• Journal of Preventive Medicine and Public Health
• /
• v.46 no.6
• /
• pp.300-308
• /
• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• Journal of Preventive Medicine and Public Health
• /
• v.43 no.3
• /
• pp.265-273
• /
• 2010

Objectives: Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? Methods: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. Results: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: $39.8{\pm}19.9$ unemployed: $29.3{\pm}18.8$). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. Conclusions: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.

• Journal of Preventive Medicine and Public Health
• /
• v.40 no.5
• /
• pp.381-387
• /
• 2007

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.

• Journal of Korean Public Health Nursing
• /
• v.32 no.3
• /
• pp.451-467
• /
• 2018

Purpose: The aim of this study was to determine the related factors for psychological crises in Korean middle aged adults. Methods: RISS, KISS, National Assembly Digital Library, CINAHL, and PubMed were searched for relevant articles published until October 3, 2016. Finally, a total of 23 studies were included. Meta-analysis of the studies was conducted using Comprehensive Meta-Analysis 3.0 software to calculate the effect size. Results: The related variables of psychological crisis were categorized into 23 variables and 5 factor groups. The effects size (ES) of the overall defensive variables was -0.28. In the defensive factors, the psychological factor (ES=-0.67), followed by cognitive and behavioral factor (ES=-0.34), physical factor (ES=-0.31), and social relational factor (ES=-0.29) had the greatest effect on psychological crises. The effects size of the overall risk variables was 0.48. In the risk factors, the physical factor (ES=0.61) had the greatest effect on psychological crises, followed by the psychological factor (ES=0.53), and cognitive and behavioral factor (ES=0.10). Conclusion: An intervention program is needed to strengthen the defensive factors and reduce the risk factors for psychological crises of Korean middle aged adults.

• Journal of Preventive Medicine and Public Health
• /
• v.40 no.6
• /
• pp.422-430
• /
• 2007

The socioeconomic inequalities in health have recently become an important public health concern in South Korea, and the issue has gained increasing attention from many South Korean researchers due to the increasing income inequality and Widening social polarization following its economic crisis in the late 1990s. However, despite the mounting literature on health inequalities published in recent years, the history of research on health inequality in South Korea is premature in comparison to the long histories in several Western countries. Understanding the historical background underlying the issue of health inequality research may aid in establishing and accumulating scientifically solid evidence in South Korea. It may also direct the South Korean research community to develop research agendas that are. more politically and academically appropriate for South Korean society. This paper describes the historical development of health inequality research in the West and introduces several important issues contributing to the advancement of health inequality research. Specifically, the major studies conducted before and after the UK Black Report are presented. In addition, the history and current status of health inequality research in South Korea are documented and evaluated. Finally, several research agendas for the quantitative and qualitative improvement of health inequality research in South Korea are proposed.

• Journal of Korean Public Health Nursing
• /
• v.10 no.2
• /
• pp.61-73
• /
• 1996

The Korea now incarcerates a greater percentage of its Population than any other country : For 63,000 prisoners in 40 prisons and jails. Most inmates are mate. young, poor, and morbidity groups. Most are substance abusers with substantial physical and mental health needs. Corrections in general and correctional health care in particular have suffered negative consequence : severe overcrowding, insuffcient programs as the acquired immunodeficiency syndrome(AIDS). tuberculosis, and hepatitis. The large increase in the number of substance abusers and sick and terminally ill inmates has rendered our nation's prisons and jails physically or financially unable to deal with their current populations, much less the explosive increases the future holds. It is the magnitude of inmate health problems that threatens to overwhelm the substantial gains made in correctional health care over the past two decades. As measured by recognized standards of inmate health and health services, our correctional systems are in crisis. As a nation. we must respond to the problem of health problem with national strategies that do not overwhelm the capacity of our criminal justice system to care for its inmates.

• Journal of the Korean Society of School Health
• /
• v.36 no.3
• /
• pp.103-112
• /
• 2023

Purpose: The COVID-19 pandemic, which emerged in late 2019, had a profound impact on global public health and disrupted the daily lives of people worldwide. Particularly, university students faced a challenging situation as their university life underwent a drastic transformation due to long-term remote learning and isolation measures. This study aimed to investigate the relationship between changes in daily life during the 2020 COVID-19 pandemic and depressive symptoms among university students aged between 19 and 29 in Korea. Methods: We analyzed data from the nationally representative 2020 Community Health Survey (CHS). Among the 229,269 participants, 9,279 university students aged 19-29, either enrolled or on leave, were selected. After excluding 401 cases with missing values, the final sample comprised 8,878 individuals. Using multivariate logistic regression with a complex sample design, we explored the association between daily life changes during the COVID-19 pandemic and depressive symptoms. Results: Changes in daily life during the COVID-19 pandemic was associated with depressive symptoms in Korean university students aged 19 to 29, even after adjusting for sociodemographic characteristics, health-related factors, and COVID-19-related aspects (OR=1.28, 95% CI=1.09~1.50). Conclusion: Our study suggests that when examining the impact of COVID-19 on health issues, it is crucial to consider the changes in daily life caused by the pandemic. These findings can provide insights into the psychological well-being of university students during times of crisis.

• Safety and Health at Work
• /
• v.11 no.4
• /
• pp.533-536
• /
• 2020

Strengthening of the health system is a safety imperative, especially in a crisis as caused by the ongoing COVID-19 pandemic. While there is a need for enhancing the number and skill sets of the public health professionals, especially the frontline workers, it will be prudent to use the digital health technologies, including artificial intelligence, in enhancing the capacity of the healthcare professional education and delivery. However, it has to be ensured that an ethical and safe approach is adopted to develop and use digital health technology and, ethically appropriate training is imparted, to enhance the capacity of the human resources for health, leading to an overall health system strengthening.

• The Korean Society of Law and Medicine
• /
• v.21 no.2
• /
• pp.105-162
• /
• 2020

In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.

• Korean Journal of Community Nutrition
• /
• v.11 no.2
• /
• pp.172-179
• /
• 2006

Since the economic crisis in 1997, the number of low income families has increased and the turmoil is likely to affect nutritional and health status of the children in low-income families. The purpose of this study was to investigate dietary behaviors and physical development of low income family children in the Seoul area. The subjects were 44 boys and 56 girls, between the ages of 7 and 12 years, from the beneficiary families of the governmental assistant program and enrolled in after school-care centers. A self-reported questionnaire, including general characteristics and dietary behaviors, was applied to the children and their parents. Skipping meal rate was higher in breakfast than in lunch or dinner, and was less frequent in parents and children families compared to that of the other types of families (p<0.05). Most students are shown that they usually keep the dietary guideline for Korean children. There were significant differences in keeping the dietary guidelines between the parents and children family group and other groups in several items. The results imply that the nutrition education program should be more focused on the families which are not composed of parents and children.