• Title/Summary/Keyword: 사회적 건강결정요인

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담배자판기, 신규설치 금지 및 철거 규제안 철회되다

  • 한국자동판매기공업협회
    • Vending industry
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    • v.2 no.5 s.6
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    • pp.56-62
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    • 2002
  • 담배자판기의 신규설치를 금지하고 기존 설치된 자판기마저 전면철거하도록 하는 보건복지부의 초강력 규제안이 마침내 철회가 되게 되었다. 보건복지부는 올 들어 확대되는 금연정책에 편승, 기존 흡연 구역 내 담배자판기 신규설치를 금지하고, 기존 설치된 제품들마저 전면철거하는 규제를 담은 국민건강증진법 시행령 개정안을 지난 4월 공고하며 그 입법추진을 진행한 바 있다. 이 공고안은 그간 국무총리실 산하 규제개혁위원회 분과위원회에 상정되어 1,2차 심의를 진행해 오다 지난 9월 27일 본회의를 통해 '보건복지부의 흡연구역 내 담배자판기 신규설치 금지 및 기존 자판기 철거는 명백히 영업활동 자유 및 재산권 침해에 해당된다.'는 이유로 이를 철회토록 하는 결정을 진행했다. 이 결정을 담은 국민건강증진법 개정안은 조만간 법제처 심사 및 차관회의 등을 거쳐 최종 확정 되게 된다. 이같은 규제개혁위원회의 결정은 협회를 중심으로 한 산업의 적극적인 대응이 있었기에 가능했다. 성인인증장치 도입을 통해 청소년 흡연문제를 완전, 해결하겠다는 산업계의 적극적인 자율대책에도 불구하고 아예 담배자판기를 뿌리 채 뽑겠다는 보건복지부의 행정만능주의적인 발상은 도저히 수용하지 못할 부당한 처사라는 데 관련업계가 인식을 같이 했다. 따라서 이를 반대하는 산업계 입장을 분명히 하며 분명히 하며 적극적인 저지 대응을 최근까지 진행해 왔다. 협회에서는 1차적으로 보건복지부 건강증진과에 담배자판기 전면철거에 대한 산업계 반대 입장을 피력하는 소견서 제출하고 적극적인 산업계의 반대의지를 피력하는 작업을 진행했다. 또한 청소년보호위원회를 통해 청소년 흡연감소를 위한 성인인증 담배자판기 설치 활용방안 건의하며 담배자판기의 긍정적인 활용측면을 집중 부각시키기도 했다. 재정경제부를 통해서는 담배사업법 관련 담배자판기 설치기준에 대한 질의를 통해 현행 관련법 내에서의 설치기준을 명확히 하기도 했다. 이같은 대응에 있어서의 핵심 설득 논리는 담배자판기가 이제는 성인인증장치 부착을 통해 청소년 및 사회적 위해 요인을 극소화 할 수 있다는 점에 있었다. 과거와는 달리 담배자판기가 오히려 청소년의 담배 구입루트 차단이라는 긍정적 역할을 할 수 있는 시점에 있어 이를 전면규제하기보다는 합법적인 설치 환경을 확보하여 사회적으로 떳떳하게 존재가치를 평가받을 수 있게 해달라는게 산업계의 초지일관의 주장이었던 것. 협회는 이같은 주장이 결코 산업계의 이기만이 아니라 세계적인 추세라는 점, 또 담배자판기를 전면철거까지 하면서 과당규제를 할 명분이 부족하다는 점을 반대논리로 적극 내세웠다. 규제개혁위원회가 이번 공공 이용시설 중 흡연구역으로 지정된 장소 내에 담배자판기는 설치 금지 및 철거규제에 철회권고를 내리게 된 것은 이러한 산업계의 주장을 적극 수용함에 힘입은 바 크다. 규제개혁위원회는 이번 결정의 주된 이유로 우선 기설치된 자판기에 대한 철거는 재산권 침해로 위헌 소지가 있음을 들고 있다. 또한 흡연자를 위한 흡연구역내에서마저 자판기 설치를 금지하는 등의 규제는 과도하며 흡연자의 권익보호 역시도 필요함을 인정하고 있다. 따라서 전면적인 규제보다는 청소년 이용통제 가능한 흡연구역에 한하여 담배자판기를 설치토록한 현행규정의 실질적 관리를 강화하며, 전체적으로 흡연구역을 축소 제한하는 방향으로 추진함이 바람직하다는 의견을 제시했다. 규제개혁위원회의 이번 결정으로 흡연구역 내 담배자판기의 설치는 현행법의 적용을 받게 되며, 산업계의 자율대책대로 성인인증 장치를 부착한 담배자판기의 설치 확대가 크게 촉발될 수 있을 것으로 기대된다. 담배자판기가 적극적이고 능동적인 사회적 역할을 할 수 있을 때 자연 이를 반대할 수 있는 명분도 약해질 수 밖에 없다. 산업계는 보다 신뢰성 있게 청소년 이용을 차단할 수 있는 담배자판기 관련 기술 수준을 향상시켜야 할 것이며, 협회에서는 담배자판기의 공공성과 역할에 대한 지속적인 계몽 홍보를 통해 소비자 인식을 고양시켜 나갈 수 있게 해야 할 것이다. 비록 전면 규제 완화가 어렵고 힘든 길이기는 하지만 소비자에게 신뢰성을 부여하고 청소년의 담배 구입 루트 차단에 혁혁한 역할을 다할 수 있게 된다면 그 입지기반을 재평가 받을 수 있게 될 것이다. 담배자판기의 내일은 이제 암울함이 아닌 서서히 희망을 비치는 쪽으로 급선회되고 있다.

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Indebtedness and Mental Health - Focusing on Depressive Symptoms and Suicidal Ideation - (가계부채가 정신건강에 미치는 영향 - 우울감과 자살생각을 중심으로 -)

  • Park, Jung Min;Oh, Uk Chan;Gu, Sea Juang
    • Korean Journal of Social Welfare
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    • v.69 no.2
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    • pp.171-190
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    • 2017
  • This study examined the impact of indebtedness on depressive symptoms and suicidal ideation. The data came from the 4th to 10th waves of the Korea Welfare Panel Study, collected from 2009 to 2015. Analyses were conducted using logistic regression for longitudinal data that combines the fixed effects and random effects approaches. The results show that a high level of indebtedness substantially increased the risk of depressive symptoms. The household leverage ratio-the ratio of total household debt to disposable personal income-of 400% or higher increased the odds of probable depression by 50% compared with the ratio under 100%. When the percentage of personal income that goes toward paying debt is 30% or higher, the odds of probable depression went up by 66% than when the percentage of debt payment of disposal income is under 10%. The findings suggest that debt relief agencies and their programs need to incorporate means to identify and address emotional stress related to the excessive debt. This study also contributed to enriching the literature on social determinants of health by demonstrating that indebtedness is an important socioeconomic characteristic affecting individuals' mental health.

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The Determinants of Community Service Utilization Among Family Caregivers of the Impaired Older Persons (만성질환 및 기능손상노인 가족수발자의 재가복지서비스 이용 결정요인에 관한 연구)

  • Lee, In-Jeong
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.183-205
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    • 2004
  • This Study explored three issues in regard to the determinants of community service utilization among family caregivers of the dependent older persons. First, the differences between users and nonusers of community services were compared regarding to predisposing, enabling, need characteristics of the primary caregiver as well as the elder care recipient. Second, the variables which determined the contact of community services were examined. Third, the influence of the variables on duration of the community services among users was also examined. The data collected from 164 family caregivers were used for analyses. Findings suggest that community service users had higher education and higher emotional support, lower family income than nonusers. The level of cognitive impairment of the elder was also higher for users than nonusers. The entry into community services is more likely for elders cared for by caregivers who have higher educational attainment, lower family income and lower level of instrumental support. Once interaction terms for relationship between need factors and social support are entered, caregivers with poorer level of his/her perceived physical health and lower level of instrumental support are more likely to report use of community services. Among those reporting contact with services, more extensive use occurs for caregivers with lower emotional support and lower depression. The entry of interaction terms for relationship between need and support reveals that the combination of lower support(instrumental and emotional) and elder's greater physical impairment are associated with longer period of community service use. However, the effect of caregivers' depression followed the different pattern. For caregivers with greater depression, more supports are related with more service utilization. According to the results, implications for research and practice are discussed.

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Path Analysis of Determinants Influencing ADL Among the Adult Population with Cerebral Palsy (뇌성마비인의 일상생활활동(ADL) 결정 요인에 관한 경로분석)

  • Kim, Jung-Woo
    • Korean Journal of Social Welfare
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    • v.58 no.2
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    • pp.57-85
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    • 2006
  • This study tries to understand how the physical impairment develops to practical disabilities among adults with cerebral palsy through path analysis, based on the concept of disability by WHO that the physical impairment and "activities of daily living"(ADL) are affected by the combination of interrelated concept of personal health and environment. Pain and instrumental support are conceptualized as mediating variables for ADL among the adults with cerebral palsy, which are used in the analysis. As a result of surveying of 381 participants, paralyzed region is the only variable directly influencing ADL; other variables such as gender, age, and types of cerebral palsy do not have direct effect on ADL. However, it turns out that age, types of cerebral palsy, and paralyzed region influence on pain problems and also on ADL indirectly, when pain is introduced as a mediating variable. The study also shows that the extent of instrumental support works directly and indirectly toward pain and ADL. It means that individual impairment does not necessarily have influence on the limitations of ADL, but on the result of interrelatedness of individual factors and social factors. Finally, this study implies that the social work practice should be intervened with a new approach of the consideration of the effects of mediating variables.

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Study on Frailty Profiles and Associated Factors in Later Adulthood (노년기 허약 유형과 영향요인에 관한 연구)

  • Kim, Young-Sun;Kang, Eunna
    • 한국노년학
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    • v.38 no.4
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    • pp.963-979
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    • 2018
  • The purpose of this study was to identify frailty profiles based on physical, psychological, and social domains of functioning and to examine the associated factors showing the differences among frailty profiles. Respondents were 70 years and older(n=403) and latent class analysis was applied to determine the optimal subgroups based on Tilberg Frailty Indicators which comprised of three domains(the physical, psychological, and social domain). Also, we performed multinominal logistic regression analysis to find out factors making differences among frailty profiles. Latent class analysis(LCA) identified three distinct types: multi-frail type(27.0%), psychologically frail type(26.8%), inadequate support type(46.2%). All three types had common difficulties in dealing with daily life problems and did not receive enough help with theses difficulties. Based on the results of the LCA three-class models, people in multi-frail type accumulated problems in physical and psychological domains and had partially social domain. On the other hands, psychologically frail type showed a relatively high anxiety disorder and depression. Lastly, people in inadequate support type reported the lack of helps, but they were relatively healthy. Comparing these groups with inadequate support type, people with multi-frail had lower educational level, poor nutritional management status and were less likely to participate in labor market. People in psychologically frail type were more likely to be male, to live in big cities rather than middle and small cities, and less likely to smoke. Based on these results, our results showed the multifaceted concept of frailty among Korean elderly people and we suggested several implications for preventing frail process.

Factors Affecting Satisfaction with Medical Service of the Elderly with Disabilities : Focusing on Health Characteristics and Medical Service Characteristic (장애노인의 의료서비스 만족도 영향 요인 : 건강 특성과 의료서비스 특성을 중심으로)

  • Kwak, Jee-Young;Shin, Eunkyoung
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.788-797
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    • 2022
  • The purpose of this study is to identify the satisfaction with medical services of the disabled elderly who have the highest need for medical services. For this purpose, the effect of health characteristics and medical service characteristics of the disabled elderly on medical service satisfaction was verified. The subjects of analysis were 3,323 persons with disabilities aged 65 or older who were taken from the national survey of people with disabilities in 2017. For statistical analysis, descriptive analysis, correlation analysis, and regression analysis were performed using the SPSS 26.0 program. The results of the study showed as follows. As a result of the regression analysis, gender (β= -.045, p<.05) and residence status (β= -.048, p<.05) among the demographic characteristics as control variables had a statistically significant effect on the level of medical service satisfaction. Among the health characteristics, IADL (β=-.044, p<.05) had a statistically significant effect on medical service satisfaction level. In the case of medical service characteristics, satisfaction with medical facilities and equipment (β = .290, p< .001), medical staff's level of understanding of disability (β = .404, p< .001), health-related service use (β = .182, p<.05) had a statistically significant effect on the level of medical service satisfaction. Based on the results, practical alternatives to ensure health equity in the community medical system were suggested in the discussion to enhance the health management and self-determination capabilities of the disabled elderly.

Determinants of Demand for Alternative Education in Korea (한국사회의 대안교육 수요 결정요인)

  • Kim, Kyung-keun
    • (The)Korea Educational Review
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    • v.14 no.1
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    • pp.45-69
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    • 2008
  • Using a sample from Korea Education Employment Panel(KEEP), this study attempts to ascertain determinants of demand for alternative education in Korea. It found that children's gender and duration of computer use exert a strong effect on demand for alternative education. Also, those parents, who show more interest in government's education policy; are less content with the schools their children are attending; and exhibit the higher likelihood of migration for children's education, appear to have the stronger tendency to seek alternative education for their children. Meanwhile, there was a significant difference between male and female students in the factors that influence demand for alternative education. For male students, duration of computer use and the parents' interest in government's education policy tend to matter. For female students, however, health condition seems to be associated with demand for alternative education. For both male and female students, those parents' who are more discontent with the schools their children are attending and/or have the higher likelihood of migration for children's education seem more likely to send their children to alternative schools.

Psychosocial Characteristics and Factors Associated with Referral to Psychiatric Care in the Suicide Attempters Visiting Emergency Center (응급실에 내원한 자살 시도자들의 정신사회학적 특성과 정신건강의학과 진료 의뢰 관련 요인)

  • Kwon, Jung-Woo;Ko, Young-Hoon;Han, Chang-Su;Lee, Moon-Soo;Yoon, Ho-Kyung;Lee, Hongjae
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.106-113
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    • 2013
  • Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.

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Multiple roles of Korean Immigrant wives Depression (한국 이민 주부의 다양한 역할이 우울에 미치는 영향)

  • Um, Chae-Chung
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.223-231
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    • 1998
  • 결혼한 여성의 우울과 관련된 주 요인의 하나는 그들의 다양한 역할이 정신적인 건강에 부정적인 영향을 심리적으로 미친다고 발표되어 있다. 그럼에도 불구하고 한국 이민 주부에 대한 이러한 영역에서의 연구가 매우 부족한 실정이다. 중서부의 주요 도시인 시키고의 도심지에 위치한 11곳의 한국인 교회에서 편의 표출 방법으로 다음과 같은 기준에 맞는 대상자를 선택하였다. 나이는 25-55세 사이, 결혼하여 남편과 함께 살고 있으며, 매주 20시간 이상씩 일하고 있는 여성 등의 기준을 충족시키는 응답자의 수는 282명이었다 대상자들에게는 5가지의 설문 즉 인구통계학적, 우울에 대한 역학 연구, 성 역할 지향성의 지수, 역할 분담 및 대처 전략 등에 관한 질문이었다. 중다회귀분석 (Multiple Regression Analysis)에서 통계학적으로 유의한 관계를 보인 것은 다음과 같았다. 주부의 자녀가 적을수록 우울의 수준은 높았고, 가족의 수입이 많을수록 우울의 수준은 낮았으며, 주부가 일하는 것이 경제적 필요를 충족시키기 위함이라고 스스로 지각(주부들은 일하는 역할이 합법적으로 판단되어지기를 원했고 또 지각했는데 이와 대조하여 일의 역할을 비합법적으로 지각하는 것)할수록 우울의 수준은 더 높았다. 비록 일하는 것이 저녁 늦게 자고 아침 일찍 일어남을 의미할지라도 모든 가사를 완수하기 위하여 열심히 일한다고 하면 할수록 우울의 수준은 더 높았다. 주부가 일의 역할을 합법적으로 지각하면 할수록 남편과 다른 가족의 구성원들에게 도움을 요청하거나 도움을 받는 것을 원하지 않았으며, 일을 더 열심히 하기 위해 대처전략과 우선순위(주부가 일을 전혀 완수 할 수 없을지라도 가정의 어떤 일이 중요하고 어느 것이 두 번째로 중요한지를 결정하는)를 더 잘 설정하고 더 잘 수용하는 것 같았다. 식품 등을 쇼핑하는데에 많은 시간을 소모할수록 우울의 수준은 더 높았다. 이 자료는 스트레스와 대처이론을 지지하고 있다.

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Determinants of Length of Stay in Geriatric Hospitals - Focused on Alzheimer Dementia's Inpatients (요양병원 입원 알츠하이머 치매노인의 재원일수 결정요인 분석)

  • Bang, Hyo-Jung;Lee, Kwang-Soo
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.900-909
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    • 2013
  • This study purposed to analyze the determinants of length of stay for patients having alzheimer dementia in geriatric hospitals. Sample data was collected from the National Patient Sample (NPS) produced by the Health Insurance Review & Assessment Service (HIRA) in 2009. Total 538 alzheimer inpatients over 65 years were used in the analysis. Patients were classified into 5 risk groups to represent the case-mix differences of patients. Organizational characteristics of geriatric hospitals such as number of beds, doctors, and nurses were included in the analysis model. In multivariate regression analysis, hospital variables were not statistically significant in explaining the length of stay. Two risk group were statistically significant in analysis, However, their signs of relationship with the dependent variable were opposite to the expectations. These results suggest that the characteristics of patients and hospitals did not have impacts on the length of stay. There will be needs to test the effects of other factor such as social needs which represents the socio-economic status of the family for the patients.