Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 8, 2025
Date Accepted: Jan 6, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Regional Disparities in Factors Affecting Subjective Health Among Older Adults in Aging and Super-Aged Areas of Korea
ABSTRACT
Background:
As South Korea transitions into a super-aged society, understanding regional disparities in subjective health among older adults is critical to addressing health inequalities and supporting healthy aging
Objective:
This study aimed to compare determinants of subjective health between aging and super-aged regions in South Korea and identify region-specific characteristics contributing to disparities among older adults.
Methods:
A cross-sectional analysis was conducted using data from the Korea Community Health Survey (2020–2023), a nationwide population-based survey at the city, county, and district levels. Adults aged 65 years and older (n = 179,571) were categorized into aging (n = 19,759) or super-aged (n = 159,782) regions based on regional aging rates. Propensity score matching was applied to adjust for demographic differences, yielding 18,574 matched participants from each group. Subjective health was assessed on a five-point Likert scale. Ordinal logistic regression was used to examine associations between subjective health and various exposures, including demographic characteristics, health behaviors, physical and mental health status, and health literacy indicators such as nutrition label recognition and reading.
Results:
: Older adults in super-aged regions reported poorer subjective health than those in aging regions. While physical activity and mental health were consistently associated with better subjective health in both regions, region-specific patterns were observed. In aging regions, nutrition label recognition was significantly associated with better subjective health, whereas in super-aged regions, nutrition label reading showed a stronger association. The negative impact of hypertension and diabetes on subjective health was more pronounced in super-aged regions.
Conclusions:
: Although common determinants of subjective health exist across regions, region-specific differences highlight the importance of tailored approaches. Public health strategies that enhance health literacy and address chronic disease awareness should be adapted to the aging characteristics of each region to reduce disparities and promote healthy aging.
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