본문 바로가기 주메뉴 바로가기


  • P-ISSN0023-3900
  • E-ISSN2733-9343

Investigating the Space of Poverty and Health Care: Poverty, Mortality, and the Inverse Care Law in Seoul

Korea Journal / Korea Journal, (P)0023-3900; (E)2733-9343
2013, v.53 no.1, pp.9-30

  • Downloaded
  • Viewed


This study addresses the relationship between poverty, health needs, and health care in South Korea. According to Hart’s inverse care law, the availability of good medical care tends to vary inversely with need. The results of this study indicate significant increases in the mortality rate when poverty is high and the number of hospitals is low in the metropolitan area of Seoul, the capital of South Korea. These results support the validity of the inverse care law. Hart was primarily concerned with the effects of market forces on the accessibility of health care. The paradox of the South Korean health care system in a geographical context is that while the authoritative governmental structure supports the development of a private provider market and social policy, the same administrative structure must correct the inequitable distributions of hospitals and assistance for the poor. These findings indicate that the tenets of the inverse care law may apply in some regions but not in others due to differences in the historical formation of the health care system of each region and specific locale.

poverty health care inverse care law mortality Seoul



Bahl, Roy W., and Johannes F. Linn. 1992. Urban Public Finance in Developing Countries. New York: Oxford University Press.


Bundgaard, Frank, and Mads Christofferson. 1986. Decentralization in Denmark: Towards a New Inequality. Copenhagen: Institute for Kultursociologi.


Chun, Chang-Bae, Soon Yang Kim, Jun Young Lee, and Sang Yi Lee. 2009. “Republic of Korea: Health System Review.” Health Systems in Transition 11.7: 1-184.


Curtis, Sarah. 1989. The Geography of Public Welfare Provision. London: Routledge.


Edwards, Phillip, and Flatley John. 1996. The Capital Divided: Mapping Poverty and Social Exclusion in London. London: London Research Centre.


Eikemo, Terje A., Claire Bambra, Kerry Joyce, and Espen Dahl. 2008. “Welfare State Regimes and Income-related Health Inequalities: A Comparison of 23 European Countries.” European Journal of Public Health 18.6: 593-599.


Elander, Ingemar. 1997. “Between Centralization and Localism: On the Development of Local Self-Government in Postsocialist Europe.” Environment and Planning C: Government and Policy 15.2: 143-159.


Feitosa, Flávia da Fonseca, and Anna Wissman. 2006. “Social-Mix Policy Approaches to Urban Segregation in Europe and the United States.” Interdisciplinary Term Paper, International Doctoral Studies Programme, Center for Development Research, University of Bonn.


Furler, John S., et al. 2002. “The Inverse Care Law Revisited: Impact of Disadvantaged Location on Accessing Longer GP Consultation Times.” Medical Journal of Australia 177.2: 80-83.


Gills, Barry. 1993. “Korean Capitalism and Democracy.” In Low Intensity Democracy, edited by Barry Gills, Joel Rocamora, and Richard Wilson, 226-257. London: Pluto.


Glennerster, Howard, John Hills, David Piachaud, and Jo Webb. 2004. One Hundred Years of Poverty and Policy. York: Joseph Rowntree Foundation.


Greer, Scott L. 2010. “How Does Decentralisation Affect the Welfare State? Territorial Politics and the Welfare State in the UK and US.” Journal of Social Policy 39.2: 181-201.


Ha, Seong-Kyu. 2004. “Housing Poverty and the Role of Urban Governance in Korea.” Environment and Urbanization 16.1: 139-153.


Hart, J. Tudor. 1971. “The Inverse Care Law.” Lancet 297.7696: 406-412.


Haynes, Robin. 1987. The Geography of Health Services in Britain. Kent: Croom Helm.


Hwang, Gyu-jin. 2006. Pathways to State Welfare in Korea: Interests, Ideas and Institutions. Aldershot: Ashgate.


Hvinden, Bjorn. 1994. Divided against Itself: A Study of Integration in Welfare Bureaucracy. Oxford: Oxford University Press.


Joassart-Marcelli, Pascale M., Juliet A. Musso, and Jennifer R. Wolch. 2005. “Fiscal Consequences of Concentrated Poverty in a Metropolitan Region.” Annals of the Association of American Geographers 95.2: 336-356.


Kangas, Olli. 2010. “One Hundred Years of Money, Welfare and Death: Mortality, Economic Growth and the Development of the Welfare State in 17 OECD Countries 1900-2000.” International Journal of Social Welfare 19: S42-S59.


Kawachi, Ichiro, and Bruce P. Kennedy. 1999. “Income Inequality and Health: Pathways and Mechanisms.” Health Service Research 34.1: 215-227.


King’s Fund. 1997. Transforming Health in London. London: King’s Fund London Commission.


Ku, In-Hoe. 2007. “Social Welfare Reform since the 1997 Economic Crisis in Korea: Achievement, Limits, and Future Prospects.” Asian Social Work and Policy Review 1: 21-35.


Lee, Jae-Wan, and Kim Kyo-Sung. 2007. “Jibang jachi danche sahoe bokji jichul sujun-ui gyeoljeong yoin bunseok: 1995-2005” (Determinants of Social Welfare Expenditure in Local Government: 1995-2005). Sahoe bokji jeongchaek (Social Welfare Policy) 31: 105-124.


Lewis, Janet Diana. 1975. “The Local Authority Health and Social Services in Four London Boroughs: An Examination of the Source of Variation.” PhD diss., Goldsmith College, London.


Mercer, Stewart W., and Graham C. M. Watt. 2007. “The Inverse Care Law: Clinical Primary Care Encounters in Deprived and Affluent Areas of Scotland.” Annals of Family Medicine 5.6: 503-510.


OECD. 2003. Korea: OECD Review of Health Care Systems. Paris: OECD.


OECD. 2010. OECD Health Data. Paris: OECD.


Oh, Young-Ho, and Shin Ho-Sung. 2008. Bogeon uiryo jawon baebun-ui hyoyulseong jeungdae-reul wihan moniteoring siseutem guchuk mit unyeong (Development and Management of Monitoring System to Improve the Efficiency of Health Care Resources Allocation). Seoul: Korea Institute of Health and Social Affairs.


Pain, Rachel, Jamie Gough, Graham Mowl, and Michael Barke. 2001. Introducing Social Geographies. London: Edward Arnold.


Park, Bong-Gil, and Yi Sang-Il. 2005. “Jeosodeukcheung jipjung geoju-wa gongjeok bujo jaejeong-ui jiyeokjeok bulgyunhyeong-e daehan sahoe bokji jeongchaekjeok hamui” (Social Welfare Policy Implication of Poor Neighborhood Concentration and Regional Disparity of Budget for Social Welfare). Bokji haengjeong nonchong (Journal of Public Welfare Administration) 15.1: 105-144.


Payne, Judy. 1999. Researching Health Needs. London: Sage.


Phillips, Ceri, Colin Palfrey, and Paul Thomas. 1994. Evaluating Health and Social Care. London: Macmillan Press.


Philo, Chris. 1995. Off the Map: The Social Geography of Poverty in the UK. London: Child Poverty Action Group (CPAG).


Powell, Martin. 1987. “Access to Primary Health Care in London.” PhD diss., University of London.


Powell, Martin, and George Boyne. 2001. “The Spatial Strategy of Equality and the Spatial Division of Welfare.” Social Policy and Administration 35.2: 181-194.


Ronzio, Cynthia R., Elsie R. Pamuk, and Gregory D. Squires. 2004. “The Politics of Preventable Deaths: Local Spending, Income Inequality, and Premature Mortality in U.S. Cities.” Journal of Epidemiology and Community Health 58: 175-179.


Rowntree, B. Seebohm. [1901] 2000. Poverty: A Study of Town Life. London: Macmillan.


Seoul Metropolitan Government. 2002. Seoul tonggye yeonbo 2002 (Seoul Statistical Yearbook 2002). Seoul: Seoul Metropolitan Government.


Seoul Metropolitan Government. 2010. Seoul tonggye yeongbo 2010 (Seoul Statistical Yearbook 2010). Seoul: Seoul Metropolitan Government.


Torfing, Jacob. 1998. Politics, Regulation and the Modern Welfare State. London: Macmillan.


Townsend, Peter. 1979. Poverty in the United Kingdom: A Survey of Household Resources and Standards of Living. London: Penguin.


Townsend, Peter, and Davidson Nick. 1988. Inequalities in Health. London: Penguin.


United Nations Centre for Human Settlements Programme (UN-HABITAT). 1996. An Urbanizing World: Global Report on Human Settlements. Oxford: Oxford University Press.


Wagstaff, Adam. 2002. “Poverty and Health Sector Inequalities.” Bulletin of the World Health Organization 80.2: 97-105.


Watt, Graham. 2002. “The Inverse Care Law Today.” Lancet 306: 252-254.


World Health Organization (WHO). 2008. The World Health Report 2008: Primary Health Care: Now More Than Ever. Geneva: WHO.


Wilkin, David, David Metcalfe, and Ralph Leavey. 1987. Anatomy of Urban General Practice. London: Tavistock.


Wyke, Sally, Gerrie Campbell, and Sheila MacIver. 1992. “Provisions of, and Patient Satisfaction with, Primary Care Services in a Relatively Affluent Area and a Relatively Deprived Area of Glasgow.” British Journal of General Practice 42: 271-275.

Korea Journal