An Assessment of Magnitudes and Patterns of Socioeconomic Inequalities across Various Health Problems: A Large National Cross-Sectional Survey in Korea

Abstract

Magnitudes of health inequalities present consequences of socioeconomic impact on each health problem. To provide knowledge on the size of health problems in terms of socioeconomic burden, we examined the magnitudes and patterns of health inequalities across 12 health problems. A total of 17,292 participants older than 30 years were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010⁻2012). The age-adjusted prevalence ratios were compared across socioeconomic positions (SEPs) based on income, education, and occupation. The magnitudes of socioeconomic inequalities varied across 12 health problems and, in general, the patterns of socioeconomic inequalities were similar among groups of health problems (i.e., non-communicable diseases (NCDs), mental health, and subjective health states). Significant health inequalities across NCDs, such as diabetes, hypertension, ischemic heart disease, and arthritis, were observed mainly in women. Socioeconomic inequalities in mental health problems, such as depression, suicidal ideation, and suicide attempts, were profound for both genders and across SEP measures. Significant socioeconomic inequalities were also observed for subjective health. No or weak associations were observed for injury and HBV infection. The patterns of socioeconomic inequalities were similar among groups of health problems. Mental illnesses appeared to require prioritization of socioeconomic approaches for improvement in terms of absolute prevalence and relative socioeconomic distribution.

Keywords: Korea; health inequalities in mental diseases; health inequalities in non-communicable diseases; health inequalities policy; socioeconomic factors; socioeconomic inequalities in common health problems.

Figure 1

Age-adjusted prevalence ratios of 12 health problems in men (A) and women (B) according to income, education, and occupational groups in KNHANES 2010–2012. Notes: KNHANES = Korea National Health and Nutrition Examination Survey, EQ-5D = EuroQol five-dimension questionnaire. * denotes statistical significance at the 95% confidence level. †Reference categories of SEP measures are highest income quartile for income, college graduated and above for education of the middle aged (30–64), high school graduate and above for education of elderly people (≥65), and manager and office workers for occupational class.