Spatial analysis of the regional variation of hypertensive disease mortality and its socio-economic correlates in South Korea

Abstract

This paper presents a cross-sectional study based on the cause of death statistics in 2011 extracted from all 229 local governments in South Korea. The standardised hypertensive disease mortality rate (SHDMR) was defined by age- and sex-adjusted mortality by hypertensive diseases distinguished by International Classification of Disease- 10 (ICD-10). Variables taken into account were the number of doctors per 100,000 persons, the proportion with higher education (including university students and high school graduates), the number of recipients of basic livelihood support per 100,000 persons, the annual national health insurance premium per capita and the proportion of persons classified as high-risk drinkers. Ordinary least square (OLS) regression and geographically weighted regression (GWR) were applied to identify the potential associations. The statistical analysis was conducted with SAS ver. 9.3, while ArcGIS ver. 10.0 was utilised for the spatial analysis. The OLS results showed that the number of basic livelihood recipients per 100,000 persons had a significant positive association with the SHDMR, and the proportion with higher education had a significant negative one. GWR coefficients varied depending on region investigated and some regional variables had various directions. GWR showed higher adjusted R2 than that of OLS. It was found that the SHDMR was affected by socio-economic status, but as the effects observed were not consistent in all regions of the country, the development of health policies will need to consider the potential for regional variation.