OECD Reviews of Public Health: A Healthier Tomorrow. Korea

Description

This review assesses Korea's public health system, highlights areas of strength and weakness, and makes a number of recommendations for improvement. The review examines Korea's public health system architecture, and how well policies are responding to population health challenges, including the growing burden of chronic disease, and resulting pressures on the health system. In particular, the review assesses Korea's policies to prevent harmful alcohol use, and the risks and opportunities around public health genomics in Korea, which is both a growing field in the health sector, and a booming commercial industry. The review also examines Korea's exposure to public health emergencies, and capacity to respond to emergencies as and when they occur. Foreword Acknowledgements Acronyms and abbreviations Executive summary Assessment and recommendations Korea’s public health system OECD Reviews of Public health examine the core public health architecture in place in countries to prevent disease, detect disease early, prevent secondary complications from diseases, and promote good population health and wellbeing. The public healt... Like other OECD countries, in Korea non-communicable diseases account for the majority of the disease burden A mixed and evolving picture when it comes to risky health behaviours Efforts to reduce tobacco consumption are comprehensive, though some policies should be strengthened Vertical prevention programmes are used to deliver public health interventions Korea has a strong collaborative approach to public health governance by data and information linkage should be improved Second, there are some positive signs of engagement with civil society actors, patient and consumer groups in Korea, although it is not clear how systematic this approach is. For example, Seoul Government engaged with civil society panels in designing... High levels of health care consumption, but a very hospital-centric system not well aligned with changes needs of the population Tackling harmful alcohol use Korea has implemented a range of policies to try to reduce harmful alcohol consumption Relatively low prices, limited marketing restrictions, and few restrictions on points of sale make alcoholic beverages widely accessible To change Korea’s harmful patterns of alcohol consumption, a comprehensive policy package is needed Restricting the ubiquitous presence of alcohol through more limits on advertising and point of sale Addressing alcohol culture in schools, universities and workplaces Tweaking alcohol pricing policies to better align with public health objectives Public health genomics in Korea Precision medicine and public health genomics Korea’s extensive genomic research field could be better leveraged for public health policy if data linkage were possible Precision medicine for preventive interventions and public health in Korea Direct-to-consumer genetic testing is booming in Korea, and generates some concerns Korea should develop a national strategy on precision medicine Public health emergency preparedness Despite a moderate exposure to disasters, recent crises and increasing vulnerabilities call for increased attention to public health emergency preparedness Korea makes of preparedness for public health emergencies a priority, as reflected in recent reforms of its public policies A good knowledge of the critical risks and their public health consequences are essential to prepare for public health emergencies Capabilities for public health preparedness and response in Korea are fairly robust An encouraging dynamic is shaping up to improve emergency response in Korea, but this remains an unfinished agenda 1 The public health system in Korea Introduction 1.1. The public health picture in Korea 1.1.1. The health status of the Korean population 1.1.2. Burden of disease 1.1.3. Risk factors 1.1.4. Mental wellbeing 1.2. Organisational structure 1.2.1. The Korean Health System Health Insurance Long-term care insurance 1.2.2. Primary care system Public Health Centres 1.2.3. Delivery of essential public health operations in Korea Vaccination programmes in Korea Food Safety Commission for Food and Drug Safety Assurance 1.2.4. Environmental Protection 1.2.5. Primary, secondary and tertiary prevention in Korea Primary prevention Primary prevention – tobacco consumption Primary prevention – healthy eating 1.2.6. Secondary prevention 1.2.7. Tertiary prevention 1.3. Leadership and governance 1.3.1. Ministry of Health and Welfare, Regional and Municipal Governments 1.3.2. Korea Centre for Disease Control 1.3.3. Korea Health Promotion Institute 1.3.4. Seoul City Government 1.4. Partnerships and collaboration 1.4.1. Engagement with civil society, patient and consumer groups 1.4.2. Collaboration and cross-Ministry working 1.5. Financial resources 1.5.1. Spending on health and public health 1.5.2. Payment mechanisms to incentivise public health functions 1.6. Knowledge development 1.6.1. Key data sources for understanding public health 1.6.2. Promoting health literacy around public health 1.6.3. Generating Health-Related Data 1.7. Workforce 1.7.1. Human resources in public health care Conclusion References 2 Tackling harmful alcohol use Introduction 2.1. Harmful alcohol use is a public health issue in Korea 2.1.1. Although the overall alcohol consumption rate in Korea is around OECD average, working men and young women are frequent drinkers 2.1.2. Heavy episodic and high-risk drinking is common in Korea 2.1.3. Alcohol use has a considerable impact on Korean health and society 2.2. Korea has in place a multifaceted alcohol prevention strategy 2.2.1. Organisation of alcohol prevention 2.2.2. Awareness and education 2.2.3. Pricing 2.2.4. Advertising and media 2.2.5. Labelling 2.2.6. Sales and consumption regulations 2.2.7. Treatment of alcoholism and prevention of relapse 2.2.8. Drink-driving 2.3. To reduce harmful alcohol use, Korea should implement a range of alcohol policies 2.3.1. Reduce the constant exposure to marketing by regulating advertising and media portrayal 2.3.2. Control the availability of alcohol by regulating sales and consumption 2.3.3. Invest in education to increase awareness, reduce social pressures and to mobilise public opinion 2.3.4. Review the taxation and pricing policies Conclusion References Notes 3 Public health genomics in Korea Introduction 3.1. Precision medicine and public health genomics 3.1.1. Precision medicine and public health genomics 3.1.2. Precision medicine may advance preventive health care and public health more broadly 3.2. Genomic research and gene mapping in Korea 3.2.1. The National Biobank of Korea and gene mapping project 3.2.2. Using the Korean Biobank, Korean Genome Project and other genomic initiatives to strengthen population health knowledge 3.2.3. Linkage of genetic information and other health system data is critical 3.3. The use of precision medicine for preventive interventions and public health 3.3.1. Use of genomics in Korea 3.3.2. The clinical genetics workforce in Korea genetic literacy amongst physicians 3.3.3. Using precision medicine for public health interventions 3.4. The use of direct-to-consumer (DTC) testing 3.4.1. DTC genetic testing availability and regulation 3.4.2. DTC genetic testing availability and regulation in Korea 3.4.3. Weak regulation of DTC genetic testing could constitute a privacy risk 3.4.4. Potential risk to consumers and the health system from DTC genetic testing 3.5. Strengthening the use of genomics for public health in Korea 3.5.1. Develop a national strategy on precision medicine 3.5.2. Ensure that quality assurance and regulation are robust 3.5.3. Strengthen data linkages 3.5.4. Focus on building on genetic literacy amongst medical professionals and the Korean population 3.5.5. Take a cautious approach to DTC genetic testing 3.5.6. From a public health perspective, ‘traditional’ approaches to preventing ill-health still have the strongest evidence-based Conclusion References 4 Korea’s preparedness for public health emergencies Introduction 4.1. Korea’s risk profile and potential public health consequences 4.1.1. Preparedness for public health emergencies should be at the top of the policy agenda in Korea 4.1.2. Korea is exposed to natural hazards and climate change calls for elevating public health emergency preparedness for these risks 4.1.3. Korea is at risk of infectious diseases outbreaks and has a high tuberculosis prevalence rate 4.1.4. Accidents have caused significant public health damages in Korea 4.1.5. Rising vulnerabilities call for strengthening public health emergency preparedness in the years to come 4.2. Korea makes of preparedness for public health emergencies a priority, as reflected in its public policies 4.2.1. Korea’s legal framework for public health emergencies is based on an all-hazard approach 4.2.2. Korea reformed its institutional setting for public health emergency preparedness in recent years 4.2.3. Horizontal and vertical policy coordination for public health emergency preparedness 4.3. Identifying and assessing public health emergencies risk in Korea 4.3.1. Korea has developed advanced risk analysis tools with a multi-hazard approach 4.3.2. For infectious diseases, KCDC has strengthened its risk assessment process following the MERS-CoV outbreak 4.3.3. Korea could further benefit from its advanced risk assessment capacities by developing a National Risk Assessment 4.4. Capabilities for public health emergency preparedness and response in Korea 4.4.1. Surveillance, monitoring and information systems make good use of innovation to detect public health emergencies. 4.4.2. Korea is currently investing in strengthening health infrastructures dedicated to emergencies to increase preparedness and safety following a series of failures 4.4.3. Korea plans large stocks of medical countermeasures and emergency supplies for emergency response 4.4.4. Workforce development for public health emergency preparedness is an on-going priority in Korea 4.5. Emergency countermeasures and their implementation during crisis 4.5.1. Public health emergency plans are developed at all levels in Korea but this approach does not favour agile emergency response 4.5.2. Korea is making efforts to foster inter-agency coordination in public health emergency response 4.5.3. Revisiting approaches to crisis communication in Korea is a priority 4.5.4. Multi-stakeholder emergency simulation exercises based on complex scenarios could be undertaken regularly Conclusion References