Effects of Behavioral Risk Factors and Social-Environmental Factors on Non-Communicable Diseases in South Korea: A National Survey Approach.

Nam Jeong Jeong,Eunil Park,Angel P Del Pobil

doi:10.3390/ijerph18020612

Abstract

Non-communicable diseases (NCDs) are one of the major health threats in the world. Thus, identifying the factors that influence NCDs is crucial to monitor and manage diseases. This study investigates the effects of social-environmental and behavioral risk factors on NCDs as well as the effects of social-environmental factors on behavioral risk factors using an integrated research model. This study used a dataset from the 2017 Korea National Health and Nutrition Examination Survey. After filtering incomplete responses, 5462 valid responses remained. Items including one’s social-environmental factors (household income, education level, and region), behavioral factors (alcohol use, tobacco use, and physical activity), and NCDs histories were used for analyses. To develop a comprehensive index of each factor that allows comparison between different concepts, the researchers assigned scores to indicators of the factors and calculated a ratio of the scores. A series of path analyses were conducted to determine the extent of relationships among NCDs and risk factors. The results showed that social-environmental factors have notable effects on stroke, myocardial infarction, angina, diabetes, and gastric, liver, colon, lung, and thyroid cancers. The results indicate that the effects of social-environmental and behavioral risk factors on NCDs vary across the different types of diseases. The effects of social-environmental factors and behavioral risk factors significantly affected NCDs. However, the effect of social-environmental factors on behavioral risk factors was not supported. Furthermore, social-environmental factors and behavioral risk factors affect NCDs in a similar way. However, the effects of behavioral risk factors were smaller than those of social-environmental factors. The current research suggests taking a comprehensive view of risk factors to further understand the antecedents of NCDs in South Korea.

Highlights

Non-communicable diseases (NCDs) have been highlighted as a significant global health threat
Social-environmental factors were significantly related to the prevalence of stroke (β = 0.101, p < 0.001), myocardial infarction (MI) (β = 0.058, p < 0.001), angina (β = 0.077, p < 0.001), diabetes (β = 0.201, p < 0.001), and cancers (β = 0.069, p < 0.001), which include gastric, colon, lung, and thyroid cancers
The significant negative effect of social-environmental factors on behavioral risk factors was observed in female cancer models (β = −0.053, p = 0.004), while no significant effect was found in models with a complete dataset (β = −0.024, p = 0.08)

Summary

Introduction

Non-communicable diseases (NCDs) have been highlighted as a significant global health threat. According to the World Health Organization’s (WHO) report, NCDs accounted for approximately 71% of global deaths in 2016. Cardiovascular disease (CVD), cancer, diabetes, and chronic pulmonary disease—are responsible for the majority of deaths by NCDs [1]. The South Korean government reported that over 60% of deaths in 2017 were significantly associated with NCDs [2]. Cancer, CVD, and diabetes were the top three causes of NCD deaths, accounting for 27.6%, 20.8%, and 17.9%, respectively [2]. Prior studies on NCDs indicated that both environmental and behavioral risk factors play critical roles in the development of NCDs [3,4].

Methods

Results

Discussion

Conclusion