Health Literacy and Its Related Factors in North Korean Refugees

BACKGROUND: In September 2016, the number of North Korean refugees living in South Korea was 29,688. They have been struggling with health problems due to their poor health status and the differences in medical system and terminology between South and North Korea. We aimed to investigate the level of health literacy and its related factors in North Korean refugees. METHODS: This study was conducted with 142 patients who visited North Korean refugees' counseling center at Seoul Medical Center and National Central Medical Center and 100 South Korean patients who visited outpatient clinics or Health Promotion Center of Seoul Medical Center. General and health-related characteristics were surveyed through a questionnaire and health literacy was measured by using ‘Korean Adult Health Literacy Scale’. RESULTS: The average age of North Korean refugees was 48.92±11.49 years old. Almost 95% reported that their monthly income was less than 2 million KRW. The survey showed that North Korean refugees obtain health information mainly through TV, radio, and acquaintances and more than half (54.9%) said their health was bad or very bad. The mean score of North Korean refugees' health literacy was much lower than that of South Koreans (12.42±7.58 vs. 25.3±5.7, P<0.001). This discrepancy was maintained after adjusting related factors such as age, sex, and socioeconomic status with stratified analysis. CONCLUSIONS: It suggest the urgent need for policies which support for futher researches and development of education system, which may lead to the improvememt of the health literacy of North Korean regugees.

Reporting of National Notifiable Infectious Diseases (NNIDs) and Related Characteristics / 한국역학회지

communicable diseases. The purposes of the study is to estimate reporting proportion of National Notifiable Infectious Diseases(NNIDs) and investigate characteristics related to reporting using KAP(knowledge, attitude, practice) model. METHOD: We surveyed randomly selected 2,185 physicians (speciality: internal medicine, family medicine, pediatrics, dermatology, general physicians) of their knowledge, attitude, and practice of NNIDs reporting through self-administered mail questionnaires. Of them, 231 physicians responded (response proportion: 10.6%). RESULT: The reporting proportion was estimated to 27.0%. Recognition level (knowledge) of NNIDs was relatively high with proportion of 69.4%, and attitude (public health importance) of reporting was 65.8%. Multiple logistic regression analysis showed that knowledge, attitude significantly affected physicians' reporting in a positive direction (O.R. 6.2, 6.2 respectively). Whereas, senior age group, specialty (family medicine, pediatrics, dermatology) showed significantly lower reporting. General (tertiary care) hospital level of care showed significantly higher reporting practice (alpha=0.05). CONCLUSION: The NNIDs reporting proportion, 27.0% is similar with those studied recently. Continuous efforts to increase the performance level of communicable diseases surveillance system. Of those, restructuring surveillance systems considering characteristics of notifiable diseases classes must be stressed. Educational approach of physicians needs to be tailored specially to newly-designated diseases such as Group II, Designated Group NNIDs.

Now, Let's Look at HIV/AIDS

No abstract available.

Risk Factors for Cerebrovascular Disorders in Koreans / 예방의학회지

OBJECTIVES: To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. METHODS: The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (I60-I68) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. RESULTS: In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. CONCLUSION: We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.

Prevalence of Stroke in Pyongchang County / 한국역학회지

PURPOSE: The purpose of this study was to identify the prevalence of stroke in Pyongchang county, Kangwon do. METHODS: The presumptive stroke patients of Pyongchang county were identified with a key-person method in October 2000. And then, medical records of these patients were reviewed by well-trained two students who major in the science of medical record. RESULTS: In the year 2000, there were 92 males and 68 females of self-diagnosed stroke. Of these, stroke patients based on physician's diagnosis were 102, and stroke patients based on CT/MRI findings or Minnesota criteria were 93. Prevalence rate of self-reported stroke, stroke based on physician's diagnosis, and stroke based on CT/MRI findings or Minnesota criteria were 0.33%, 0.29%, and 0.26% respectively. CONCLUSION: We conclude that verifying process of diagnosis is needed to estimate the prevalence of stroke in community.

The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims / 예방의학회지

OBJECTIVES: We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.

Factors Related to Self-Perceived Health of Young Adults / 예방의학회지

OBJECTIVES: To determine which factors are related to young adults perception of their health. Two research questions were asked. Which aspects of health does self-perceived health as a index of general health reflect? Why do two individuals with the same level of general health have different health perceptions? METHODS: The sampling frame comprised college or graduate school students, aged 20 to 29, who were members of A, one of the 4 biggest internet communication services. The questionnaires were sent to study samples(n= 1,000) and answered by E-mail. Response rate was 37.0%. RESULTS: Firstly, physical health ranked highest and self-perceived health ranked lowest. Secondly, health, anxiety, depression, and self-perceived health showed significant differences between the sexes, with women showing a higher health status in these categories except for self-perceived health. Thirdly, the two factors significantly related to self-perceived health were physical health and self-esteem, as determined by multivariate analysis. CONCLUSIONS: The factors significantly related to self-perceived health were physical health and self-esteem. Further studies of the health characteristics of young adults are needed.

What Factors Affect Mortality over the Age of 40? / 예방의학회지

OBJECTIVES: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

The Epidemiological Characteristics of a Shigellosis Outbreak (1998) in Wonju City, Kangwon-Do / 한국역학회지

From September 8-28 1998, 55 cases of shigellosis, characterized by watery diarrhea, high fever, abdominal cramps and headache were reported at K elementary school in Wonju City. The isolated serotype was Shigella sonnei (group D). We collected bacteriologic specimens from high-risk populations, disinfected epidemic areas, and monitored all the medical facilities in Wonju City. Through these efforts, we found 168 cases of shigellosis, and of these, 117 were culture-confirmed and 51 were diagnosed by symptoms. The incidence rate per 10,000 population in Wonju City was 1.00 in males and 1.19 in females. The secondary attack rate was 13.6%. The mode of transmission at K elementary school was most often caused by the common epidemic source of single exposure. The source of infection was believed to be the foods distributed on September 7. However, epidemiologic evidence suggested that the sources of infection were scattered over many places within the city. The reasons included: i) shigellosis is an endemic disease in Korea; ii) there were shigellosis-like patients at J primary school in Wonju City in late August; and iii) there was a shigellosis outbreak at Chongil Myun, Hoeng Seong Gun, which was located near Wonju City, in early August.