韩国慢性病成年人健康相关生活质量的社会经济不平等:韩国社区健康调查分析。
Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey.
机构信息
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
Department of Cancer AI & Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
出版信息
Epidemiol Health. 2024;46:e2024018. doi: 10.4178/epih.e2024018. Epub 2024 Jan 8.
OBJECTIVES
Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality.
METHODS
Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life.
RESULTS
Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities.
CONCLUSIONS
Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.
目的
健康相关生活质量对于患有慢性疾病的人至关重要。本研究调查了韩国 5 种常见慢性疾病患者的生活质量。我们还分析了教育、收入、职业和城市化等社会经济因素,以确定不平等的决定因素。
方法
使用 2016 年韩国社区健康调查数据,我们使用 EuroQol 5-Dimension 3 级工具检查了患有慢性病(糖尿病、高血压、心血管疾病、高脂血症、关节炎)的 30 岁及以上个体。我们使用描述性统计和回归分析分析了社会经济因素(教育、收入、职业、城市化)与生活质量之间的关联。不平等指数(相对不平等指数、绝对不平等指数)用于衡量生活质量的不平等。
结果
收入水平较高的个体比收入最低的个体更有可能拥有更好的生活质量,其可能性高出 1.95 倍。最低收入组在移动能力(调整后的优势比 [aOR],2.2)、自我护理(aOR,2.1)、活动受限(aOR,2.4)、疼痛/不适(aOR,1.8)和焦虑/抑郁(aOR,2.3)方面的可能性更高。教育差异包括受教育程度较低的个体在移动能力和日常活动方面的问题增加了 3 倍。受过良好教育的参与者的生活质量提高了 3 倍,在焦虑/抑郁和自我管理方面的差异较小。收入差距占生活质量差异的 14.1%。
结论
解决慢性病患者生活质量方面的社会经济差异需要有针对性的干预措施和有针对性的卫生政策。这项研究为政策制定者制定有针对性的举措以减轻健康不平等提供了信息。它强调了心理健康支持和确保负担得起、可及的医疗保健服务的重要性。