Objectives : Despite various government initiatives, including the expansion of national health insurance coverage, health inequality has been a key health policy issue in South Korea during the past decade. This study describes and compares the extent of the total health inequality and the income-related health inequality over time among Korean adults. Methods : This study employs the 1998, 2001 and 2005 Korean National Health and Nutrition Examination Surveys (KNHANESs). The self-assessed health (SAH) ordinal responses, measured on a five-point scale, resealed to cardinal values to measure the health inequalities with using interval regression. The boundaries of each threshold for the interval regression analysis were obtained from the empirical distribution of the EuroQol-5 Dimension (EQ-5D) valuation weights estimated from the 2005 KNHANES. The final model predicting the individuals' health status included age, gender, educational attainment, occupation, income, and the regional prosperity index. The concentration index was used to measure and analyze the health inequality. Results : The KNHANES data showed an unequal distribution of the total health inequality in favor of the higher income groups, and this is getting worse over time (0.0327 in 1998, 0.0393 in 2001 and 0.0924 in 2005). The income-related health inequality in 2005 was 0.0278, indicating that 30.1% of the total health inequality can be attributed to income. Conclusions : The findings indicate there are health inequalities across the sociodemographic and income groups despite the recent government's efforts. Further research is warranted to investigate what potential policy actions are necessary to decrease the health inequality in Korea.
Purpose: The purpose of this study was to develop a comprehensive health promotion program for North Korean young adult defectors in South Korea. Methods: The comprehensive health promotion program consisted of nutrition, mental healthcare, physical activity and sexual behavior was developed on the basis of need assessment results. For the evaluation of the program, 70 North Korean young adults who were attending two alternative schools for North Korean defectors were recruited. The program had taken place once a week for 13 or 19 weeks. Effectiveness of the health promotion program was evaluated using anthropometric measurement, 3-day food records and a questionnaires that comprised the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36) and health behaviors. The surveys were proceeded at the beginning and after the program. Results: After health promotion program, participants' height was significantly increased (p=0.004) and body fat mass (0=0.004) and percentage of body fat mass (p=0.003) were significantly decreased. The number of subjects who ate breakfast alone was decreased whereas the number of subjects who ate breakfast with friends was increased (p<0.001). There were no significant changes in dietary intakes, mental health status and quality of life. North Korean young adult defectors' willingness to participate and interests in the health promotion program were high, however the practice rate was low. Conclusion: The health promotion program could induce interests and willingness to participate, but bring about limited effects on the health behaviors. These results imply that a health promotion program for North Korean young adult defectors should have a long-term strategy as well as short-term plan. Furthermore, it should be based on their health problems, health related behaviors, academic performance and daily life matters.
Purpose: Maintaining a lifelong health is very important. The purpose of this study is to know the perception of youth about health teacher's servant leadership, student's self-efficacy, and health promoting behavior, and the relationship among the variables. Methods: This study used surveys of health teacher's servant leadership, student's self-efficacy, and health promotion behaviors. The subjects were 1,286 elementary, middle and high school students. PASW Statistics 18.0 was used in the data analysis. Percentage, mean and standard deviation, t-test, and ANOVA test were used to compare the difference of the health teacher's servant leadership, student's self-efficacy, and health promotion behavior according to the background variables of the subject. Results: There was a statistically significant difference in the perception of youth about health teacher's servant leadership, student's self-efficacy, and health promotion behaviors according to school level, establishment type, and grade. There was also a statistically significant difference in the perception of youth about student's self-efficacy and health promotion behaviors between male and female student. In addition, student's self-efficacy serves as a positive mediator to the effects of health teacher's servant leadership on student's health promoting behavior. Conclusion: Based on these results, it needs to implement the human resources and policy support for the systematic health education of elementary, middle, and high schools, the development of the program for the teacher's servant leadership, and the health promotion of students in curriculum.
The Journal of Korean Academic Society of Nursing Education
/
v.7
no.2
/
pp.229-244
/
2001
The purposes of this study are to do surveys of the state of health and dental health behaviors of higher grade students in elementary school and their mothers, to investigate the relationship of students' dental health, and to apply those results to the systematic and efficient dental health care. The subjects were totally 618 people, including 309 elementary school students in 4th, 5th, or 6th grades and their mothers in Pusan. The questionnaires were used as instruments, which were made by the researcher and related with other preceeding studies. The content validity of the instruments was tested by two professors of nursing. Dental checking were conducted by an expert of dental sanitation, according to the standard of the World Health Organization. The period of collecting data was 20 months from October 20th to December 20th in 2000 and the collected data were analyzed by SAS program and classified as the real number, the percentage, the mean, the standard deviation, t-test, and F-test. In conclusion, there is no significant correlation between grades and treated or treatment-needed permanent teeth. There is the highest significant correlation between treated or treatment-needed permanent teeth and students' dental health behaviors. There is high significant correlation between mothers' dental health behaviors and students' dental health behaviors. Also, There is significant correlation between mothers' state of dental health and students' state of dental health. From the results of this study, the students' dental health behaviors are the most important variables in the students' state of dental health. But both boys(9.48) and girls(9.97) get the low marks on the total mark 15 about brushing, which can be self-controlled. Therefore, the developments of dental health guidance in education about dental health by mothers or the educational courses in schools, such as brushing educations by the experts, dental health education, brushing after lunch, or the various equipments in brushing, should be accomplished. Above all, behavior-centered education should be conducted instead of knowledge-centered education.
Community Health Planning has been used in public health centers for over 10 years, but little is known about its effect and how it is utilized by public health centers. This paper examines the effect of Community Health Planning on public health centers'organizational performance through the use of the Structural Equation Modeling(SEM) technique. We conducted e-mail surveys of chiefs, people in charge of planning and other staff members in all the public health centers in the country. The instrument measured self-evaluated levels of Community Health Planning, implementation and the effect on the public health centers. The model of the SEM technique has five latent constructs: requirements of planning, plan formulation, implementation, organizational capacity and performance. The SEM technique validated the instrument used in the study and exhibited a relatively good fit. Results of this study were as follows. First, the requirements of planning have positive effects on plan formulation. Second, plan formulation has positive effects on organizational capacity but plan implementation doesn't. Third, there was no statistically significant path between plan formulation, implementation and performance. Fourth, organizational capacity has positive effects on performance. Consequently, this study revealed that Community Health Planning has a positive influence on organizational performance through organizational capacity.
Journal of the Korean Operations Research and Management Science Society
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v.13
no.2
/
pp.72-77
/
1988
Subjective scoring by different groups on different status of morbidity are compared to objective data obtained from legal awards. A power law is tested between subjective and objective scores. Regression analysis by means of a power function provides a measure of consistency in its regression coefficient. Power functions fitting also leads to a justified use of geometric averaging of individual scores into group scores.
The study is investigated socioeconomic variations in perceived oral health status and contribution of oral health behavioral factors. A nationally representative sample (365 health and 1,787 unhealth aged 20 over years) from the 2015 Korea National Health and Nutrition Surveys was analyzed using logistic regression. Perceived oral health was lower among lower socioeconomic groups compared with higher socioeconomic groups. This association was increased when demo-socioeconomic factors and oral health behavioral were adjusted. When each oral health behavioral factor was considered separately, mediators such as smoking, frequency of tooth brushing and used oral care products or oral health examination explained a large part of the increased socioeconomic oral health status. Subjective bad oral health arise from different socioeconomic status, but this difference is increased by oral health behavioral factors. Therefore, socioeconomic inequity in perceived oral health status can be corrected more effectively by promotional oral health behaviors.
Objectives: This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. Methods: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). Results: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. Conclusions: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.
The purpose of this study was to develop the evaluation indicator for the health promotion programs of the Community Health Centers and to test its validity. The modified logic model was used as the evaluation model based on the literature reviews. Using this model, four dimensions, eleven subdimensions, and fortyone individual indicators were developed. These evaluation indicators are superior in reflecting the distinctiveness of the community health promotion programs, and also flexible enough to accommodate diverse programs. These indicators also emphasize the role of process evaluation, and the diversity of outcomes. To test content validity, survey method of experts in the community health promotion field was conducted. Eleven in three expert groups(professionals, practitioners in Community Health Centers, and policy makers) generally agreed with the validity of evaluation indicators. To examine criteria and construct validity, these indicators were used to evaluate the health promotion programs conducted by the 18 Key Community Health Centers. The data came from the interview surveys of the main health promotion practitioner and 30 visitors from each center. The ranks of these eighteen Community Health Centers were computed from these data. There was no significant difference in ranking either by these indicators or by the existing indicators, which was developed by Technical Support and Evaluation Team for criteria validity. There was no statistically significant difference in ranking between input, process and outcome dimensions. Based on these study results, evaluation indicators developed in this study are valid to evaluate Community Health Center's health promotion program. It can be used both by the Community Health Center for internal evaluation, and by the stakeholders for external evaluation.
Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.
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