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Systematic review of evidence on public health in the Democratic People's Republic of Korea

 John J Park  ;  Ah-Young Lim  ;  Hyung-Soon Ahn  ;  Andrew I Kim  ;  Soyoung Choi  ;  David HW Oh  ;  Owen Lee-Park  ;  Sharon Y Kim  ;  Sun Jae Jung  ;  Jesse B Bump  ;  Rifat Atun  ;  Hee Young Shin  ;  Kee B Park 
 BMJ Global Health, Vol.4(2) : e001133, 2019 
Journal Title
Issue Date
DPRK ; North Korea ; public health ; systematic review
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.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Jung, Sun Jae(정선재) ORCID logo https://orcid.org/0000-0002-5194-7339
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