BackgroundThe current public health research agenda was to identify the means to reduce oral health inequalities internationally. The objectives of this study were to provide evidence of inequality in unmet dental needs and to find influencing factors attributable to those among South Korean adults.MethodsPooled cross-sectional data from the fourth Korean National Health and Nutrition Examination Survey (2007–2009) on 17,141 Korean adults were used. Demographic factors (sex, age, and marital status), socioeconomic factors (education level, employment status, and income level), need factors (normative dental needs and self-perceived oral health status), and oral health-related factors (the number of decayed teeth, the presence of periodontitis, and the number of missing teeth) were included. Multiple logistic regression analysis was performed.ResultsOf South Korean adults, 43.9% had perceived unmet dental needs, with the most common reason being financial difficulties. The disparities in unmet dental care needs were strongly associated with income level, normative treatment needs, and self-perceived oral health status. The low-income group, people with normative dental treatment needs, and those with perceived poor oral health status were more likely to have unmet dental needs. There was considerable inequality in unmet dental care needs due to economic reasons according to such socioeconomic factors as income and education level.ConclusionsPublic health policies with the expansion of dental insurance coverage are needed to reduce inequalities in unmet dental care needs and improve the accessibility of dental care services to vulnerable groups who are experiencing unmet dental care needs due to socioeconomic factors despite having normative and self-perceived needs for dental treatment.
To estimate future demand for institutional long-term care (LTC) by Koreans, the intention to use LTC facilities was estimated, and the underlying influencing factors were explored. Data from the Korean National Survey of LTC Need in the Elderly compiled in 2001 were used, and 1,850 people aged 65 and older who were classified as the targets for LTC in the survey and for whom complete data were available were sampled. The following influencing variables were selected based on Anderson's service-use model: demographics, social structural factors, family and community resources, and felt and assessed needs. The result shows that, of all the participants, 18.8% intended to use LTC facilities. A stronger intention was related to younger age, Christian religion, fewer children, lower family income, higher chronic comorbidity, and more education. The rapid industrialization of Korea has lead to a transition from the traditional family-centered mode of caregiving to a nontraditional one, but the intention to use LTC facilities is still lower than in Western developed countries. Regarding family resources, the effect of extended families comprising three or more generations is not as significant as expected, but children continue to be regarded as the main resources for LTC. The recent introduction of nontraditional religions to Korea has had a positive effect on intention to use LTC facilities, suggesting that cultural factors influence their use.
These results showed that the prevalence of dementia in Korea was similar to its presence in Western countries but different from that previously reported in other Asian countries, e.g., China and Japan.
Objectives: To simultaneously examine the effects of area-level and individual-level socioeconomic position on fatal injuries in children ,5 years of age. Methods: A retrospective cohort study based on the national birth and death registers of Korea. 2 667 060 children born during 1995-8 were followed up from birth to the 5th birthday. Cumulative incidences of fatal injuries were calculated, and through multilevel Poisson regression models, relative risks (RRs) of incidence rate were estimated according to children's sex, father's occupation and mother's education at individual level, and deprivation and degree of urbanity at area level. Results: Girls had lower risk for fatal injuries than boys (RR 0.81; 95% confidence interval (CI) 0.75 to 0.87). Compared with children with fathers in non-manual occupations, those with fathers in manual (RR 1.45; 95% CI 1.34 to 1.58) or other occupations (RR 1.35; 95% CI 1.13 to 1.62) had higher risk. Children with mothers who were high school graduates (RR 1.23; 95% CI 1.12 to 1.36) or junior school graduates (RR 1.91; 95% CI 1.66 to 2.19) had higher risk than those whose mothers were college graduates. After controlling for individual-level variables, residence in more deprived districts (RR 1.13; 95% CI 1.05 to 1.21) or nonmetropolitan regions (urban RR 1.34; 95% CI 1.22 to 1.47 and rural RR 1.61; 95% CI 1.40 to 1.86) was significantly associated with increased risk. Conclusions: Both individual-level and area-level socioeconomic position influenced the risk for childhood fatal injuries. To reduce the socioeconomic inequalities and the absolute burden in Korea, universal strategies should receive priority, and special efforts in implementation should be directed towards both disadvantaged households and areas.
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