Factors Associated with Unmet Needs for Medical Care among Island Inhabitants in Korea / 農村醫學 地域保健

OBJECTIVE: Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. METHODS: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. RESULTS: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. CONCLUSION: In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

The PTSD Symptom and Related Factors among the Residents after Samsung-Hebei Spirits Oil Spill / 대한산업의학회지

BACKGROUND: The purpose of the study was to estimate the mental health problems and other related factors in residents that experienced the Samsung-Hebei spirits oil spill by surveying PTSD symptoms. METHOD: Trained interviewers performed direct interviews of the residents approximately 70 days after the oil spill. We investigated PTSD symptoms through PTSD Symptom Scale Interview Version (PSS-I). To determine those factors related to PTSD symptoms, the following factors were determined as part of the survey: gender, age, occupation, duration of cleanup activity, monthly income and amount of debt. Logistic regression analysis was used to analyze all factors. RESULTS: Of the 318 residents investigated, 56.6% of the subjects had PTSD symptoms related to the spirits oil spill (about 70 days post spill). With regard to occupation, those subjects answering fishery (POR:3.05) and commerce (POR:4.24) as their occupations experienced higher PTSD symptoms than residents answering farming as their occupation. Residents who answered that they had debt over 10 million KRW (POR:2.61) were more vulnerable to PTSD symptoms compared to residents without debt; residents with acute physical symptoms were vulnerable (POR:5.11) to PTSD symptom compared to residents without acute physical symptoms. The results of multiple logistic analysis, including the cleanup activity, age, gender, occupation, acute physical symptoms and amount of debt in the model suggest that only cleanup activity increased PTSD symptoms. The subjects who had engaged in cleanup activities for longer periods of time had more PTSD symptoms and an additional dose-response relationship. CONCLUSION: Many residents in Samsung-Hebei spirits oil spill area had PTSD symptoms. This suggests that there were serious mental health problems among the residents, who might require specific social supports and psychiatric interventions as a result of the oil spill.