Korean Journal of Health Equity, The Korean Society for Equity in Health

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PDF Citaion Reconstructing the Social Value of Care and Systemic Transformation

Hyun-Hee Heo(Institute for Future Public Health, Graduate School of Public Health, Korea University) pp.4-6 https://doi.org/10.23163/KJHE.PUB.3.1.4

PDF Citaion Community-Based Integrated Care and the Structure of Inequality

Chang-yup Kim(School of Public Health, Seoul National University, People's Health Institute) pp.9-21 https://doi.org/10.23163/KJHE.PUB.3.1.9

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Abstract

This study analyzes how inequality emerges in the formation and transformation of Korea’s community-based integrated care system. The study explores the social reality of integrated care from the perspectives of ‘Morphogenetic Approach’ (Margaret Archer) and the ‘Laminated System’ (Roy Bhaskar). It emphasizes that community-based integrated care is not merely a policy measure but a dynamic social practice shaped by interactions among various actors, including the government, service providers, and users. Special attention is given to how the capitalist market structure and historically established health and welfare policies contribute to structuring inequality in integrated care. The study also examines how disparities in service accessibility and resource allocation, influenced by regional and socioeconomic conditions, exacerbate care inequality. Finally, through a people-centered perspective, the study highlights the experiences and problem awareness of residents and service users, often overlooked in existing policies and research, and explores the role and potential of social power in enhancing equity in community-based integrated care.

PDF Citaion Community-Based Participatory Integrated Care for Elderly Living Alone : A Case Study from a Neighborhood in a Large City

Taeho Yoon(Pusan National University School of Medicine, Department of Preventive Medicine and Occupational & Environmental Medicine) ; Minhyeok Choi(Pusan National University School of Medicine, Pusan National University Yangsan Hospital) pp.22-34 https://doi.org/10.23163/KJHE.PUB.3.1.22

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Integrated community care aims to enable individuals facing difficulties in daily life to continue living healthily in their own communities through coordinated medical, nursing, and social care. While prior studies have largely focused on service-provider-driven integration approaches, emphasizing community participation remain limited. This study examines ‘Dadolbom (meaning Care for All)’, a community-based participatory initiative addressing the care needs of elderly residents living alone in Yongho 3-dong, Nam-gu, Busan. Originating from local recognition of the need for collective action, the project involved forming a neighborhood network, conducting comprehensive surveys with 802 elderly individuals living alone, identifying their problems, and implementing collaborative solutions for tackling the problems. Participants included residents, healthcare workers, social workers, and local government representatives. The elderly were categorized into three disadvantaged groupscardiovascular disease, mental health, and social support-to intervention. Especially, pre- and post- intervention changes among the individuals identified as the mental health vulnerable group revealed statistically significant positive improvements in all measured domains, including subjective health status, depression, suicidal ideation, and social support. ‘Dadolbom’ emphasized community-driven planning, regular discussions, and rapid responses to urgent cases. This experience underscores the potential of participatory frameworks in delivering effective integrated care and offers practical insights for developing community-centered initiatives.

PDF Citaion The Care Crisis and Alternatives for the Elderly

Jayoung Yoon(Chungnam National University) pp.35-42 https://doi.org/10.23163/KJHE.PUB.3.1.35

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With one of the lowest fertility rates and highest elderly suicide rates in the world, the care deficit in our society increases the health risks and social unrest of our citizens. Despite the expansion of long-term care insurance schemes, the quality of care services to maintain a decent life is still inadequate. The recent push for greater marketisation of care services and reliance on foreign workers risks undermining the sustainability of care provision. This article highlights the need for a policy direction to make care infrastructure more public and argues that the socialization of care is not just a labor market issue but an essential task for building more inclusive and sustainable societies.

PDF Citaion Korean Society Leans on The Work of Migrant Women, Are We Taking Care of Them? : An Interview with HeoOh Young-sook, Representative of the Women Migrants Human Rights Center of Korea

Seong-Yi Kim(People’s Health Institute) pp.43-52 https://doi.org/10.23163/KJHE.PUB.3.1.43

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This article is an interview with HeoOh Young-sook, Representative of the Women Migrants Human Rights Center of Korea, about the lives and labor of migrant women, who account for 47.5% (1.17 million) of foreign residents living in Korea. Many migrant women are entering Korea for labor, marriage, and study purposes, but their basic rights are guaranteed differently due to the visa type of residence requirements. In particular, workers who enter the country under the Employment Permit System (E-9) can be protected by the Labor Standards Act or the Labor Relations Act by applying the 「Act on Foreign Employment」 . However, since the employment permit system was designed from the beginning in a way that does not recognize the right to family composition to prevent migrant workers from settling down, there are no protective measures for the Sexual and reproductive health and rights, such as pregnancy and childbirth. In addition, due to strong legal marriage standards and normal family ideology, the Korean government does not apply a universal birth registration system for migrants, so if a female migrant worker or an international student gives birth, there is a problem that they have to go through complex birth registration procedures. In the field of caring labor, many Korean Chinese women who entered the country under the special employment permit system (visiting employment visa H-2), but poor working conditions and discrimination against caring labor continue. In order to respect the values of caring labor and caring workers, it is necessary to seek a method such as caring insurance as a public social system. Overall, since Korea's migrant women's policy is biased toward an instrumental perspective to secure the labor force and resolve the population crisis, more systems should be prepared to allow them to enjoy the basic rights of citizens and settle in a stable manner.

PDF Citaion Research on Social Inequality in Contemporary Society: Concepts and Research Programs

Kwang-Yeong Shin(Department of Sociology, Chung-Ang University) pp.54-69 https://doi.org/10.23163/KJHE.PUB.3.1.54

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This paper addresses the concepts and key theoretical issues necessary for studying inequality in contemporary society. Inequality is understood as a product shaped by social structures and institutions, explained through differential access and relational approaches. The major types of inequality are classified into economic inequality, gender inequality, racial inequality, health inequality, and environmental inequality. Structural factors that produce these inequalities operate in a complex and multidimensional manner through the intersections and causal linkages of class, gender, and race. The cumulative effects of these systems of inequality hinder intergenerational mobility. Globalization exacerbates inequality, leading to political instability and the rise of far-right politics. This study emphasizes that research on inequality must explore complex causal relationships and intersections and ultimately provide academic and policyoriented solutions.

PDF Citaion Representative Measures for Monitoring Health Inequality: Introduction, Calculation and Interpretation Approaches

Min Hui Moon(Pusan National University Yangsan Hospital) ; Minhyeok Choi(Pusan National University School of Medicine, Pusan National University Yangsan Hospital) pp.70-84 https://doi.org/10.23163/KJHE.PUB.3.1.70

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Measuring and monitoring health inequalities is essential for achieving health equity. This study provides an overview of measurements for measuring health inequalities, including classifications, selection criteria, calculation methods, interpretation approaches, and practical applications. Widely used indicators are introduced, pairwise comparison (absolute difference [AD] and relative difference [RD]), regression-based measures (slope index of inequality [SII], relative index of inequality [RII]), the index of dissimilarity (a measure of segregation between groups), mean disproportionality measures (Gini coefficient [GC], concentration index [CI], and Theil index [TI]), and between-group variance (BGV). Furthermore, this study examines the advantages and limitations of each measure, providing practical insights and guidelines to assist researchers in selecting appropriate summary measures for analyzing health inequalities and effectively presenting their findings.

PDF Citaion An Evaluation of Public Healthcare in South Korea : Contemporary Challenges and Agenda for Future Research

Myoung-Hee Kim(National Medical Center) ; Juyeon Lee(School of Public Health Sciences, University of Waterloo) pp.85-102 https://doi.org/10.23163/KJHE.PUB.3.1.85

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The growing demand to reform South Korea's inequitable and commercialized healthcare system underscores the critical necessity for comprehensive structural change. Current efforts to improve economic accessibility by expanding health insurance coverage have proven insufficient, underscoring the need to advance "public healthcare" as a central focus of reform. Despite its growing prominence, the concept of publicness remains insufficiently examined within academic discourse, particularly concerning its theoretical foundations, practical implications, and the specific dimensions in which the current healthcare system is critically assessed as deficient. This study critically investigates the discourse on publicness in South Korea's healthcare system, analyzes the current state of public healthcare as defined by legal frameworks, and identifies key directions for future research. It calls for a paradigm shift from the conventional focus on state-centered ownership structures to a multidimensional conceptualization of publicness. This approach involves defining the fundamental essence of publicness that healthcare systems should aim to achieve while systematically investigating the institutional configurations necessary for its realization and addressing the structural and practical barriers that obstruct progress. Additionally, the study highlights the importance of analyzing the political and contextual dynamics of healthcare policy-making. By examining how policy priorities are established, identifying the key actors involved, and understanding their underlying interests, such research can generate critical insights to inform the design of alternative frameworks capable of reshaping both policy and discourse. As societal calls for public healthcare intensify, this study underscores the importance of systematic and rigorous academic engagement to address these pressing issues. Ultimately, this paper provides a foundation for scholarly inquiry into public healthcare and publicness, contributing to the development of transformative strategies for healthcare reform.

PDF Citaion A Socioeconomic Approach to Suicide Prevention : A Rapid Literature Review

Yeaseul Yoon(Department of Public Health, College of Medicine, Korea University) ; Minji Hwang(Department of Public Health, College of Medicine, Korea University) ; Mingyeong Bae(Department of Preventive Medicine, College of Medicine, Korea University) ; Hyun-Hee Heo(Institute for Future Public Health, Gradaute School of Pulbic Health, Korea University) ; Joon Park(International School of Urban Sciences, University of Seoul) ; Weon Young Lee(Department of Preventive Medicine, College of Medicine, Chung-Ang University) ; Min-Hyuk Kim(Department of Psychiatry, Yonsei University Wonju College of Medicine) ; NakHyeok Choi(Division of Public Administration, Gachon University) ; Hye Sun Park(Research Institute of Community and Human Services, Rikkyo University) ; Myung Ki(Department of Preventive Medicine, College of Medicine, Korea University) pp.103-118 https://doi.org/10.23163/KJHE.PUB.3.1.103

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The importance of socioeconomic approaches in suicide prevention has been increasingly emphasized. This study conducted a rapid literature review to explore how socioeconomic policies and programs are applied in suicide prevention. A total of ten cases from eight countries, including Canada, Japan, the United Kingdom, and Australia, were selected and analyzed. Suicide prevention efforts incorporating socioeconomic approaches, based on the social determinants of health, were widely implemented in various contexts, including financial debt, housing instability, and employment, as well as in high-risk situations such as suicide crises and post-attempt discharge phases. These approaches were systematically structured in three main forms. First, national or municipal-level plans supported a multisectoral approach, ensuring that suicide prevention was not confined to medical interventions but was also addressed within a broader social framework. Second, institutional mechanisms assigned specific roles and responsibilities to integrate mental health responses into social protection systems, such as those for housing and financial support. Third, care coordinators or coordination teams were strategically positioned at critical suicide risk points, including hospitalization and discharge, to facilitate the provision of diverse social services. The findings highlighted that social programs in suicide prevention not only contributed to reducing suicide risk but also demonstrated positive impacts on mental health. Moreover, lived experiences, civic engagement, and community participation emerged as key mechanisms in the effective delivery of integrated services. This study reviewed the evolving trend of suicide prevention from a primarily healthcare-centered responsibility to a comprehensive, government-wide approach and examined the practical applicability of socioeconomic interventions through concrete case studies.

PDF Citaion Digital Health and Health Equity : Understanding and Challenges

Ji-Eun Park(Center for Global Collaboration, Korea Institute of Oriental Medicine) ; Sujin Kim(Department of Health Care Policy Research, Korea Institute for Health and Social Affairs) ; Youn Jung(Department of Health Care Policy Research, Korea Institute for Health and Social Affairs) ; Sylvia Park(Department of Health Care Policy Research, Korea Institute for Health and Social Affairs) ; Bo Ram Yang(College of Pharmacy, Chungnam National University) ; Inmyung Song(Department of Health Administration, College of Nursing and Health, Kongju National University) ; Dong-Sook Kim(Department of Health Administration, College of Nursing and Health, Kongju National University) ; Eunjeong Kang(Department of Health Administration and Management, Soonchunhyang University) ; Sang-Eun Choi(College of Pharmacy, Korea University Sejong Campus) pp.119-133 https://doi.org/10.23163/KJHE.PUB.3.1.119

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Digital health technology (DHT) is gaining significant policy and industrial support, driven by expectations that it will improve users' access to and utilization of healthcare services while making healthcare systems more efficient and cost-effective. However, concerns have been raised that DHT may systematically exclude digitally vulnerable groups throughout its development, adoption, and implementation, and application phases, potentially exacerbating health inequities. This paper seeks to explore how DHT is understood and addressed from a health equity perspective through a review of prior studies. First, it introduces developed frameworks to understand the relationship between DHT and health inequity. Second, it explores empirical studies on the utilization of DHT and its outcomes from a health equity lens. Third, it presents a case of policy aimed at reducing digital health inequity by introducing a ‘Framework for NHS action on digital inclusion’ of NHS England. Lastly, it reviews recommendations and suggestions for the equitable utilization and research of DHT, offering insights into the challenges facing health equity research.

PDF Citaion Participatory Interview Techniques in Qualitative Research : Applications to Health Inequality Research

Dahye Yim(London School of Hygiene and Tropical Medicine) ; Myounghee Kim(National Medical Center) pp.135-151 https://doi.org/10.23163/KJHE.PUB.3.1.135

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This study explores the application of participatory interview techniques in health inequalities research. Participatory interview techniques provide a platform for participants to actively identify problems and discuss solutions by using various visual materials and activities. These techniques aim to minimise the power imbalance between researchers and participants throughout the interview process. It is particularly effective in studies involving vulnerable populations and socially sensitive topics, enabling the exploration of complex issues often obscured by social stigma or conceptual challenges, and identifying structural determinants of health inequalities. Such techniques allow a comprehensive and deep understanding to the reality as participants actively identify and discuss solutions addressing health inequalities. This study provides detailed examples of the application of participatory interview techniques, including word clouds, vignettes, problem walls, and solution trees, in research on gender norms and Sexual and Reproductive Health (SRH). By sharing step-by-step experiences, this study provides practical insights and guidance for researchers aiming to use these tools in health inequalities research.

PDF Citaion Transforming Democracy through the Lens of Care Inequality : A Book Review of 『Caring Democracy: Markets, Equality, and Justice』 by Joan C. Tronto

Jeongin Sohn(Kangwon National University Hospital, Dept. of Preventive Medicine) pp.153-159 https://doi.org/10.23163/KJHE.PUB.3.1.153

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