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Submission of documentation Sokcho, Republic of Korea June 2008 Document prepared by: Sokcho Public Health Center, Sokcho-City, Republic of Korea

Contents Ⅰ. Policy statement in support of Healthy Cities...1 Ⅱ. Future vision and goal...3 1. Vision, Mission and Objectives...4 1.1 Vision...4 1.2 Mission...4 1.3 Objectives...4 Ⅲ. Profile of the city...5 2. History of Sokcho-city...7 3. General Status...7 3.1 Physical Characteristics...7 3.2 Administrative District...8 3.3 The Emblem of Sokcho-city...8 3.4 Goal and Policy...9 3.5 Administrative Organization...9 3.6 Public Health Center...10 4. Demographic Characteristics...11 5. Health Status...13 5.1 Vital Statistics...13 5.2 Chronic Disease Prevalence...13 5.3 Disabilities...14 5.4 Obesity and overweight...14 5.5 Self-rated Health Status...15 6. Lifestyles...15 6.1 Smoking...15 6.2 Alcohol Drinking...17 6.3 Physical Activities...18 7. Housing Conditions...18 8. Socio-Economic Conditions...19 8.1 Unemployment Rate...19

8.2 Major Industries...19 8.3 Economic Status...20 8.4 Lower Income Class...20 8.5 Social Safety...20 8.6 Education...21 9. Physical Environment...21 9.1 Air Quality...21 9.2 Water Quality...22 9.3 Solid Waste Management...22 10. Physical and Social Infrastructure...23 10.1 Park...23 10.2 Culture and Sports Facilities...24 10.3 Communication System...24 10.4 Roads...25 11. Public Health Policies and Services...25 11.1 Health Care Facilities and Manpower...25 11.2 Vaccination...27 11.3 Cancer Screening...27 11.4 Epidemics...28 11.5 Traffic Accidents...28 12. Cause of Death in Sokcho-city...29 Ⅳ. Analysis of priority health problem...31 13. SWOT Analysis...32 14. Priority of Health Problem...33 14.1 9 Health Problems...33 14.2 Development of 17 Healthy City Programs...33 15. Summary...34 16. References...36

List of Tables Table 3.1: Trend of Population Size...11 Table 3.2: Crude Marriage and Divorce Rates...12 Table 3.3: Crude Birth and Death Rates...13 Table 3.4: Registered Disabled Persons by type of the disabled...14 Table 3.5: Self-rated Health Status...15 Table 3.6: Types of Housing...18 Table 3.7: Number of employees per Industry...19 Table 3.8: Households and populations Receiving Basic Livelihood Allowance Benefits...20 Table 3.9: Criminal act...20 Table 3.10: Number of Educational Institutions and Students...21 Table 3.11: The capacity of tap water supply...22 Table 3.12: Sewage Treatment...22 Table 3.13: Daily amount of solid waste collection and disposal...23 Table 3.14: Number and Area of Park...23 Table 3.15: Cultural and Sports Facilities...24 Table 3.16: Telephone Subscribers by Types of Telephones in Use...24 Table 3.17: Rate of paved roads...25 Table 3.18: Health Care Facilities...26 Table 3.19: Health Services Manpower...26 Table 3.20: Immunizations Services by Public Health Center...27 Table 3.21: Cancer Screening...27 Table 3.22: The Number of Incident cases of Registered Legal Communicable Disease...28 Table 3.23: Annual Traffic Accidents...29 Table 3.24: Ten Leading Cause of Death in Sokcho...29

List of Figures Figure 3.1: Location of Sokcho-city...7 Figure 3.2: Administrative District...8 Figure 3.3: The Emblem of Sokcho-city...8 Figure 3.4: Goal and Policy...9 Figure 3.5: Administrative Organization Chart...10 Figure 3.6: Organization Chart of Public Health Center...11 Figure 3.7: Population Structure by Ages and Sex...12 Figure 3.8: Prevalence of Hypertension, Diabetes Mellitus...14 Figure 3.9: Obesity and Overweight...15 Figure 3.10: Smoking Rates...16 Figure 3.11: Smoking Rates by Sex in Adults...16 Figure 3.12: Alcohol Drinking Rates...17 Figure 3.13: Alcohol Drinking Rates by Sex in Adults...17 Figure 3.14: Physical Activity Rates by Sex in Adults...18 Figure 3.15: Cancer Screening Rates...28 Figure 4.1: SWOT Analysis to Sokcho-city...32

Ⅰ. Policy statement in support of Healthy cities Sokcho, Republic of Korea June 2008 Document prepared by: Sokcho Public Health Center, Sokcho-City, Republic of korea - 1 -

Declaration of Healthy City, Sokcho Sokcho will give a priority to "Health" among all policy. Sokcho will provide its citizens with health-friendly physical and social environment. Sokcho will help all citizens to lead a healthy life through physical, mental and social well-being. Sokcho will do its best to solve the health inequality problem for lower income class. June 20, 2008 Chae Yong Saeng Mayor of Sokcho-City Gangwon-do Republic of Korea - 2 -

Ⅱ. Future vision and goal Sokcho, Republic of Korea June 2008 Document prepared by : Sokcho Public Health Center, Sokcho-city, Republic of Korea - 3 -

1. Vision, Mission and Objectives 1.1 Vision healthy city with clean air and clear water on the basis of health equality. 1.2 Mission Encourage all citizens to engage in a healthy lifestyle and to develop a healthy city environment 1.3 Objectives Clean and safe city (including quality of living standard) A city wherein the ecosystem is stable and well-preserved A cooperative local society with no room for exploitation A systematically regulated city wherein the residents actively participate in the decision-making of policies affecting their lives, health and well-being A city wherein the basic requirements of all residents (food, water, housing, source of income, safety, jobs) are satisfied Diverse and vibrant economy A society wherein the succession of historical, cultural and biological heritage, as well as the existence of diverse groups of people, are actively encouraged A city wherein the above-mentioned ideals are satisfied and encouraged A city wherein all residents have easy access to excellent public health and medical services A city wherein the overall health conditions of residents are excellent (excellent health conditions, low rate contracting disease) - 4 -

Ⅲ. Profile of The city Sokcho, Republic of Korea June 2008 Document Prepared by: Sokcho Public Healthy Center, Sokcho-City, Republic of Korea - 5 -

Sokcho-City Health Profiles Submitted by: Sokcho-City Submitted: June 2008 Submitted to: Promotion Committee for Healthy Cities WHO Collaborating Center for Healthy Cities and Urban Policy Research International Health, Tokyo Medical and Dental University 1-5-45 Yushima, Bunkyo-ku, Tokyo Japan(113-8519) Proposal Prepared bv: 1) Sokcho-city Public Health Center 780, Gyo-dong, Sokcho-city, Gangwon-do, Republic of Korea(217-060) contact Person: Dr. Ham Su-Geun Phon: +82 33 639 2549 Fax: +82 33 639 2554 E-mail: hsg9284@hanmir.com 2) contributor : Lee, Seon-Hye, Professor, Dong - U college Department of Nursing 244, NoHak-dong, Sokcho-city, Gangwon-do, Republic of Korea(217-711) Phone: +82 33 639 0680 Fax: +82 33 639 0689 E-mail: shlee@duc.ac.kr - 6 -

2. History of Sokcho-City This region belong to Sokcho Lee. Sokcho was a part of Sokcho Lee in Josun dynasty. It grew bigger with the development of the harbor ChungCho in the Japanese colonial age. In 1937, the name of Myun changed from DoChun-Myun to Sokcho-Myun as Myun office transferred from DaePo-Lee to SokCho-Lee. So, the name Sokcho has the Myun name(also was a name of a village) and at the same time became `Eup` in 1942, and it finally became city in 1963. So far, because of the increase of population, Sokcho-Lee has divided into 4Gus, and after the Liberation from the Japanese, refugees came to Sokcho and 5Gu was seperated from 3Gu, 6Gu from 4Gu. And now it has finally been settled as YoungRang-Dong(1Gu), DongMyung-Dong(2Gu), ChungAng-Dong(3Gu), KumHo-Dong (4Gu), ChungHo-Dong(5Gu), ChungHak-Dong Kyo-Dong(6Gu). 3. General Status 3.1 Physical Characteristics Sokcho-city is located between 38 12 17 North Latitude and 128 28 29 East Longitude. Located northeast of Gangwon-do, with the splendid Mt. Seorak(1,708m) in between, the city borders with the East Sea to the east, and Yangyang, Goseong, and Inje-gun to the west. The city is 62 Km south of the Demilitarized Zone(see Figure 3.1). Figure 3.1 Location of Sokcho-city - 7 -

3.2 Sokcho Administrative District Sokcho-city is made up 8 Dongs(see Figure 3.2). Figure 3.2 Administrative District 3.3 The Emblem of Sokcho-city Creatively expressing the various tourist resources of Sokcho, it shows Sokcho as a cozy and pleasant world-famous tourist city in warm and bright colors(see Figure 3.3). Figure 3.3 The Emblem of Sokcho-city - 8 -

3.4 Goal and Policy The goal of Sokcho-city is to build a natual Tour-city with clean air and clear water. Four major policies have been set in order to achieve these goals, plentiful jobs, harmonious city. fond memories that lure tourists back, rich maritime environment. Figure 3.4 shows all the policies of Sokcho-city. Figure 3.4 Goal and Policy 3.5 Administrative organization Figure 3.5 demonstrates the administrative organization of Sokcho-city. The city governor leads the overall administration as well as secretarial section. Sokcho's administration consists of one office, seventeen departments and two centers. - 9 -

Figure 3.5 Administrative Organization Chart 3.6 Public Health center Sokcho's Public Health Center is located in the part of the city which represents Sokcho-city's clean air and clear water. The Sokcho Public Health center has been providing various kinds of health services such as physical care, oral health care and home visiting nursing care through projects to cope with the medical demands of local poor residents. The public health center, responsible for Sokcho's health, provides preliminary diagnosis and treatment, health and sanitation services, health services, and also operates a Senior Citizens Nursery, among others. It also offers services on line through its website so that hospital, schools and patients really have no need to physically visit it. Its mission is to serve the residents of Sokcho with due care and a strong sense of responsibility and commitent(see Figure 3.6). - 10 -

Figure 3.6 Organization Chart of Public Health Center 4. Demographic characteristics In 2006, the population of Sokcho city was 86,073. The population slightly decreased from 90,543 in 2001 as shown in Table 3.1. The ratio of gender indicates that 98 men per 100 women in 2006, which is contrast with the national gender ratio of 107.4 men per 100 women in 2006(Korea National statistical Office, 2007). Table 3.1 Trend of population size (Unit:persons,%) Population Household Year Number Men Gender Women Number people per Gender ratio 1986 71,211 35,451 35,760 17,584 4.0 0.99 1991 74,905 37,095 37,810 21,012 3.6 0.98 1996 82,568 40,845 41,723 27,022 3.1 0.98 2001 90,543 44,786 45,757 32,782 2.8 0.98 2006 86,073 42,799 43,885 34,921 2.5 0.98 Korean National Statistical Office, http://www.nso.go.kr - 11 -

Figure 3.7 Population Structure by Ages and sex source : Sokcho-city, Annual Statistics, 2007 The ratio of over 65 years old people was 10.36% and under 64 years olds was 19.05%. In contrasts to this, former was 9.23% and the latter was 19.10% in nationwide statistics (see Figure 3.7). Sokcho-city is therefore a city where older population is dominant. The crude marriage and divorce rates during 2002 to 2006 in Sokcho-city indicated to be 5.4-5.4 and 3.6-3.9 per 1,000 residents respectively(see Table 3.2) Table 3.2 Crude Marriage and Divorce Rates (Unit:per 1,000 population) Year Marriage rate Divorce rate Sokcho Nation Sokcho Nation 2002 5.4 6.4 3.6 3.0 2003 5.3 6.3 4.6 3.5 2004 4.9 6.4 3.6 2.9 2005 5.0 6.5 3.6 2.6 2006 5.4 6.8 3.9 2.6 Korean National Statistical Office, http://www.nso.go.kr - 12 -

5. Health status 5.1 Vital statistics The crude birth rate of Sokcho-city, as recorded in 2006, was 7.4 per 1,000 residents and the crude death rate was 6.2 per 1,000 residents. Compared with national average, the crude birth rate of Sokcho is lower than that of the whole nation, but the crude death rate is higher than that of the nation (see Table 3.3). Table 3.3 Crude birth and death rates (Unit:per 1,000 population) year Crude birth rate Crude death rate Sokcho Nation Sokcho Nation 2002 10.5 10.3 5.5 5.1 2003 9.6 10.2 6.3 5.1 2004 8.8 9.8 6.2 5.0 2005 7.7 9.0 6.5 5.0 2006 7.4 9.2 6.2 5.1 Korean National Statistical Office, http://www.nso.go.kr 5.2 Prevalence of chronic Diseases Figure 3.8 shows the prevalence of two major chronic diseases of Sokcho-city. Hypertension found in Sokcho-city was 12.4 per 1,000 residents and Diabetes mellitus was 6.2 per 1,000 residents. - 13 -

Figure 3.8 prevalence of hypertension, diabetes mellitus. 14 12 12.4 per 1,000 10 8 6 4 2 6.2 0 Hypertension Diabetes Mellitus Source : Gangwon-do,Supporting Structure of Gangwon Health Promotion Program, Health behavior survey in Adult of Gangwon-do, 2006 5.3 Disabilities In 2006, 4,024 persons were registered as a disabled in Sokcho-city. Six major disabilities were crippling conditions (2,164 persons), brain disorders(440), auditory disorder(431), visual disorder(414), and mental retardation(229), mental illness(127) (see Table 3.4). Table 3.4 Registered Disabled Persons by type of the disabled (Unit:persons) Year Total Cripping condition Brain disoder Visually disabled Auditory disabled Lingually disabled Mental retardation Autism Mental illness Etc 2006 4,024 2,164 440 414 431 34 229 13 127 172 5.4 Obesity and overweight Fig 9 shows the percentage being overweight or obese, in 2006 to be 18.1% in Sokcho and 19.8% in the average of Gangwon. Sokcho tends to show lower percentages being obese or overweight than Gangwon. - 14 -

Figure 3.9 Obesity or overweight % 1 0 0 9 0 8 0 7 0 6 0 5 0 4 0 3 0 2 0 1 0 0 1 8. 1 1 9. 8 S o k c h o G a n g w o n Source : Gangwon-do, Supporting Structure of Gangwon Health Promotion Program, Health behavior survey in Adult of Gangwon-do, 2006 5.5 Self-rated Health Status 66.3% of the subjects of the survey considered their health status to be good or very good, which is higher than the average of 57.0% in Gangwon-do(see Table 3.5). Table 3.5 Self-rated Health Status (Unit:%) Very good Good Neutral Poor Very poor Total Sokcho 16.6 49.7 21.0 12.1 0.7 100 Gangwon 10.8 46.2 28.8 12.6 1.6 100 Source : Gangwon-do, Supporting Structure of Gangwon Health Promotion Program, Health behavior survey in Adult of Gangwon-do, 2006 6. Lifestyles 6.1 Smoking The Smoking Rates of Sokcho are reported to be 26.5% among the population, of aged 20 and above. And Gangwon shows 26.0% (see Figure 3.10). The Smoking rates among women shows 6.1% and this tells us that men's smoking rates is estimated to be seven times higher than that women's(see Figure 3.11). - 15 -

Figure 3.10 Smoking rates % 100 90 80 70 60 50 40 30 20 10 0 26.5 26.0 Sokcho Gangwon Source : Gangwon-do, Supporting Structure of Gangwon Health Promotion Program, Health behavior survey in Adult of Gangwon-do, 2006 Figure 3.11 Smoking rates by Sex in adult 100 90 80 70 60 % 50 40 30 20 10 0 44.6 6.1 Men Women source : Sokcho city, Public Health Center, Dong-u college, community health survey of Sokcho,2005. - 16 -

6.2 Alcohol Drinking The alcohol drinking rates of Sokcho is 76.2% in populations, aged 20 years and over(see Figure 3.12). The alcohol drinking rates in Sokcho is 60.8% in men and 44.9% in women, thus implying the alcohol drinking rates in men to be about 1.35 times as high as in women(see Figure 3.13). Figure 3.12 Alcohol drinking rates % 100 90 80 70 60 50 40 30 20 10 0 76.2 76.8 S o k c h o G a n g w o n Source : Gangwon-do, Supporting Structure of Gangwon Health Promotion Program, Health behavior survey in Adult of Gangwon-do, 2006. Figure 3.13 Alcohol drinking rates by Sex in adult % 100 90 80 70 60 50 40 30 20 10 0 60.8 44.9 M e n W o m e n source : Sokcho city, Public Health Center, Dong-u college, community health survey of Sokcho, 2005. - 17 -

6.3 Physical Activities Among the population of Sokcho-city, 75.8% of men and 58.6% of women get regular physical activities. Accordingly more than 50 percent of the total population get physical exercises (see Figure 3.14). Figure 3.14 Physical activity rates by Sex in adult % 1 0 0 9 0 8 0 7 0 6 0 5 0 4 0 3 0 2 0 1 0 0 7 5. 8 5 8. 6 M e n W o m e n source : Sokcho city, Public Health Center, Dong-u college, community health survey of Sokcho, 2005. 7. Housing Conditions Table 6 show details of the types of housing in Sokcho-city. the total number of housing was 30,574 and the housing supply rate indicated to be a high 133.56%. In 2006, The major types of housing in the city appeared to be apartments and detached houses. Table 3.6 Types of Housing (Unit : household, %) Year Number of households Total Housing supply rate(%) Number of houses by type of housing unit Detached house Multi family house Apartment Rowhouse Apartment units in a private house Nonhousing unit 2006 22,892 30,574 133.56 9,410 808 18,309 1,796 238 821-18 -

8. Socio-Economic Conditions 8.1 Unemployment Rate Unfortunately, There is no the unemployment rate in Sokcho-city, but it was 1.9% for Gangwon-do and 3.4% for the nation, as registered in January, 2008(Korean statistics office,2008) 8.2 Major Industries In 2006, The three major industries accommodating the working population in Sokcho-city appeared to be hotels and restaurants(23.0%), wholesale and retail trade(19.3%), education(7.9%)(see Table 3.7). Table 3.7 Number of employees per Industry (Unit:person) Sectors Number % Agriculture and forest 0 0.0 Fishing 2 0.0 Mining and quarrying 0 0.0 Manufacturing 1,159 4.5 Electricithy, gas and watersupply 116 0.4 Construction 961 3.7 Wholesale and retail trade 4,984 19.3 Hotels and restaurants 5,942 23.0 Transport 1,982 7.7 post and telecommunication 224 0.9 Financial institutions and insurance 1,112 4.3 Real estate, and renting and leasing 654 2.5 Business activities 810 3.1 Public administration & defence, compulsory social security 1,524 5.9 Education 2,046 7.9 Health and Social work 1,213 4.7 Recreational, cultural and sporting activities 1,291 5.0 Other community, repair and personal service 1.817 7.0 Total 25,838 100-19 -

8.3 Eeconomic Status Unfortunately, There is no the data of economic status in Sokcho-city. 8.4 Lower Income Class In 2006, 6.7% of households and 4.8% of populations in Sokcho-city are recipients of the basic livelihood allowance Benefits(see Table 3.8). Table 3.8 Households and populations Receiving Basic Livelihood Allowance Benefits (Unit:person) Households Populations Total Recipients % of total Households Total Recipients % of total Populations 34,921 2,342 6.7 86,073 4.070 4.8 8.5 Social Safety In 2006, There were 5,326 registered criminal cases in Sokcho-city. Extra law offender, violence, and intellectual property offender cases showed to be the biggest part of the registered criminal acts(see Table 3.9). Table 3.9 Criminal act, 2006 (Unit:case) Total Felony offenses Thefts Violent offenses intellectual offenses Other criminal offense Offenses other than criminal code 5,326 45 313 1,034 602 273 3,059-20 -

8.6 Education In 2006, There were 34 educational institutions and 18,335 enrollees in Sokcho-city registered. Table 3.10 shows the number of facilities as well as student numbers by level of education. Table 3.10 Number of Educational Institutions and Students (Unit:place,person) Education level Number of schools Number of students Total Male Female Teachers Number of Teachers and staffs Clerical staffs Number of students per teacher Total 34 18,335 9,054 9,281 824 143 15 Kindergarten 12 574 289 285 37 13 16 Elementary school 12 7,491 3,881 3,610 307 54 24 Middle school 4 4,039 2,107 1,932 206 19 20 High school 3 3,057 1,574 1,483 130 12 16 Colledge 1 2,976 1,095 1,881 62 7 54 Other 2 198 108 90 27 11 7 9. Physical Environment 9.1 Air Quality Unfortunately, there is no air pollution data in Sokcho-city. but thanks to Seorok mountain and the sea and the lake, we can easily presume that the air quality of Sokcho is unparallel to any other cities around the world. - 21 -

9.2 Water Quality The capacity of tap water supply of Sokcho-city has increased since 2002 and reaches to 99.8 percent in 2006 (see Table 3.11). Table 3.11 The capacity of tap water supply Year population Watersupply population Watersupply rates (%) Watersupply capacity ( m3 /day) Amount of Watersupply ( m3 /day) Watersupply amount per person a day(l) 2002 90,447 88,430 97.8 49,000 32,200 363 2003 89,458 88,166 98.6 49,000 32,395 367 2004 88,386 87,470 99.0 49,000 32,700 370 2005 87,583 86,835 99.1 64,000 37,807 435 2006 86,073 85,936 99.8 64,000 34,910 406 In 2006, The capacity of sewage treatment facilities was 46 thousand tons per day whereas the actual quantity of sewage treatment showed to be 47.1 thousand tons per day (see Table 3.12). Table 3.12 Sewage Treatment (unit : m 3 /day) Year Capacity of plants Treatment amount 2005 46,000 44,000 2006 46,000 47,100 9.3 Solid Waste Management In 2006, The daily amount of solid waste collection and disposal was 516.8 tons(see Table 3.13). - 22 -

Table 3.13 Daily amount of solid waste collection and disposal (Unit:ton) Year Disposal ratio(%) Amount of discharged waste Amount of waste disposal 02 100.0 505.4 505.4 03 100.0 566.6 566.6 04 100.0 567.3 567.3 05 100.0 505.2 505.2 06 100.0 516.8 516.8 10. Physical and Social Infrastructure 10.1 Park Citing the Sokcho-city Park Plan "to build a city with clean air and clear water", 67.602km 2 of Sokcho-city's park areas had been reserved to accomplish this plan, which accounts for 64.2 percent of the available city area(105.28km 2 ) (see Table 3.14). Table 3.14 Number and Area of Park <Unit:km 2 > Year Total Natural parks Urban parks Number Area Number Area Number Area 2002 33 76.430 1 75.576 32 0.854 2003 33 76.428 1 75.575 32 0.854 2004 33 73.061 1 72.211 32 0.853 2005 33 73,062 1 72.211 32 0.851 2006 36 67.602 1 66.747 35 0.855-23 -

10.2 Culture and Sports Facilities In 2006, there were 9 Cultural Facilities and 14 sports facilities in Sokcho-city(see Table 3.15). Table 3.15 Cultural and Sports Facilities Cultural Facilities (Unit:place) Public & Registered Sports Facilities Performing public private Movie theater Exhibition Museum Art museum Cultural center Gymnasiums Public sports complex Tennis courts Registered Golf Course 3 1 2 2 1 2 1 9 2 10.3 Communication System In 2006, the number of telephone subscribers was 43,995 in Sokcho-city, representing 51.1% of the residents. Table 3.16 shows the number of subscribes by types of telephones in use. Table 3.16 Telephone subscribers by the types of telephones in Use. (Unit:Subscribers) Telephone Subscribers Year Public Total Business Residential telephones 2002 49,146 16,205 32,941 1,545 2003 49,169 17,504 31,665 1,325 2004 45,635 14,666 30,969 1,155 2005 39,738 12,782 26,956 778 2006 43,995 13,958 30,037 923-24 -

10.4 Roads Total paved road was up-to 229,926m that came to 52.1 percent by 2006. The paving rate has been slowly increased since 2002(see Table 3.17). Table 3.17 Rate of paved roads (unit:m.%) Year Total Paved Unpaved Unimproved Paved Rate 2002 241,766 115,821 23,354 102,591 47.9 2003 241,766 115,821 23,354 102,591 47.9 2004 241,766 115,821 23,354 102,591 47.9 2005 233,638 121,757 16,335 95,546 52.1 2006 229,926 119,756 16,091 94,079 52.1 11. Public Health Policies and Services 11.1 Health Care Facilities and Manpower As shown in table 18 showed Sokcho-city has 1 general hospital, 2 hospitals, 51 clinics, 24 dental clinics and 18 oriental medicine clinics. There were 577 health professionals working in Sokcho-city in 2006 (see Table 3.18, Table 3.19). - 25 -

Table 3.18 Health Care Facilities (Unit:Number,Person) General Hospitals Hospitals Clinics Dental Clinics Oriental medicine Clinics Midwife Clinics Health center Total Facility Type 2002 2003 2004 2005 2006 Number 1 1 1 1 1 Beds 130 120 120 143 143 Number - 2 2 2 2 Beds - 212 212 219 219 Number 53 51 52 49 51 Beds 277 211 211 255 307 Number 21 22 22 23 24 Beds - - - - - Number 15 18 18 17 18 Beds - - - - - Number 1 2 1 - - Beds - - - - - Number 1 1 1 1 1 Beds - - - - - Number 92 97 97 93 96 Beds 407 543 543 617 669 Table 3.19 Health Services Manpower (Unit:Person) Health Professionals 2002 2003 2004 2005 2006 Physicians 73 77 83 80 83 Dentists 23 23 24 28 29 Oriental medicine doctor 18 18 18 17 18 Pharmacists 46 2 2 2 2 Midwives 1 3 1 - - Nurses 127 150 185 179 151 Nurse aids 72 109 76 101 172 Medical Technician 41 46 46 47 120 Medical record technician - - 2 1 2 Total 401 428 437 455 577-26 -

11.2 Vaccinations Table 3.20 shows the number of immunizations conducted by public health facilities in Sokcho-city during the period 2002 to 2006. Table 3.20 Immunization Services by Public Health Center (Unit:Person) Year DPT Polio MMR Japanese encephalitis Typhoid fever Hepatitis B BCG Influenza Hemorrhagic fever Others 2002 1,861 1,452 1,174 3,147 1,275 624 479 14,478 363-2003 2,231 3,620 1,369 3,435 375 1,398 326 19,563 81-2004 2,462 2,015 1,484 4,115 1,294 1,406 216 16,625 262-2005 1,943 1,267 1,153 3,349 1,174 1,785 181 15,691 271-2006 2,654 2,123 1,577 3,534 1,179 3,335 421 11,091 210 4,843 11.3 Cancer Screening In 2007, Target population number of cancer screening in Nation, Gangwon-do, Sokcho-city was 16,457,758 and 623,193 and 36,624(see Table 3.21). Cancer screening rates of Taget papulation in Nation, Gangwon, Sokcho was 23.4%, 25.1%, 15.7%. Cancer screening rates of Sokcho-city was very lower than Nation and Gangwon-do(see Figure 3.15). Table 3.21 cancer screening Nation Ganwon Sokcho Taget papulation number of cancer screening 16,457,758 623,193 36,624 Number of cancer screening 3,858.353 157,016 5,737 source: National cancer center, http://www.ncc.re.kr/index.jsp - 27 -

Figure 3.15 Cancer screening rates % 100 90 80 70 60 50 40 30 20 10 0 23.4 25.1 15.7 National Gangwon Sokcho source: National cancer center, http://www.ncc.re.kr/index.jsp 11.4 Epidemics In 2006, Table 3.22 demonstrates the number of incident cases of registered legal communicable disease in Sokcho-city. The most frequent epidemic is shown to be tuberculosis, followed by Varicella. Table 3.22 The number of incident case of registered legal communicable disease (Unit:Number) Typhoid fever Mumps Varicella Tuberculosis Tsutsugamushi fever Hemorrhagic fever with renal syndrome 2 1 16 55 1 3 11.5 Traffic Accidents In 2006, there were 15.6 killed person per 100 thousand person and 1,302.8 injured person per 100 thousand person by 843 traffic accident case in Sokcho-city(see Table 3.23). - 28 -

Table 3.23 Annual Traffic Accidents Year Cases (Per 10 thousand automobile) Killed (Per 100 thousand person) Injured (Per 100 thousand person) Type Vehicle Vehicle to person to Vehicle 2002 1,993 (750.0) 22 (24.0) 1,775 (1,962.0) 257 1,716 2003 2,316 (410.5) 28 (31.3) 1,003 (2,264.7) 227 723 2004 1,932 (262.3) 39 (44.1) 1,523 (2,026.3) 205 693 2005 919 (241.1) 23 (26.3) 1,588 (1,813.1) 169 715 2006 843 (218.8) 18 (15.6) 1,506 (1,302.8) 178 634 12. Cause of Deaths in Sokcho-city Table 3.24 Ten leading cause of death in Sokcho-city. (Unit:person) Order Cause of death number % 1 Malignant neoplasm of bronchus and lung 93 5.6 2 Malignant neoplasm of liver and intrahepatic bile ducts 88 5.3 3 Malignant neoplasm of stomach 72 4.4 4 Cerebral infarction 68 4.1 5 Intracerebral haemorrhage 59 3.6 6 Unspecified diabetes mellitus 58 3.5 7 Asphyxiation 53 3.2 8 Non-insulin-dependent diabetes mellitus 46 2.8 9 Acute myocardial infarction 44 2.7 10 Pneumonia, organism unspecified 41 2.5 sum of 1-10 622 37.6 Total Number of Death 1,655 100.0 Source : Korean National Statistical Office, http://www.nso.go.kr - 29 -

Table 3.24 shows Ten leading causes of death in Sokcho-city by sum of 3 years period from 2004 to 2006 year. In order, Ten leading cause of death in Sokcho-city were Malignant neoplasm of bronchus and lung, Malignant neoplasm of liver and intrahepatic bile ducts, Malignant neoplasm of stomach, Cerebral infarction, Intracerebral haemorrhage, Unspecified diabetes mellitus, Asphyxiation, Non-insulin-dependent diabetes mellitus, Acute myocardial infarction, Pneumonia(organism unspecified). - 30 -

Ⅳ. Analysis of priority health problems Sokcho, Republic of Korea June 2008 Document prepared by : Sokcho Public Health Center, Sokcho-city, Republic of Korea - 31 -

13. SWOT Analysis Fig 4.1 illustrates the SWOT analysis for Sokcho-city. S stands for strengths, W means weakness, O expresses opportunities and the T represents threats. Figure 4.1 SWOT analysis to Sokcho-city Strengths Weakness Relatively low "overweight or obese" rate Relatively low cancer screening rate (Sokcho 18,1%, Gangwon 19.8%, 2006) (Sokcho 15.7%, Nation 23.4%, 2007) Relatively high ratio of "good or Relatively high smoking rate among men very good" self-reported health status (Men 44.6%, Women 6.1%) (Sokcho 66,3%, Gangwon 57.0%, 2006) High alcohol drinking rate (76.2%) Relatively high ratio of exercise Relatively low physical activities rate among Women (Men 75.8%, Women 58.6%, 2005) Opportunities Threats Many environmental resources available. Aging community such as ; (sports or exercise sites, (persons over 65, 10.4%, 2006) for hiking, jogging and walking) Decrease in crude birth rate each year Clean air and Clear water (3.1 down over 4 years, since 2002) Decrease in the cases of traffic accidents Decrease in population each year (63.6 percent down over 3 years (5% down over 5 years, since 2001) since 2003) Relative high divorce rate High housing supply (133.56%, 2006) (Sokcho 3.9%, Nation 2.6%, 2006) High water supply (99.8%, 2006) Relative high "lower income class" rate Perfect disposal in solid waste management among the populations (100%, 2006 ) (Sokcho 4.8%, Nation 3.2%, 2006 ) - 32 -

14. Priority of Health Problem 14.1 9 health problems 9 health problems of Sokcho by the SWOT analysis are as follows ; - Relatively low cancer screening rates - Relatively high smoking rates - high alcohol drinking rates - Relatively low physical activities rates among Women - Aging community - Decrease in crude birth rates each year - Decrease in population each year - Relatively high divorce rates - Relatively high "lower income class" rates 14.2 Development of Healthy City Programs There are 21 programs to resolve 9 health problems and build heathy city, Sokcho, that can be broken down to 4 categories as follows ; 1) Lifestyle improvement and health promotion Develop program and indicators for diabetes self-help management Develop program and indicators for hypertension self-help management Operate a diabetes self-help classroom Operate a hypertension self-help classroom Operate a arthritis self-help classroom Operate a Taichi self-help exercise classroom Develop volunteers for Taichi exercise Rehabilitation program for aged people Rehabilitation program for disabled people Promote health and cancer screening - 33 -

Operate Walking contest with citizens Operate Healthcare educations for healthy citizens(topic ; Non-smoking, Adequate drinking, Weight control Physical exercise and etc.) Organizing and running working exercise campaign and competition Organizing and running periodical healthcare educations for elder(such as, Chronic disease managements ; Hypertension and Diabiabitus mellitus) 2) Health inequality improvement Economic Support for the cancer patients of lower income class. The special supplement nutrition program for women, infant and children at nutritional risk of lower income class. Supply home visiting case management program service for the aged or the disabled of lower income class. 3) Fertility policies Economic Support for Fertility Supply prenatal examinations for all pregnant women 4) Operate non-smoking Clinic Provide education for prevention of smoking by step theory of change Provide some drugs to help stop-smoking 15. Summary Sokcho-city has 10 goals to accomplish its vision( healthy city with clean air and clear water on the basis of health equality ) and mission( Encourage citizens to exercise healthy lifestyles and to develop a healthy environment for their city ). In 2006, the population of Sokcho-city was dropped to 86,073 from 90,543 in 2001. - 34 -

The gender ratio was 98 men per 100 women in 2006. Women were outnumbered. The crude birth rate in Sokcho-city was 7.4 per 1,000 persons and the crude death 6.2 per 1,000 persons in 2006. In 2006, Overweight or obese among the residents aged 20 years and above was 18.1%. The rate of smoking for men aged 20 years and above in Sokcho-city is 44.6%, 6.1% for women. The rate of Alcohol drinking population in Sokcho-city is 60.8% for men and 44.7% for women. The rate of getting physical activities is 75.8% for men and 58.6% for women. The three major industries in Sokcho-city can be classified as follows: hotels and restaurants 23.0%, wholesale and retail trade 19.3%, education 7.9%. The major causes of death of the popultaion in Sokcho-city are Malignant neoplasm of bronchus and lung, Malignant neoplasm of liver and intrahepatic bile ducts, Malignant neoplasm of stomach, Cerebral infarction, Intracerebral haemorrhage, diabetes mellitus, Asphyxiation, Acute myocardial infarction, Pneumonia. Sokcho-city has action plan that includes 21 programs to resolve 9 health problems and build healthy city, Sokcho. - 35 -

16. References Sokcho-city, Annual Statistics, 2006 Sokcho city, Public Health Center, Dong-u college, community health survey of Sokcho, 2005. Gangwon-do, Suporting Structure of Gangwon Health Promotion Program, Health behavior survey for Adult of Gangwon-do, 2006. Werna, E. and Harpham, T.(1995), The Evaluation of Healthy City Projects in developing Countries, Habiat international, 19(4), Quoted in A. Tsouros (1990), World Health Organization Healthy Cities Project: A project becomes a movement, review of progress 1987 to 1990, WHO, Copenhagen. WHO Regional Office for Europe(1998), City Health Profiles: A review of progress. WHO Regional Office for Europe(1998), City Health Profiles: How to report on health in your city. WHO Regional Office for Europe(undated), Measuring Health: A step in the development of city health profiles. Sokcho-city website, http://sokcho.gangwon.kr/foreign/eng/html/main.html Sokcho-city Public Health Center website,http://sokcho.gangwon.kr/ section/health/html/main.html Korea National Statistical Office, http://www.nso.go.kr National cancer center, http://www.ncc.re.kr/index.jsp - 36 -