[Changes in mortality inequality in relation to the South Korean economic crisis: use of area-based socioeconomic position].
OBJECTIVE
An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001.


METHODS
Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression).


RESULTS
Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between, 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period.


CONCLUSIONS
The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.
Khang
Young-Ho
YH
Department of Preventive Medicine, University of Ulsan College of Medicine. youngk@amc.seoul.kr
Yun
Sung-Cheol
SC
Hwang
In-A
IA
Lee
Moo-Song
MS
Lee
Sang-Il
SI
Jo
Min-Woo
MW
Lee
Min-Jung
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004467:Economics; D005260:Female; D006801:Humans; D007223:Infant; D007723:Korea; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012923:Social Class