title: Socioeconomic disparities in behavioral risk factors and health outcomes by gender in the Republic of Korea.
abstract: BACKGROUND
  Few studies have examined socioeconomic disparities in health and behavioral risk factors by gender in Asian countries and in South Korea, specifically. We investigated the relationship between socioeconomic position (education, income, and occupation) and subjective and acute and chronic health outcomes and behavioral risk factors by gender, and compared results from 1998 and 2005, in the Republic of Korea.
  
  
  METHODS
  We examined data from a nationally representative stratified random sample of 4213 men and 4618 women from the 1998 Korea National Health and Nutrition Examination Survey, and 8289 men and 8827 women from the 2005 Korea National Health and Nutrition Examination Survey using General Linear Modeling and multiple logistic regression methods.
  
  
  RESULTS
  Controlling for behavioral risk factors (smoking, drinking, obesity, exercise, and sleep), those in lower socioeconomic positions had poorer health outcomes in both self-reported acute and chronic disease and subjective measures; differences were especially pronounced among women. A socioeconomic gradient for education and income was found for both men and women for morbidity and self-reported health status, but the gradient was more pronounced in women. In 1998, the odds ratios (ORs) of higher morbidity for illiterate vs. college educated females was 5.4:1 and 1.9:1 for females in the lowest income quintile vs. the highest. The OR for education decreased in 2005 to 2.9:1 and that for income quintiles remained the same at 1.9:1. The OR of lower self-reported health status for illiterate vs. college educated females was 2.9:1 and 1.6:1 for females in the lowest income quintile vs. the highest in 1998, and 3.3:1 and 2.3:1 in 2005.
  
  
  CONCLUSIONS
  Among Korean adults, men and women in lower socioeconomic position, as denoted by education, income, and somewhat less by occupation, experience significantly higher levels of morbidity and lower self-reported health status, even after controlling for standard behavioral risk factors. Disparities were more pronounced for women than for men. Efforts to reduce health disparities in South Korea require attention to the root causes of socioeconomic inequality and gender differences in the impact of socioeconomic position on health.
authors.affiliation: Dongguk University, Department of Social Welfare, Seoul, Republic of Korea.
authors.forename: Hak-Ju
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jennifer Prah
authors.initials: JP
authors.lastname: Ruger
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006305:Health Status Indicators; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D009790:Occupations; D017063:Outcome Assessment, Health Care; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D057566:Self Report; D017678:Sex Distribution; D012893:Sleep Wake Disorders; D012923:Social Class; D011795:Surveys and Questionnaires
references.citation: BMJ. 2002 Jan 5;324(7328):20-3
references.pmid: 11777799
references.citation: BMJ. 2000 May 13;320(7245):1303-7
references.pmid: 10807620
references.citation: J Epidemiol Community Health. 2001 Oct;55(10):693-700
references.pmid: 11553651
references.citation: Epidemiology. 2001 Mar;12(2):173-9
references.pmid: 11246577
references.citation: J Epidemiol Community Health. 2004 Apr;58(4):308-14
references.pmid: 15026444
references.citation: J Epidemiol Community Health. 2000 Mar;54(3):166-72
references.pmid: 10746109
references.citation: Am J Public Health. 2006 Jan;96(1):152-9
references.pmid: 16373668
references.citation: Soc Sci Med. 2004 Apr;58(8):1501-9
references.pmid: 14759693
references.citation: Am J Public Health. 2003 Aug;93(8):1302-9
references.pmid: 12893619
references.citation: Soc Sci Med. 2008 Dec;67(12):1982-94
references.pmid: 18951671
references.citation: Am J Ind Med. 2008 Oct;51(10):748-57
references.pmid: 18704916
references.citation: BMJ. 2000 Nov 4;321(7269):1124-8
references.pmid: 11061736
references.citation: Int J Epidemiol. 2004 Apr;33(2):299-308
references.pmid: 15082630
references.citation: J Epidemiol Community Health. 2002 Oct;56(10):798-9
references.pmid: 12239208
references.citation: N Engl J Med. 2008 Jun 5;358(23):2468-81
references.pmid: 18525043
references.citation: BMJ. 2001 May 19;322(7296):1233-6
references.pmid: 11358781
references.citation: Soc Sci Med. 1994 May;38(10):1385-96
references.pmid: 8023188
references.citation: Public Health. 2008 Mar;122(3):229-36
references.pmid: 17935744
references.citation: BMJ. 2001 Mar 10;322(7286):591-4
references.pmid: 11238156
references.citation: BMJ. 2000 Nov 25;321(7272):1311-5
references.pmid: 11090512
references.citation: Int J Epidemiol. 2005 Jun;34(3):630-7
references.pmid: 15746204
references.citation: Soc Sci Med. 2008 Sep;67(6):988-1001
references.pmid: 18632197
references.citation: Br Med Bull. 2007;81-82:21-37
references.pmid: 17284541
references.citation: Eur J Epidemiol. 2005;20(3):217-20
references.pmid: 15921038
references.citation: Soc Sci Med. 1991;33(5):545-57
references.pmid: 1962226
references.citation: Annu Rev Public Health. 1997;18:341-78
references.pmid: 9143723
references.citation: BMJ. 2002 Apr 13;324(7342):860-1
references.pmid: 11950717
references.citation: Lancet. 1991 Jun 8;337(8754):1387-93
references.pmid: 1674771
references.citation: Int J Epidemiol. 1995 Jun;24(3):559-68
references.pmid: 7672897
references.citation: Obes Res. 2004 Dec;12(12):2031-40
references.pmid: 15687405
references.citation: N Engl J Med. 2001 Jul 12;345(2):134-6
references.pmid: 11450663