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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The population attributable fraction of low education for mortality in South Korea with improvement in educational attainment and no improvement in mortality inequalities

Authors: Dohee Lim, Kyoung Ae Kong, Hye Ah Lee, Won Kyung Lee, Su Hyun Park, Sun Jung Baik, Hyesook Park, Kyunghee Jung-Choi

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

The educational attainment of Koreans has greatly increased, which was expected to reduce the magnitude of the population attributable fraction (PAF) of mortality associated with low education levels. However, increase in the relative risk (RR) of mortality among those with lower educational levels actually increased the PAF. The purpose of this study was to examine the change in the PAF of lower educational levels for mortality in Korea, where educational attainment has improved and is associated with the exacerbation of inequalities in mortality levels.

Methods

National census data were used to derive educational levels. The mortality-associated RR of lower educational levels was calculated by reference to national census and death certificate data from 1995, 2000, 2005, and 2010. PAFs were calculated for all-cause mortality, malignant neoplasms, cerebrovascular disease, heart disease, and suicide by gender and age group (30–44 and 45–59 years).

Results

The PAF of low educational level in terms of total mortality has decreased since 1995 in both genders. This trend was more prominent among those aged 30–44 years. However, the PAFs of suicide in younger females (30–44 years) and of cerebrovascular disease in older males (45–59 years) have increased. The RRs of all-cause mortality and those of the four leading causes of death in those with the lowest educational levels have increased, especially in females aged 30–44 years.

Conclusions

The consistent and sharp increase in the attainment of education has contributed to the reduction in the PAFs of lower education for mortality, despite the fact that mortality inequalities have not improved. Efforts to reduce health inequalities must promote healthy public policy and address public health policies.
Appendix
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Literature
1.
Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Harding S, et al. Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol. 2003;32(5):830–7.CrossRefPubMed
2.
Mackenbach JP, Stirbu I, Roskam A-JR, Schaap MM, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European Countries. N Engl J Med. 2008;358(23):2468–81.CrossRefPubMed
3.
Huisman M, Kunst AE, Bopp M, Borgan J-K, Borrell C, Costa G, et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet. 2005;365(9458):493–500.CrossRefPubMed
4.
Spiegelman D, Hertzmark E, Wand HC. Point and interval estimates of partial population attributable risks in cohort studies: examples and software. Cancer Causes Control. 2007;18(5):571–9.CrossRefPubMed
5.
Galobardes B, Shaw M, Lawlor DA, Smith GD, Lynch J. Indicators of socioeconomic position. In: Oakes JM, Kaufman JS, editors. Methods in social epidemiology. San Francisco: John Wiley & Sons; 2006. p. 47–85.
6.
Ljung R, Peterson S, Hallqvist J, Heimerson L, Diderichsen F. Socioeconomic differences in the burden of disease in Sweden. Bull World Health Organ. 2005;83(2):92–9.PubMedPubMedCentral
7.
Kulhánová I, Hoffmann R, Judge K, Looman CW, Eikemo TA, Bopp M, et al. Assessing the potential impact of increased participation in higher education on mortality: evidence from 21 European populations. Soc Sci Med. 2014;117:142–9.CrossRefPubMed
8.
9.
Telfair J, Shelton TL. Educational attainment as a social determinant of health. N C Med J. 2012;73(5):358–65.PubMed
10.
World Bank, Birger F, Jee Peng T. An African exploration of the East Asian education experience. In: Lee J-J, Adams D, Kim S-Y, Kim S-K, Jung J-Y, Cho N-S, et al., editors. Korea Education '60, Achievements and Challenges. 611th ed. Seoul: Korea Institute for Curriculum and Evaluation; 2009. p. 155–217.
11.
Yang S, Khang YH, Harper S, Davey Smith G, Leon DA, Lynch J. Understanding the rapid increase in life expectancy in South Korea. Am J Public Health. 2010;100(5):896–903.CrossRefPubMedPubMedCentral
12.
Son M, Oh J, Choi YJ, Kong JO, Choi J, Jin E, et al. The effects of the parents’ social class on infant and child death among 1995–2004 birth cohort in Korea. J Prev Med Public Health. 2006;39(6):469–76.PubMed
13.
Cho HJ, Khang YH, Yang S, Harper S, Lynch JW. Socioeconomic differentials in cause-specific mortality among South Korean adolescents. Int J Epidemiol. 2007;36(1):50–7.CrossRefPubMed
14.
Khang YH, Kim HR. Socioeconomic mortality inequality in Korea: mortality follow-up of the 1998 National Health and Nutrition Examination Survey (NHANES) data. J Prev Med Public Health. 2006;39(2):115–22.PubMed
15.
Khang YH, Lynch JW, Kaplan GA. Health inequalities in Korea: age- and sex-specific educational differences in the 10 leading causes of death. Int J Epidemiol. 2004;33(2):299–308.CrossRefPubMed
16.
Jeong BG, Jung KY, Kim JY, Moon OR, Lee YH, Hong YS, et al. The relationship between regional material deprivation and the standardized mortality ratio of the community residents aged 15–64 in Korea. J Prev Med Public Health. 2006;39(1):46–52.PubMed
17.
KIHASA. Developing Health Inequalities Indicators and Monitoring the Status of Health Inequalities in Korea. Seoul, South Korea: Korea Institute for Health and Social Affairs; 2013.
18.
Jung-Choi K, Khang YH, Cho HJ. Changes in contribution of causes of death to socioeconomic mortality inequalities in Korean adults. J Prev Med Public Health. 2011;44(6):249–59.CrossRefPubMedPubMedCentral
19.
20.
Kwon TH, Kim TH. Life table in Korea, 1970–1985. Seoul, Korea: Seoul National University Press; 1990.
21.
Kim HR, Khang YH. Reliability of education and occupational class: a comparison of health survey and death certificate data. J Prev Med Public Health. 2005;38(4):443–8.PubMed
22.
23.
Vander Hoorn S, Ezzati M, Rodgers A, Lopez AD, Murray CJL. Estimating attributable burden of disease from exposure and hazard data. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva, Switzerland: World Health Organization; 2004. p. 2129–40.
24.
WHO. Handbook on health inequality monitoring: with a special focus on low- and middle-income countries. Luxembourg: World Health Organization; 2013.
25.
Galea S, Tracy M, Hoggatt KJ, DiMaggio C, Karpati A. Estimated death attributable to social factors in the United States. Am J Public Health. 2011;101(8):1456–65.CrossRefPubMedPubMedCentral
26.
Kim S, Lee J-H. Private tutoring and demand for education in South Korea. Economic Development and Cultural Change. 2010;58(2):259–96.CrossRef
27.
Lee S, Brinton MC. Elite education and social capital: the case of South Korea. Sociol Educ. 1996;69(3):16.CrossRef
28.
Sorensen CW. Success and education in South Korea. Comparative Educ Rev. 1994;38(1):10–35.
29.
Seth MJ. Education fever: society, politics, and the pursuit of schooling in South Korea. United States of America: University of Hawai Press; 2002.
30.
Lee WY, Khang YH, Noh M, Ryu JI, Son M, Hong YP. Trends in educational differentials in suicide mortality between 1993–2006 in Korea. Yonsei Med J. 2009;50(4):482–92.CrossRefPubMedPubMedCentral
31.
32.
Hee Ahn M, Park S, Ha K, Choi SH, Hong JP. Gender ratio comparisons of the suicide rates and methods in Korea, Japan, Australia, and the United States. J Affect Disord. 2012;142(1–3):161–5.CrossRefPubMed
33.
Hong J. Socio-economic inequalities in mental health and their determinants in South Korea. PhD thesis, The London School of Economics and Political Science. 2012.
34.
Kim MH, Jung-Choi K, Jun HJ, Kawachi I. Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Soc Sci Med. 2010;70(8):1254–61.CrossRefPubMed
35.
Mackenbach JP, Cavelaars AE, Kunst AE, Groenhof F. Socioeconomic inequalities in cardiovascular disease mortality; an international study. Eur Heart J. 2000;21(14):1141–51.CrossRefPubMed
36.
Kamphuis CB, Turrell G, Giskes K, Macenbach JP, Lenthe FJ. Socioeconomic inequalities in cardiovascular mortality and the role of childhood socioeconomic conditions and adulthood risk factors: a prospective cohort study with 17-years of follow up. BMC Public Health. 2012;12:1045.CrossRefPubMedPubMedCentral
37.
Strand BH, Tverdal A. Can cardiovascular risk factors and lifestyle explain the educational inequalities in mortality from ischaemic heart disease and from other heart diseases? 26 year follow up of 50,000 Norwegian men and women. J Epidemiol Community Health. 2004;58(8):705–9.CrossRefPubMedPubMedCentral
38.
Khang YH, Cho HJ. Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989–2003. Prev Med. 2006;42(6):415–22.CrossRefPubMed
39.
Cho HJ, Song YM, Smith GD, Ebrahim S. Trends in socio-economic differentials in cigarette smoking behaviour between 1990 and 1998: a large prospective study in Korean men. Public Health. 2004;118(8):553–8.CrossRefPubMed
40.
Yoon TH, Moon OR, Lee SY, Jeong BG, Lee SJ, Kim NS, et al. Differences in health behaviors among the social strata in Korea. J Prev Med Public Health. 2000;33(4):8.
41.
Yang YJ, Yoon YS, Oh SW, Lee ES. The amount of physical activity of Korean adults measured from the 2001 KNHANES. Korean J Fam Med. 2005;26(1):22–30.
42.
Yoon YS, Oh SW, Park HS. Socioeconomic status in relation to obesity and abdominal obesity in Korean adults: a focus on sex differences. Obesity. 2006;14(5):909–19.CrossRefPubMed
43.
Khang YH, Lynch JW, Jung-Choi K, Cho HJ. Explaining age-specific inequalities in mortality from all causes, cardiovascular disease and ischaemic heart disease among South Korean male public servants: relative and absolute perspectives. Heart. 2008;94(1):75–82.CrossRefPubMed
44.
45.
Khang YH, Yun SC, Cho HJ, Jung-Choi K. The impact of governmental antismoking policy on socioeconomic disparities in cigarette smoking in South Korea. Nicotine Tob Res. 2009;11(3):262–9.CrossRefPubMed
46.
Park J. Accessibility of Emergency Medical Services (EMS) to acute myocardial infarction by educational level. Master’s thesis, Korea University Graduate School of public health. 2011.
Metadata
Title
The population attributable fraction of low education for mortality in South Korea with improvement in educational attainment and no improvement in mortality inequalities
Authors
Dohee Lim
Kyoung Ae Kong
Hye Ah Lee
Won Kyung Lee
Su Hyun Park
Sun Jung Baik
Hyesook Park
Kyunghee Jung-Choi
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1665-x

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