Background: Despite its growing significance, studies on the burden of disease associated with natural disasters from the perspective of public health were few. This study aimed at estimating the national burden of disease associated with typhoons and torrential rains in Korea. Methods: During the period of 2002-2012, 11 typhoons and five torrential rains were selected. Mortality and morbidities were defined as accentual death, injury and injury-related infection, and mental health. Their incidences were estimated from National Health Insurance Service. Case-crossover design was used to define the disaster-related excess mortality and morbidity. Disability-adjusted life years (DALYs) were directly assessed from excess mortality and morbidity. Results: The burden of disease from typhoons increased with the intensity, with 107.7, 30.6, and 36.6 DALYs per 100,000 per event for strong, moderate, and weak typhoons, respectively. Burden of disease from torrential rains were 56.9, 52.8, and 26.4 DALYs per 100,000 per event for strong, moderate, and weak episodes, respectively. Mental disorders contributed more years lived with disability (YLDs) than did injuries in most cases, but the injury-induced YLDs associated with strong typhoon and torrential rain were higher than those of lower-intensity. The elderly was the most vulnerable to most types of disaster and storm intensities, and males younger than 65 years were more vulnerable to a strong torrential rain event. Conclusion: The intensity of torrential rain or typhoon was the strongest determinant of the burden of disease from natural disasters in Korea. Population vulnerable may vary depending on the nature and strength of the disasters.
Lim, Hyungryul;Lim, Ji-ae;Choi, Jong Hyuk;Kwon, Ho-jang;Ha, Mina;Kim, Heon;Park, Jung-duck
Toxicological Research
/
v.32
no.1
/
pp.57-64
/
2016
Recently several studies reported that the renal toxicity of lead (Pb) and cadmium (Cd) may exist in even a low level exposure. In terms of the deterioration of tubular function, it affects the loss of divalent metals and leads to other complications, so renal tubular effect of heavy metals should be well managed. Considering the exposure to heavy metals in reality, it is hard to find the case that human is exposed to only one heavy metal. We designed a cross-sectional study using Korean Research Project on the Integrated Exposure Assessment (KRIEFS) data to investigate the renal effects of multiple metal exposure in general population. We used blood Pb and urinary Cd as exposure measures, and urinary N-acetyl-${\beta}$-D-glucosaminidase (NAG) and ${\beta}_2$-microglobulin (${\beta}_2$-MG) as renal tubular impairment outcome. We conducted linear regression to identify the association between each heavy metal and urinary NAG and ${\beta}_2$-MG. And then, we conducted linear regression including the interaction term. Of 1953 adults in KRIEFS (2010~2011), the geometric mean of blood Pb and urinary Cd concentration was $2.21{\mu}g/dL$ (geometric $SD=1.49{\mu}g/dL$) and $1.08{\mu}g/g\;cr$ (geometric $SD=1.98{\mu}g/g\;cr$), respectively. In urinary Cd, the strength of the association was also high after adjusting (urinary NAG: ${\beta}=0.44$, p < 0.001; urinary ${\beta}_2$-MG: ${\beta}=0.13$, p = 0.002). Finally, we identified the positive interactions for the two renal biomarkers. The interaction effect of the two heavy metals of ${\beta}_2$-MG was greater than that of NAG. It is very important in public health perspective if the low level exposure to multiple heavy metals has an interaction effect on kidney. More epidemiological studies for the interaction and toxicological studies on the mechanism are needed.
There is general agreement that the Korean health care delivery system has two basic structural problems. One is the limited capacity and role of public hospitals, and the other is the absence of functional differentiation and referral arrangement between the clinics and hospitals of various technological sophistication levels. This study is intended to make an empirical observation of the system's growth process from the viewpoint of the population ecology model of organizations so as to understand the background of these problems and to find out ways of approaching them. As predicted from the population ecology model of organizations, all the types of medical care facilities have expanded in response to the environmental changes for the past three decades or so, and the differences in the extent and pattern of expansion among the types are related to what have taken place in the environment. These findings suggest that the efforts for reforming the health care delivery system should be directed not only to medical care institutions but also to the environmental context under which they function. It is believed that the usefulness of the population ecology perspective on organizations for studying the health care delivery system has been demonstrated. Thus further studies along this line based upon more strict design would improve systematic understanding of the system that is needed for developing policy approaches needed to increase its effectiveness.
This paper discusses a new perspective in health approach and the effect of health life on health status, and suggests some points to be improved in the establishment of health policies hereafter. Today's health problems changed from the acute epidemic diseases caused by simple factor to the multifactorial chronic diseases. Therefore, the health approach tries the holistic health approach, that is, the integrative approach by the interdisciplinary cooperation. With the advent of holistic health and holistic medicine in 1970's, the behavioral medicine was born in 1977, which is the interdisciplinary field concerned with the development and integration of behavioral and biomedical science knowledge and techniques relevent to prevention, diagnosis and treatment. As a means to the reducement of the unnecessary medical utilization and medical expense, the medical self care and self-help movement is well under way in the countries of America, England, and Canada, in which lay persons are encouraged to actively function for themselves to prevent, detect and treat common illnesses and to promote positive health habits through the health activation programs such as The Course for Activated Patients and The Health Activated Person. This study shows that the individual health life gives great positive effect to his health status with the reducement of medical expense. These above facts suggest that the preventive health programs such as health education should be developed and strengthened instead of medical care-oriented health policy.
Objective: The purpose of this study is to draw the accident prevention model using the signal detection theory, and to implement accident prevention program, based on a health promotion and support activities in a shipbuilding company. Background: Workers' health management is perceived important from the human resource management perspective, as well as from the personal perspective. Method: This study developed an accident prevention model by analyzing the correlation between 704 workers' health examination variables, and reviewed the verification of the model through a follow-up survey on the control variables and status of hazards targeting 650 workers for four years from 2007 to 2010. Also, a health promotion program was implemented targeting a production division to improve alcohol habits, smoking, musculoskeletal pain complaints and hearing control indices, which are the control variables of the model. Results: As a result of four years' implementation, the following effects were obtained: the days away from work fell 87.5%, and accident rate dropped 71.5% in 2010, respectively, compared to 2006, before the activity was implemented. Conclusion: This study shows that the accident prevention activities based on workers' health promotion activities are effective to prevent industrial accidents and injuries. Application: The research findings will serve as a practical guideline for establishing preventive measures in the shipbuilding company.
2010 is the year when the Korean baby boomer generation faces retirement. With the need for affective strategies to keep this population healthy, the government has placed much effort to increase the regular physical activity (PA) level of older adults. Yet the prevalence of active seniors is still relatively low. This paper reviews the recent government strategies and efforts to enhance the physical activity levels of older adults and the PA programs provided in the community settings by major organizations and institutions. In addition, the problems of the current approaches are shown, and based on a review, the author provides five suggestions for promoting the PA level of older adults as follows. First, specific physical activity goals and objectives for older adults should be included in the National Health Plan 2020. Second, the recommendations for PA for seniors, which include a proper intensity, duration and frequency of exercise, should be provided. Third, the role of organizations and institutions should be rearranged for the proper dissemination of government provided community-based exercise programs. Fourth, a standard quality-control system should be provided, and finally, an evidence-based exercise program, which should be specifically created for the older Korean population, should be developed. Physical activity offers opportunities for people to extend the years of their active independent life and reduce functional limitations. To maximize the effects of government efforts to promote PA for seniors, we feel the comments provided in this paper should be closely examined.
Objectives: The purpose of this study was to investigate the factors of importance in the medical field from the perspective of the consumer, using "Consumption Life Indicators in Korea." Methods: We examined the general characteristics, economic conditions, information acquisition, complaint-provoking experiences, cognitive score on dispute resolution, and factors affecting medical domain importance selection, using SAS 9.4. software. Results: It was found that "age" among general characteristics and "income" among economic conditions were important factors in selecting medical domain importance. Thus, it was possible to reaffirm the poor health of socioeconomically vulnerable people and their socioeconomic difficulties. Conclusions: The medical domain selection group needs the attention of the government, medical institutions, academia, consumer groups, community service groups and professional organizations, and needs substantial economic support and customized education.
Objectives: This study aimed to explore the health inequality discourse in the Korean press by analyzing newspaper articles using a relatively new content analysis technique. Methods: This study used the search term "health inequality" to collect articles containing that term that were published between 2000 and 2018. The collected articles went through pre-processing and topic modeling, and the contents and temporal trends of the extracted topics were analyzed. Results: A total of 1038 articles were identified, and 5 topics were extracted. As the number of studies on health inequality has increased over the past 2 decades, so too has the number of news articles regarding health inequality. The extracted topics were public health policies, social inequalities in health, inequality as a social problem, healthcare policies, and regional health gaps. The total number of occurrences of each topic increased every year, and the trend observed for each theme was influenced by events related to its contents, such as elections. Finally, the frequency of appearance of each topic differed depending on the type of news source. Conclusions: The results of this study can be used as preliminary data for future attempts to address health inequality in Korea. To make addressing health inequality part of the public agenda, the media's perspective and discourse regarding health inequality should be monitored to facilitate further strategic action.
Cancer management has become a major policy goal for the government of the Korea. As such, the government introduced the National Cancer Control Plan (NCCP) to reduce the individual and social burdens caused by cancer and to promote national health. During the past 25 years, 3 phases of the NCCP have been completed. During this time, the NCCP has changed significantly in all aspects of cancer control from prevention to survival. The targets for cancer control are increasing, and although some blind spots remain, new demands are emerging. The government initiated the fourth NCCP in March 2021, with the vision of "A Healthy Country with No Concerns about Cancer Anywhere at Any Time," which aims to build and disseminate high-quality cancer data, reduce preventable cancer cases, and reduce gaps in cancer control. Its main strategies include (1) activation of cancer big data, (2) advancement of cancer prevention and screening, (3) improvement in cancer treatment and response, and (4) establishment of a foundation for balanced cancer control. The fourth NCCP has many positive expectations, similar to the last 3 plans; however, cross-domain support and participation are required to achieve positive results in cancer control. Notably, cancer remains the leading cause of death despite decades of management efforts and should continue to be managed carefully from a national perspective.
Objectives: Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. Methods: For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. Results: A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. Conclusions: Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.
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