만성질환에 대한 개인주의 접근방식의 한계 = The Limitation of the Individualism Approach on Chronic Diseases

다국어 초록 (Multilingual Abstract)

The purpose of this study is to examine whether the Western Individualism underlies the arguments and theories related to the elderly health. The arguments and theories of health burden and health promotion are evolved in the perspectives of the Western Individualism.
First, ‘the age of delayed degenerative diseases’ can be regarded as the rising of ages when chronic diseases occur, which means the lengthening of the elderly's life-period spent independently of younger generations. Second,according to the theories of ‘the compression of morbidity’, the life-period that an individual maintains his/ her autonomy has been extended. Third, the ‘active aging’ approaches are based on the concept that the elderly is not a passive but active, independent person who can enjoy his/ her own utonomous life. According to the ‘life-course’ approach, the frailty of an elderly results from not overcoming the bad habits and/or experiences they used to have when young. Therefore, the elderly is responsible for his/her failing health. Fourth, as the naming of ‘lifestyle diseases’ shows, if one controls one's own lifestyles such as smoking, drinking, diet and exercise, the occurrence rate of ‘lifestyle diseases’ can decrease. Most people tend to think that ‘lifestyle diseases’ are due to the individual's bad lifestyles, which, we argue, is wrong.
The government health policies based on the Western Individualism ignore the fact that the aging population has the largest socioeconomic inequality, compared to any other age group. If interdependency among individuals and/or groups is more important than individual independency in the aging society, we need to develop the theories for elderly health which are based not on individualism but on collectivism perspective, which emphasizes the interdependency among individuals and/or groups.

국문 초록 (Abstract)

이 연구의 목적은 만성질환과 건강관련 이론들에 내재한 서구의 개인주의 이데올로기를 분석하는 것이다. 이 글에서 분석한 건강부담과 건강증진에 관련된 주장이나 이론들은 서구의 개인주의 이데올로기 관점에서 전개되고 있다. 첫째, 만성질환이 지연된 시대를 역학변천의 네 번째 단계로 언급하는 역학변천 이론은 기능장애가 발생할 수 있는 연령의 상승 즉 젊은 세대에게 의존하지 않은 삶의 연장을 이야기 한다. 둘째, 이환기 압축 이론도 개인의 자율성과 독립성을 유지하면서 지낼 수 있는 삶이 기간이 증가한다고 주장한다. 셋째, 활동적 노화는 노인이 수동적 존재가 아니라 자신의 삶을 자율적으로 책임질 수 있는 능동적이고 독립적인 존재라는 개념에 기초한다. 생애과정 접근방식에 따르면, 노년의 나쁜 건강은 젊었을 적 건강에 나쁜 영향을 줄 수 있는 경험들을 잘 극복하지 못한 결과로서 당사자인 개인의 책임이 크다. 넷째, 생활습관병이란 이름에서 보듯이, 흡연과 음주, 식습관, 그리고 운동과 같은 개인의 생활습관을 잘 통제하면 생활습관병의 발병률을 상당히 줄일 수 있다. 생활습관병은 이러한 생활습관을 변화시키지 못한 개인의 탓이다. 개인주의 이데올로기에 기초한 노인 건강정책은 노인집단이 어느 연령집단보다 사회경제적 불평등과 건강불평등이 심한 집단이란 사실을 간과할 수 있는 위험이 있다. 만일 인구고령화가 개인의 독립성보다 집단 혹은 개인들 간 상호의존이 더 중시된다면, 만성질환과 건강관련이론도 집단 간 혹은 개인들 간의 상호의존을 중시하는 집단주의 관점에서 발전시킬 필요가 있다.

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