Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Regional Inequalities in Healthcare Indices in Korea: Geo-economic Review and Action Plan

우리나라 보건지표의 지역 격차: 지경학적 고찰과 대응방안

  • Kim, Chun-Bae (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Chung, Moo-Kwon (Institute for Poverty Alleviation and International Development, Yonsei University) ;
  • Kong, In Deok (Center for Exercise Medicine, Yonsei University Wonju College of Medicine)
  • 김춘배 (연세대학교 원주의과대학 예방의학교실) ;
  • 정무권 (연세대학교 빈곤문제국제개발연구원) ;
  • 공인덕 (연세대학교 원주의과대학 운동의학센터)
  • Received : 2018.07.31
  • Accepted : 2018.08.21
  • Published : 2018.09.30
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Abstract

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying "the balanced development of the state" or "ensuring the balanced development of all regions." In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the "Special Committee on Regional Balanced Development" with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.

Keywords

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