Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
J Korean Med Sci. 2018 Feb 5;33(6):e44. doi: 10.3346/jkms.2018.33.e44.
We compared age-standardized prevalence of cigarette smoking and their income gaps at the district-level in Korea using the National Health Screening Database (NHSD) and the Community Health Survey (CHS).
Between 2009 and 2014, 39,049,485 subjects participating in the NHSD and 989,292 participants in the CHS were analyzed. The age-standardized prevalence of smoking and their interquintile income differences were calculated for 245 districts of Korea. We examined between-period correlations for the age-standardized smoking prevalence at the district-level and investigated the district-level differences in smoking prevalence and income gaps between the two databases.
The between-period correlation coefficients of smoking prevalence for both genders were 0.92-0.97 in NHSD and 0.58-0.69 in CHS, respectively. When using NHSD, we found significant income gaps in all districts for men and 244 districts for women. However, when CHS was analyzed, only 167 and 173 districts for men and women, respectively, showed significant income gaps. While correlation coefficients of district-level smoking prevalence from two databases were 0.87 for men and 0.85 for women, a relatively weak correlation between income gaps from the two databases was found.
Based on two databases, income gaps in smoking prevalence were evident for nearly all districts of Korea. Because of the large sample size for each district, NHSD may provide stable district-level smoking prevalence and its income gap and thus should be considered as a valuable data source for monitoring district-level smoking prevalence and its socioeconomic inequality.
本研究利用全国健康筛查数据库（NHSD）和社区健康调查（CHS）比较了韩国按年龄标准化的吸烟流行率及其在地区层面的收入差距。
2009 年至 2014 年间，共分析了 39049485 名参与 NHSD 的受试者和 989292 名参与 CHS 的受试者。计算了韩国 245 个地区的吸烟流行率的年龄标准化率及其五分位数收入差异。我们检验了地区层面吸烟流行率的同期相关系数，并调查了两个数据库中吸烟流行率和收入差距的地区差异。
NHSD 中男性和女性的吸烟流行率的同期相关系数分别为 0.92-0.97 和 0.58-0.69，而 CHS 中则分别为 0.69-0.82 和 0.50-0.62。当使用 NHSD 时，我们发现男性所有地区和女性 244 个地区的收入差距均具有统计学意义。然而，当分析 CHS 时，仅发现男性和女性分别有 167 个和 173 个地区的收入差距具有统计学意义。尽管两个数据库的地区吸烟流行率的相关系数男性为 0.87，女性为 0.85，但两个数据库的收入差距相关性较弱。
基于两个数据库，韩国几乎所有地区的吸烟流行率的收入差距均很明显。由于每个地区的样本量都很大，NHSD 可能提供稳定的地区吸烟流行率及其收入差距，因此应被视为监测地区吸烟流行率及其社会经济不平等的有价值的数据源。
