A Qualitative Study on the Health Literacy and Health Resilience of North Korean Refugees

Background/Purpose: As the numbers of refugees greatly increased worldwide in recent years, interest in their right to heath is also increasing. However, insufficient attention has been paid to addressing health needs of North Korean Refugees(NKRs). They have extreme health problems caused by poor life in North Korea and danger in illegal border crossing. Also, health is one of the biggest difficulty in adapting to new society. Previous studies on health of NKRs in South Korea focused on their physical and mental health status. There are limited studies on their ability to understand and apply health information to make appropriate health decisions. Therefore, this study aims to examining NKRs’ experience of health literacy and resilience in the process of settling down in South Korea.

Methods: This research was an empirical qualitative study with focus group interviews. This interview study included fifteen NKRs who settled in South Korea. Each focus group consisted of five NKRs by settlement period(within 5 years, more than 5 years, and mixed). Participant’s characteristics are as follows: Sex(11 females, 4 males), Age(range 20s-70s), Subjective health status(6 Very bad, 4 Tendency to improvement, 5 Excellent). Participants were recruited via posted flyers sent through the support Center for NKRs. Interviews collected participants’ health lifestyles experiences. The interviews were audio-recorded and transcribed verbatim and analyzed with qualitative content analysis.

Findings: The analysis resulted in five themes: (a) unique conception of health by North Korea cultures (b) neglecting to take care of themselves in mental, physical, social dimensions for economic stability (c) little knowledge of public health and medical service systems due to few chances of health education (d) lack of capacity to cope with unfamiliar ‘capitalist economy’ stressor systems (e) learning health beliefs and health efficacy over time. Participants were not taking care of their health for survival in the early days of settlement. The most important purpose of life for them during this period was economic stability. Also, they showed a passive attitude when using medical systems in South Korea due to their familiarity with North Korean-style socialist culture. As living in South Korea, they came to recognize the necessity of health lifestyle to optimize their health.

Conclusions and Implications: Data analysis reveals NKRs had a hard time accessing to health services due to cultural and linguistic barriers. In addition, their social support network was poor to talk about their health or to ask for help from people around them. Findings indicate the importance of filling gap between NKRs’ daily lives and health services. By developing cultural/transnational competence for in the health professional individuals and social work institutions supporting with NKRs, the gap will be reduced.