The association of education in a new society and social support from the education with the health of North Korean defectors: a cross-sectional study

Background

The number of North Korean defectors (NKDs) escaping to South Korea has increased. The health status of NKDs is an essential factor for a successful settlement into South Korean society. However, no studies have been conducted on the health status of NKDs in terms of education and social support. The aim of this study was to determine the associations of education and social support with the self-rated health status among NKDs.

Methods

This study utilized data gained from face-to-face interviews with 126 NKDs. A multivariable logistic regression and path analysis were performed to assess the effects of education in South Korea and social support on their self-rated health status and to explore the complex relationships between direct and indirect effects of the variables.

Results

NKDs who did not experience regular education in South Korea responded that they were in poor health compared to their counterpart (OR = 5.78). Although a direct association between education in South Korea and self-rated health was not shown, there was an indirect path from education in South Korea to self-rated health through social support.

Conclusions

Participation in regular education in South Korea is important for the health status of NKDs. Moreover, social support has an important role in the association between education and self-rated health. Social policies and NKD assistance programs should consider and reflect the combination of education and social support interventions relevant to the health status of NKDs.

Health literacy and use of preventive health services among North Korean defectors in the Republic of Korea

It is known that some groups of immigrants can have low health literacy and it may affect their health. Although the number of North Korean defectors in the Republic of Korea has increased, little is known about their health literacy and health behavior. Adult North Korean defectors (n = 399) in this study were surveyed on health literacy, using the Korean Health Literacy Scale, and on the use of preventive services. Those with better health literacy scores were more likely to have vaccination than the lower scoring group (adjusted OR = 2.44; 95% CI, 1.19–5.00). However, undergoing medical check-up may not be associated with health literacy. In subgroup analysis, among defectors who lived alone (P = 0.032) or who had longer time in other countries before entering (P = 0.007), the vaccination coverage was associated with their health literacy scores. This study provides evidence for an association between health literacy and influenza vaccination coverage among North Korean defectors even though they may have fewer language barriers than other immigrants. Further research is needed to develop interventions for improving health literacy and their preventive health behavior.

Influenza Vaccination Coverage and Its Associated Factors among North Korean Defectors Living in the Republic of Korea

This study aimed to examine influenza vaccination coverage of North Korean defectors (NKD) in the Republic of Korea (Korea) and explore the factors affected the vaccination coverage. Total 378 NKD were analyzed. Four Korean control subjects were randomly matched by age and gender from the Korea National Health and Nutrition Examination Survey V (n = 1,500). The adjusted vaccination coverage revealed no statistical difference between the defectors group and indigenous group (29.1% vs. 29.5%, P = 0.915). In the aged under 50 group, the vaccination coverage of NKD was higher than that of Korean natives (37.8% vs. 25.8%, P = 0.016). However in the aged 50 yr and over group, the vaccination coverage of North Korean defectors was lower than that of the natives (28.0% vs. 37.6%, P = 0.189). Even the gap was wider in the aged 65 yr and over group (36.4% vs. 77.8%, P = 0.007). Gender and medical check-up experience within 2 yr showed association with the vaccination coverage of NKD. Influenza vaccination coverage of aged defectors' group (aged 50 yr and over) was lower than indigenous people though overall vaccination coverage was similar. Further efforts to increase influenza vaccination coverage of this group are needed.

Factors associated with the frequency of physician visits among North Korean defectors residing in South Korea: a cross-sectional study

BACKGROUND

Since the mid-1990s, a growing number of North Korean defectors have been arriving in South Korea, many of whom have various somatic and mental disorders. The health status of defectors is an important predictor of their successful resettlement. Therefore, this study examined the frequency of physician visits among North Korean defectors residing in South Korea, as well as the factors associated with this frequency.

METHODS

The data used in this study were collected through survey questionnaires and interviews conducted from April 6 to May 20, 2009, and involving 500 North Korean defectors who entered South Korea in 2007. This study used three domains of independent variables: 'health-related factors,' 'special characteristics of North Korean defectors,' and 'demographic and socio-economic factors'. Nested multivariable linear regression analysis was conducted in order to determine the factors related to the frequency of physician visits between January 1 and December 31, 2008.

RESULTS

The average number of physician visits made by the participants during 2008 was 15.3; 14.5% of participants did not have physician visits. The number of physician visits was largely associated with health-related variables including disability, chronic disease and self-rated health status. The frequency of physician visits was higher among those with a disability, chronic disease, lower self-rated health score, a greater number of traumatic experiences during their escape, lower annual family income, and among females.

CONCLUSIONS

This study confirmed that the number of defectors' physician visits was related with objective and subjective health status, traumatic experiences during their migration, economic, and demographic variables. The results serve useful understanding of medical utilization characteristics among North Korean defectors in South Korea.

Preference and awareness of telemedicine in primary care patients

BACKGROUND

The telemedicine services in Korea are expected to rapidly expand its use to the general population due to the development of digital networking, and its recent revision of related law and regulations. The purpose of this study was to investigate the knowledge and attitude of telemedicine in primary care patients.

METHODS

We enrolled a total 243 participants, visited Family Medicine clinics and health promotion centers of university hospital in Seoul metrocity and Chungju city from April 1, 2010 to May 31, 2010. Data was collected by questionnaire, including demographic variables, knowledge and attitude of telemedicine.

RESULTS

Among the total of 243 participants, 117 (49.8%) respondents were aware of telemedicine, and 178 (73.3%) respondents preferred telemedicine. The awareness showed differences according to the residence (P = 0.007), education (P = 0.03), and occupation (P = 0.02) of the respondents. The patient preference showed the differences at 50 years of age (P = 0.01) and in income of the participants (P = 0.005).

CONCLUSION

Awareness of telemedicine in primary care patients was low. As for the patients more than 50 years of age who will be having difficulty manipulating the instruments, more education is crucial. Establishment of appropriate plans to increase patient preference is needed, especially for patients with low-incomes.