기후변화 폭염으로 인한 초과사망 위험 감소에 대한 통계적 인간생명가치 측정

이수형 ( Suehyung Lee ),신호성 ( Hosung Shin ),김대은 ( Daeeun Kim ) 한국보건경제정책학회 2016 보건경제와 정책연구 Vol.22 No.2

The study aimed to estimate the economic valuation of statistical life (VSL) in mortality risk of heat wave due to climate change. The double-bounded dichotomous choice (DBDC) of contingent valuation method was used to estimate the willingness to pay (WTP) with 801 adult respondents aged 30 to 75 residing in Seoul. We modified DBDC with adopting spike model to deal with genuine zero willingness to pay. Monthly mean WTP was 18,210 KRW, and monthly mean WTP adjusted by income was 18,488 KRW. Based on the monthly mean WTP, VSL was estimated to 369.8 million KRW (95% CI 325.1 million KRW c- 414.4 million KRW). Our results showed that more serious perception regarding the risk of climate change, the higher WTP to reduce risk of heat wave, and in addition, the seriousness was related with respondent perception that threat would be happen to be real. These patterns of WTP showed similar trend regardless of vulnerable or non-vulnerable groups. The study findings suggested that policy adaptation and alternatives of heat wave should include non-vulnerable population as well as vulnerable population on which the adaption policy of heat wave was mainly focused.

기초자치단체의 폭염으로 인한 온열 및 심뇌혈관질환 부담

이수형(Suehyung Lee),신호성(Hosung Shin) 한국보건교육건강증진학회 2014 보건교육건강증진학회지 Vol.31 No.4

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

근력강화운동을 통한 허약노인의 신체적 기능 및 삶의 질 향상에 대한 분석

선우덕(Duk SunWoo),이수형(Suehyung Lee),박지선(Ji Sun Park),배상수(Sang Soo Bae),조유향(Yoo Hyang Cho),김춘배(Chun-Bae Kim),고광욱(Kwang Wook Koh),김연아(Yeon-A Kim) 한국보건교육건강증진학회 2008 보건교육건강증진학회지 Vol.25 No.1

Objectives: The purpose of this study was to investigate the effects of muscle strength exercise on physical function and quality of life in the frail elderly. Methods: Subjects were 401 frail elderly people selected by the screening tool developed by Japan department of Health, Labor and welfare. The program was carried out for twice a week for 12 weeks. Data were analyzed with paired t-test and t-test using STATA program. Results: 1) Muscle strength exercise for the frail elderly showed statistically significant effects on improving grip strength, single leg stand, TUG(Time up to go) and quality of life. 2) The grip strength and single leg stand indicators showed statistically significant effects between the over 75 years old and the under 75 years old. However, TUG and quality of life indicators didn't show statistically significant effects between the over 75 years old and the under 75 years old. Conclusions: The muscle strength exercise for the frail elderly people was very effective on improving grip strength, single leg stand, TUG and quality of life and especially, it was more effective in the over 75 years old than in the under 75 years old.

The Burden of Tsutsugamushi Attributable to Climate Changes in South Kore

Hosung Shin(신호성),Suehyung Lee(이수형),Seongwoo Seo(서성우) 환경독성보건학회 2012 한국독성학회 심포지움 및 학술발표회 Vol.2012 No.10

한파로 인한 건강피해 적응대책에 대한 지불의사금액

신호성 ( Shin Hosung ),이수형 ( Lee Suehyung ) 한국보건사회연구원 2017 保健社會硏究 Vol.37 No.3

본 연구는 조건부가치측정법(Contingent Valuation Method)을 이용하여 한파로 인한 건강피해를 감소하기 위한 정부 정책의 경제적 가치를 추정하고자 하였다. 경제적 가치 추정시 흔히 발생하는 영(0)의 응답 문제를 해결하기 위해 본 연구는 혼합모형을 적용하고 Weibull 분포를 가정한 베이지안 방법을 이용하여 지불의사금액을 추정하였다. 분석에 사용된 자료는 소득이 있는 만 30세 이상에서 75세 미만 성인남녀 1,500명 중 가구를 대표하는 세대주 또는 주부를 대상으로 수집한 자료이다. 연구결과, 한파로 인한 건강피해 적응대책에 대한 평균 지불의사금액은 가구당 연간 8,492원이었다. 한파지역 거주 여부, 한파빈도에 대한 주관적 생각, 성별, 연령, 교육수준, 가구의 소득수준은 한파 건강피해 적응정책에 대한 지불의사금액과 양의 관계를 보였으나 한파 피해경험은 통계적 유의성이 관찰되지 않았다. 폭염에 대한 연구에 비해 한파에 대한 연구는 미흡한 실정이다. 향후 한파의 건강영향과 사회적 부담에 대한 연구 및 미래 리스크 기반 적응정책에 대한 연구가 필요하다. The purpose of this study is to estimate the amount of willingness to pay (WTP) for adaptation policy to reduce the health damage attributable to cold waves using contingent valuation method (CVM). The survey was conducted on 1,500 adult males and females aged from 30 to 75 years old in Wonju, Ganwon Province, Yeoncheon-gun, Gyeonggi-do, Seoul, Geoje, Gyeongsangnam-do, Namhae, Gyeongsangnam-do, Gwangju from January 23, 2015 to February 13, 2015. In order to solve the problem of treating nonpayment amount, which is common in CVM, we applied the mixed model and estimated the payment amount by the Bayesian method assuming the Weibull distribution. As a result, the average WTP for adaptation policy to prevent the health damage caused by cold waves was 8,492 won per household per year and the median price was 363 won per household. There was a positive relationship between the respondents living in the cold wave areas, the subjective thoughts on the frequency of the cold waves, sex, age, education level and income level of the households. The study of cold wave is insufficient compared to the study of heat wave. Future research should be conducted on health impacts, social burdens of the cold waves and risk based adaptation policies.

자살과 사회경제적 요인과의 관계에 있어서 한국과 다른 OECD 국가들과의 차이

강은정(Eunjeong Kang),이수형(Suehyung Lee) 한국보건교육건강증진학회 2014 보건교육건강증진학회지 Vol.31 No.1

Objectives: This study aimed to examine how the relationship between socioeconomic factors at the macro level and suicide mortality rate of Korea was different from that of other OECD countries. Methods: We created OECD panel data of 29 OECD countries from 1985 to 2006 and analyzed the relationship between socioeconomic factors and suicide mortality rate for separate age and sex groups using a fixed-effect model. Economic factors included per capita GDP, per capita GDP growth rate, unemployment rate, and womens economic participation rate. Social factors included birth rate, alcohol consumption, and the percentage of population 65 and older. Results: Unemployment rate had a positive relationship with suicide in other countries but it had a negative relationship in some groups of Korea. Womens economic participation rate was both positively and negatively related with suicide in Korea but it did not relate to suicide in others. The negative relationship of birth rate and the positive relationship of alcohol consumption with suicide were evident in Korea, which were not found in other countries. The percentage of population 65 and older was negatively correlated in some female groups in Korea, while no significant relationship was found in other countries. Conclusions: Korea was substantially different from other OECD countries in the relationship between socioeconomic factors and suicide mortality rate.

기후변화로 인한 폭염의 질병부담

신호성(Hosung Shin),서성우(Seongwoo Seo),이수형(Suehyung Lee) 한국환경독성학회 2012 한국독성학회 심포지움 및 학술발표회 Vol.2012 No.5

기후변화와 식중독 발생 예측

신호성 ( Shin Hosung ),정기혜 ( Yun Simon ),윤시몬 ( Chung Kee Hey ),이수형 ( Lee Suehyung ) 한국보건사회연구원 2009 保健社會硏究 Vol.29 No.1

기후변화에 대한 관심이 고조되고 있고 기후변화에 대응한 적응정책의 수립은 각 분야가 당면한 주요과제이다. 식중독 및 수인성 전염병의 경우 미생물 유기체와 독성이 있는 식품의 섭취 및 오염된 식수원에 의해 감염될 위험이 있으며 이러한 질병매개체의 활동은 기상 및 기후변화에 영향을 받는다. 본 연구의 목적은 기후변화와 식중독 발생과의 관계를 조명하고 미래 기후변화 시나리오에 입각하여 식중독 발생 예측을 수행하는 것이다. 본 연구의 예측모형은 기온상승, 상대습도변화에 따른 주간 식중독 발생 건수 및 환자 수의 변화에 주목하여 분석을 수행하였다. 분석은 임의효과 Poisson 시계열 분석과 식중독 발생의 계절성과 기온 및 상대습도의 시간지연효과를 고려한 분석 분배시차모형(Distributed Lag Model) 두 가지를 사용하였다. 식중독 발생 감시자료는 우리나라 16개 광역단위별 주간식중독 발생보고 자료 중 2003년 이후 자료를 이용하였고 기상자료는 기상대와 관측소 관측 지점의 기온과 상대습도 값을 사용하였다. 분석결과 상대위험률(Relative Risk Rate, IRR)은 단위기온 상승 당 5.27%(시간지연효과 포함) ~ 5.99%의 식중독 발생 건수가 증가하는 것으로 예측되었다. 상대습도 계수는 음의 값을 보이나 통계학적으로 유의하지 않아 발생 건수에 영향을 미치지 못하는 것으로 보인다. 주간 환자 수의 경우 기온이 평균 1도 상승하면 6.18%(시간지연효과 포함) ~ 7.01%의 환자수가 증가하는 것으로 예측되었다. 주간최고 상대습도는 주간 발생 건수의 경우와 달리 식중독 발생 환자 수에 통계적으로 유의한 영향을 미쳐 상대습도가 1% 증가할수록 환자수는 1.7% 감소하는 것으로 예측되었다. 기준연도인 2003년과 비교하여 식중독 발생 건수는 연도별에 따라 높고 낮음의 차이가 있고 분석방법에 따라서도 약간의 차이를 보여 일정한 경향을 보이지 않았다. 식중독 발생에 대한 기온 효과는 지구 온난화에 따른 일반적 경향과 예측 불가능한 기후변화를 동시에 고려하여 판단하여야 한다. 이 같은 현상을 반영할 경우 식중독 발생은 경시적 변화에 따른 발생증가보다 훨씬 큰 폭으로 나타날 수 있다. 본 연구의 결과 수입식품에 대한 안전관리, 식중독에 대한 예방법과 교육 홍보활동의 강화, 공공부문 관련자, 식품생산자, 식품소비자간 의사소통 개선 등 잠재적 식품 위해 발생 분야와 요인을 분석하여 효과적인 대응전략을 마련하며 향후 식중독 증가 등 식품안전사고에 의한 사회 경제적 피해를 최소화할 필요가 있다. There is enormous public interest in measuring the impacts of climate change. Food borne diseases may be one of the most significant contemporary public health problems. The purpose of this study was to estimate the prevalence of food borne diseases due to the climate change and to predict their future impact. The analytical approach used generalized linear Poisson regression models adapted for timeseries data. To account for seasonal patterns of food-borne disease not directly due to weather factors, Fourier terms with annual periodicity were introduced into the model. To allow autocorrelation due to biological process of pathogen development and host reaction and the longterm trend, we considered time lags and year variable. The data we used was a panel data for the years between 2003 and 2007. The food-borne disease patients increased 5.27~5.99%(relative risk rate) per a Celsius degree. Moreover, the weekly food-borne disease patients increased 6.18~7.01%(relative risk rate) per a Celsius degree. In the case of the weekly patients, the relative humidity was significant, so the weekly patient decreased 1.7% when the relative humidity increased 1%. Compared to reference year, 2003, there was no a certain trend in the food borne disease patients due to differences as per year and analysis methods. Climate change will not result in a uniform warming over the globe. With the oceanic and atmospheric circulations, large scale change will adjust smaller scale weather features including the frequency of extreme events, and in turn the prevalence of food-borne diseases. Disease surveillance, proper case management, environmental monitoring and international communication systems were the keys for curbing the spread of contamination and the outbreak of food-borne diseases.