Objectives This study investigated the factors influencing unmet healthcare needs of people during the early stage of the COVID-19 pandemic in Seoul, South Korea. The findings help to identify people who have difficulty accessing healthcare services during a pandemic situation. Design We conducted a cross-sectional study using a proportionate quota sampling method according to five major districts, sex and age, using an online survey. We analysed the key characteristics of influencing factors of unmet healthcare needs based on the Andersen behavioural model of healthcare utilisation: predisposing factors (eg, sex, age), need factors (eg, health status, illness) and enabling factors (eg, income, efficacy belief). Setting The questionnaire was sent via email and mobile text messages from the end of April to the beginning of May 2020 during the first wave of the COVID-19 pandemic. Participants A sample of 813 respondents was used, and the respondent information was anonymised in the analysis process. Results For the predisposing factors, sex, age, education level and occupational cluster were associated with unmet needs for healthcare. Chronic diseases and mental health were the influencing factors as an enabling factor that exerted an influence on the unmet need for healthcare in South Korea. Women, younger persons, those with lower education and persons with white-collar jobs were more likely to experience unmet healthcare needs. In addition, the more chronic diseases people had, the more COVID-19 negatively affected them mentally; and the more people felt fear of COVID-19, the higher chances they experienced unmet healthcare needs. Conclusion Government and policymakers are guided to draw out measures such as health communication and telemedicine to reduce the unmet healthcare needs during the pandemic and to recognise the different influencing factors.

This study applied the extended parallel process model (EPPM) to investigate the factors affecting people’s preventive behaviors against COVID-19, and thereby, draw relevant policy implications for current and future other epidemics. The EPPM was used to examine the danger control and fear control responses, along with the separate effects of their sub-factors (perceived susceptibility, perceived severity, response efficacy, and self-efficacy) on personal hygiene behaviors, social distancing measures, and fatalism. In total, data from an online survey of 813 adults were analyzed. The results of multiple regression analysis showed a strong effect of self-efficacy on danger control (ß= 0.23 for personal hygiene behaviors,β= 0.26 for social distancing) and fear control responses (ß= -0.13 for fatalism). However, based on the type of control response, the effect of perceived susceptibility and perceived severity, which were the main factors in threat appraisal, was insignificant or marginally significant. Further, a higher perceived severity was associated with higher fatalism in the fear control response (ß= 0.09). Those who were currently employed performed fewer social distancing measures compared to those who did not (ß= -0.11), whereas there was no difference in personal hygiene behaviors. These results suggest that risk communication in emerging infectious disease crises should provide customized information on people who are hard to comply with social distancing. Besides delivering the message of self-efficacy, policies should be implemented to create a social environment in which individuals can practice social distancing without constraints.

The coronavirus disease (COVID-19) pandemic is traumatic and causes a substantial psychological burden on the general public. The aim of the present study is to examine the severity and prevalence of peritraumatic distress among the citizens of Seoul, which conducted preemptive and aggressive social distancing policy before the central government during the early stage of COVID-19. Furthermore, this study aims to explore the associated risk factors for peritraumatic distress, including risk perception, fear, and COVID-19-related experiences. We conducted an online survey to 813 participants at the end of the first wave of COVID-19 in South Korea. Peritraumatic distress inventory (PDI) was used to measure the level of pandemic-related distress. One-third of participants were at risk for the development of clinically elevated peritraumatic distress. The perception of risk, fear of COVID-19, and stigma were significantly associated with elevated levels of distress. Individuals who had poor health, or who spent more than 1 h per day using the media, also expressed a higher level of distress. Moreover, the level of disruption of daily life and financial difficulties due to the COVID-19 pandemic is significantly associated with a higher level of peritraumatic distress. The results of this study highlight the urgent need to develop evidence-based and tailored public mental health interventions, along with various measures to help recovery to daily life.

Physicians in both Western and Eastern countries are being confronted by changes in health care delivery systems and medical professionalism values. The traditional concept of “In-Sul” (benevolent art) and the modern history of South Korea have led to cultural differences between South Korea and other countries in conceptualizing medical professionalism; thus, we studied medical students’ perceptions of professionalism as described in essays written on this topic. In 2014, we asked 109 first-year medical students who were enrolled in a compulsory ethics course to anonymously write a description of an instance of medical professionalism that they had witnessed, as well as reflecting on their own professional context. We then processed 105 valid essays using thematic content analysis with computer-assisted qualitative data analysis software. Thematic analysis of the students’ essays revealed two core aspects of professionalism in South Korea, one focused on respect for patients and the other on physicians’ accountability. The most common theme regarding physician–patient relationships was trust. By contrast, distributive justice was thought to be a non-essential aspect of professionalism. In Western countries, physicians tend to promote justice in the health care system, including fair distribution of medical resources; however, we found that medical students in South Korea were more inclined to emphasize doctors’ relationships with patients. Medical educators should develop curricular interventions regarding medical professionalism to meet the legitimate needs of patients in their own culture. Because professionalism is a dynamic construct of culture, medical educators should reaffirm cultural context-specific definitions of professionalism for development of associated curricula.

To improve urban adolescents’ dietary behaviors and health, factors that influence them to buy meals in convenience stores with regard to urban food environments must be determined. This study investigated the factors which influence adolescents’ substitution of meals with convenience store meals and its impact on their health in Seoul (South Korea). Multilevel analysis and logistic regression analysis were conducted using data from the Korea Youth Risk Behavior Survey, a national health survey with a representative sample of Korean adolescents. Among 17,624 teenagers who responded to surveys in 2017 and 2019, 30.5% of them substituted meals with convenience store meals more than three times a week. Girls and students with a lower family economic level were more likely to frequently consume food from convenience stores. Unhealthy lifestyles and poor mental health status also influenced their decisions to substitute meals with convenience store food. Those who frequently consumed meals from convenience stores were more likely to have unhealthy lifestyles, featuring bad diets, smoking, drinking, and sedentary behaviors. They also reported significantly poorer self-rated health and mental health. To promote healthy lifestyles among adolescents, efforts to raise awareness and develop supportive environments for healthy diets are strongly recommended.

Obesity is a global pandemic that brings about a myriad of health consequences. In the past, policies for combating obesity mainly focused on improving individual health and behavior, but nowadays some policies have changed and now concentrate on improving the built environment believing this can improve health through positive changes to health-related behaviors. We examined whether both individual and environmental factors were associated with body mass index in Seoul, the capital city of South Korea. Data from the 2011 and 2013 Community Health Surveys were used (n = 20,147 men and 25,300 women). We staged multilevel logistic regression models to estimate the effect of individual and environmental factors on obesity. Among individual covariates, high-risk drinking, the time spent watching TV and surfing the Internet, high salt intake, stress, and the negative recognition of health were significantly associated with obesity. When controlling individual covariates, the number of sports facilities, number of fried chicken stores, and food insecurity level were statistically associated with probability of obesity. Therefore, this study emphasizes that it is important not only to improve the health behavior of the individual, but also to improve the urban environment in order to reduce the obesity rates of city dwellers.