Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea

Abstract Background The Korean National Health Examination Baseline (KNHEB) cohort was established in 2019 by the Korea Disease Control and Prevention Agency and the National Health Insurance Service to address research gaps and improve standardized monitoring of the health effects of smoking and ot...

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Main Authors: Suyoung Jo, Eunsil Cheon, Heewon Kang, Min Kyung Lim, Wankyo Chung, Sun Ha Jee, Keum Ji Jung, Yeun Soo Yang, Seong Yong Park, Sunmi Lee, Jin-Kyoung Oh, Kyoungin Na, Soyeon Kim, Jieun Hwang, Sung-il Cho
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Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22856-4
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author Suyoung Jo
Eunsil Cheon
Heewon Kang
Min Kyung Lim
Wankyo Chung
Sun Ha Jee
Keum Ji Jung
Yeun Soo Yang
Seong Yong Park
Sunmi Lee
Jin-Kyoung Oh
Kyoungin Na
Soyeon Kim
Jieun Hwang
Sung-il Cho
author_facet Suyoung Jo
Eunsil Cheon
Heewon Kang
Min Kyung Lim
Wankyo Chung
Sun Ha Jee
Keum Ji Jung
Yeun Soo Yang
Seong Yong Park
Sunmi Lee
Jin-Kyoung Oh
Kyoungin Na
Soyeon Kim
Jieun Hwang
Sung-il Cho
author_sort Suyoung Jo
collection DOAJ
description Abstract Background The Korean National Health Examination Baseline (KNHEB) cohort was established in 2019 by the Korea Disease Control and Prevention Agency and the National Health Insurance Service to address research gaps and improve standardized monitoring of the health effects of smoking and other modifiable risk factors. It provides scientific evidence to inform national policies on tobacco control and other health determinants, aiming to reduce preventable mortality and disease burden in South Korea. Methods The cohort includes 8,916,544 individuals aged ≥ 20 who underwent general health screenings in 2002–2003. It integrates three linked databases: insurance eligibility, medical visits (diagnostic codes, healthcare utilization), and health check-ups (behavioral risk factors, blood test results, etc.). Medical visit and health check-up data were collected until December 2018, while mortality records have been updated through 2019 and continue to be updated annually. At baseline, the mean age of participants was 44.2 years (SD 13.8). The mean follow-up duration was 16.2 years (SD 2.6) for health check-ups among all participants and 9.7 years (SD 4.6) for mortality among deceased individuals. The cohort enables long-term analysis of health outcomes, including cause-specific mortality based on death records and disease incidence identified through diagnostic codes and medical visit data. Findings to date Analyses using the KNHEB cohort have provided key insights into smoking-related health risks. One study estimated that 60,213 smoking-attributable deaths occurred in South Korea in 2020, while another identified smoking intensity as the strongest predictor of all-cause mortality. Ongoing research include examining the effect of combined health-related factors (HRFs) on cause-specific mortality across age groups and investigating long-term smoking trajectories and alcohol consumption patterns in relation to major non-communicable diseases (NCDs). Conclusions The KNHEB cohort provides a large-scale, population-based dataset that supports comprehensive analyses of the long-term effects of modifiable risk factors on NCDs. Its findings contribute to evidence-based policymaking in South Korea and offer comparative insights for global research on chronic disease prevention and risk factor management. Furthermore, its standardized data collection and integration with health records facilitate cross-country comparisons, reinforcing its value as a model for large-scale epidemiological studies on NCDs.
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spelling doaj-art-7204a979323f48b98717ff74c265e4192025-08-20T04:03:07ZengBMCBMC Public Health1471-24582025-05-0125111010.1186/s12889-025-22856-4Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South KoreaSuyoung Jo0Eunsil Cheon1Heewon Kang2Min Kyung Lim3Wankyo Chung4Sun Ha Jee5Keum Ji Jung6Yeun Soo Yang7Seong Yong Park8Sunmi Lee9Jin-Kyoung Oh10Kyoungin Na11Soyeon Kim12Jieun Hwang13Sung-il Cho14Institute of Health and Environment, Seoul National UniversityDepartment of Public Health Science, Graduate School of Public Health, Seoul National UniversityInstitute of Health and Environment, Seoul National UniversityDepartment of Social & Preventive Medicine, College of Medicine, Inha UniversityInstitute of Health and Environment, Seoul National UniversityDepartment of Transdisciplinary Healthcare Sciences, Graduate School of Transdisciplinary Health Sciences, Yonsei UniversityDepartment of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei UniversityDepartment of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei UniversityDepartment of Big Data Service, National Health Insurance ServiceHealth Insurance Policy Research Institute, National Health Insurance ServiceGraduate School of Cancer Science and Policy, National Cancer CenterDivision of Health Hazard Response, Korea Disease Control and Prevention AgencyDivision of Health Hazard Response, Korea Disease Control and Prevention AgencyDepartment of Health Administration, College of Health Science, Dankook UniversityInstitute of Health and Environment, Seoul National UniversityAbstract Background The Korean National Health Examination Baseline (KNHEB) cohort was established in 2019 by the Korea Disease Control and Prevention Agency and the National Health Insurance Service to address research gaps and improve standardized monitoring of the health effects of smoking and other modifiable risk factors. It provides scientific evidence to inform national policies on tobacco control and other health determinants, aiming to reduce preventable mortality and disease burden in South Korea. Methods The cohort includes 8,916,544 individuals aged ≥ 20 who underwent general health screenings in 2002–2003. It integrates three linked databases: insurance eligibility, medical visits (diagnostic codes, healthcare utilization), and health check-ups (behavioral risk factors, blood test results, etc.). Medical visit and health check-up data were collected until December 2018, while mortality records have been updated through 2019 and continue to be updated annually. At baseline, the mean age of participants was 44.2 years (SD 13.8). The mean follow-up duration was 16.2 years (SD 2.6) for health check-ups among all participants and 9.7 years (SD 4.6) for mortality among deceased individuals. The cohort enables long-term analysis of health outcomes, including cause-specific mortality based on death records and disease incidence identified through diagnostic codes and medical visit data. Findings to date Analyses using the KNHEB cohort have provided key insights into smoking-related health risks. One study estimated that 60,213 smoking-attributable deaths occurred in South Korea in 2020, while another identified smoking intensity as the strongest predictor of all-cause mortality. Ongoing research include examining the effect of combined health-related factors (HRFs) on cause-specific mortality across age groups and investigating long-term smoking trajectories and alcohol consumption patterns in relation to major non-communicable diseases (NCDs). Conclusions The KNHEB cohort provides a large-scale, population-based dataset that supports comprehensive analyses of the long-term effects of modifiable risk factors on NCDs. Its findings contribute to evidence-based policymaking in South Korea and offer comparative insights for global research on chronic disease prevention and risk factor management. Furthermore, its standardized data collection and integration with health records facilitate cross-country comparisons, reinforcing its value as a model for large-scale epidemiological studies on NCDs.https://doi.org/10.1186/s12889-025-22856-4Korean National health examination baseline (KNHEB) cohortModifiable risk factorsNon-communicable diseases (NCDs)Tobacco control policyDisease burden
spellingShingle Suyoung Jo
Eunsil Cheon
Heewon Kang
Min Kyung Lim
Wankyo Chung
Sun Ha Jee
Keum Ji Jung
Yeun Soo Yang
Seong Yong Park
Sunmi Lee
Jin-Kyoung Oh
Kyoungin Na
Soyeon Kim
Jieun Hwang
Sung-il Cho
Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
BMC Public Health
Korean National health examination baseline (KNHEB) cohort
Modifiable risk factors
Non-communicable diseases (NCDs)
Tobacco control policy
Disease burden
title Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
title_full Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
title_fullStr Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
title_full_unstemmed Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
title_short Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
title_sort cohort profile the korean national health examination baseline knheb cohort for longitudinal health monitoring in south korea
topic Korean National health examination baseline (KNHEB) cohort
Modifiable risk factors
Non-communicable diseases (NCDs)
Tobacco control policy
Disease burden
url https://doi.org/10.1186/s12889-025-22856-4
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