Risk of all-cause mortality is associated with multiple health-related lifestyle behaviors and does not differ between urban and rural areas in Korea.

IF 2 4区 医学 Q3 NUTRITION & DIETETICS
Nutrition Research and Practice Pub Date : 2024-08-01 Epub Date: 2024-06-24 DOI:10.4162/nrp.2024.18.4.554
Seunghee Kim, Clara Yongjoo Park
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引用次数: 0

Abstract

Background/objectives: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea.

Subjects/methods: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural).

Results: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed.

Conclusion: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.

全因死亡风险与多种与健康相关的生活方式行为有关,在韩国城市和农村地区之间并无差异。
背景/目的:韩国是一个高度集中的发达国家,在健康和死亡率方面存在城乡不平等。多种与健康相关的生活方式行为对死亡率的潜在影响以及城乡之间的差异尚未完全明了。本研究旨在调查高风险健康行为对韩国城市和农村居民全因死亡率的影响:本研究对 2013-2015 年韩国全国健康与营养调查中 8298 名 40 岁及以上的成年人进行了横断面分析。高危行为被定义为饮食质量差、当前吸烟、高危饮酒或体力活动不足。死亡状况与跟踪至 2019 年 12 月 31 日的死因数据相关联。全因死亡率与高风险行为之间的关联采用考克斯比例危险回归模型进行评估,并对年龄、性别、教育程度、收入和调查年份进行了调整。计算了人口可归因分数(PAF),并进行了效应修正分析。根据居住地区(城市或农村)对参与者进行了分层:在随访期间(中位数:5.4 年),共有 313 人死亡。从事多种高风险行为的农村居民比例高于城市居民(28.9% 对 22.6%;P < 0.0001)。就个体因素而言,较高的死亡风险与饮食质量差、目前吸烟和体育锻炼不足有关,这些倾向在农村居民中持续存在,尤其是在饮食质量方面。在城市和农村地区生活的韩国人中,多种高风险行为与较高的死亡风险呈正相关。城市和农村居民的 PAF(95% 置信区间)分别为 18.5%(7.35-27.9%)和 29.8%(16.1-40.2%)。没有观察到地区的叠加或倍增效应:结论:农村居民的多种高风险生活方式行为发生率较高,这可能是农村地区死亡率高于城市地区的原因。可能需要制定全面的公共卫生政策来改善农村居民的健康相关行为。
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来源期刊
Nutrition Research and Practice
Nutrition Research and Practice NUTRITION & DIETETICS-
CiteScore
3.50
自引率
4.20%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Nutrition Research and Practice (NRP) is an official journal, jointly published by the Korean Nutrition Society and the Korean Society of Community Nutrition since 2007. The journal had been published quarterly at the initial stage and has been published bimonthly since 2010. NRP aims to stimulate research and practice across diverse areas of human nutrition. The Journal publishes peer-reviewed original manuscripts on nutrition biochemistry and metabolism, community nutrition, nutrition and disease management, nutritional epidemiology, nutrition education, foodservice management in the following categories: Original Research Articles, Notes, Communications, and Reviews. Reviews will be received by the invitation of the editors only. Statements made and opinions expressed in the manuscripts published in this Journal represent the views of authors and do not necessarily reflect the opinion of the Societies.
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