• Title/Summary/Keyword: the inequality of health

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Analysis of the Inequalities in Healthcare Service Usage Considering Healthcare Service Needs (의료필요를 고려한 의료이용의 형평성 분석)

  • Lee, Yong-Jae;Lee, Hyun-Ok;Kim, Hyung-Eick
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.435-445
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    • 2017
  • This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

Health Improvement; Health Education, Health Promotion and the Settings Approach (건강 향상: 건강 교육, 건강 증진 및 배경적 접근)

  • Green, Jackie
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.111-129
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    • 2004
  • This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community. The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.

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A Case Study on the UK Park and Green Space Policies for Inclusive Urban Regeneration (영국의 포용적 도시재생을 위한 공원녹지 정책 사례 연구)

  • Kim, Jung-Hwa;Kim, Yong-Gook
    • 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.

The Association Between Number of Remaining Teeth and Health-related Quality of Life(GOHAI) by Economic Activity Status in Elderly: Ninth Wave of the Korean Longitudinal Study of Ageing(KLoSA) (노인의 경제활동 상태에 따른 잔존치아수와 구강 건강관련 삶의 질(GOHAI)의 관련성: 고령화연구 패널조사 9차 자료를 이용하여)

  • Han-A Cho
    • Journal of Korean Dental Hygiene Science
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    • v.7 no.1
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    • pp.1-15
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    • 2024
  • Background: This study aims to determine the association between the number of remaining teeth and oral health-related quality of life according to economic activity status in elderly. Methods: Data from the 9th Korean Longitudinal Study of Ageing (KLoSA) were used to analyze 6,004 older adults aged 59 years and older. The number of remaining teeth was categorized as less than 20 and more than 20, and the Geriatric Oral Health Assessment Index (GOHAI) was used to measured the oral health-related quality of life of the elderly. Independent t-tests were performed to compare demographic, economic, sociodemographic, and health characteristics, as well as GOHAI scores, between economically active and inactive individuals. In the case of ANOVA analysis, Scheffe's post hoc analysis was performed to confirm statistical significance between groups. Linear regression analysis was conducted to determine the influence of the number of remaining teeth on GOHAI according to economic activity status. Results: Among the study population, 33.9% were economically active, which is approximately half the proportion of those were not economically active. The mean GOHAI scores were 43.32 and 40.15 for economically active and economically inactive individuals with 20 or more residual teeth, respectively (p<0.001). Simple linear regression analysis revealed that having more than 20 remaining teeth was associated with a statistically significant increase in GOHAI by approximately 4.56 times and 4.92 times compared to having fewer than 20 teeth for economically active and non-economically active individuals, respectively (p<0.001). Multiple linear regression analysis, adjusted for demographic, economic, sociodemographic, and health characteristics, showed that having more than 20 remaining teeth was associated with a statistically significant increase in GOHAI by approximately 3.62 and 2.97 times compared to having fewer than 20 teeth in economically active and non-economically active individuals, respectively (p<0.001). Conclusion: This study explored economic activity status as one of several approaches to enhance the oral health-related quality of life of the elderly. By using the number of remaining teeth as an indicator of oral health status. supporting economic activity could potentially improve both oral health and overall quality of life for older individuals. Such interventions may have positive effects on policy outcomes, including reducing economic inequality by promoting economic engagement among the elderly.

A Multilevel Study on the Relationship between the Residential Distribution of High Class (Power Elites) and Smoking in Seoul (서울시 동별 상류계층(파워엘리트) 주거 분포와 흡연과의 관련성에 대한 다수준분석)

  • Kim, Chang-Seok;Yun, Sung-Cheol;Kim, Hye-Ryun;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.1
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    • pp.30-38
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    • 2006
  • Objectives: We examined whether the neighborhood socioeconomic position predicts the smoking rates after adjusting for individual socioeconomic position indicators. Methods: Data were obtained from the 2001 Seoul Health Indicators Survey. The neighborhood socioeconomic position was the residential distribution of the high class (power elites), as measured by the location quotients (LQ) for each administrative dong (district). A high LQ denotes a high neighborhood socioeconomic status. The individual socioeconomic position included education, occupation and income. Age-adjusted smoking rates according to the LQ level were computed with the direct method. The total number of subjects in this study (26,022 men and 28,007 women) was the reference. A multilevel logistic regression analysis was conducted with the individuals at the first level and the neighborhoods at the second level to estimate the odds ratios of smoking with 95% confidence intervals. Results: For men, the age-adjusted smoking rates increased with a decrease in the LQ. For women, the relationship between the age-adjusted smoking rate and the LQ was not clear. The odds of smoking for both genders were greater among those subjects with lower incomes and lower education. The manual occupational class had greater odds of smoking than the non-manual class for the males, while the odds ratio of smoking among females with a manual occupation tended to be lower than those females with a non-manual occupation. For the males, the LQ levels independently predicted smoking after adjustment for individual income. However, this relation between the LQ and smoking in males was explained by full adjustment for the individual socioeconomic position indicators (education, occupation and income). Conclusions: A low level of neighborhood socioeconomic position was associated with higher smoking rates among the men residing in Seoul. This association between the neighborhood socioeconomic position and smoking in men was explained by the individual socioeconomic position. Anti-smoking efforts to reduce geographical inequality in smoking should be directed at reducing the smoking rates between the individuals with different socioeconomic backgrounds in the metropolitan city of Seoul, South Korea.

Development of a Linking Model between Community Resourses and Industrial Injury Insurance Organs for the Activation of Medical Rehabilitation Services for Industrial Injury Patients (산재환자의 의료재활서비스 활성화를 위한 산재보험시설과 민간시설간의 연계모형 개발)

  • Kim, Hee-Girl
    • Korean Journal of Occupational Health Nursing
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    • v.14 no.1
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    • pp.56-70
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    • 2005
  • Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.

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A Study on the Position and Role of Korean Medicine Doctors Working at Long-Term Care Hospitals (요양병원 근무 한의사의 지위와 역할에 관한 연구)

  • Kang, Tae-Ri;Lee, Sang-Ryong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.77-90
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    • 2015
  • Objective : The purpose of this study is to discuss the role and ways to improve the position and rights of Korean Medicine Doctors (KMDs) working at long-term care hospitals (LTCHs) through survey analysis. Method : (1) The legal and institutional position of KMDs is studied using current law and related papers. (2) The online survey was conducted through KMD community websites, targeted at KMDs working at LTCHs. Results : (1) Whereas there is perceived added benefit for the eight specializations for a specialist of Western medicine at LTCHs, in the case of a specialist of Korean Medicine, their value is not institutionally recognized at all. (2) A Western inpatient's medical fee is more than a Korean inpatient's medical fee, and the individual fee for the same medical treatment is also higher in Western hospitalization. So, Korean medical hospitalization actually cannot be made. Because of that, Korean Medicine Doctors find it difficult to be primary care physicians. (3) Musculoskeletal diseases and the aftereffects of cerebrovascular diseases were the most common chief complaints addressed in Korean medical consultations. Conclusion : This study shows that KMDs working at LTCHs have suffered many kinds of inequality. That is because of the limited medical scope of the current medical system and real constraints from the gap in Korean-Western medical fees by the National Health Insurance Corporation. Therefore, it is necessary to eliminate these variations along with revising the statute with continuous research.

Analysis of the Vulnerable Class on Digital Divide (디지털 정보격차에 대한 취약계층의 계층별 분석)

  • Sun Hee Kwon
    • Knowledge Management Research
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    • v.23 no.4
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    • pp.1-19
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    • 2022
  • As the untact culture spreads, the digital divide, which is a problem of access to digital information for the vulnerable, can appear as information inequality in various fields, including the social and cultural field. This study identified the digital divide level for the vulnerable population and analyzed the effects of information accessibility, demographic and social characteristics, and physical and mental health characteristics on the information level. As a result, the higher the accessibility of information, the smaller the digital divide and the greater the digital utilization, so it is necessary to increase the accessibility of information devices and increase the ability to utilize them. In addition, the higher the age, the more women than men, and the lower the income level, the greater the digital divide, so it is necessary to increase digital capabilities through detailed class-specific programs for the vulnerable. Finally, it was found that the digital divide and the level of digital literacy had a significant effect on the life satisfaction and daily life satisfaction of the vulnerable. The expansion of competency-building education programs to enhance information utilization capabilities by changing the paradigm to a digital inclusion policy should be continuously operated.

Prevalence of fimA Genotypes of Porphyromonas gingivalis Strains in peri-implant sulcus (임플란트 주위 치주낭내의 Porphyromonas gingivalis 섬모유전형의 출현율)

  • Seo, Dong-Keon;Kwon, Young-Hyuk;Park, Joon-Bong;Herr, Yeek;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.907-919
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    • 2005
  • Porphyromonas gingivalis is a gram negative. black-pigmented anaerobe, associated with periodontitis & peri-implantitis. Fimbriae(fimA) of P. gingivalis are filamentous components on the cell surface and important in the colonization and invasion of periodontal tissue. But all P. gnigivalis strains don't have equal pathogenicity, inequality among strains originates from different fimA genotype. P. gnigivalis fimA gene encoding fimbrillin(structural subunit of fimbriae) has been classified into 5 genotypes(types I to V) based on the nucleotide sequences. In the present study, we examined the prevalence of these fimA genotypes in patients with dental implant and the relationship between prevalence of these genotypes and a condition of peri-implant tissue. Dental plaque specimens obtained from 189 peri-implant sulci of 97 patients with dental implants were analyzed by 16S rRNA fimA gene-directed PCR assay. P. gingivalis were detected in 86.2% of the alll samples. Among the P. gingivalis-positive samples, a significant difference in the occurrence of typeII was observed between test and the two control groups. In two control groups, typeII fimA were detected in 6.3%(PD<5mm/BOP-). 18.7%(PD<5mm/BOP+). In the test $group(PD{\geqq}5mm/BOP+)$, type II fimA genotype were detected most frequently in 50.0% . And a correlation between specific fimA types and peri-implantitis was found in $typeII(R^2=l.105)$. These results suggest that P. gingivalis strains that possess typeII fimA are gradually increased, as a condition of peri-implant tissue is getting complicated and are closely associated with peri-implant health status. We speculate that these organisms be involved in peri-implantitis

A Psychological Approach to Reducing the Digital Divide for the Elderly Consumer: From the Perspective of Socioemotional Selectivity Theory (노년층 소비자의 디지털 정보격차 완화를 위한 심리적 접근: 사회정서적 선택이론의 관점에서)

  • Min, Dongwon
    • Journal of Digital Convergence
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    • v.18 no.3
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    • pp.133-138
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    • 2020
  • The ability to use ICT is now a prerequisite for living in the information age, and digital literacy, which can access and utilize various digital information such as online banking, shopping, news, and health care, is more important. It is increasing. Accordingly, the social inequality, or digital divide, related to accessing and accepting digital information and knowledge is also an important social issue. In particular, the digital divide by age is becoming a major issue, not only in terms of resolving social imbalances but also in resolving the structural problems of the economy in addition to the survival of the elderly. This study aims to find ways to resolve the digital gap of the elderly in terms of socioemotional selectivity theory and suggests the reasons for the elderly's less access to digital information acquisition and the implications for the solution.