The Impact of COVID-19 pandemic on Health Status and Behaviors in Korea: An Analysis of the Nationwide Survey.

Background The Coronavirus Disease-19 (COVID-19) pandemic has radically shifted living practices, influencing changes in the health status and behaviors of everyone. Objective The aim of this study is to investigate the impact of COVID-19 on self-reported health status and health behaviors, along with any associated factors in a country without stringent lockdown measures. Methods We conducted an online self-reported survey from November 2020 to December 2020. The study participants were identified through quota sampling by age, sex, and geographical regions among residents aged 19 years or older in Korea. The online survey collected information on basic demographics, changes in self-reported health status and health behaviors during the COVID-19. Self-reported health status and health behaviors were categorized into three groups (unchanged, improved, or worsened). A chi-square test was performed to compare categorical variables, and logistic regression analyses were conducted to identify the factors associated with improving or worsening health behaviors. Results In changes in self-reported health status, the majority (70.5%) reported their health was unchanged, and 20.0% reported having worse health after the COVID-19 outbreak. In changes in health behaviors, the number of people with an increase in tobacco consumption and decrease in tobacco consumption were similar (20.2% vs 19.5%), while those with decreased drinking were more than twice as many as those with increased (36.1% vs 16.8%), and those with decreased exercise were more than those who increased (15.9% vs 10.0%). In logistic regression analysis, the factor that had the greatest influence on lifestyle was age. In the subgroup analysis, participants aged 20-29 years had the highest number of individuals with both a worsened (26.5%) and an improved (15.7%) health status. Further, individuals aged 20-29 years had greater odds of increased smoking (6.44, 95% CI 2.15 - 19.32), increased alcohol use (4.64, 95% CI 2.60 - 8.28), and decreased moderate or higher intensity aerobic exercise (3.39, 95% CI 1.82 - 6.33) than 60 years and older. Young age was a factor that deteriorated health behaviors, and old age was a factor that improved health behaviors. Conclusions In a country without lockdown measures, Korea has not been heavily affected by COVID-19 in terms of the health status and behavior of the majority of people. However, in some cases, changes in health status or health behavior were identified. This study highlighted that some groups were overwhelmingly affected by COVID-19 compared to others. Certain groups reported experiencing both worsening and improving health, while other groups reported unchanged health. Age was the most influential factor for change, in particular, young generation's negative health behaviors need more attention in terms of public health. As COVID-19 prolongs, public health interventions for vulnerable groups may be needed.