Determinants of Socioeconomic Inequalities in the Use of Eye Care Services among Individuals with Diabetes in Alberta, Canada 1995-2009

Jongnam Hwang(Jongnam Hwang ),Christopher Rudnisky(Christopher Rudnisky ),Sarah Bowen(Sarah Bowen ),Jeffrey Johnson(Jeffrey Johnson ) 한국캐나다학회 2016 Asia-Pacific Journal of Canadian Studies (APJCS) Vol.22 No.1

Diabetic retinopathy (DR) is a serious life-threatening complication in individuals with diabetes. The Canadian Diabetes Association clinical guidelines recommend an annual dilated eye examination by an eye care specialist for timely detection and effective prevention. Previous studies have suggested that socioeconomic status (SES) is associated with use of the recommended eye care services. However, Canadian evidence on the factors associated with SES-related inequalities in the use of eye screening services among individuals with diabetes is limited. Therefore, the aim of this aim of this study was to assess SES-related inequalities, in the of eye care services among individuals with diabetes in Alberta, Canada. We applied the econometric techniques of Concentration Index (CI), and used regression-based decomposition analysis to identify major contributors to SES-related inequalities. Horizontal inequity index (HI), which represents equal access for equal need, was calculated based on decomposition methods by quantifying contributions of need and non-need factors. SES was represented by 3 different measures: census-based median household income, and material (MDI) and social deprivation (SDI) indices. This study used data from the Alberta Diabetes Surveillance System (ADSS) 1995-2009: a total of 1,949,498 individuals with diabetes over a 15-year period were included in the analyses. Eye care service was defined in this study as any visit to an ophthalmologist, based on the medical services claims database. The study found horizontal inequity among individuals with diabetes in the use of eye care services by an ophthalmologist but these differed depending on the specific SES indicator. Income and material deprivation-related His have been in favor of richer groups (i.e., pro-rich), however, the social deprivation-related His have been in favor of poorer groups (i.e. socially deprived individuals with diabetes tended to use more eye screening services than those who were less socially deprived). In addition, the study found that the MDI and place of residence (urban/rural) were important contributors to the observed “pro-rich” income-and MDI-related CIs. The observed SDI-related inequity was explained by SDI itself. The findings imply that economic- and social-related resources generate different directions of inequalities in the use of eye screening services and also suggest the need for developing health policy to alleviate different determinants if SES-related inequalities in the use of eye screening services in individuals with diabetes in Alberta.

대도시 거주지역 환경에 대한 만족과 자살생각 간의 관계 - 서울시 사례를 중심으로 -

황종남(Jongnam Hwang),오종묵(Jongmuk Oh) 서울연구원 2020 서울도시연구 Vol.21 No.4

캐나다 사회보장제도의 이해

황종남(Jongnam Hwang) 한국캐나다학회 2019 Asia-Pacific Journal of Canadian Studies (APJCS) Vol.25 No.1

Health care and the social welfare system is part of social security policies, which aim at ensuring people’s health and well-being in every country in the modern era. Despite the relatively short history of Canada, it is known that its health care system and social welfare system has been well established at both federal and provincial levels in terms of service process and coverage compared to other countries such as the U.S. The purpose of this article was to review the fundamental principles of Canada’s health care and social welfare systems, respectively, and to introduce the basic schemes of these systems. In spite of increasing social and economic burdens, the federal and provincial governments have attempted to sustain the current schemes of health care and welfare systems by expanding the role of the public sector and regulating the role of the private sector in Canada. It may be necessary to fully understand Canada’s social security systems in response to the increasing needs for suggesting the future direction of health and social policies in Korea.

중ㆍ고령자의 사회활동 참여와 인지기능과의 관계

황종남(Jongnam Hwang),권순만(Soonman Kwon) 한국노년학회 2009 한국노년학 Vol.29 No.3

본 연구에서는 중ㆍ고령자의 다양한 사회활동 참여가 치매 진단의 1차적 기준이 되는 인지기능에 미치는 영향을 살펴보았으며 이를 위해 2006년 고령화 연구패널 자료를 활용하여 만 45세 이상 중ㆍ고령자들의 사회활동 참여와 인지기능 점수간의 관계를 분석하였다. 사회활동의 유형은 김영범ㆍ이승훈(2008)의 연구에서 정의한 종교활동, 여가활동, 공공집단 활동과 연고집단 활동으로 분류하였으며 인지기능을 측정하는 MMSE-K의 원점수를 분석에 사용하였고 사회경제수준과 건강수준을 통제변수로 사용하였다. 만 45세 이상 중ㆍ고령자 전체를 분석한 결과 종교활동과 여가활동이 인지기능에 유의한 영향을 주는 것으로 나타났으며 연령과 성별을 층화하여 중년 남성, 여성집단과 고령 남성, 여성집단으로 분석한 결과 중년 남성집단에서는 여가활동이 유의하였으며 중년 여성에서는 4가지 사회활동이 모두 유의하지 않았다. 고령 남성과 여성에서는 종교활동과 여가활동이 모두 인지기능에 유의한 영향을 주는 것으로 나타났으며 고령 여성의 공공집단 활동 참여가 인지기능에 유의한 영향을 미치는 것으로 나타났다. 연구의 결과를 통해 중년자들의 사회활동 참여보다 고령자의 종교활동과 여가활동의 참여가 인지기능 장애와 치매예방에 더 긍정적인 영향을 준다고 볼 수 있으며 이를 근거로 노인들이 건전한 여가활동을 누릴 수 있도록 체계적인 정책과 지원의 확대가 필요하다는 것을 확인하였다. This research investigated how the participation of various social activities affects cognitive function in middle-aged and elderly population. To examine the relation between the participation of various social activities and cognitive function, we used data from the Korean Longitudinal Study of Ageing. Social activities were classified into four types as religious ritual, leisure, public association and ascriptive association activities, and MMSE-K score was used to measure cognitive function. Results from multiple regression analyses after adjusting for socio-economic status and health status show that the participation in religious and leisure activities have positive effects on cognitive function in middle-aged and elderly population. Participation in leisure activities in middle-aged male group helps preserve cognitive function, and leisure activity and ritual activity are significantly related to cognitive function in middle-aged female group. Meanwhile the participation in religious and leisure activities have positive effects on cognitive function in elderly male and female group. Based on these findings, we suggest that various programs to support the participation of elderly population in social activities should be developed for healthy life for the elderly.

서울시 의료서비스 환경에 대한 주관적 인식과 미충족 의료 경험과의 관계

황종남 ( Jongnam Hwang ),손창우 ( Changwoo Shon ) 대한보건협회 2021 대한보건연구 Vol.47 No.4

연구목적 : 본 연구의 목적은 서울시 지역사회 의료서비스 환경에 대한 주관적 인식과 미충족 의료 경험과의 관계를 살펴보고자 한다. 연구방법 : 본 연구를 위해 지역사회 건강조사 2019년 자료를 활용하여 서울시 거주 성인남녀 만 19세 이상 응답자 19,646명(여성:11,117; 남성:8,529 )을 연구대상으로 선정하였다. 지역사회 의료서비스 환경에 대한 인식은 만족과 불만족으로 구분하였으며, 지난 1년간 필요한 의료서비스를 받지 못한 경험 유무에 따라 미충족 의료 경험유무 집단을 분류하고 다수준 로지스틱 회귀분석을 실시하였다. 연구결과 : 분석결과, 지역사회 의료서비스 환경에 불만족할 경우 미충족 의료를 경험할 확률이 1.96배 증가하는 것으로 나타났다. 미충족 의료의 이유에 따라 개인적 요인과 시스템 요인으로 층화분석을 실시한 결과에서도 지역사회 의료서비스 환경에 대한 주관적 인식과 의료이용 장애와 개인적 사유에 따른 미충족 의료에 각각 유의미한 영향을 주는 것을 확인하였다. 결론 : 미충족 의료 개선을 위해서는 보건의료제도와 물리적 접근성의 개선 뿐만 아니라, 지역사회 의료서비스 환경 인식 개선을 위한 노력이 필요함을 시사한다. Objectives : The purpose of this study was to examine an association between community perception of healthcare services and experience of unmet healthcare needs among urban dwellers in Seoul. Methods : For this study, data from the 2019 Community Health Survey (CHS) were utilized, and a total number of 19,646 residing in Seoul were included in the analytic models. A multi-level logistic regression analyses were conducted after controlling socio-demographic factors and a number of physician per 1,000 people by 25 districts. Results : The results from this study indicate that a poor community perception of healthcare services was associated with experiencing unmet healthcare. In addition, a poor community perception of healthcare service was associated with personal reason-, and systematic reason-related unmet healthcare need. Conclusions : This finding suggests that individual’s perception of healthcare service plays an important role in the experience of unmet healthcare needs, suggesting the importance of community-based policy development for improving social aspect of healthcare services in addition to physical conditions.

소득 수준에 따른 미충족 의료

황종남(Jongnam Hwang) 한국보건교육건강증진학회 2017 보건교육건강증진학회지 Vol.34 No.4

One-Nanometer-Scale Size-Controlled Synthesis of Monodisperse Magnetic Iron Oxide Nanoparticles

Park, Jongnam,Lee, Eunwoong,Hwang, Nong-Moon,Kang, Misun,Kim, Sung Chul,Hwang, Yosun,Park, Je-Geun,Noh, Han-Jin,Kim, Jae-Young,Park, Jae-Hoon,Hyeon, Taeghwan WILEY-VCH Verlag 2005 Angewandte Chemie Vol.44 No.19

<B>Graphic Abstract</B> <P>Accurate to size: Monodisperse magnetic iron oxide nanoparticles with a continuous size spectrum of 6–13 nm have been synthesized by a procedure similar to seed-mediated growth and characterized by transmission electron microscopy (see picture) and magnetic measurements. This method yields monodisperse nanoparticles directly without a size-selection process. <img src='wiley_img/14337851-2005-44-19-ANIE200461665-content.gif' alt='wiley_img/14337851-2005-44-19-ANIE200461665-content'> </P>

Retaining Wall Structure Stability Evaluation using 3D Lidar

Jongnam Do,Beomsik Hwang,Nagyoung Kim 한국도로학회 2022 한국도로학회 학술대회 발표논문 초록집 Vol.2022 No.10

위성탑재체 개발사업에서 형상관리 적용사례

원종남(Jongnam Won),심영규(Yeonggyu Shim),정성훈(Sunghoon Jung),황용철(Yongchul Hwang) 한국항공우주학회 2021 한국항공우주학회 학술발표회 논문집 Vol.2021 No.11

충청지역 지층별 전단파속도와 N값의 상관관계 분석

도종남(Do, Jongnam),황필재(Hwang, Piljae),정성래(Chung, Sungrae),천병식(Chun, Byungsik) 한국지반환경공학회 2011 한국지반환경공학회논문집 Vol.12 No.10

본 연구는 충청 지역에서 측정된 전단파 속도를 지층별로 점성토층, 사질토층, 자갈층, 풍화토층, 풍화암층으로 분류하여 표준관입시험 N값과 전단파 속도의 상관관계식을 제안하였으며, 참고적으로 풍화암층을 제외한 전체토층의 상관관계식을 도출하였다. 제안된 상관관계식은 국내외 기존 제안식을 고려하여 모두 멱함수로 산정하였으며 지반강도의 경우 N값이 50 이상일 경우에는 선형으로 환산하여 적용하였다. 금번 연구에서 제안한 관계식을 국내외 사례와 지층별로 비교 분석한 결과 점성토층, 사질토층, 자갈층, 풍화토층의 경우에는 유사한 특성을 보이고 있음을 알 수 있었다. 다만, 풍화암층에 대한 상관관계식의 경우 국내 관계식과 다소 낮은 결과치를 나타내는 차이가 있음을 확인하였다. 풍화암층의 경우 상관관계식 산정에 있어 N값이 50 이상일 경우는 선형으로 환산하여 적용함에 따라 지반 강도가 높은 지층인 풍화암층에서 차이가 발생한 것으로 파악된다. In this study, features of correlation between S-velocity and N value are derived from 9 suspension PS layers in Chungcheong Buk-do. S-velocity to be measured on Chungcheong Buk-do is classified into 5 as conditions of stratum that are ; cohesive soil layer, sandy soil layer, gravel layer, weathering soil layer, weathered rock layer. Each correlation formulas between N value by SPT and S-velocity is proposed from these classifications. And correlation formula for whole soil body except weathered rock layer also is proposed for reference. Corelation formulas developed this study formed square expression considering existing formulas produced internationally. Strength parameter converted to linear if N value is more than 50. Features of proposed formula which came up with comparative analysis of international result of cohesive soil layer and sandy soil layer and gravel layer show similar to existing ones. But there is deference that result of correlation formula for weathered rock layer is a little smaller than domestic formula’s one. Because correlations of weathered rock layer above the N value of 50 is converted into a linear formation.