Regional population decline and health screening uptake in Korean adults: nationwide study using multilevel regression analysis

TL;DR

This study shows that population decline in regions of South Korea is linked to lower health screening uptake among adults.

Contribution

The study introduces a multilevel regression analysis linking regional demographic changes to health screening behavior in Korea.

Findings

Regions with declining populations had lower odds of health screening uptake.

Stable population regions also showed reduced screening rates.

Population-based policies should consider regional differences to ensure equitable access.

Abstract

Health screening is crucial for detecting medical needs and presenting effective alternatives. As Korea undergoes rapid demographic shifts and widening regional gaps, screening is increasingly important to identify these needs. This study explores how changes in regional population size related to health screening uptake among Korean adults.

Data on 182,437 adults from the 2021 Korean Community Health Survey (KCHS) were used, with health screening divided into cancer and general medical screening. Regional population size, aging index and financial independence ratio from 2012 to 2022 KOSIS were linked to our data. Generalized linear mixed effects models were applied for hierarchical logistic regression analysis of the association between the regional population size and screening, controlling for regional- and individual-level variables.

Decrease in regional population size were significantly associated with lower odds ratio (OR) of receiving health screening; OR 0.85 (95% CI 0.83–0.88), as well as cancer screening; OR 0.87 (95% CI 0.85–0.90). Similar results were observed in regions with stable in population size.

Our study findings indicate the significant associations between regional population size decline and screening. Population-based policies should consider regional attributes to ensure equitable access to screening services.