Khang Young-Ho, Lynch John W, Kaplan George A
Department of Preventive Medicine, University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea.
Int J Epidemiol. 2005 Dec;34(6):1291-301. doi: 10.1093/ije/dyi224.
Economic changes can be powerful determinants of health. In the late 1990s, South Korea experienced a steep economic decline. This study examines whether the massive economic changes affected trends in all-cause and cause-specific mortality in South Korea.
Mid-year population estimates of 5 year age groups (denominators) and death certificate data (numerators) from the National Statistical Office of Korea were used to compute cause-specific age-standardized mortality rates before and after the economic crisis.
All-cause mortality continued to decrease in both sexes and all age groups during the crisis. Cerebrovascular accidents, stomach cancer, and liver disease contributed most to this decline. A remarkable decrease in transport accident mortality rates was also observed. The most salient increase in mortality was suicidal death. Mortality from homicide, pneumonia, and alcohol dependence increased during the economic crisis, but these accounted for a small proportion of total mortality.
Short-term mortality effects of the South Korean economic crisis were relatively small. It appears that any short-term effects of the economic decline were overwhelmed by the momentum of large declines in causes of death such as stroke, stomach cancer, and liver disease, which are probably related to exposures with much longer aetiological periods. However, this study focused on rather immediate mortality effects and follow-up studies are needed to elucidate any longer-term health effects of the South Korean economic crisis.
经济变化可能是健康状况的有力决定因素。20世纪90年代末,韩国经历了经济的急剧衰退。本研究旨在探讨这种大规模的经济变化是否影响了韩国全因死亡率和特定病因死亡率的趋势。
利用韩国国家统计局提供的5岁年龄组年中人口估计数(分母)和死亡证明数据(分子),计算经济危机前后特定病因的年龄标准化死亡率。
在危机期间,男女各年龄组的全因死亡率持续下降。脑血管意外、胃癌和肝病是死亡率下降的主要原因。交通事故死亡率也显著下降。死亡率上升最显著的是自杀死亡。经济危机期间,凶杀、肺炎和酒精依赖导致的死亡率上升,但这些在总死亡率中所占比例较小。
韩国经济危机对短期死亡率的影响相对较小。经济衰退的任何短期影响似乎都被中风、胃癌和肝病等死因大幅下降的趋势所掩盖,这些死因可能与病因期长得多的暴露因素有关。然而,本研究关注的是相当直接的死亡率影响,需要进行后续研究以阐明韩国经济危机的任何长期健康影响。