The number of papers on health inequalities in South Korea has exploded over the past 20 years. However, given that the ultimate role of research is to improve health inequalities, it is hard to argue that the quantitative growth of research has made a significant contribution. In this article, I would like to critically look back on the progress of health inequalities research in Korea and make a proposal to overcome the severance of knowledge translation. First of all, the question of health inequality research should be changed from 'Is there health inequality across socioeconomic groups?' to 'Why/How does health inequality develop across socioeconomic groups?' Second, it is necessary to take an epistemology relevant to research questions rather than giving exclusive priority to specific epistemology, especially positivism. Third, in order to fully understand the process of social determinants of health being embodied in the human body and mind, it is necessary to revive an academic community in which researchers from various disciplines can cooperate and have a discussion about social reality
While research on domestic health inequality in Korea has grown in quantity, a small but steady stream of policy research on health inequality has also been published since the 2010. Policy evaluation studies tend to be more common than policy analysis studies. Many of the Policy evaluation studies have analyzed the effect on equity of health insurance coverage policies. Most studies used secondary data, while some used primary survey data or qualitative interview data. New research topics and methods have also been explored since 2015. Some research projects on health equity policy have been successful, leading to the policy adoption and implementation. In other cases, valuable research results could not be implemented due to political circumstances. Currently, there is an imbalance between research on health inequality status and pathway versus studies focused on policy. To further address health inequalities in Korea, additional emphasis should be placed on research directed towards implementation of policy. Apart from measuring the effect of public health policies on equity, it is also necessary to expand the research topics to analyze and evaluate the effects of policies in other sectors as the socioeconomic determinants of health. Systematic planning and evaluation of interventions aimed towards reducing health inequalities should be promoted. Efforts should be made to identify and use new research methods to produce more accurate results. Finally, it is necessary to establish an organization or institute that can support health policy research, including health equity policy research, throughout the planning, support, synthesis of the results, and dissemination.
This study examines the possibilities of public participation in building public health policy through the case of public deliberation held i Jeju, South Korea. This public deliberation called "Town-hall meeting of the public healthcare system in Jeju during the Post COVID-19 era", was conducted to improve the capacity to respond to infectious disease outbreaks in Jeju, on March 26th and 27th, 2002. Fifty-one residents of Jeju participated and discussed how the government should respond to COVID-19 and emerging infectious diseases. Among the measures to strengthen the capacity of infectious disease response, the participants preferred 'remodeling local medical centers and expanding dedicated beds', and 'expanding manpower such as specialists and nurses' the most. Through the assessment of the operation of the town-hall meeting, by applying the principle of deliberation throughout each policy stage, we found that it is necessary to improve the representation and deliberation in the process of recruiting participants, providing information, and reflecting policies. For effective deliberation in the future, it is necessary to select appropriate discussion topics, engage diverse stakeholders and minorities, design discussions with experts on information provision, and create an institutional framework for policy-making. All in all, this paper provides and insight into the future tasks and possibilities of public engagement in public healthcare in the future through the case of public deliberation in Jeju.
The climate crisis is becoming a health crisis, exacerbating social and structural contradictions that affect health. Growing climate disasters exacerbate health inequalities, with dramatically disproportionate impacts across regions and social classes. This article explains that health and environmental crises occurred in the process of capital accumulation, and seeks a health justice theory to overcome the alienation of humans and nature. Health justice theory proposes to think of health as an issue that permeates all class relations in the changing capitalist system and calls for challenging the dichotomy that traps health within pre-determined social boundaries. In order to reveal the cause of structural inequality, it emphasizes the political nature of restoring the reality of the capital-spider that has disappeared from the health inequality discourse. The political nature of the health justice movement includes the possibility of multiple rights struggles by interdependent beings taking place around the globe, and aims for a hybrid community through the ‘ethic of cohabitation’.
This study aimed to verify whether the healthcare utilization indicators developed from the user’s point of view could measure healthcare inequality more accurately than conventional unmet healthcare needs indicators. A face-to-face survey was conducted with 617 people using a measurement tool developed from the user’s point of view. Two groups were identified. The first group responded that there were no unmet healthcare needs with both the existing and developed items. The second group responded that there were no unmet healthcare needs with the existing items but with the developed item. The characteristics between the groups were analyzed. Analysis results indicated a significant difference in “in the stages of seeking healthcare,” “during utilization,” and “results of utilization” between age, self-rated health, and availability of healthcare facilities. More unmet healthcare needs were reported for tools developed in the group with people aged 50 and older (OR 3.23, 4.25, and 4.69, respectively), those in their 60s and older (OR 2.62, 10.53, 9.51, respectively), those with poor self-rated health (OR 2.22, 5.21, and 8.51, respectively), and those with poor availability of healthcare facilities (OR 3.68, 4.33, and 2.22, respectively). The study results show that the risk of underestimating unmet healthcare needs in more vulnerable groups can be prevented (and more sensitively revealed) when measured from the user’s standpoint than when measured with conventional unmet healthcare needs indicators. In the future, it is necessary to supplement the user’s point of view when measuring healthcare inequality.