Educational Inequality in Obesity-Related Mortality in Korea

Abstract

The prevalence of obesity has been increasing worldwide, which raises concerns about the disease burden associated with obesity. Socioeconomic status (SES) has been suggested to be associated with obesity and obesity related diseases. This study aimed to evaluate the time trend in socioeconomic inequality in obesity-related mortality over the last decade in Korean population. We evaluated the influence of education level, as an indicator of SES, on obesity-related mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases. The rate ratio of the mortality of people at the lowest education level as compared with those at the highest education level (relative index of inequality [RII]) was estimated using Poisson regression analysis. Between 2001 and 2011, RII (95% confidence interval) for overall obesity-related disease mortality increased from 2.10 (2.02–2.19) to 6.50 (6.19–6.82) in men, and from 1.94 (1.79–2.10) to 3.25 (3.05–3.45) in women, respectively. Cause-specifically, the same trend in RII was found for cardiovascular mortality and mortality from diabetes mellitus, whereas the RII of mortality from obesity-related cancers in men did not show the similar trend. Subgroup analysis stratified by age revealed that the RII of obesity-related mortality was much higher in younger people than in older people. In conclusion, there has been persistent socioeconomic inequality in obesity-related mortality in Korea, which was more evident in younger people than in older people and has been deepened over the last decade especially for cardiovascular disease and diabetes.

Temporal trends in educational inequalities in non-communicable diseases in Korea, 2007-2015

“…To date however, few studies have empirically examined the time trends in socioeconomic patterning of NCDs. In particular, existing studies have mostly focused on outcomes such as mortality [ 13 – 15 ], self-rated health [ 16 , 17 ] and fatal diseases like cancer [ 18 , 19 ] and cardiovascular diseases including stroke [ 20 ]. Yet the extent of and the trends in socioeconomic inequality with respect to nonfatal diseases, such as arthritis and asthma, despite being one of the leading contributors to Quality-Adjusted Life-years (QALYs) lost in Korea, have received relatively little attention [ 21 ].…”

Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review

“…Thirty-four studies (71.0%) employed a compositional approach to measuring SEP. Of those 34 studies, 17 depended on a single parameter and classified SES level according to a continuous or dichotomous distribution or standardized categori-zation. In these studies, the principal indicators were traditional measures of education [12][13][14][15][16][17][18], household income [19][20][21], and occupation [22,23]. Some studies specified the SES level according to proxy measures such as type of health insurance or health-insurance premium levels, which are determined in proportion to one's comprehensive living status [24][25][26][27][28].…”

Effect of methanol extract of Salviae miltiorrhizae Radix in high-fat diet-induced hyperlipidemic mice

“…Urbanized living environments and excessive nutritional intake have resulted in the recent increase of various metabolic diseases such as diabetes, hypertension, hyperlipidemia, and cardiovascular diseases [ 1 , 2 ]. After cancer, cerebrovascular disease and heart disease are the second and third most common causes of death in Korea [ 3 – 5 ].…”