The Life Expectancy Gap between Registered Disabled and Non-Disabled People in Korea from 2004 to 2017.
ABSTRACT: This study aimed to estimate and compare life expectancy at birth among people with and without officially registered disabilities in Korea between 2004 and 2017. We used the National Health Information Database in Korea to obtain aggregate data on the numbers of population and deaths according to calendar year (2004 to 2017), sex, age groups, and officially registered disability status. A total of 697,503,634 subjects and 3,536,778 deaths, including 33,221,916 disabled subjects (829,464 associated deaths), were used to construct life tables. Between 2004 and 2017, life expectancy for people with disabilities increased by 9.1 years in men and 8.3 years in women, while life expectancy for the non-disabled increased by 5.5 years in men and 4.6 years in women. The average life expectancy difference between non-disabled and disabled people was 18.2 years during the study period, decreasing from 20.4 years in 2004 to 16.4 years in 2017. In 2017, the life expectancy of people with the most severe grade of disabilities was 49.7 years, while the life expectancy of people with the least severe grade of disabilities was 77.7 years. The government should implement more effective policies to protect the health of people with officially registered disabilities.
Project description:Evidence suggests that people with disabilities are the most marginalised and vulnerable group within any population. However, little is known about the extent of inequality between people with and without disabilities in contexts where the majority of persons experience extreme poverty and hardship. This includes in Liberia, where very little is understood about the lives of disabled people in general. This study uses a multidimensional wellbeing framework to understand perceived relative inequality associated with disability by assessing several facets of wellbeing across and within households containing disabled members (N = 485) or households with no disabled members (N = 538) in Liberian communities (Total individuals surveyed, N = 2020). Statistical comparisons (adjusted for age, sex, education and wealth differences and clustered at the household, village and county level) reveal that disabled Liberians are managing similarly to non-disabled Liberians in terms of income and education, but experience many perceived relative inequalities including in life satisfaction, transport access, political participation and social inclusion. Our results further suggest that disability may lead to perceived relative inequality at the household level in terms of trust held in neighbours. However, they also show that being the head of a household may protect against perceived relative inequality in certain dimensions (e.g. healthcare and transport access, political participation) irrespective of disability status. Results are discussed in terms of practical implications for development efforts in Liberia and for disabled people in other low- and middle-income settings.
Project description:BACKGROUND:There are many types of disabilities, and each type has a variety related to socioeconomic factors. Such factors affect to many health problems of the disabled. However, surveys of the oral health status of the disabled in Korea are rare. OBJECTIVE:The purpose of this study was to estimate oral health disparity through comparing oral health status of the disabled to the non-disabled, adjusted for the net effect of the disability on oral health status. METHODS:A cross-sectional study was conducted among the disabled in urban and suburban areas in Korea from June to September 2016. People with physical, mental, and multiple disabilities took part in this survey. The clinical examinations were carried out by trained dentists. Statistical analysis was performed to quantify the association between oral health and socioeconomic status after restricting the analysis using a propensity score matching method. RESULTS:The disabled had more DMFT, DT, and MT, fewer FT, and fewer teeth than the non-disabled based on entire groups (P<0.01). No difference in the ratio of periodontitis was observed. The subjects with mental disabilities (MD) scored 3.09 (95% CI, 1.07-8.97), and those with multiple disabilities scored 4.37 (95% CI, 1.16-16.37) for edentulous status. The MD had an odds ratio of 1.34 (95% CI, 1.03-1.74), and those with multiple disabilities had an odds ratio of 1.75 (95% CI, 1.11-2.76) for the DMFT index. CONCLUSIONS:These results represent poor oral health status of the disabled compared to the non-disabled. Consequentially, we can verify that not only the existence of disability but also the type of disability has a decisive effect on oral health condition. This comparison is necessary to widen our approach to evaluate the actual status condition of the disabled.
Project description:This study was aimed to estimate life expectancy (LE), disability-free life expectancy (DFLE) and disabled life expectancy (DLE) among older adults from Santiago, Chile, and to determine the existence of differences by gender and by body mass index (BMI) categories in these indicators.A sample of 1216 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being was recruited in 2000; two follow-up assessments were carried out in a 10-year period. Functional limitation was assessed through self-report of difficulties in activities of daily living, instrumental activities of daily living and mobility. BMI was determined with measured weight and height. Multistate life tables were employed to estimate LE and healthy life expectancy (HLE).At 60 years, women could expect to live on average an additional 20.4 years (95% CI 19.0-21.6), and men an additional 16.4 years (95% CI 14.9-17.7). Total LE was longer among women at all ages, but they had a higher proportion of disabled years to be lived compared to men, with a difference of 14% at 60 years, and 10% at 90 years. There were no significant differences in LE, DFLE and DLE between BMI categories.Despite a longer LE, Chilean older women expect to live a higher proportion of years with disabilities, compared to men. Public health programs should address factors affecting LE of older men, and those associated with disability among older women.
Project description:BACKGROUND:Medical Aid beneficiaries in Korea are more likely to have poor health status and to receive insufficient healthcare services, but their life expectancy has not been compared with that of National Health Insurance beneficiaries. METHODS:We used the National Health Information Database in Korea to obtain aggregate data on the numbers of population and deaths according to calendar year (2004 to 2017), sex, age group, and insurance eligibility (Medical Aid or National Health Insurance). Between 2004 and 2017, a summed total of 697,503,634 subjects (combining numbers of subjects for 14 years) and 3,536,778 deaths, including 22,417,216 Medical Aid beneficiaries and 499,604 associated deaths, were used to construct annual abridged life tables. RESULTS:In 2017, the life expectancy of Medical Aid beneficiaries was 70.9 years, while that of National Health Insurance beneficiaries was 83.7 years. Between 2004 and 2017, life expectancy for Medical Aid beneficiaries increased by 8.7 years in men and 6.1 years in women, while life expectancy for National Health Insurance beneficiaries increased by 5.2 years in men and 4.5 years in women. The life expectancy difference between National Health Insurance beneficiaries and Medical Aid beneficiaries was especially great among men across all study periods. The life expectancy difference was 15.8 years for men and 8.9 years for women in 2017. CONCLUSIONS:The life expectancy of Medical Aid beneficiaries was shorter than that of National Health Insurance beneficiaries. The government should implement policies to deliver more adequate health care to Medical Aid beneficiaries.
Project description:<h4>Background</h4>Health indicators, such as mortality rates or life expectancy, need to be presented at the local level to improve the health of local residents and to reduce health inequality across geographic areas. The aim of this study was to estimate life expectancy at the district level in Korea through a spatio-temporal analysis.<h4>Methods</h4>Spatio-temporal models were applied to the National Health Information Database of the National Health Insurance Service to estimate the mortality rates for 19 age groups in 250 districts from 2004 to 2017 by gender in Korea. Annual district-level life tables by gender were constructed using the estimated mortality rates, and then annual district-level life expectancy by gender was estimated using the life table method and the Kannisto-Thatcher method. The annual district-level life expectancies based on the spatio-temporal models were compared to the life expectancies calculated under the assumption that the mortality rates in these 250 districts are independent from one another.<h4>Results</h4>In 2017, district-level life expectancy at birth ranged from 75.5 years (95% credible interval [CI], 74.0-77.0 years) to 84.2 years (95% CI, 83.4-85.0 years) for men and from 83.9 years (95% CI, 83.2-84.6 years) to 88.2 years (95% CI, 87.3-89.1 years) for women. Between 2004 and 2017, district-level life expectancy at birth increased by 4.57 years (95% CI, 4.49-4.65 years) for men and by 4.06 years (95% CI, 3.99-4.12 years) for women. To obtain stable annual life expectancy estimates at the district level, it is recommended to use the life expectancy based on spatio-temporal models instead of calculating life expectancy using observed mortality.<h4>Conclusion</h4>In this study, we estimated the annual district-level life expectancy from 2004 to 2017 in Korea by gender using a spatio-temporal model. Local governments could use annual district-level life expectancy estimates as a performance indicator of health policies to improve the health of local residents. The approach to district-level analysis with spatio-temporal modeling employed in this study could be used in future analyses to produce district-level health-related indicators in Korea.
Project description:This paper examines how older individuals living in 9 European countries evaluate their chances of survival. We use survey data for the years 2004 and 2015 to construct population-level gender-specific subjective length of life (or subjective life expectancy) in people between 60 and 90 years of age. Using a specially designed statistical approach based on survival analysis, we compare people's estimated subjective life expectancies with those actually observed. We find subjective life expectancies to be lower than actual life expectancies for both genders in 2004. In 2015 men become more realistic in the sense that their subjective life expectancy is close to what was actually observed, while women retain their subjective expectations of a shorter than actual life expectancy. These results help to better understand how people might construct diverse decisions related to their remaining life course.
Project description:BACKGROUND: Many patients with disability require orthodontic treatment (OT) to achieve adequate oral function and aesthetic appearance. The cooperation of disabled patients and of their parents is central to the success of OT, as treatment can involve ethical dilemmas. The aim of this study was to analyze the motivation, expectations and overall satisfaction with OT among parents of patients with disabilities. METHODS: The parents of 60 disabled Spanish children with physical, mental and/or sensory impairment undergoing OT were surveyed on attitudes to OT and level of satisfaction with the outcomes. The survey consisted of 23 questions in 4 sections: attitude and adaptation, benefits, adverse effects, and level of satisfaction after completion of OT. A control group formed of the parents of 60 healthy children undergoing OT at the same institution were also surveyed. RESULTS: Parents of disabled children undergoing OT showed a high level of motivation and they are willing to collaborate in oral hygiene procedures. Adaptation to the removable appliances was poorer in disabled children but adaptation to fixed appliances was excellent. OT can provide a marked improvement in quality of life, social relationships and oral functionality in disabled children. CONCLUSIONS: Among parents of disabled children undergoing OT, the perceived level of overall satisfaction was very high and expectations were often exceeded.
Project description:The social participation of the disabled people is unsatisfactory and low, one of the reasons often overlooked but of great importance may lie in the disparate patterns of social interaction between the disabled people and the abled people. The current study respectively recruited 41 and 80 disabled people in two experiments and adopted give-some games and public good dilemma to explore social interaction patterns between the disabled abled people. The results were as follows: (1) the disabled people preferred to interact with the disabled people and the abled people preferred to interact with the abled people. (2) The disabled abled people had higher cooperation, satisfaction and sense of justice when interacting with the disabled people than interacting with the abled people. (3) Advantage in the number of the disabled people could reverse their disadvantage in the identity. These results are of important practical value, which provides related theoretical support for the disabled people's federation and communities when carrying out activities for the disabled people.
Project description:BACKGROUND:One quarter of the global population is of menstruating age, yet menstruation is shrouded in discrimination and taboos. Disability also carries stigma, so disabled people may face layers of discrimination when they are menstruating. The objective of the review is to assess the menstrual hygiene requirements of disabled people, the barriers they face, and the available interventions to help them manage their menstruation hygienically and with dignity. METHODS:Eligible studies, gathered across all countries, were identified by conducting searches across four databases (MEDLINE, PubMed, EMBASE, Global Health) in May 2017, with alerts set on each database to highlight new titles added until April 2018. Eligible studies incorporated analyses relevant to menstruating disabled people and/or how their carers provide support during their menstrual cycle. RESULTS:The 22 studies included were published since 1976; the majority after 2010 (n = 12; 55%). One study was a quasi-experiment; all others were observational. Most studies (n = 15; 68%) were from high income countries and most (n = 17; 77%) focused on people with intellectual impairments, so the review findings focus on this group and their carers. Outcomes investigated include choice and preference of menstrual product, ability to manage menstrual hygiene and coping strategies applied. Barriers faced included a lack of standardised guidance for professional carers; a lack of menstruation training, information and support provided to people with intellectual impairments and their carers; a lack of understanding of severity of symptoms experienced by people with intellectual impairments, the high cost of menstrual products and lack of appropriate options for people with physical impairments. Few interventions were found, and strategies for menstrual hygiene management applied by carers of persons with intellectual impairments include limiting the disabled person's movements when menstruating and suppressing their menstruation. CONCLUSIONS:Little evidence was identified on the requirements of disabled people and their carers in managing their menstruation, and only one intervention, but a range of barriers were identified. This gap in evidence is important, as the consequences of failing to meet menstrual hygiene needs of disabled people includes shame, social isolation, and even sterilisation. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42018095497.
Project description:The objective of disability policy is to create a society where people with disabilities and their families enjoy an equal standard of living to those without disabilities, though evidence to underpin policy is sparse. We defined the compensating variation (CV) of child disability as the amount of additional income a family with a disabled child would require to achieve the same living standards as a similar family without a disabled child. The aims of this study were to estimate the CV for child disability and to explore how this varied for different levels of disability and reference levels of living standards. Using data on 54,641 families from the Family Resources Survey (2004-2012), we matched families with (cases) and without (controls) a disabled child on family and child characteristics plus living standards and calculated the income difference inclusive of disability benefits. Our findings suggest that across families with the most disabled children, a compensating variation equal to an extra £56-£79 a week was required to achieve the same living standards as matched families without a disabled child compared with the mean level of state disability benefit £47-£71 a week in this group.