Rural Areas Of South Korea Research Articles

Development and Effectiveness of an AI Chatbot- Based Mobile Cognitive Screening and Customized Training Application for Preventing Dementia: Older Adults Living in Rural Areas of South Korea

Development and Effectiveness of an AI Chatbot- Based Mobile Cognitive Screening and Customized Training Application for Preventing Dementia: Older Adults Living in Rural Areas of South Korea

Preparedness, Challenges, and Opportunities for Digital Intervention for Chronic Disease Management: A Qualitative Study in Rural Areas of South Korea

ABSTRACT Motivated by the prevalence of an aging population and the associated increase in chronic diseases, coupled with rising medical expenditure, the Korean government initiated a pilot project in Pyeongchang-gun, Gangwon-do, a rural area, to implement a “smart online-to-offline (O2O) digital health care model” aimed at managing and preventing chronic diseases. However, there is limited understanding regarding perspectives and levels of preparedness for digital health among stakeholders at various levels. In-depth focus group interviews were conducted with elderly and non-elderly community members, health care providers, and staff members at Pyeongchang Health and Medical Center. The study found the presence of both positive and negative perceptions and a lack of preparedness across different levels. At the end-user level, it was observed that community members, especially the elderly, have low levels of health and digital literacy, compounded by limited access to social support. At the health care provider level, there was uncertainty about the acceptance of the digital health program. At the area level, the need to bolster health staff members and enhance their capacity was observed. Recommendations include: customizing the design of the online and offline service components by considering end-user factors (such as age, occupation, and household type) that may contribute to disparities in health; establishing a platform for providers to share their experiences to facilitate the effective incorporation of digital health into their practices; and preparing an appropriate provider payment mechanism.

Analysis of digital capacity-related factors influencing health promotion participation and active aging of older adults residing in rural areas in South Korea: A structural equation model.

This study aimed to identify the correlation between digital capacity, health promotion participation, and active aging of older people living in rural areas in South Korea to assess the factors influencing participation in programs for health promotion and active aging. Data were collected through a 1:1 face-to-face survey using a structured questionnaire from 13 February to 24 February 2023 during the older individuals' visits in the senior citizen welfare centers and senior citizen centers in the region. The Measuring Digital Skills questionnaire used to assess the digital competence of South Korean individuals was employed in this study. To confirm the structural relationship between digital capacity and health promotion participation and active aging in the older population aged 65 years and older based on the collected data, a structural equation modeling analysis was performed. Active health promotion participation had a positive effect on active aging. The pathway that older adults in Korea can led to participation in health promotion and active aging in the current situation is not mainly through the digital competency whereas mobile internet skill showed positive influneces. In the digital era and super-aged society, various programs are provided to older individuals to enhance the utilization of smartphones. However, education and programs for strengthening digital capacity should be organized to explain the advantages of digital use and to inform of the dangers of addiction to ensure healthy aging through social participation and exchange both online and offline.

The relationship between depressive mood and subjective health in centenarians and near-centenarians: a cross-sectional study from Korean centenarian cohort

Background With the rapid increase in population longevity, more clinical attention is being paid to the overall health of long-lived people, especially centenarians. Subjective health, which is the perception of one’s health status, predicts both mortality and declining physical function in older adults. The purpose of this study was to investigate the factors related to subjective health among centenarians and near-centenarians (ages ≥95) living in a rural area of South Korea. Methods A total of 101 participants were enrolled from four different regions (Gurye, Gokseong, Sunchang, and Damyang), known as the Longevity Belt in Korea. Variables assessing physical and mental health, including the results of blood tests, were examined. Factors associated with good subjective health were identified with logistic regression analysis. Results Fifty-six participants (59.6%) were subjectively healthy among the centenarians and near-centenarians. Logistic regression analysis revealed that depressive mood was the only factor associated with subjective health and was negatively correlated. The regression model explained 39% of the variance in subjective health. Conclusions These findings emphasize the importance of mental health at very advanced ages. Because depressive mood negatively correlates with subjective health, more attention is needed to prevent and manage mood symptoms of people of advanced ages, including centenarians.

Comparison of Personal or Indoor PM2.5 Exposure Level to That of Outdoor: Over Four Seasons in Selected Urban, Industrial, and Rural Areas of South Korea: (K-IOP Study).

This study aimed to compare the distribution of indoor, outdoor, and personal PM2.5 (particulate matter ≤ 2.5 μm) hourly concentrations measured simultaneously among 81 nonsmoking elderly participants (65 years or older) living in urban, industrial, or rural areas over 4 seasons (2 weeks per season) from November 2021 to July 2022). PM2.5 measurements were conducted using low-cost sensors with quality control and quality assurance tests. Seasonal outdoor PM2.5 levels were 16.4 (9.1-29.6) μg/m3, 20.5 (13.0-38.0) μg/m3, 18.2 (10.2-31.8) μg/m3, and 9.5 (3.8-18.7) μg/m3 for fall, winter, spring, and summer, respectively. For indoor PM2.5, the median seasonal range was 5.9-7.5 μg/m3, and the median personal PM2.5 exposure concentration was 8.0-9.4 μg/m3. This study provided seasonal distributions of IO (ratio of indoor to outdoor PM2.5 concentration) and PO (ratio of personal to outdoor PM2.5 concentration) using a total of 94,676 paired data points. The median seasonal IO ranged from 0.30 to 0.51 in fall, winter, and spring; its value of summer was 0.70. The median PO by season and study area were close to 1.0 in summer while it ranged 0.5 to 0.7 in other seasons, statistically significantly lower (p < 0.05) than that in summer. Our study has revealed that the real-world exposure level to PM2.5 among our elderly study participants might be lower than what was initially expected based on the outdoor data for most of the time. Further investigation may need to identify the reasons for the discrepancy, personal behavior patterns, and the effectiveness of any indoor air quality control system.

Analysis of Inequality Levels of Industrial Development in Rural Areas through Inequality Indices and Spatial Autocorrelation

To achieve a balanced and sustainable rural development pattern, this study used the Theil index, Gini coefficient, and Spatial Autocorrelation method to analyze the inequality of industrial economic development between rural areas in South Korea. The results showed that considering the whole of South Korea, the inequality in industrial economic development level among rural areas was reasonably balanced, and the inequality level showed a trend of narrowing. Considering the first-level regions, the levels of inequality varied. The economic development level of the rural areas around the Capital Area and Metropolitan Cities was higher than that of other rural areas, and policies should be established to support the economic development of other rural areas.

Comparisons of Spatial and Temporal Variations in PM2.5-Bound Trace Elements in Urban and Rural Areas of South Korea, and Associated Potential Health Risks

PM2.5-bound trace elements were chosen for health risk assessment because they have been linked to an increased risk of respiratory and cardiovascular illness. Since the Korean national air quality standard for ambient particulate matter is based on PM2.5 mass concentration, there have only been a few measurements of PM2.5 particles together with trace elements that can be utilized to evaluate their effects on air quality and human health. Thus, this study describes the trace elements bound to PM2.5 in Seoul (urban area) and Seosan (rural area) using online nondestructive energy-dispersive X-ray fluorescence analysis from December 2020 to January 2021. At both the Seoul and Seosan sites, S, K, Si, Ca, and Fe constituted most of the PM2.5-bound trace elements (~95%); major components such as S, K, and soil (estimatedcalculatedcalculated based on oxides of Si, Fe, Ca, and Ti) were presumably from anthropogenic and crustal sources, as well as favorable meteorological conditions. During winter, synoptic meteorology favored the transport of particles from severely contaminated regions, such as the East Asian outflow and local emissions. The total dry deposition flux for crustal elements was 894.5 ± 320.8 µg m−2 d−1 in Seoul and 1088.8 ± 302.4 µg m−2 d−1 in Seosan. Moreover, potential health risks from the trace elements were estimated. Cancer risk values for carcinogenic trace elements (Cr, As, Ni, and Pb) were within the tolerable limit (1 × 10−6), suggesting that adults and children were not at risk of cancer throughout the study period in Seoul and Seosan. Furthermore, a potential risk assessment of human exposure to remaining carcinogens (Cr, As, Ni, and Pb) and non-carcinogens (Cu, Fe, Zn, V, Mn, and Se) indicated that these trace elements posed no health risks. Nevertheless, trace element monitoring, risk assessment, and mitigation must be strengthened throughout the study area to confirm that trace-element-related health effects remain harmless. Researchers and policymakers can use the database from this study on spatial and temporal variation to establish actions and plans in the future.

The South Korean case of deploying rural broadband via fiber networks by implementing universal service obligation and public-private partnership based project

Despite broadband being essential infrastructure for conducting basic socio-economic activities and reducing inequality and the digital divide, expanding broadband coverage in rural areas remains a significant challenge in many countries due to high deployment costs. South Korea, a developed country in terms of fixed broadband penetration, implemented two policies for rural broadband via fiber access networks simultaneously during the COVID-19 pandemic. One is the universal broadband service at 100 Mbps speed introduced in 2020, and the other is the rural broadband project in terms of a public-private partnership (PPP) that proceeded from August 2020 to 2022. While both policies contribute to reducing the broadband gap between the urban and the rural in the country, it is still important to find the optimal cost-effective combination of the plural rural policies as much as possible from the cost perspective. Accordingly, this study proposes an investment cost estimation model for deploying rural broadband via fiber networks in South Korea and evaluates whether implementing two rural broadband policies in the country is cost-effective. The proposed model is designed according to the bottom-up approach, which involves building an efficient network with the latest technologies; thus, it gives a more accurate and reliable estimation of the investment cost of building rural broadband in the South Korean territory. The significant findings of this study are twofold. First, the PPP-based project could make the participating internet service providers (ISPs) deploy broadband at a cost-effective level, similar or lower to the universal service, and then recover the investment cost per building within a reasonable period. Thus, the result implies that governments need to consider the PPP-based project as an effective measure to deploy rural broadband, in addition to the introduction of universal service. Implementing multiple broadband policies to expand rural broadband coverage could be a reasonable and practical approach to improving broadband availability. Second, the governments still needs to make efforts to solve the complicated difficulties in rural areas in South Korea where rural-related broadband policies are still challenging to implement. This study confirmed that in some regions, the PPP-based project was still inferior to universal service in terms of average investment cost. In contrast, universal service had significant constraints to providing broadband because of the end-users cost burden, resulting in low broadband adoption. Therefore, the government needs to consider some measures to increase broadband availability and broadband adoption, such as widening the rural areas under the jurisdiction of participating ISPs, decreasing the proportion of participating ISPs bearing the investment cost of deploying broadband, and improving the cost burden of the end-users of universal service in some limited areas.

The Gangwon Obesity and Metabolic Syndrome Study: Methods and Initial Baseline Data.

The prevalence of obesity has been continuously increasing, especially in rural areas of South Korea. Therefore, it is important to examine various genetic, behavioral, and environmental factors associated with obesity in these rural areas. The Korean Society for the Study of Obesity commenced a community-based prospective cohort study of the Gangwon area called the Gangwon Obesity and Metabolic Syndrome (GOMS) study to investigate longitudinal changes in the status of obesity and its related factors. A total of 317 adults 40-69 years of age were recruited from Hongcheon and Inje districts, Gangwon province, as part of the first wave of this cohort study. Information on participants' demographic, behavioral, psychological, dietary, and environmental factors and past medical histories were collected by self-administered questionnaires and interviewer-administered questionnaires. Anthropometric measurements, blood tests, and a hand grip strength test were performed, and skin keratin and stool samples were collected. Among the 317 enrolled subjects, two participants who did not have anthropometric data were excluded from the data analyses, resulting in an inclusion of a total of 315 participants. The mean age of the 315 participants in the GOMS initial baseline survey was 58.5 years old, 87 of them were men, and the mean body mass index was 24.7±3.7 kg/m2. Among all participants, 48.9% had hypertension, 21.4% had diabetes mellitus (DM), 55.6% had dyslipidemia, and 46.0% had metabolic syndrome (MS). Both the prevalence rates of DM and MS were significantly higher in men. The first baseline survey of the GOMS study was initiated, and a more detailed analysis of respondents' data is expected to be continued. Further follow-up and additional recruitment will allow the investigation of risk factors and the etiology of obesity and its comorbidities in rural areas of Gangwon province.

Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods.

The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. This study applied an exploratory, descriptive and cross-sectional design. The participants were older adults (N=650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.

Factors Associated with Health-Related Quality of Life among Older Adults in Rural South Korea Based on Ecological Model.

As the portion of older adults in the population in rural areas of South Korea exceeds 20%, the importance of health-related quality of life is increasing. The aim of the study was to examine the health-related quality of life through the ecological model and its basic determining factors for older adults. The study was conducted on 184 respondents aged 65 and over living in rural areas of South Korea. The measurements were health-related quality of life, health care service needs, sleep quality, social support, and personal characteristics. The collected data were tested using descriptive, t-test, ANOVA, and hierarchical multiple regression. The results showed that older adults in rural areas experienced a low quality of life. Religion, having a helper, and social support were significantly related to health-related quality of life in older adults. This directly shows that the government should make efforts to build a social support system to improve the gap between urban and rural areas. To improve the health-related quality of life of older adults in rural areas, it would be helpful to increase physical activity and to form a community, leading to a social network.

Analysis of Industrial Diversification Level of Economic Development in Rural Areas Using Herfindahl Index and Two-Step Clustering

The purpose of this study is to analyze the possible relationship between industrial structure and economic development in rural areas in South Korea. Accordingly, this study uses the Herfindahl–Hirschman Index and a two-step cluster analysis method to conduct an empirical analysis of the rural areas of Chungcheongbuk-do as the research object. The results show that among the 11 regions with concentrated industrial structures, the cluster results of 2 regions changed from the decentralized low employment cluster in 2010 to a concentrated high employment cluster in 2015, while the cluster results of other regions remained unchanged. Among the 18 regions with decentralized industrial structure, the cluster results of 5 regions changed from the concentrated high employment cluster in 2010 to the decentralized low employment cluster. Meanwhile, the cluster results of three regions changed from the decentralized low employment cluster in 2010 to the concentrated high employment cluster in 2015, while the cluster results of other regions remained unchanged. Based on this, it can be concluded that, for general rural areas, a low level of industrial diversification, that is, a concentrated industrial structure, is more conducive to promoting the economic development of rural areas. However, there is a special case, namely that rural areas with certain specific advantages, a high level of industrial diversification, or a decentralized industrial structure are more conducive to the development of the regional economy.

Factors influencing the community capacity of rural residents in South Korea

ABSTRACT This research aims to identify the factors that influence community capacity as it affects the mobilisation of inner resources and community conflict management for community residents. Data from an on-site survey consisting of self-administered questionnaires were obtained from 339 community residents in rural areas of South Korea. Factor analysis identified four dimensions: problem assessment, leadership, connections and self-help. Education, income, length of residence, as well as participation in agricultural cooperatives, community development organisations and hobby organisations were significant factors in influencing individuals having positive or negative attitudes and abilities associated with community capacity. Conclusions suggest that community development specialists and policymakers should consider these factors to understand individuals participation in community-based organisations in order to build community capacity.

Urban-rural differences in intention to age in place while receiving home care services: Findings from the National Survey of Older Koreans

PurposeAging in place has been a crucial goal of long-term care policies, yet little is known about regional differences in older adults’ perceptions of aging in place. This study examined the factors associated with the intention to age in place while receiving home care services among older adults in urban and rural areas in South Korea. MethodsData were obtained from the 2020 National Survey of Older Koreans conducted in South Korea. The study population comprised 10,097 adults aged ≥ 65 years. Multivariate logistic regression analysis was performed separately for residential areas. ResultsAmong urban residents, being married, having higher satisfaction with the distance to healthcare facilities, and owning a house were associated with higher odds of the intention to age in place, whereas higher educational level, higher income, having interaction with friends and neighbors, and having perceived control over death preparation issues were associated with lower odds of the outcome. Among rural residents, only homeownership was associated with higher odds of aging in place, while female gender, higher income, not wanting to burden family and friends, and knowledge of formal care services were associated with lower odds of the outcome. ConclusionsBy applying the expanded Andersen model, the study showed that enabling and psychosocial factors significantly affect older adults’ intention to age in place. The results also revealed urban and rural differences in the factors associated with the intention to age in place. The study suggests that home-and community-based services, considering urban-rural differences, are needed to support successful aging in place.

The Effect of a Mobile and Wearable Device Intervention on Increased Physical Activity to Prevent Metabolic Syndrome: Observational Study.

BackgroundResearch on whether wearable devices and app-based interventions can effectively prevent metabolic syndrome (MetS) by increasing physical activity (PA) among middle-aged people living in the rural areas of South Korea remains insufficient.ObjectiveThe aim of this study was to determine whether mobile and wearable device interventions can improve health indicators, including PA, in MetS risk groups in rural South Korea.MethodsIn this clinical trial, performed from December 2019 to June 2020, participants were asked to use a wearable device (GalaxyWatch Active1) alone (standard intervention) or the wearable device and mobile app (Yonsei Health Korea) (enhanced intervention). Clinical measures and International Physical Activity Questionnaire (IPAQ) scores were evaluated initially and after 6 months. The number of steps was monitored through the website. The primary outcome was the difference in PA and clinical measures between the enhanced intervention and standard intervention groups. The secondary outcome was the decrease in MetS factors related to the change in PA.ResultsA total of 267 participants were randomly selected, 221 of whom completed the 6-month study. Among the 221 participants, 113 were allocated to the enhanced intervention group and 108 were allocated to the standard intervention group. After 6 months, the body weight and BMI for the enhanced intervention group decreased by 0.6 (SD 1.87) and 0.21 (SD 0.76), respectively (P<.001). In both groups, systolic blood pressure, diastolic blood pressure, waist circumference, and glycated hemoglobin A1c (HbA1c) decreased (P<.001). The total PA was approximately 2.8 times lower in the standard intervention group (mean 44.47, SD 224.85) than in the enhanced intervention group (mean 124.36, SD 570.0). Moreover, the enhanced intervention group achieved the recommended level of moderate to vigorous physical activity (MVPA), whereas the standard intervention group did not (188 minutes/week vs 118 minutes/week). Additionally, the number of participants in the enhanced intervention group (n=113) that reached 10,000 daily steps or more after the intervention increased from 9 (8.0%) to 26 (23.1%) (P=.002), whereas this number did not increase significantly in the standard intervention group (n=108), from 8 (7.4%) to 16 (14.8%) (P=.72). The number of participants without any MetS factors increased by 12 (11%) and 8 (7%) in the enhanced and standard intervention group, respectively.ConclusionsPA monitoring and an intervention using wearable devices were effective in preventing MetS in a rural population in Korea. Blood pressure, waist circumference, and HbA1c were improved in both intervention groups, which were effective in reducing MetS factors. However, only the participants in the enhanced intervention group continuously increased their MVPA and step counts above the recommended level to prevent MetS. Body weight and BMI were further improved, and a higher number of participants with zero MetS factors was attained from the enhanced intervention.Trial RegistrationClinical Research Information Service KCT0005783; https://cris.nih.go.kr/cris/search/detailSearch.do/16123

Stress and Depression in Family Members of Patients with Dementia in Urban and Rural Communities: Cross-Sectional Surveys in Korea.

Background:We compared the associations of socioeconomic factors with stress and depression among family members living with a dementia patient in urban and rural areas of South Korea.Methods:Data were collected from 9,730 (4,560 urban and 5,170 rural) participants in the Korean Community Health Survey from 2014–17. The variable of interest was the presence of a cohabitating dementia patient, and the dependent variables were stress and depression.Results:Family members living with a dementia patient in rural areas had a significantly lower socioeconomic status (education, household income, marital status, and employment) than those living in urban areas (p<0.001). In addition, family members living with a dementia patient in rural areas reported statistically significantly less stress and depression than did those in urban areas after adjusting for related factors(rural stress OR=0.87, 95% CI=0.80–0.95; rural depression OR=0.75, 95% CI=0.66–0.85). Female gender and a low family income were associated with stress and depression in both rural and urban areas. Age, educational attainment, number of family members, marital status, and employment status differed slightly between urban and rural areas.Conclusion:The socioeconomic factors associated with stress and depression differ slightly in the rural and urban areas of South Korea.

Simulation and validation for count-based binary decision of target blood pressure achievement in home blood pressure monitoring data analysis for clinical practice

Abstract Introduction Home blood pressure monitoring (HBPM) is a useful tool to identify hypertension and to decide whether a patient's blood pressure (BP) is controlled. The use of automatized oscillometric BP measurement devices has become increasingly popular with help of information technology and internet of things to the devices. However, applying HBPM to daily clinical practices is still challenging, because most patients with hypertension are in age groups not familiar to digital devices and internet and high BP criteria using average home BP values are often useless in outpatient clinics without easily accessible average BP calculation tools. Therefore, we developed a simple and straightforward method to interpret HBPM through counts of BP ≥135/85 mmHg. Methods We simulated 400 cases of HBPM using a random number generator function in statistical software. The simulated average home systolic BP (SBP) and its standard deviation (SD) were 125±15 mmHg and 12±5 mmHg and the number of HBP readings was 24 times. The simulated diastolic BP (DBP) was randomly selected to 50–75% of the SBP. The validation of the binary interpretation method was conducted using actual HBPM data from 386 subjects in a rural area of South Korea. Receiver operating characteristics curve analysis was conducted, and linear regression and logarithmic models were fitted between the numbers of home BP ≥135/85 mmHg and mean BP. Hypertension was defined with average home BP ≥135/85 mmHg. Results In the simulated cohort, hypertension was presented in 197 cases (49.3%). The C-index of the numbers of BP readings ≥135/85 mmHg was 0.994 (95% confidence interval [CI] 0.990–0.998), and ≥12 of 24 BP readings ≥135/85 mmHg showed a sensitivity of 95.4%, a specificity of 95.1% and an accuracy of 95.3% for the diagnosis of hypertension. In validation cohort, the numbers of home BP measurements varied from 8 to 81 times. The validation cohort similarly showed that the C-index of the ratio between the number of high BP readings (≥135/85 mmHg) to the number of BP measurements (R-NHBP/NBP) was 0.985 (95% CI, 0.976–0.994) and the best accuracy was shown at R-NHBP/NBP of ≥0.45. R-NHBP/NBP of ≥0.5 showed a sensitivity of 0.957, a specificity of 0.907 and an accuracy of 0.927. The accuracy of the R-NHBP/NBP of ≥0.5 decreased as SD and the range of SBP increased, whereas it did not change with the number of measurements (Figure 1). R-NHBP/NBP &amp;lt;0.2 predicted normotension and R-NHBP/NBP &amp;gt;0.8 predicted hypertension in 95% confidence. Mean widths of the 95 prediction intervals for the average SBP and DBP were 18.2 mmHg and 12.6 mmHg, respectively (Figure 2). Conclusion Counting the number of BP ≥135/85 mmHg can provide accurate assessments for the BP levels. R-NHBP/NBP of ≥0.5 is a simple and accurate marker of high BP in HBPM, and R-NHBP/NBP could be a useful tool to assess BP levels in patients practicing HBPM. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2

Effects of urbanization on vulnerability to heat-related mortality in urban and rural areas in South Korea: a nationwide district-level time-series study.

Although urbanization is often an important topic in climate change studies, the complex effect of urbanization on heat vulnerability in urban and rural areas has rarely been studied. We investigated the disparate effects of urbanization on heat vulnerability in urban and rural areas, using nationwide data. We collected daily weather data for all 229 administrative districts in South Korea (2011-17). Population density was applied as an urbanization indicator. We calculated the heat-mortality risk using a distributed lag nonlinear model and analysed the relationship with population density. We also examined district characteristics that can be related to the spatial heterogeneity in heat-mortality risk. We found a U-shaped association between population density and heat-mortality risk, with the highest risk for rural populations; in urban areas, risk increases with increasing population density. Higher heat-mortality risk was associated with a lower number of hospital beds per person and higher percentage of people requiring recuperation. The association between hospital beds and heat-mortality risk was prominent in high-density urban areas, whereas the association between the percentage of people requiring recuperation and heat-mortality risk was pronounced in rural areas. Our findings indicate that the association between population density and heat-mortality risk is different in urban and rural areas, and that district characteristics related to heat-mortality risk also differ by urbanicity. These results can contribute to understanding the complex role of urbanization on heat vulnerability and can provide evidence to policy makers for prioritizing resources.

Effects of social prescribing pilot project for the elderly in rural area of South Korea during COVID-19 pandemic.

BackgroundOlder adults—classified as a high‐risk group—are highly likely to experience increased loneliness due to the implementation of various policies designed to prevent the spread of COVID‐19. Accordingly, this study aims to examine the effects of a pilot social prescribing project for elderly people in rural area of South Korea during the COVID‐19 pandemic.MethodsUsing the PRECEDE‐PROCEED model, the effectiveness of the pilot project was verified through pre‐ and post‐impact and outcome evaluation.ResultsAccording to the results of the impact evaluation, loneliness reduced significantly, while the social participation attitude score increased. Although the average score of self‐efficacy increased, it was not statistically significant. Moreover, it was found that self‐esteem increased significantly. In the outcome evaluation, depression reduced considerably.ConclusionTo conclude, the pilot social prescribing project was effective in reducing depression and loneliness for the elderly in rural areas of Korea. It was also confirmed that there is potential to develop a new health promotion project that can improve the self‐esteem of the elderly, and expand their social activities. Second, the pilot project was carried out in an integrated manner by utilizing resources in communities with good accessibility. Therefore, it is expected to be used as a new “Integrated community care model” to improve the mental health of the elderly in rural areas. Third, during the COVID‐19 pandemic, the elderly tend to experience increasing feelings of depression, isolation, and loneliness due to “social distancing.” Therefore, it is expected that social prescribing programs for the elderly in rural areas would become a new alternative for relieve mental disorder of the seniors.

More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly.

Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function.