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신영전,김명희,Shin, Young-Jeon,Kim, Myoung-Hee 대한예방의학회 2007 예방의학회지 Vol.40 No.6
Objectives : The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. Methods : Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. Results : Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. Conclusions : Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.
현재 진행되고 있는 남북한 의료협력사업 : 영유아 지원 사업을 중심으로
신영전 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.7
The economic recession of North Korea has been prolonged, the need for humanitarian assistance for the women and children of DPRK has been raised. In March 2006, South Korean government signed MOU with World Health Organization (WHO) to financially support "Improving Women's and Children's Health in DPRK (IWCH)" project. The assistance projects through UNICEF and the non-government organizations of South Korea were also followed. IWCH project consists of three parts; nutrition, disease management, children and maternity care. The first term (2006-2007) of the project leading by WHO was finished, and the second term (2008-2010) is just begun. The projects driven by NGOs have relatively been delayed due to difficulties in negotiating on project contents and places with North Korea. Recently, however, re-modeling processes of an obstetric/gynecology hospital and a children hospital in Nampo were started. Up to recently, South Korean government has played only a limited role in the humanitarian assistance for North Korea. IWCH project is, however, a full-scale initiative driven by government based on a systematic review of need and priorities. A significant amount of budget and relatively long term (five year) project compare to the previous short term and small size programs were expected to make more meaningful achievement. Despite these positive aspects, the project remains a list of unsolved problems a lack of mutual trust, a different decision making process between South and North Korea, a lack of conflict management process, and unpredictability and complexity of international politics. In spite of such kind of political uncertainty, the health care sector will be a leading area in the process of improving relationship between South and North Korea, particularly, humanitarian assistance for women and children will play a crucial role in the process. The successful implementation of IWCH project, therefore, will contribute to provide the reference model in developing the mutually constructive relationship between South and North Korea. (Korean J Pediatr 2008;51:671-689)
신영전 한국보건사회연구원 2009 보건복지포럼 Vol.155 No.-
최근 국내외 경제상황은 견고한 의료안전망을 더욱 필요로 하고 있다. 그러나 현재 의료안전망의 개념과 내용에 대한 논의는 아직도 체계적으로 이루어지지 못하고 있으며, 현재 통상적인 의료안전망이라고 여기는 건강보험, 의료급여, 의료비지원 등과 같은 제도들은 형식적인 틀만 갖추었을 뿐 그 실효성에 많은 제약을 가지고 있다. 의료안전망의 실효성을 높이기 위해서는 그 개념과 내용의 재구성이 필요한데, 구체적으로 의료안전망에 예방과 건강증진, 재활과 사회복귀 영역을 추가하고, 여전히 의료사각지대에 있는 사람들을 주요정책대상에 포함시키며, 민간부문을 통한 재원조달과 서비스 제공 역시 그 틀 안에 포함시킬 필요가 있다. 시민사회와 당사자가 참여하는 운영체계를 구축하고 사업을 지속적으로 모니터링 하는 장치도 만들어야 한다. 그리고 소득, 주거, 교육, 문화부문의 사회안전망과 유기적으로 결합하는 형태로 설계, 운영되어야 한다. 이러한 과정은 본질적으로 정치적 과정을 동반하고, 그 과정에는 의료안전망의 역할과 의미에 대한 정치적 입장 정립과 국민의 지지를 필요로 한다. 또한 의료안전망구축을 위해 노력하는 전문가들, 시민사회의 역할이 중요하다. 아울러 견고한 의료안전망의 구축여부는 우리 사회의 성격을 보여주는 중요한 지표가 될 것이다.
신영전,Shin, Young-Jeon 대한예방의학회 2005 예방의학회지 Vol.38 No.3
Major approaches of Social epidemiology; 1)holistic, ecological approach, 2)population based approach, 3)development and life-course approach, 4)contextual multi-level approach, have stressed the importance of not only social context of health and illness, but also the population based strategy in the health interventions. Ultimately, it provides the conceptual guidelines and methodological tools to lead toward the healthy public policies; integrated efforts to improve condition which people live: secure, safe, adequate, and sustainable livelihoods, lifestyles, and environments, including housing, education, nutrition, information exchange, child care, transportation, and necessary community and personal social and health services.