1092Questioning health inequality as policy agenda in Korea: using Luke’s three-dimensional theory of power

Abstract

Abstract Focus of Presentation Health inequality is an important public health concern in Korea. However, policies to reduce health inequalities still falls behind. This research focus on political agenda making process of health inequality. To achieve this aim, we utilized Lukes’ three-dimensional theory of power to explain current state of ‘health inequality’ as political agenda in South Korea. Findings We conducted 12 in-depth interviews with 6 policymakers and 6 practitioners, and focus-group interview with 5 researchers in 2016. From the qualitative analysis, we constructed 3 main themes. First theme, the perception, participants’ perspective on health inequality varied widely. Some participants assumed health inequality in Korea as an inevitable social condition, not even a problem to be tackled. Despite differing views on the condition, most participants attributed health inequality as result of accumulated result of socio-economic inequality. Second theme, the barriers, many claimed health inequality too abstract, complex, and ambiguous concept to be politicized. Policy actors saw current political apathy to paucity of empirical evidence, which was the complete opposite to the researchers. Third theme, the supression, was analyzed using luke's theory of power. On first dimension, the pluralistic power, conservative government has been marginalizing overal inequality issue. On second dimension, two major obstacles of growth-first policy and result-ased management of bureaucratic organization were found. On third dimension, the governmentality, 3 mechanisms that suppress health inequality were found. Those were medicalization of health, neoliberal discourse that individualize health as personal asset, and policy monopoly by 'health insurance' that absorbe every health-related issue. Conclusions/Implications In conclusion, we derived five propositions for making health inequality a policy agenda in Korea. Strong political leadership to tackle structrual inequality is needed, more decentralized, democratic governance system should be founded, intersectoral approach and comprehensive intervention for health inequality should be implemented, alternative health regime to reorganized current medicalization of health should suffuse, finally, more knowledge and experience to denaturalize health inequality should be followed. Key messages To tackle health inequality, power that supress health equity becoming policy agenda should be anlalized.