Korean Community Health Survey Research Articles

Factors Affecting Adherence to Social Distancing among Adults Aged 19-44 Years: Insights from a Nationwide Survey during COVID-19 Pandemic.

Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with older ones. We hypothesized that it would be worthwhile to find factors that influenced SD compliance among young people during the pre-vaccination phase of a pandemic. Materials and Methods: We analyzed data of adults aged 19-44 from the 2020 South Korean Community Health Survey and compared socio-demographic, health-related behavioral, and psychological factors between compliant and non-compliant cohorts. Results: A total of 59,943 participants were enrolled and we found that older age groups (30-39 and 40-44) and safety concerns (such as viral infection, virus-related death, economic damage, and transmitting virus to vulnerable people) were significantly associated with adherence to SD. Conversely, participants who were not living with a spouse, were unable to stay at home despite symptoms, smoked, drank, and had a negative attitude toward government policy statistically correlated with non-compliance. Conclusions: In times when NPIs were the primary defense against the pandemic, it is essential to identify factors that positively or negatively affect individual compliance with them, especially among young people. Using a large-scale, well-designed national survey, we could gain insights into the early recognition of risk factors for non-compliance and appropriate follow-up interventions (i.e., education campaigns, clear communication of public guidelines, and implementation of guidelines), which will help people to avoid suffering from other waves of future infectious diseases.

Association between Changes in Daily Life Due to COVID-19 and Depressive Symptoms in South Korea.

We aimed to examine changes in daily life due to coronavirus disease 2019 (COVID-19) among younger (≤64 years) and older (≥65 years) individuals and to analyze their association with depressive symptoms. Raw data from the 2020 Korean Community Health Survey were used to analyze 228,485 individuals. Changes in daily life due to COVID-19 were measured using a questionnaire that evaluated changes in physical activity, sleep duration, instant food intake, and drinking and smoking status. Depressive symptoms were assessed using the Patient Health Questionnaire 9 scale, and logistic regression analysis was performed to explore the association between the two variables. This study confirmed a significant association between the two variables and found that the intake of instant food showed the largest difference in odds ratios between the younger (OR: 1.851; 95% CI: 1.720-1.992) and older groups (OR: 1.239; 95% CI: 1.060-1.447). A major finding of this study is that the analysis of the association between the two variables revealed a stronger correlation in more variables in the younger population compared to the older population. To address COVID-19-related depression and prepare for potential mental health crises, countries should expand response measures.

Satisfaction with local healthcare services and medical need among hypertensive patients: a nationwide study

BackgroundInvestigating the factors associated with unmet medical needs is important since it can reflect access to healthcare. This study examined the relationship between the unmet medical needs of patients with hypertension and their satisfaction with the healthcare services available in their neighborhoods.MethodsData were from the 2021 Korean Community Health Survey. The sample included individuals aged 19 years who were diagnosed with hypertension. The main outcome measure was unmet medical need. The relationship between the outcome measure and independent variables were analyzed using multivariate logistic regressions, along with a subgroup analysis based on whether patients were currently receiving treatment for hypertension.ResultsUnmet medical needs were found in 4.3% of the study participants. A higher likelihood of unmet medical needs was found in individuals not satisfied with the healthcare services at proximity (adjusted OR = 1.69, 95% CI: 1.49–1.92) compared to those satisfied with services nearby. Similar tendencies were found regardless of whether individuals were currently receiving treatment for hypertension, although larger differences were found between groups in participants who were currently not receiving treatment.ConclusionsThe findings infer the need to consider patient satisfaction with nearby healthcare services in implementing public health policies that address unmet medical need in patients with hypertension.

Examining the association of breakfast skipping with sleep disturbance, mental health, and health-related quality of life: data from the 2018 Korean community health survey

ABSTRACT Objectives: This study aimed to explore the relationship between breakfast skipping and its effects on sleep disorders, mental health, and health-related quality of life among Korean adults. Methods: Utilizing data from the 2018 Korea Community Health Survey, this cross-sectional analysis included 173,272 adults aged 19 years and older. Instruments used for assessment included the Patient Health Questionnaire-9 for depression, the EuroQol 5-dimension (EQ-5D) for health-related quality of life, and the Pittsburgh Sleep Quality Index for sleep disorders. The complex sample logistic regression analysis was employed to adjust for potential confounders. Results: Breakfast skipping was found to be significantly associated with delayed mid-sleep time, an increased propensity for daytime sleepiness, and a notable decline in sleep quality. Additionally, it was linked to a significant increase in depression risk, compromised health-related quality of life, and elevated stress levels across both genders. All five dimensions of the EQ-5D were negatively impacted by breakfast skipping. Discussion: The findings highlight the detrimental effects of skipping breakfast on sleep patterns, mental health, and overall quality of life, stressing the importance of regular breakfast consumption for enhancing these health outcomes. The study suggests the need for further research to uncover the mechanisms behind these associations and to devise targeted interventions to mitigate the negative impacts of breakfast skipping.

Impact of electronic cigarette use on the increased risk of diabetes: the Korean Community Health Survey.

Only a few studies have solely investigated the health impacts of electronic cigarettes on diabetes while considering the impact of conventional cigarettes. Therefore, this study aimed to examine the effect of electronic cigarette smoking on diabetes in Korean dual smokers, electronic cigarette smokers, conventional cigarette smokers, and non-smokers. Data were obtained from the 2021 and 2022 Korean Community Health Surveys of 460,603 Korean adults. The main independent variable was smoking behavior. Participants were categorized according to their smoking behavior, as dual smokers, electronic cigarette smokers, conventional cigarette smokers, and non-smokers. The dependent variable, the presence of diabetes, was defined by a doctor's diagnosis. Multiple logistic regression analysis was performed to examine the association between smoking behavior and diabetes. Subgroup analyses were also performed to investigate the associations among different socioeconomic groups. Conventional cigarette smokers had a higher risk of diabetes than did non-smokers (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.19 to 1.26). More importantly, those who only vaped electronic cigarettes were at high risk of diabetes (aOR, 1.15; 95% CI, 1.01 to 1.31). Lastly, dual smokers had the highest aOR for diabetes among other smoking behavior groups (aOR, 1.39; 95% CI, 1.22 to 1.58). Dual smoking was associated with the highest risk of diabetes in most subgroups. This study suggests that conventional cigarette use and smoking electronic cigarettes negatively impact diabetes, and using both types leads to worse health outcomes. Therefore, cessation of all types of smoking is necessary for a healthy life.

Association between exposure to heavy metals in atmospheric particulate matter and sleep quality: A nationwide data linkage study

BackgroundRecent studies have demonstrated that long-term exposure to particulate matter (PM) is associated with poor sleep quality. However, no studies have linked PM constituents, particularly heavy metals, to sleep quality. ObjectiveThis study investigated the association between exposure to heavy metals in PM and sleep quality. MethodsWe obtained nationwide data from the Korean Community Health Survey conducted in 2018 among adults aged 19–80 years. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as PSQI ≥5. One-year and three-month average concentrations of heavy metals (lead, manganese, cadmium, and aluminum) in PM with diameter ≤10 μm were obtained from nationwide air quality monitoring data and linked to the survey data based on individual district-level residential addresses. Logistic regression analyses were performed after adjusting for age, gender, education level, marital status, smoking status, alcohol consumption, history of hypertension, and history of diabetes mellitus. ResultsOf 32,050 participants, 17,082 (53.3%) reported poor sleep quality. Increases in log-transformed one-year average lead (odds ratio, 1.14; 95% confidence interval, 1.08−1.20), manganese (1.31; 1.25−1.37), cadmium (1.03; 1.00−1.05), and aluminum concentrations (1.17; 1.10−1.25) were associated with poor sleep quality. Increases in log-transformed three-month average manganese (odds ratio, 1.13; 95% confidence interval, 1.09−1.17) and aluminum concentrations (1.28; 1.21−1.35) were associated with poor sleep quality. ConclusionWe showed for the first time that exposure to airborne lead, manganese, cadmium, and aluminum were associated with poor sleep quality. This study may be limited by self-reported sleep quality and district-level exposure data.

Protective Behaviors Against COVID-19 and Related Factors in Korean Adults With Depressive Symptoms: Results From an Analysis of the 2020 Korean Community Health Survey.

This study evaluated protective behaviors against coronavirus disease-2019 (COVID-19) and related factors in individuals with depressive symptoms. This cross-sectional study included data from the 2020 Korean Community Health Survey. Depressive symptoms, COVID- 19 protection behaviors, and related factors were investigated in 228,485 people. Chi-square test and logistic regression analysis were used to analyze categorical variables. Statistical analysis was performed using SPSS software (version 27.0). In the study, 3.9% (n=8,970) had depressive symptoms. The prevalence of depressive symptoms was higher in individuals in their 19-39 years , and ≥60s than in those in their 40-59 years (p<0.001). Lower education level and household income were associated with a higher prevalence of depression (p<0.001). Among the various occupations, service workers had the highest prevalence of depressive symptoms (p<0.001). Individuals with depressive symptoms were less likely to adopt protective behaviors against COVID-19 (p<0.001) or exhibit concerns regarding death and economic damage (p<0.001) compared to individuals without depressive symptoms. Individuals with depressive symptoms were more likely to have unhealthy behaviors than those without depressive symptoms (p<0.001). Individuals with depressive symptoms considered that the COVID-19 response by the government and other organizations was inadequate (p<0.001). During the COVID-19 pandemic, individuals with depressive symptoms faced greater challenges in adopting protective behaviors. Therefore, it is crucial to develop strategies to protect people with depressive symptoms during another pandemic in the future.

Socioeconomic inequality in health-related quality of life among Korean adults with chronic disease: an analysis of the Korean Community Health Survey.

Health-related quality of life is crucial for people dealing with chronic illness. This study investigated the quality of life in individuals with 5 common chronic conditions in Korea. We also analyzed socioeconomic factors such as education, income, occupation, and urbanization to identify determinants of inequality. Using 2016 Korea Community Health Survey data, we examined individuals aged 30 or older with chronic diseases (diabetes, hypertension, cardiovascular disease, hyperlipidemia, arthritis) using the EuroQol 5-Dimension 3 Level tool. We analyzed the associations between socioeconomic factors (education, income, occupation, urbanization) and quality of life using descriptive statistics and regression analysis. Inequality indices (relative inequality index, absolute inequality index) were used to measure inequality in quality of life. Individuals with higher income levels showed a 1.95-fold higher likelihood of a better quality of life than those with the lowest income. The lowest income group had higher odds of mobility (adjusted odds ratio [aOR], 2.2), self-care (aOR, 2.1), activity limitations (aOR, 2.4), pain/discomfort (aOR, 1.8), and anxiety/depression (aOR, 2.3). Educational disparities included a 3-fold increase in mobility and daily activity problems for those with elementary or lower education. Well-educated participants had a 1.94 times higher quality of life, with smaller differences in anxiety/depression and self-management. The income gap accounted for 14.1% of variance in quality-of-life disparities. Addressing socioeconomic disparities in the quality of life for individuals with chronic diseases necessitates tailored interventions and targeted health policies. This research informs policymakers in developing focused initiatives to alleviate health inequities. It emphasizes the importance of mental health support and ensuring affordable, accessible healthcare services.

전라북도 청년층의 우울감 및 자살생각 결정요인

The purpose of the present study is to examine sex differences in determinants of depression and suicidal ideation risks among young adults in Jeollabuk-do before and after the COVID-19 outbreak, with focused on variables related to socioeconomic status and social isolation. Towards this end, we used the sample of twenties and thirties from the Korean Community Health Survey data in 2017 and 2021. During the pandemic, we found 1) the greater gradient in moderate or stronger depressive symptoms along educational attainment and the principle economic status regardless of gender and in suicidal ideation among economically inactive women during the pandemic; 2) the wider difference in the risk of suicidal thought between the married and the single due to divorce, separation, or non-marriage; and 3) solitary living and residing in urban areas as independent risk factors for both depression and suicidal ideation among women and for depression regardless of sex, respectively. In addition, good environmental amenities in neighborhood serves as a resource factor for mental health, whereas high risk drinking is more likely to suppress the association between depression and suicidal ideation among women than among men. From the perspective of the internal inequalities within the same group of young adults, we provide overarching principles to overcome their health disparities for local policy makers and practitioners based on our main findings.

Unmet dental care needs and related factors among pregnant women: analysis based on data from 2019 Korean Community Health Survey

Unmet dental care needs and related factors among pregnant women: analysis based on data from 2019 Korean Community Health Survey

Effect of oral health on depression: an analysis of the 2021 Korea Community Health Survey

Objectives: This study aimed to identify factors related to oral health and depression in Korean adults and contribute to the development of a mental health program to improve depression through oral health management. Methods: Data was obtained from the 2021 Korean Community Health Survey. The chi-square test was used to determine the differences in depression experience relative to general participant characteristics and their oral health. To determine the odds ratio and 95% confidence interval, multiple logistic regression analysis was used. All statistical analyses were performed using the SAS software (version 9.4). Results: The results suggest that depression may be influenced by gender, age, household generation, drinking habits, subjective health level, moderate to high exercise, breakfast, high blood pressure, diabetes, subjective oral health level, chewing discomfort, and tooth brushing. An increasing level of depression was associated with decreasing subjective oral health level (1.34 times), uncomfortable chewing (3.08 times), and frequency of toothbrushing after lunch or before going to bed (1.23 times and 1.58 times, respectively). Conclusions: Our study confirmed a close relationship between oral health and mental health. In developing health programs for improving depression, appropriate oral health care should be considered.

Association between sleep hours and changes in cognitive function according to the morningness-eveningness type: A population-based study

ObjectiveThe aim of this study was to investigate proper sleep hours to reduce the risk of cognitive decrease considering morningness-eveningness type. MethodsThe Korean Community Health Survey was used, which includes adults aged over 19 years old. These data were obtained from a cross-sectional study and assessed sleep hours using questionnaire of Pittsburgh Sleep Quality Index. Based on the wake-up time of each participant, they were classified into the morningness, intermediate, eveningness, and none groups. The change in cognitive function was determined by a single question about memory loss experience. ResultsA total of 224,714 participants were included in the analysis. Of the participants, 55.6 % and 5.0 % of whom had morningness and eveningness, respectively. The risk of cognitive decline was significantly different by sleep hours and morningness-eveningness type. Without considering sleep quality, the intermediate and eveningness groups showed a higher risk of cognitive decline than the morningness group, and the risk was lowest in those with 7–9 sleep hours. However, when sleep quality showing significant effect was included in the analysis, sleep hours showing the lowest risk were different among morningness, intermediate, eveningness groups, and it was the shortest in the morningness type at 5–6 h and the longest in the eveningness type at 7–8 h. ConclusionProper sleep hours to decrease the risk of cognitive decline may be different by morningness-eveningness types. However, when considering sleep quality, sleep duration had little influence on cognitive decline. Future studies investigating healthy sleep hours need to consider sleep quality as well as the habitual sleep schedules. LimitationsThe morningness-eveningness types were classified based on wake-up time not morningness-eveningness types. The morningness-eveningness types in this study would be interpreted as habitual sleep schedule rather than chronotype.

Regional disparities in food security and depression among single-person households in the Republic of Korea

BackgroundSingle-person households constitute over 40% of all households in the Republic of Korea and are more vulnerable to food insecurity and depression than multi-person households. There is a lack of research on examining whether regional characteristics are associated with the degree of food insecurity and depression among single-person households. This study aimed to examine the regional disparities in food security and depression among single-person households in the Republic of Korea.MethodsA total of 227,873 adults from the 2019 Korean Community Health Survey was included in the analysis. According to population density and poverty rate, the residence of the participants was classified into four regions: metropolitan areas with high population density were classified into areas with low poverty rates (Region 1) and high poverty rates (Region 2), and provinces with low population density were classified into areas with low poverty rates (Region 3) and high poverty rates (Region 4). Using a single item of household food security, those who had experienced a lack of food due to financial difficulties over the past year were classified as food insecure. Depression was measured using the Patient Health Questionnaire-9. Odds ratios and 95% confidence intervals (CI) for the risk of food insecurity and depression according to regional characteristics were calculated after adjusting for potential confounding variables.ResultsAfter adjusting for confounding variables, single-person households in regions with high population density, Regions 1 and 2, had 1.16 times (95% CI = 1.04–1.30) and 1.43 times (95% CI = 1.27–1.61) higher odds of food insecurity, respectively, compared to those in Region 4. Single-person households in regions with low poverty rates, Regions 1 and 3, had 1.54 times (95% CI = 1.34–1.77) and 1.21 times (95% CI = 1.01–1.46) higher odds of depression, respectively, than those in Region 4. Among those who lived alone, the middle-aged, having low income, receiving livelihood benefits, or having a low educational attainment had higher odds of experiencing both food insecurity and depression than their counterparts.ConclusionsAs the risk of food insecurity and depression in single-person households differs according to regional characteristics, local governments need to implement policies for single-person households in consideration of these distinct characteristics.

Effect of Drinking Pattern on the Quality of Sleep Among Korean Male Adults Below 65 Years.

This study aimed to analyze the differences in sleep quality according to drinking patterns and identify factors associated with poor sleepers among Korean male adults younger than 65 years. Data from 68,711 male participants from the Korean Community Health Survey collected in Korea in 2018 were analyzed. After dividing them into binge drinking and nonbinge drinking groups, each group was further categorized into three subgroups according to the frequency of drinking: less than occasionally, frequent, and very frequent. The quality of sleep and depression were assessed through face-to-face interviews using the Pittsburgh Sleep Quality Index and the Patient Health Questionnaire-9, respectively. Total sleep quality was the lowest in the group that participated in "very frequent" binge drinking; the groups that participated in "frequent" binge drinking and "very frequent" nonbinge drinking had similar levels of sleep quality. Poisson regression with robust variance analysis revealed an almost 50% higher prevalence of poor sleep in the "very frequent" binge drinking group (prevalence ratio = 1.49, p < .001) compared with the reference group (nonbinge drinking, less than occasionally) after controlling for confounding variables. Significantly higher prevalence ratios of poor sleep were found in the "frequent" and "very frequent" drinking groups compared with the reference group. Health policies could emphasize the importance of reducing one's frequency and amount of drinking. In addition, it is also necessary for healthcare professionals to assess drinking patterns when caring for people experiencing poor quality sleep and support them in correcting such drinking behaviors.

The association between alcohol drinking and subjective salty taste preference based on Korean Community Health Survey data

The association between alcohol drinking and subjective salty taste preference based on Korean Community Health Survey data

Awareness and related factors of depressive symptoms in breastfeeding people in South Korea: a survey-based cross-sectional study

ObjectivesThis study identifies depressive symptoms and the factors that could explain its presence in breastfeeding people.DesignThis study is a cross-sectional study from national survey data.Setting and participantsData were derived from...

Relationship between functional limitations due to subjective cognitive decline and falling focusing exercise intensity: Results from the Korean Community Health Survey.

To explore the association between functional limitation due to subjective cognitive decline (SCD) and falling by focusing on exercise intensity in the Korean population aged 45 years and older. The 2019 Korean Community Health Survey (KCHS) was used to analyze 35,387 people by applying individual weights imposed from the raw data. To analyze the association between functional limitation due to SCD and falling in the Korean population aged 45 years and older, weighted logistic regression analysis and weighted zero-inflated Poisson regression analysis were used. In both the middle-aged group and the older adult group, the functional limitation due to SCD had a higher fall experience rate and more falls than the non-functional limitation due to SCD group. Additionally, the middle-aged group and the moderate or vigorous physical exercise (MVPE) group had a higher fall experience rate and number of falls than the non-MVPE group; however, the older adult group walking regularly and performing MVPE had a lower fall experience rate and number of falls than the non-exercise group. Active participation in exercise is encouraged and should lead to fewer falls in older adults. Furthermore, a group with functional limitations due to SCD should be provided with exercise guidelines and a community program and facilities that enable regular participation should be developed.

Patient Health Questionnaire-9, Body Mass Index, Household Income According to Sleep Duration: Findings From a Community Health Survey

Background and Objective Research on the relationship between sleep duration and Patient Health Questionnaire-9 (PHQ-9), body mass index (BMI), and income in South Korea was scarce. This study aimed to investigate the relationship between sleep duration and the PHQ-9, BMI, and household income.Methods We used data from the Korean Community Health Survey (KCHS) conducted by the Korean Center for Disease Control and Prevention in 2018 which included a total of 228340 participants from across the country. We divided the participants into four groups based on their sleep duration and used one-way analysis of variance (ANOVA) to compare the mean values of PHQ-9, BMI, and household income among the groups.Results A total of 227899 respondents were included in the study. Based on a one-way ANOVA, the mean PHQ-9 score tended to increase as sleep duration decreased. However, the group with a sleep duration of 9 hours or more had an exceptionally higher mean PHQ-9 score than the group with a sleep duration of 7 to 9 hours. The BMI score generally decreased as the sleep duration increased. Additionally, the group with a sleep duration of 5 to 7 hours and 7 to 9 hours had higher household income than the group with a sleep duration of 5 hours or less or 9 hours or more.Conclusions This study demonstrated the association between sleep duration and PHQ-9, BMI, and household income. Sleep duration was found to be a factor influencing PHQ-9, BMI, and household income.

The effects of sociodemographic factors on help-seeking for depression: Based on the 2017-2020 Korean Community Health Survey.

When individuals face psychological difficulties that exceed their resources, consulting professionals for mental health treatment can be an effective way to overcome these difficulties. However, in general, only a few patients receive treatment for depression. The goal of the present study was to explore the help-seeking behaviors of currently employed individuals with depression and the factors influencing their help-seeking behaviors. This study used raw data from the Korean Community Health Survey (KCHS) obtained from 2017 to 2020. A total of 6,505 employed individuals, who responded as having experiences of sadness or hopelessness that caused problems in their lives for more than two weeks and who scored more than nine points on the Patient Health Questionnaire-9, were included in our analysis. Help-seeking behavior was measured as receiving expert advice due to feelings of sadness or hopelessness. Of the 6,505 people with depression, only 1,781 (27.38%) received professional counseling for it. Male participants (adjusted odds ratio [aOR] = 1.31, 95% confidence interval [CI] = 1.157-1.487), those aged 45-64 years (aOR = 1.192, 95% CI = 1.022-1.389) and more than 75 years (aOR = 1.446, 95% CI = 1.059-1.973), those not having a Medical Aid program (aOR = 1.750, 95% CI = 1.375-2.226), and those having low educational levels (aOR = .896, 95% CI = .830-.968) were less likely to seek professional help for depression. Our study found that help-seeking behaviors for depression in the Korean population were low. Furthermore, we identified the characteristics associated with individuals with depressive symptoms who chose not to receive help from mental health professionals. The results of this study provide insights to guide national interventions to increase help-seeking behaviors for depression.

The effects of cigarette smoking and alcohol drinking on salty taste preferences based on Korean Community Health Survey data.

Excessive sodium intake, cigarette smoking, and alcohol consumption are risk factors for a wide range of diseases. This study aimed to determine whether smokers and drinkers are more likely to enjoy their food with more salt, and whether the combination of smoking and drinking is associated with salty taste preferences. This study analyzed the data of over 16 million Koreans from two four-year Korean Community Health Survey cycles (i.e., 2010 to 2013 and 2014 to 2017). The respondents' preferences for salty foods (i.e., their salt intake levels, whether they added salt or soy sauce to foods served on the table, and whether they dipped fried foods in salt or soy sauce), and the odds ratio (OR) of their preference were examined among smokers and drinkers when adjusted for sex, age, body mass index, educational level, household income, marital status, and cigarette smoking or alcohol consumption status. Cigarette smoking and alcohol consumption were correlated with the consumption of salty food. Based on the adjusted model, cigarette smokers and alcohol drinkers preferred adding salt or soy sauce or dipping fried foods in soybean more than non-smokers and non-drinkers. In addition, people who smoked and consumed alcohol reported a more significant stacking effect regarding the salty taste preference. This large population-based study found that both cigarette smoking and alcohol consumption were correlated with salty taste preferences, which may cause excessive sodium intake.