• 한국경제지리학회지
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• 제26권3호
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• pp.289-309
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• 2023

우리나라의 국민건강보험은 빠른 시간에 보편적 의료시스템을 정착시키는데 큰 기여를 했다. 하지만 연령대에 따른 의료서비스의 차이는 지속되고 있으며, 내과, 가정의학과, 소아청소년과와 같은 핵심의료 서비스에서 이러한 불평등이 존재하는 것은 큰 우려를 불러일으킬 수 밖에 없다. 진료기관 접근에 대한 불평등은 연령대만이 아니라 지역, 특히 도시와 농촌 사이에도 크게 나타나고 있다. 본 연구는 1995년부터 2021년까지 초기진료기관의 분포를 이용하여 변화하는 경제환경 속에서 의료서비스의 공간적 불평등이 어떻게 변화되어 왔는지를 살핀다. 다양한 불평등 지수와 공간통계분석의 결과를 토대로 볼 때, 1997년 IMF 경제위기, 2008년 금융위기, 그리고 2020년의 COVID-19 공중보건 위기를 겪으며 불평등이 심화 확대된 것을 확인할 수 있었다. 또한 초기의료기관의 불균등 분포에 큰 변화가 온 시기도 밝혀낼 수 있었는데, 이러한 변화에는 유소년이나 전체 인구 분포보다는 고령인구의 분포가 큰 역할을 하고 있었다. 본 연구결과는 인구와 의료서비스의 공간적 분포를 통합적으로 고려하여 핵심적인 의료자원의 불평등을 해소하기 위한 노력이 절실히 필요하다는 것을 강조한다. 특히 이러한 노력은 미래의 경제적 충격에도 적절한 수준의 의료 서비스를 지속할 수 있는 기반이 될 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• 유통과학연구
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• 제16권7호
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• pp.47-56
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• 2018

Purpose - This study aims to not only investigate spatial pattern of immigrants' residence and crime occurrences in South Korea, but shed light on how geographic distribution of immigrants and immigrant segregation affect crime rates. Research design, data, and methodology - Th unit of analysis is Si-Gun-Gu municipal level entities of South Korea. The crime data was obtained by Korea National Police Agency and two major types(violence and property) of crime were measured. Most demographic, social, and economic variables were derived from Korean Census Data in 2015. In order to examine spatial patterns of immigrants' distribution and crime rates in South Korea, the present study utilized GIS mapping technique and Exploratory Spatial Data Analysis(ESDA) tools. The causal linkage was investigated by a series of regression models using STATA. Results - Spatial inequality between urban metropolitan vs rural areas was visualized by mapping. Assuming large Moran's I value, spatial autocorrelation appeared to be quite strong. Several neighborhood characteristics such as residential stability and economic prosperity were found to be important factors leading to crime rate change. Residential distribution and segregation for immigrants were negatively significant in the regression models. Conclusions - Unlike the traditional arguments of social disorganization theory, immigrant segregation appeared to reduce violent crime rate and the high proportion of immigrants also turned out to be a crime prevention factor.

• 대한공간정보학회지
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• 제10권5호
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• pp.29-43
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• 2002

Accesses to lands, houses, the Internet and other utilities are regarded as basic human needs to escape poverty and are required to recognize the relationships between the digital divide and socio-economical inequality. The digital divide might not be a single technical disparity, but stems from a complicated mixture of economic and socio-technical symptoms of inequality. There is growing awareness of scrutinizing causal mechanisms between the digital divide and poverty since combating poverty could be a primary step to mitigate the digital divide. In this paper, the Hexad model is proposed to explicate poverty interpretation by using 6 parameters as a major tool for partly assisting in poverty monitoring system in connection with land information. A solution model of the Internet is suggested to break the digital divide. It expounds a conceptual framework and new idea for poverty management to notify spatio-temporal locations of poor actors and geography of the digital divide when efforts of poverty eradication hinge on understandings of geographic location of digital disadvantaged groups through parcel-based land information.

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.33-40
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• 2018

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.

• 한국경제지리학회지
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• 제26권4호
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• pp.359-374
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• 2023

본 연구의 목적은 마오쩌둥 이후 중국 지역 발전 정책의 진화와 공간 불균등과의 관계를 분석하고자 하는 것이다. 이를 위해 본 논문은 1인당 GRDP 변동계수와 지니계수를 적용하여 중국 31개 시·성·자치구 간 지역 경제력 격차와 지역 발전 정책과의 관계를 분석하였다. 중국의 지역 간 경제력 격차는 1979년 이후 심화되었다가 제10차 5개년 계획(2001~2005년) 이후 중부, 서부, 동북부 지역의 지속적인 정부 주도의 대규모 경제성장 정책에 따라 완화되는 것으로 분석되었다. 그러나 이는 31개 시·성·자치구 전체를 대상으로 분석한 결과이며, 동부, 중부, 서부, 동북부 4대 지역을 대상으로 GDP 변동계수를 각각 분석했을 때 상이한 결과가 나타났다. 예를 들어, 제10차 5개년 계획 이후 중부 지역 내 격차는 지속적으로 심화되었지만 서부와 동북부의 지역 내 경제력 격차는 지속적으로 완화되었다. 이는 중국의 지역 간 경제력 격차를 완화시키는데 큰 역할을 한 것으로 분석되었다. 특히 동부 지역 내 격차는 제12차 5개년 규획(2010~2015년) 이후에도 지속적으로 심화되어 중국 지역 경제력의 수렴 현상이 둔화되는 결과를 가져왔다. 이는 제11차 5개년 규획(2006~2010년) 시기에 본격적으로 시행되었던 중부 권역 발전 정책의 한계에 기인한 것으로 볼 수 있다.

• 한국지리정보학회지
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• 제24권2호
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• pp.64-77
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• 2021

본 연구의 목적은 고학력 인적 자본 집단의 공간적 분포를 살펴보고 공간적 분포에 미치는 영향요인을 파악하는 것이다. 본 연구는 지니계수와 탐색적 공간자료분석을 통해 불균형과 공간적 집중정도를 살펴보았으며 공간회귀모형을 통해 고학력 인적 자본 집단의 분포에 미치는 경제적 요인과 어메너티 요인의 영향 정도를 확인하였다. 분석결과, 석·박사 집단 고학력 인적 자본은 불균등하게 분포하고 있으며 수도권을 중심으로 충남 및 강원 일부지역에서 군집을 형성하고 있는 것으로 나타났다. 석·박사 집단 고학력 인적 자본의 분포에 영향을 미치는 영향요인은 경제적 요인이 강하게 작용하고 있었다. 어메너티 요인은 석·박사 집단 고학력 인적 자본의 분포의 영향요인으로서 큰 역할을 하지 못하는 것으로 나타났다. 본 연구의 결과는 인적 자본을 유입하고자 하는 지역경제개발 정책에 있어 시사점이 있다.

• 한국경제지리학회지
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• 제17권2호
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• pp.385-401
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• 2014

본 연구는 3개년 2,065,177건의 수능 결과 전수 자료를 이용하여 학교별, 구별 단위의 과목별 평균, 1등급비율, 표준편차 등의 교육 성과의 공간적 시간적 특성을 연구하였다. 데이터베이스관리시스템(DataBase Management System)과 지리정보시스템을 활용하였다. 서울시 25개 구의 인문계 고등학교를 대상으로 1999년 11월 17일에 시행된 2000학년도 대학수학능력시험 원자료 868,029건과 2004년 11월 17일에 시행된 2005학년도 대학수학능력시험 원자료 609,258건 그리고, 2008년 11월 13일에 시행된 2009학년도 대학수학능력시험 원자료 587,890건을 바탕으로 시간적 교육 성과와 교육 격차의 공간적 특성을 알아보았다. 분석 결과 서울시내 구(區) 간 교육성과의 격차가 매우 상당하며, 시간이 흐름에 따라 그 격차의 폭이 매우 크게 증가하였다. 해당 기간 동안 서울 교육성과가 전국 평균대비 향상되고 있음에도 구(區) 간 격차가 증가하는 것은 교육의 공간적 불평등이 시간이 흐름에 따라 심화되고 있는 것을 의미한다. 특이한 점은 구(區) 간 교육격차의 차이가 큼에도 불구하고, 구(區) 내 교육격차의 차이(구 내 일반계 고등학교의 성적 표준편차의 범위)는 거의 없고, 시간이 흐름에도 일정하게 유지되고 있다는 점이다.

• 농촌지도와개발
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• 제22권2호
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• pp.159-173
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• 2015

The purpose of this study was to identify the conditions of neighborhood facilities for the elderly, paying special attention to the accelerated aging phenomenon in rural areas of Korea. We contrived a new index to measure spatial accessibility for people aged over 65 years, and we analyzed spatial accessibility by focusing on community facilities: public bath facilities, beauty shops, rural public facilities, markets, big stores, and large-scale retail shops. The most outstanding spatial accessibility among community facilities was found with the rural public facilities thanks to governmental installing adequate facilities in the past, followed by the beauty shops and the public bath facilities. In contrast, spatial accessibility of the markets was in the lowest. Spatial accessibility of community facilities for the elderly exhibited high variability among the rural areas. We confirmed significant inequality of spatial accessibility in all facilities we studied. The areas that had better spatial accessibility diverse combinations of the facilities. The areas that had worse spatial accessibility were, on the whole, consistent with traditional undeveloped regions. In the near future rational planning of facilities will be needed to supply adequate accessibility in targeted areas which currently had low accessibility. In order to improve the spatial accessibility of neighborhood facilities, the most essential factor is to take into account the geographical distribution patterns of rural settlements.

• 보건행정학회지
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• 제28권3호
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• pp.240-250
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• 2018

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying "the balanced development of the state" or "ensuring the balanced development of all regions." In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the "Special Committee on Regional Balanced Development" with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.