地域社會의 構造的 特性이 死亡水準에 미치는 影響에 關한 硏究 = A Study on the Impact of Community-level Characteristics on the Mortality level
저자
鄭惠瓊 (서울大學校 保健大學院 國民保健硏究所)
발행기관
서울大學校保健大學院 (GRADUATE SCHOOL OF PUBLIC HEALTH, SEOUL NATIONAL UNIVERSITY)
학술지명
國民保健硏究所硏究論叢(THE JOURNAL OF THE INSTITUTE OF HEALTH & ENVIRONMENTAL SCIENCE)
권호사항
발행연도
1991
작성언어
Korean
주제어
KDC
517
자료형태
학술저널
수록면
17-50(34쪽)
제공처
소장기관
The mortality rate of Korea has gradually decreased from 26.2-30.3 per 1,000 in 1926-30 to 6.4 in 1981-85. Despite the overall decline of the mortality, there remain differentials between areas and social classes, which are indicated as an issue.
In general, mortality level of the areas can be seen from two directions. One explains the areal differences with the characteristics of the individuals and the other deals with the community-level characteristics, as the human-beings are social who cannot but be influenced by the community where he lives.
As the former approaches have been taken in the researches of the public health fields so far, there have also been some limitations in explaining the health-related issues of area.
Therefore, the latter theory, which emphasizes the commuity-level characteristics, will be taken in this study to provide not only the holistic viewpoints in dealing with the mortality data, but also some references for planning, organizing and managing the areal health program.
Based on the above-mentioned justification, specific objectives of this study are established. First, to find out the patterns and differences of crude death rates and age-adjusted death rates of the areas, with cities and guns as observation units. Second, to provide the relationship between age-adjusted death rates and the community-level characteristics, in order to clarify the factors arousing the differential mortality. Third, to examine the relative importance of the socio-economic characteristics, in order to clarify the factors arousing the differential mortality. Forth, to examine the relative importance of the socio-economic characteristic variables and health care resource characteristic variables.
Data used in this study were secondary data officially published by the Government including local governments. Data were collected as of December, 1985, but there were some gaps according to the data sources.
Sources for anlaysis were administrative areas, i.e.,4 special cities, 44 cities, 4 chuljangso's and 129 guns, but the 4 special cities were excluded in actual analyses.
Following dependent and independednt variables were chosen, crude death rates and age-adjusted death rates of the cities and guns were selected as dependent variables.
Among the various variables which could have impact on the mortality level, 22 aggregate variables were selected as independent variables based on the reliable theory.
As statistical methods for analysis, two methods were applied. To illustrate the areal variation of death rates, mapping method was adopted. And because of the multicollinearity of the independent variables, factor analysis was used. Through the factor analysis, 22 variables were summarized in 5 factors. In order to estimate the age adjusted death rate(Y) with 5 factors, Y was transformed by logistic function, and the regression analysis was conducted afterwards.
Through analysis, following results were obtained.
1) There are big differentials in mortality level(both crude death rates and age-adjusted death rate) among cities and guns. Crude death rates of the gun areas of the Jeonnam Do was the highest 11.54, and that of the Gyeonggi Do was the lowest 7.00. Age-adjusted death rate of the gun areas of the Jeonnam Do was the highest again, 7.67 and that of the Jeju Do was the lowest, 4.55.
2) To find out the factors causing differential mortality, factor analysis was conducted. As a result, 5 factors were drawn, such as socio-economic development charcteristics, health care resource characteristics and others. Explanation power of the socio-economic development characteristics was three times higher than that of the health care resource characteristics. Similar results were obtained in comparative analysis between Gyeonggi Do where the mortality rate was the lowest, and Jeonnam Do where the mortality rate was the highest.
In conclusion, mortality level of a given area can be explained by community-level characteristics, among which the socio-economic development characteristics explained the most. The contribution of the health care resource characteristics on the mortality decline was much less significant than expected.
It is considered that in-depth study to investigate the causality between the characteristics should be conducted.
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