Health in North Korea

Staff at Pyongyang Maternity Hospital

North Korea had a life expectancy of 69.8 years in 2013.[1] While North Korea is classified as a low-income country, the structure of North Korea's causes of death (2013) is unlike that of other low-income countries.[2] Instead, it is closer to the worldwide averages, with non-communicable diseases – such as cardiovascular disease – accounting for two-thirds of the total deaths.[2]

A 2013 study reported that communicable diseases and malnutrition are responsible for 64% of the total deaths in North Korea. Those of high-income countries and South Korea, but half of the average 57% of all deaths in other low-income countries.[2]

The same 2013 study stated that the largest obstacle for understanding the accurate health status of North Korea is the lack of the validity and reliability of its health data.[2]

Health infrastructure

Healthcare in North Korea includes an alleged national medical service and health insurance system.[3] North Korea’s government claims that it provides universal health care for all citizens. Defectors and some health professionals working abroad with contacts to North-Koreans claim that health services only exist for those who can pay for them.[4]

North Korea claims that health services are offered for free.[5] In 2001 North Korea spent 3% of its gross domestic product on health care. Beginning in the 1950s, the DPRK put great emphasis on healthcare, and between 1955 and 1986, the number of hospitals grew from 285 to 2,401, and the number of clinics – from 1,020 to 5,644.[6] There are hospitals attached to factories and mines. Since 1979 more emphasis has been put on traditional Korean medicine, based on treatment with herbs and acupuncture. A national telemedicine network was launched in 2010. It connects the Kim Man Yu Hospital in Pyongyang with 10 provincial medical facilities.[7]

North Korea's healthcare system suffered a steep decline since the 1990s because of natural disasters, economic problems, and food and energy shortages. By 2001, many hospitals and clinics in North Korea lacked essential medicines, equipment, running water and electricity.[8]

In 2010, the World Health Organization described the healthcare system as "the envy of the developing world" while simultaneously acknowledging that "challenges remained, including poor infrastructure, a lack of equipment, malnutrition and a shortage of medicines." WHO criticized an earlier Amnesty International report that described "barely functioning hospitals" as outdated and factually inaccurate.[9]

Health status

Life expectancy

North Korea has a life expectancy of 69.7 years (in 2014).[10] The 2009 gender breakdown was 72.8 years life expectancy for females and 64.9 for males.[11]

Non-communicable diseases

Cardiovascular disease as a single disease group is the largest cause of death in North Korea (2013).[2] The three major causes of death in DPR Korea are ischaemic heart disease (13%), lower respiratory infections (11%) and cerebrovascular disease (7%).[11]

Non-communicable diseases risk factors in North Korea include high rates of urbanisation, an aging society, high rates of smoking and alcohol consumption amongst men.[2]

Approximately 54.8% of all North Korean adult males smoke an average of 15 cigarettes per day.[11] Smoking prevalence is slightly higher amongst the urban worker population than the farming population.[11] Amongst men, a high rate of excessive alcohol consumption has been reported, defined by the world health organisation as consumption of more than one bottle, per sitting, per person (26.3% of males)[11]

Infectious diseases

Infectious diseases, such as tuberculosis, malaria, and hepatitis B, are considered to be endemic to North Korea.[12] An estimated 4.5% of North Koreans had hepatitis B in 2003.[11]

North Korea is experiencing a tuberculosis epidemic, with 5% of the population infected with the disease. This has been attributed to the “overall deterioration in health and nutrition status of the population as well as the rundown of the public health services”.[13]

Infections that cause pneumonia and diarrhea are the leading causes of child death.[14] One third of the school-age children in North Korea have diseases caused by intestinal parasites.[15]

HIV/AIDS

WHO estimates that North Korea has less than 100 people with HIV/AIDS.[16] According to UNAIDS, less than 0.2% of North Korea's adult population has HIV.[17] Officially, the country maintains that it is completely free of AIDS.[18]

Malnutrition

During the 1990s, North Korea was ravaged by famine, causing the death of between 500,000 and 3 million people.[19] Food shortages are ongoing today, with factors such as bad weather, lack of fertilizer and a drop in international donation meaning that North Koreans do not have enough to eat.[20] A study of North Koreans in 2008 found that three-quarters of respondents had reduced their food intake.[21] Extreme poverty is also a factor in the hunger faced by North Korean people, with 27% of the population living at or below the absolute poverty line of less than US $1 a day.[22]

These food shortages cause a number of malnutrition diseases. For example, a 2009 UNICEF report found that North Korea was “one of 18 countries with the highest prevalence of stunting (moderate and severe) among children under 5 years old”.[23]

References

  1. ↑ "Country Comparison: Life Expectancy at Birth". CIA World Factbook. Retrieved 22 July 2014.
  2. 1 2 3 4 5 6 Overview of the Burden of Diseases in North Korea, Journal of Preventative Medicine and Public Health, May 2013; 46(3): p. 111–117.
  3. ↑ Library of Congress – Federal Research Division 2007 ‘Country Profile: North Korea’, Library of Congress – Federal Research Division, viewed 6 September 2010, <http://lcweb2.loc.gov/frd/cs/profiles/North_Korea.pdf>
  4. ↑ World Opinion 2010 ‘North Korea’s ‘horrifying’ health care system’, The Week, viewed 6 September 2010, <http://theweek.com/article/index/205123/north-koreas-horrifying-health-care-system>
  5. ↑ Country Profile 2007, pp. 7–8.
  6. ↑ North Korea Public Health, Country Studies
  7. ↑ "NKorea launches telemedicine network with WHO help". The Seattle Times. 27 April 2010. Retrieved 17 June 2014.
  8. ↑ "N Korea healthcare 'near collapse'". BBC News. 20 November 2001.
  9. ↑ "Aid agencies row over North Korea health care system". BBC News. 10 July 2010.
  10. ↑ "Country Comparison: Life Expectancy at Birth". CIA World Factbook. Retrieved 22 July 2014.
  11. 1 2 3 4 5 6 "WHO country cooperation strategy: Democratic People's Republic of Korea 2009–2013. 2009.", World Health Organization.
  12. ↑ "Life Inside North Korea". U.S. Department of State. Archived from the original on 11 July 2008. Retrieved 18 November 2008.
  13. ↑ Amnesty International 2010 ‘The Crumbling State of Health Care in North Korea’, Amnesty International, viewed 6 September 2010, <http://www.amnesty.org/en/library/asset/ASA24/001/2010/en/13a097fc-4bda-4119-aae5-73e0dd446193/asa240012010en.pdf>
  14. ↑ ["Countdown to 2015 decade report (2000–2010): taking stock of maternal, newborn and child survival.", World Health Organization, 2010.
  15. ↑ [Soil-transmitted helminthiases: estimates of the number of children needing preventive chemotherapy and number treated, 2009. Wkly Epidemiol Rec. 2011;86(25):257–267.]
  16. ↑ "Young People and HIV/AIDS : Fact Sheet : DPR Korea" (PDF). Regional Office for South East Asia, World Health Organization. 20 November 2006. Retrieved 7 December 2015.
  17. ↑ "2006 Report on the global AIDS epidemic : A UNAIDS 10th anniversary special edition" (PDF). UNAIDS. 2006. p. 343. Retrieved 7 December 2015.
  18. ↑ O'Byrne, Tom (2 December 2001). "North Korea fights AIDS". ABC Radio National. Retrieved 2015-12-08.
  19. ↑ Library of Congress – Federal Research Division 2007 ‘Country Profile: North Korea’, Library of Congress – Federal Research Division, viewed 6 September 2010, <http://lcweb2.loc.gov/frd/cs/profiles/North_Korea.pdf>
  20. ↑ Amnesty International 2010 ‘The Crumbling State of Health Care in North Korea’, Amnesty International, viewed 6 September 2010, <http://www.amnesty.org/en/library/asset/ASA24/001/2010/en/13a097fc-4bda-4119-aae5-73e0dd446193/asa240012010en.pdf>
  21. ↑ Amnesty International 2010 ‘The Crumbling State of Health Care in North Korea’, Amnesty International, viewed 6 September 2010, <http://www.amnesty.org/en/library/asset/ASA24/001/2010/en/13a097fc-4bda-4119-aae5-73e0dd446193/asa240012010en.pdf>
  22. ↑ Library of Congress – Federal Research Division 2007 ‘Country Profile: North Korea’, Library of Congress – Federal Research Division, viewed 6 September 2010, <http://lcweb2.loc.gov/frd/cs/profiles/North_Korea.pdf>
  23. ↑ Amnesty International 2010 ‘The Crumbling State of Health Care in North Korea’, Amnesty International, viewed 6 September 2010, <http://www.amnesty.org/en/library/asset/ASA24/001/2010/en/13a097fc-4bda-4119-aae5-73e0dd446193/asa240012010en.pdf>

Bibliography

External links

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