Lee Chiyoung, Yang Qing, Im Eun-Ok, McConnell Eleanor Schildwachter, Jung Sin-Ho, Kim Hyeoneui
University of Washington Bothell School of Nursing & Health Studies, Bothell, WA, USA.
Duke University School of Nursing, Durham, NC, USA.
SSM Popul Health. 2020 Oct 20;12:100682. doi: 10.1016/j.ssmph.2020.100682. eCollection 2020 Dec.
Although cardiovascular disease (CVD) risk has lessened in Korea, it is unclear whether older adults in all socioeconomic strata have benefited equally. This study explored trends in income disparities in CVD risk among older adults in Korea.
This was a secondary analysis of Korean National Health and Nutrition Examination Survey data (2008-2017), targeting 14,836 older adults (≥65 years). Socioeconomic position, defined as income and use of welfare benefits, was the primary indicator. The outcome was binary for predicted CVD risk (<90th vs. ≥ 90th). The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were used to assess trends in disparities.
The percentage of older adults with a predicted CVD risk of 90% or more declined over time, but this was due to a decrease among the more affluent. Disparities have persisted since 2012, with a worsening trend seen for Medicaid recipients. We found significant absolute and relative disparities among men over 75 years of age in recent years (SII > 0.19, RII > 7).
These results may inform and improve policies regarding income disparity reduction and cardiovascular health.
尽管韩国心血管疾病(CVD)风险有所降低,但尚不清楚所有社会经济阶层的老年人是否均同等受益。本研究探讨了韩国老年人CVD风险收入差距的趋势。
这是对韩国国家健康与营养检查调查数据(2008 - 2017年)的二次分析,目标对象为14,836名老年人(≥65岁)。社会经济地位定义为收入和福利津贴的使用情况,是主要指标。结局为预测的CVD风险的二元变量(<第90百分位数与≥第90百分位数)。不平等斜率指数(SII)和不平等相对指数(RII)用于评估差距趋势。
预测CVD风险为90%或更高的老年人比例随时间下降,但这是由于较富裕人群中的下降。自2012年以来差距一直存在,医疗补助领取者呈恶化趋势。近年来,我们发现75岁以上男性存在显著绝对和相对差距(SII>0.19,RII>7)。
这些结果可为减少收入差距和心血管健康相关政策提供参考并加以完善。