Association between health financial capacity of local governments and health behaviors of local residents: a cross-sectional study

Abstract

Objectives: The budget gap in the health sector of local governments affects the supply of health services, which can cause the health gap. This study classified local governments according to their financial characteristics, such as local financial independence and health budget level. It analyzed the health behaviors and disease prevalence of local residents to examine the effect of local government financial investment on the health of local residents. Methods: To classify types according to the financial characteristics of local governments, financial independence and the health budget data for 17 local governments were collected from the local fiscal yearbook of the Ministry of Public Administration and Security. The prevalence of chronic diseases and healthy behavior was compared using the 16,333 data of adults between the ages of 30 and 65 years among the original data of the National Health and Nutrition Examination Survey (2016–2020). Results: Cluster analysis was used to classify local governments into five clusters according to the health financial capacity type. A comparison of the prevalence of local residents by cluster revealed a similar prevalence of hypertension, diabetes, and hypercholesterolemia. On the other hand, the obesity rate (P < 0.01), high-risk drinking rate (P < 0.01), aerobic physical activity rate (P < 0.001), and healthy eating practice rate (P < 0.001) were significantly different. In addition, an analysis of the odds ratio based on the Seoul area revealed a higher risk of health behavior of non-Seoul residents. Conclusions: It is necessary to review the universal health promotion project budget considering the degree of regional financial vulnerability from the viewpoint of health equity to narrow the health gap among regions.

Keywords

• local government
• health budget
• health behavior
• health equity
• health gap