Khang Young-Ho, Kim Hye Ryun
Department of Preventive Medicine, University of Ulsan College of Medicine, Korea Institute for Health and Social Affairs.
J Prev Med Public Health. 2006 Mar;39(2):115-22.
This study was conducted to examine the relationships of the several socioeconomic position indicators with the mortality risk in a representative longitudinal study of South Korea.
The 1998 National Health and Nutrition Examination Survey was conducted on a cross-sectional probability sample of South Korean households, and it contained unique 13-digit personal identification numbers that were linked to the data on mortality from the National Statistical Office of Korea. Of 5,607 males and females, 264 died between 1999 and 2003. Cox's regression was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) of mortality.
Socioeconomic differences in mortality were observed after adjustments were made for gender and age. Compared with those people having college or higher education, those people without any formal education had a greater mortality risk (RR = 2.21, 95% CI = 1.12-4.40). The mortality risk among manual workers was significantly greater than that for the non-manual workers (RR = 2.73, 95% CI = 1.47-5.06). A non-standard employment status was also associated with an increase in mortality: temporary or daily workers had a greater mortality risk than did the full-time workers (RR = 3.01, 95% CI = 1.50-6.03). The mortality risk for the low occupational class was 3.06 times greater than that of the high and middle occupational classes (95% Cl = 1.75-5.36). In addition, graded mortality differences according to equivalized monthly household income were found. A reduction of monthly household income by 500 thousand Korean Won (about 400 US dollars) was related with a 20% excess risk of mortality. Self-reported poor living standards were also associated with an increased risk of mortality. Those without health insurance had a 3.63 times greater risk of mortality than the insured (95% CI = 1.61-8.19).
This study showed the socioeconomic differentials in mortality in a national longitudinal study of South Korea. The existence of socioeconomic mortality inequalities requires increased social discussion on social policies in Korean society. Furthermore, the mechanisms for the socioeconomic inequalities of mortality need to be explored in future studies.
在一项具有代表性的韩国纵向研究中，本研究旨在探讨几种社会经济地位指标与死亡风险之间的关系。
1998年韩国国民健康与营养检查调查针对韩国住户的横断面概率样本进行，其中包含与韩国国家统计局的死亡率数据相关联的唯一13位个人识别码。在5607名男性和女性中，有264人在1999年至2003年间死亡。采用Cox回归来估计死亡的相对风险（RR）及其95%置信区间（CI）。
在对性别和年龄进行调整后，观察到了死亡率方面的社会经济差异。与接受过大学及以上教育的人相比，未接受任何正规教育的人有更高的死亡风险（RR = 2.21，95% CI = 1.12 - 4.40）。体力劳动者的死亡风险显著高于非体力劳动者（RR = 2.73，95% CI = 1.47 - 5.06）。非标准就业状况也与死亡率增加相关：临时工或日工的死亡风险高于全职工作者（RR = 3.01，95% CI = 1.50 - 6.03）。低职业阶层的死亡风险是高职业阶层和中职业阶层的3.06倍（95% Cl = 1.75 - 5.36）。此外，还发现了根据家庭月收入等值化后的分级死亡差异。家庭月收入减少50万韩元（约400美元）与死亡风险增加20%相关。自我报告的生活水平差也与死亡风险增加相关。没有医疗保险的人死亡风险是有保险者的3.63倍（9% CI = 1.61 - 8.19）。
本研究在韩国的一项全国纵向研究中显示了死亡率方面的社会经济差异。社会经济死亡率不平等的存在需要韩国社会对社会政策进行更多的社会讨论。此外，未来的研究需要探索死亡率社会经济不平等的机制。
