• Journal of Preventive Medicine and Public Health
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• 제46권5호
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• pp.237-248
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• 2013

Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

• 보건행정학회지
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• 제28권3호
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• pp.226-232
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• 2018

The objectives of this study were to evaluate the current state of governance structure and management of the health system to achieve the goals of the health system in South Korea, and to propose reform plan. This study drew implications from the governance of United Kingdom, Germany, and Netherlands, based on the principle of health system proposed by World Health Organization. The presidency and the health ministry should make macroscopic decision-making. The government has to decentralize the enforcement by municipality to operate public health and national health insurance (NHI), and to distribute the centralized NHI fund by municipality. The front line health centers and community centers should provide integrated health and social services. The government has to establish diversified regulatory bodies to enhance both the patient-centered care and the efficiency and equity of health care, and to provide mechanisms for ensuring autonomy of providers. The governance of the health system should be composed of the centralization of macro decision-making, the decentralization of implementation by municipality, the integration of health and social services on the front line, and the well-balanced regulation and autonomy on both consumers and suppliers.

• Toxicological Research
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• 제31권3호
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• pp.227-240
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• 2015

Recent amendment on the Food Sanitation Act in Korea mandated the Minister of Food & Drug Safety to secure the scientific basis for management and reevaluation of standards and specifications of foods. Especially because the current food safety control is limited within the scope of 'Farm to Market' covering from production to retail in Korea, safety control at the plane of true 'Farm to Fork' scope is urgently needed and should include 'total diet' of population instead of individual food items. Therefore, 'Total Diet Study (TDS)' which provides 'closer-to-real' estimates of exposure to hazardous materials through analysis on table-ready (cooked) samples of foods would be the solution to more comprehensive food safety management, as suggested by World Health Organization and Food and Agriculture Organization of the United Nations. Although the protection of diets from hazards must be considered as one of the most essential public health functions of any country, we may need to revisit the value of foods which has been too much underrated by the meaningless amount of some hazardous materials in Korea. Considering the primary value of foods lies on sustaining life, growth, development, and health promotion of human being, food safety control should be handled not only by the presence or absence of hazardous materials but also by maximizing the value of foods via balancing with the preservation of beneficial components in foods embracing total diet. In this regard, this article aims to provide an overview on TDS by describing procedures involved except chemical analysis which is beyond our scope. Also, details on the ongoing TDS in Korea are provided as an example. Although TDS itself might not be of keen interest for most readers, it is the main user of the safety reference values resulted from toxicological research in the public health perspective.

• 한국병원경영학회지
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• 제29권1호
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• pp.64-75
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• 2024

Purposes: This study aims to identify the characteristics of the study subjects by age, including non-elderly people aged 19 to 65, pre-elderly people aged 65 to 75, and elderly people aged 75 and over, and to identify factors affecting health literacy based on an investigation of the health literacy level of each study group. This study would like to find out the differences in health literacy factors by age group. Methodology: The HLS-EU-Q16, developed by the World Health Organization Regional Office for Europe for the Health literacy Survey of Europeans, will be applied in this study. Findings: We found that scores decreased in order of nonelderly, pre-elderly, and late-elderly in health care, disease prevention, and health promotion. In addition, health literacy was lower in the older age group, and higher health literacy was associated with being unmarried, higher education, and higher income. In terms of influencing factors, marital status was significantly different in the non-elderly group, and higher education level was associated with higher health literacy. Practical Implications: The results of this study show that health literacy levels are low in all age groups, and efforts to improve health literacy in younger, older, and non-elderly groups are needed. It is expected that age-specific health literacy strategies can help improve the level of understanding and utilization of health information, improve health, and lead a healthy life.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup1호
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• pp.37-42
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• 2016

Studies have shown that smoking is a learnt behavior, often initiated during adolescence. This paper aims to describe tobacco-related knowledge, attitude and associations among school adolescents aged 13-15 with exposure to anti-smoking information. Using data from the Global Youth Tobacco Survey (GYTS) in Viet Nam, 2014, knowledge was measured through 4 questions about tobacco use, and attitude was assessed through 3 questions on personal, social and environmental aspects. Students giving most anti-tobacco responses to all questions were considered as having correct knowledge or appropriate attitude or both. Access to anti-smoking information was determined by exposure to any media messages on tobacco control during the past 30 days and teaching in school about the danger of tobacco use during the past 12 months. A substantial percentage of students thought that being near others who smoke might be harmful to them and smoking is harmful to health (89.4% and 89.6% respectively). However, only 46.4% reported that it is definitely difficult to quit smoking and 66.9% thought that smoking for only 1 or 2 years, once stopped, is harmful to health. Slightly more than half of the respondents reported appropriate attitude that young smokers have fewer friends than others and smoking makes them less attractive and less comfortable at social events. Noticing anti-smoking messages in the media together with having lessons in school about the dangers of tobacco substantially increased the likelihood of having correct knowledge, appropriate attitude and both. Despite relatively high awareness about smoking harms, effective educational communication is still highly needed to improve the level of comprehensive knowledge and an appropriate attitude regarding tobacco use.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup1호
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• pp.17-23
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• 2016

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%-3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.6-14
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• 2019

Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

• 한국도서관정보학회지
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• 제51권3호
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• pp.1-25
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• 2020

유엔 산하의 전문기구인 세계보건기구(WHO)는 지구촌 장애인이 10억 명(또는 세계 인구의 15%)을 상회하는 것으로 추정하였다. 장애인의 지식정보 욕구는 비장애인과 동일함에도 세계시각장애인연합(World Blind Union)에 따르면 장애인이 접근할 수 있는 자료포맷은 선진국마저 연간 출판된 도서의 10% 미만으로 추산되고 있다. 어느 국가를 불문하고 장애인 정보접근성을 개선하려면 국가도서관 역할이 매우 중요하다. 이에 본 연구는 대륙별로 장애인을 위한 국가도서관 및 전국 도서관서비스를 대표하는 미국의 의회도서관(Library of Congress), 스웨덴의 매체접근기구(Myndigheten fö Tillgägliga Medier), 일본의 국립국회도서관(NDL), 남아프리카공화국의 SALB(The South African Library for the Blind)를 대상으로 역사와 발전, 법적 근거와 조직, 주요 업무 및 자아앤서비스의 특징을 정밀 분석·비교하고 시사점을 도출하였다. 그 결과를 바탕으로 2019년 국립중앙도서관 소속에서 문화체육관광부 1차 소속기관으로 격상된 국립장애인도서관의 역량강화 방안을 제언하였다.

• Safety and Health at Work
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• 제8권4호
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• pp.371-377
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• 2017

Background: Social status might be a determinant of occupational health inequalities. This study analyzed the effects of social status on both work environments and health outcomes. Methods: The study sample consisted of 27,598 wage employees aged 15 years and older from among the Korean Working Condition Survey participants in 2011. Work environments included atypical work, physical risks, ergonomic risks, work demands, work autonomy, social supports, and job rewards. Health outcomes comprised general health, health and safety at risk because of work, the World Health Organization-5 Well-being Index, work-related musculoskeletal disease, and work-related injury. Multivariable logistic-regression models were used to identify the associations between social status and work environments and health outcomes. Results: Employees in the demographically vulnerable group had lower occupational status compared with their counterparts. Low social status was largely related to adverse work environments. Especially, precarious employment and manual labor occupation were associated with both adverse work environments and poor health outcomes. Conclusion: Precarious and manual workers should take precedence in occupational health equity policies and interventions. Their cumulative vulnerability, which is connected to demographics, occupational status, adverse work environments, or poor health outcomes, can be improved through a multilevel approach such as labor market, organizations, and individual goals.

• 여성건강간호학회지
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• 제21권2호
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• pp.150-159
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• 2015

Purpose: This study was aimed to identify gender-based health inequality and explore impacting factors on health inequality in one province in Korea. Methods: This was an explanatory study using the secondary data on Chungnam province from the Fifth Community Health Survey from August 16 to Oct 31, 2012. Variables included in this analysis were education level, poverty, marital status, and residential community for socio-cultural characteristics and subjective health status as an indicator of health inequality. Data were analyzed by ${\chi}^2$-test, t-test, ANOVA, and multiple linear regression. Results: There were gender inequalities and disparities in health, and these inequalities were greater in woman than in man (${\chi}^2$=161.8, p<.001). The impacting factors were education level, poverty, marital status, and residential community, which was accounted for 22.6% of variances of health inequality. Among these variables, gender showed the largest influence in health inequalities. Conclusion: To solve health inequalities, it should be considered gender differences based on social determinants of health. It is necessary to develop long term project based on these results and the social determinants model of World Health Organization.