• Journal of Nutrition and Health
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• v.52 no.5
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• pp.449-464
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• 2019

Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

• Journal of Nutrition and Health
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• v.56 no.5
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• pp.496-509
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• 2023

Purpose: This study aimed to identify the general characteristics, chronic diseases, health behavior, mental health, and nutritional status of young-old women based on their vitality. Methods: This study used data from the 2019 and 2021 Korea National Health and Nutrition Examination Survey (KNHANES). The subjects were 1,113 young-old women aged 65 to 74 years old. The health-related quality of life concept with an 8-item questionnaire was used to measure the quality of life. Subjects were categorized into 4 groups (always, often, sometimes, never) based on their vitality. General characteristics, chronic diseases, health behavior, dietary behavior, food intake, and nutrient intake were compared among the groups. Results: Age, education level, household income, employment, fruit intake, dietary supplements, abundance of food, and nutrition labeling recognition were associated with the vitality of the subjects. Young-old women with arthritis, diabetes, and osteoporosis displayed lower vitality. Moreover, subjective health status, exercise, activity restrictions, and average daily sitting hours were related to vitality, while no significant difference was found in vitality between smoking and drinking. In terms of mental health factors, higher vitality was associated with 6-8 hours of sleep, lower stress levels, and reduced depression. The high-vitality group exhibited a higher intake of potatoes, starch, mushrooms, fruits, meat, milk, animal oils, and beverages than the low-vitality group. Additionally, the group with higher levels of vitality showed a higher intake of protein, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, n-6 fatty acids, dietary fiber, sugars, phosphorous, potassium, magnesium, iron, zinc, and riboflavin. Conclusion: This study suggests that the vitality of young-old women is related to socioeconomic factors, health behavior, mental health, and food intake. To maintain a vibrant lifestyle in elderly women, it is necessary to have social and economic stability, prevent arthritis, diabetes, and osteoporosis, exercise regularly, get sufficient sleep, maintain mental health, and have a balanced diet.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.412-420
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• 2000

Background : There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. Method : We studied 68 cases with drug-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. Results : Patients with primary drug-resistant tuberculosis(PDR) were younger (39.6$\pm$16.3 years vs. 48.2$\pm$16.5 years ; p<0.05), had more population of less than more were under the age of 40 years aged -group(62.9% vs. 36.4% ; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1% ; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0$\pm$0.8 vs. 1.4$\pm$0.7 ; p<0.01) and longer treatment duration than those with PDR(18.3$\pm$7.2 months vs. 10.6$\pm$6.3 months ; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly- and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4% ; p<0.05). Conclusions : Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.139-167
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• 2009

A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

• Journal of the Korean Institute of Landscape Architecture
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• v.47 no.5
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• pp.78-90
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• 2019

The purpose of this study is to explore the direction of developing policies for parks and green spaces for inclusive urban planning and regeneration. By reviewing the status, budget, and laws pertaining to urban parks in Korea, as well as assessing the inclusivity of urban parks, this study revealed the problems and limitations in Korea as follows. First, the urban park system, which takes into account indicators such as park area per capita and green space ratio, is focused only on quantitative expansion. Second, the distribution of urban parks is unequal; hence, the higher the number of vulnerable residents, the lower the quality of urban parks and green spaces. Moreover, this study focused on the UK central government, along with the five local governments, including London, Edinburgh, Cardiff, Belfast, and Liverpool. Through an analysis of the contexts and contents establishing UK park and green space policies that can reduce socioeconomic inequalities while at the same time increase inclusiveness. This study discovered the following. The government's awareness of the necessity of tackling socioeconomic inequalities to make an inclusive society, the change in the urban regeneration policies from physical redevelopment to neighborhood renewal, and the survey and research on the correlation of parks and green spaces, inequality, health, and well-being provided the background for policy establishment. As a result, the creation of an inclusive society has been reflected in the stated goals of the UK's national plan and the strategies for park and green space supply and qualitative improvement. Deprived areas and vulnerable groups have been included in many local governments' park and green space policies. Also, tools for analyzing deficiencies in parks and methods for examining the qualitative evaluation of parks were developed. Besides, for the sustainability of each project, various funding programs have been set up, such as raising funds and fund-matching schemes. Different ways of supporting partnerships have been arranged, such as the establishment of collaborative bodies for government organizations, allowing for the participation of private organizations. The study results suggested five policy schemes, including conducting research on inequality and inclusiveness for parks and green spaces, developing strategies for improving the quality of park services, identifying tools for analyzing policy areas, developing park project models for urban regeneration, and building partnerships and establishing support systems.

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.260-273
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• 2010

Objectives: The purpose of this study was to investigate the perceptions of married Korean women regarding marriage and childbirth, and their awareness of childbirth-related issues such as low birth rates, sex preferences and sex imbalances in Korea. Methods: A total of 453 married women aged 20 or older were randomly selected from four urban districts and five rural districts out of 25 districts in Gyeongju, a consolidated city located in Gyeongsangbuk-do Province, South Korea. The survey was conducted from December 2005 to February 2006. A total of 392 out of 453 questionnaires(86.5% response rate) were collected, and 44 incomplete questionnaires were excluded, leaving 348 completed questionnaires to be used for data analysis. Age was divided into three groups as below 49, 50-69, 70 or older. Results: Women's perceptions of marriage were associated with age(p<0.01). Perceptions about childbirth were also significantly related to age(p<0.01), type of residential area (p<0.01) and education level(p<0.05). Sex preferences were significantly related to age(p<0.05) and occupation(p<0.01). Of the respondents aged 49 or younger, 34.8% indicated that the ideal number of children is two, while 25.5% of respondents aged 50 to 69 and 15.3% of respondents aged 70 and 33.7% of respondents aged 70 or older considered four children to be the ideal number. Perceptions of sex imbalance were significantly related to socioeconomic status(p<0.01) and occupation(p<0.01). The largest number of respondents cited "economic burden" as the main reason for low birth rates. Multiple logistic regressions were performed for all three age groups using male sex preference as the dependent variable under the assumption that respondents can have only a single child. Socioeconomic status (p<0.01) and residential area (p<0.05) were significant variables for those aged 49 or below. Education level(p<0.05) and residential area (p<0.01) were statistically significant variables on preferring son in case of having only one child for respondents aged 50 to 69. We did not detect any significant independent variables in respondents who were 70 or older. Conclusions: Our results highlight the necessity of developing policies and public education programs to explain the consequences of low birth rates and sex imbalances in Korea. As increasing numbers of women work outside the home, it is important for the government and employers to provide social and working environments where women do not consider marriage and childbirth to be obstacles to social and business activities.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.323-334
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• 1998

To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

• Health Policy and Management
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• v.34 no.2
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• pp.185-195
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• 2024

Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

• Korean journal of communication and information
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• v.41
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• pp.41-74
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• 2008

Based on the theory of news media's agenda-setting function, this study analyzed Korean public's most important problems (MIP) and the degree of public consensus on the importance of those MIP's. The analysis was done in terms of both time and social strata. According to the findings, economy, social welfare, and political issues were in the for tier of the MIP list. The analysis of issue diversity (H-statistic) also demonstrated a relatively high degree of agenda consensus among Korean public despite some fluctuation in the consensus level, which appears to be higher than that among the American public. A decrease in the degree of agenda consensus with the passage of time appealed to be a general phenomenon across diverse social strata. However, the degrees of consensus-building were different in light of education, socioeconomic status, and the size of residential area. Those who are more educated, have more economic power, and live in a larger city had more chances to experience agenda consensus. These results seem to be basically attributable to the presumed positive relationship between these demographic variables and media exposure. The different degrees of public consensus according to the different levels of those demographic variables suggest that a closer investigation into the various influences on the importance of public issues among the respondents should be done in future studies.

• Health Policy and Management
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• v.19 no.2
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• pp.71-84
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• 2009

Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.