Journal List > Korean J Women Health Nurs > v.25(3) > 1133348

Chae and Kim: Health Behavior, Health Service Use, and Health Related Quality of Life of Adult Women in One-person and Multi-person Households

Abstract

Purpose

This study was to identify health behavior, health service use, and health related quality of life of adult women in one-person and multi-person households.

Methods

It was used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-2017). Subjects were 2,522 women with age of 19 to 64 years in 2017. Complex sampling design and data analysis were performed using SPSS 20.1.

Results

Women in one-person households had higher rates of alcohol drinking (χ2=13.77, p=.003), smoking (χ2=16.07, p=.001), unmet medical care (χ2=8.77, p=.004) and non-practice of cancer screening (χ2=13.77, p=.003) compared to women in multi-person households. Health-related quality of life was also lower for women in one-person households (t=−2.46, p=.015). Factors affecting health-related quality of life in one-person households were household income, job status, and unmet dental care, having 32.4% explanatory power. One-person household women with low incomes, no jobs, and unmet dental care showed low health-related quality of life. In comparison, factors affecting health-related quality of life of women in multi-person household women were age, education level, unmet medical care, and unmet dental care, having 10.4% explaining power. Women in multi-person households with age of 60–64, low education level, unmet medical care, and unmet dental care showed low health-related quality of life.

Conclusion

Health promotion strategies should be developed based on unique understanding of social, economic, and health of adult women in one-person and multi-person households.

Figures and Tables

Table 1

General Characteristics (N=2,552)

kjwhn-25-299-i001
Characteristics Categories One-person household (n=187) Multi-person household (n=2,335) χ2 (p)
% (SE) % (SE)
Age (year) 19–29 28.3 (5.2) 19.7 (1.1) 1,819.63 (<.001)
30–39 13.7 (2.8) 21.7 (1.3)
40–49 12.3 (2.7) 25.5 (1.1)
50–59 25.4 (3.8) 24.4 (0.9)
60–64 20.3 (3.1) 8.7 (0.6)
Living area Urban 87.1 (3.5) 87.2 (2.6) <0.01 (.994)
Rural 12.9 (3.5) 12.8 (2.6)
House type Non-apartment 72.3 (4.0) 36.9 (1.7) 79.57 (<.001)
Apartment 27.7 (4.0) 63.1 (1.7)
Marriage Living with spouse, bereavement 30.2 (4.4) 75.0 (1.2) 162.53 (<.001)
Separation, divorce 18.6 (3.1) 4.3 (0.5)
Unmarried 51.1 (5.2) 20.7 (1.1)
Education ≤Elementary school 12.3 (2.7) 7.7 (0.6) 12.52 (.012)
Middle school 13.5 (2.6) 7.4 (0.7)
High school 29.9 (4.0) 35.7 (1.4)
≥University 44.3 (5.3) 49.2 (1.6)
House income Low 24.2 (3.8) 7.8 (0.8) 78.43 (<.001)
Low middle 28.4 (3.6) 24.0 (1.3)
Upper middle 37.3 (4.4) 31.7 (1.2)
High 10.1 (2.6) 36.4 (1.7)
Occupation Yes 72.1 (4.1) 59.5 (1.3) 9.51 (.006)
No 27.9 (4.1) 40.5 (1.3)
SE=standard error.
Unweighted frequency, Valid percent.
Table 2

Health Behavior, Health Service Use and Health Related Quality of Life (EQ-5D index) (N=2,552)

kjwhn-25-299-i002
Variables Categories One-person household (n=187) Multi-person household (n=2,335) χ2 or t p
% (SE) or M (SE) % (SE) or M (SE)
Health behavior
Drinking No 38.5 (4.0) 49.2 (1.1) 6.96 .014
Yes 61.5 (4.0) 50.8 (1.1)
Smoking No 86.8 (2.9) 94.6 (0.6) 16.07 .001
Yes 13.2 (2.9) 5.4 (0.6)
Exercise No 51.8 (4.9) 52.4 (1.3) 0.02 .914
Yes 48.2 (4.9) 47.6 (1.3)
Health service use
Unmet medical needs Yes 17.8 (3.1) 10.2 (0.8) 8.77 .004
No 82.2 (3.1) 89.8 (0.8)
Influenza vaccination Yes 27.8 (3.9) 33.1 (1.2) 1.84 .208
No 72.2 (3.9) 66.9 (1.2)
Medical check-up Yes 65.7 (3.4) 66.6 (1.4) 0.06 .795
No 34.3 (3.4) 33.4 (1.4)
Cancer screening Yes 47.4 (5.0) 62.5 (1.2) 13.77 .003
No 52.6 (5.0) 37.5 (1.2)
Unmet dental needs Yes 34.2 (4.4) 26.8 (1.2) 4.20 .103
No 65.8 (4.4) 73.2 (1.2)
Dental check-up Yes 33.6 (3.9) 41.5 (1.3) 3.86 .056
No 66.4 (3.9) 58.5 (1.3)
EQ-5D index 0.95 (0.01) 0.97 (<0.01) −2.46 .015
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
Unweighted frequency, Valid percent.
Table 3

Health Related Quality of Life (EQ-5D Index) according to General Characteristics (N=2,552)

kjwhn-25-299-i003
Characteristics Categories One-person household (n=187) Multi-person household (n=2,335)
M (SE) F (p) M (SE) F (p)
Age (year) 19–29 0.97 (0.01) 4.27 (.003) 0.98 (<0.01) 13.12 (<.001)
30–39 0.97 (0.01) 0.98 (<0.01)
40–49 0.98 (0.01) 0.98 (<0.01)
50–59 0.94 (0.02) 0.96 (<0.01)
60–64 0.91 (0.02) 0.93 (0.01)
Living area Urban 0.95 (0.01) 0.01 (.935) 0.97 (<0.01) 3.94 (.048)
Rural 0.95 (0.02) 0.96 (0.01)
House type Non-apartment 0.95 (0.01) 0.01 (.926) 0.96 (<0.01) 19.54 (<.001)
Apartment 0.95 (0.02) 0.97 (<0.01)
Marriage Living with spouse, bereavement 0.95 (0.01) 4.21 (.016) 0.97 (<0.01) 7.34 (.001)
Separation, divorce 0.90 (0.03) 0.95 (0.01)
Unmarried 0.97 (0.01) 0.98 (<0.01)
Education ≤Elementary school 0.86 (0.04) 4.48 (.004) 0.92 (0.01) 18.01 (<.001)
Middle school 0.93 (0.02) 0.96 (0.01)
High school 0.97 (0.01) 0.97 (<0.01)
≥University 0.97 (0.01) 0.98 (<0.01)
House income Low 0.88 (0.02) 19.01 (<.001) 0.94 (0.01) 7.86 (<.001)
Low middle 0.97 (0.01) 0.97 (<0.01)
Upper middle 0.97 (0.01) 0.97 (<0.01)
High 1.00 (<0.01) 0.97 (<0.01)
Occupation Yes 0.97 (0.01) 9.54 (.002) 0.97 (<0.01) 1.89 (.170)
No 0.90 (0.02) 0.97 (<0.01)
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
Unweighted frequency.
Table 4

Health Related Quality of Life (EQ-5D Index) according to Health Behavior and Health Service Use (N=2,552)

kjwhn-25-299-i004
Variables Categories One-person household (n=187) Multi-person household (n=2,335)
M (SE) F (p) M (SE) F (p)
Health behavior
Drinking No 0.92 (0.02) 6.76 (.010) 0.97 (<0.01) 3.57 (.060)
Yes 0.97 (0.01) 0.97 (<0.01)
Smoking No 0.95 (0.01) 2.04 (.154) 0.97 (<0.01) 0.05 (.831)
Yes 0.97 (0.01) 0.97 (<0.01)
Exercise No 0.94 (0.01) 1.83 (.177) 0.97 (<0.01) 2.44 (.119)
Yes 0.96 (0.01) 0.97 (<0.01)
Health service use
Unmet medical needs Yes 0.91 (0.03) 2.04 (.154) 0.93 (0.01) 32.33 (<.001)
No 0.96 (0.01) 0.97 (<0.01)
Influenza vaccination Yes 0.93 (0.02) 4.22 (.041) 0.96 (<0.01) 8.92 (.003)
No 0.96 (0.01) 0.97 (<0.01)
Medical check-up Yes 0.95 (0.01) 0.05 (.826) 0.97 (<0.01) 0.01 (.736)
No 0.95 (0.01) 0.97 (<0.01)
Cancer screening Yes 0.94 (0.01) 2.92 (.088) 0.97 (<0.01) 0.47 (.492)
No 0.96 (0.01) 0.97 (<0.01)
Unmet dental needs Yes 0.91 (0.02) 11.41 (.001) 0.95 (<0.01) 29.38 (<.001)
No 0.97 (0.01) 0.97 (<0.01)
Dental check-up Yes 0.96 (0.01) 1.89 (.171) 0.97 (<0.01) 0.09 (.762)
No 0.94 (0.01) 0.97 (<0.01)
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
Unweighted frequency.
Table 5

Factors Associated with Health Related Quality of Life (EQ-5D Index) in One-person Household Women (N=187)

kjwhn-25-299-i005
Variables Categories B (SE) 95% CI t p
Lower Upper
Intercept 1.04 (0.04) 0.97 1.11 30.07 <.001
Age (year) 19–29 −0.06 (0.04) −0.13 0.01 −1.59 .113
30–39 −0.06 (0.04) −0.13 0.02 −1.53 .128
40–49 −0.05 (0.03) −0.11 0.01 −1.55 .122
50–59 −0.02 (0.03) −0.08 0.04 −0.68 .495
60–64 Reference
Marriage Living with spouse, bereavement −0.02 (0.02) −0.06 0.01 −1.28 .201
Separation, divorce −0.05 (0.03) −0.10 0.01 −1.60 .110
Unmarried Reference
Education ≤Elementary school −0.08 (0.04) −0.17 0.00 −1.89 .060
Middle school −0.02 (0.02) −0.06 0.01 −1.29 .197
High school 0.02 (0.01) −0.00 0.05 1.70 .090
≥Universities Reference
House income Low −0.07 (0.02) −0.11 −0.03 −3.60 <.001
Low middle −0.01 (0.02) −0.04 0.02 −0.64 .521
Upper middle −0.04 (0.02) −0.07 −0.01 −2.71 .007
High Reference
Occupation Yes 0.05 (0.02) 0.01 0.08 2.66 .008
No Reference
Drinking No −0.02 (0.01) −0.05 0.01 −1.43 .153
Yes Reference
Influenza vaccination Yes −0.02 (0.02) −0.05 0.01 −1.33 .183
No Reference
Unmet dental needs Yes −0.05 (0.01) −0.07 −0.02 −3.89 <.001
No Reference
R2=.32, F=4.48, p<.001
EQ-5D=Euro Quality of Life-5 Dimensions; B=unstandardized coefficients; SE=standard error; CI=confidence interval.
Table 6

Factors Associated with Health Related Quality of Life (EQ-5D Index) in Multi-person Household Women (N=2,335)

kjwhn-25-299-i006
Variable Categories B (SE) 95% CI t p
Lower Upper
Intercept 1.04 (0.04) 0.97 1.11 30.07 <.001
Age (year) 19–29 0.02 (0.01) 0.00 0.04 2.23 .026
30–39 0.02 (0.01) 0.00 0.03 2.43 .016
40–49 0.02 (0.01) 0.01 0.04 2.66 .008
50–59 0.01 (0.01) −0.00 0.03 1.58 .115
60–64 Reference
Living area Urban 0.00 (0.01) −0.01 0.01 0.45 .653
Rural Reference
House type Non-apartment 0.01 (0.00) −0.01 0.00 −1.37 .173
Apartment Reference
Marriage Living with spouse, bereavement 0.00 (0.01) −0.01 0.01 −0.30 .531
Separation, divorce −0.01 (0.01) −0.03 0.01 −0.72 .475
Unmarried Reference
Education ≤Elementary school −0.03 (0.01) −0.05 −0.02 −3.60 <.001
Middle school −0.01 (0.01) −0.02 0.01 −0.87 .383
High school 0.00 (0.00) −0.01 0.00 −0.90 .368
≥Universities Reference
House income Low −0.01 (0.01) −0.03 0.00 −1.66 .098
Low middle 0.00 (0.00) −0.01 0.01 0.79 .428
Upper middle 0.01 (0.00) 0.00 0.01 1.72 .086
High Reference
Unmet medical needs Yes −0.03 (0.01) −0.04 −0.02 −4.51 <.001
No Reference
Influenza vaccination Yes −0.01 (0.00) −0.01 0.00 −1.73 .084
No Reference
Unmet dental needs Yes −0.02 (0.00) −0.02 −0.01 −4.52 <.001
No Reference
R2=.10, F=8.71, p<.001
EQ-5D=Euro Quality of Life-5 Dimensions; B=unstandardized coefficients; SE=standard error; CI=confidence interval.

Notes

Conflict of Interest The authors declared no conflict of interest.

Author Contributions

  • Conceptualization: Kim MJ, Chae HJ.

  • Formal analysis: Kim MJ, Chae HJ.

  • Writing - original draft: Kim MJ, Chae HJ.

  • Writing - review & editing: Kim MJ, Chae HJ.

Summary Statement

  • What is already known about this topic?

  • One-person household women have more risky health behaviors and have more limitations in using health services than multi-person household women.

  • What this paper adds?

  • One-person household women have lower health related quality of life than multi-person household women. Factors influencing health related quality of life are different between one-person household women and multi-person household women.

  • Implications for practice, education and/or policy

  • Intervention programs and policies should be provided to improve health related quality of life of one-person household women. Factors influencing health related quality of life of one-person household women should be considered and included in these programs and policies.

References

1. Statistics Korea. Statistical indicators [Internet]. Daejeon: Statistics Korea;2019. cited 2019 Jul 26. Available from: http://kosis.kr/search/search.do#.
2. Byun MR. Single person household and urban policy in Seoul. Korean Journal of Culture and Social Issues. 2015; 21(3):551–573.
crossref
3. Kim H, Lee K, Kim K, Lee G, Ahn J, Hwang J. The impact of social networks and leisure life on the subject health condition of middle aged single-person households. Journal of Leisure Studies. 2019; 17(1):73–94.
4. Bennett J, Dixon M. Single person households and social policy: looking forwards. York: Joseph Rowntree Foundation;2006.
5. Choi JS, Lee EH, So AY, Lee KS. Quality of life in the urban adults by age. The Journal of Muscle and Joint Health. 2012; 19(3):362–372.
crossref
6. Ban JH. Study on employment and poverty for single-person households. Seoul: Korea Labor Institute;2012. p. 55–67.
7. Park G, Kim Y. Lifestyle survey of single-woman households in Seoul: Survey of living conditions and support policy plans for individuals in their 40s and 50s with a focus on preparations for old age and social relationships. Seoul: Seoul Foundation of Women & Family;2016. p. 1–204.
8. Yeung WJ, Cheung AK. Living alone: one-person households in Asia. Demographic Research. 2015; 32(40):1099–1112.
9. Park MJ, Choi SE. The effects of health behavior and health status on heath-related quality of life in older people: gender analysis by using the 2012 Korea Health Panel Data. Journal of Korean Academy of Community Health Nursing. 2017; 28(2):118–128.
crossref
10. Lim GT. Differences in health-related quality of life among social classes and related factors in Korea [doctoral dissertation]. Daejeon: Chungnam National University;2011.
11. Kim YJ. Comparison of health practices between single- and multiple-member households by gender in Korean adults. Journal of Korean Academy of Public Health Nursing. 2009; 23(2):219–231.
12. Park C, Lee J. Differential gender effects of family disorganization on the health and quality of life. Health and Social Welfare Review. 2010; 30(1):142–169.
13. Yoo GM, Jin S, Moon SH. Exploratory study on factors of unmet medical needs using data mining analysis. Korean Policy Studies Review. 2016; 25(4):269–300.
14. Kim MA, Choi SE, Moon JH. Effect of heath behavior, physical health and mental health on heath-related quality of life in middle aged women: by using the 2014 Korea Health Panel Data. Journal of Korean Academic Society of Home Care Nursing. 2019; 26(1):72–80.
15. Kim EK, Park SK. Comparison of health behaviors, disease prevalence between one-person women and multiple households women in Korea. Journal of Korean Public Health Nursing. 2016; 30(3):483–494.
crossref
16. Jeong YR, Jeong SH, Han SS. Factors influencing health-related quality of life among women workers. Journal of Korean Society of Occupational and Environmental Hygiene. 2018; 28(1):117–123.
17. Lee JS, Choi WS. A study on path of work-family reconciliation conflict of married working women. Journal of Asian Women. 2011; 50(1):169–198.
18. Won MR, Choi YJ. Are Koreans prepared for the rapid increase of the single-household elderly? Life satisfaction and depression of the single-household elderly in Korea. The Scientific World Journal. 2013; 2013:972194.
crossref
19. Alho J, Keilman N. On future household structure. Journal of the Royal Statistical Society: Series A (Statistics in Society). 2010; 173(1):117–143.
crossref
20. Victor CR, Yang K. The prevalence of loneliness among adults: a case study of the United Kingdom. The Journal of psychology. 2012; 146(1-2):85–104.
crossref
21. Seok J, Jang E. The effect of social relationship resource by gender on the life satisfaction of elderly living alone. Korean Journal of Gerontological Social Welfare. 2016; 71(2):321–349.
22. Nam YH. The increase in the number of single-person households increases the number of the die alone. Medical Today [Internet]. 2019. 07. 18. cited 2019 Jul 26. Available from: http://www.mdtoday.co.kr/mdtoday/index.html?no=360097.
23. Ministry of Gender Equality and Family. Directly listens to the difficulties of single-person households in their 30s and 40s [Internet]. Sejong: Policy Briefing;2019. 02. 14. cited 2019 Jul 18. Available from: http://www.korea.kr/news/pressReleaseView.do?newsId=156317172.
24. Kim JE, Chung H, Nam Y. A study on the current status of female single-person households for policy improvement: focusing on Gyeonggi province with secondary data analyses. Korean Journal of Family Welfare. 2018; 23(3):463–488.
crossref
25. Lee J, Shin A. Vegetable and fruit intake in one person household: The Korean national health and nutrition examination survey (2010~2012). Journal of Nutrition and Health. 2015; 48(3):269–276.
crossref
26. Hur SI, Lee HJ. Unmet health care needs and attitudes towards health care system in Korea. Korean Journal of Health Economics and Policy. 2016; 22(1):59–89.
27. Kim HJ, Jang J, Park EC, Jang SI. Unmet healthcare needs status and trend of Korea in 2017. Health Policy and Management. 2019; 29(1):82–85.
28. Yim ES, Kim KH, Chae HJ. The influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. Journal of Korean Academy of Community Health Nursing. 2010; 21(4):502–511.
crossref
29. Park JT. The association between smoking status and infleunza vaccination coverage rate in Korean adults: analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey [master's thesis]. Seoul: Korea University;2017.
TOOLS
ORCID iDs

Hyun Ju Chae
https://orcid.org/http://orcid.org/0000-0002-6946-4060

MiJong Kim
https://orcid.org/0000-0002-4365-2338

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