kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2017.17.2.99 kjhp-17-99 Original Article Factors Related to Awareness of Cardiocerebrovascular Disease among Korean Adults: the 2013 Community Health Survey LeeYoung-Hoon 1 2 NohSe-Eung 2 3 Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea Jeonbuk Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea Corresponding author : Se Eung Noh, MD Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Hospital, 895 Muwang-ro, Iksan 54538, Korea Tel: +82-63-859-1622, Fax: +82-63-843-1385 E-mail: wusuman@hanmail.net 012017 19012017 17299 108 06102016 04052017 Copyright © 2017 The Korean Society of Health Promotion and Disease Prevention 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:

This study investigated factors related to awareness of cardio-cerebrovascular disease (CCVD) in a large Korean general population.

 Methods:

Data for 228,781 subjects older than 19 years in 253 cities, counties, and districts were collected from the 2013 Community Health Survey in Korea. Associations between socio-demographics, health behaviors, comorbidities, and awareness of CCVD were examined using the chi-squared test and multiple logistic regression analysis. A total of 219,461 subjects were included in the final analysis after excluding subjects with null responses to any questions.

 Results:

The awareness of CCVD was 26.7% in the total population (27.8% in males, 25.8% in females). Of the significant associating factors, the odds ratios for awareness of CCVD were two-fold higher in people aged 40-49 years, 50-59 years, and 60-69 years (ref. 19-29 years), living in Chungbuk provinces (ref. Seoul), higher education (ref. non-formal education), and diagnosed with angina pectoris (ref. non-diagnosed), as compared to their individual reference groups.

 Conclusions:

Socio-demographics, health behaviors, and comorbidities have significant impact on awareness of CCVD. To improve the public's awareness of CCVD and to reduce health inequalities, effective and specialized interventions should be developed that take these factors into account.

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The age-specific experience rate of exposure to public relations media on cardio-cerebrovascular disease according to gender.

The age-specific experience rate of exposure to public relations media on cardio-cerebrovascular disease according to pathway of experience.

Socio-demographic characteristics according to awareness of cardio-cerebrovascular disease

  n Awareness of cardio-cerebrovascular disease P
  Unawared (row %) Awared (row %)
Total 219,461 73.3 26.7  
Gender       <0.001
Male 98,825 72.2 27.8  
Female 120,636 74.2 25.8  
Age group, y       <0.001
19-29 23,853 80.4 19.6  
30-39 33,461 67.1 32.9  
40-49 41,607 60.9 39.1  
50-59 44,018 65.7 34.3  
60-69 34,784 77.3 22.7  
≥70 41,738 91.1 8.9  
Metropolitan cities and provinces       <0.001
Seoul 22,208 69.1 30.9  
Busan 14,524 66.6 33.4  
Daegu 6,951 70.2 29.8  
Incheon 8,272 71.6 28.4  
Gwangju 4,594 69.2 30.8  
Daejeon 4,403 63.3 36.7  
Ulsan 4,396 65.0 35.0  
Gyeonggi 39,381 75.5 24.5  
Gwangwon 15,503 75.4 24.6  
Chungbuk 10,798 61.6 38.4  
Chungnam 12,905 72.7 27.3  
Jeonbuk 11,640 76.4 23.6  
Jeonnam 18,972 80.4 19.6  
Gyeongbuk 21,647 79.6 20.4  
Gyeongnam 17,856 75.6 24.4  
Jeju 4,626 71.5 28.5  
Sejong 785 72.0 28.0  
Location of residence       <0.001
Rural (eup·myeon) 95,620 78.2 21.8  
Urban (dong) 123,841 69.5 30.5  
Occupation       <0.001
Managers and professionals 23,472 58.5 41.5  
Clerks 18,471 63.0 37.0  
Service and sales workers 26,788 66.9 33.1  
Agricultural, forestry and fishery workers 29,502 82.9 17.1  
Mechanical and manual laborers 39,508 73.8 26.2  
Othersa 81,720 78.2 21.8  
Education level       <0.001
Non-formal education 26,049 95.4 4.6  
Elementary school 34,719 85.9 14.1  
Middle school 24,257 74.6 25.4  
High school 73,790 69.0 31.0  
College or higher 60,646 61.3 38.7  
Marital status       <0.001
Married and living with a spouse 150,238 69.9 30.1  
Divorced or separated 11,768 69.0 31.0  
Widowed 25,107 90.0 10.0  
Never married 32,348 77.6 22.4  
Monthly household income, million won       <0.001
<1.00 40,909 88.6 11.4  
1.00-1.99 36,791 77.8 22.2  
2.00-2.99 37,693 72.0 28.0  
3.00-3.99 34,149 68.4 31.6  
4.00-4.99 24,648 67.0 33.0  
≥5.00 45,271 63.9 36.1  
National Basic Livelihood Security       <0.001
Recipient 9,029 83.6 16.4  
Non-recipient 210,432 72.8 27.2  

Soldiers, students, housewives, and unemployed.

Health behaviors and comorbidities according to awareness of cardio-cerebrovascular disease

  n Awareness of cardio-cerebrovascular disease P
  Unawared (row %) Awared (row %)
Smoking status       <0.001
Never smokers 138,240 73.5 26.5  
Current smokers 44,530 73.8 26.2  
Former smokers 36,691 71.8 28.2  
Drinking frequency       <0.001
None 73,438 79.1 20.9  
≤1 time per month 53,601 69.9 30.1  
2-4 times per month 45,349 68.8 31.2  
2-3 times per week 30,288 69.8 30.2  
≥4 times per week 16,785 77.1 22.9  
Body mass index, kg/m2       <0.001
Underweight (<18.5) 22,203 87.5 12.5  
Normal (18.5-24.9) 145,392 72.0 28.0  
Obesity (≥25.0) 51,866 70.9 29.1  
Hypertension       <0.001
Absent 166,435 71.6 28.4  
Present 53,026 78.5 21.5  
Diabetes       <0.001
Absent 199,464 72.8 27.2  
Present 19,997 78.3 21.7  
Dyslipidemia       <0.001
Absent 194,802 74.1 25.9  
Present 24,659 66.8 33.2  
Stroke       <0.001
Absent 215,164 73.2 26.8  
Present 4,297 78.7 21.3  
Myocardial infarction       <0.001
Absent 216,610 73.4 26.6  
Present 2,851 66.1 33.9  
Angina pectoris       <0.001
Absent 215,465 73.4 26.6  
Present 3,996 65.6 34.4  

Associating factors for awareness of cardio-cerebrovascular disease using multivariate logistic regression analysis

  Total Pathway
  Internet Television, radio, and advertising on outdoor or subway Hospitals and clinics Public health centers
Female (/male) 1.07 (1.04-1.11) 0.79 (0.75-0.84) 1.06 (1.02-1.10) 1.12 (1.07-1.17) 1.17 (1.07-1.28)
Age (/19-29, y)          
30-39 1.65 (1.57-1.73) 1.28 (1.19-1.38) 1.71 (1.62-1.81) 1.50 (1.39-1.61) 1.15 (1.01-1.32)
40-49 2.32 (2.21-2.44) 1.38 (1.28-1.49) 2.42 (2.29-2.56) 1.97 (1.82-2.12) 1.32 (1.14-1.52)
50-59 2.51 (2.38-2.64) 0.99 (0.91-1.08) 2.75 (2.59-2.92) 2.07 (1.91-2.23) 1.35 (1.16-1.57)
60-69 2.06 (1.95-2.19) 0.59 (0.52-0.66) 2.35 (2.20-2.52) 1.89 (1.73-2.06) 1.43 (1.20-1.70)
≥70 1.12 (1.05-1.20) 0.26 (0.21-0.31) 1.22 (1.13-1.33) 1.19 (1.08-1.32) 1.30 (1.07-1.58)
Metropolitan cities and provinces (/Seoul)          
Busan 1.33 (1.27-1.39) 0.95 (0.87-1.04) 1.35 (1.28-1.42) 1.32 (1.24-1.41) 1.15 (0.99-1.34)
Daegu 1.11 (1.04-1.18) 1.01 (0.91-1.14) 1.19 (1.11-1.28) 0.97 (0.89-1.06) 0.85 (0.68-1.05)
Incheon 1.06 (0.99-1.12) 1.04 (0.93-1.15) 1.17 (1.10-1.25) 1.05 (0.97-1.14) 0.93 (0.76-1.12)
Gwangju 1.04 (0.97-1.12) 0.89 (0.78-1.01) 1.07 (0.98-1.16) 1.08 (0.98-1.18) 0.87 (0.68-1.11)
Daejeon 1.41 (1.32-1.52) 1.55 (1.39-1.74) 1.55 (1.44-1.68) 1.31 (1.19-1.43) 2.23 (1.86-2.66)
Ulsan 1.33 (1.24-1.43) 1.28 (1.14-1.45) 1.46 (1.35-1.58) 1.17 (1.06-1.29) 1.66 (1.36-2.02)
Gyeonggi 0.76 (0.73-0.79) 0.78 (0.73-0.83) 0.79 (0.76-0.83) 0.77 (0.73-0.81) 0.63 (0.55-0.72)
Gwangwon 1.06 (1.01-1.12) 1.18 (1.07-1.29) 1.18 (1.12-1.25) 0.95 (0.89-1.02) 1.54 (1.33-1.77)
Chungbuk 2.29 (2.17-2.42) 1.39 (1.25-1.53) 2.60 (2.45-2.75) 1.66 (1.55-1.79) 1.90 (1.64-2.21)
Chungnam 1.32 (1.25-1.40) 1.27 (1.15-1.40) 1.45 (1.36-1.54) 1.22 (1.13-1.31) 1.66 (1.43-1.92)
Jeonbuk 1.28 (1.21-1.35) 1.36 (1.22-1.51) 1.52 (1.43-1.62) 1.10 (1.01-1.19) 2.02 (1.74-2.34)
Jeonnam 1.10 (1.04-1.16) 1.21 (1.10-1.34) 1.22 (1.15-1.29) 1.06 (0.98-1.14) 1.15 (0.99-1.34)
Gyeongbuk 0.93 (0.89-0.98) 1.01 (0.92-1.10) 1.08 (1.03-1.15) 0.79 (0.74-0.85) 1.16 (1.00-1.33)
Gyeongnam 1.11 (1.06-1.17) 1.04 (0.95-1.14) 1.24 (1.17-1.31) 0.94 (0.87-1.01) 1.06 (0.92-1.24)
Jeju 1.34 (1.24-1.44) 1.50 (1.31-1.71) 1.49 (1.37-1.62) 1.38 (1.25-1.53) 1.83 (1.52-2.22)
Sejong 1.25 (1.06-1.48) 0.54 (0.36-0.83) 1.12 (0.92-1.36) 1.06 (0.83-1.35) 1.12 (0.70-1.79)
Urban (/rural) 1.09 (1.06-1.12) 0.95 (0.91-1.00) 1.09 (1.05-1.12) 1.10 (1.06-1.15) 0.68 (0.63-0.74)
Occupation (/othersa)          
Managers and professionals 1.30 (1.26-1.35) 1.55 (1.46-1.64) 1.06 (1.02-1.10) 1.55 (1.48-1.63) 1.69 (1.54-1.87)
Clerks 1.11 (1.07-1.15) 1.42 (1.33-1.51) 1.00 (0.96-1.04) 1.14 (1.08-1.20) 1.64 (1.47-1.82)
Service and sales workers 1.07 (1.03-1.10) 1.08 (1.01-1.15) 1.05 (1.01-1.09) 1.03 (0.99-1.08) 1.09 (0.98-1.20)
Agricultural, forestry and fishery workers 0.88 (0.84-0.92) 0.71 (0.63-0.79) 0.86 (0.82-0.90) 0.94 (0.88-0.99) 1.32 (1.18-1.46)
Mechanical and manual laborers 0.90 (0.87-0.93) 0.72 (0.67-0.78) 0.91 (0.88-0.94) 0.88 (0.84-0.93) 0.93 (0.84-1.03)
Education level (/non-formal education)          
Elementary school 2.26 (2.11-2.42) 2.69 (1.65-4.39) 2.49 (2.29-2.72) 2.06 (1.87-2.28) 2.03 (1.69-2.44)
Middle school 3.93 (3.66-4.23) 7.83 (4.88-12.57) 4.30 (3.94-4.69) 3.63 (3.27-4.02) 3.15 (2.60-3.83)
High school 5.79 (5.40-6.22) 21.41 (13.45-34.09) 6.10 (5.59-6.65) 4.92 (4.45-5.43) 3.95 (3.27-4.78)
College or higher 7.88 (7.23-8.37) 35.34 (22.18-56.33) 7.53 (6.89-8.23) 6.48 (5.84-7.19) 5.56 (4.56-6.78)
Marital status (/married and living with a spouse)          
Divorced or separated 1.01 (0.97-1.06) 1.13 (1.03-1.23) 0.99 (0.94-1.04) 0.99 (0.93-1.06) 0.87 (0.76-1.00)
Widowed 0.80 (0.76-0.84) 0.89 (0.75-1.05) 0.78 (0.74-0.83) 0.81 (0.76-0.87) 0.83 (0.72-0.96)
Never married 0.79 (0.76-0.83) 1.11 (1.04-1.18) 0.84 (0.80-0.88) 0.75 (0.71-0.80) 0.88 (0.78-0.99)
Monthly household income (/<1.00, million won)          
1.00-1.99 1.23 (1.17-1.28) 1.15 (1.01-1.30) 1.23 (1.17-1.30) 1.26 (1.18-1.34) 0.99 (0.88-1.12)
2.00-2.99 1.30 (1.24-1.36) 1.32 (1.17-1.49) 1.32 (1.26-1.39) 1.32 (1.24-1.41) 1.13 (0.99-1.28)
3.00-3.99 1.34 (1.28-1.40) 1.37 (1.22-1.55) 1.32 (1.25-1.40) 1.43 (1.34-1.53) 1.19 (1.04-1.35)
4.00-4.99 1.35 (1.28-1.42) 1.41 (1.25-1.60) 1.31 (1.24-1.38) 1.40 (1.31-1.51) 1.25 (1.09-1.43)
≥5.00 1.44 (1.38-1.51) 1.66 (1.47-1.87) 1.36 (1.29-1.43) 1.56 (1.46-1.67) 1.24 (1.09-1.41)
Recipient of National Basic Livelihood Security (/non-) 1.04 (0.98-1.11) 0.89 (0.76-1.05) 1.00 (0.93-1.08) 1.03 (0.94-1.13) 1.12 (0.93-1.34)
Smoking status (/never smokers)          
Current smokers 0.85 (0.82-0.88) 0.82 (0.77-0.87) 0.81 (0.77-0.84) 0.92 (0.87-0.97) 0.73 (0.66-0.81)
Former smokers 1.03 (0.99-1.06) 1.00 (0.93-1.07) 0.95 (0.92-0.99) 1.13 (1.07-1.18) 0.92 (0.83-1.02)
Drinking frequency (/none)          
≤1 time per month 1.15 (1.11-1.18) 1.09 (1.03-1.15) 1.15 (1.12-1.19) 1.04 (0.99-1.08) 1.19 (1.11-1.29)
2-4 times per month 1.11 (1.07-1.14) 1.04 (0.98-1.10) 1.13 (1.09-1.17) 0.99 (0.94-1.03) 1.10 (1.01-1.20)
2-3 times per week 1.04 (1.01-1.08) 0.91 (0.85-0.97) 1.05 (1.01-1.09) 0.96 (0.92-1.01) 0.97 (0.88-1.08)
≥4 times per week 0.93 (0.88-0.97) 0.71 (0.64-0.79) 0.96 (0.91-1.01) 0.87 (0.81-0.92) 0.73 (0.63-0.85)
Body mass index (/normal)          
Underweight 0.78 (0.75-0.82) 0.91 (0.84-0.99) 0.77 (0.73-0.81) 0.84 (0.79-0.90) 0.70 (0.61-0.80)
Obesity 1.01 (0.98-1.03) 1.01 (0.96-1.05) 0.98 (0.95-1.00) 1.05 (1.01-1.08) 1.03 (0.96-1.10)
Hypertension (/absent) 1.04 (1.01-1.07) 1.16 (1.09-1.24) 0.99 (0.95-1.02) 1.27 (1.22-1.32) 1.12 (1.04-1.22)
Diabetes (/absent) 0.99 (0.95-1.03) 0.90 (0.81-0.99) 0.89 (0.85-0.94) 1.29 (1.23-1.36) 1.02 (0.91-1.14)
Dyslipidemia (/absent) 1.42 (1.38-1.47) 1.19 (1.11-1.28) 1.25 (1.21-1.30) 1.51 (1.45-1.57) 1.34 (1.23-1.47)
Stroke (/absent) 1.41 (1.29-1.53) 1.12 (0.86-1.44) 1.00 (0.90-1.11) 2.20 (2.00-2.42) 1.33 (1.07-1.65)
Myocardial infarction (/absent) 1.95 (1.78-2.13) 1.26 (0.98-1.62) 1.03 (0.92-1.15) 3.08 (2.79-3.39) 1.70 (1.36-2.11)
Angina pectoris (/absent) 2.16 (2.00-2.33) 1.47 (1.19-1.80) 1.28 (1.17-1.40) 3.23 (2.97-3.51) 1.41 (1.16-1.73)

Values are presented as odds ratio (95% confidence interval). Adjusted for gender, age, metropolitan cities and provinces, location of residence, occupation, education level, marital status, monthly household income, the National Basic Livelihood Security, smoking status, drinking frequency, body mass index, hypertension, diabetes, dyslipidemia, stroke, myocardial infarction, and angina pectoris.

Soldiers, students, housewives, and unemployed.

Gender- and age-specific odds ratio (95% confidence interval) for awareness of cardio-cerebrovascular disease using multivariate logistic regression analysis

  Gender
  Male Female
Age, y    
19-29 1.00 (reference) 1.20 (1.12-1.29)
30-39 1.73 (1.61-1.85) 1.94 (1.81-2.07)
40-49 50-59 2.46 (2.30-2.64) 2.62 (2.44-2.82) 2.71 (2.53-2.90) 2.94 (2.73-3.15)
60-69 2.34 (2.16-2.52) 2.20 (2.03-2.38)
≥70 1.39 (1.28-1.51) 0.99 (0.90-1.09)

Adjusted for metropolitan cities and provinces, location of residence, occupation, education level, marital status, monthly household income, the National Basic Livelihood Security, smoking status, drinking frequency, body mass index, hypertension, diabetes, dyslipidemia, stroke, myocardial infarction, and angina pectoris.