Abstract
It is known that some groups of immigrants can have low health literacy and it may affect their health. Although the number of North Korean defectors in the Republic of Korea has increased, little is known about their health literacy and health behavior. Adult North Korean defectors (n = 399) in this study were surveyed on health literacy, using the Korean Health Literacy Scale, and on the use of preventive services. Those with better health literacy scores were more likely to have vaccination than the lower scoring group (adjusted OR = 2.44; 95% CI, 1.19–5.00). However, undergoing medical check-up may not be associated with health literacy. In subgroup analysis, among defectors who lived alone (P = 0.032) or who had longer time in other countries before entering (P = 0.007), the vaccination coverage was associated with their health literacy scores. This study provides evidence for an association between health literacy and influenza vaccination coverage among North Korean defectors even though they may have fewer language barriers than other immigrants. Further research is needed to develop interventions for improving health literacy and their preventive health behavior.
Highlights
From 1995 to 2000, millions of people died from starvation and hunger-related diseases in North Korea
Our study suggests North Korean defectors with high health literacy might be more likely to have influenza vaccination, while medical check-up within 2 years was not associated with health literacy
This study provides some information about the association between health literacy and preventive healthcare use among North Korean defectors, it has significant limitations
Summary
From 1995 to 2000, millions of people died from starvation and hunger-related diseases in North Korea. This period is called the “March of Hardship” [1]. Since the late 1990s, many North Koreans escaped to the Republic of Korea (Korea) through other Asian countries, for political or economic reasons. About 150 defectors entered every month; roughly 30,000 defectors had settled in Korea by August 2016, accounting for about 0.06% of the Korean population [2]. About 70% of defectors are women and those aged less than 30 years comprise 45% of them.
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