연령, 성, 지역, 사회경제적 상태에 따른 백내장의 유병률과 오즈비 분석 = Prevalence and Odds ratio analysis of Cataract related with Age, Sex, Regions and Social status

다국어 초록 (Multilingual Abstract)

Purpose : This study was conducted to evaluate the eye health equity of grown-up Koreans with analyzing cataract is important factors of the health equity criterion of Korean adults.
Methods : In this study, the Korea National Health and Nutrition Examination Survey (KNHNE) of 2009-year data, 7,412 people who are over 20 years old adults except aphakia, was referred to analyze the odds ratio and prevalence rate of cataract which followed house income, educated level, occupation and regions. Cataract was analyzed by applying slit-lamp. As followed by the important factors of the health equity criterion of Korean adults, prevalence rate was analyzed with t-test and chi square test(χ2). Odds ratio was conducted by applying the Logistic Regression. The significant level was 0.05 and it was analyzed by applying PASW version 18.0.
Results : Standardized prevalence rate showed that cataract was 26.4% respectively. Prevalence rate of cataract showed that 31.2% at ‘below Primary school’, 59.9% at ‘Unemployed’, and 62.8% at ‘Urban’. The odds ratio of cataract represented that 2.60(CI, 1.96-3.44) at ‘low house income people who are over 50 years old’, 2.23(CI, 1.49-3.34) at ‘Unemployed’ and 1.24(CI, 0.99-1.56) at ‘Urban’. Moreover, ‘20-49 years old group’ revealed 5.48(CI, 2.71-11.06) at ‘below Primary school’ and 3.33(CI, 1.37-8.10) at ‘Forestry and fisheries’. ‘Urban’ represented comparably higher odd ratio of cataract than that of ‘Rural’ by 2.23(CI, 1.35-3.69) at ‘low house income’, 2.03(CI, 0.97-4.26) at ‘below Primary school’ and 1.28(CI, 0.52-3.14) at ‘Simple worker’. As female, the odds ratio of cataract was 1.60(CI, 1.12-2.30) at ‘low house income’ and 1.79(CI, 1.09-2.92) at ‘below Primary school’ which are higher than male.
Conclusion : As relating low socioeconomic condition, high prevalence rate and high odds ratio of cataract represents that there exists eye health inequity of adults in Korean. These results insist that it needs to make comprehensive primary public eye health medical treatment policy. Moreover, it is needed to develop the heath medical treatment policy from curing centered health medical treatment to be preclusive and more educative policy by referring the eye health medical treatment policy of overseas.

국문 초록 (Abstract)

목 적 : 본 연구는 우리나라 성인의 건강형평성 주요 척도에 따른 백내장을 분석함으로써 눈 건강 형평성을 평가하고자 하였다.
방 법 : 국민건강영양조사(2009) 안검진 조사 데이터를 이용하여 무수정체안을 제외한 만 20세 이상의 성인 7,412명을 대상으로 소득수준, 교육수준, 직업, 지역에 따른 백내장의 유병률 및 오즈비를 분석하였다. 백내장은 안과전문의가 slit-lamp를 이용하여 검사하였다. 건강형평성 주요 척도에 따른 유병률은 t-검정 및 χ2 검정하였고, 오즈비(odds ratio)는 로지스틱 회귀분석을 이용하였으며, 유의수준은 0.05로 PASW 18.0을 사용하여 분석하였다.
결 과 : 백내장의 표준화 유병률은 26.4%이었다. 유병률은 가구소득 ‘하’에서 41.2%, ‘초졸 이하’ 59.9%, ‘무직’ 53.9%, ‘도시지역’ 62.8%이었다. 건강형평성 주요 척도에 따른 백내장의 오즈비는 50세 이상군에서 가구소득이 ‘하’일 때 2.60(CI, 1.96-3.44), ‘무직군’일 때 2.23(CI, 1.49-3.34), 농촌지역에서 1.24(CI, 0.99-1.56)로 높게 나타났다. 20-49세군은 ‘초졸 이하’에서 5.48(CI, 2.71-11.06)이었고, ‘농림어업 숙련 종사자군’에서 3.33(CI, 1.37-8.10)으로 높았다. 농촌지역에서 가구소득이 ‘하’일 때 오즈비는 2.23(CI, 1.35-3.69), ‘초졸 이하’일 때 2.03(CI, 0.97-4.26), ‘단순노무 종사자군’에서 1.28(CI, 0.52-3.14)로 도시지역에 비해 높았다. 여자의 경우 가구소득이 ‘하’에서 1.60(CI, 1.12-2.30), ‘초졸 이하’에서 1.79(CI, 1.09-2.92)로 남자에 비해 높게 나타났다.
결 론 : 낮은 사회경제적 상태에서 백내장의 유병률과 오즈비가 증가하여 우리나라 성인의 눈 건강 불평등이 존재하였으며, 이를 위해 저소득층을 위한 종합적인 일차안보건의료정책이 필요하다. 또한 외국의 안보건정책과의 비교를 통해 기존의 치료 위주의 보건정책보다는 예방과 교육 중심의 보건정책의 개발이 요구된다.

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