Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
J Epidemiol Community Health. 2011 Feb;65(2):124-9. doi: 10.1136/jech.2008.086884. Epub 2009 Nov 22.
To determine the contribution of different causes of death to absolute socioeconomic inequalities in mortality for the whole population of children of South Korea aged 1-4 years and 5-9 years.
A cohort study based on the national birth and death registers of Korea was performed for 3,724,347 children born in 1995-2000 and 657,209 children born in 1995 to analyse mortality among children aged 1-4 and 5-9 years old, respectively. Adjusted mortality, risk difference (RD), slope index of inequality (SII), RR and relative index of inequality were calculated. The contributions of different causes of death to absolute mortality inequalities were calculated as percentages based on RD and SII.
Injuries other than from transport accidents contributed the most to total SIIs for male deaths at ages 1-4 (30.0% for father's education). The second largest contribution was from transport accident injuries (19.6% for father's education). For male deaths at ages 5-9, transport accident injuries and other injuries also accounted for most of the educational and occupational differentials in absolute mortality (63.5-90.5%). Patterns in cause-specific contribution to total inequalities in mortality among girls were generally similar to those among boys.
The major contributing causes to absolute socioeconomic inequality in all-cause mortality for children aged 1-9 were external. To reduce the absolute magnitude of socioeconomic inequalities in childhood mortality, policy efforts should be directed towards injury prevention and treatment in South Korea.
确定不同死因对韩国 1-4 岁和 5-9 岁儿童全人群死亡率的绝对社会经济不平等的贡献。
本研究基于韩国国家出生和死亡登记处,对 1995 年至 2000 年出生的 3724347 名儿童和 1995 年出生的 657209 名儿童进行了队列研究,以分别分析 1-4 岁和 5-9 岁儿童的死亡率。计算了校正死亡率、风险差异(RD)、不平等斜率指数(SII)、相对危险比(RR)和相对不平等指数。根据 RD 和 SII,计算了不同死因对绝对死亡率不平等的贡献百分比。
在导致 1-4 岁男性死亡的总 SII 中,除交通意外之外的其他伤害的贡献最大(父亲教育程度的 30.0%)。其次是交通意外伤害(父亲教育程度的 19.6%)。对于 5-9 岁的男性死亡,交通意外伤害和其他伤害也占了教育和职业绝对死亡率差异的大部分(63.5-90.5%)。特定死因对女童总死亡率社会经济不平等的贡献模式总体上与男童相似。
导致 1-9 岁儿童全因死亡率的绝对社会经济不平等的主要原因是外部因素。为了减少儿童死亡率的社会经济不平等的绝对程度,韩国应努力预防和治疗伤害。