[Comparison of cardiovascular health status and health behaviors in Korean women based on household income]

Health promoting behaviors in low-income overweight and obese women in Korea: an exploratory qualitative study

PURPOSE

This study aimed to explore and understand the health promoting behaviors of low-income overweight and obese women in Korea.

METHODS

Data were collected from 10 low-income overweight and obese women working at a community self-sufficiency center through semi-structured in-depth interviews. Individual interviews were conducted and transcribed. Deductive content analysis was done, using the MAXQDA program.

RESULTS

The health promoting behaviors practiced by low-income overweight and obese women were affected by intrapersonal, interpersonal, and organizational/community factors. Six categories were identified and two category clusters were derived that could best describe their health promoting experiences. As main category clusters, despite "feeling that the body and mind are not healthy" participants noted "difficulty maintaining a healthy lifestyle." Overall, the participants had poor nutritional status, lacked physical activity, experienced much stress in intrapersonal level, and faced intrapersonal-level barriers to health promoting behaviors. Moreover, participants had a lack of personal will, and lack of specific information to practice health promoting behaviors, a lack of time, and too many overall burdens to earn a living for their family while trying to maintain health promotion behaviors.

CONCLUSION

Lifestyle interventions for nutrition management, encouragement of physical activity, and stress management are needed for overweight and obese low-income women. In addition, social support and policies are needed to improve their living environment.

Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review

OBJECTIVES

The validity of instruments measuring socioeconomic position (SEP) has been a major area of concern in research on cardiovascular health disparities. The purpose of this systematic review is to identify the current status of the methods used to measure SEP in research on cardiovascular health disparities in Korea and to provide directions for future research.

METHODS

Relevant articles were obtained through electronic database searches with manual searches of reference lists and no restriction on the date of publication. SEP indicators were categorized into compositional, contextual, composite, and life-course measures.

RESULTS

Forty-eight studies published from 2003 to 2018 satisfied the review criteria. Studies utilizing compositional measures mainly relied on a limited number of SEP parameters. In addition, these measures hardly addressed the time-varying and subjective features of SEP. Finding valid contextual measures at the organizational, community, and societal levels that are appropriate to Korea's context remains a challenge, and these are rarely modeled simultaneously. Studies have rarely focused on composite and life-course measures.

CONCLUSIONS

Future studies should develop and utilize valid compositional and contextual measures and appraise social patterns that vary across time, place, and culture using such measures. Studies should also consider multilevel influences, adding a focus on the interactions between different levels of intertwined SEP factors to advance the design of research. More attention should be given to composite and life-course measures.

Effects of a Social Welfare Program for Health Promotion on Cardiovascular Risk Factors

Background

Socioeconomic status is closely associated with an individual’s health status. However, there are few studies examining the role of exercise-training as part of a community-based social welfare program in socially vulnerable groups. Given this, our aim was to measure whether long-term exercise training as a social welfare program affects the prevalence of depressive symptoms, metabolic syndrome and peripheral blood vessel condition among participants with low household income.

Methods

Twenty-nine adults and twenty-two older adults were recruited into this study with non-radomized, pre/post-test design. The subjects underwent a combined training consisting of aerobic and muscle strengthening exercises for 6 months or more. Depressive symptoms were evaluated using the Beck Depression Inventory and the Korean version of Geriatric Depression Scale. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Blood vessel condition was assessed using non-invasive accelerated photoplethysmograph.

Results

Mean skeletal muscle mass increased after exercise-training, but body mass index and percent body fat were unchanged. Overall age-specific physical fitness and performance increased markedly among both adult and elderly subjects, respectively. The proportion of depressive symptoms was significantly reduced by 33% after exercise-training among all participants. The prevalence of individuals having metabolic syndrome was significantly reduced by 19.6% and the number of individual components of metabolic syndrome decreased after the exercise intervention. Among components of metabolic syndrome, waist circumference, HDL cholesterol and systolic blood pressure significantly improved. In addition, the proportions of moderate and severe arteriosclerotic progression significantly decreased.

Conclusion

Long-term exercise-training as a social welfare program is beneficial for health promotion and effective in simultaneously improving psychological and physiological health status in a low income population. This suggests that the development and expansion of an exercise intervention as a health-promoting welfare program are needed to address the inequality of exercise participation among socially vulnerable groups.