ArticleJournal of Korean medical science2023
Socioeconomic Disparities in the Association Between All-Cause Mortality and Health Check-Up Participation Among Healthy Middle-Aged Workers: A Nationwide Study.
Article in Journal of Korean medical science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association of Stroke and Myocardial Infarction Symptom Knowledge with Cancer Screening Participation Among Patients with Hypertension and Diabetes: A Cross-Sectional Study in Korea.Healthcare (Basel, Switzerland) · 2026Article
- Patterns of proactive health behaviors and associated factors among middle-aged and older women in China: a latent class analysis.BMC nursing · 2025Article
- Positive Impact of Health Check-Ups and Guidance in the General Population: A Database-Based Cohort Study in Japan.AJPM focus · 2025Article
- Association Between Area-Level Deprivation and Cardio-Metabolic Risk Factors Among the Adult Population in Russia.International journal of environmental research and public health · 2025Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundThis study assessed the relationship between non-participation in health check-ups and all-cause mortality and morbidity, considering socioeconomic status.
methodsHealthy, middle-aged (35-54 years) working individuals who maintained either self-employed or employee status from 2006-2010 were recruited in this retrospective cohort study from the National Health Insurance Service in Korea. Health check-up participation was calculated as the sum of the number of health check-ups in 2007-2008 and 2009-2010. Adjusted hazard ratio (HR) and 95% confidence interval (CI) of all-cause mortality were estimated for each gender using multivariable Cox proportional hazard models, adjusting for age, income, residential area, and employment status. Interaction of non-participation in health check-ups and employment status on the risk of all-cause mortality was further analyzed.
resultsAmong 4,267,243 individuals with a median 12-year follow-up (median age, 44; men, 74.43%), 89,030 (2.09%) died. The proportion (number) of deaths of individuals with no, one-time, and two-time participation in health check-ups was 3.53% (n = 47,496), 1.66% (n = 13,835), and 1.33% (n = 27,699), respectively. The association between health check-up participation and all-cause mortality showed a reverse J-shaped curve with the highest adjusted HR (95% CI) of 1.575 (1.541-1.611) and 1.718 (1.628-1.813) for men and women who did not attend any health check-ups, respectively. According to the interaction analysis, both genders showed significant additive and multiplicative interaction, with more pronounced additive interaction among women who did not attend health check-ups (relative excess risk due to interaction, 1.014 [0.871-1.158]).
conclusionOur study highlights the significant reverse J-shaped association between health check-up participation and all-cause mortality. A pronounced association was found among self-employed individuals, regardless of gender.
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