Employment conditions and use of gastric cancer screening services in Korea: a nationwide survey

• Published in: BMC public health Vol. 19; no. 1; p. 485
• Main Authors: Shim, Hye-Young, Jun, Jae Kwan, Shin, Ji-Yeon
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.05.2019; BioMed Central; BMC
• Subjects: Adult; Age; Cancer; Cancer research; Cancer screening; Cardiovascular disease; Colorectal cancer; Confidence intervals; Contract terms; Diagnosis; Early Detection of Cancer - statistics & numerical data; Employment; Employment - statistics & numerical data; Employment status; Endoscopy; Female; Gastric Cancer; Gastroscopy; Health aspects; Health disparities; Health insurance; Health screening; Health services; Health surveys; Hepatitis; Humans; Labor contracts; Labor market; Male; Mass Screening - statistics & numerical data; Medical care utilization; Medical screening; Middle Aged; Nutrition; Nutrition Surveys; Occupational health; Occupational Health Services - statistics & numerical data; Occupational training; Participation; Population studies; Precarious employment; Preventive health services; Preventive medicine; Public health; Regression analysis; Republic of Korea; Socioeconomic factors; Staff participation; Statistical analysis; Stomach cancer; Stomach Neoplasms - diagnosis; Stomach Neoplasms - epidemiology; Surveys; Surveys and Questionnaires; Temporary employees; Wages and salaries; Work hours; Working conditions; Workplace; Republic of Korea; South Korea; Gastric Cancer; Precarious employment; Cancer screening; Employment status; Preventive health services
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-019-6841-y

Although it is well known that employment conditions exert considerable effects on health and health equity, the association between employment conditions and the use of preventative health services has rarely been studied. We explored whether inequities in the use of preventative services were associated with employment conditions. We used gastric cancer screening as a surrogate for the use of preventative health services. The study population was derived from the Korea National Health and Nutrition Survey IV (2007-2009), which included data on 5626 individuals over 40 years of age. Employment conditions were grouped by employment status, work hours, employment contract term, and salary source. Participants who had undergone gastroscopy or an upper gastrointestinal series within the past 2 years were considered to have used cancer screening services according to the National Cancer Screening Program guidelines. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression analysis. As the survey procedure incorporated sample weights, we adjusted our calculations to consider the complex sample design. Self-employed workers were less likely to participate in regular cancer screening than were wage workers (OR = 0.79, 95% CI = 0.68-0.92), and part-time workers were less likely to participate than were full-time workers (OR = 0.81, 95% CI = 0.67-0.99). Among wage workers, temporary workers and daily workers exhibited lower participation rates than did regular workers (OR = 0.81, 95% CI = 0.63-1.05 and OR = 0.58, 95% CI = 0.44-0.76, respectively). Dispatched workers also exhibited lower participation rates (OR = 0.45, 95% CI = 0.25-0.80). We found obvious inequities in the use of preventative health services associated with various employment conditions. Self-employed, irregular, and dispatched workers were significantly less likely to participate in cancer screening than were other workers. Political efforts should be made to reduce employment insecurity and to improve participation in preventative screening services by vulnerable employees so as to resolve the evident health inequities.