Lookism hurts: appearance discrimination and self-rated health in South Korea

Background

Despite a growing body of evidence suggesting that discrimination harms health, the association between appearance discrimination and health has been understudied. Our study investigated the association between perceived appearance discrimination and self-rated health among emerging adults using a nationally representative cohort study in South Korea.

Methods

We analyzed the 2nd-10th (2005–2013) waves of cohort data from the Korean Education Employment Panel (KEEP). KEEP consists of two groups of individuals who were 15 (group I) and 18 (group II) years old at the 1st wave of the survey (2004) and were followed annually. Appearance discrimination was assessed at baseline (19 years old: 5th wave for group I, 2nd wave for group II) and at follow-up (24 years old: 10th wave for group I, 7th wave for group II). Responses of appearance discrimination at the two-time points were classified into four groups: 1) never (no discrimination at both baseline and follow-up); 2) repeated (discrimination at both baseline and follow-up); 3) incident (discrimination only at follow-up); and 4) in error (discrimination only at baseline). Multivariate logistic regression was applied to examine the association between reporting patterns of appearance discrimination and poor self-rated health, adjusting for potential confounders.

Results

Compared to those who did not experience appearance discrimination, ‘repeated’ (OR: 3.70; 95% CI: 2.19–6.27) and ‘incident’ (OR: 3.10; 95% CI: 1.99–4.83) groups had a higher odds ratio of poor self-rated health after adjusting for potential confounders including respondents’ body mass index change and baseline self-rated health. However, no significant association was observed among those who reported appearance discrimination ‘in error’.

Conclusions

These results suggest that perceived appearance discrimination is associated with the health of Korean emerging adults considering participants’ reporting patterns of appearance discrimination.

     

Socioeconomic inequalities in under-five mortality in rural Bangladesh: evidence from seven national surveys spreading over 20 years

Background

Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities in under-five mortality in rural Bangladesh. It also examined whether mother’s education had any effect in reducing socioeconomic inequalities.

Methods

Data from rural samples of seven Bangladesh Demographic Health Surveys, carried out so far, were used. Children born alive during 5 years preceding the surveys were included in the analysis. Univariate, bivariate and multivariate analyses were carried out.

Results

Under-five mortality rate steadily declined over the years from 128/1000 in 1994 to 48 in 2014. Females had 8% lower mortality rates than males. Children of mothers with no schooling had 1.88 times higher mortality than those whose mother had six or more years of schooling. Similarly, children from low asset category households had on an average 1.17 times higher mortality rate than those from high asset category households. Inequality by mother’s education disappeared in the recent years, and inequality by household socioeconomic condition persisted all through. The pattern of inequality by sex, mother’s education, and household socioeconomic status was not changed statistically significantly over the years, and mothers’ education did not reduce socioeconomic inequalities.

Discussion

The reduction in mortality was consistent with changes in the proximate determinants of child survival in the country. Proximate determinants included maternal factors, environmental contamination, nutrient deficiency, personal illness control, and injury. Health and population programmes have been effective in increasing immunization coverage, use of ORS for managing diarrhoeal diseases, and increasing contraceptive use. Development activities on the other hand raised the literacy, especially among females, demand for modern health services, and reduction of poverty. However, socioeconomic inequality still exists in both under-five mortality and proximate determinants of child survival.

Conclusions

The socioeconomic inequality in under-five mortality is showing resistance against further reduction. An assessment of the adequacy of the existing programmes taking the proximate determinants of child survival into consideration will be useful for further improvement.

     

Disruptive behavior in childhood and socioeconomic position in adulthood: a prospective study over 27 years

Objectives

We examined whether childhood disruptive behavior (aggressiveness, hyperactivity and social adjustment), predicts adulthood socioeconomic position (SEP), i.e., educational level, occupational status and income and social mobility.

Methods

Social mobility was defined by comparing the participants’ adulthood socioeconomic position with that of their parents (“intergenerational social mobility”). The subjects were derived from a population-based cohort study (N = 3,600) and our sample consisted of 782 participants (403 women) aged 3–9 years at baseline and were followed until they were aged 30–36.

Results

High childhood aggression associated with low educational level and occupational status suggesting an early beginning negative tracking of aggressive behavior. High hyperactivity and poor social adjustment predicted adulthood low occupational status proposing a more slow effect on adulthood SEP. No associations between disruptive behavior and income-related mobility were found, but high hyperactivity associated with educational downward drift, whereas high aggression and low social adjustment related with occupational downward drift.

Conclusions

Results suggest that childhood disruptive behavior may have long-lasting negative effects. In order to reduce the adverse effects of disruptive behavior, early intervention of problematic behavior becomes salient.     

Health care reform in South Korea: success or failure?

South Korea is one of the world's most rapidly industrializing countries. Along with industrialization has come universal health insurance. Within the span of 12 years, South Korea went from private voluntary health insurance to government-mandated universal coverage. Since 1997, with the intervention of the International Monetary Fund, Korean national health insurance (NHI) has experienced deficits and disruption. However, there are lessons to be drawn for the United States from the Korean NHI experience.     

Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study

Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40–59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.     

A closer look at the increase in suicide rates in South Korea from 1986–2005

Background  

Suicide rates have recently been decreasing on average among OECD countries, but increasing trends have been detected in South Korea, particularly since the 1997 economic crisis. There have been no detailed analyses about the changes of the suicide rates over time periods in Korea. We examined trends in both absolute and proportional suicide rates over the time period of economic development, crisis, and recovery (1986 – 2005) as well as in birth cohorts from 1924 to 1978.     

Metabolic syndrome in carbon disulfide-poisoned subjects in Korea: does chemical poisoning induce metabolic syndrome?

Objective  Mass carbon disulfide (CS₂) poisoning was reported at a viscose rayon factory in Korea. We evaluated the association between CS₂ poisoning and the prevalence of metabolic syndrome. Methods  The cases (n = 170) involved CS₂-poisoned subjects, who participated in a health examination conducted at a hospital in Korea in 2005. The controls (n = 170) were selected randomly from the participants in the third Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined as having at least three of following metabolic abnormalities: abdominal obesity, elevated triglyceride, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose levels. Results  After adjusting for covariates (age, gender, education, marital status, alcohol consumption, and smoking), CS₂-poisoned subjects had an increased risk of metabolic syndrome (prevalence ratio 1.57, 95% CI 1.25–1.98). Conclusions  The findings suggest that CS₂ poisoning may increase the risk of metabolic syndrome.     

Parental practices for prevention of home poisoning in children 1-6 years of age

On the basis of calls to the US poison control centers, each year more than 1 million children less than 5 years of age experience potentially toxic ingestions. Several prevention efforts and interventions have been tried to protect young children from poisonings occurring in their homes. The purpose of this study was to determine practices of parents and caregivers of children 1–6 years of age about home poisoning prevention. Seventy-six participants answered an anonymous survey. Caregivers demonstrated poor knowledge about the home poisoning prevention strategies. Only 20% of the participants knew the telephone number of the poison control center and 49% had it near the telephone in case of an emergency. This lack of knowledge was not related to gender, educational level, or occupation. Primary care physicians need to reinforce the orientation about poisoning prevention techniques to all caregivers in order to prevent accidental poisonings in small children.     

Cancer mortality in workers exposed to dieldrin and aldrin: over 50 years of follow up

Objective  Dieldrin and aldrin, pesticides widely used until the 1970s, have been under suspicion of being carcinogenic. In this study, overall and cause-specific mortality was assessed in a cohort of 570 employees occupationally exposed to the pesticides dieldrin and aldrin to investigate the long-term health effects, in particular carcinogenic effects. Methods  All of the employees worked in the production plants between January 1954 and January 1970 and were followed for cause-specific mortality until 30 April 2006. Based on dieldrin levels in blood samples taken from 343 workers during the exposure period, the total intake of dieldrin was estimated for each individual subjects in the cohort. The estimated total intake ranged from 11 to 7,755 mg of dieldrin, with an average of 737 mg. Results  Two hundred and twenty-six workers had died before 30 April 2006 compared with an expected number of 327.3, giving a standardized mortality ratio (SMR) of 69.0 (95% confidence interval (CI): 60.3–78.7). Overall cancer mortality was also significantly lower than expected (SMR: 76.4, 95% CI: 60.8–94.9). Also, none of the specific cancer sites showed a significant excess mortality and no association between exposure level and cancer mortality was found. Conclusion  The results from this study support findings from other epidemiological and recent animal studies concluding that dieldrin and aldrin are not likely human carcinogens.     

Drug poisoning in the community among children: a nine years’ experience from a tertiary care center in south India

Objectives: This study was performed to determine the incidence, demographic distribution, types and outcomes across various drug poisonings among children from south India.

Methods: This retrospective study included children less than 16 years who presented to the Pediatric Emergency Department with drug poisoning from the 1st of October 2004 to the 30th of September 2013.

Results: Out of the total 997 poisoning cases, 366 (36.71%) were contributed by drugs; mainly antiepileptics, central nervous system depressants, psychotropics, analgesic-antipyretics and natural drugs. Males and children of < 5 years were mostly affected. Although many children developed complications and required intensive care unit admissions, the total mortality rate was less than 1%. The incidence of drug poisoning showed a decreasing trend over the last 4 years.

Conclusion: This study for the first time gives an elaborative insight into pediatric drug poisoning over a nine-year period from a Pediatric Emergency Department tertiary care center in south India.     

Acute myocardial infarction incidence in immigrants to Sweden. Country of birth,time since immigration,and time trends over 20 years

This study investigates incidence of first acute myocardial infarction (MI) among foreign born persons in Sweden using case control methods, taking into consideration country of birth, gender, socio-economic group and time since immigration and evaluates if the decreasing incidence of MI in Sweden during the study period was also present in immigrants. The study base consisted of persons 30–74 years of age in Stockholm County 1977–96. All incident cases of first acute MI in the study population were identified using registers of hospital discharges and deaths. Controls were selected randomly from the study base and the sampling fractions were known, enabling estimates of person time at risk. Foreign born subjects had a higher incidence of MI than subjects born in Sweden (men RR[Relative risk]=1,17; 95% CI 1,13–1,21; women RR = 1,15; 95% CI 1,09–1,21) after adjustment for calendar year, age and socio-economic group. An increased incidence was present primarily in subjects born in Finland, other Nordic countries, Poland, Turkey, Syria and South Asia in both genders, from the Netherlands among men and from Iraq among women and was still present after more than 20 years in Sweden. The incidence rate of MI 1977–96 among foreign born persons followed the general decline in the Swedish population. We conclude that foreign born persons in Sweden have an increased incidence of first MI which persists several years after immigration and is not explained by socio-economic differences. It is likely that this to an important extent has a background in factors in the country of origin.     

Health-related quality of life in mothers of children with epilepsy: 10 years after diagnosis

Purpose

Epilepsy in childhood extends far beyond seizures and affects child and parental well-being. The long-term impact of childhood-onset epilepsy on parental well-being is unknown. This study assessed health-related quality of life (HRQOL) in mothers 10 years after their child’s diagnosis of epilepsy.

Methods

Data come from the Health-Related Quality of Life in Children with Epilepsy Study, a multicenter prospective cohort study of children with newly diagnosed epilepsy. Mothers completed a mailed questionnaire at the 10-year follow-up, which included the Short-Form Health Survey (SF-12-v2) to evaluate the physical and mental health components of their HRQOL. Block-wise linear regressions identified child/epilepsy, maternal/family, and maternal psychosocial factors associated with mothers’ HRQOL.

Results

A total of 159 mothers participated in this study (46% of the sample assessed at baseline). At follow-up, 69% of youth had been seizure free for the past 5 years. Mothers scored similarly to population norms (mean: 50, SD: 10) on the mental health subscale (mean: 49.5, SD: 9.3) and significantly better on the physical health subscale (mean: 53.0, SD: 7.6). Better family resources were associated with higher (better) scores on the physical health subscale (B?=?0.20; 95% CI 0.03, 0.36). Better family functioning (B?=?0.34; 95% CI 0.06, 0.62), fewer maternal depressive symptoms (B?=?0.33; 95% CI 0.20, 0.47), and perception of less stress (B?=?0.70; 95% CI 0.52, 0.88) were associated with higher (better) scores on the mental health subscale.

Conclusion

Ten years after the diagnosis of epilepsy in children, the HRQOL of mothers was similar to reports from women in the general population. This study identified factors contributing to better maternal HRQOL and highlights the importance of family environment over epilepsy-related variables.

     

Evaluation of anthropometric indices for metabolic syndrome in Chinese adults aged 40 years and over

Background  

The prevalence of metabolic syndrome (MetS) is increasing worldwide with a marked impact in cardiovascular disease (CVD) and diabetes risk.