Paraquat is associated with a high rate of fatalities in acute poisoning. This study aimed to examine the association between the national public health policy that banned the use of paraquat and the incidence of pesticide-associated mortality. All external causes of death from 2009 to 2013 of Korea were analyzed. The intervention was a national public health policy that annulled the authorized use (2011) and banned the purchase of paraquat (2012). Two periods were compared as follows: before (2009-2010) and after (2012-2013) the intervention period. The main outcome was pesticide-associated death coded on the death certificate. Multivariable logistic regression analysis adjustment for gender, age, season and weekday of death, province, education level, marital status, and occupation was performed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for pesticide-associated mortality. The effect sizes of the intervention across all intents (Accident, Suicide, Homicide, and Undetermined) were compared by adding an interaction term (intervention*intent group) to the above model. A total of 127,866 deaths from for all external causes were analyzed, including 65,538 from 2009 to 2010 and 62,373 from 2012 to 2013. Pesticide-associated mortality decreased from 9.7% (2009-2010) to 6.5% (2012-2013) (p < 0.001). The AOR (95% CI) of the intervention on pesticide-associated mortality was 0.59 (0.56-0.62). The AORs of the intervention according to intent were 0.72 (0.55-0.96) in the Accident group, 0.61 (0.58-0.64) in the Suicide group, 1.29 (0.43-3.87) in the Homicide group, and 0.44 (0.38-0.50) in the Undetermined group. The national public health policy that banned paraquat resulted in a significant decrease in pesticide-associated mortality.

This study examined differences in health behaviors between elderly people living alone and with others; it also investigated whether the effect of living with others differs according to housemate type, namely a spouse and/or younger generations. Gender-stratified data from the 2013 Korea Community Health Survey for individuals aged 60 to 74 living in Seoul were analyzed. Logistic regression modeling was conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of the outcome variables (smoking, drinking, eating salty foods, inactive lifestyle) for the variables of interest (living alone/with others, housemate type). Models were adjusted for confounding variables including history of medical conditions, employment type, and adjusted household income. Analysis involved 1,814 men and 2,199 women. Risk of smoking was 1.80 times (95% CI, 1.21 to 2.67) higher for men living alone than living with others. Risk of eating salty foods was 0.78 times lower (95% CI, 0.62 to 0.98) for men living with a spouse than a spouse and younger generations. Risk of inactive lifestyle was 1.47 times higher (95% CI, 1.13 to 1.92) for women living alone. Risk of smoking was higher for women living alone (OR, 1.41; 95% CI, 1.03 to 1.92) or with younger generations (OR, 9.12; 95% CI, 2.04 to 40.80) than with a spouse and younger generations. Living alone was associated with smoking in men and physical activity in women; housemate type was associated with dietary habits in men and smoking in women. These gender-specific findings can help identify groups of individuals vulnerable to risky health behaviors and to develop policies.

To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners. We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners' corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ≥ 65 years) and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife. Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49) was highest when the participant's partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66), eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62); and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98). In comparison to non-housewives, housewives had higher odds of eating salty food. The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.

The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and selfrated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

Kim M, et al. J Korean Med Sci. 2017 Dec;32(12):2042-2050. https://doi.org/10.3346/jkms.2017.32.12.2042