Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
Department of Health Policy and Management, Seoul National University, College of Medicine, Seoul, Korea.
J Korean Med Sci. 2020 Jun 1;35(21):e141. doi: 10.3346/jkms.2020.35.e141.
This study compared inequalities in the longitudinal trajectory of health measured by latent growth curves (LGCs) in Korea and six other developed European countries.
Unconditional and conditional LGCs were fitted, with standardized self-rated health (SRH) as the outcome variable. Two nationally-representative longitudinal datasets were used: the Survey of Health, Aging and Retirement in Europe (2007-2015; 2,761 Swedish, 2,546 Danish, 2,580 German, 2,860 French, 2,372 Spanish, and 2,924 Italian respondents) and the Korean Longitudinal Study of Aging (2006-2014; 8,465 Korean respondents).
The unconditional patterns of SRH trajectory were similar and unfavorable for women across the countries. Social factors such as education and income generally exerted a significant impact on health trends among older adults. Korea showed less favorable results for the disadvantaged than the advantaged as compared with Denmark, Germany, and France, which was consistent with theoretical expectations. In contrast, the relative SRH trajectory of the disadvantaged as against the advantaged was better as compared with Sweden and worse as compared with Spain/Italy, which was inconsistent with theories that would predict Korea's results were worse than Sweden and similar to Spain/Italy. Women had good SRH trajectory in Denmark and poorer SRH trajectory in Spain, Italy, and Korea, which were consistent. However, women in Sweden showed poorer and mixed outcome, which does not correspond to theoretical predictions.
These findings suggest that it is inconclusive whether Sweden and Denmark (with the most generous welfare arrangements) have better trajectories of health, and Spain, Italy, and Korea (with the least advanced state policies) have worse SRH paths among older adults. However, it can be inferred that Korean governmental policies may have produced a relatively worse context for the less-educated than the six European countries, as well as poorer settings for women than Denmark in terms of their initial SRH status.
本研究比较了韩国和其他六个欧洲发达国家在通过潜在增长曲线（LGC）衡量的健康纵向轨迹方面的不平等情况。
使用标准化自评健康（SRH）作为因变量，拟合无条件和条件 LGC。使用两个具有全国代表性的纵向数据集：欧洲健康、老龄化和退休调查（2007-2015 年；2761 名瑞典人、2546 名丹麦人、2580 名德国人、2860 名法国人、2372 名西班牙人和 2924 名意大利人）和韩国老龄化纵向研究（2006-2014 年；8465 名韩国人）。
SRH 轨迹的无条件模式在各国对女性都不利。教育和收入等社会因素通常对老年人的健康趋势产生重大影响。与丹麦、德国和法国相比，韩国对弱势群体的结果不如对优势群体的结果有利，这与理论预期一致。相比之下，与瑞典相比，弱势群体与优势群体相比，相对 SRH 轨迹更好，而与西班牙/意大利相比则更差，这与预测韩国的结果比瑞典差且与西班牙/意大利相似的理论不一致。丹麦的女性 SRH 轨迹较好，而西班牙、意大利和韩国的女性 SRH 轨迹较差，这与理论预测一致。然而，瑞典的女性表现出较差和混合的结果，这与理论预测不一致。
这些发现表明，尚不确定瑞典和丹麦（拥有最慷慨的福利安排）的健康轨迹是否更好，以及西班牙、意大利和韩国（国家政策最不先进）的老年人自评健康路径是否更差。然而，可以推断，与六个欧洲国家相比，韩国政府政策为教育程度较低的人创造了相对较差的环境，而且在初始自评健康状况方面，女性的处境也比丹麦更差。
