Kim and Ruger BMC Public Health 2010, 10:195 http://www.biomedcentral.com/1471-2458/10/195 R E S E A R C H A R T I C L E Open Access RSeoseacrcihoaerticcleonomic disparities in behavioral risk factors and health outcomes by gender in the Republic of Korea Hak-Ju Kim1 and Jennifer Prah Ruger*2 Abstract Background: Few studies have examined socioeconomic disparities in health and behavioral risk factors by gender in Asian countries and in South Korea, specifically. We investigated the relationship between socioeconomic position (education, income, and occupation) and subjective and acute and chronic health outcomes and behavioral risk factors by gender, and compared results from 1998 and 2005, in the Republic of Korea. Methods: We examined data from a nationally representative stratified random sample of 4213 men and 4618 women from the 1998 Korea National Health and Nutrition Examination Survey, and 8289 men and 8827 women from the 2005 Korea National Health and Nutrition Examination Survey using General Linear Modeling and multiple logistic regression methods. Results: Controlling for behavioral risk factors (smoking, drinking, obesity, exercise, and sleep), those in lower socioeconomic positions had poorer health outcomes in both self-reported acute and chronic disease and subjective measures; differences were especially pronounced among women. A socioeconomic gradient for education and income was found for both men and women for morbidity and self-reported health status, but the gradient was more pronounced in women. In 1998, the odds ratios (ORs) of higher morbidity for illiterate vs. college educated females was 5.4:1 and 1.9:1 for females in the lowest income quintile vs. the highest. The OR for education decreased in 2005 to 2.9:1 and that for income quintiles remained the same at 1.9:1. The OR of lower self-reported health status for illiterate vs. college educated females was 2.9:1 and 1.6:1 for females in the lowest income quintile vs. the highest in 1998, and 3.3:1 and 2.3:1 in 2005. Conclusions: Among Korean adults, men and women in lower socioeconomic position, as denoted by education, income, and somewhat less by occupation, experience significantly higher levels of morbidity and lower self-reported health status, even after controlling for standard behavioral risk factors. Disparities were more pronounced for women than for men. Efforts to reduce health disparities in South Korea require attention to the root causes of socioeconomic inequality and gender differences in the impact of socioeconomic position on health. Background Health disparities research has documented the signifi- cant relationship between social and economic inequali- ties and health status, although the role of specific types of social and economic stratification (income [1,2], edu- cation [3-6], occupation [4-6]) and the role of behavioral risk factors remains an open question [7-12]. National studies differ in their results: a study of European coun- * Correspondence: jennifer.ruger@yale.edu 2 Yale University Schools of Medicine and Public Health, Division of Health Policy and Administration, New Haven, CT, USA Full list of author information is available at the end of the article tries found that health inequalities relate to social vari- ables such as education level and occupational class [4]; other studies indicate that health inequalities do not nec- essarily relate to behavioral factors [3], but to economic disparities such as poverty level [9,10]. One study equated poverty with shorter life expectancy [7]. Further studies give great import to the social environment's impact on health [9,13], especially social class. A comparison of cor- onary heart disease (CHD) among women from high and low social classes in the UK, for example, found that the © 2010 Kim and Ruger; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons BioMed Central Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.