Transcript to view - Public Health Observatories

Harbin
Vladivostok
Institutionalizing
HIA in Korea
Seoul
Eun Jeong Chun(M.D, M.P.H)
Seoul University
Republic of Korea
Jinhee, Kim1), Ok Ryun, Moon2), Eun Jeong, Chun
1) Seoul National University
2) Inje institute for Advanced Studies
1)
Contents
Hambuk
Hamnam
Pyeongbuk
2. Background
Pyeongnam
Hwanghae
1. Introduction of Korea
Gangwon
3. Strategy
Gyeonggi
Chungbuk
Chungnam
Gyeongnam
Jeonbuk
Gyeongbuk
Jeonnam
Jeju
4. Conclusion
Location
Korea at a Glance
Population: 48.456 million (2007. OECD)
Seoul
Area: South Korea(99,000㎢ )
Incheon
Geographical Location: Eastern Asia, southern
half of the Korean Peninsula, bordering the
East Sea and the Yellow Sea
Daejeon
Daegu
Ulsan
Busan
Gwangju
Climate: distinctive 4 seasons, with rainfall
heavier in summer
Administrative divisions: 9 Provinces (do)
+ 7 Metropolitan Cities (gwangyoksi, tukpyolsi)
Local Self-Government System (June, 1995)
Statistics of Korea
GDP per capita: 23,038 $
Life expectancy at birth: 78.5(OECD, 2005)
Total fertility rate: 1.24 (2005)
Infant mortality rate: 4.7 (2005)
The Korean Health Care System
Ministry of Health, Welfare and Family Affairs (MIHWAF)
Central
Province
Center for Disease Control
& Prevention (CDC)
Province
(Department of Health)
County
local
(Community Health Center
Public Hospital)
Township
Public Institute
National Health Insurance
Corporation (NHIC)
: Head quarter
TEXT
NHIC
Private Voluntary Agency
Regional head quarter
NHIC
Branch office/ a hospital
Private Hospital
/Clinic/Solo practitioner
(Community Health Subcenter
/Community Health Post)
village
Private Organization
Village
(Community Health Post)
People
Harbin
Vladivostok
Why Health Impact Assessment?
Background
Seoul
Other Impact Assessment
Transport Population
Main
Ministry
Start
from
Disaster
Environment
Gender
Ministry of
Land,
Transport
and
Maritime
Affairs
Ministry of
Land,
Transport
and
Maritime
Affairs
Ministry of
Public
Administrati
on and
Security
Ministry of
Environment
Ministry of
Gender
Equality
1987
1984
1996
1981
2002
The Environmental Health Act
The Environmental Health Act
(Mar 28, 2008)
Established to implement HIA in 2010
 Ministry of Environment
->plans to conduct HIA within the existing EIA
->kind of Health Risk Assessment
 Ministry of Health, Welfare and Family Affairs
->looking for opportunities to conduct
independent HIA
 Some conflict is expected

Seoul
Health inequality
 Health inequality is constructed
regionally and by social class in Korea
Citizens living north of the Han River have a
30% higher death risk than those who live in
the South within Seoul.
 Lower 20% income group spend 1/3 in medical
expenses compared to those of the higher
20% income group.
 A family with a total income of less than
500,000KRW per month has 2.37 time higher
risk of death than a family with 2,500,000
KRW per month.
-> Use HIA to reduce health inequalities

Harbin
Vladivostok
Strategy
Seoul
HIA within EIA
more efficient
faces less resistance in the
institutionalization process
Independent HIA
EIA : conducted for projects
-> difficult to run an HIA on policies
EIA’s methodologies and tools are
sophisticated and well developed
-> HIA can be lost in the vast volume of the EIA
report
Conflict
 Until now

HIA has been under developed and considerations for
social determinants of health were underscored.
 Health professionals and the Ministry of
Health, Welfare and Family Affairs

Advocated the implementation of an independent HIA,
separate from the EIA process
 However


New administration is pro-market economy and against
government regulations
HIA has little chance to be institutionalized
Cooperation Model
MoE - major agency
MIHWAF - support on the health
sector


This will minimize redundancy
Practical strategy
The two ministries


Should minimize their self interest
Research on establishing this cooperative
relationship is required
Harbin
Vladivostok
Conclusion
Seoul
Action Plan (1)
Pre-step
conducting
pilot cases
and research
projects
HIA center
Policy
Policy of MIHWAF
->Other policy
Project
Public financed project
Private project
Large scale project
↓
Step 1
↓
Step 2
↓
Step 3
Action Plan (2)
Main Responsibility to conduct HIA

MIHWAF -> policy/project conductor
HIA as mandatory

Add on the regulation of HIA to existing law
Preparation -> comprehension ->
regulatory
Start from what we can do now!


Policy of MIHWAF
Desktop or rapid HIA