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IJE Advance Access published online on November 3, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl239
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted October 3, 2006

Original paper

Socioeconomic differentials in cause-specific mortality among South Korean adolescents

Hong-Jun Cho 1 *, Young-Ho Khang 2, Seungmi Yang 3, Sam Harper 3, and John W. Lynch 3

1 Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2 Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
3 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

* To whom correspondence should be addressed.
Hong-Jun Cho, E-mail: hjcho{at}amc.seoul.kr


  Abstract

Background There is inconsistent evidence regarding the presence of a socioeconomic differential in adolescent all-cause and cause-specific mortality. This study examines possible socioeconomic mortality differentials in Korean adolescents.

Method A total of 330 321 boys and 311 830 girls aged 10-19, who are health insurance beneficiaries for civil servants and private school teachers of Korean Health Insurance Cooperation, were followed for 9 years (1995-2003). Parental income information was linked to national death certificate data.

Results For boys, all-cause mortality showed a graded inverse relationship with income level in both 10-14 year olds (RR = 1.64, 95% CI: 1.40-1.91) and 15-19 year olds (RR = 1.68, 95% CI: 1.40-1.91). The major contributor was mortality differentials from external causes, with differentials of transport accident death the most important. Mortality from circulatory disease was higher in the lowest income groups in 15-19 year olds (RR = 2.21, 95% CI: 1.09-4.50). A significant socioeconomic gradient of non-external cause mortality was found in 15-19 year olds. For girls, socioeconomic differentials were less evident than boys. The all-cause mortality gradient for girls was smaller than for boys and only significant between the lowest and the highest tertile in both 10-14 year olds and 15-19 year olds (RR = 1.33, 95% CI: 1.02-1.72, RR = 1.38, 95% CI: 1.11-1.72, respectively). There were significant socioeconomic mortality differentials in all external causes and transport accidents and a marginally significant difference in suicide mortality for 10-19 year olds. Mortality from non-external causes showed no social gradient in girls.

Conclusions Socioeconomic differentials in all-cause mortality were observed in adolescents, even in early youth. This pattern might also apply to mortality from non-external causes, especially cardiovascular disease in 15-19 year old males.

Keywords: Adolescence; income; mortality; socioeconomic factor; South Korea.
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