Journal of Preventive Medicine and Public Health

COVID-19: Special Article

Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era: Hongjo Choi, Seong-Yi Kim, Jung-Woo Kim, Yukyung Park, Myoung-Hee Kim; J Prev Med Public Health. 2021;54(1):1-7. Published online January 15, 2021; DOI: https://doi.org/10.3961/jpmph.20.593

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The Korean government’s strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

Summary

Korean summary
"이 연구는 코로나19 대유행이 건강불평등에 미치는 영향을 검토하고, 불평등 완화 방안을 제시하고자 한다. 건강의 사회적 결정요인은 코로나19와 건강불평등을 이해하기 위한 출발점이다. 건강의 사회적 결정요인은 코로나19 감염과 그로 인한 사망 등 직접영향 경로와 코로나19 대응과정의 문제로 건강불평등을 야기하는 간접영향 경로에 모두 관여한다. 공중보건위기로 인한 건강불평등을 줄이기 위해서는 시민참여를 통한 협력적 거버넌스 강화와 모든 건강정책에서 사람중심돌봄의 관점을 견지하는 것이 필요하다."

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Special Articles

General Factors of the Korean Exposure Factors Handbook: Jae-Yeon Jang, So-Yeon Kim, Sun-Ja Kim, Kyung-Eun Lee, Hae-Kwan Cheong, Eun-Hye Kim, Kyung-Ho Choi, Young-Hee Kim; J Prev Med Public Health. 2014;47(1):7-17. Published online January 29, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.1.7

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Abstract PDF

Risk assessment considers the situations and characteristics of the exposure environment and host. Various physiological variables of the human body reflects the characteristics of the population that can directly influence risk exposure. Therefore, identification of exposure factors based on the Korean population is required for appropriate risk assessment. It is expected that a handbook about general exposure factors will be used by professionals in many fields as well as the risk assessors of the health department. The process of developing the exposure factors handbook for the Korean population will be introduced in this article, with a specific focus on the general exposure factors including life expectancy, body weight, surface area, inhalation rates, amount of water intake, and soil ingestion targeting the Korean population. The researchers used national databases including the Life Table and the 2005 Time Use Survey from the National Statistical Office. The anthropometric study of size in Korea used the resources provided by the Korean Agency for Technology and Standards. In addition, direct measurement and questionnaire surveys of representative samples were performed to calculate the inhalation rate, drinking water intake, and soil ingestion.

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Activity Factors of the Korean Exposure Factors Handbook: Jae-Yeon Jang, Soo-Nam Jo, So-Yeon Kim, Kyung-Eun Lee, Kyung-Ho Choi, Young-Hee Kim; J Prev Med Public Health. 2014;47(1):27-35. Published online January 29, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.1.27

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Abstract PDF

Exposure factors based on the Korean population are required for making appropriate risk assessment. It is expected that handbooks for exposure factors will be applied in many fields, as well as by health department risk assessors. The present article describes the development of an exposure factors handbook that specifically focuses on human activities in situations involving the possible risk of exposure to environmental contaminants. We define majour exposure factors that represent behavioral patterns for risk assessment, including time spent on routine activities, in different places, on using transportation, and engaged in activities related to water contact including swimming, bathing and washing. Duration of residence and employment are also defined. National survey data were used to identify recommended levels of exposure factors in terms of time spent on routine activities and period of residence and employment. An online survey was conducted with 2073 subjects who were selected using a stratified random sampling method in order to develop a list of exposure factors for the time spent in different places and in performing water-related activities. We provide the statistical distribution of the variables, and report reference levels of average exposure based on the reliable data in our exposure factors handbook.

Summary

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Original Article

Deprivation and Mortality at the Town Level in Busan, Korea: An Ecological Study: Min-Hyeok Choi, Kyu-Seok Cheong, Byung-Mann Cho, In-Kyung Hwang, Chang-Hun Kim, Myoung-Hee Kim, Seung-Sik Hwang, Jeong-Hun Lim, Tae-Ho Yoon; J Prev Med Public Health. 2011;44(6):242-248. Published online November 14, 2011; DOI: https://doi.org/10.3961/jpmph.2011.44.6.242

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Abstract PDF

Objectives

Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality.

Methods

Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation.

Results

The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high.

Conclusions

Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

Summary

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