• Korean Journal of Health Education and Promotion
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• v.29 no.5
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• pp.37-48
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• 2012

Objectives: The economic evaluation of health promotion programs has increasingly become an imperative activity for securing public fund or budget. The purpose of this study is to conduct an economic evaluation for the healthy school canteen program using the contingent valuation method(CVM). Methods: To estimate the benefit from the healthy school canteen program, double-bounded dichotomous choice method as a sort of willingness to pay was employed. Four hundred parents who lived in Seoul and have students at middle or high schools, were administrated by semi-constructive questionnaire containing the necessary information for benefit estimation. Cost estimation of healthy school canteen program was made referring to three types of pilot programs. Finally, the benefit against the cost was worked out according to the three levels of estimated cost. Results: Cost estimate is 8,488 and 9,311 won depending on the two senarios about how to invest on the program, respectably. The results of benefit estimate shows that the average cost willingness to pay(WTP) for healthy school canteen program is 21,275 won(16,963-59,838 won, 95% CI) and total benefits turned out 14.7 billion won. According to the cost-benefit analysis, average benefit-cost ratio is from 2.3 to 3.6. Conclusions: Healthy school canteen program could be economically accepted, and government can take consideration of expanding beneficiaries of healthy school canteen program for health promotion.

• Korean Journal of Health Education and Promotion
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• v.31 no.5
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• pp.159-166
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• 2014

Purpose: In spite of many Healthy Cities projects in Korea, there are few research about healthy urban planning. So we tried to use available recent models to a Healthy Cities project in a medium sized city in Gyeongnam province. Methods: Using mainly European Healthy Urban Planning Model and opinion leader survey, SWOT analysis, forum and discussion have been done to a city. Secondary city health indicator obtained from Ministry of Statistics. Results: There are strong need to develop health industry, green traffic and healthy living from survey using Healthy Cities policy direction of Korean Health Promotion Fund. Among the Healthy Urban Planning objectives, improvements of physical environments, prevention of accidents and crime, improvements of healthy esthetics rated highly. Although environmental pollution was problem local government push forward to the pilot healthy urban project as active healthy water-front development. Considering secondary healthy city indicators, change of external forces and internal capacity final task for healthy urban planning for Yangsan city were development of riverside physical education park and active living and anti-ageing environments etc. Conclusions: Comprehensive assessment and plan was possible through MAPP Model using European Healthy Urban Planning objectives to draw the direction of future urban planning for Healthy Cities Projects. Further research and formal introduction would be needed.

• Journal of Radiation Protection and Research
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• v.47 no.1
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• pp.1-7
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• 2022

Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.157-171
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• 1999

This paper analyzed health practices of students in an university in Chollabukdo Province. It attempted to study how many university students had what kinds of health practices. Furthermore, it tried to find out what are the major problems in health practice among university students. To study health practices of university students, this study sampled 1,469 students randomly. Many of the students had poor practices of teeth care. In tooth-brushing, many students (35.8%) brushed their teeth before breakfast in the morning. Most of the students (95% or more) visit dental clinic only when they had problem(s) in their teeth. For weights, there exists a great gap between perception and BMI (Body Mass Index), especially among female students. Among the female students who perceived their weights were above average, 96.4% of them were normal according to BMI. Many of the students were drinking greater amount of alcohol than safe amount suggested by the National Health and Medical Research Council of Australia. The proportion of the students drinking harmful or hazardous amount of alcohol were 79.5% of the male students and 74.9% of the female students. It suggests that health promotion fund or tax need to be levied on alcohol to frustrate unhealthful drinking. More than half (59.0%) of the male students and about 6.0% of the female students were smoking cigarettes. The smoking initiation ages were 17.8 for male and 18.2 for female students. It means that many of the students started smoking in their junior high or high schools. It implies that smoking prevention and smoking cessation programs need to be emphasized in these schools. For perception on sex, 27.8% of the male students and 60.9% of the female students thought to keep their virginity before their marriage. The female students were more conservative in perception on sex. The average number of sexual intercourses per year of male students was 17.0 times with their lovers, 7.9 times with prostitutes, and 7.0 times with maids. The female students had sexual intercourses 5.0 times with their lovers and 4.0 times with waiters per year. The proportion of students who had experience of sexual intercourse with homosexual partners was 1.0%. The finding this study was that the university students were vulnerable to poor health practices. It is suggested that public health intervention program be provided for university students to keep them in good healthy lifestyle.

• Health Policy and Management
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• v.27 no.4
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.146-157
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• 2009

Korean diet is high in plant foods but also high in salted vegetables. World Cancer Research Fund (WCRF) recommends consumption of fruits and vegetables excluding salted vegetables for prevention cancer. This study aimed to analyze relations between intakes of salted and non-salted vegetables and socioeconomic factors, providing a data for targeted groups in promotion of fruits and vegetables consumption. Dietary and socioeconomic status data of the 5,400 subjects over 30 years of age from the 2005 Korea National Health and Nutrition Examination Survey (KNHANESIII) were used. Dietary intake data from KNHANESIII was obtained by one day 24-hour recall method. Mean daily intakes of salted vegetables, non-salted vegetables and fruits of subjects were 151 g, 237 g, and 71 g respectively. Mean daily intake of salted vegetables was significantly higher in men than women for daily amount (173 g vs. 133 g) as well as percentage of total food intake (9.9% vs. 9.6%). Subjects living in rural area consumed more salted vegetables. Salted vegetables as percent of total food were lower in subjects with higher education levels (p < 0.001). Intakes of non-salted vegetables were significantly affected by age and gender. Intake levels of fruit were significantly higher in younger groups, in females, and subjects with higher income and education levels (p < 0.05). Average intake of fruits and non-salted vegetables was 307 g, lower than WCRF recommended level of 400 g for personal guideline. Intake of salted vegetables was positively correlated with sodium intake (Pearson's correlation coefficient, r = 0.43) but less so with potassium (r = 0.16) and other micronutrients intake (r < 0.1). On the other hand, non-salted vegetables had higher correlations with potassium (r = 0.45), carotene (r = 0.38), vitamin A (r = 0.37), iron (r = 0.34) and low for sodium (r = 0.13). Fruits intake was highly correlated with vitamin C intake (r = 0.46). Proportion of subjects satisfying WCRF personal guideline of fruits and non-salted vegetables was 25.7%. Results of this study indicate that intake of salted vegetable is considerably high among Koreans, and it is highly correlated with sodium intake and less so with other micronutrients.

• Health Policy and Management
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• v.29 no.1
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• pp.4-10
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• 2019

The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.

• Korean Journal of Health Education and Promotion
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• v.15 no.1
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• pp.79-95
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• 1998

The purpose of this study was to investigate the sanitation affairs of general restaurants. The questionnaire survey on the attitude and knowledge toward sanitation, the attitude for sanitary administration and the sanitary education was conducted against new 600 restaurateurs who were educated from June 20 to July 11, 1996, at the administration hall's division of Kyungsangbook-do in charge of food industry that offered regular sanitary education to new restaurateurs annually. And the visit survey on sanitary practice was also conducted over 93 restaurateurs who obtained the commercial license for food service business. The findings from the survey were as follows; In regard to food sanitation, some 87.1 to 88.3% got the right knowledge about the reason and precaution of food poisoning, food's frozen or cold-storage, and the disposal of products after expiration of validity term. But it was about 20.8% to 50.0% who knew right about major precaution, storage temperature in refrigerator, fermented milk product's storage temperature and validity term. There was therefore a necessity for education in food sanitation. 38.2% of the subjects placed an emphasis on sanitary storage of foodstuffs as the most important thing in sanitary management. 33.8% emphasized cooking sanitation. The environmental sanitation was counted as the most important thing by 19.2%, and personal sanitation of worker was counted by 8.8%. There was differences in what they thought the most important thing was, according to the respondent's educational level and cooker. 86.6% replied it necessary to improve the sanitary level. The respondents who were younger or had better educational level emphasized more the need for it. Concerning health examination, 90.2% replied it necessary. 81.4% answered the reason was because there was a potentiality Quests might be infected with contagious disease. 78.5% pointed the need for sanitary education, but respondents with higher educational level less emphasized its needs. As the reason for poor sanitation, restaurateur's poor awareness about it was most frequently pointed out, by 46.9%. Cooking sanitation was most frequently counted, by 38.5%, as the first thing to be improved. As the most critical point in sanitary education, 34.5% indicated food's sanitary Quality control 30.9% mentioned sanitary treatment of kitchen facilities and peripheral environment, and 27.1% emphasized the summary of the general food sanitation. 77.7% answered to correct immediately in case of violating the Food Hygiene Law, and 12.0% replied to correct in the same case if they would get the order from public official or administrative action would be taken. Respondents with higher educational level answered more to correct immediately. What they wanted the government office to do toward sanitary improvement was a fund aid an facilities and management which was pointed out by 38.9%, a periodical sanitary education by 26.3% and a on-the-spot guidance of sanitary officials by 22.3%. In view of the food service business's sanitary practice, the rate of wearing a sanitary clothes was 32.9% in city and 35.0% in county. The rate of hand-washing without soap or non-washing at cooking was 73.9%, 85%, respectively. The rate of personnel sanitation was 34.2% in city and 50.0% in county. These things indicated the sanitation was not well practiced. To improve the poor sanitary conditions of the food service businesses, it is recommended to offer institutional backing and financial aid from administrative office, and encourage restaurateurs to take pride in their job. and conduct the sanitary education effectively by sanitary education institution.

• Korean Journal of Health Education and Promotion
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• v.2 no.1
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• pp.3-50
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• 1984

The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.