Objectives: This study aimed to estimate the risk of disease- and death-causing obesity and to calculate direct and indirect costs using national health insurance big data. Methods: We constructed cohort data for 10,091,251 participants who underwent a national health screening between 2003 and 2004. Cox’s proportional hazard models were adopted to analyze the relative risk (RR) of related diseases and causes of death, adjusted for age, smoking, alcohol consumption, and exercise. Population attributable risk (PAR) of obesity was calculated considering prevalence of obesity and RR of incidence and death of obesity related diseases. Socioeconomic costs were estimated including direct and indirect costs. Results: The risk of diabetes increased with increasing body mass index (BMI). In severely obese males, the risk of diabetes was 4.83 times higher than in normal weight males. In severely obese females, the risk of diabetes was 4.01 times higher than in normal weight females. In case of the socioeconomic cost of obesity, the direct and indirect costs differed by sex: the direct cost of male and female obesity was 50.8 % and 85.9 % in 2015, respectively. Conclusions: This study identified that obesity is not only a significant risk factor of diseases and death but also the cause of economic loss for the health insurance sector. Therefore, it is considered that it is necessary to develop an intervention program to manage examinees who are determined to be obese.

Objectives: The aim of this study was to investigate cognitive function decline by socio-demographic and health-related characteristics (health behaviors and health status) using 5th Korean Longitudinal Study of Aging panel data. Methods: The subjects were 4,440 community-dwelling people aged over 57 years. The data were analyzed with descriptive statistics, frequency analysis, χ²-test, and binary logistic regression analysis using SPSS ver. 25.0. Results: The findings revealed that socio-demographic characteristics (gender, age, area of residence, educational level, marital status, number of children, number of grand-children) and health-related characteristics (smoking, drinking, regular exercise, weight category by body mass index, hypertension and diabetes mellitus) were factors that influenced cognitive function decline (p<.05). Conclusions: Cognitive function decline was closely related to health behaviors and disease types. Future studies must examine related constructs to accurately determine these relationships among various populations. The present study could be used as a tool for the development and implementation of health promotion and prevention strategies.

본 연구는 국민건강보험공단의 건강백세운동교실이 참여자의 정신건강에 미치는 영향을 객관적으로 검증하여 향후 노인인구 대상 건강증진사업의 근거자료로 활용하고자 한다. 건강백세운동교실 참여 전후의 정신건강상태에 대한 자가보고 형식의 설문지를 수집하여 분석하였다. 연구대상은 2017년 기준 건강백세운동교실에 등록한 65세 이상 여성 노인 총 7,643명을 대상으로 하였다. 자료수집은 2017년 4월부터 11월까지 운영된 운동교실 전후에 연구대상자의 일반적 특성, 우울감 그리고 인지기능 수준을 측정하였다. 수집된 자료는 SAS 9.2 Program을 이용하여 일반적 특성은 빈도분석을 하였고, 운동교실 참여 전후의 차이를 알아보기 위해 paired t-test, X2-test를 사용하여 대상자의 우울감과 인지기능 수준을 운동교실 참여 전후에 비교하여 분석하였다. 분석 결과, 우울감(t=12.96, p<.001) 및 인지기능(X2=476.57, p< .001)에서 긍정적인 변화를 보였다. 정기적인 집단운동 참여가 여성 노인의 우울감 개선과 인지기능 향상에 긍정적인 효과가 있음을 확인하였다.

Objectives: This study aimed to analyze nationwide representative data from the 11th Korean Youth Health Risk Behavior Web-Based Survey to determine whether factors including socio-demographics, smoking and alcohol consumption, were factors related to high school students that had experienced sexual intercourse. Methods: A total of 33,744 students (17,346 boys and 16,398 girls) in 1st, 2nd, and 3rd grade at high school were analyzed. SPSS complex samples methods were used for analyses. Socio-demographic and health risk behaviors (type of region of residence, family structure, and economic status, student academic achievement, gender, high school grade, pocket money, student smoking, alcohol consumption, and having engaged in sexual intercourse) were considered as independent variables. Results: There were 3.6% of girls and 9.9% of boys in high school that were sexually active. This behavior and the average number of cigarettes smoked daily, and alcohol consumed weekly, represented a doseresponse relationship, after considering confounding factors. Compared with students that did not smoke or consume alcohol, smoking 1-9 cigarettes per day and consuming 1-6 cups of alcohol and group “smoking more than 10 cigarettes per day and consuming more than 7 cups of alcohol, had a 5.94 and 22.25 higher risk of having had sexual intercourse, respectively. Conclusion: Cigarette smoking and alcohol consumption were associated with an increased likelihood of high school students engaging in sexual intercourse.

Objectives: This study aimed to identify the relationship between thoughts and psychological anxiety about nuclear power among Busan residents. Methods: Convenience sampling was used for this cross-sectional survey conducted from February 13 to 14, 2016. A total of 520 residents participated in the study and completed a self-administered questionnaire. Results: We found a significant association between negative thoughts and psychological anxiety about nuclear power. People older than 60 years (odds ratio (OR) 2.53, 95% confidence interval (CI) 1.41-4.54), who feared the possibility of radiation accidents (OR 1.75, 95% CI 1.17-2.62), considered nuclear power plants unsafe (OR 1.94, 95% CI 1.10-3.40), and believed the Gori nuclear power plant in Busan must be shut down (OR 1.84, 95% CI 1.22-2.79), had the highest anxiety about radiation exposure. Conclusions: The authors suggest the need for the formulation of a policy to provide people with precise information on nuclear power to increase their understanding and help eliminate unfounded negative thoughts. Furthermore, policy decisions about nuclear power must be based on social consensus.

Objectives: The purpose of this study is to obtain the basic data for the development of maternal health care by analyzing the status and needs of service target persons in Timor-Leste. Methods: The subjects were selected through the non-probability sampling method applying the FGI. Researchers interviewed 3 maternal health service managers, 6 midwives at Gleno and Railaco Health Centers and 2 women between 15 and 45 years of age. Results: In the results of on-site visit of the delivery facility and the FGI, we found poor sanitation in delivery room, lack of medical equipment related to antenatal consultation and delivery. In the case of the health center manager, the public health center provides various maternity health services, but the lack of the staff has difficulty in providing the service and managing the subjects. Midwives asked for regular maintenance education. Women in child bearing age living in mountainous areas had poor access to delivery facilities and lack of awareness of delivery services. Conclusions: It is necessary to increase the maternity management rate through regular maternity and maternal health check service and application to maternal management database, to improve the sanitation of the maternity clinic in the public health center, to strengthen the midwife competency program.

Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.

Objectives: This study aims to examine the recognition of Health education specialists qualification system of public health center workers in Busan. Methods: The study selected 137 workers from sixteen public health centers located in Busan. The data was collected from December 8 in 2016 to February 23 in 2017 and analyzed using descriptive statistics, t-test and ANOVA. Results: There was the lowest perception of the usefulness of qualifications related to industry treatment and warranty for licensees in relation to the health education specialists. Conclusions: It is necessary to prepare various researches and plans related to the qualification system of health education specialists. It is also necessary to prepare measures and legislative amendments to increase the usefulness of qualifications.

Objectives: This study aimed to identify the effects of anti-smoking public service announcements on the attitudes of Korean college students toward smoking. Methods: This study involved students via convenience sampling from seven universities who were randomly assigned to four groups. All groups completed a preliminary questionnaire, before being shown a public service announcement twice, and then completed a post viewing questionnaire. Results: For announcements with positive messages, the proportion of changes in beliefs and attitudes were 39.1% and 19.8%, respectively, whereas those with negative messages showed a greater proportion of changes in the beliefs (59.7%) and attitudes (40.3%). After adjusting for sex and change in belief, the message types and smoking status were identified as factors affecting the change in the participants attitudes. A negative message resulted in a greater change in attitudes (odds ratio [OR], 3.047; 95% confidence interval [CI], 1.847–5.053). Ever-smokers including current smokers showed a greater positive change in attitude than never-smokers (OR, 6.965; 95% CI, 4.107–11.812). Conclusion: This study found that positive anti-smoking public service announcements were more effective on attitude change than negative messages. Additionally these announcements were more effective among viewers who were current smokers or had a prior smoking experience.