The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data.

OBJECTIVES: Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. METHODS: This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. RESULTS: The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. CONCLUSIONS: ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.

A Health Information Quality Assessment Tool for Korean Online Newspaper Articles: Development Study.

BACKGROUND: Concern regarding the reliability and accuracy of the health-related information provided by online newspaper articles has increased. Numerous criteria and items have been proposed and published regarding the quality assessment of online information, but there is no standard quality assessment tool available for online newspapers. OBJECTIVE: This study aimed to develop the Health Information Quality Assessment Tool (HIQUAL) for online newspaper articles. METHODS: We reviewed previous health information quality assessment tools and related studies and accordingly developed and customized new criteria. The interrater agreement for the new assessment tool was assessed for 3 newspaper articles on different subjects (colorectal cancer, obesity genetic testing, and hypertension diagnostic criteria) using the Fleiss κ and Gwet agreement coefficient. To compare the quality scores generated by each pair of tools, convergent validity was measured using the Kendall τ ranked correlation. RESULTS: Overall, the HIQUAL for newspaper articles comprised 10 items across 5 domains: reliability, usefulness, understandability, sufficiency, and transparency. The interrater agreement for the article on colorectal cancer was in the moderate to substantial range (Fleiss κ=0.48, SE 0.11; Gwet agreement coefficient=0.74, SE 0.13), while for the article introducing obesity genetic testing it was in the substantial range, with values of 0.63 (SE 0.28) and 0.86 (SE 0.10) for the two measures, respectively. There was relatively low agreement for the article on hypertension diagnostic criteria at 0.20 (SE 0.10) and 0.75 (SE 0.13), respectively. Validity of the correlation assessed with the Kendall τ showed good correlation between tools (HIQUAL vs DISCERN=0.72, HIQUAL vs QUEST [Quality Evaluation Scoring Tool]=0.69). CONCLUSIONS: We developed a new assessment tool to evaluate the quality of health information in online newspaper articles, to help consumers discern accurate sources of health information. The HIQUAL can help increase the accuracy and quality of online health information in Korea.

Development and validation of prediction equations for the assessment of muscle or fat mass using anthropometric measurements, serum creatinine level, and lifestyle factors among Korean adults.

BACKGROUND/OBJECTIVES: The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS: A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008-2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland-Altman plot and intraclass correlation coefficient (ICC). RESULTS: The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS: All equations had low bias, moderate agreement based on the Bland-Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.

Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea.

OBJECTIVES: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. METHODS: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. RESULTS: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and selfrated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. CONCLUSIONS: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

Stent Thrombosis With Drug-Eluting Stents and Bioresorbable Scaffolds: Evidence From a Network Meta-Analysis of 147 Trials.

OBJECTIVES: This study sought to perform a systematic review and network meta-analysis to compare the relative safety and efficacy of contemporary DES and BVS. BACKGROUND: To improve outcomes of patients undergoing percutaneous coronary revascularization, there have been advances in the design of drug-eluting stents (DES), including the development of drug-eluting bioresorbable vascular scaffolds (BVS). METHODS: Prospective, randomized, controlled trials comparing bare-metal stents (BMS), paclitaxel-eluting stents (PES), sirolimus-eluting stents (SES), Endeavor zotarolimus-eluting stents (E-ZES), cobalt-chromium (CoCr) everolimus-eluting stents (EES), platinum-chromium (PtCr)-EES, biodegradable polymer (BP)-EES, Resolute zotarolimus-eluting stents (R-ZES), BP biolimus-eluting stents (BP-BES), hybrid sirolimus-eluting stents (H [Orsiro]-SES), polymer-free sirolimus- and probucol-eluting stents, or BVS were searched in online databases. The primary endpoint was definite or probable stent thrombosis at 1 year. RESULTS: A total of 147 trials including 126,526 patients were analyzed in this study. All contemporary DES were superior to BMS and PES in terms of definite or probable stent thrombosis at 1 year. CoCr-EES, PtCr-EES, and H-SES were associated with significantly lower risk than BVS. CoCr-EES and H-SES were superior to SES and BP-BES. The risk of myocardial infarction was significantly lower with H-SES than with BVS. There were no significant differences regarding all-cause or cardiac mortality. Contemporary devices including BVS showed comparably low risks of repeat revascularization. CONCLUSIONS: Contemporary DES, including biocompatible DP-DES, BP-DES, and polymer-free DES, showed a low risk of definite or probable stent thrombosis at 1 year. BVS had an increased risk of device thrombosis compared with CoCr-EES, PtCr-EES, and H-SES. Data from extended follow-up are warranted to confirm the long-term safety of contemporary coronary devices.

Assessment of radiation exposure from cesium-137 contaminated roads for epidemiological studies in Seoul, Korea.

OBJECTIVES: We aimed to assess the radiation exposure for epidemiologic investigation in residents exposed to radiation from roads that were accidentally found to be contaminated with radioactive cesium-137 ((137)Cs) in Seoul. METHODS: Using information regarding the frequency and duration of passing via the (137)Cs contaminated roads or residing/working near the roads from the questionnaires that were obtained from 8875 residents and the measured radiation doses reported by the Nuclear Safety and Security Commission, we calculated the total cumulative dose of radiation exposure for each person. RESULTS: Sixty-three percent of the residents who responded to the questionnaire were considered as ever-exposed and 1% of them had a total cumulative dose of more than 10 mSv. The mean (minimum, maximum) duration of radiation exposure was 4.75 years (0.08, 11.98) and the geometric mean (minimum, maximum) of the total cumulative dose was 0.049 mSv (<0.001, 35.35) in the exposed. CONCLUSIONS: An individual exposure assessment was performed for an epidemiological study to estimate the health risk among residents living in the vicinity of (137)Cs contaminated roads. The average exposure dose in the exposed people was less than 5% of the current guideline.

Disparities in Children's Blood Lead and Mercury Levels According to Community and Individual Socioeconomic Positions.

We aimed to examine the associations between blood lead and mercury levels and individual and community level socioeconomic positions (SEPs) in school-aged children. A longitudinal cohort study was performed in 33 elementary schools in 10 cities in Korea. Among a total of 6094 children included at baseline, the final study population, 2281 children followed-up biennially, were analyzed. The geometric mean (GM) levels of blood lead were 1.73 µg/dL (range 0.02-9.26) and 1.56 µg/dL (range 0.02-6.83) for male and female children, respectively. The blood lead levels were significantly higher in males, children living in rural areas, and those with lower individual SEP. The GM levels of blood mercury were 2.07 µg/L (range 0.09-12.67) and 2.06 µg/L (range 0.03-11.74) for males and females, respectively. Increased blood mercury levels were significantly associated with urban areas, higher individual SEP, and more deprived communities. The risk of high blood lead level was significantly higher for the lower individual SEP (odds ratio (OR) 2.18, 95% confidence interval (CI) 1.36-3.50 in the lowest educational attainment of the father), with a significant dose-response relationship observed after adjusting for the community SEP. The association between high blood lead levels and lower individual SEP was much stronger in the more deprived communities (OR 2.88, 95% CI 1.27-6.53) than in the less deprived communities (OR 1.40, 95% CI 0.76-2.59), and showed a significant decreasing trend during the follow-up only in the less deprived communities. The risk of high blood mercury levels was higher in higher individual SEP (OR 0.64, 95% CI 0.40-1.03 in the lowest educational attainment of the father), with a significant dose-response relationship noted. Significant decreasing trends were observed during the follow-up both in the less and more deprived communities. From a public health point-of-view, community level intervention with different approaches for different metals is warranted to protect children from environmental exposure.

Association of cardiovascular health screening with mortality, clinical outcomes, and health care cost: a nationwide cohort study.

OBJECTIVE: To determine whether a cardiovascular disease (CVD) health screening program is associated with CVD-related health conditions, incidence of cardiovascular events, mortality, healthcare utilization, and costs. METHODS: Cohort study of a 3% random sample of all Korea National Health Insurance members 40years of age or older and free of CVD or CVD-related health conditions was conducted. A total 443,337 study participants were followed-up from January 1, 2005 through December 31, 2010. RESULTS: In primary analysis, the hazard ratios for CVD mortality, all-cause mortality, incident composite CVD events, myocardial infarction, cerebral infarction, and cerebral hemorrhage comparing participants who attended a screening exam during 2003-2004 compared to those who did not were 0.58 (95% CI: 0.53-0.63), 0.62 (95% CI: 0.60-0.64), 0.82 (95% CI: 0.78-0.85), 0.84 (95% CI: 0.75-0.93), 0.84 (95% CI: 0.79-0.89), and 0.73 (95% CI: 0.67-0.80), respectively. Screening attenders had higher rates of newly diagnosed hypertension, diabetes mellitus, and dyslipidemia, lower inpatient days of stay and cost, and lower outpatient cost compared to non-attenders. CONCLUSIONS: Participation in CVD health screening was associated with lower rates of CVD, all-cause mortality, and CVD events, higher detection of CVD-related health conditions, and lower healthcare utilization and costs.

The radiologic technologists' health study in South Korea: study design and baseline results.

PURPOSE: To describe the study design, methods, and baseline results of a prospective cohort of radiologic technologists which we have initiated in South Korea. METHODS: The cohort participants were enrolled through a self-administered questionnaire survey administered from April 2012 to May 2013. Survey data were linked with radiation dosimetry, a cancer registry, and health insurance data by personal identification numbers. A nationwide representative survey was also conducted using a stratified random sampling design with face-to-face interviews. RESULTS: A total of 12,387 radiologic technologists were enrolled, which accounted for approximately 63% of all diagnostic radiologic technologists working in South Korea. For nationwide survey, 585 workers were interviewed using the detailed questionnaire, and buccal cells were also collected by scraping the inside of the cheek. The majority of study subjects were under 50-year-old and male workers. The average annual effective dose of radiation declined both men (from 2.75 to 1.43 mSv) and women (from 1.34 to 0.95 mSv) over the period of 1996-2011. A total of 99 cancers (66 cancers in men and 33 in women) were reported from 1992 to 2010. The standardized incidence ratio of all cancer combined was significantly lower in men (SIR = 0.75, 95% CI 0.58-0.96) than general population, but the ratios for thyroid cancer were significantly higher than expected among both men and women. CONCLUSIONS: This cohort provides comprehensive information on work activities and health status of diagnostic radiologic technologists. In addition, the nationwide representative sample provides unique opportunities compared with previous radiologic technologist studies.

The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study.

AIMS/INTRODUCTION: The incidence and prevalence of type 2 diabetes mellitus (T2DM) and related macrovascular complications in Korea were estimated using the Health Insurance Review and Assessment (HIRA) database from 2007-2011, which covers the claim data of 97.0% of the Korean population. MATERIALS AND METHODS: T2DM, coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral artery disease (PAD) were defined according to ICD-10 codes. We used the Healthcare Common Procedure Coding System codes provided by HIRA to identify associated procedures or surgeries. When calculating incidence, we excluded cases with preexisting T2DM within two years before the index year. A Poisson distribution was assumed when calculating 95% confidence intervals for prevalence and incidence rates. RESULTS: The prevalence of T2DM in Korean adults aged 20-89 years was 6.1-6.9% and the annual incidence rates of T2DM ranged from 9.5-9.8/1,000 person-year (PY) during the study period. The incidence rates of T2DM in men and women aged 20-49 years showed decreasing patterns from 2009 to 2011 (P<0.001); by contrast, the incidence in subjects aged 70-79 years showed increased patterns from 2009 to 2011 (P<0.001). The incidence rates of CAD and CVD in patients newly diagnosed with T2DM were 18.84/1,000 PY and 11.32/1,000 PY, respectively, in the year of diagnosis. Among newly diagnosed individuals with T2DM who were undergoing treatment for PAD, 14.6% underwent angioplasty for CAD during the same period. CONCLUSIONS: Our study measured the national incidences of T2DM, CAD, CVD, and PAD, which are of great concern for public health. We also confirmed the relatively higher risk of CAD and CVD newly detected T2DM patients compared to the general population in Korea.

Regional factors associated with participation in the national health screening program: a multilevel analysis using national data.

High participation rates are important for maximizing the effects of a health screening program. Previous studies have suggested that individual or regional characteristics have effects on health behaviors. In this study, we investigated the determinants of participation in the National Screening Program for Transitional Ages by simultaneously analyzing individual and area-level factors by multilevel analysis. A total of 1,081,216 subjects, aged 40 and 66 yr and nested in 254 areas, were included. There was a significant variation in participation rates across the areas even after adjusting for individual and area-level variables. Among the individual-level variables, increasing age, sex, higher income, and mild disability grade were associated with a higher participation rate. In urban areas, the 40-yr-old group had higher participation rates than the 66-yr-old group. Deprived areas had significantly high participation rates for both age groups. The number of screening centers per 1,000 inhabitants had no significant effect on participation in the screening program. In conclusion, regional characteristics are associated with participation rates independent of personal features and regional factors have differential effects with respect to age. A multi-dimensional approach is recommended to promote participation in health screening programs.

Quality of life assessment in male patients with androgenetic alopecia: result of a prospective, multicenter study.

BACKGROUND: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one's life and the individual's overall quality of life (QoL). OBJECTIVE: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. METHODS: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. RESULTS: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3±19.5, function scale: 24.0±20.1, emotion scale: 32.1±21.8, and global score: 27.3±19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. CONCLUSION: This study showed that AGA could harmfully affect the patients' QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.

Prevalence of treated epilepsy in Korea based on national health insurance data.

The Korean national health security system covers the entire population and all medical facilities. We aimed to estimate epilepsy prevalence, anticonvulsant utilization pattern and the cost. We identified prevalent epilepsy patients by the prescription of anticonvulsants under the diagnostic codes suggesting seizure or epilepsy from 2007 Korean National Health Insurance databases. The information of demography, residential area, the kind of medical security service reflecting economic status, anticonvulsants, and the costs was extracted. The overall prevalence of treated epilepsy patients was 2.41/1,000, and higher for men than women. The age-specific prevalence was the lowest in those in their thirties and forties. Epilepsy was more prevalent among lower-income individuals receiving medical aid. The regional prevalence was the highest in Jeju Island and lowest in Ulsan city. New anticonvulsants were more frequently used than old anticonvulsants in the younger age group. The total annual cost of epilepsy or seizure reached 0.46% of total medical expenditure and 0.27% of total expenditure on health. This is the first nationwide epidemiological report issued on epilepsy in Korea. Epilepsy prevalence in Korea is comparable to those in developed countries. Economic status and geography affect the prevalence of epilepsy.

Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon.

OBJECTIVES: To examine differences in the survival rates of cancer patients according to socioeconomic status, focusing on the role of the degree of healthcare utilisation by the patient. METHODS: An observational follow-up study was done for 261 lung cancer, 259 liver cancer, 268 stomach cancer and 270 colon cancer patients, diagnosed during 1999-2002. Income status and healthcare utilisation were assessed with National Health Insurance (NHI) data; survival during 1999-2002 was identified by death certificate. HRs and 95% CI were derived from Cox proportional hazards regression. RESULTS AND CONCLUSIONS: The HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time.

Deprivation and mortality at the town level in Busan, Korea: an ecological study.

OBJECTIVES: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. METHODS: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. RESULTS: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. CONCLUSIONS: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

Factors associated with the overuse or underuse of health care services among medical aid beneficiaries in Korea.

PURPOSE: To compare and contrast demographic characteristics and health care service utilization between overusers and underusers of health care services and to identify factors associated with the overuse or underuse of health care services among the medical aid beneficiaries in Korea. METHODS: Secondary data analysis was performed using health care costs and medical aid case management progress data. Data on demographic characteristics, health-related quality of life (HRQoL), and inappropriate health care service user category (overuse or underuse) were provided by the Medical-Aid Case Management Center of Korea, and heath care service reimbursement data were provided by the Korea National Health Insurance Corporation (NHIC). Data on 22,697 beneficiaries were used for analysis, and logistic regression analysis was conducted to examine factors that are associated with overuse and underuse of health care services. RESULTS: The study results revealed that older individuals, women, unemployed individuals, type 1 medical aid beneficiaries, and those with higher education and disabilities were more likely to belong to the overuse group, but urban residents, compared to metropolitan residents, and those with higher HRQoL were more likely to belong to the underuse group (p < .05). CONCLUSIONS: Understanding factors associated with the overuse or underuse of health care services may help to provide tailored case management services to improve the HRQoL of the beneficiaries and optimize their use of health care services. CLINICAL RELEVANCE: Promoting appropriate use of health care services may enhance clients' quality of life and preserve resources for other essential services for medical aid beneficiaries.

Assessment of hirsutism among Korean women: results of a randomly selected sample of women seeking pre-employment physical check-up.

BACKGROUND: The objectives of this study were to define the distribution of the modified Ferriman-Gallwey (mF-G) score in a random group of Korean women and to study any association(s) between hirsutism and endocrine/metabolic markers. METHODS: A single investigator assessed the mF-G score prospectively in 1010 Korean women, who consulted a health-care center as part of a group check-up for employment. Logistic regression models were utilized to test the relationships between the presence of hirsutism and levels of endocrine/metabolic markers. RESULTS: Subjects had mF-G scores ranging from 0 to 19, and 505 subjects (50.0%) had an mF-G score of zero. Of the 1010 subjects, 95.1% had a score at or below six; thus, a score of six or greater represented hirsute women in our population. The most frequently affected site was the upper back, but the most densely affected area was found to be the lower abdomen. Hirsutism was significantly and positively associated with serum levels of total testosterone (T) and hemoglobin A1(c), but negatively associated with those of sex hormone binding globulin (SHBG). In addition, the odds of a woman developing hirsutism were higher for increased total T and HbA1(c), and lower for decreased SHBG. Hirsutism and homeostatic model assessment for insulin resistance were positively associated, but the relationship was not significant after adjusting for age and BMI. CONCLUSIONS: mF-G scores greater that six represent the appropriate diagnostic cutoff for the detection of hirsutism in Korean women. Increased serum total T and HbA1(c,) and decreased SHBG concentrations were associated with the presence of hirsutism.

[Trend of socioeconomic inequality in participation in cervical cancer screening among Korean women].

OBJECTIVES: While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. METHODS: Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, and the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. RESULTS: Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. CONCLUSIONS: Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

[Changes in smoking status among current male smokers and factors associated with smoking cessation success].

OBJECTIVES: This study (a) investigated the rate of smoking cessation sucess for current male smokers, and (b) identified the factors that are associated with the smoking cessation success. METHODS: Data were collected from four follow-up surveys of 700 current male smokers. The follow-up period was from December 2004 to June 2005. Success of smoking cessation was defined as "maintaining a smoking cessation status for six months". The demographic and socioeconomic factors included age, the household income level and, occupation. The smoking behavioral factors were composed of the amount of smoking, the duration of smoking, the age of initiating smoking, the willingness to quit, the frequency of trying to quit smoking and the smoker's attitude toward the anti-smoking policies. RESULTS: The proportion of quitters increased from 6.6% to 11.0% during the follow-up period. The majority of quitters answered that the increase of tobacco price acted as cue to achieve smoking cessation. The age-standardized experience and success rate of smoking cessation were 16.0% (95% C.I.=13.0% to, 19.0%) and 4.5% (95% C.I.=3.0% to, 6.0%), respectively. On the multivariate analysis, success for smoking cessation was associated with the willingness to quit smoking, low prior tobacco consumption, and agreement on the tobacco price increase. CONCLUSIONS: The results of this study suggest that the recent anti-smoking policies provided an opportunity to quit smoking. The results of this study can be used to establish evidence for further anti-smoking policies.