Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea.
Office of Public Healthcare Service, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
Int J Environ Res Public Health. 2022 Mar 15;19(6):3475. doi: 10.3390/ijerph19063475.
This study aims to investigate the trends of avoidable mortality and regional inequality from 1995 to 2019 and to provide evidence for policy effectiveness to address regional health disparities in Korea. Mortality and population data were obtained from the Statistics Korea database. Age-standardized all-cause, avoidable, preventable, and treatable mortality was calculated for each year by sex and region. Changes in mortality trends between metropolitan and non-metropolitan areas were compared with absolute and relative differences. Avoidable mortality decreased by 65.7% (350.5 to 120.2/100,000 persons) in Korea, 64.5% in metropolitan areas, and 65.8% in non-metropolitan areas. The reduction in avoidable mortality was greater in males than in females in both areas. The main causes of death that contribute to the reduction of avoidable mortality are cardiovascular diseases, cancer, and injuries. In preventable mortality, the decrease in non-metropolitan areas (-192.4/100,000 persons) was greater than that in metropolitan areas (-142.7/100,000 persons). However, in treatable mortality, there was no significant difference between the two areas. While inequalities in preventable mortality improved, inequalities in treatable mortality worsened, especially in females. Our findings suggest that regional health disparities can be resolved through a balanced regional development strategy with an ultimate goal of reducing health disparities.
本研究旨在探讨 1995 年至 2019 年期间可避免死亡率和地区不平等的趋势,并为解决韩国地区卫生差异的政策效果提供证据。死亡率和人口数据来自韩国统计局数据库。按性别和地区计算了每年的全因、可避免、可预防和可治疗死亡率的年龄标准化率。比较了大都市和非大都市地区死亡率趋势的变化,以及绝对差异和相对差异。韩国的可避免死亡率下降了 65.7%(从 350.5/100,000 人降至 120.2/100,000 人),大都市地区下降了 64.5%,非大都市地区下降了 65.8%。在这两个地区,男性的可避免死亡率下降幅度都大于女性。导致可避免死亡率下降的主要死因是心血管疾病、癌症和伤害。在可预防死亡率方面,非大都市地区(-192.4/100,000 人)的下降幅度大于大都市地区(-142.7/100,000 人)。然而,在可治疗死亡率方面,两个地区之间没有显著差异。尽管可预防死亡率的不平等状况有所改善,但可治疗死亡率的不平等状况却有所恶化,尤其是在女性中。我们的研究结果表明,通过实施平衡的区域发展战略,可以解决地区卫生差异问题,最终目标是减少卫生差异。