Comparing the social determinants of self-rated health in China and Korea : socio-demographic factors, health risks, and social capital influences

Abstract

Cross-national comparisons of the social determinants of health in countries with different socioeconomic and cultural backgrounds can help identify opportunities to reduce health inequities. However, very few studies have directly compared the social determinants of health in East Asian countries.This study set out to compare the social determinants of self-rated health in China and Korea using the 2010 East Asian Social Survey, which consists of nationally representative samples from each country.A multinomial logistic regression was utilized to identify the significant social determinants of self-rated health in the two nations, based on data from 3,629 and 1,351 participants in China and Korea, respectively.The results showed that 1) socio-demographic characteristics had substantial effects on the self-rated health of both countries, although the sizes of the effects tended to differ. The age, employment, income, and social class were stronger predictors of health in Chinese respondents, while gender and education had greater effects on health in Korea; the effects of marital status and religion on health were only significant in China; 2) the effects of socioeconomic characteristics on health were much stronger in China than in Korea; 3) the health risk and health care access characteristics were correlated with health in both countries, but tended to differ in strength: chronic diseases, frequent drinking, and being underweight had a stronger negative effect on the health of Chinese participants, while current smoking habits, being overweight or obese, a lack of physical exercise, and unmet medical needs had a stronger effect on Koreans; and 4) the health effects of social capital characteristics were stronger in Korea than in China.These findings demonstrate the importance of social health determinants in both countries. They also indicate that, due to systemic and cultural differences, certain social determinants matter more in one country than in the other. Further cross-national studies are required for a better understanding of the social determinants of health in other Asian nations.