Association between household income and mental health among adults during the COVID-19 pandemic in Korea: Insights from a community health survey.

People of low socioeconomic status are vulnerable to health problems during disasters such as the COVID-19 pandemic. Using data from the 2019 and 2021 Korea Community Health Survey, this study analyzed the associations between Korean adults' mental health and their national and regional-level household incomes during the pandemic. The prevalence of perceived stress and depression experience for each risk factor category was calculated through univariate analyses. A multivariate logistic regression analysis helped identify the association between two types of income levels (national or regional) and perceived stress and experience of depression. Additionally, we investigated the effect of income levels by subgroup (gender and residential area) on perceived stress and the experience of depression. During the pandemic, the crude prevalence of an experience of depression was higher (6.24% to 7.2%) but that of perceived stress remained unchanged. Regarding regional-income based mental health disparities, even after adjusting for each independent variable, perceived stress (2019 odds ratio (OR): 1.26, 95% confidence interval (CI):1.26-1.27, 2021 OR: 1.32, 95% CI: 1.32-1.32) and experience of depression (2019 OR: 1.56, 95% CI: 1.55-1.56, 2021 OR: 1.63, 95% CI: 1.63-1.64) increased as the income level decreased. The perceived stress based on the two income levels was higher in women than in men. For both income levels, the experience of depression of women was higher than that of men before COVID-19 and vice versa during the COVID-19 period. National income had a more pronounced effect on mental health in urban areas than in rural areas. Contrarily, the effect of regional income level on mental health was not consistent across residential areas (urban and rural areas). Our findings demonstrated that mental health disparities based on income level were more likely to occur during the COVID-19 pandemic and are better reflected through disparities in regional income levels.

Factors Influencing the Size of a Non-Traumatic Full-Thickness Rotator Cuff Tear: Focusing on Socioeconomic Factors.

This study aimed to identify the risk factors for non-traumatic rotator cuff tears in Korean adult patients who underwent surgical treatment, focusing on socioeconomic factors. A retrospective study was conducted with 659 patients who were diagnosed with a full rotator cuff tear and underwent surgical treatment. The outcome variable was the rotator cuff tear size (mm), as indicated by preoperative magnetic resonance imaging. Socioeconomic variables included occupation, education level, insurance type, and residential area. Univariate analyses were used to evaluate the relation between tear size and independent variables, and multivariate regression was used to estimate the effects of socioeconomic factors on tear size after adjusting for other variables. Significant differences were found in mean tear size according to age, occupation, residence area, and symptom duration (p < 0.05) in multivariate regression analysis. Rural residents had a 2.12 mm larger tear size than urban residents. Compared to National Health Insurance patients, the tear size of Medicaid beneficiaries was significantly larger (6.79 mm) in urban areas. The larger the rotator cuff tear, the greater the risk of retear and poor shoulder function. Therefore, policy efforts are required to expand access to medical care for the vulnerable.

Avoidable Mortality between Metropolitan and Non-Metropolitan Areas in Korea from 1995 to 2019: A Descriptive Study of Implications for the National Healthcare Policy.

This study aims to investigate the trends of avoidable mortality and regional inequality from 1995 to 2019 and to provide evidence for policy effectiveness to address regional health disparities in Korea. Mortality and population data were obtained from the Statistics Korea database. Age-standardized all-cause, avoidable, preventable, and treatable mortality was calculated for each year by sex and region. Changes in mortality trends between metropolitan and non-metropolitan areas were compared with absolute and relative differences. Avoidable mortality decreased by 65.7% (350.5 to 120.2/100,000 persons) in Korea, 64.5% in metropolitan areas, and 65.8% in non-metropolitan areas. The reduction in avoidable mortality was greater in males than in females in both areas. The main causes of death that contribute to the reduction of avoidable mortality are cardiovascular diseases, cancer, and injuries. In preventable mortality, the decrease in non-metropolitan areas (-192.4/100,000 persons) was greater than that in metropolitan areas (-142.7/100,000 persons). However, in treatable mortality, there was no significant difference between the two areas. While inequalities in preventable mortality improved, inequalities in treatable mortality worsened, especially in females. Our findings suggest that regional health disparities can be resolved through a balanced regional development strategy with an ultimate goal of reducing health disparities.