서울시 토지이용과 저체중아 비율과의 관련성

곽영린 한국모자보건학회 2018 한국모자보건학회 학술대회 연제집 Vol.2018 No.2

서울시 토지이용률과 저체중아 출생률 간의 관련성: 생태학적 연구

곽영린,오종민,김민호,예신희,하은희 한국모자보건학회 2019 한국모자보건학회지 Vol.23 No.2

Purpose: This paper is based on an ecological study. From 2008 to 2014, we identified the differences in the Low Birth Weight (LBW) rate according to land use rate among the 25 autonomous regions of Seoul. We also demonstrated the effects of ecological environmental differences on maternal outcomes. Methods: The National Statistical Office obtained data of residential areas and rates, commercial areas and rates, industrial areas and rates, green areas and rates of the 25 autonomous regions from 2008 to 2014. It also obtained data regarding low birth weight rates for the same region and period. The rate of land use is divided into four stages by residential rate, three by commercial rate, three by industrial rate, and four by green area rate The higher the step, the higher the rate is. The method by Baron and Kenny was used to investigate the mediating effects of the concentration of air pollutants (PM10, PM2.5, SO2, NO2, O3, CO) on LBW and its relationship to land use in each district of Seoul. The relationship between the change of land use and LBW rate in each region was analyzed with general regression analysis and cluster analysis. Results: This study shows that as the rate of green area to overall area increases in Seoul’s industrial area, a causal effect is observed with low birth weight, mediated by SO2. Regression analysis revealed that LBW rates were significantly higher in heavily industrial areas (beta=1.27, SE=0.27, p<0.05), while LBW rate was significantly lower in considerably greener areas (beta=-2.21, SE=0.39, p<0.05). Conclusion: We confirmed differences in the relationship between residential, commercial, industrial, and green areas, air pollutants, and LBW rate. Areas with high industrial rates have a high LBW rate, while areas with high green rates have a low LBW rate. The autonomous land use ratio includes direct environmental factors. Therefore, pregnant women who are living in highly industrial areas should be especially careful to manage their living environment.

Development of gender-sensitive comprehensive health matrix: A Comparative Analysis on the Cases of South Korea and North Korea

곽영린,방유림,김은미,하은희,김혜순,권오란 한국모자보건학회 2019 한국모자보건학회 학술대회 연제집 Vol.2019 No.2

Purpose: According to the SDGs Index and Dashboards Report 2018, Korea ranked 19th among 156 countries in terms of SDGs achievement. However, it appears that Korea has difficulty in achieving sustainability in 17 goals. In particular, SDG 5 (Gender Equality), SDG 13 (Climate Action) and SDG 17 (Global Partnership) are in red, which shows urgent need for improvement. In addition, in the era of SDGs by 2030, the need to develop a SDGs-based gender-sensitive health matrix has emerged. In this context, this study aims to define six domains of health (gender equality, medicine, education, economy, nutrition and environment) and analyze the health of each domain from a gender-sensitive perspective. Methods: This study will (1) conduct an integrated analysis of health determinants through a convergence study involving medical, social and natural sciences based on literature review and focus group discussion; (2) develop six domains and indicators based on SDGs; (3) adopt objective quantitative indicators for six domains and indicators and comparatively analyze South Korea, North Korea, and other countries; (4) develop sexual and reproductive health matrix based on the concept of comprehensive health. Results: South Korea scored lower than North Korea in gender equality health, although both countries scored low in gender equality health compared to the overall SDGs countries’ national average. While South Korea scored high on environment, nutrition, medicine and economy health, it scored low on gender equality and education health. In the case of North Korea, the score was higher in gender equality and education health compared to lower score in other domains. Conclusion: This research applied the comprehensive model to the study of sexual and reproductive health (SRH) and sexual and reproductive health and rights (SRHR), which discovers domains and indicators that determine SRH. Based on this, it will present solutions in order to support the development of state policy projects, sex education textbooks, and curriculum.

서울시 토지이용률과 저체중아 출생률 간의 관련성: 생태학적 연구

곽영린 ( Youngrin Kwag ),오종민 ( Jongmin Oh ),김민호 ( Min-ho Kim ),예신희 ( Shinhee Ye ),하은희 ( Eun-hee Ha ) 한국모자보건학회 2019 한국모자보건학회 학술대회 연제집 Vol.2019 No.2

Purpose: This paper is based on an ecological study. From 2008 to 2014, we identified the differences in the Low Birth Weight (LBW) rate according to land use rate among the 25 autonomous regions of Seoul. We also demonstrated the effects of ecological environmental differences on maternal outcomes. Methods: The National Statistical Office obtained data of residential areas and rates, commercial areas and rates, industrial areas and rates, green areas and rates of the 25 autonomous regions from 2008 to 2014. It also obtained data regarding low birth weight rates for the same region and period. The rate of land use is divided into four stages by residential rate, three by commercial rate, three by industrial rate, and four by green area rate The higher the step, the higher the rate is. The method by Baron and Kenny was used to investigate the mediating effects of the concentration of air pollutants (PM10, PM2.5, SO2, NO2, O3, CO) on LBW and its relationship to land use in each district of Seoul. The relationship between the change of land use and LBW rate in each region was analyzed with general regression analysis and cluster analysis. Results: This study shows that as the rate of green area to overall area increases in Seoul’s industrial area, a causal effect is observed with low birth weight, mediated by SO2. Regression analysis revealed that LBW rates were significantly higher in heavily industrial areas (beta=1.27, SE=0.27, p<0.05), while LBW rate was significantly lower in considerably greener areas (beta=-2.21, SE=0.39, p<0.05). Conclusion: We confirmed differences in the relationship between residential, commercial, industrial, and green areas, air pollutants, and LBW rate. Areas with high industrial rates have a high LBW rate, while areas with high green rates have a low LBW rate. The autonomous land use ratio includes direct environmental factors. Therefore, pregnant women who are living in highly industrial areas should be especially careful to manage their living environment.

실내 미세먼지 노출이 가정주부의 대사 증후군에 미치는 영향: 예비연구결과

오종민,곽영린,예신희,하은희 한국모자보건학회 2018 한국모자보건학회 학술대회 연제집 Vol.2018 No.2

Background and Aim: 최근 국내에서는 미세먼지 노출 및 건강 영향에 대한 관심이 지속적으로 높아지고 있다. 영유아가 있는 가정주부는 직장 여성에 비해 가정에서 상대적으로 많은 시간을 보내며 가정에서 요리, 청소, 빨래 육아 등 가사노동을 하며 다량의 실내 미세먼지에 노출되게 된다. 가정주부의 대부분은 가임기 여성으로 소아, 노인 등과 같이 미세먼을지에 취약한 민감 집단이다. 우리나라 가정 주부는 하루 80% 이상의 시간 동안 실내에 머무르기 때문에 실내 미세먼지가 가정주부의 건강에 미치는 영향을 파악하는 것은 매우 중요하다. 본 연구는 국내 가정주부를 대상으로 실내 미세먼지 노출과 대사 증후군간의 미치는 관련성을 파악하고자 하였다. Methods: 본 연구의 연구 대상은 기 구축된 국내 어린이 환경보건 출생 코호트(Ko-CHENS, 코챈스) 연구에 참여한 어머니들 중 상세 코호트에 가입한 비 직장 어머니를 대승상으로 하였으며, 2017년 75명, 2018년 145명, 2019년 80명을, 3년간 총 300명을 모집 계획하여 자료를 구축 중이다. Ko-CHENS는 대한민국 에 거주하고 있는 임신 여성 10만 명을 모집하여 유해환경오염물질이 태아에서 출생 이후 청소년까지 성장과정에 어떠한 영향을 미치는지 주기적으로 관찰하는 장기추적연구이다. 본 연구에서는 2018년 1월부터 2018년 11월까지 모집된 인원 189명 중 중도 탈락자 (N=6)와 검진 정보가 없는 자 (N=19), 설문지 문항에서 가정수입 및 흡연에 대한 정보가 없는 경우 (N=30), 실내 미세먼지 센서 값이 불 충분한 경우 (N=44)를 모두 제외한 후, 총90명을 분석 대상으로 정의하였다. 본 연구에서는 가정주부가 노출되는 실내 미세먼지의 특성과 노출 현황을 파악하기 위하여 각 가정마다 실내 미세먼지 센서를 설치하여 일주일 간 미세먼지 정보와 시간활동일지 정보를 동시에 수집하였다. 미세먼지 센서는 초 미세먼지(PM2.5)와 미세먼지 (PM10) 농도 자료를 약 5분 간격으로 수집 하며, 본 연구에서는 미세먼지 농도 원 자료를 한 시간 평균 및 일 평균 자료로 산술 평균하여 이용하였다. 가정주부의 건강영향은 일주일 간의 실내 미세먼지 노출 측정 후, 혈액검사, 소변 검사를 통해 평가하였다. 대사 증후군의 정의는 미국 국립 콜레스테롤 교육 프로그램(NCEP) 기준으로 1) 허리둘레 80 cm 이상(아시아 여성 기준), 2) 공복 혈청 중성 지망 150 mg/dl 이상, 3) 공복 혈청 고밀도지단백 콜레스테롤 50 mg/dl 미만 (여성 기준) 4) 공복 혈청 수축기 혈압 130 mmHg 또는 이완기 혈압 85 mmHg 이상 5) 공복 혈당 100mg/dl 이상 또는 당뇨병 치료중인 대상 중 3가지 이상 해당되면 대사증후군으로 간주 하였다. 본 연구의 통계 분석 방법은 로지스틱 회귀분석을 이용하였으며 보정 변수에 따라 다음과 같이 3가지 모델을 사용하였다. Model 1) 대사증후군 ~ 실내 미세먼지 농도 Model 2) 대사증후군 ~ 실내 미세먼지 농도 + 연령 Model 3) 대사증후군 ~ 실내 미세먼지 농도 + 연령 + 가정 수입 + 흡연력 Result: 센서로 측정된 PM2.5, PM10 농도는 가정 주부의 대사증후군과 유의하게 관련성이 있는 것으로 나타났다. 실내 미세먼지 농도가 1ug/m3 증가할 때, 대사 증후군 유병 위험이 Model 1에서 PM2.5는 오즈비가 1.07(95% Confidence Interval [95% C.I]=0.99-1.14), PM10은 오즈비가 1.06(95% Confidence Interval [95% C.I] =1.00-1.13), Model 2에서 PM2.5는 오즈비가1.08(95% Confidence Interval [95% C.I]=1.00-1.17), PM10은 오즈비가 1.08(95% Confidence Interval [C.I]=1.01-1.15), Model 3에서는 PM2.5는 오즈비가 1.09(95% Confidence Interval [95% C.I]=(1.00-1.18)), PM10은 오즈비가 1.08(95% Confidence Interval [95% C.I]=1.01-1.17) 증가하였다. Conclusion: 본 연구는 가정주부 코호트 자료를 이용하여 실내 미세먼지 농도와 가정주부들의 대사증후군 유병률과 관련성을 예비 분석하였다. 예비 분석 결과 실내 미세먼지 농도가 증가할수록 가정주부의 대사증후군 유병률이 증가하였다. 센서로 측정된 미세먼지 값은 모니터링으로 측정된 미세먼지 값 또는 중량법으로 측정된 미세먼지 데이터보다 신뢰성이 낮을 수 있으나, 연속적으로 가정의 실내 미세먼지 농도를 측정할 수 있다는 점에서 장점이 있다.

성인지적 성건강의 융복합적 모형개발: 성인지 지표에 기반한 Sustainable Development Goals 국가와 북한과의 비교 연구

방유림,곽영린,김은미,하은희,권오란,김혜순,김혜숙,김석향,김미주,김은실,한재진,정구영,하헌주 한국모자보건학회 2020 한국모자보건학회지 Vol.24 No.1

Purpose: South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. Methods: An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focus group discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. Results: The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. Conclusion: A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

기온과 임신 중 당뇨병과의 연관성 연구

한혜지,곽영린,오종민,하은희 한국모자보건학회 2023 한국모자보건학회지 Vol.27 No.4

Purpose: Exposure to heat and cold stress can negatively affect pregnant women. However, studies on the association between ambient temperature exposure and pregnant women, especially those with diabetes mellitus, are limited. The presence of this disease is likely to affect the woman’s capacity to adapt to the demands of pregnancy, consequently affecting fetal development. We examined the association between exposure to the mean temperature and diabetes mellitus during pregnancy. Methods: Health Insurance Reviews and Assessment Service was used to obtain data on patients hospitalized between January 2015 and August 2022. The association between the number of pregnant patients with diabetes mellitus according to monthly mean temperature and seasonal differences was analyzed using a generalized additive model. The model was adjusted for the treatment date, mean humidity, and mean age of the women. Results: The total number of patients with diabetes mellitus in pregnancy was 651,655 and the mean temperature was 12.87℃±9.89℃. The association between the mean temperature and diabetes mellitus during pregnancy showed a U-shaped nonlinear association. During the entire period, the number of patients with diabetes mellitus in pregnancy significantly increased by 2.82 per 1℃ increase in mean temperature (estimate, 2.82; 95% confidence interval [CI], -2.06 to 7.71). The number of patients significantly increased by 72.12 per 1℃ increase in mean temperature in the summer (estimate, 72.12; 95% CI, 50.36–93.89), but the increase was not statistically significant in the winter. Conclusion: Our findings suggest that maternal exposure to mean temperature during pregnancy is associated with diabetes mellitus.

‘임신 전 건강관리’에 대한 남녀 지식 비교

이은주,신은지,손인숙,황한성,홍순철,안기훈,김영주,박미혜,이경주,신종철,위정하,곽영린,김은미,박은석,한정열,하은희 한국모자보건학회 2018 한국모자보건학회지 Vol.22 No.3

Background: There have been many voices highlighting the necessity of preconception care as a preventive approach to achieve better pregnancy outcomes for health promotion of mothers and babies. It is important to get preconception care for both men and women, as they play equally important roles for healthy pregnancy. Also, awareness and knowledge of men and women about their health are important factors for behavioral changes for preconception care. Purpose: The purpose of this study is to analyze the level of awareness about men and women’s preconception care and knowledge of the determinants of healthy pregnancy by gender. Our second goal was to compare men and women’s level of awareness and knowledge on it. Methods: The participants were 500 males and females (aged over 19 years and under 49 years old) either living or working in Seoul city. The data collection period of the study was from July to December, 2017. An online survey was conducted using a panel of online vendors. Then the collected data were analyzed using SPSS 24.0. Results: Awareness about both men and women’s preconception care was significantly higher in women than in men (p=0.004, p=0.002). Furthermore, there was a significant difference between men and women (p=0.00) in the total score of knowledge on the determinants of preconception care, including smoking, alcohol drinking, age, folic acid intake, and check-up for infectious disease (p=0.00; means women 8.20±1.95 and men 7.27±2.38). Significant gender differences were also found on some items, such as men’s alcohol drinking, men’s age, men’s check-up for infectious disease, women’s intake of folic acid, women’s check-up for infectious disease. The level of knowledge on men’s folic acid intake was the lowest in both men and women. Conclusion: Based on the results on the analysis of gender differences in the awareness and knowledge about preconception care, it is necessary to develop and implement preconception care programs based on the gender perspective approach to make women and men equally share responsibility of the birth result.