Background: Diabetes mortality has decreased in many high-income countries, but it remains unclear whether these improvements have occurred evenly across regions. We examined long-term national and municipal-level trends in diabetes mortality in Korea and assessed changes in regional disparities over time.Methods: We used nationwide cause-of-death microdata from Statistics Korea for 1998–2024 to identify deaths for which diabetes was recorded as the underlying cause. Annual crude death rates and age- and sex-standardized death rates (ASDRs) were calculated at the national and municipal levels, with the 2005 Korean population used as the standard. Relative regional disparity was evaluated using the population-weighted Gini coefficient of municipal-level ASDRs.Results: From 1998 to 2024, the national ASDR decreased by 69.0%, from 27.4 to 8.5 per 100,000 population, whereas the crude death rate changed little, from 21.2 to 21.7 per 100,000 population. Mean municipal ASDRs followed a similar downward trend, decreasing from 28.8 to 8.9 per 100,000 population. However, relative regional disparity increased during the same period, with the Gini coefficient rising from 0.14 to 0.24. This pattern was observed consistently within both metropolitan and nonmetropolitan areas.Conclusions: Diabetes mortality in Korea decreased substantially over 27 years, but relative regional disparities across municipalities widened. Further research is needed to identify the factors that contributed to these divergent national and subnational trends.
Minsung Cho, Kyung Hwa Ha, Hok-You Lee et al.· Cardiovascular Prevention an...· 1 citation
BACKGROUND
Despite advances in hypertension treatment, achieving optimal blood pressure control remains a major public health challenge. Socioeconomic status (SES) may influence hypertension management; however, evidence on its associations with pharmacotherapy, lifestyle modification, and self-management education remains limited. In this study, the association between SES and hypertension-related outcomes in the Republic of Korea was investigated.
METHODS
In this nationwide cross-sectional study, data from the 2023 Korea Community Health Survey were analyzed, comprising 231,584 and 228,608 adults for educational attainment and household income analyses, respectively. Hypertension-related outcomes included diagnosed hypertension, pharmacotherapy, lifestyle modification, and self-management education. Crude and age- and sex-adjusted rates were calculated, followed by multivariable logistic regression analyses, adjusting for potential confounders.
RESULTS
Overall, the prevalence of diagnosed hypertension was 31.3%. Among participants with hypertension, the rates of pharmacotherapy, lifestyle modification, and self-management education were 95.9%, 23.8%, and 15.5%, respectively. The multivariable analyses showed a dose-response relationship between SES and outcomes: participants with primary school education or less had higher odds of diagnosed hypertension (odds ratio, 1.79; 95% confidence interval, 1.71-1.88) and pharmacotherapy use (2.04; 1.67-2.50) but lower odds of lifestyle modification engagement (0.47; 0.43-0.50) and receiving self-management education (0.34; 0.31-0.38) compared to those with college degree or higher. Notably, these socioeconomic gradients remained robustly consistent across all strata, while significantly steeper gradients were observed among females and younger adults (< 65 years). Analyses by household income showed similar patterns of associations, although with slightly weaker magnitudes.
CONCLUSIONS
Lower SES was associated with a higher prevalence of diagnosed hypertension and pharmacotherapy use but lower participation in lifestyle modifications and self-management education. Strengthening tailored self-management education and lifestyle modification support for socioeconomically disadvantaged groups may be an important strategy to reduce hypertension-related disparities.
Eunji Kim, Hokyou Lee, YunJae Jung et al.· BMC Public Health· 0 citations
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