Korea is in the midst of its fourth wave of covid-19, facing its worst surge infections since the pandemic erupted in December 2019. A variety of public health policy actions can be implemented in response to the covid-19 virus and other infectious diseases, among which are medical interventions like vaccination and treatment and non-medical policy measures such as travel restrictions and social distancing. Amid the covid-19 epidemic, it has become more challenging than ever for the health care system to meet its primary goal of protecting people’s health. The OECD has emphasized the importance of maintaining strong public health programs and optimized allocation of health care resources in such a time as now when demand for care is surging rapidly. More specifically, the OECD recommends to mobilize “staff to diagnose and treat patients”; boost “supplies of required equipment to diagnose people and provide them with acute treatment when needed”; and optimize “space to isolate and treat patients.” Korea has implemented flexible social distancing measures in keeping with the fluctuations of covid-19 case count. Also, medical staff, health care supplies and hospital beds have been managed at the policy level, keeping the health care system at the ready to respond to potential surges in infection. This study takes a look at the past one and half years of effort the government has exerted to mobilize health care staff, supplies and beds in the face of the covid-19 pandemic, and discusses what remains to be done.

Elder abuse and the rights of older persons have become issues of growing public interest since, with the amendment in 2004 to the Welfare of Senior Citizens Act, provisions were laid down for the prevention of elder abuse. However, cases of elder abuse―acts that pose a threat to the safety and rights of older persons―have continued to increase since 2005, when the data were first collected. According to the Elder Abuse Report published by the Ministry of Health and Welfare, the number of elder abuse counselling cases handled at 34 local elder protection agencies nationwide doubled to 5,243 in 2019 from 2,674 in 2009. In that 10-year period, residential facilities including long-term care homes saw a nine-fold increase in the number of elder abuse cases. Victims of elder abuse in residential care facilities are among the most vulnerable in society, who, mostly aged with dementia or little ability to express themselves, require increased attention and active intervention. This study examines the current state and causes of institutional elder abuse and discusses what should be done to prevent abuse from occurring in elder facilities.

Local total fertility rates differ conceptually from the national-level total fertility rate, due to a diverse range of population processes that occur at local levels. This study thus compares the population characteristics of localities with high total fertility rates and of those with low total fertility rates and, with evidence, analyzes why high fertility rates in many localities in Korea do not lead to high birth numbers or to a population increase. High local total fertility rates are found to have a close bearing on the size, migration and distribution of the female population aged 15~49, while not much correlated with the number of births or a local population increase. Local total fertility rates have been used widely, regarded as indicators that have closely to do with natural population changes and as outcome indicators of locallevel population policies. The findings of this study suggest that there is a need to further consider whether it is valid to use local total fertility rates in the way they have been used. The total fertility rate, defined in short as the average number of children women would have during their childbearing years (15~49 years of age), is also calculated as the sum of age-specific fertility rates. Localities in Korea over the years saw a continued decline in their median total fertility rate within the range of 1~2, in slightly varying degrees, with the magnitudes of the variations remaining largely constant. A point worthy of attention here is that time and again there have occurred upper outliers in the distribution of total fertility across the observed years. To look at the characteristics of localities where those upper outliers occur can be meaningful as it is in a way an exploration of factors to which local fertility differentials are attributed.

Underpinned by the budgetary and organizational resources made available via the legislation of the National Health Promotion Act in 1995 and the subsequent launch of the National Health Promotion Fund in 1997, the Korean government embarked in 2002 on the National Health Promotion Plan (Health Plan), a national master plan that guides the implementation of mid-to-long-term policies on disease prevention and health promotion. The Health Plan sets national-level health visions and goals, and presents strategies for achieving them. Every decade or so since 2002, the master plan has come out renewed, followed by two 5-year plans that update revisions made to it. As the 4th 5-year Health Plan ended in 2020 and the 3rd 10-year Health Plan was launched earlier this year, it is high time now to take a close look at how the latest Health Plan should be implemented for disease prevention and health promotion for Koreans in the post-covid-19 era. Many of the health promotion programs as planned in the Health Plan 2030 consist of services of the type that are delivered in the traditional in-person settings in public health centers in cities, counties and boroughs. However, as it is hard in the current covid-19 situation to expect that these programs will be delivered in ways they were intended, ways should be sought, by means of strengthening the monitoring of progress, of keeping the Health Plan 2030 on track.

Korea has recently shifted the focus of its population policy away from raising the total fertility rate to addressing the socio-structural factors of low fertility, toward a more encompassing goal of promoting the quality of life throughout the life course (Fourth Basic Plan for Low Fertility and Aging Society, December 2020). The rationale behind such a shift in policy approach consists in the need for narrowing the gap between the desired fertility and the actual fertility, the idea that individuals’ quality of life can improve by realizing in life their desired fertility levels. Both the ideal number of children and the expected number of children have, since as early as 1982, declined to below the period total fertility rate. With the shift in the focus of Korea’s population policy to helping people realize their desired fertility, the need has grown for concrete research into fertility intentions and fertility planning and into the demographic and socioeconomic factors that are at play in the process of women forming fertility intentions and realizing them. Korea’s policy on low fertility should be implemented, drawing on such research efforts, in such a way as to do away with factors that hamper people from realizing fertility intentions.

Inasmuch as raising the efficiency of pharmaceutical expenditures is an important policy goal toward keeping the National Health Insurance financially sustainable, off-patent drugs are regarded as a market with significant potential. Pharmaceutical expenditures have been growing more rapidly in Korea than in any other OECD country. It is crucial thus to add efficiency to Korea’s pharmaceutical expenditures. In theory, using generics in place of off-patent brand-name drugs, as long as they have the same clinical effect, can be conducive to reducing pharmaceutical spending. The larger the range of drugs of the same active ingredients and pharmaceutical formulation, the more likely it is that the prices of these products will fall through competition.

The government revealed its First Basic Youth Policy Plan last December, after the Framework Act on Youth was enacted in February and implemented six months later. The task of establishing a “youthfriendly policy delivery system” falls under “Youth Participation and Rights”, one of the five areas the First Basic Youth Policy Plan is set up for. The establishment of a youth-friendly delivery system is largely about revamping the current “Online Youth Center” into “Youth Hanaro”, an expanded online platform that links local youth policies to national youth policies and setting up within every lowertier municipality at least one “Youth Madang” to provide functional space for youth activities and participation.In its third meeting held on March 30, the Youth Policy Coordination Committee reviewed and decided on action plans for various issues, including those concerning youth participation in government committees, ways to get youth employment policy measures to take hold, and a plan of activities for non-government members of the Committee. As for Youth Hanaro, the Committee decided that the online-based youth policy planform would be established by a task force team consisting of members from relevant ministries and non-government stakeholders. The Committee also decided that it woulddesignate sites for a total of 12 new Youth Madang centers and set up standard operation procedures for them.As of now, there are 278 youth employment service centers, 152 of which being managed by the national government and the rest by local governments. Also, the Ministry of the Interior and Safety has of late helped several lower-tier municipal governments build and manage Active Youth Centers, with a view to helping young people with their activities and self-reliance.With such circumstances in mind, this brief looks at the example of Seoul City’s own youth policy delivery and discusses its implications for the proposed youth policy delivery system.

The Ministry of Health and Welfare earlier this year reported that, citing findings of the 2020 Health Care Experience Survey, health care utilization rates declined after the covid-19 outbreak. Conducted between July and October 2020 face-to-face with a total of 6,000 households sampled across the country, the survey found that in the period between July 2019 and June 2020, the proportion of people who had visited hospitals or clinics seeking health care services declined year-on-year, to 60.8 percent for outpatient care and to 3.5 percent for inpatient care.More than a year after the first covid-19 case was reported in Korea on January 20 last year, the pandemic remains unabated, with the number of new cases falling and rising repeatedly. Covid-19 has reshaped Korea’s social landscape. The pandemic also affected the way Koreans use health care, as is shown by recent statistical data and perception surveys. According to the Health Insurance and Assessment Service (HIRA), the use of health care services decreased significantly year-on-year in the first half of 2020, with the number of reimbursement claims declining by 13.3 percent and the number of outpatient visits by 12.5 percent. Another survey, conducted by the National Health Insurance Service, found that during the same period the number of inpatient days declined by 4.5 percent year-on-year and the number of outpatient visit days by 15.2 percent year-on-year. Also, Covid-19 Perception Survey by Hankook Research (3rd ~ 22nd) revealed that more than 50 percent of respondents on average reported having put off or called off a hospital visit.This brief uses data from the Health Care Experience Survey to examine changes that covid-19 effected in the use of health care services. A total of 12,507 people participated in the Health Care Experience Survey in 2019. In the 2020 survey, 12,133 people participated. The two groups had similar sociodemographic characteristics. In this brief, an individual was considered having used health care if he or she had used outpatient or inpatient services at least once during the first half of either 2019 or 2020. The figures presented in this brief may therefore differ from the figures presented in earlier reports on the Health Care Experience Survey.

In 2020, covid-19 plunged the world economy into turmoil. The pandemic’s economic shockwaves affected Korea too, making life even harder for its vulnerable groups. Protracted social distancing led to income declines for not only socially vulnerable households, but also a segment of high-income selfemployed people, thereby creating new at-risk groups.The structure of the Korean family has undergone significant changes since the 2000s. One-person households have increased over the years, with a majority of them comprised of either elderly persons or young people. Older adults and young people who live alone tend be unstable in their economic participation. They are highly susceptible to changes in economic conditions and, in that sense, have come under the direct impact of covid-19.The data on which this discussion is based come from Statistics Korea’s Household Income and Expenditure Survey (HIES). This brief examines quarterly changes in income among one-person households between 2019 and 2020, and identifies groups that are particularly vulnerable to the economic impact of covid-19. Income in this brief refers to equivalised disposable income, i.e., a household’s disposable income divided by the square root of the number of members in the household.The unit used here for analysis is the household.