국민건강영양조사 자료의 복합표본설계효과와 통계적 추론

정진은(Chung, Chin-Eun) 한국영양학회 2012 Journal of Nutrition and Health Vol.45 No.6

Nutritional researchers world-wide are using large-scale sample survey methods to study nutritional health epidemiology and services utilization in general, non-clinical populations. This article provides a review of important statistical methods and software that apply to descriptive and multivariate analysis of data collected in sample surveys, such as national health and nutrition examination survey. A comparative data analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) was used to illustrate analytical procedures and design effects for survey estimates of population statistics, model parameters, and test statistics. This article focused on the following points, method of approach to analyze of the sample survey data, right software tools available to perform these analyses, and correct survey analysis methods important to interpretation of survey data. It addresses the question of approaches to analysis of complex sample survey data. The latest developments in software tools for analysis of complex sample survey data are covered, and empirical examples are presented that illustrate the impact of survey sample design effects on the parameter estimates, test statistics, and significance probabilities (p values) for univariate and multivariate analyses.

국민건강영양조사 제4기 계획

오경원(Kyungwon Oh),이정미(Jeongmi Lee),이봉숙(Bongsuk Lee),권상희(Sanghui Kweon),이연경(Yeonkyung Lee),김영택(Youngtaek Kim) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  The general aim of Korea National Health and Nutrition Examination Survey (KNHANES) was to assess the health and nutritional status in the Korean population. The KNHANES began in 1998 and has been conducting as a series of surveys: 1998(1st), 2001(2nd), 2005(3rd) and 2007-2009(4th). Specific aims were, in a cross-sectional study of nationally representative samples of the noninstitutionalized civilian Korean population aged > 1 year (4,600 households each year), to monitor trends the prevalence, awareness, treatment and control of selected chronic diseases, monitor trends in nutritional status and risk behaviors, and analyze risk factors for chronic diseases. For these purposes, with standardized high-quality methods, extensive data on health and nutrition are collected by health interview, health examination (physical examination, clinical measurements and tests) and dietary interview. In 2007, the 4th KNHANES became a continuous annual survey by highly trained field staff. In addition, the 4th KNHANES expanded examination components (addition of oral examination, pulmonary function test and laboratory test items such as ferritin, vitamin D, insulin, manganese, and arsenic), simplified survey procedure, and strengthened quality control. Further works will be focused on the selection of new examination and interview components, planning of KNHANES follow-up survey, continuous training of field staff and quality control, and improvement of dietary survey method.

Original Articles : Prevalence of Eye Diseases in South Korea: Data from the Korea National Health and Nutrition Examination Survey 2008-2009

( Kyung Chul Yoon ),( Gui Hyeong Mun ),( Sang Duck Kim ),( Seung Hyun Kim ),( Chan Yun Kim ),( Ki Ho Park ),( Young Jeung Park ),( Seung Hee Baek ),( Su Jeong Song ),( Jae Pil Shin ),( Suk Woo Yang ) 대한안과학회 2011 Korean Journal of Ophthalmology Vol.25 No.6

Purpose: The aim of this study is to report on preliminary data regarding the prevalence of major eye diseases in Korea. Methods: We obtained data from the Korea National Health and Nutrition Examination Survey, a nation-wide cross-sectional survey and examinations of the non-institutionalized civilian population in South Korea (n = 14,606), conducted from July 2008 to December 2009. Field survey teams included an ophthalmologist, nurses, and interviewers, traveled with a mobile examination unit and performed interviews and ophthalmologic examinations. Results: The prevalence of visual impairment, myopia, hyperopia and astigmatism in participants over 5 years of age was 0.4 ± 0.1%, 53.7 ± 0.6%, 10.7 ± 0.4%, and 58.0 ± 0.6%, respectively. The prevalence of strabismus and blepharoptosis in participants over 3 years of age was 1.5 ± 0.1% and 11.0 ± 0.8%, respectively. In participants over 40 years of age, the prevalence of cataract, pterygium, early and late age-related macular degeneration, diabetic retinopathy and glaucoma was 40.2 ± 1.3%, 8.9 ± 0.5%, 5.1 ± 0.3%, 0.5 ± 0.1%, 13.4 ± 1.5%, and 2.1 ± 0.2%, respectively. Conclusions: This is the first nation-wide epidemiologic study conducted in South Korea for assessment of the prevalence of eye diseases by both the Korean Ophthalmologic Society and the Korea Center for Disease Control and Prevention. This study will provide preliminary information for use in further investigation, prevention, and management of eye diseases in Korea.

한국인의 주관적 구강건강불평등 인식수준 및 관련 요인 분석

신보미 ( Bo Mi Shin ),정세환 ( Se Hwan Jung ) 대한예방치과·구강보건학회 2012 大韓口腔保健學會誌 Vol.36 No.3

Objectives: This study aimed to assess the socio-economic inequalities in the self-rated oral health status in the study group of South Koreans, as associated with other factors (health behaviors factors, psychological factors, and oral health status) on the social gradients in the self-rated oral health status. Methods: The cross-sectional data was from the Forth Korea National Health & Nutrition Examination Survey. Subjects were 18,886 people over the age of 6 years who participated in the health interview, dental examination, and dietary survey. They were divided into four groups according to their life course: children (6-11 years), adolescents (12-18 years), adults (19-64 years), and the elderly (65 years and older). The income and education level brackets were selected as measures of socio-economic position (SEP). The complex samples logistic regression models were used to analyze the data. To assess the association of the other factors, additional models (which adjusted for the gender, age, and each of the other factors) were compared to the initial model (which adjusted for the gender and age only). Results: We found that there were socio-economic differences in the self-rated oral health status at all stages of life, and that the differences were up sharply for the vulnerable social groups. Dental care utilization factors and the oral health status mainly affected the socio-economic inequalities of the poor self-rated oral health status group at all stages of life. Socio-eoconomic differences remained statistically significant in the models that controlled for all related factors except the models of household income in adults. Conclusions: There were socio-economic differences in the poor self-rated oral health status at all stages of life. But it is difficult to definitely confirm the pathway of socio-economic inequalities in the selfrated oral health status, because of the limitations of the cross sectional study and the use of restricted variables in this survey. Therefore more extensive longitudinal research is required to better address the pathways that explain the socio-economic inequalities in the self-rated oral health status throughout the life courses in the Republic of Korea.

The Relationship between Health Behavior and General Health Status: Based on 2011 Korea National Health and Nutrition Examination Survey

Cheon, C.,Oh, S.M.,Jang, S.,Park, J.S.,Park, S.,Jang, B.H.,Shin, Y.C.,Ko, S.G. Korea Centers for Disease ControlPrevention 2014 Osong Public Health and Research Persptectives Vol.5 No.1

Objectives: The aim of the present study is to investigate the relationship between health behavior and general health status. Methods: We used data from the 2011 Korea National Health and Nutrition Examination Survey. Mental health was measured by stress recognition and depression. Dietary habit was measured by mixed grain diet. Life pattern was measured by sleeping time and working pattern. Physical activity was measured by walking and exercise. We defined general health status as Euro Quality of Life-5 Dimension (EQ-5D<SUB>index</SUB>), Euro Quality of Life Visual Analogue Scale (EQ-5D<SUB>vas</SUB>), number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations. Results: Mental health, dietary habit, life pattern, and physical activity have seven factors. Most of the factors have a significant correlation with EQ-5D<SUB>index</SUB>, EQ-5D<SUB>vas</SUB>, number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations. Conclusion: Health behavior and general health status have a positive correlation.

Korea National Health and Nutrition Examination Survey, 20th Anniversary: Accomplishments and future directions

오경원,Yoonjung Kim,Sanghui Kweon,김소연,윤성하,Suyeon Park,이연경,김영택,Park Ok,정은경 한국역학회 2021 Epidemiology and Health Vol.43 No.-

The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.

직군별 건강관련 삶의 질

김선미,이지원 한국보건복지학회 2022 보건과 복지 Vol.24 No.3

This study aimed to identify factors related to health-related quality of life (EuroQol-5 Dimension) for occupational groups of the domestic working-age population based on the 2019 Korea National Health & Nutrition Examination Survey data. We provide data for the development of health management programs for them by identifying health-related quality of life by occupational group. This study is a secondary data analysis study. The subjects were 4,144 working-age population (19~65 years old and the final analysis was done by classifying them into white blue and others by occupation. These data were analyzed using the chi-square test multi-variable logistic regression using SPSS 26.0. Subjective health status suicidal ideation and stress perception were common factors affecting health-related quality of life in all groups. In addition sleep time in the white group body mass index (BMI) in blue, and BMI, sleep time, and smoking in other groups were health-related quality-of-life related variables. There were differences in health-related quality of life related factors by occupational group. It is necessary to improve subjective health status by improving health behaviors that greatly affect quality of life by occupation and to help manage mental health to cope with stress and prevent suicidal ideation. 본 연구는 2019년 국민건강영양조사 데이터를 활용하여 국내 생산가능인구의 직군별 건강관련 삶의 질의 관련요인을 규명하고자 하였다. 직군별로 건강관련 삶의 질의 5가지 차원을 파악함으로써 직군별 건강관리 프로그램 개발의 기초자료를 제공하고자 한다. 본 연구는 2차 자료분석 연구로 대상자는 생산가능인구 4,144명(만 19세 이상 ∼ 65세 미만)을 white, blue, others 직군으로 분류하여 최종분석하였고 SPSS 26.0을 활용하여 교착분석, 다변량 로지스틱 회귀분석을 실시하였다. 주관적 건강상태, 자살생각 및 스트레스 인지는 모든 직군의 건강관련 삶의 질에 영향을 미친 공통요인이었고, 특히 white 군에서는 수면시간이, blue 군에서는 체질량지수가, others 군에서는 체질량지수, 수면시간, 흡연이 건강관련 삶의 질의 주요 관련 요인이었다. 직군별 건강관련 삶의 질 관련 요인은 차이가 있는 것으로 나타나 직군별 삶의 질에 부정적인 영향을 미치는 건강행태를 개선하여 주관적 건강상태를 향상시키고 스트레스에 대처하고 자살생각을 예방하기 위한 정신건강 관리가 필요하다.

인구역학적 요인에 따른 한국인의 사시 및 눈떨림 유병률 조사: 제5기 국민건강영양조사 자료

이지은(Ji Eun Lee),김창주(Chang Zoo Kim),남기엽(Ki Yup Nam),이승욱(Seung Uk Lee),이상준(Sang Joon Lee) 대한안과학회 2017 대한안과학회지 Vol.58 No.11

목적: 사시 질환은 어느 연령대에서도 발병 가능하며 다양한 기능적 또는 비기능적 안과적 문제를 발생시킬 수 있다. 인구 기반 연구를 통해 다양한 인구역학적 요인에 따른 한국의 사시, 눈떨림 등을 포함한 사시 질환의 유병률을 확인하고자 한다. 대상과 방법: 2008년 7월부터 2011년 12월까지 실시된 국민건강영양조사(National Health and Nutrition Examination Survey, n=30,538)의 자료를 사용하여 분석하였다. 사시와 눈떨림의 유병률을 파악하고, 관련된 인구역학적 요인에 대해 평가하였다. 결과: 3세 이상에서 사시 및 눈떨림 환자의 전체 유병률은 1.4 ± 0.1% (95% confidence interval [CI] 1.3-1.6%, 남자 1.5 ± 0.1%, 여자 1.3 ± 0.1%)였다. 외사시(15프리즘디옵터 이상), 내사시(10프리즘디옵터 이상), 수직 편위, 기타 복잡한 사시 및 눈떨림의 유병률은 각각 1.0%, 0.2%, 0.2%, 0.1% 및 0.1%였다. 유병률은 6–15세 연령층에서 가장 높았으며(1.9 ± 0.3%), 40–49세(0.8 ± 0.1%)에서 가장 낮았다(p=0.005). 성별, 지역, 주거 지역, 가구 소득, 교육 수준 및 직업과 관련하여 통계적으로 유의한 차이는 없었다. 결론: 국민건강영양조사 자료를 분석한 결과 한국의 인구역학적 요인에 따른 사시 질환의 유병률은 연령 집단을 제외하고는 통계적으로 유의하지 않았다. 향후 사시 질환의 유병률과 관련된 추가적인 다른 보건 및 사회적 지표들의 검토가 유병률 연구에 도움이 될것으로 판단된다. Purpose: Strabismus affects any age and represents various functional or non-functional eye problems. This population-based study was conducted to determine the prevalence of strabismus and nystagmus in South Korea according to various sociodemographic factors. Methods: We acquired data from the Korea National Health and Nutrition Examination Survey, a nation-wide cross-sectional survey and examinations of the non-institutionalized civilian population in South Korea (n = 30,538), conducted from July 2008 to December 2011. The prevalence of strabismus and nystagmus were verified, and associated sociodemographic factors was evaluated. Results: The overall prevalence of strabismic disorder in participants over 3 years of age was 1.4 ± 0.1% (95% confidence interval [CI] 1.3-1.6%; 1.5 ± 0.1% in males, 1.3 ± 0.1% in females). The prevalence of exodeviation (15 or more prism diopters), esodeviation (10 or more prism diopters), vertical deviation, and other complicated strabismus and nystagmus was 1.0%, 0.2%, 0.2%, 0.1% and 0.1% respectively. The prevalence was highest in the 6 to 15-year age group (1.9 ± 0.3%), and lowest in the 40 to 49 years age group (0.8 ± 0.1%) (p = 0.005). There were no statistically significant differences for gender, region, residential area, household income, educational level and occupation. Conclusions: This nation-wide epidemiologic study demonstrated that the prevalence of strabismus and nystagmus according to various sociodemographic factors in South Korea was not statistically significant except for age group. Further investigations are required based on more surveys to better recognize the etiologic or risk factors that may be related to strabismus and nystagmus. J Korean Ophthalmol Soc 2017;58(11):1260-1268

The Korea National Health and Nutrition Examination Survey data linked Cause of Death data

Yun Sungha,Oh Kyungwon 한국역학회 2022 Epidemiology and Health Vol.44 No.-

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.

한국 가임기 여성의 혈청 비타민 A 수준과 빈혈의 연관성: 제7기(2016-2018) 국민건강영양조사를 이용하여

김화원,권은영,최지영 한국지역사회생활과학회 2024 한국지역사회생활과학회지 Vol.35 No.1

In Korea, vitamin A intake is consistently diminishing, with less than 60% of the recommended amount being consumed, as per the Korea National Health and Nutrition Examination Survey. Vitamin A plays a crucial role in growth, vision, epithelial tissue differentiation, immunity, red blood cell generation, and hematopoietic function, and has antioxidant effects. Adequate vitamin A consumption is particularly vital, especially among children and women of reproductive age in underdeveloped countries, where its deficiency can lead to a spectrum of health issues. Despite existing studies on anemia-related nutrients in Korea, there is still insufficient research on the association between vitamin A and anemia. This study aimed to investigate the correlation between serum vitamin A levels and anemia in women aged 15-49 years, utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Upon analyzing the data from 1,612 women, notable differences were observed in age, household income, health insurance type, smoking experience, serum fat levels, hemoglobin levels, hematocrit levels, serum vitamin A levels, and nutritional status. Age-specific analyses revealed additional variations in education, smoking, drinking, height, weight, body mass index (BMI), obesity, serum triglyceride levels, serum vitamin E levels, serum folate levels, and daily nutrient intake. Furthermore, an association of anemia with smoking (30-49 years), BMI (15-18 years), serum triglyceride levels, hemoglobin levels, hematocrit levels, serum vitamin A levels, and serum vitamin E levels (15-18 years) was demonstrated. Serum vitamin A displayed a negative relationship with anemia, with an increased prevalence in the ‘subnormal range’. This pioneering study in Korea explored the link and established a significant correlation between serum vitamin A levels and anemia in women of reproductive age. Even after adjusting for various factors, diminished serum vitamin A levels were associated with an elevated risk of anemia. These findings offer valuable insights for formulating guidelines on vitamin A intake and serve as foundational data for anemia prevention and treatment. Continuous research and targeted interventions are imperative to enhance vitamin A intake to mitigate anemia prevalence.