Abstract
Objectives
We quantified the impact of reducing socioeconomic inequalities in risk factors on mortality and mortality inequalities in South Korea.
Methods
The mortality risk function from the 12-year mortality follow-up data of the National Health Insurance Service-National Health Screening Cohort, the prevalence of major risk factors from the Korea National Health and Nutrition Examination Survey 2013–2015, and the Health Plan 2020 (HP2020) goals for major risk factors were used to estimate the magnitude of reduction in mortality inequalities by changing the magnitude of income-based inequalities in risk factors in various scenarios under gender-specific models among participants aged 40–79 years.
Results
The greatest reduction in absolute and relative inequalities in mortality would occur if the low-income group achieved the HP2020 goals earlier than the high-income group. A 10–20% reduction in all-cause mortality inequalities was expected if absolute gaps between income groups in risk factors were halved.
Conclusions
With the practical goal halving the socioeconomic gaps in modifiable risk factors, reducing inequalities in all-cause mortality by 10–20% would be possible. Further reduction in mortality inequalities would need more aggressive policies on social determinants of health.
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Acknowledgements
The authors thank Hee-Yeon Kang for her assistance in preparing the paper. This study was administratively supported by the National Health Insurance Service of Korea (NHIS-2017-2-368). HK Lim and YH Khang were supported by the Mid-career Researcher Program of the National Research Foundation (NRF), funded by the Ministry of Science and ICT (Nos. NRF-2014R1A2A1A11051392 and NRF-2017R1A2A2A05069746). This study was also supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HI18C0446).
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Both authors were involved in the planning of the study, implementation of the study, and writing and approving the manuscript. HKL performed the data analysis under the consultation of YHK. Both authors interpreted the results. HKL drafted the manuscript. YHK reviewed and edited the manuscript.
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The present study protocol was reviewed and approved by the Seoul National University Hospital Institutional Review Board (IRB No. E-1411-001-620).
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Lim, HK., Khang, YH. Quantifying the impact of reducing socioeconomic inequalities in modifiable risk factors on mortality and mortality inequalities in South Korea. Int J Public Health 64, 585–594 (2019). https://doi.org/10.1007/s00038-019-01231-2
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DOI: https://doi.org/10.1007/s00038-019-01231-2