• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

• Korea journal of population studies
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• v.11 no.2
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• pp.54-66
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• 1988

I. Introduction Since the 1970's drug abuse among young people has increasingly become a social problem in Korea. In the 1980's, drug abuse, especially glue sniffing, has become the cause of many unfortunated incidents resulting in harm to others as well as the abusers themselves. Taking into consideration of the seriousness of this problem, the Republic of Korea National Red Cross initiated a nation-wide research programme, to understand the present situation and to raise the level of public awareness. The goal of this research was to begin a nation - wide campaign against drug abuse. The research team was composed of the Advisary Committee members and the staff of the Youth Department of the Republic of Korea National Red Cross. The data were collected in February 1988 with the collaboration of the staff and volunteers in the local Chapters. The respondents were allocated nation-wide by the quota sampling method. The questionnaires were distributed to the respondents in three groups :2, 700 to junior and senior high school students, 605 to working youths, and 916 to delinquent youths. A total of 4, 221 questionnaires were collected. II. Characteristics of the Respondents The respondents in each group were selected evenly from rural and urban areas. The general characteristics of the respondents can be described as follow: in case of students, the proportions between male and female respondents, and between senior high school and junior high school students were almost evenly distributed. In case of working youths, the proportion of females (80.5%) was higher than those of the students and the delinquents groups. Delinquent youths were defined as those currently being under custody of the centers for juvenile delinquents. Of this number, 38.8% and 68.2% were junior and senior high school drop-outs respectively. The majority of them (92.6%) were male. As for the family background of the respondents, the proportion of those residing in poverty - stricken areas, and the proportion of those from broken families were higher in case of working youths and delinquent youths than those in case of students. III. Present Patterns of Drug Abuse The following summarizes the presents of drug abuse, as tabulated from the results of the survey. 1. Smoking The percentage of youths who smoke was 36% in the student group, 32% m the working youths group, and 94.4% in the delinquent youths group. 2. Alcohol 50.3% of students, 71.6% of working youths, and 93.3% of delinquent youths has experienced drinking alcohol beverages. 3. Tonic: non - alcoholic, caffeinated beverages popular in Korea and Japan The percentage of those who have used tonic at least once was over 90% in all of the three groups. 4. Sedative About 70% of each group has used sedative with the proportion of working youths use higher than those in other groups. 5. Stimulants Those who have used stimulants comprised around 15% in each group. 6. Tranquilizers Somewhat less than 5% of students and working youths, and 28% of delinquent youths, have used tranquilizers. 7. Hypnotics The users of hypnotics amounted to 0.4% of students, 2.6% of working youths and 7.1% of delinquent youths. 8. Marihuana Those who have used marihuana indicated 0.7% of students, 0.8% of working youths, and 13% of delinquent youths. 9. Glue-sniffing The percentage of glue-sniffing was 3.7%, 5% in the students group and in the youths group respectively, but the proportion was unusually high, at 40.7% in the delinquent youths group. From the results of the survey the present situation of drug abuse in Korea can be summarized as follows: 1. A high percentage of Korean youths have experienced smoking cigarettes and drinking alcoholic beverages. 2. Tonics (non - alcoholic, caffeinated beverages), antipyretic analgesics and stimulants quite regularly used. 3. Tranquilizers, hypnotics, marihuana and glue-sniffing are more widely used among delinquent youths than the other youths. From this fact, there exists a correlation between drug abuse and juvenile delinquency. IV. Time-series Analysis of the First Experience of Drug Abuse and Deviant Behaviour The respoundents were asked when they were first exposed to drugs and when they committed deviant acts. By calculating the average age of each experience, the following pattern was found (See Figure 1). Youths are first exposed to drugs by abuse of tonic(non - alcoholic, caffeinated beverages). At the age of 13, they amoke cigarettes, the use of antipyretic analgesics begins at 14 year old, while at the age of 15, they use tranquilizers, and at 16 hynotics. The period of drug abuse which starts from drinking caffeinated beverages and smoking cigarettes and ends in the use of hypnotics takes about three years. During this period, other delinquent behaviours begin to surface, that is, at the age of 13 when smoking cigarettes begins, the delinquent behaviour pattern starts with truancy. Next, they start taking money from others by using physical force. Prior to the age of 15, they are suspended from school, become hostile to adults, begin running away from home, and start using stimulants and alcohol. Soon they become involved even in glue-sniffing and in the use of marihuana. At the age of 15, they begin to see adult videos and carry weapons. Sexual promiscuity and usage of tranquilizers follows the viewing of adult videos. Consequently, by the time they reach the age of 16, they visit drinking establishments, and are picked up by police for committing delinquent acts. And finally, they come to use hypnotic - type drugs. From the above descriptions, drug abuse can be assumed to have a close correlation with delinquent behaviour. V. Social Factors Related to Drug Abuse As for the Korean youths, glue-sniffing is found to he related to aggressive delinquency, in such cases as run - aways, being picked up by the police, and taking money by force. Smoking cigarettes and drinking alcohol is found to be related to seeing adult videos and visiting drinking establishments. Hypnotics and marihuana were found to be representive of drugs which are related to degenerational delinquency, irrespective of social delinquency. The social factors connected with these drug abuse are as follows: 1. Individual factors Male students were more heavily involved in the usage of drug than females. Youths who do not attend church were more likely to be involved in drugs than those who attend. 2. Family factors The youths who were displeased with their mothers smoking and those who thought their parents did not love each other, or those whose parents had used drugs without prescription, were more likely to he drug users. 3. School factors Those youths who found school life boring, were unsuccessful in their studies, spend most of their time with friends, feel their teachers smoke too much, those who had a positive perception of their teachers smoking were likely to he drug users. To sum up, drug abusers depend on the influence of their parents, teachers and peers. IV. Reasons for Drug Abuse Korean students have mainly used drugs to release stress (42.8%), to stay awake (19.7%), and because of the easy accessibility of drugs( 16.6%). Other reasons are due to their ignorance of the side effects of the drugs (3.6%), natural curiosity (4.2%), and to increase strength(3.O%). From the above facts, the major reasons for drug abuse among Korean youths are to release stress and to stay awake in order to prepare exams. Furthermore, since drugs are readily available, we can conclude that drug abuse is caused by the school system(such as entrance exams) in Korea. VII. Conclusion Drug usage among Korean youths are relatively less common than those of western youths. In some cases, such as, glue-sniffing and use of stimulants, the pattern of drug abuse is found. Moreover, early drug abuse is evident, and it has a close connection with deviant behaviour, resulting in juvenile delinquency. Drug abuse cannot be attributed to any one social factor. Specifically, drug abuse depends on parents, peers, teachers and other members of the community, and also is influenced by social institutions such as the entrance exam system. Every person and organization concerned with youth must participate collectively in restraining drug abuse. Finally, it is suggested that social agencial working for youth welfare should make every effort to tackle this serious problem confronted by the Korean youths today.