The Impact of Community Environment on Mortality Disparities of Older Adults in South Korea

In Korea, rapidly changing community environment including gentrification adversely affect the health of older adults, who have a strong place attachment to their long-term residences. As their physical functions decline and social roles reduce, they spend more time within their local community, becoming increasingly sensitive to changes in the environment. Older adults with low socioeconomic status face greater difficulties in adapting to this social environmental changes. Accordingly, this study aims to analyze the differential impact of the local social environment on the mortality of older adults with disparate socioeconomic status. We utilized administrative big data from the National Health Insurance Service (NHIS), which contain information on date of death, income, and assets of approximately 18% of the entire older adults in Korea. In an exploratory analysis, we calculated age-standardized mortality rates by province, gender, and income level. We compared the gaps in age-standardized mortality rates between the lower 33% and upper 33% income levels. The mortality disparities by income level for each gender showed statistically significant regional differences. Drawing on these findings, this study seeks to identify specific community level factors which have impact on income-based mortality disparities among older adults. We particularly plan to analyze the effects of community environment such as degrees of urbanization, intensities of gentrification, density of social networks on income-based mortality disparities. Spatial regression approach will be used. It is anticipated that higher level of urbanization, greater degree of gentrification, and lower level of social network will be related to income-based mortality disparities among older men and women, with considerable spatial correlation. This study is expected to contribute to the importance of community environments for older adults and provides region-specific policy basis.