Young-Ho Khang

Seoul National University, Sŏul, Seoul, South Korea

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Publications (114)992.74 Total impact

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    Jinwook Bahk · Sung-Cheol Yun · Yu-Mi Kim · Young-Ho Khang
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    ABSTRACT: Pregnancy intention is important for maternal and child health outcomes. The purpose of this study was to examine the causal relation between pregnancy intention and maternal depression and parenting stress in Korean women who gave birth during 2008. This study is a retrospective evaluation of prospectively collected data from the Panel Study on Korean Children from 2008 to 2010. Causal analyses were conducted using propensity score matching and inverse probability of treatment weighted methods. In addition, mediation analyses were performed to test mitigating effects of marital conflict, fathers' participation in childcare, and mothers' knowledge of infant development on the relation between unintended pregnancy and adverse maternal mental health. Results showed that the overall effect of an unintended pregnancy on maternal depression and parenting stress was statistically significant. An unintended pregnancy was associated with 20-22% greater odds of maternal depression, 0.28-0.39 greater depression score, and 0.85-1.16 greater parenting stress score. Relations between pregnancy intention and maternal depression, maternal depression score and parenting stress score were moderately explained by marital conflict and fathers' participation in childcare. Unintended pregnancy contributed to increased risks of maternal depression and parenting stress. Efforts to increase fathers' participation in childcare and decrease marital conflict might be helpful to mitigate adverse impacts of unintended pregnancy on perinatal maternal mental health.
    BMC Pregnancy and Childbirth 12/2015; 15(1):85. DOI:10.1186/s12884-015-0505-4 · 2.15 Impact Factor
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  • Young-Ho Khang · Jinwook Bahk · Nari Yi · Sung-Cheol Yun
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    ABSTRACT: Income is not frequently used to monitor health equity on a national level largely due to the lack of public data on income. Information on income allows policy makers to identify the economically disadvantaged population in a country directly. We examined differences in life expectancy (LE) at birth by income and quantified age- and cause-specific contributions to the LE differences using national health insurance data. Data from a nationally representative sample of 1 097 333 South Koreans (2% of the total population) collected between 2002 and 2010 (39 737 deaths) were used. National health insurance premiums were used to estimate income level. Age- and cause-specific contributions to differences in LE at birth by income were estimated using Arriaga's decomposition method. LE at birth gradually increased with income in both genders. Interquintile income LE differences were 7.93 years in males and 3.82 years in females. Most of LE differentials were attributed to differences in mortality in middle-aged and older adults. Suicide and cerebrovascular accidents were the two leading causes of death contributing the most to income LE differences in both males and females. The top 10 causes of death accounted for over 50% of the total LE differences by income in both genders. Alcohol-related causes of death explained the majority of the gender differences in the income LE differentials. Income differentials in LE at birth according to national health insurance premiums and data linkage systems could provide a valuable opportunity for monitoring and prioritizing population health inequalities in South Korea. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
    The European Journal of Public Health 06/2015; DOI:10.1093/eurpub/ckv128 · 2.46 Impact Factor
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    ABSTRACT: Background Diabetes has been defined on the basis of different bio-markers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the bio-markers used for defining diabetes. Diabetes was defined using HbA1c (HbA1c ≥6·5% or history of diabetes diagnosis or using insulin or oral hypoglycemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG ≥7·0 mmol/L or 2hOGTT ≥11·1 mmol/L or history of diabetes or using insulin or oral hypoglycemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (i.e., excluding those with history of diabetes or using insulin or oral hypoglycemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG-or-2hOGTT was correlated with prevalence based on FPG alone (r=0·98), but was higher by 2–6 percentage points at different prevalence levels. Prevalence based on HbA1c was lower than prevalence based on FPG in 42·8% of age–sex–survey groups and higher in another 41·6%; in the other 15·6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA1c-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, sub-national, or from specific communities. Diabetes defined as HbA1c 6·5% or more had a pooled sensitivity of 52·8% (95% CI 51·3–54·3%) and a pooled specificity of 99·74% (99·71–99·78%) compared with FPG 7·0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30·5% (28·7–32·3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA1c versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA1c-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
    The Lancet Diabetes & Endocrinology 06/2015; DOI:10.1016/S2213-8587(15)00129-1 · 9.19 Impact Factor
  • Dong-Hun Han · Young-Ho Khang · Hye-Ju Lee
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    ABSTRACT: Evidence suggests that taller individuals have better health than that of shorter individuals. However, evidence for links to tooth loss is scarce. The aim of this study was to examine the association between adult height and tooth loss and to examine the roles of covariates in explaining the association in different birth cohorts in Korea. Using data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey (KNHANES IV and V), the subjects were grouped into two birth cohorts based on their historical context: born from 1920 to 1945 and 1946 to 1962. The dependent variables were loss of 8 or more teeth and total tooth loss (edentulism), while the independent variable was the height quartile. Demographic factors (survey year, age, and gender), early childhood/adult socioeconomic status (SES) (father's education, own education, income, and place of residence), health behaviors (cigarette smoking, binge drinking, frequency of toothbrushing, and regular dental visit), and health problems (diabetes and hypertension) were included in a series of analytical models. The survey year-, age-, and gender-adjusted prevalence ratios (PR) of the loss of 8 or more teeth for the shortest quartile were 1.23 (95% confidence intervals, CI: 1.13-1.35) for the 1920-1945 birth cohorts and 1.39 (95% CI: 1.20-1.62) for the 1946-1962 birth cohorts. The PRs for edentulousness were 1.64 (95% CI: 1.34-2.02) for the 1920-1945 birth cohorts and 2.26 (95% CI: 1.31-3.91) for the 1946-1962 birth cohorts. These associations were moderately attenuated after adjusting for own education but still significant in the fully adjusted models. After full adjustment for the covariates, those in the shortest height quartiles in the relatively young birth cohorts (1946-1962 birth cohorts) had a 1.93 (95% CI: 1.09-3.43) times greater prevalence of edentulism than that of their tallest counterparts. Given that adult height reflects early-life conditions, independent associations between height and tooth loss support the view that early-life circumstances significantly influence oral health outcomes in later life. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    Community Dentistry And Oral Epidemiology 06/2015; DOI:10.1111/cdoe.12175 · 1.94 Impact Factor
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    ABSTRACT: Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
    The Lancet 06/2015; 386(9995):743–800. DOI:10.1016/S0140-6736(15)60692-4 · 45.22 Impact Factor
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    Young-Ho Khang
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    ABSTRACT: This article discusses issues on the causality between smoking and lung cancer, which have been raised during the tobacco litigation in South Korea. It should be recognized that the explanatory ability of risk factor(s) for inter-individual variations in disease occurrence is different from the causal contribution of the risk factor(s) to disease occurrence. The affected subjects of the tobacco litigation in South Korea are lung cancer patients with a history of cigarette smoking. Thus, the attributable fraction of the exposed rather than the population attributable fraction should be used in the tobacco litigation regarding the causal contribution of smoking to lung cancer. Scientific evidence for the causal relationship between smoking and lung cancer is based on studies of individuals and groups, studies in animals and humans, studies that are observational or experimental, studies in laboratories and communities, and studies in both underdeveloped and developed countries. The scientific evidence collected is applicable to both groups and individuals. The probability of causation, which is calculated based on the attributable fraction for the association between smoking and lung cancer, could be utilized as evidence to prove causality in individuals.
    05/2015; 37:e2015026. DOI:10.4178/epih/e2015026
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    ABSTRACT: A neighborhood-level analysis of mortality from suicide would be informative in developing targeted approaches to reducing suicide. This study aims to examine the association of community characteristics with suicide in the 424 neighborhoods of Seoul, South Korea. Neighborhood-level mortality and population data (2005-2011) were obtained to calculate age-standardized suicide rates. Eight community characteristics and their associated deprivation index were employed as determinants of suicide rates. The Bayesian hierarchical model with mixed effects for neighborhoods was used to fit age-standardized suicide rates and other covariates with consideration of spatial correlations. Suicide rates for 424 neighborhoods were between 7.32 and 71.09 per 100,000. Ninety-nine percent of 424 neighborhoods recorded greater suicide rates than the Organization for Economic Cooperation and Development member countries' average. A stepwise relationship between area deprivation and suicide was found. Neighborhood-level indicators for lack of social support (residents living alone and the divorced or separated) and socioeconomic disadvantages (low educational attainment) were positively associated with suicide mortality after controlling for other covariates. Finding from this study could be used to identify priority areas and to develop community-based programs for preventing suicide in Seoul, South Korea.
    International Journal of Public Health 05/2015; DOI:10.1007/s00038-015-0694-7 · 2.70 Impact Factor
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    ABSTRACT: Treatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations. We aimed to develop, and apply in example countries, a risk prediction equation for cardiovascular disease (consisting here of coronary heart disease and stroke) that can be recalibrated and updated for application in different countries with routinely available information. We used data from eight prospective cohort studies to estimate coefficients of the risk equation with proportional hazard regressions. The risk prediction equation included smoking, blood pressure, diabetes, and total cholesterol, and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries. We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease. We validated the risk equations internally and also using data from three cohorts that were not used to create the equations. We then used the risk prediction equation and data from recent (2006 or later) national health surveys to estimate the proportion of the population at different levels of cardiovascular disease risk in 11 countries from different world regions (China, Czech Republic, Denmark, England, Iran, Japan, Malawi, Mexico, South Korea, Spain, and USA). The risk score discriminated well in internal and external validations, with C statistics generally 70% or more. At any age and risk factor level, the estimated 10 year fatal cardiovascular disease risk varied substantially between countries. The prevalence of people at high risk of fatal cardiovascular disease was lowest in South Korea, Spain, and Denmark, where only 5-10% of men and women had more than a 10% risk, and 62-77% of men and 79-82% of women had less than a 3% risk. Conversely, the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico. In China, 33% of men and 28% of women had a 10-year risk of fatal cardiovascular disease of 10% or more, whereas in Mexico, the prevalence of this high risk was 16% for men and 11% for women. The prevalence of less than a 3% risk was 37% for men and 42% for women in China, and 55% for men and 69% for women in Mexico. We developed a cardiovascular disease risk equation that can be recalibrated for application in different countries with routinely available information. The estimated percentage of people at high risk of fatal cardiovascular disease was higher in low-income and middle-income countries than in high-income countries. US National Institutes of Health, UK Medical Research Council, Wellcome Trust. Copyright © 2015 Elsevier Ltd. All rights reserved.
    03/2015; 3(5):339–355. DOI:10.1016/S2213-8587(15)00081-9
  • Jinwook Bahk · Sung-Cheol Yun · Yu-Mi Kim · Young-Ho Khang
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    ABSTRACT: Maternal depression is a common health problem during the perinatal period. The purpose of this study was to examine changes in the relationship between socioeconomic position and maternal depressive symptoms from prenatal to 3 years postpartum in Korean women. Prospective cohort data were collected from the Panel Study on Korean Children between 2008 and 2011. Maternal depression was assessed using the Kessler 6-Item Psychological Distress Scale. Socioeconomic position indicators used were maternal education, paternal education, maternal occupation, paternal occupation, and household income. Repeated-measures analyses with a generalized estimating equation approach were used to investigate relationships between socioeconomic position and maternal depressive symptoms during the study period. Low socioeconomic position was associated with greater levels of maternal depressive symptoms between 4 months after childbirth and 3 years postpartum, but the association was not evident between 1 month before and after childbirth. The magnitude of the significant association between socioeconomic position and maternal depression was the greatest at 1 year postpartum but then became smaller. Among the five socioeconomic position indicators included, maternal education, paternal education, and household income showed graded inverse relationships with maternal depressive symptoms, while no significant relationship was found for paternal occupation over the study period. Socioeconomic inequalities in maternal depressive symptoms emerged in early childhood in a prospective study of Korean mothers. These emerging inequalities may contribute to socioeconomic inequalities in childhood health and development.
    Maternal and Child Health Journal 02/2015; 19(9). DOI:10.1007/s10995-015-1718-x · 2.24 Impact Factor
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    ABSTRACT: Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
    The Lancet 12/2014; 385(9963):117-171. · 45.22 Impact Factor
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    ABSTRACT: Background Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
    The Lancet 12/2014; 385(9963):117-171. DOI:10.1016/S0140-6736(14)61682-2 · 45.22 Impact Factor
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Publication Stats

4k Citations
992.74 Total Impact Points

Institutions

  • 2014–2015
    • Seoul National University
      • Department of Health Policy and Management
      Sŏul, Seoul, South Korea
    • Chung-Ang University
      • College of Medicine
      Sŏul, Seoul, South Korea
    • Seoul National University Hospital
      Sŏul, Seoul, South Korea
  • 2004–2014
    • University of Ulsan
      • • Department of Preventive Medicine
      • • College of Medicine
      Urusan, Ulsan, South Korea
  • 2004–2013
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
  • 2005–2006
    • Korea Institute for Health and Social Affairs
      Sŏul, Seoul, South Korea