Household and area income levels are associated with smoking status in the Korean adult population
Tóm tắt
Some previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults. This study was based on the Korean Community Health Survey (KCHS) performed in South Korea, between September and November 2009. In total, 222,242 subjects (103,124 men and 119,118 women) were included in the analysis. Information on smoking status was collected using a standardized questionnaire. Income status was determined by monthly household income. Household income was categorized as: <1 million won; <2 million won; <3 million won; and ≥3 million won. Area-level income categorized as quartiles. Data were analyzed using multilevel regression models. The analysis was conducted separately urban and rural, by sex. The lowest household income group had a higher risk of smoking than the highest household income group in both urban and rural areas for both men and women after adjusting for individual characteristics (urban men: odds ration [OR], 1.44; 95% confidence interval [CI], 1.36–1.53; rural men: OR, 1.33; 95% CI, 1.25–1.42; urban women: OR, 2.38; 95% CI, 2.06–2.76; rural women: OR, 1.51; 95% CI, 1.25–1.83). In men, the lowest area-level income group had a higher risk for smoking than the highest area-level income group in urban areas after adjusting for individual characteristics and household income (OR, 1.17; 95% CI, 1.02–1.33). In women, the lowest area-level income group had a lower risk for smoking than the highest area-level income group in rural areas after adjusting for individual characteristics and household income (OR, 0.52; 95% CI, 0.39–0.70). However, no association was observed between area-level income and smoking in rural areas for men or in urban areas for women. The results showed that smoking is strongly associated with household income status in both men and women, and area-level income is partly associated with smoking. Effects of area-level income on smoking differed by sex and region. These findings suggest that area characteristics have contextual effects on health related behavior independent of individual characteristics.
Tài liệu tham khảo
De Bacquer D, De Backer G, Ostor E, Simon J, Pyorala K. Predictive value of classical risk factors and their control in coronary patients: a follow-up of the EUROASPIRE I cohort. Eur J Cardiovasc Prev Rehabil. 2003;10(4):289–95.
Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003;290(7):898–904.
Morris RW, Whincup PH, Lampe FC, Walker M, Wannamethee SG, Shaper AG. Geographic variation in incidence of coronary heart disease in Britain: the contribution of established risk factors. Heart. 2001;86(3):277–83.
Shafey O eae. The Tobacco Atlas. 3rd ed. Atlanta: American Cancer Society; 2009. p. 38–9.
OECD (2011): Health at a glance 2011 : OECD Idicators, OECD Publishing. 2011:50–51
Korean Ministry of Health and Welfare. The Fifth Korea National Health & Nutrition Examination Survey(KNHANES V). 2010.
Laaksonen M, Rahkonen O, Karvonen S, Lahelma E. Socioeconomic status and smoking. The European Journal of Public Health. 2005;15(3):262–9.
Siahpush M, Borland R, Scollo M. Smoking and financial stress. Tob Control. 2003;12(1):60–6.
Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grotvedt L, Helmert U, et al. Educational differences in smoking: international comparison. BMJ. 2000;320(7242):1102–7.
Macintyre S, Ellaway A. Social and local variations in the use of urban neighbourhoods: a case study in Glasgow. Health Place. 1998;4(1):91–4.
Marmot M, Ryff CD, Bumpass LL, Shipley M, Marks NF. Social inequalities in health: next questions and converging evidence. Soc Sci Med. 1997;44(6):901–10.
Stead M, MacAskill S, MacKintosh AM, Reece J. Eadie D: ‘It’s as if you’re locked in”: qualitative explanations for area effects on smoking in disadvantaged communities. Health Place. 2001;7(4):333–43.
Kim CS, Yun SC, Kim HR. Khang YH: [A multilevel study on the relationship between the residential distribution of high class (power elites) and smoking in Seoul]. J Prev Med Public Health. 2006;39(1):30–8.
Park EJ, Kim H, Kawachi I, Kim IH, Cho SI. Area deprivation, individual socioeconomic position and smoking among women in South Korea. Tob Control. 2010;19(5):383–90.
Lynch J, Kaplan G. Socioeconomic position. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. p. 13–35.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.
Laaksonen M, Prattala R, Helasoja V, Uutela A, Lahelma E. Income and health behaviours. Evidence from monitoring surveys among Finnish adults Journal of Epidemiology and Community Health. 2003;57(9):711–7.
Choi Y-J, Jeong B-G, Cho S-I, Jung-Choi K, Jang S-N, Kang M, et al. A Review on Socioeconomic Position Indicators in Health Inequality Research. J Prev Med Public Health. 2007;40(6):475–86.
Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006;60(1):7–12.
Kim YT, Choi BY, Lee KO, Kim H, Chun JH, Kim SY, et al. Overview of Korean Community Health Survey. J Korean Med Assoc. 2012;55(1):74–83.
Ryan H, Trosclair A, Gfroerer J. Adlt current smoking: differences in definitions and prevalence estimates--NHIS and NuSDUH, 2008. J Environ Public Health, 2012:1-11.
Korea Centers for Disease Control and Prevention. Community Health Survey. 2009. http://chs.cdc.go.kr 2012.
Townsend J, Roderick P, Cooper J. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity. BMJ. 1994;309(6959):923–7.
Osler M, Holstein B, Avlund K, Damsgaard MT, Rasmussen NK. Socioeconomic position and smoking behaviour in Danish adults. Scand J Public Health. 2001;29(1):32–9.
Gilman SE, Abrams DB, Buka SL. Socioeconomic status over the life course and stages of cigarette use: initiation, regular use, and cessation. J Epidemiol Community Health. 2003;57(10):802–8.
Fernandez E, Garcia M, Schiaffino A, Borras JM, Nebot M, Segura A. Smoking initiation and cessation by gender and educational level in Catalonia. Spain Prev Med. 2001;32(3):218–23.
Copeland L. An exploration of the problems faced by young women living in disadvantaged circumstances if they want to give up smoking: can more be done at general practice level? Fam Pract. 2003;20(4):393–400.
Marsh A, McKay S. Poor smokers. London: Policy Studies Institute; 1994.
Graham H. Women, smoking and disadvantage. London: HSMO; 1993.
Stead M, MacAskill S, MacKintosh AM, Eadie D. G H: An investigation into smoking cessation in disadvataged communities: qualitative focusgroup research. Center for Tobacco Control Research: University of Strathclyde; 1999.
Williams DR. Socioeconomic differentials in health: A review and redirection. Soc Psych Q. 1990;53:81–99.
Kenkel D. Health behaviours, health knowladge and schooling. Journal of Political Economy. 1991;99:287–305.
Muramatsu N. County-level income inequality and depression among older Americans. Health Serv Res. 2003;38(6 Pt 2):1863–83.
Hanson BS, Isacsson SO, Janzon L, Lindell SE. Social support and quitting smoking for good. Is there an association? Results from the population study, “Men born in 1914. 1990;15(3):221–33.
Lacey LP, Manfredi C, Balch G, Warnecke RB, Allen K, Edwards C. Social support in smoking cessation among black women in Chicago public housing. Public Health Rep. 1993;108(3):387–94.
Hiscock R, Bauld L, Amos A, Fidler JA, Munafo M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2011;1248:107–23.
Smit ES, Fidler JA, West R. The role of desire, duty and intention in predicting attempts to quit smoking. Addiction. 2011;106(4):844–51.
Ross CE. Walking, exercising, and smoking: does neighborhood matter? Soc Sci Med. 2000;51(2):265–74.
van Lenthe FJ, Mackenbach JP. Neighbourhood and individual socioeconomic inequalities in smoking: the role of physical neighbourhood stressors. J Epidemiol Community Health. 2006;60(8):699–705.
Macintyre S. Area class and health: should we be focusing an places or people? Journal of Soc Policy. 1993;22:213–34.
Stronks K, van de Mheen HD, Looman CW, Mackenbach JP. Cultural, material, and psychosocial correlates of the socioeconomic gradient in smoking behavior among adults. Prev Med. 1997;26(5 Pt 1):754–66.
Lindstrom M. Social capital and the miniaturization of community among daily and intermittent smokers: a population-based study. Prev Med. 2003;36(2):177–84.
Kavanagh AM, Bentley R, Turrell G, Broom DH, Subramanian SV. Does gender modify associations between self rated health and the social and economic characteristics of local environments. J Epidemiol Community Health. 2006;60(6):490–5.
Wen M, Christakis NA. Neighborhood effects on posthospitalization mortality: a population-based cohort study of the elderly in Chicago. Health Serv Res. 2005;40(4):1108–27.
Mayer SE, Jencks C. Growing up in Poor Neighborhoods: How Much Does it Matter? Science. 1989;243(4897):1441–5.
Diez Roux AV, Merkin SS, Hannan P, Jacobs DR, Kiefe CI. Area characteristics, individual-level socioeconomic indicators, and smoking in young adults: the coronary artery disease risk development in young adults study. Am J Epidemiol. 2003;157(4):315–26.
Sundquist J, Malmstrom M, Johansson SE. Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis. Int J Epidemiol. 1999;28:841–5.
Duncan C, Jones K, Moon G. Smoking and deprivation: are there neighbourhood effects? Soc Sci Med. 1999;48:497–505.
Reijneveld SA. The impact of individual and area characteristics on urban socioeconomic differences in health and smoking. Int J Epidemiol. 1998;27(1):33–40.
Smith GD, Hart C, Watt G, Hole D, Hawthorne V. Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. J Epidemiol Community Health. 1998;52(6):399–405.
Kleinschmidt I, Hills M, Elliott P. Smoking behaviour can be predicted by neighbourhood deprivation measures. J Epidemiol Community Health. 1995;49 Suppl 2:S72–77.
Waldron I. Patterns and causes of gender differences in smoking. Social Science &. Medicine. 1991;32(9):989–1005.
Lopez A, Collishaw N, Piha T. A descriptive model of the cigarette epidemic in developed countries. Tob Control. 1994;3(3):242–7.
Rowe K. Multi-level Structural Equation Modelling with MLN and LISREL: An Integrated Course. 1st ed. Australia: University of Melbourne; 1997.
Gray L. National comparisons of healh-related behaviours abd health measures in Glasgow. Glasgow: Medical Research Council Social and Public Health Sciences Unit and the Glasgow Cntre for Population Health; 2007.