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Achieving Health Equity Through Health Promotion (건강증진사업의 효율성과 형평성: 건강증진을 통한 건강 형평성 제고)

  • Moskowitz, Joel M.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2005.09a
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    • pp.91-119
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    • 2005
  • 오타와 헌장에 따르면 건강증진은 건강형평성을 성취하는 것이다. 건강격차를 감소시키고, 모든 사람들이 건강잠재력을 달성할 수 있도록 동등한 기회와 자원이 제공되어야 한다. 또한 각 개인들은 자신의 건강에 대한 결정요인들에 대한 통제능력을 가져야 한다. 미국의 조기사망은 40%가 행동양식에 의하여, 30%가 유전적인 문제로, 15%가 사회적 환경에 의하여, 10%는 의료적 치료의 부족으로, 그리고 5%는 환경위해 물질에 대한 노출로 발생한다. 건강불평등을 발설시키는 사회적 요인으로는 경제적 요인을 들 수 있다. 이러한 요인으로 야기되는 건강불평등의 문제를 해결하여 건강형평성을 달성하기 위해서는 절대적 목표들과 평등관련 목표들이 모두 필요하다. 건강형평성은 인구집단의 건강과 함께 향상되는 것으로 나은 건강상태에 있는 사람들의 건강을 악화시키면서 건강형평성을 달성하는 것은 아니다. 각자의 관심이 형평성을 어떻게 규정하는가에 영향을 미친다. 혜택을 받은 사람들은 성과/투입의 정의를 선호하며, 소외계층은 똑같은 성과 또는 요구에 기반한 정의를 선호한다. Healthy People 2010은 미국의 국가적 예방체계를 의미하며, 가장 중요하며 예방 가능한 건강위협들을 파악하고 이러한 위협들을 감소하기 위한 목적들이 설정되어 있다. 궁극적인 목적은 건강한 삶의 질적인 면과 양적인 측면을 향상시키는 것이며, 건강불평등을 제거하는 것이다. 그러나 미국이 유럽의 국가들에 비해서 사회 프로그램에 대한 투자가 적은 이유는 재분배는 소수인종만을 위한 것이라는 믿음과, 우리는 개방되고 공정한 사회에 살고 있기 때문에 가난하다는 것은 가난한 사람들 자신들의 잘못으로 인한 것이라는 믿음 그리고 재분배를 방지하는 정치체계 때문이다. 국가기관인 CDC의 예방연구센터(Prevention Research Centers)는 지역사회 파트너들과 함께 건강증진, 질병예방, 그리고 질병과 상해로 인한 합병증을 관리하게 위한 효과적인 예방 전략을 개발하고 있다. 예방연구센터의 프로그램들은 지역사회 기반 참여연구와 소외된 계층에 중점을 두며, 다학제 간 접근방법을 활용하고, 교육기관, 공공보건기관 그리고 지역사회의 파트너들 간의 네트웍을 형성을 통한 협력관계를 강조하고 있다. 지역사회 위원회가 구성되어 있으며, 또한 근거중심 프로그램을 개발하고 있다. 이들은 건강 결정요인에 관한 연구, 형성적 연구, 개입 프로그램 및 프로그램의 확산에 관한 연구를 진행한다. UC Berkeley의 가족/지역사회 보건센터(Center for Family & Community Health)는 1993년에 설립되었다. 사업의 대상이 되는 주요 지역사회는 한국교민사회이며, 한국교민사회 자문위원회(Korean Community Advisory Board, KCAB)가 구성되어 있다. 1993년부터 2003년까지는 'Health is Strength' 사업이 시범연구사업으로 진행되었는데, 그 내용은 유방암과 자궁경부암 검진 프로그램이었다. 2003년부터 2009년까지 진행될 'Quitting is Winning'이라는 두 번째 시범연구사업은 남성들의 금연에 중점을 둔 사업이다. 'Health is Strength'는 아시아 보건서비스 및 한국교민사회 자문위원회가 함께 협력하여 진행된 사업으로, 주요 목표는 18세 이상 여성의 자궁암 조기 검진(Pap test)과 자가 유방검진 실천을 증가시키는 것이며, 50세 이상여성의 유방 임상검사와 유방 X선촬영 비율을 증가시키는 것이었다. 한 지역의 카운티에 거주하는 한국 여성들은 4년간의 개입프로그램의 대상이 되었으며, 이들을 대상으로 횡단적인 전화조사를 3번(사전, 중간, 사후)실시하였다. 개입 프로그램은 교회에서 워크샵 개최, Tell-A-Friend Form 작성하기, 포스터 및 책자 발행, 신문광고 등과 함께 자궁암 조기 검진(Pap test)과 유방 X선 촬영권을 무료로 제공하는 것으로 구성되었다. 'Quitting is Winning'은 지역사회 기반 참여 연구모형으로 한국교민사회 자문위원회는 흡연을 1순위의 사업으로 선정하였고, 근거에 기반한 금연 프로그램에 대한 연구들을 검토하여, 기존의 보편적 방법이 아닌 인터넷을 활용하는 프로그램을 진행하는 것으로 결정되었다. 이는 무작위 임상실험으로 연구대상으로 미국에 거주하는 한국인 남성흡연자 2300명을 모집하였다. 이들의 1/2은 실험군인 인터넷 프로그램 집단에, 또 다른 1/2은 대조군인 인쇄책자 집단에 무작위 할당되었다. 12개월 동안 11번의 진단이 인터넷을 통하여 진행되었으며, 참여와 참여유지에 대한 금전적인 보상이 제공되었다.

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The Oral Health Behaviors for Children and Teachers by Teacher-Supervised Toothbrushing in Community Child Center (지역아동센터 교사의 칫솔질 지도여부에 따른 아동과 교사의 구강보건행태)

  • Shin, Sun-Jung;Jang, Jung-Yoo;Kim, Chang-Hee
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.572-582
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    • 2012
  • The purpose of this research was to compare the oral health behaviors for children and teachers in toothbrushing facilities installed community child center related with teacher-supervised toothbrushing. This research was follow-up study from the Korean Dental Hygienists Association third project '2010 program of making of the diamond tooth'. 266 child support teachers were invited and 201 were included in the study (response rate: 75.6%). Statistical analysis conducted using PASW ver. 18.0 for Windows. The difference on the distribution of independent variables related with teacher-supervised toothbrushing was verified with chi-square test. The results of this research could be summarized as follows: The children in the teacher-supervised toothbrushing community child center, the practice rate of toothbrushing was higher than the children in the non-supervised toothbrushing community child center (p<0.05). Teachers offered children one of snacks and drinks per day independently of teacher-supervised toothbrushing (p>0.05). Most of participated teachers accepted to be responsible for oral health of children (73.4%) and demanded that improve facilities for a toothbrushing in community child center (77.2%). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing can be effectively targeted into community child center.

The Private-Initiated Park Development Project in Terms of Securing Publicity Operation Characteristics Analysis - Busan Metropolitan City as a Case - (공공성 확보측면에서 민간공원특례사업 운영특성분석 - "부산광역시를 사례로" -)

  • Gweon, Young-Dal;Park, Hyun-Bin;Kim, Dong-Pil
    • Journal of the Korean Institute of Landscape Architecture
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    • v.51 no.1
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    • pp.13-28
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    • 2023
  • This study examines the process of project promotion in Busan, which introduced the private participation-type consultative body for the first time in the country in the promotion stage of the private-initiated park development project, and introduced flexible application of the system and differentiated policy elements in the implementation process, and examines the operational characteristics and we tried to analyze performance, etc. As a result of the analysis, first, the preferred bidder was selected by introducing a mixed method in the project method, which is an independent project method that cannot be seen in other local governments. Second, by specifying guidelines considering the characteristics of each park and detailed guidelines such as the location, area, and maximum height of non-park facilities, criteria for establishing a rational development plan utilizing regional identity and the basis of evaluation standards were laid. Third, in the project process, transparency was secured through the delegation-type roundtable, in which the private sector performs the functions and roles of key actors, thereby preventing disputes such as suspicion of preferential treatment. Fourth, in order to improve the quality of park facilities to be donated and to secure design adequacy, after approval of the implementation plan, a general planner was introduced and construction project management (design stage) services were performed to promote efficient implementation and specialization of luxury parks in the region. As a result, the city of Busan carried out the project efficiently by conserving 5 parks from sunset, a park area of 2.25km2, and reducing land compensation and park construction costs by KRW 740 billion. Reinforcement of the public nature of the private-initiated park development project was suggested. However, due to the application of these systems and verification procedures, the project period is prolonged, and park services are delayed along with the financial burden on private operators.

Research on Factors Affecting Smartphone App Market Selection: App Market Platform Provider's Perspective (스마트폰 앱 마켓 선택에 영향을 미치는 요인에 관한 연구: 앱 마켓 플랫폼 사업자 관점으로)

  • Lee, Ho;Kim, Jae Sung;Kim, Kyung Kyu;Lee, Youngin
    • Journal of the Korea Knowledge Information Technology Society
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    • v.13 no.1
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    • pp.11-23
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    • 2018
  • This paper empirically investigates the factors that influence the consumer choice of an app market based on the rational choice theory. The app market is the only channel where a consumer can buy smartphone apps, which give various functional convenience and are considered to be a major contributor to the proliferation of smartphones. Analyses of 281 questionnaires show that usability and structural guarantees as benefit factors significantly influence the app market choice. From the cost perspectives, both monetary and non-monetary conversion costs are found to significantly influence the app market choice. On the other hand, customer trust, information quality, and market image were found to have no significant effect on app market selection. In particular, Korean app market platform providers (KT, LG U +) seem to be superior in terms of structural guarantees, such as customer center operation and damage compensation regulations, compared to overseas app market platform operators (Google). However, in the case of the Google App Market, it is pre-installed on all Android phones, so it is not inconvenient to install additional apps to use other app market. This is disadvantageous to domestic app market platform operators, and it is necessary to establish a policy solution point. In terms of operator costs, both monetary and non-monetary conversion costs have a significant impact on app market choice. In particular, non-monetary conversion costs have a negative impact on Korean app market platform operators. It can be explained that the service expectation level of the domestic app market is low and it is recognized that the time cost factor such as membership is large for new users to use. It seems to be necessary to improve the domestic app market business. Meanwhile, extant research on smartphone apps focuses on the purchase of apps themselves, but not on the selection of the app market itself. In order to fill in this gap, this study focuses on the determinants of app market selection, including the characteristics of an app market and the switching costs.

Job importance, job performance, and job satisfaction in dietitians at geriatric hospitals or elderly healthcare facilities in Jeju (제주지역 요양 (병)원 영양사의 직무중요도, 직무수행도 및 직무만족도 분석)

  • Kang, Hye-Sook;Lee, Yunkyoung;Chae, In-Sook
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.189-200
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    • 2016
  • Purpose: This study analyzed job importance, job performance, and job satisfaction in 38 dietitians working at geriatric hospitals and elderly healthcare facilities in Jeju surveyed from September 15-24, 2014 with the aim of providing basic data for improving the quality of meals and nutrition management for elderly patients. Methods: Data were analyzed using descriptive analysis, ${\chi}^2$-test, t-test, ANOVA, and Pearson's correlation coefficients using the SPSS Win program (version 12.0). Results: Regarding job importance, the average score was 4.29 (out of 5), indicating that hygiene and safety management scored the highest at 4.77 (out of 5), and nutrition management scored the lowest at3.86. In terms of job performance of subjects, the average score was 2.87 (out of 5), indicating that cooking operation management scored the highest at 4.42 (out of 5). Regarding the Importance-Performance Analysis (IPA) of job importance and job performance, hygiene and safety management and cooking operation management scored high for importance and performance (B quadrant) menu management, human resource management, and nutrition management scored low for importance and performance (C quadrant) and purchasing management and financial management were included inD quadrant and A quadrant, respectively. For the level of job satisfaction of subjects, the average score was 3.37 (out of 5), indicating that relationships with colleagues scored the highest at 3.72, and improving professionalism scored the lowest at 2.95. Additionally, job importance and performance of subjects were positively correlated withjob satisfaction (r = 0.395, r = 0.386, both p < 0.05). Conclusion: In conclusion, scores for job importance and job performance of nutrition management were low, and job satisfaction of improving professionalism scored low. Therefore, continuous training and education programs of nutrition management should be provided to improve professionalism of dietitians at geriatric hospitals and elderly healthcare facilities.

Open Skies Policy : A Study on the Alliance Performance and International Competition of FFP (항공자유화정책상 상용고객우대제도의 제휴성과와 국제경쟁에 관한 연구)

  • Suh, Myung-Sun;Cho, Ju-Eun
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.139-162
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    • 2010
  • In terms of the international air transport, the open skies policy implies freedom in the sky or opening the sky. In the normative respect, the open skies policy is a kind of open-door policy which gives various forms of traffic right to other countries, but on the other hand it is a policy of free competition in the international air transport. Since the Airline Deregulation Act of 1978, the United States has signed an open skies agreement with many countries, starting with the Netherlands, so that competitive large airlines can compete in the international air transport market where there exist a lot of business opportunities. South Korea now has an open skies agreement with more than 20 countries. The frequent flyer program (FFP) is part of a broad-based marketing alliance which has been used as an airfare strategy since the U.S. government's airline deregulation. The membership-based program is an incentive plan that provides mileage points to customers for using airline services and rewards customer loyalty in tangible forms based on their accumulated points. In its early stages, the frequent flyer program was focused on marketing efforts to attract customers, but now in the environment of intense competition among airlines, the program is used as an important strategic marketing tool for enhancing business performance. Therefore, airline companies agree that they need to identify customer needs in order to secure loyal customers more effectively. The outcomes from an airline's frequent flyer program can have a variety of effects on international competition. First, the airline can obtain a more dominant position in the air flight market by expanding its air route networks. Second, the availability of flight products for customers can be improved with an increase in flight frequency. Third, the airline can preferentially expand into new markets and thus gain advantages over its competitors. However, there are few empirical studies on the airline frequent flyer program. Accordingly, this study aims to explore the effects of the program on international competition, after reviewing the types of strategic alliance between airlines. Making strategic airline alliances is a worldwide trend resulting from the open skies policy. South Korea also needs to be making open skies agreements more realistic to promote the growth and competition of domestic airlines. The present study is about the performance of the airline frequent flyer program and international competition under the open skies policy. With a sample of five global alliance groups (Star, Oneworld, Wings, Qualiflyer and Skyteam), the study was attempted as an empirical study of the effects that the resource structures and levels of information technology held by airlines in each group have on the type of alliance, and one-way analysis of variance and regression analysis were used to test hypotheses. The findings of this study suggest that both large airline companies and small/medium-size airlines in an alliance group with global networks and organizations are able to achieve high performance and secure international competitiveness. Airline passengers earn mileage points by using non-flight services through an alliance network with hotels, car-rental services, duty-free shops, travel agents and more and show high interests in and preferences for related service benefits. Therefore, Korean airline companies should develop more aggressive marketing programs based on multilateral alliances with other services including hotels, as well as with other airlines.

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