BMJ Global Health
Volume 4, Issue 2, 2019

Systematic review of evidence on public health in the Democratic People's Republic of Korea (Article) (Open Access)

Park J.J. , Lim A.-Y. , Ahn H.-S. , Kim A.I. , Choi S. , Oh D.H. , Lee-Park O. , Kim S.Y. , Jung S.J.* , Bump J.B. , Atun R. , Shin H.Y. , Park K.B.
  • a Harvard T.H. Chan School of Public Health, Boston, MA, United States
  • b Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, South Korea
  • c Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, South Korea
  • d Harvard Medical School, Boston, MA, United States
  • e Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, South Korea
  • f Tufts University School of Medicine, Boston, MA, United States
  • g University of Maryland School of Medicine, Baltimore, MD, United States
  • h University of Pennsylvania, Philadelphia, PA, United States
  • i Harvard T.H. Chan School of Public Health, Boston, MA, United States, Yonsei University College of Medicine, Seoul, South Korea
  • j Harvard T.H. Chan School of Public Health, Boston, MA, United States
  • k Harvard T.H. Chan School of Public Health, Boston, MA, United States, Harvard Medical School, Boston, MA, United States
  • l Institute for Health and Unification Studies, Seoul National University College of Medicine, Seoul, South Korea
  • m Harvard T.H. Chan School of Public Health, Boston, MA, United States, Harvard Medical School, Boston, MA, United States

Abstract

Background Engaging in public health activities in the Democratic People's Republic of Korea (DPRK, also known as North Korea) offers a means to improve population health for its citizens and the wider region. Such an engagement requires an understanding of current and future needs. Methods We conducted a systematic search of five English and eight Korean language databases to identify available literature published between 1988 and 2017. A narrative review of evidence was conducted for five major categories (health systems, communicable diseases (CDs), non-communicable diseases (NCDs), injuries, and reproductive, maternal, newborn and child health (RMNCH) and nutrition). Findings We found 465 publications on the DPRK and public health. Of the 253 articles that addressed major disease categories, we found under-representation of publications relative to proportion of disease burden for the two most significant causes: NCDs (54.5% publications vs 72.6% disability adjusted life years (DALYs)) and injuries (0.4% publications vs 12.1% DALYs), in comparison to publications on the third and fourth largest disease burdens, RMNCH and nutrition (30.4% publications vs 8.6% DALYs) and CDs (14.6% publications vs 6.7% DALYs) which were over-represented. Although most disease category articles were on NCDs, the majority of NCD articles addressed mental health of refugees. Only 165 articles addressed populations within the DPRK and among these, we found publication gaps on social and environmental determinants of health, CDs, and NCDs. Conclusion There are gaps in the public health literature on the DPRK. Future research should focus on under-studied, significant burdens of disease. Moreover, establishing more precise estimates of disease burden and their distribution, as well as analysis on health systems responses aimed at addressing them, can result in improvements in population health. © 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Author Keywords

DPRK Public health Systematic review North Korea

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062775036&doi=10.1136%2fbmjgh-2018-001133&partnerID=40&md5=1b7668667f7166d51911b533741231cf
DOI: 10.1136/bmjgh-2018-001133
ISSN: 20597908
Cited by: 1
Original Language: English