Changes and Determinants of Health Indicators in Gyeonggi Province Before and After the COVID-19 Pandemic
Year2025
Author Lee Eun-hwan
Original
Abstract
This study aimed to analyze the changes in major health indicators in local communities within Gyeonggi Province before and after the COVID-19 pandemic, and to identify the factors influencing these indicators across the different periods. Using data from the Community Health Survey, which is representative of over 250 local communities nationwide, the study examined temporal changes by dividing the timeline into pre-pandemic (2017-2019), during the pandemic (2020-2022), and post-pandemic (2023). The findings are intended to provide foundational evidence for developing tailored public health strategies for each region within Gyeonggi Province.
An analysis of changes in key health indicators across 31 cities and counties in Gyeonggi Province before and after the COVID-19 pandemic revealed the following trends: Among health behavior indicators, current smoking rate, monthly drinking rate, and high-risk drinking rate showed a general downward trend before the pandemic. However, this decline slowed during the pandemic, and in some communities, these indicators began to worsen after the pandemic. Among chronic disease indicators, the obesity rate, which had been on the rise before the pandemic, plateaued during the pandemic period but worsened again in certain areas after the pandemic. The prevalence of hypertension and diabetes showed mixed patterns before the pandemic, remained relatively stable during the pandemic, and showed signs of deterioration in some communities after the pandemic.
An analysis of community-level determinants of health indicators before and after the COVID-19 pandemic revealed that structural characteristics, infrastructure, and environmental conditions of local communities had a greater influence during the pandemic. Demographic factors such as the proportion of male residents, foreigners, older adults, and single-person households emerged as key variables. Economic capacity, represented by fiscal self-reliance, and environmental infrastructure indicators such as the number of physicians per 1,000 population, urbanization rate, and park area per capita also showed significant associations. Notably, fiscal self-reliance, single-person household ratio, physician density, and park space per capita emerged as new significant determinants during the pandemic, suggesting that structural and infrastructural conditions? often overlooked in normal times? play a crucial role in shaping health outcomes during public health crises.
An analysis of individual-level determinants of health status revealed that both socioeconomic characteristics and the environmental context of residence significantly influenced health outcomes during the pandemic. Key socioeconomic factors included educational attainment, income level, receipt of basic livelihood benefits, and living alone. Environmental determinants were the type of residential area (urban vs. rural), local fiscal self-reliance, and park area per capita. In particular, individuals with lower education and income levels and recipients of public assistance were more likely to smoke, less likely to engage in walking activities, and had an increased risk of chronic diseases?highlighting how socioeconomic vulnerability amplified health risks during the pandemic. Notably, living alone was not a significant risk factor before the pandemic, but emerged as a new determinant of smoking, high-risk drinking, and hypertension during the crisis. This suggests that individuals experiencing social isolation, such as single-person households, are especially vulnerable in public health emergencies. These findings underscore the need for targeted health promotion strategies and policy interventions for socioeconomically disadvantaged groups and those at risk of social isolation to mitigate health deterioration during future public health crises.
This study provides empirical evidence identifying which regions, which individuals, and which health indicators are more vulnerable during public health crises such as future pandemics. By revealing these vulnerabilities, the study offers a basis for prioritizing policy interventions for specific communities and population groups.
Through a comprehensive analysis of changes and determinants in health indicators at both the regional and individual levels, the findings serve as a foundational resource for designing proactive and targeted health policies. These results can be used to inform the development of preventive strategies aimed at mitigating the deterioration of health outcomes in future public health emergencies.
An analysis of changes in key health indicators across 31 cities and counties in Gyeonggi Province before and after the COVID-19 pandemic revealed the following trends: Among health behavior indicators, current smoking rate, monthly drinking rate, and high-risk drinking rate showed a general downward trend before the pandemic. However, this decline slowed during the pandemic, and in some communities, these indicators began to worsen after the pandemic. Among chronic disease indicators, the obesity rate, which had been on the rise before the pandemic, plateaued during the pandemic period but worsened again in certain areas after the pandemic. The prevalence of hypertension and diabetes showed mixed patterns before the pandemic, remained relatively stable during the pandemic, and showed signs of deterioration in some communities after the pandemic.
An analysis of community-level determinants of health indicators before and after the COVID-19 pandemic revealed that structural characteristics, infrastructure, and environmental conditions of local communities had a greater influence during the pandemic. Demographic factors such as the proportion of male residents, foreigners, older adults, and single-person households emerged as key variables. Economic capacity, represented by fiscal self-reliance, and environmental infrastructure indicators such as the number of physicians per 1,000 population, urbanization rate, and park area per capita also showed significant associations. Notably, fiscal self-reliance, single-person household ratio, physician density, and park space per capita emerged as new significant determinants during the pandemic, suggesting that structural and infrastructural conditions? often overlooked in normal times? play a crucial role in shaping health outcomes during public health crises.
An analysis of individual-level determinants of health status revealed that both socioeconomic characteristics and the environmental context of residence significantly influenced health outcomes during the pandemic. Key socioeconomic factors included educational attainment, income level, receipt of basic livelihood benefits, and living alone. Environmental determinants were the type of residential area (urban vs. rural), local fiscal self-reliance, and park area per capita. In particular, individuals with lower education and income levels and recipients of public assistance were more likely to smoke, less likely to engage in walking activities, and had an increased risk of chronic diseases?highlighting how socioeconomic vulnerability amplified health risks during the pandemic. Notably, living alone was not a significant risk factor before the pandemic, but emerged as a new determinant of smoking, high-risk drinking, and hypertension during the crisis. This suggests that individuals experiencing social isolation, such as single-person households, are especially vulnerable in public health emergencies. These findings underscore the need for targeted health promotion strategies and policy interventions for socioeconomically disadvantaged groups and those at risk of social isolation to mitigate health deterioration during future public health crises.
This study provides empirical evidence identifying which regions, which individuals, and which health indicators are more vulnerable during public health crises such as future pandemics. By revealing these vulnerabilities, the study offers a basis for prioritizing policy interventions for specific communities and population groups.
Through a comprehensive analysis of changes and determinants in health indicators at both the regional and individual levels, the findings serve as a foundational resource for designing proactive and targeted health policies. These results can be used to inform the development of preventive strategies aimed at mitigating the deterioration of health outcomes in future public health emergencies.
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