIGNIFICANCE OF IMPACT: The data suggests a significant difference in mean child motivation and income level. Child’s high motivation may be from the idea of participating in something new, a rare opportunity for low-income children. To improve the implementation and efficacy of FBT, further study into the relationship between motivation and income level should be done.

scholarly journals The potential global gains in health and revenue from increased taxation of tobacco, alcohol and sugar-sweetened beverages: a modelling analysis

2020 ◽  
Vol 5 (3) ◽  
pp. e002143
Author(s):  
Amit Summan ◽  
Nicholas Stacey ◽  
Johanna Birckmayer ◽  
Evan Blecher ◽  
Frank J Chaloupka ◽  
...  
Keyword(s):  
Low Income ◽  
National Level ◽  
Economic Effects ◽  
Data Availability ◽  
Alcoholic Beverages ◽  
Sugar Sweetened Beverages ◽  
Uncertainty Interval ◽  
Sweetened Beverages ◽  
Life Years ◽  
Global Population

IntroductionGlobally, a growing burden of morbidity and mortality is attributable to lifestyle behaviours, and in particular to the consumption of tobacco, alcohol and sugar-sweetened beverages (SSB). In low-income and middle-income countries, this increased disease burden falls on already encumbered and resource-constrained healthcare systems. Fiscal policies, specifically taxation, can lower consumption of tobacco, alcohol and SSB while raising government revenues.MethodsWe simulated the health and economic effects of taxing cigarettes, alcohol and SSB over 50 years for 30–79 years old populations using separate mathematical models for each commodity that incorporated country-level epidemiological, demographic and consumption data. Based on data availability, national-level health effects of higher tobacco, alcohol and SSB taxes were simulated in 141, 166 and 176 countries, respectively, which represented 92%, 97% and 95% of the global population, respectively. Economic effects for tobacco, alcohol and SSB were estimated for countries representing 91%, 43% and 83% of the global population, respectively. These estimates were extrapolated to the global level by matching countries according to income level.ResultsOver 50 years, taxes that raise the retail price of tobacco, alcoholic beverages and SSB by 20% could result in a global gain of 160.7 million (95% uncertainty interval (UI): 96.3 to 225.2 million), 227.4 million (UI: 161.2 to 293.6 million) and 24.3 million (UI: 15.7 to 35.4 million) additional life years, respectively.ConclusionExcise tax increases on tobacco, alcohol and SSB can produce substantial health gains by reducing premature mortality while raising government revenues, which could be used to increase public health funding.

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