Cho Jaehyeong, Son Yejun, Kim Soeun, Park Jaeyu, Lee Kyeongmin, Jo Hyesu, Kim Tae Hyeon, Lee Hayeon, Lee Sooji, Oh Jiyeon, Cho Hanseul, Woo Ho Geol, Pizzol Damiano, Woo Selin, Yon Dong Keon
Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea.
Department of Medicine, CHA University School of Medicine, Seongnam, Korea.
J Korean Med Sci. 2025 Aug 4;40(30):e180. doi: 10.3346/jkms.2025.40.e180.
Due to the lack of comprehensive longitudinal studies examining the impact of long-term volatility on health issues, existing research primarily focused on income levels rather than fluctuation. Thus, we aimed to investigate the relationship between income instability and a range of physical health conditions using an extensive longitudinal dataset.
This study utilized data from the Korean Genome and Epidemiology Study (KoGES) Ansan-Anseong cohort (2001-2022), which includes valuable confounding factors such as demographic, socioeconomic, lifestyle, and clinical factors. Income volatility was calculated as the intra-individual standard deviation of income changes across study waves. A Cox proportional hazards model was employed to assess correlations between income volatility and the risk of 12 non-communicable diseases (NCDs; hypertension, myocardial infarction [MI], coronary artery disease [CAD], cerebrovascular disease, diabetes, hyperlipidemia, gout, gastric disease, renal disease, arthritis, allergic disease, and asthma).
A total of 9,185 participants (mean age, 52.21; male, 47.59%) were analyzed. In the fully adjusted model, medium volatility was correlated with a higher disease risk (hazard ratio, 1.14; 95% confidence interval, 1.07-1.21), as similar to high volatility (1.09; 1.03-1.16). The highest risk was observed in individuals experiencing income decreases (1.61; 1.13-2.28). All health conditions examined in this study showed an increased risk correlated with higher income volatility as follows: hypertension (1.13; 1.03-1.25); MI (2.15; 1.33-3.48); CAD (1.37; 1.04-3.48); cerebrovascular disease (1.69; 1.21-2.37); hyperlipidemia (1.14; 1.01-1.28); gout (2.11; 1.12-3.95); gastric disease (1.15; 1.01-1.32); renal disease (2.28; 1.22-4.25); arthritis (1.33; 1.04-1.70); allergic disease (1.54; 1.16-2.03); asthma (1.67; 1.04-1.67).
Income volatility, particularly income decreases and fluctuations, is significantly correlated with higher risk of chronic NCDs in South Korea. These findings underscore the need to develop interventions to mitigate financial instability, thereby improving public health outcomes.
由于缺乏全面的纵向研究来考察长期收入波动对健康问题的影响，现有研究主要关注收入水平而非收入波动。因此，我们旨在使用一个广泛的纵向数据集来研究收入不稳定与一系列身体健康状况之间的关系。
本研究利用了韩国基因组与流行病学研究（KoGES）安山 - 安城队列（2001 - 2022年）的数据，其中包括人口统计学、社会经济、生活方式和临床因素等重要的混杂因素。收入波动通过研究各波次中个体收入变化的标准差来计算。采用Cox比例风险模型来评估收入波动与12种非传染性疾病（NCDs；高血压、心肌梗死[MI]、冠状动脉疾病[CAD]、脑血管疾病、糖尿病、高脂血症、痛风、胃病、肾病、关节炎、过敏性疾病和哮喘）风险之间的相关性。
共分析了9185名参与者（平均年龄52.21岁；男性占47.59%）。在完全调整模型中，中等波动与较高的疾病风险相关（风险比，1.14；95%置信区间，1.07 - 1.21），与高波动情况类似（1.09；1.03 - 1.16）。在经历收入下降的个体中观察到最高风险（1.61；1.13 - 2.28）。本研究中考察的所有健康状况均显示，随着收入波动增加，风险升高，具体如下：高血压（1.13；1.03 - 1.25）；心肌梗死（2.15；1.33 - 3.48）；冠状动脉疾病（1.37；1.04 - 3.48）；脑血管疾病（1.69；1.21 - 2.37）；高脂血症（1.14；1.01 - 1.28）；痛风（2.11；1.12 - 3.95）；胃病（1.15；1.01 - 1.32）；肾病（2.28；1.22 - 4.25）；关节炎（1.33；1.04 - 1.70）；过敏性疾病（1.54；1.16 - 2.03）；哮喘（1.67；1.04 - 1.67）。
在韩国，收入波动，尤其是收入下降和波动，与慢性非传染性疾病的较高风险显著相关。这些发现强调了制定干预措施以减轻金融不稳定从而改善公共卫生结果的必要性。
