J Korean Med Assoc.  2013 Mar;56(3):206-212. 10.5124/jkma.2013.56.3.206.

Current status of policy developments in tackling health inequalities and the next steps to be taken in Korea

• Kim MH
• Lee J

• KMID: 2064825
• DOI: http://doi.org/10.5124/jkma.2013.56.3.206

Abstract

Considering that health inequalities derive from socioeconomic inequalities, fair policies and strategies to tackle health inequalities must focus on socioeconomic conditions. What is needed here is Health in All Policies, a comprehensive and intersectoral approach beyond health and healthcare sectors. However, based on a review of policies and programs of the Ministry of Health and Welfare and the 3rd National Health Promotion Strategies (Health Plan 2020) in Korea, we conclude that they totally lacked in perspective on health equity and social determinants of health. In fact, even most programs under the name of health equity include only supplementary health services targeted for low-income groups. As socioeconomic inequalities are worsening in Korea, health inequalities are more likely to be further aggravated if timely actions are not taken.

Keyword

Health impact assessment; Health promotion; Policy; Republic of Korea; Socioeconomic factors

MeSH Terms

Health Care Sector
Health Impact Assessment
Health Promotion
Health Services
Korea
Policy Making
Republic of Korea
Socioeconomic Factors

Figure

• 

  Figure 1 Diderishcen's model for explaining health inequalities (From Solar O, et al. A conceptual framework for action on the social determinants of health: social determinants of health discussion paper 2. Geneva: World Health Organization; 2010, with permission from WHO Publicaton) [2].

• 

  Figure 2 Framework of national health promotion strategy (From Ministry of Health and Welfare. The 3rd National Health Promotion Strategy 2011-2020. Seoul: Ministry of Health and Welfare; 2011) [6].

• 

  Figure 3 Action spectrum on inequalities in health (From Whitehead M. Milbank Q 1998; 76:469-492, with permission from Milbank Memorial Fund) [11].

Reference

1. Macinko JA, Starfield B. Annotated bibliography on equity in health, 1980-2001. Int J Equity Health. 2002; 1:1.

2. Solar O, Irwin A. A conceptual framework for action on the social determinants of health: social determinants of health discussion paper 2. 2010. Geneva: World Health Organization.

3. Marmot M, Atkins T, Bell J, Black C, Broadfoot P, Cumberlege J. Fair society, healthy lives: the Marmot review. Strategic review of health inequalities in England post-2010. 2011. London: Marmot Review.

4. Khang YH, Lee SI. Health inequalities policy in Korea: current status and future challenges. J Korean Med Sci. 2012; 27:Suppl. S33–S40.

5. Ministry of Health and Welfare. Annual report on nation's health and welfare 2011. 2011. Seoul: Ministry of Health and Welfare.

6. Ministry of Health and Welfare. The 3rd National Health Promotion Strategy 2011-2020 (HP2020). 2011. Seoul: Ministry of Health and Welfare.

7. World Health Organization, Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. 2008. Geneva: World Health Organization.

8. Yoon TH. The proposal of policies aimed at tackling health inequalities in Korea. J Prev Med Public Health. 2007; 40:447–453.

9. Ministry of Health and Welfare. Korea Institute for Health and Social Affairs. Developing the framework for the National Health Plan 2020 of Korea. 2009. Seoul: Ministry of Health and Welfare.

10. Shin YJ, Yoon TH, Kim MH, Jeong BG, Seo JH. Health equity policy and practice: strategic approach for alleviation of health inequality. Korea Soc Policy Rev. 2011; 18:41–77.

11. Whitehead M. Diffusion of ideas on social inequalities in health: a European perspective. Milbank Q. 1998; 76:469–492.

12. Stahl T, Wismar M, Ollila E, Lahtinen E, Leppo K. Health in all policies: prospects and potentials. 2006. [place unknown]: Ministry of Social Affairs and Health, European Observatory on Health Systems and Policies.

13. Puska P, Stahl T. Health in all policies-the Finnish initiative: background, principles, and current issues. Annu Rev Public Health. 2010; 31:315–328.

14. World Health Organization. The 62nd World Health Assembly. Reducing health inequalities through action on the social determinants of health. 2009. Geneva: World Health Organization.

15. Mackenbach JP, Bakker M. Reducing inequalities in health: a European perspective. 2002. London: Routledge.

16. Organization for Economic Cooperation and Development. OECD economic surveys: Korea. 2012. Paris: Organization for Economic Cooperation and Development.

17. Kim MH, Kim CY, Park JK, Kawachi I. Is precarious employment damaging to self-rated health? Results of propensity score matching methods, using longitudinal data in South Korea. Soc Sci Med. 2008; 67:1982–1994.

18. Lee JH. High road social rights. 2012. Seoul: Humanitas.