한국의 지역별 소득불평등이 고혈압‧당뇨병 비약물요법 시행에 미치는 영향: 다수준 분석을 활용하여 = Regional Income Inequality and the Implementation of Non-pharmacological Treatments for Hypertension and Diabetes in South Korea: A Multilevel Analysis

다국어 초록 (Multilingual Abstract)

Background: Income inequality can affect individuals’ dietary habits and physical activity through psychosocial pathways, both of which are important for chronic disease management. Dietary control and exercise are essential non-pharmacological strategies for managing hypertension and diabetes. However, empirical research on the impact of income inequality on the practice of such health behaviors remains limited. Therefore, this study analyzed the association between regional income inequality and the implementation of non-pharmacological interventions (dietary control and exercise) for hypertension and diabetes. Methods: Using data from the 2020–2022 Community Health Survey, we analyzed data from 229,575 individuals who reported a diagnosis of hypertension (197,675 participants) or diabetes (84,837 participants). Multilevel logistic regression models were conducted with the implementation of non-pharmacological interventions as a dependent variable. Regional Gini coefficients were used as indicators of income inequality. We also assessed interaction effects between the Gini coefficient and individual income level to determine whether the impact varied by income group. Results: The multilevel logistic regression model showed that higher income inequality was associated with decreased odds of implementing non-pharmacological treatments for both hypertension (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.94–0.97) and diabetes (OR, 0.96; 95% CI, 0.94–0.99). The negative effect was more pronounced among individuals with lower income levels. Conclusion: This study provides empirical evidence that income inequality negatively affects the implementation of non-pharmacological treatments among patients with hypertension and diabetes. These findings highlight the need for policy interventions that address not only individual-level factors but also the broader socioeconomic context, including the contextual effects of income inequality