title: Disparities in socioeconomic status and neighborhood characteristics affect all-cause mortality in patients with newly diagnosed hypertension in Korea: a nationwide cohort study, 2002-2013.
abstract: BACKGROUND
  Previous studies have shown that contextual factors and individual socioeconomic status (SES) were associated with mortality in Western developed countries. In Korea, there are few empirical studies that have evaluated the association between SES and health outcomes.
  
  
  METHODS
  We conducted cohort study to investigate the socioeconomic disparity in all-cause mortality for patients newly diagnosed with hypertension in the setting of universal health care coverage. We used stratified random sample of Korean National Health Insurance enrollees (2002-2013). We included patients newly diagnosed with hypertension (n = 28,306) from 2003-2006, who received oral medication to control their hypertension. We generated a frailty model using Cox's proportional hazard regression to assess risk factors for mortality.
  
  
  RESULTS
  A total of 7,825 (27.6%) of the 28,306 eligible subjects died during the study period. Compared to high income patients from advantaged neighborhoods, the adjusted hazard ratio (HR) for high income patients from disadvantaged neighborhoods was 1.10 (95% CI, 1.00-1.20; p-value = 0.05). The adjusted HR for middle income patients who lived in advantaged versus disadvantaged neighborhoods was 1.17 (95% CI, 1.08-1.26) and 1.27 (95% CI, 1.17-1.38), respectively. For low income patients, the adjusted HR for patients who lived in disadvantaged neighborhoods was higher than those who lived in advantaged neighborhoods (HR, 1.35; 95% CI, 1.22-1.49 vs HR, 1.28; 95% CI, 1.16-1.41).
  
  
  CONCLUSIONS
  Neighborhood deprivation can exacerbate the influence of individual SES on all-cause mortality among patients with newly diagnosed hypertension.
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.|Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Kyoung Hee
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Korea.|Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Korea.|Department of Biostatistics, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Chung Mo
authors.initials: CM
authors.lastname: Nam
authors.affiliation: Graduate School of Social Welfare, Yonsei University, Seoul, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Korea.|Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea.
authors.forename: Suk-Yong
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Department of Nursing Science, College of Nursing, Gachon University, Seongnam, Korea.
authors.forename: Seon-Heui
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Korea. ECPARK@yuhs.ac.|Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea. ECPARK@yuhs.ac.|Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. ECPARK@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D007341:Insurance / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D016019:Survival Analysis