Analysis of factors contributing to occupational health inequality in Korea: a cross-sectional study using nationally representative survey data

Eunjeong Noh,Young-Ho Khang

doi:10.1186/s13690-021-00638-9

Eunjeong Noh, Young-Ho Khang

Open Access

https://doi.org/10.1186/s13690-021-00638-9

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Abstract

BackgroundDespite the consensus that higher occupational classes tend to have better health and lower mortality rates, one study has reported reversed occupational gradients in mortality rates among Korean men after the economic crisis in the late 2000s. To examine these patterns of health inequality in more detail, we investigated the tendency of occupational gradients in socioeconomic position and multiple pathway indicators known to affect mortality in Korea.MethodsWe used data from 4176 men aged 35–64 in Korea derived from the 2007–2009 and 2013–2015 Korean National Health and Nutrition Examination Surveys. We compared the age-standardized prevalence and age-adjusted mean values of each contributing factor to health inequality among occupational groups, which are divided into upper non-manual workers, lower non-manual workers, manual workers, and others. Contributing factors included childhood and adulthood socioeconomic position indicators, biological risk factors, health behaviors, psychosocial factors, and work environment.ResultsUpper non-manual workers had prominently higher levels of education, income, parental education, and economic activity than lower non-manual and manual workers. The rates of smoking and high-risk alcohol consumption were lower, and the rate of weight control activities was higher, in the non-manual classes. Further, the rates of depression and suicidal ideation were lower, and perceptions of the work environment were more favorable, among non-manual workers than among their manual counterparts.ConclusionsWe detected occupational inequality in a wide range of socioeconomic positions and pathway indicators in Korea with consistently favorable patterns for upper non-manual workers. These occupational gradients do not support the previously reported reversed pattern of higher mortality rates in non-manual groups versus in the manual job class in Korea.

Highlights

Despite the consensus that higher occupational classes tend to have better health and lower mortality rates, one study has reported reversed occupational gradients in mortality rates among Korean men after the economic crisis in the late 2000s
Tanaka et al argued that occupational gradient patterns in mortality in Korea have diverged from European countries since the economic crisis of the 2000s [8]
They claimed that since this time, the allcause mortality rate for people with upper non-manual jobs has increased dramatically, exceeding that of people with lower non-manual and manual jobs. They proposed that the economic crisis might have affected the rising prevalence of cancer and suicide among non-manual workers, thereby contributing to the reversed patterns of health inequalities [8,9,10]. Mackenbach stated in his recent book that “the main exception is Japan and South Korea where occupational class inequalities in mortality do not follow the usual pattern” (p. 47) [10]

Summary

Introduction

Despite the consensus that higher occupational classes tend to have better health and lower mortality rates, one study has reported reversed occupational gradients in mortality rates among Korean men after the economic crisis in the late 2000s. To examine these patterns of health inequality in more detail, we investigated the tendency of occupational gradients in socioeconomic position and multiple pathway indicators known to affect mortality in Korea. Tanaka et al argued that occupational gradient patterns in mortality in Korea have diverged from European countries since the economic crisis of the 2000s [8] They claimed that since this time, the allcause mortality rate for people with upper non-manual jobs has increased dramatically, exceeding that of people with lower non-manual and manual jobs. The category of an “inactive or class-unknown” group, which accounted for 44–51% of total deaths in the most recent decade in Korea, may be related to the reversed pattern that Tanaka et al and Tanaka reported [8, 9]

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