Epidemiology and Health最新文献

{"title":"Identifying adverse reactions following COVID-19 vaccination in Korea using data from active surveillance: a text mining approach.","authors":"Hye Ah Lee, Bomi Park, Chung Ho Kim, Yeonjae Kim, Hyunjin Park, Seunghee Jun, Hyelim Lee, Seunghyun Lewis Kwon, Yesul Heo, Hyungmin Lee, Hyesook Park","doi":"10.4178/epih.e2025034","DOIUrl":"10.4178/epih.e2025034","url":null,"abstract":"<p><strong>Objectives: </strong>Unstructured text data collected through vaccine safety surveillance systems can identify previously unreported adverse reactions and provide critical information to enhance these systems. This study explored adverse reactions using text data collected through an active surveillance system following coronavirus disease 2019 (COVID-19) vaccination.</p><p><strong>Methods: </strong>We performed text mining on 2,608 and 2,054 records from 2 survey seasons (2023-2024 and 2024-2025), in which participants reported health conditions experienced within 7 days of vaccination using free-text responses. Frequency analysis was conducted to identify key terms, followed by subgroup analyses by sex, age, and concomitant influenza vaccination. In addition, semantic network analysis was used to examine terms reported together.</p><p><strong>Results: </strong>The analysis identified several common (≥1%) adverse events, such as respiratory symptoms, sleep disturbances, lumbago, and indigestion, which had not been frequently noted in prior literature. Moreover, less frequent (≥0.1 to <1.0%) adverse reactions affecting the eyes, ears, and oral cavity were also detected. These adverse reactions did not differ significantly in frequency based on the presence or absence of simultaneous influenza vaccination. Co-occurrence analysis and estimation of correlation coefficients further revealed associations between frequently co-reported symptoms.</p><p><strong>Conclusions: </strong>This study utilized text mining to uncover previously unrecognized adverse reactions associated with COVID-19 vaccination, thereby broadening our understanding of the vaccine's safety profile. The insights obtained may inform future investigations into vaccine-related adverse reactions and improve the processing of text data in surveillance systems.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025034"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of self-rated health, depression, and work ability with employee control over working time.","authors":"Heejoo Ko, Seong-Sik Cho, Jaesung Choi, Mo-Yeol Kang","doi":"10.4178/epih.e2025036","DOIUrl":"10.4178/epih.e2025036","url":null,"abstract":"<p><strong>Objectives: </strong>Work-time control (WTC), defined as employees' ability to influence their work schedules, is a crucial determinant of work-life balance and well-being. This study aims to evaluate the associations between WTC and health-related outcomes among Korean workers and examine potential effect modifications by working hours and shift work status.</p><p><strong>Methods: </strong>This study analyzed data from the 2024 wave of the Korean Work, Sleep, and Health Study, a nationwide panel study of workers aged 19 years to 70 years (n=5,195). WTC was measured using a 6-item scale, and participants were categorized into low (≤12) or high (>12) WTC groups. Outcomes included self-rated health (SRH), depression (measured by the Patient Health Questionnaire-9), and work ability (WA; measured by the Work Ability Index). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for poor SRH, moderate-to-severe depression, and poor WA, adjusting for demographic and occupational variables. Subgroup analyses assessed effect modifications by working hours and shift work.</p><p><strong>Results: </strong>Higher WTC was associated with lower odds of poor SRH (OR, 0.73; 95% CI, 0.62 to 0.86), moderate-to-severe depression (OR, 0.71; 95% CI, 0.61 to 0.83), and poor WA (OR, 0.62; 95% CI, 0.46 to 0.84). These associations were significant among daytime workers but not shift workers. The protective effects of WTC were attenuated among workers whose working hours exceeding 52 hr/wk.</p><p><strong>Conclusions: </strong>Higher WTC is associated with better health and work outcomes, emphasizing its importance for employee well-being. However, its benefits may be limited among shift workers and employees working excessive hours.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025036"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in sustainable dietary patterns in United States adults, 2007-2018.","authors":"Sukyoung Jung, Heather A Young, Barbara H Braffett, Samuel J Simmens, Eunice Hong Lim Lee, Cynthia L Ogden","doi":"10.4178/epih.e2025045","DOIUrl":"10.4178/epih.e2025045","url":null,"abstract":"<p><strong>Objectives: </strong>Adopting sustainable diets is essential for improving both human and planetary health, and such diets should be evaluated from a multidimensional perspective. We characterized trends in sustainable dietary patterns, quantified by the sustainable diet index for United States (SDI-US) adults, along with trends in diet quality, diet-related environmental impacts, food affordability, and food practices.</p><p><strong>Methods: </strong>This study analyzed data from the National Health and Nutrition Examination Survey (2007-2018) for adults aged ≥20 years (n=25,543). The SDI-US (range, 4-20 points), with higher scores indicating more sustainable diets, was calculated using 24-hour dietary recall data and responses to consumer and dietary behavior questionnaires. Mean total SDI-US scores, sub-indices, and 12 individual indicators were estimated for each survey cycle. Trends were assessed using orthogonal polynomial contrasts in regression models.</p><p><strong>Results: </strong>From 2007 to 2018, total SDI-US scores showed no significant overall trend (overall mean, 13.1). Nutritional and socio-cultural indicators remained relatively stable, whereas the economic indicator (food expenditures) worsened from 21.4% to 26.4% (p<0.05, linear trend) between 2007-2008 and 2017-2018. Environmental impacts initially worsened between 2007-2008 and 2013-2014 but improved through 2017-2018 (all p<0.05, quadratic trend). When stratified by age (p for interaction <0.001), a slight decline in SDI-US was observed among adults aged ≥60 years (14.1 to 13.9, p<0.001).</p><p><strong>Conclusions: </strong>From 2007 to 2018, total SDI-US scores largely remained unchanged, although declines occurred among adults ≥60 years and scores remained lower among adults aged 20-39 years. Ongoing monitoring and coordinated improvements across all dimensions are needed to advance sustainable diets in all age groups.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025045"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventable cancer cases and deaths attributable to deficit of physical activity in Korea from 2015 to 2030.","authors":"Soseul Sung, Sungji Moon, Jihye An, Jeehi Jung, Hyeon Sook Lee, Youjin Hong, Sangjun Lee, Woojin Lim, Kyungsik Kim, Inah Kim, Jung Eun Lee, Sun Ha Jee, Aesun Shin, Ji-Yeob Choi, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Yoon-Jung Choi, Jeong-Soo Im, Hong Gwan Seo, Sohee Park, Kwang-Pil Ko, Sue K Park","doi":"10.4178/epih.e2025010","DOIUrl":"10.4178/epih.e2025010","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the population-attributable fractions (PAFs) of cancers using various calculation methods and to estimate the PAFs of cancer incidence and mortality resulting from deficit in physical activity (DPA) from 2015 to 2030, based on data on prevalence rates.</p><p><strong>Methods: </strong>The PAF of cancer was estimated using a cohort study-based meta-analysis of relative risk (RR), national prevalence rates of DPA from 2000 to 2015, and national cancer statistics from 2015 to 2030, with a latency of 15 years.</p><p><strong>Results: </strong>In 2015, DPA contributed to 909 cancer cases and 548 deaths, accounting for 0.42% and 0.68% of new cancer cases and deaths, respectively. By 2030, the PAF values are expected to increase to 1.31% of incidence and 1.80% of mortality, with a continual increase from 2015 to 2030. When the low metabolic equivalent of task (MET) criteria were selected, the PAF values decreased for both incidence and mortality. The PAF calculated with <900 MET-min/wk for the sex-specific MET criterion was higher than that calculated with <900 MET-min/wk for both incidence and mortality.</p><p><strong>Conclusions: </strong>The risk of cancer associated with DPA is expected to rise in both male and female. Future research and strategies should emphasize the promotion of physical activity for cancer prevention, considering its significant implications for public health.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025010"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of dietary inflammatory index with mortality risk: a prospective analysis of the Korea National Health and Nutrition Examination Survey.","authors":"Dahyun Park, Hee Ju Jun, Garam Jo, Soyoung Kwak, Min-Jeong Shin","doi":"10.4178/epih.e2025017","DOIUrl":"10.4178/epih.e2025017","url":null,"abstract":"<p><strong>Objectives: </strong>The energy-adjusted dietary inflammatory index (E-DII), a tool developed based on comprehensive research and literature reviews, is used to assess the inflammatory potential of specific diets. Although previous research has demonstrated an association between E-DII and mortality, longitudinal studies investigating a causal relationship in Asian populations are lacking. This study aimed to explore the prospective association between E-DII and the risk of all-cause, cancer, and cardiovascular disease (CVD) mortality using a population-based Korean cohort.</p><p><strong>Methods: </strong>The analysis included data from 40,596 individuals who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2015. The exclusion criteria encompassed the diagnosis of cancer or CVD at baseline, pregnancy at baseline, and death within the first 2 years after baseline. The E-DII was calculated using data from 24-hour dietary recall interviews. Cox proportional hazard regression models were employed to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality risk across E-DII tertiles.</p><p><strong>Results: </strong>Over an 8.2-year follow-up period, 2,070 deaths were recorded. Compared with the lowest E-DII, a higher index was associated with an increased risk of mortality from all causes (HR, 1.45; 95% CI, 1.25 to 1.69), cancer (HR, 1.41; 95% CI, 1.09 to 1.81), and CVD (HR, 1.53; 95% CI, 1.07 to 2.18). The association between E-DII and all-cause mortality was particularly pronounced among individuals with metabolic conditions.</p><p><strong>Conclusions: </strong>Our findings suggest a strong positive association between high E-DII and increased mortality in Korean adults, especially those with metabolic disorders.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025017"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and psychosocial factors associated with sugar-sweetened beverage consumption among Korean adolescents: a path analysis using the 2022 Korea Youth Risk Behavior Survey.","authors":"Hye-Young Park, Soo Rack Ryu, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park","doi":"10.4178/epih.e2025047","DOIUrl":"10.4178/epih.e2025047","url":null,"abstract":"<p><strong>Objectives: </strong>Rising obesity rates among adolescents are a major global health concern and are closely linked to the consumption of sugar-sweetened beverages (SSBs). This study aimed to identify key behavioral and psychosocial factors influencing SSB consumption among adolescents.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the 2022 Korea Youth Risk Behavior Survey, which included 49,548 participants aged 12-18 years. Information on SSB consumption frequency, socio-demographic characteristics, eating habits, sedentary behaviors, and other health-related factors was collected through self-administered questionnaires. Path analysis was used to model SSB consumption and estimate the direct and indirect effects of modifiable factors.</p><p><strong>Results: </strong>Male students, current alcohol drinkers, those with higher frequencies of fast-food or late-night snack consumption, and heavy smartphone users were more likely to frequently consume SSBs. Fast-food intake had the strongest direct effect on SSB consumption (B=0.3884), while nighttime eating showed a substantial direct effect (B=0.1437) and mediated 21.7% of the relationship between fast-food intake and SSB consumption. Leisure sitting time exerted both direct (B=0.0741) and indirect effects on SSB intake, mediated through watching mukbang, smartphone use, fast-food consumption, and nighttime eating. Self-perceived health status was negatively associated with SSB consumption (B=-0.0619), with indirect effects mediated by fast-food intake and nighttime eating.</p><p><strong>Conclusions: </strong>Among Korean adolescents, SSB consumption was strongly associated with unhealthy eating patterns and prolonged leisure sitting time. Increased fast-food consumption, nighttime eating, watching mukbang, smartphone use, and negative self-perceived health status not only directly influenced SSB intake, but also acted as mediating factors.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025047"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-period-cohort analysis of dietary sodium, potassium, and sodium-to-potassium ratio in Korea.","authors":"Hee Ju Jun, Shieon Kim, Garam Jo","doi":"10.4178/epih.e2025062","DOIUrl":"10.4178/epih.e2025062","url":null,"abstract":"<p><strong>Objectives: </strong>Excessive sodium and insufficient potassium consumption are major dietary contributors to hypertension (HTN) and cardiovascular diseases. The sodium-to-potassium ratio is a known predictor of blood pressure (BP) and HTN. This study evaluated 16-year-trends in dietary sodium, potassium, and the sodium-to-potassium ratio, and their associations with BP and HTN in Korea.</p><p><strong>Methods: </strong>Data from 76,484 participants aged 19-79 years were obtained from the Korea National Health and Nutrition Examination Survey conducted in 2007-2022. Sodium and potassium intake were assessed using 24-hour recalls, and the sodium- to-potassium ratio was calculated. All values were energy-adjusted using the residual method. Age-period-cohort (APC) models were used to analyze temporal trends. Associations with BP and HTN were examined using multivariate linear and logistic regression models, adjusting for confounders.</p><p><strong>Results: </strong>Energy-adjusted sodium intake decreased across all age groups, and potassium slightly increased in the recent 5 years, though both remained suboptimal relative to recommendations. APC analyses showed increasing potassium intake with age and a reversed U-shape cohort pattern. The sodium-to-potassium ratio decreased with age and calendar year but increased in recent cohorts. A higher sodium-to-potassium ratio was strongly associated with elevated systolic (β=0.028, p<0.001) and diastolic BP (β=0.036, p<0.001), and increased odds of HTN (odds ratio, 1.19; 95% confidence interval, 1.07 to 1.33). A linear association appeared when the sodium-to-potassium ratio exceeded 1.00 in the spline model.</p><p><strong>Conclusions: </strong>Despite improvements, sodium intake remains excessive, and potassium insufficient, particularly in younger adults and recent cohorts. Public health interventions should prioritize reducing sodium and promoting potassium-rich foods to reduce cardiovascular risk.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025062"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data profile: cancer sample cohorts (stomach, breast, colorectal, and liver) in Korea.","authors":"Daewoo Pak, Suk Yong Jang, Jin-Ha Yoon, Dong Wook Kim, Jin-Won Noh, Dong-Woo Choi, Minyeong Guk, Hyeri Kim, Ju-Won Oh, Heejung Chae, Hyun-Joo Kong, Gi Hyun Kim, Ji Woong Nam, Ga Ram Lee, Dayun Park, Jehoo Jeon, Byungyoon Yun, Ki-Bong Yoo, Kui Son Choi","doi":"10.4178/epih.e2025058","DOIUrl":"10.4178/epih.e2025058","url":null,"abstract":"<p><p>Cancer Public Library Database (CPLD) links data from four major population-based public sources: the Korea National Cancer Incidence Database in the Korea Central Cancer Registry, cause-of-death data in Statistics Korea, the National Health Information Database in the National Health Insurance Service, and the National Health Insurance Research Database in the Health Insurance Review & Assessment Service. The National Cancer Data Center has developed a new nationally representative sample cohort dataset from Korean Clinical Data Utilization for Research Excellence project (K-CURE) CPLD: Stomach Cancer Sample Cohort, Breast Cancer Sample Cohort, Colorectal Cancer Sample Cohort, and Liver Cancer Sample Cohort. The sample populations consisted of approximately 21% of all cancer patients from 2012 to 2019. The populations of the Stomach Cancer Sample Cohort, Breast Cancer Sample Cohort, Colorectal Cancer Sample Cohort, and Liver Cancer Sample Cohort were 51,951, 39,586, 53,485, and 27,375 patients, respectively. The dataset included cancer incidence information, demographics, socioeconomic variables, health utilization data (procedures, diagnoses, and medications), general health checkup data, cancer screening data before and after the cancer incidence, as well as death information. These cohorts could help researchers analyze time-to-event data on mortality, treatment outcomes, comorbid conditions following a cancer diagnosis, and cancer incidence risk factors. The data can be accessed through the K-CURE portal (https://k-cure.mohw.go.kr/).</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025058"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fraction of cancer incidence and mortality attributable to dietary factors in Korea from 2015 to 2030.","authors":"Hyun Jeong Cho, Jin Young Yoo, Ga-Eun Yie, An Na Kim, Soseul Sung, Sungji Moon, Youjin Hong, Sangjun Lee, Inah Kim, Kwang-Pil Ko, Sun-Seog Kweon, Jung Eun Lee, Sue K Park","doi":"10.4178/epih.e2025065","DOIUrl":"10.4178/epih.e2025065","url":null,"abstract":"<p><strong>Objectives: </strong>Dietary factors play an important role in modifying cancer risk. This study aimed to assess the proportion of cancer incidence and mortality in Korea attributable to dietary factors from 2015 to 2030.</p><p><strong>Methods: </strong>We estimated the population-attributable fraction (PAF) of cancer incidence and mortality using dietary intake levels, exposure rates, and relative risks (RRs). Intake and exposure rates were derived from the Korean National Health and Nutrition Examination Survey, assuming a 15-year latency. RRs were obtained from meta-analyses of Korean cohort and case- control studies.</p><p><strong>Results: </strong>In 2020, 6.08% of cancer cases and 5.70% of deaths in Korea were attributable to dietary factors. High salted vegetable intake (2.12% for incidence and 1.78% for deaths) and low intake of non-starchy vegetables and fruits (1.92 and 2.34%, respectively) were major contributors. However, high intakes of red meat and processed meat showed low PAFs, each less than 1%. The projected PAF for cancer attributable to high salted vegetable intake is expected to decrease substantially to 1.17% in 2030. In contrast, the PAF linked to low intake of non-starchy vegetables and fruits is projected to remain relatively stable.</p><p><strong>Conclusions: </strong>Our findings provide evidence that dietary factors make a substantial contribution to cancer incidence and mortality in Korea. This study highlights that reducing salted vegetable intake and encouraging a diet rich in non-starchy vegetables and fruits may support cancer prevention efforts. Continuous monitoring of dietary trends remains crucial for reducing the cancer burden.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025065"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of student human rights ordinances on mental health among middle and high school students in South Korea: a difference-in-differences analysis.","authors":"Sang Jun Eun","doi":"10.4178/epih.e2025011","DOIUrl":"10.4178/epih.e2025011","url":null,"abstract":"<p><strong>Objectives: </strong>To actively protect and enhance students' human rights, student human rights ordinances (SHROs) have been enforced in seven provinces in South Korea at different times since 2010. Although human rights are closely linked to mental health, there has been no research on the effectiveness of human rights legislation on adolescent mental health. This study evaluated the effects of SHROs on the mental health of middle and high school students.</p><p><strong>Methods: </strong>Repeated cross-sectional data were used, including 1,148,257 respondents from the Korea Youth Risk Behavior Web-based Survey between 2006 and 2023. Probabilities of perceived stress, sleep insufficiency, depressive mood, suicide ideation, and suicide attempt in treated provinces were estimated through a difference-in-differences approach that accounts for treatment effect heterogeneity across groups over time.</p><p><strong>Results: </strong>SHROs had no consistently significant effects on any mental health outcomes, except for slightly increased suicide ideation in total students (0.7%, 95% confidence interval 0.3% to 1.1%). Suicide attempts in total and male students and perceived stress and sleep insufficiency in female students tended to decrease, while other mental health outcomes tended to increase. Uncertainty in the effect estimates of SHROs increased for all mental health outcomes with possible violations of parallel trends, rendering originally significant effects insignificant.</p><p><strong>Conclusions: </strong>SHROs failed to improve mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025011"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}