Original article
Disparities in Health-Risk Behaviors, Preventive Health Care Utilizations, and Chronic Health Conditions for People With Disabilities: The Korean National Health and Nutrition Examination Survey

https://doi.org/10.1016/j.apmr.2011.03.004Get rights and content

Abstract

Ko KD, Lee KY, Cho B, Park MS, Son KY, Ha JH, Park SM. Disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions for people with disabilities: the Korean National Health and Nutrition Examination Survey.

Objective

To examine how disability status is related with health disparities in South Korea.

Design

The study compared 3 indicators of health (health-risk behaviors, preventive health care utilizations, and chronic health conditions) according to the presence of disabilities using the Third Korean National Health and Nutrition Examination Survey, 2005 (KNHANES III).

Setting

We obtained data from the KNHANES III, which is the third nationwide representative study using a stratified, multistage probability sampling design.

Participants

Subjects (N=5475) aged 20 years or older were included in the study; persons with disabilities (n=218) and persons without disabilities (n=5257).

Interventions

Not applicable.

Main Outcome Measures

Nonconditional multiple logistic regression and adjusted mean were used to identify health disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions.

Results

Subjects with disabilities were more likely to be physically inactive (adjusted odds ratio [AOR]=3.06; 95% confidence interval [CI], 1.71–5.48 for no physical activity; AOR=1.70; 95% CI, 1.19–2.43 for insufficient physical activity) than those without disabilities. Women aged 40 years or older with disabilities were less likely to receive cervical cancer screening services (AOR=0.52; 95% CI, 0.27–0.98). Adults with disabilities had higher proportion of osteoporosis (AOR=2.41; 95% CI, 1.50–3.88), underweight (AOR=2.14; 95% CI, 1.07–4.28), suicidal thoughts (AOR=1.86; 95% CI, 1.35–2.56), and had impaired quality of life (95% CI of adjusted mean, 60.89–65.35 compared to 69.95–70.84 in adults without disabilities).

Conclusions

There exists substantial disability-related health disparities in South Korea. People with disabilities may be the underserved subpopulation demonstrating health disparities. The findings in this study underscore the continued needs in order to reduce health problems and disparities for people with disabilities.

Section snippets

Data Source and Study Sample

This study is based on the Third Korean National Health and Nutrition Examination Survey, 2005 (KNHANES III) conducted by the Korean Ministry of Health and Welfare. This survey is the third nationwide representative study using a stratified, multistage probability sampling design for the selection of household units. The selection was made from sampling units based on geographical area, sex, and age, using household registries. The survey consisted of the Health Interview Survey, the Health

Baseline Characteristics of the Sample

Descriptive characteristics of the 2 groups (respondents who have a disability versus respondents who do not have a disability) are shown in table 1. Among the 5475 subjects, 218 (4.0%) were disabled.

The group with disabilities was relatively older than those without disabilities. The disabled group included more men than women. In addition, subjects with disabilities were more likely to have a lower education level, lower income, and were less likely to be employed or married. Over 60% of the

Discussion

Using the National Representative Household Survey, this study examined health disparities for people with disabilities in South Korea. Our study is unique in that it took a comprehensive approach to studying health disparities by utilizing a wide range of health measures including health-risk behaviors, preventive health care utilizations, and chronic health conditions (comorbidities and psychosocial problems and HRQOL).

Our analyses resulted in 3 key findings.

First, with regard to health-risk

Conclusions

A growing number of contemporary efforts, including disability surveillance, support for research, and targeted health programs, have been made to address and ameliorate the health disparities experienced by people with disabilities.63 However, this nationwide representative study showed disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions between people with and without disabilities. Our findings underscore the continued need to reduce health

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    Supported by the Korean Academy of Family Medicine (research fund no. KAFM-10-01-1).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    Ko and Lee contributed equally to this work as first authors.

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