Income and Time Poverty and Metabolic Syndrome in Korea: Sex-Specific Patterns After Hierarchical Adjustment

This study examined how multidimensional poverty-combining income deprivation and time poverty (working >52 paid hours per week)-is associated with metabolic syndrome (MetS), and whether these associations vary after accounting for employment structure and behavioral risk factors. We conducted a pooled cross-sectional analysis of the Korea National Health and Nutrition Examination Survey data (2013-2023), including 34 650 economically active adults aged ≥19 years. Sex-stratified hierarchical logistic regression models sequentially adjusted for employment type and behavioral risk factors. Among men, time poverty was associated with a higher probability of metabolic syndrome in partially adjusted models (+3.22 pp, P = .009), but this association attenuated after full adjustment (+1.86 pp, P = .125). Among women, dual poverty (+4.53 pp, P = .001) and income-poverty-only (+2.73 pp, P < .001) remained significantly associated with metabolic syndrome in fully adjusted models, whereas time poverty was attenuated (+2.79 pp, P = .065). Self-employment was independently associated with metabolic syndrome in both sexes (P < .001). Associations between poverty type and metabolic syndrome differed by sex and varied across levels of adjustment. The findings indicate that employment structure and behavioral factors are important in interpreting observed associations between multidimensional poverty and metabolic risk.