Young-Ho Khang, MD, PhD, Department of Preventive Medicine, University of Ulsan College of Medicine, 388-1 Pungnap-2dong Songpa-gu, Seoul, 138-736, South Korea, +82 2 3010 4290, youngk@amc.seoul.kr and Hye Ryun Kim, MPH, PhD, Korea Insittute for Health and Social Affairs, Korea Institute for Health and Social Affairs, San 42-14, Bulgwang-Dong, Eunpyung-Gu, Seoul, 122-705, South Korea.

Objective: To examine the ability of different pathway variables to explain socioeconomic mortality inequalities in South Korea. Methods: The 1998 National Health and Nutrition Survey data representing the civilian, non-institutionalized South Korean population were linked to data on mortality from National Statistical Office through December 2002. Socioeconomic position indicator was household income. A total of 12 variables represented biological risk factors (body mass index, systolic blood pressure, cholesterol, and glucose), health behaviors (smoking, alcohol consumption, and regular exercise), psychosocial factors (feelings of sadness and depression, perceived level of stress, and marital status), and early life exposures (education and adulthood height). Results: Mortality differentials by income level did not decrease after exclusion of subjects with poor baseline health status. Biological risk factors and health behaviors caused minor reduction (10 percents or less) in relative risk for income levels. Mortality risk reduction by adjustment for psychosocial factors was not great, comparable to biological risk factors and health behaviors. Early life exposure measures caused the largest reduction in mortality risks. However, the association between income and all-cause mortality was not fully explained by a differential distribution of 12 pathway variables. Conclusions: The role of coronary heart disease risk factors on socioeconomic mortality inequality are not universal but may change in place. The contribution of each of multiple pathways to socioeconomic differentials in all-cause mortality may vary with cause-specific structure of mortality. Research efforts to explore the contributions of other pathway variables related to income should be made in South Korea.

Learning Objectives: The participants will be able to

• Assess the ability of 4 pathway variables (biological risk factors, health behaviors, psychosocial factors and early life exposures) to explain socioeconomic mortality inequality in South Korea.
• Understand that the role of coronary heart disease risk factors on socioeconomic mortality inequality are not universal but may change in place.
• Understand that the contribution of each of multiple pathways to socioeconomic differentials in all-cause mortality may vary with cause-specific structure of mortality.

Keywords: Health Disparities, International Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.