Public Health. 2025 May 28;244:105767. doi: 10.1016/j.puhe.2025.105767. Online ahead of print.
ABSTRACT
OBJECTIVES: Rapid economic growth in South Korea provides a valuable context for investigating how socioeconomic status (SES) impacts mortality and cardiovascular disease (CVD) risk in an emerging high-income Asian country. The objective of this study was to examine these associations in a general population and a subgroup with type 2 diabetes mellitus (T2DM).
STUDY DESIGN: Retrospective cohort study.
METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) linked to mortality records was used. A total of 48,190 participants including 6,382 patients with T2DM from the 2011-2020 KNHANES cohort were included and followed until death, a cardiovascular event (myocardial infarction or ischemic stroke), or the study endpoint.
RESULTS: Participants in the lowest income quintile had higher risks of mortality (Hazard ratio [HR]: 1.44, 95 % CI: 1.19-1.76) and CVD (HR: 1.35, 95 % CI: 1.05-1.74) compared to the highest quintile. Unemployed individuals had a higher mortality risk (HR: 1.34, 95 % CI: 1.19-1.51) than employed ones. Non-homeowners also had a higher mortality risk (HR: 1.46, 95 % CI: 1.20-1.77) than multi-homeowners. Participants with elementary school education or less had higher risks of mortality (HR: 1.59, 95 % CI: 1.32-1.93) and CVD (HR: 1.71, 95 % CI: 1.31-2.24) compared to college graduates. Among those with T2DM, unemployment (HR: 1.43, 95 % CI: 1.16-1.77) and low education (HR: 1.53, 95 % CI: 1.07-2.17) were associated with higher mortality.
CONCLUSIONS: This analysis revealed significant associations of low SES with increased risks of mortality and CVD. Similar associations were observed in T2DM population for mortality outcomes.
PMID:40441035 | DOI:10.1016/j.puhe.2025.105767
