Index of Charts

SEOUL, A HEALTHY CITY ‐ City Profile & Progress Report ‐                      Healthy City Project Team  Division of Health Promotion  Seoul Metropolitan Government  Seoul, Republic of Korea  HEALTHY CITY, SEOUL. Republic of Korea “Cities are sources of creativity and technology,  and they are engines for economic growth.    However,  they are also sources of poverty, inequality and health hazards  from the social and physical environment.1”  2 SEOUL, A HEALTHY CITY. Republic of Korea Introduction to Seoul, a Healthy City More than three years have passed since the City Profile of Seoul was published back in 2003. Significant changes have occurred in Seoul and its Healthy City project during those years, which warrants issuing an updated version of the City Profile and a progress report. Since July 2006, Seoul now has the new administration of Major Se-hoon Oh. The Healthy City Team that started as a temporary unit became a permanent unit of the Seoul Metropolitan Government in September of 2007. This change has allowed security and platform to further the Healthy City project. In addition, new batches of important statistical information became available after publication of the first City Profile. Seoul, A Healthy City consists of two sections. The first section is the second edition of the City Profile with new and updated statistical information. The English homepage of Seoul (http://english.seoul.go.kr/) is a great source of general and statistical information. The second section, Progress Report, describes efforts and progress made by the Healthy City Seoul. More information on Healthy City Projects of Seoul can be found at http://www.healthycity.seoul.go.kr/ (Korean) and http://www.healthycity.seoul.go.kr/eng/main.jsp (English). ACKNOWLEDGEMENTS This document is heavily indebted to the first edition of the City Profile and its makers. Dr. Soo-Kyung Lee handled most of the revision of the City Profile and the writing of the Progress Report. MARCH 2008 CONTACT INFORMATION Healthy City Project Team Division of Health Promotion Seoul Metropolitan Government 31, Taepyeongno 1ga Jung-Gu Seoul 100-744 Republic of Korea Telephone: + 82 (0) 2 6321-4404 Fax: + 82 (0) 2 6321-4409 3 HEALTHY CITY, SEOUL. Republic of Korea E-mail: healthycityseoul@yahoo.com 4 SEOUL, A HEALTHY CITY. Republic of Korea Introduction to Seoul’s City Profile, 1st edition Seoul is a dynamic city, which provides numerous opportunities. It has been experiencing remarkable economic, technological, societal and urban developments. However, Seoul – like other mega-cities – has to be prepared to cope with the negative environmental and social consequences of these developments, and the impact they can have on the citizens’ health and quality of life. The consequences of development are manifold. Tremendous quantities of water are used and large amounts of waste are produced daily. Millions of people and thousands of businesses rely on the provision of electricity. Hundreds of thousands of cars, busses and other vehicles crowd the city’s streets and pollute the air. Citizens are exposed daily to the stressors of urban life and are brought up to be ‘achievers’ – possibly without the tools needed to cope with the societal pressures they face. Health hazards linger everywhere in the city. In order to solve – and prevent – health problems in urban areas it is of utmost importance to adapt a comprehensive approach towards health promotion, based on the theoretical concepts laid down in the WHO Ottawa Charta for Health Promotion,2 and as has been put to practice via the “healthy cities approach” in numerous cities and communities around the globe. At the beginning of 2004, the City of Seoul initiated the WHO Healthy Cities Project. Seoul is also a member of the Alliance for Healthy Cities, a newly established alliance which builds on the “Healthy Cities Network” of the WHO Western Pacific Region. With these two steps the City of Seoul has publicly declared its strong commitment to working towards improving the health and quality of life of all Seoulites, and to make Seoul a city with best possible living conditions. This City Profile provides background information of the city and its infrastructure, it presents the current health status of Seoulites and it summarizes the city’s policies as well as other factors that could contribute to or hinder Seoul’s efforts in improving health and quality of life of its citizens. 5 HEALTHY CITY, SEOUL. Republic of Korea ACKNOWLEDGEMENTS Seoul’s first City profile was prepared in a collaborative effort by the Division of Health Promotion, Seoul Metropolitan Government and the School of Public Health, Seoul National University. Special mention goes to Dr Katrin Engelhardt and Ms Hyun-Joo Lee from Seoul’s Healthy City Project Team, and to Dr Ok-Ryun Moon and Ms Jin-Hee Kim from the School of Public Health, Seoul National University. The support for the preparation of Seoul’s first City Profile, received from the WHO Center for Health Development, Kobe, Japan, is gratefully acknowledged. 6 SEOUL, A HEALTHY CITY. Republic of Korea TABLE OF CONTENTS      INDEX OF CHARTS ..................................................................................................................... 5    INDEX OF TABLES ....................................................................................................................... 7      I. CITY PROFILE    1. History of Seoul................................................................................................................. 1    2. Symbols of Seoul ............................................................................................................... 2    3. Physical Characteristics and Geography ...................................................... 2    3.1. Climate ............................................................................................................................... 4    4. Demographic Characteristics and Vital Statistics................................. 5    4.1. Current Population ..................................................................................................5    4.2. Population Changes.................................................................................................. 6    4.2.1. Age Pyramids.............................................................................................................. 10    4.3. Vital Statistics ............................................................................................................. 12    5. Administrative Structure of Seoul City ......................................................... 13    5.1. Seoul City ......................................................................................................................... 13    5.2. The Mayor......................................................................................................................... 13    5.3. The Seoul Metropolitan Government........................................................... 13    5.3.1. Seoul’s Gus (Districts) and Dongs (Communities)................................. 14    5.3.2. Organization of the Seoul Metropolitan Government ............... 14    5.4. Women and Family’s Policy Bureau............................................................. 15    5.5. The Seoul Metropolitan Council ..................................................................... 15    5.5.1. Organization of the Seoul Metropolitan Council ......................... 16    5.6. Budget Overview for the Fiscal Year 2004 ................................................... 16    6. Seoul’s Major Initiatives .................................................................. 18    7. Seoul’s Economy and Economic Situation of Citizens..........................19  i HEALTHY CITY, SEOUL. Republic of Korea   7.1. Economic Growth ...................................................................................................... 19    7.1.1. Gross Regional Domestic Product ............................................................... 19    7.1.2. Economic Growth Rate......................................................................................... 19    7.2. Major Industries .......................................................................................................... 20    7.3. Tax System ........................................................................................................................ 21    7.4. Employment..................................................................................................................... 22    7.5. Income................................................................................................................................. 22    7.5.1. Poverty.......................................................................................................................... 23    7.6. Cost Of Living in Seoul.............................................................................................. 24    7.7. Household Economy................................................................................................. 24    8. Urban Planning.............................................................................................................. 24    8.1. Transportation and Traffic System............................................................... 25    8.1.1. Changes in the Transportation and Traffic System........................ 26    8.1.2. Making the Transportation System More Disability‐Friendly……. 28  8.2. Housing.............................................................................................................................. 29    8.2.1. Social Housing Project......................................................................................... 30    8.3. Urban Development...................................................................... 30      8.3.1. Green Space (Parks).................................................................................................. 30    8.3.2. Hangang Renaissance ...................................................................................31    8.3.3. Cheong‐Gye‐Cheon Reconstruction...................................................................... 34    8.4. Roads ................................................................................................................................. 34    8.5. New Town Development Project........................................................................ 35    9. Environment ..................................................................................................................... 35    9.1. Waste Management................................................................................. 36    9.2. Water Supply and Consumption....................................................................... 37  ii SEOUL, A HEALTHY CITY. Republic of Korea   9.3. Air Pollution................................................................................................................. 37    10. Education.......................................................................................................................... 40    10.1. Education System...................................................................................................... 40    10.2 Number of Schools, Students and Teachers ............................................ 40  10.3. School Hours .............................................................................................................. 41    10.4. School Enrolment and Literacy Rate ........................................................ 41    10.5. Tuition Fees ................................................................................................................... 41    10.5.1. Composition of Money Spent on Education ......................................... 42    10.6. Private Institutions (“Hag‐Kwon”)................................................................. 42  10.7. Public Libraries............................................................................................................ 42  11. Crime and Violence ................................................................................... 42    12. Health Status ................................................................................................................ 43    12.1. Adult Mortality........................................................................................................ 43    12.2. Infant and Child Mortality ............................................................................ 44    12.3. Morbidity..........................................................................................................................46    12.4. Obesity............................................................................................................................... 47    12.5. Perceived Health and Well‐Being ................................................................. 47    13. Health Behavior ....................................................................................................... 48  13.1. Smoking ........................................................................................................................... 48    13.2. Alcohol Consumption .......................................................................................... 48    13.3. Physical Activity ...................................................................................................... 49    13.4. Nutrition………………………………50    13.5. Personal Health Management........................................................................ 51    13.6. Breastfeeding Rate ................................................................................................. 51    14. Mental Health …………………….52    iii HEALTHY CITY, SEOUL. Republic of Korea 15. Abortion ......................................................................................................................... 50    16. Health Services and Infrastructure.............................................................. 52    16.1. [National] Health Insurance System .......................................................... 52    16.2. Medical Personnel and Hospital Beds ....................................................... 53    16.3. Municipal Hospitals................................................................................................. 54    16.4. Public Health Centers ........................................................................................... 55    16.4.1. Health Services Provided By the Public Health Centers ............ 56    16.4.2. Health Promotion in Public Health Centers....................................... 56    16.5. Health Related NGO’s ............................................................................................ 57    16.6. Community Centers ................................................................................................. 57    16.7. Health Promotion Networks............................................................................ 57    17. Summary.............................................................................................................................. 58    18. References ........................................................................................................................ 60    II. Progress Report    1. Introduction................................................................................................................. 1    2. Vision ............................................................................................................... 2    3. Organization ...................................................... 2    4. Milestones................................. 5    5. Activities & Accomplishments ......................................................... 13    5.1. Developing Personal Skills............................................................................................. 13    5.2. Strengthening Community Action.............................................................................. 13    5.3. Creating Supportive Environments.......................................................................... 13    5.2. Strengthening Community Action.............................................................................. 13    5.4. Building Public Health Policy.......................................................................... 13    5.5. Reorient Public Health Service System......................................................................... 13  iv SEOUL, A HEALTHY CITY. Republic of Korea 6. District‐run Healthy City Projects ......................................................... 13    6.1. “Healthy School” programs............................................................................................. 13    6.2. “Healthy Office” programs.............................................................................. 13    6.3. “Healthy Market” programs.............................................................................. 13    7. Social Marketing................................. 5    8. Global Networking ......................................................... 13    9. Summary................................. 5    5. Activities & Accomplishments ......................................................... 13      v HEALTHY CITY, SEOUL. Republic of Korea INDEX OF CHARTS    Chart 1: National Age Distribution.......................... 5  Chart 2: Population by Age Groups .......................... 5  Chart 3: Estimated Population ................. 6  Chart 4: National Crude Birth and Death Rate ............................................ 6  Chart 5: Seoulʹs Crude Birth and Death Rate .................................................. 7  Chart 6: Number of Marriages and Divorces    ................................................ 8  Chart 7: Estimated Population Growth Rate ................................................ 9  Chart 8: Percentage of Persons 65 and Over....................... 9  Chart 9: Age Pyramid 1907 ~ 2030……..10    Chart 10: National Life Expectancy....................................................... 12  Chart 11: Expenditure of 2007 Fiscal Budget .............................................. 17    Chart 12: Social Welfare Budget Allocation for FY 2007 ……17    Chart 13: Annual GRDP from 1994 ‐ 2004................................................... 19    Chart 14: Economic Growth Rate at 1995 Constant Price......................... 20    Chart 15: Number of Workers by Industry in 2004............................................ 20    Chart 16: Industry Contribution to GRDP in 2005      …… 21    Chart 17: Unemployment Rate ............................................ 22    Chart 18: Average Monthly Household Income in KWON Million...... 22    Chart 19: Consumer Price Index (CPI)    ……………....................................... 23    Chart 20: Monthly Household Expenditure .............................................. 24    Chart 21: Number of Vehicles.................... 25    Chart 22: Transportation by Various Transportion Systems …….25  vi SEOUL, A HEALTHY CITY. Republic of Korea Chart 23: Number of Subway and Bus Passengers per Day....................... 26  Chart 24: Types of Housing........................ 29    Chart 25: Living Arrangements................. 29    Chart 26: Distribution of Types of Park by Park Area ................................. 30    Chart 27: Length of Roads (Paved and Unpaved) .......................................... 34    Chart 28: Total Amount of Domestic Waste Produced (Tons/Day) …. 36    Chart 29: Seoul Metropolitan Governmentʹs Waste Management  System.............................................. 36    Chart 30: Domestic Waste Disposal (Tons/Day) ..................... 37    Chart 31: Consumption of Supplied Water ...................................................... 38    Chart 32: Increase in Seoul’s CNG Buses................................. 39      Chart 33: Number of Schools.................... 40      Chart 34: Number of Students and Teachers................................................. 40      Chart 35: Composition of Money Spent on Education per Student….. 42      Chart 36: Cases on Crimes Committed....................... 43    Chart 37: Mortality Rates by Age Groups …….43  Chart 38: Top 10 Leading Causes Of Mortality................................................ 44      Chart 39: Leading Causes of Death among Infants (Aged < 12 Months) …..44    Chart 40: Leading Causes of Death among Children Aged 1‐9.............. 45    Chart 41: External Causes of Death among Children Aged 1‐9............ 45    Chart 42: Prevalence of Chronic Diseases by Gender in Seoul, 2005.... 46      Chart 43: Obesity Prevalence ………….47    Chart 44: Seouliteʹs Perceived Health Status........................................... 47      Chart 45: Prevalence of Smoking................... 48      Chart 46: Prevalence of Alcohol Consumption ................ 49    vii HEALTHY CITY, SEOUL. Republic of Korea   Chart 47: Prevalence of Various Exercises.............. 50      Chart 48: Foods to Increase Consumption and Foods To Decrease Consumption ……50    Chart 49: Personal Health Management................. 51      Chart 50: Number of Medical Personnel per 1,000 Populations..... 53      Chart 51: Change in Number of Beds per 1.000 Populations ...... 54    Chart 52: Distribution of Beds by Medical Facility...... 54  viii SEOUL, A HEALTHY CITY. Republic of Korea INDEX OF TABLES      Table 1: Number of Births and Deaths............ 7    Table 2: Number of Marriages and Divorces    .................................. 8    Table 3: Vital Statistics    ........................................ 12    Table 4: Eligibility Criteria for the “Basic Livelihood Security”............ 23    Table 5: Average Tuition Fee for Korean Universities by Subject......... 41    Table 6: Prevalence of the Top Three Chronic Diseases for the Indicated Age  Groups ...................... 46    ix   City Profile SEOUL, A HEALTHY CITY. Republic of Korea 1. HISTORY OF SEOUL Seoul became the capital of the Joseon Dynasty in 1394 and has a history, which is more than 600 years old. Seoul began to play a key role in national commerce and trade from the 17th century. Seoul became the economic centre of the peninsula with resources and capital coming in and out, and started growing into a modernizing city. After the Ganghwa-do Treaty was signed with Japan in 1876, during the Joseon Kingdom, Seoul soon became the arena of political, economic and diplomatic competition among foreign powers. During the Japanese Annexation, Seoul was degraded to a mere local administrative unit with a new name, “Gyeongseong-bu.” Urban planning was announced in 1936, and to cope with the increasing population, Seoul was expanded four times larger, including into its territory areas south of the Han River for the first time in history. The “Gu (District)” system was adopted in 1943, just before the National Liberation. The structure of Seoul was influenced very much by foreign residents and their settlements. The Japanese who were monopolizing the economic power resided south of Cheong-Gye-Cheon (a stream, which use to flow through the northern part of the city) making the district the new center of commerce and economy. Yongsan-Gu became the center of military bases and Jongno-Gu became the center of politics. Upon the National Liberation on August 15, 1945, Gyeongseong-bu was renamed “Seoul,” a Korean word meaning “national capital,” which has been used since the Silla Dynasty. The population of Seoul rapidly increased and the territory was enlarged to 260 km2, twice of the size of the past, with a population of 1.6 million. The capital was temporarily moved to Busan during the Korean War in 1951 but returned to Seoul in 1953. Seoul started laying foundations to develop into a modern city from the early 1960s through 1970s. The blueprint for Seoul City was prepared in line with the nationwide Five-Year Economic Development Plan and Seoul was put under the direct control of the Prime Minister in 1962, reducing the control of the central government. With this Seoul became an autonomous municipality. By 1963 the population grew to about 3 million and the territory to over 600 km2. In 1971, “Green Belts” were designated for the first time. Green Belts are areas in which development is restricted. The Comprehensive Han River Development Plan was implemented to improve reservoirs and waterways, make riverside parks, and construct urban expressways along the river. To disperse the dense population in Seoul, some national government offices were relocated from Seoul to Gwacheon, a city in the outskirts of Seoul. Furthermore new satellite cities were built and are still being built around Seoul. 1 HEALTHY CITY, SEOUL. Republic of Korea 2. SYMBOLS OF SEOUL In October 2002, the Seoul City Government introduced the new city brand: “Hi Seoul.” The new brand aims to convey a friendly image of Seoul to the global community, and to promote harmony and unity among Seoulites (Seoul citizens). Since “hi” is a homophone of “high,” the brand offers a new vision for Seoul and reflects the city’s commitment to make Seoul one of the world’s leading cities. The brand features three colors to represent the Republic of Korea: blue, red and yellow. Seoul City’s emblem, which was adopted in 1996, shows mountains, the sun and the Han River. It symbolizes the look of a man and thus symbolizes Seoul tilting toward a human-oriented city. In the context of nature, human and city, the green mountain means a love of the environment, the blue Han River signifies history and vitality, and the sun in the center stands for the future and the vision. 3. PHYSICAL CHARACTERISTICS AND GEOGRAPHY Seoul, the capital of the Republic of Korea, is located in the western central part of the Korean Peninsular, and lies at 126°59’ east longitude and 37°34’ north latitude. The total area of Seoul is 605.52 km2. Seoul possesses only 0.6% of Korean land share, while it contains about more than a fourth of the population. Mountain ridges run from north to south. The Han River, one of the five major rivers in Korea, flows through the city from east to west. It divides the city into a northern (gang-buk) and a southern (gang-nam) part and provides rich water resources to the capital zone before it flows into the Yellow Sea. 2 SEOUL, A HEALTHY CITY. Republic of Korea Map of Korea, showing North and South Korea and the two country’s capital cities, Pyongyang and Seoul, respectively. View on the city center (Jung-Gu District) with the Bukhan-Mountain in the back. 3 HEALTHY CITY, SEOUL. Republic of Korea 3.1. CLIMATE The climate of Korea is characterized by four distinct seasons: spring, summer, autumn and winter3. The contrast between winter and summer is striking. Winter is bitterly cold and is influenced primarily by cold Siberian fronts. Summer is hot and humid due to the maritime pacific high. The transitional seasons, spring and autumn are sunny and generally dry. Temperatures in all seasons are somewhat lower than those at the corresponding latitudes in other continents, such as North America or Western Europe. The variation of the annual mean temperature ranges from 10oC to 16oC except for the mountainous areas. The mean annual temperature of Seoul is 11.8oC. August is the hottest month with the mean temperature ranging from 19oC to 27oC. January is the coldest month with the mean temperature ranging from -8oC to 7oC. Annual precipitation is about 1,300 mm in the central region. More than a half of the total rainfall is concentrated in summer, while precipitation in winter is less than 10 percent of the annual total. The rainy season over Korea continues for one month from late June to late July. A short period of rainfall comes in early September when the monsoon front retreats back to the north. This rain occurs over a period of 30-40 days in June through July at all points of South Korea, and accounts for more than 50 percent of annual precipitation in most regions. The relative humidity is the highest in July with 80 percent to 90 percent nationwide, and is the lowest in January and April with 30 percent to 50 percent. It has a moderate value of about 70 percent in September and October. The monsoon front approaches the Korean Peninsula from the south in late June, moving gradually to the north. 4 SEOUL, A HEALTHY CITY. Republic of Korea 4. DEMOGRAPHIC CHARACTERISTICS AND VITAL STATISTICS 4.1. CURRENT POPULATION According to the statistics from 2006, the population of Seoul is 10,356,202, which is about 21.1% of the total population of the Republic of Korea. The total population of the Republic of Korea is 49,024,737. The population density is 16,817 persons/km2. The gender distribution is equal, with 49.95% of Seoul’s population being male and 50.05% of the population being female.4 The national age distribution of the population shows that 71.6% are aged between 15-64 years, 19.1% are aged 0-14 and 9.3% are aged above 65.4 Chart 1: National age distribution (National Registry, 2005) Most people in Seoul (9.9%) are aged between 25 and 29. About 4.5% of the population is aged between 0 and 4 years. The following chart shows the distribution of the population in five-year age brackets. Chart 2: Population by age groups (National Registry, 2005) 5 HEALTHY CITY, SEOUL. Republic of Korea 4.2. POPULATION CHANGES The population of Seoul increased rapidly after the Korean War (1950-1953) 5. The National Government implemented a family planning policy to reduce the sharp population increase. The Korean Planned Parenthood Federation (KPPF) was founded in 1961 to carry out family planning campaigns and programs. A “successful” decline in population growth is observed from the late 1980s onward. This decline is not only due to the role of the government and the KPPF, but also due to changing lifestyles and values of the Korean people after the beginning of a rapid economic growth in the 1960s. Chart 3: Estimated population (National Statistical Office, 2006) As a result of the Government’s strict family planning policy and the changing lifestyles, the most striking demographic condition in Korea today, is the country’s low fertility rate, which is one of the lowest in the world at 1.135. Seoul’s fertility rate was 0.97 in 20066. In light of the population trend; the “new” government policy is to promote births. The following chart shows the changes in national crude birth and death rates from 1970 to 2005. Chart 4: National crude birth and death rate (National Statistical Office, 2007) 6 SEOUL, A HEALTHY CITY. Republic of Korea The crude birth rate for Seoul was slightly higher than the national average in 1990, however in the years thereafter, the crude birth rate for Seoul began to sink below the national average. The national crude death rate was and is still higher than the Seoul specific rate. Table 1: Crude birth and death rate (National Statistical Office, 2007) 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 National Crude birth rate Crude death rate 15.4 16.6 16.9 16.4 16.3 16.0 15.3 14.8 13.8 13.2 13.4 11.6 10.3 10.2 9.8 9.0 5.8 5.8 5.6 5.4 5.5 5.4 5.3 5.3 5.3 5.2 5.2 5.1 5.1 5.1 5.1 5.0 Seoul Crude birth rate Crude death rate 16.1 17.2 17.5 3.7 3.7 3.6 16.1 16.2 15.6 14.5 13.7 13.0 12.3 12.8 11.0 3.5 3.6 3.6 3.7 3.7 3.7 3.7 3.8 3.7 9.9 3.8 9.8 3.7 9.7 3.7 8.8 3.8 Chart 5: Seoul's crude birth and death rate (National Statistical Office, 2007) The number of marriages reported in Seoul was 107,821 in 1992 and has dropped to 73,924 in 2006. In addition to the decreasing number of marriages, the number of divorces is on the rise, resulting in more and more single households and single parent families. The number of divorces has increased from 13,461 in 1992 to 24,354 in 2006. The following graph shows the number of marriages and divorces from 1992 to 2006. 7 HEALTHY CITY, SEOUL. Republic of Korea Chart 6: Number of marriages and divorces (National Statistical Office, 2007) Table 2: Number of marriages and divorces (Seoul Statistical Yearbook, 2007) 1992 1993 103,511 2002 72,696 1993 14,548 2002 29,351 1994 100,960 2003 72,750 1994 16,321 2003 32,499 1995 98,525 2004 71,553 1995 16,296 2004 26,994 1996 105,100 2005 71,286 1996 18,464 2005 25,300 1997 93,810 2006 73,924 1997 20,391 2006 24,354 1998 26,090 1999 25,917 2000 25,477 1998 88,219 1999 85,215 2000 78,745 Number of marriages 107,821 2001 77,376 1992 Number of divorces 13,461 2001 28,962 Nowadays, Seoulites consider the “ideal number” of children per household to be less than two. With such a perception the national population growth rate is expected to hit 0% in 2021. Seoul, however has already reached that rate: once in 1990 and after a four-year period of population growth from 1995 up until 1999 Seoul’s population growth rate hit 0% again. Since then, the population has continued to decrease. The current population growth rate (crude birth rate – crude death rate) was 5 in the year 2005. 8 SEOUL, A HEALTHY CITY. Republic of Korea Chart 7: Estimated population growth rate (National Statistical Office, 2007) The percent of persons over 65 years of age in Seoul is increasing and has reached 7.2% in the year 2000 making Seoul an “ageing society.” Seoul is expected to become an “aged society,” defined as a society in which 14% of the population is over 65 years, by the year 2019. Chart 8: Percentage of persons 65 and over (National Statistical Office, 2007) The age pyramids, below, also show the characteristics of an ageing society. 9 HEALTHY CITY, SEOUL. Republic of Korea 4.2.1. AGE PYRAMIDS The age pyramids presented here show the change in population distribution for Seoul from 1970 to 2030. The pyramid shows the percentage of the total population (aged 0 to 80 and over) in 5 year age brackets. The typical pyramid form, which is wide at the bottom and narrow at the top, is transforming to a “barrel” form, an indication of low birth and death rates. Chart 9: Age Pyramid 1907 ~ 2030 (National Statistical Office, 2002) 10 SEOUL, A HEALTHY CITY. Republic of Korea 11 HEALTHY CITY, SEOUL. Republic of Korea 4.3. VITAL STATISTICS Table 3: Vital statistics (selected sources) Indicator Crude Birth Rate Fertility Rate Crude Death Rate Life Expectancy at Birth Number of Stillbirths Infant Mortality rate (< 12 month) Under 5 Mortality Rate Maternal Mortality Rate Data 8.8 (per 1,000) 0.92 (per 1,000) 3.8 (per 1,000) 78.63 years Male: 75.14 years Female: 81.89 years 1.025 / year 3.5 (per 1,000) 0.89 (per 1,000) 0.005 (per 1,000) Source & year National Statistical Office (2005) Seoul Metropolitan Government (2005) National Statistical Office (2005) National data: National Statistical Office (2005) Seoul Metropolitan Government (2003) National Statistical Office (2005) National Statistical Office (2006) National data: Korea Institute for Health and Social Affair (2005) The following chart shows the national life expectancy by age groups, with the values for the average age of males and females combined. Chart 10: National life expectancy (National Statistical Office, 2006) 12 SEOUL, A HEALTHY CITY. Republic of Korea 5. ADMINISTRATIVE STRUCTURE OF SEOUL CITY 5.1. SEOUL CITY The administrative structure of the City of Seoul is divided into the Seoul Metropolitan Government (SMG), which is the executive branch, and the Seoul Metropolitan Council (SMC), which is the legislative body. Seoul has a three-tier administrative system, comprising of: the “Si (city),” 25 autonomous ”Gus (districts)” and 517 “Dong (communities),” as of November 2007. 5.2. THE MAYOR The current mayor of the City of Seoul, Mr. Se-hoon Oh, was elected as the 33rd mayor in a local election in May 31, 2006. He took office on July 1, 2006 for a four-year term. Three vice mayors assist the mayor, two of which are responsible for administrative affairs and one for political affairs. 5.3. THE SEOUL METROPOLITAN GOVERNMENT The SMG also has four policy advisors to the mayor concerned with issues related to women, welfare, environment, and urban management. In the city government, there are five offices or headquarters, 32 bureaus, 107 divisions. There are also three project offices (Waterworks, Infrastructure Management, and Subway Construction) and six city-supported public work corporations (Seoul Metropolitan Subway Corporation, Seoul Metropolitan Installation Management Corporation, Gangnam Hospital, Seoul Agricultural & Marine Products Wholesale Market Management Corporation, Seoul Metropolitan Development Corporation, and Seoul Metropolitan Rapid Transit Corporation). Furthermore, there are 29 organizations under the direct control of the Seoul Metropolitan Government: University of Seoul, Seoul City Official Training Institute, Research Institute of Public Health & Environment, Seoul Emergency Operations Center, Fire Academy, Cheongwadae Fire Brigade, Fire Aviation Corps, and 21 fire stations. As of 2006, the number of public servants serving the city totaled 47,563 (about 3,304 working for the head office of the city government and about 31,411 for autonomous “Gu” governments). 13 HEALTHY CITY, SEOUL. Republic of Korea 5.3.1. SEOUL’S GUS (DISTRICTS) AND DONGS (COMMUNITIES) The Gu used to be an administrative “sub-division” of the City Government, but was “upgraded” in 1988 and since then is an autonomous district, performing both autonomous administrative tasks and those commissioned by the City. Each autonomous Gu has one mayor and one vice-mayor. The mayor of a Gu is elected directly by the constituents since June 1995. The administrative structure of the Gus is made up of bureaus, offices, and divisions. Each of the 25 Gus also operates a Public Health Center, which is described in Chapter 16.4. The Dongs provide services closely related to the residents’ daily lives. Each of the 517 Dongs has a “Community Center.” 5.3.2. ORGANISATION OF THE SEOUL METROPOLITAN GOVERNMENT The following figure shows the organizational chart of Seoul’s Administrative Structure (http://english.seoul.go.kr/gover/organ/organ_01cha.htm, Accessed January 8, 2008). 14 SEOUL, A HEALTHY CITY. Republic of Korea 5.4. WOMEN AND FAMILY POLICY BUREAU The health-related divisions are within the “Women and Family Policy Bureau.” The Women and Family Policy Bureau consists of the following divisions: Women’s Policy Division (35 staff members) 　 Childcare Support Division (19 staff members) Adolescents Division (30 staff members) Childbirth Promotion Division (15 staff members) Public Health Policy Division (39 staff members) Health Promotion Division (20 staff members) Each of the Divisions consists of several “teams” with more specific responsibilities. The Health Promotion Division consists of the following three teams: Healthy City Team (7 staff members) Healthy Lifestyle Team (6 staff members) Dementia Management Team (5 staff members) 5.5. THE SEOUL METROPOLITAN COUNCIL7 The Seoul Metropolitan Council (SMC), the legislative body currently has 106 members serving a four-year term in office (2006-2010). The current Council is its seventh since the local autonomy system was revived in 1991, after 30 years of a centralized governing system. The Council has autonomous legislative power to enact, revise and abolish municipal ordinances, and possesses the autonomous fiscal power to examine and decide on budget bills and to verify appropriate execution of the budget. In addition, the council deals with administrative affairs, accepts petitions submitted by citizens, and performs other duties as specified under the provisions of related laws and ordinances. 15 HEALTHY CITY, SEOUL. Republic of Korea 5.5.1. ORGANISATION OF THE SEOUL METROPOLITAN COUNCIL The Council is led by one chairperson and two Vice-chairpersons, and consists of Standing Committees, Special Committees, and the Secretariat. The following figure shows the organizational chart of Seoul’s Metropolitan Council: 5.6. BUDGET OVERVIEW FOR THE FISCAL YEAR 20076 The Seoul Metropolitan Government's (SMG) gross total budget for FY 2007 stands at 16.921 trillion won--general account 11.3585 trillion won, special accounts 5.5625 trillion won--an increase of 5.9% from the previous year. SMG's budget accounts for 8.4% of the national budget of 200.9519 trillion won (approximately $ 218.663 billion). 16 SEOUL, A HEALTHY CITY. Republic of Korea Seoul’s budget for the FY 2007 is spent as follows. Chart 11: Expenditure of 2007 fiscal budget (Seoul Metropolitan Government, 2007) The following table shows how the budget allocated to “Social Welfare,” which includes “health,” will be spent in the FY 2007. The unit is KWON billion. Chart 12: Social Welfare Budget allocation for FY 2007 17 HEALTHY CITY, SEOUL. Republic of Korea 6. SEOUL’ S MAJOR INITIATIVES This chapter provides an insight into some of Seoul’s major policy directions that have a long-term impact on Seoul’s city profile. In the Seoul City Government, every Bureau, Division and even every Team within the Divisions have a vision and a long-term work plan. The long-term work plans are submitted to the Planning and Evaluation Office, which is responsible for developing the plans for the City Government. This office selects and summarizes the priority action areas and compiles the long-term Seoul vision. It is required to achieve balanced development and budget between the 25 Gus within the City. More information on Major’s policy initiatives can be found on http://english.seoul.go.kr/gover/initiatives/inti_Vision&Objectives.htm. 18 SEOUL, A HEALTHY CITY. Republic of Korea 7. SEOUL’ S ECONOMY AND ECONOMIC SITUATION OF CITIZENS Seoul functions as an “ industrial incubator,” nurturing information technology and financial service industries, and is also the centre of banking, securities and insurance for Korea. The city has a strong purchasing power and a high level of income. 7.1. ECONOMIC GROWTH 7.1.1. GROSS REGIONAL DOMESTIC PRODUCT The Gross Regional Domestic Product (GRDP) for Seoul in 2004 was KWON 182,046.4 billion (US$ 195.01 billion) at current price, which accounts for 23.1% of whole nation. Seoul’ s per capita GRDP is KWON 18,161.900 (US$ 19,455.7). About 20 years ago, in 1994, Seoul’ s GRDP was about KWON 76,806.1 billion (US$ 82.28 billion) at current price and has thus experienced more than a 2-fold increase in about 10 years8. Chart 13: Annual GRDP from 1994-2004 (National Statistical Office, 2007) 7.1.2. ECONOMIC GROWTH RATE In the past three decades Seoul has experienced rapid economic growth, with many foreign investors entering the city. In 1997, however, Seoul - and the Republic of Korea as a whole experienced an economic crisis. As a result the economic growth rate dropped to a record low. After a recovery period of 2 years, between 1997 and 1999, Seoul’ s economic growth rate reached a peak in 2000 and 2002. The economic growth rate started to decline again thereafter and has stayed low. 19 HEALTHY CITY, SEOUL. Republic of Korea Chart 14: Economic growth rate at 1995 constant price (Seoul Statistical Yearbook, 2007) 7.2. MAJOR INDUSTRIES Seoul provides access to a large variety of industries, ranging from wholesale and trade, to real estate, to construction and to manufacturing. Most Seoulites (763,193) worked in “ Wholesale & Retail trade” in 2004, followed by people working in the “ Business service activities” industry (499,669). In general, the number of people working in primary industries has decreased, while the number of people working in tertiary industries has increased. Chart 15: Number of workers by industry in 2004 (Seoul Statistical Yearbook, 2007) 20 SEOUL, A HEALTHY CITY. Republic of Korea Of Seoul’ s industries, the real estate, renting and business services provided the largest contribution (24.7%) to Seoul’ s GRDP8. Chart 16: Industry Contribution to GRDP in 2005 (Seoul Statistical Yearbook, 2007) 7.3. TAX SYSTEM The local tax system of Seoul can be divided into two categories, “ city” and “ district” taxes. City and district taxes are levied by Seoul’ s 25 districts under the provision of the “ Local Tax Law.” All taxes are categorized into three types, based on their source of taxing: income, consumption and real estate. Taxes on consumption include, e.g. motor fuel tax, tobacco consumption tax, automobile tax, leisure tax and butchery tax. The tobacco consumption tax was established as a local tax (city and county tax) on January 1, 1989. The current tax rate is 641 KWON for 20 cigarettes, but is expected to increase this year. Out of 641 KWON, 354 KWON is set aside for health promotion activities. 21 HEALTHY CITY, SEOUL. Republic of Korea 7.4. EMPLOYMENT The economically active population of Seoul (persons aged 15 and over) was about 5,173,000 persons in 2005, which account for 63.5% of the population. Among the economically active population, 4,939,000 persons, or 95.5% were employed and 234,000 persons or 4.5% were unemployed. The unemployment rate is on a gradual decrease since the dramatic rise in 1998 during the economic crisis, when the unemployment rate once rose to almost 8 %5. Chart 16: Unemployment Rate (National Statistical Office, 2007) 7.5. INCOME Most (28%) of Seoul’ s households earned in 2005 between 2 and 3 million KWON (US $ 2,164-3,246), followed by 24% of households which have an average monthly income between 3 and 4 million KWON (US $ 3,246-4,328). Chart 18: Average monthly household income in KWON, 2005 (Seoul Survey, 2006) Monthly Income (KWON) Monthly Income (US $) < 1million < 1,082 1-2 million 1,082 - 2,164 2-3 million 3-4 million 4-5 million 4,328 - 5,410 > 5 million > 5,410 2,164 - 3,246 3,246 - 4,328 22 SEOUL, A HEALTHY CITY. Republic of Korea 7.5.1. POVERTY The population receiving “ basic livelihood security” is considered “ poor” by the Seoul Metropolitan Government. The eligibility criteria are defined by the monthly household income and the number of persons living in the household. Table 4: Eligibility criteria for the “Basic Livelihood Security” (Seoul Metropolitan Government, 2007) Persons per household Minimum monthly income (KWON) Minimum monthly income (US $) 1 435,921 472 2 734,412 795 3 972,866 1,053 4 1,205,535 1,304 5 1,405,412 1,521 6 1,609,630 1,742 A total of 106,399 household and 196,575 persons received ‘basic livelihood security’ in 2006, which is about 1.9% of the total population.6 7.6. COST OF LIVING IN SEOUL The consumer price index (CPI) of Seoul in 2006 was 119.35. The base year is the year 2005 (=100). The CPI of Seoul has been increasing continuously since 1965. Chart 19: Consumer Price Index (CPI) (National Statistical Office, 2007) According to a survey conducted by Mercer Human Resources Consulting, Seoul is the 7th most expensive city to live in the world, cheaper than London and Hong Kong, but more expensive than Beijing and New York. 23 HEALTHY CITY, SEOUL. Republic of Korea 7.7. HOUSEHOLD ECONOMY The average monthly expenditure per household in Seoul was KWON 2,515,495 (US$ 2,723) in 2005. Expenditure in medical care accounted for 5 %, or 105,996 KWON (US$ 115). Housing accounts for 3.5 % of the total household expenditure. The reason why this figure is so low is because most Koreans either own a house or an apartment, or they deposit a 2-year lump sum. No, or only low additional payments are made monthly, resulting in a low percentage of monthly household expenditure going to “housing.” Chart 20: Monthly household expenditure in 2005 (Seoul Statistical Yearbook, 2007) If monthly payments were to be made for housing, then the monthly expenditure for housing would account for 31.2% of the total monthly household expenditure. 8. URBAN PLANNING In the following section, the urban infrastructure as well as the housing and transportation situation is presented, and related the policies are elaborated on in more detail. 24 SEOUL, A HEALTHY CITY. Republic of Korea 8.1. TRANSPORTATION AND TRAFFIC SYSTEM The total number of registered motor vehicles is increasing in Seoul, as shown in the following bar chart. In 1988 a total number of 0.8 million motor vehicles were registered in Seoul. This number included privately owned, commercial and government vehicles. Within 20 years, more than two million additional vehicles were registered, increasing the number to 2.86 million in 2006. Most of the registered vehicles are privately owned cars. Chart 21: Number of vehicles (National Statistical Office, 2007) Subway system is the most widely used public transportation method, followed by bus system in 20056. The following chart shows proportions each public transportation system carries in transportation. Chart 22: Transportation by various transportion systems (Seoul Metropolitan Government, 2007) 25 HEALTHY CITY, SEOUL. Republic of Korea The number of subway passengers on Seoul’s eight subway lines, has also increased, although the rate of increase somewhat slowed after 2001. The increase in the number of passengers per day from 1997 to 2004 is shown in the following bar chart. On the other hand, the number of public city buses has been declining. In 1997 a total of 8,655 public city buses were registered compared to a total of 7,748 in 2007. Paralleling the decline in the number of buses, a decline in passengers is also observed. In 2004, a total of 1.5 billion passengers rode on the public buses, down from 1.7 billion passengers in 1997. Chart 23: Number of subway and bus passengers per day (Seoul Statistical Yearbook, 2007) The number of taxis in Seoul has not changed much since the year 1995. In the year 2004, 72,404 taxis were registered in Seoul and carried about 0.7 billion passengers that same year. 8.1.1. CHANGES IN THE TRANSPORTATION AND TRAFFIC SYSTEM Seoul’s public transportation system went under a major reformed in 2004. The reform completely renovated the old and very complicated bus routes. The new bus routes were divided into four categories and buses running each category were color-coded for consumers’ convenience. Red buses (Wide Area Line) go to the outskirts of the city (including Bundang and Ilsan). They operate on 43 local routes and are numbered from 9100 to 9999. Yellow buses (Circular Line) operate through the center of the city and have two-digit numbers. Blue buses (Main Line) operate on major arterial roads and have three digit numbers. Green buses (Branch Line) operate branch lines and their major role is to carry passengers to junctions. In addition to the Blue, Red, Yellow, and Green buses, approximately 1,229 community buses are in operation which run short distances where subways or commuter buses do not reach. 26 SEOUL, A HEALTHY CITY. Republic of Korea The most noticeable feature is the integrated fare system designed to reduce financial burdens when switching between forms of mass transportation. Under the new system, passengers will only have to pay 800 won over a given distance no matter how many times they change between buses (including village buses) and subways, with an increment of 100 won charged for every additional 5 km. Under the previous system, a passenger changing buses once to get a destination had to pay 1,250 won (650 won + 600 with 50 won discounted on the second bus). Under the new system, a passenger pays 800 won for the basic distance (10 km), no matter how many times she changes buses, and then 100 won more for every 5 km added to the basic distance. No matter how far she may travel until her destination, the fare will be less than the 1,600 won (800 won + 800 won) paid under the current system, supposing she changes buses or transfers to another form of mass transportation just once. This system has expanded to the integrated metropolitan transfer system that started on July 1, 2007 among bus and subway services in Seoul and Gyeonggi areas, resulting in 91.3 percent satisfaction rating among inter-regional commuters. Another major change the reform brought was the new “Median Bus-only lanes.” The “Median Bus-only lanes” was introduced to make public transportation the primary mode of travel around in the city and have already been yielding practical benefits and have significantly improved the speed of bus traffic. By 2008 the city expects to have 191.2 kilometers of the “median bus-only lanes.” The reform proved to be successful with high satisfaction rating and attentions from international communities. According to a survey conducted on 1,000 citizens aged over 20 years from July 21 to August 2 of 2006, 90.2 percent of people said they are satisfied with the subway, and 85.5 percent are satisfied with bus service, which were increased by 11.1% and 26.6%, respectively, from the previous year. “Medium Bus-only lanes” Color-coded bus 27 HEALTHY CITY, SEOUL. Republic of Korea The subway systems in Seoul are also being expanded with a plan to extend the running hours. Furthermore, intra city highways will be constructed. In the fiscal year 2007 the City’s budget allocated to the expansion of road and urban subway network was 1,228.3 billion KWON (US$ 1,330 million). A total of 565.5 billion KWON (US$ 61 million) were allocated to improvements of the public transportation service. 8.1.2. MAKING THE TRANSPORTATION SYSTEM MORE DISABILITY-FRIENDLY The public transportation system has improved to facilitate its use by disabled citizens. The Seoul Metropolitan Government has recently completed the installation of elevators, escalators, and other facilities to help passengers get into and out of underground subway stations. Since 2001, Seoul City has spent approximately 352 million dollars on the construction of a total of 810 facilities including 502 elevators, 209 escalators, and 97 wheelchair lifts at 262 stations. Subway Elevator Call Taxi for the Disabled Furthermore, a free shuttle bus system for people with disabilities in all areas of Seoul will be established, in addition to a call-taxi service for the disabled. 28 SEOUL, A HEALTHY CITY. Republic of Korea 8.2. HOUSING The main type of housing in Seoul is single-family houses, which make up 42% of Seoulite’s accommodation, narrowly followed by multi-story apartments, which account for 37%. About 2% of Seoulites have their business and their housing in the same location. Chart 24: Types of housing (National Statistical Office, 2007) The average size of Seoul’s households is 2.56 persons in 2006. The average area per one Seoulite was 7.9 pyong (1 pyong = 3.3 m2). Most Seoulites rent an apartment or house, followed by those who own their housing. The average cost for buying an apartment in Seoul per pyong ranges from KWON 6.2 million (US$ 6,630) to KWON 20.4 million (US$ 22,020), depending on the area8. Chart 25: Living arrangements in 2005 (National Statistical Office, 2007) The total of 24.7% in Seoul’s downtown area8 was below the minimum standard for housing. 29 HEALTHY CITY, SEOUL. Republic of Korea 8.2.1. SOCIAL HOUSING PROJECT In an effort to solve the shortage in housing, the Seoul Metropolitan Government will construct a total of 100,000 long-term lease housing units, named “Shift” over the course of the next 10 years for underprivileged citizens. In the Fiscal year 2007 the City’s budget allocated to the Social Housing Project was 217.5 billion KWON (US$ 230 million) to promote housing stability by increasing supply of public rental houses and to buy rental houses for housing stability of low-income earners. 8.3. URBAN DEVELOPMENT (GREEN SPACE, RECREATIONAL AREAS, LIVEABLE ENVIRONMENTS, ROADS) One of the City’s Mayor’s goals is to make Seoul more “livable.” Seoul is becoming greener with more inner-city parks are being built. A comprehensive plan to re-vitalize the Han River has been ambitiously launched. 8.3.1. GREEN SPACE (PARKS) There are a total of 1,437 parks in Seoul covering 155.85km2, accounting for 25% of Seoul’s total land area. The per capita park area is 15.02 m2, which is about the same area as in major cities in other countries. Unfortunately, 72% of parks in Seoul are located in the suburbs or on mountainsides at the remote edges of the city as seen in the chart below, so they are not readily accessible by the majority of the population. There are far too few neighborhood parks in Seoul. Chart 26: Distribution of types of park by park area (Seoul Statistical Yearbook, 2007) 30 SEOUL, A HEALTHY CITY. Republic of Korea The Five-Year Park Expansion Plan is now being implemented to expand parks in residential areas. A total of 400,000 m2 of land formerly belonging to industrial complexes or part of Yeouido Plaza was landscaped and converted into parklands. Old apartments and residential housing complexes in the mountain-side areas of Naksan and Namsan were removed and are now being reclaimed as parks where natural beauty will be restored for all citizens to enjoy. This year, Seoul city will invest a total of 74.2 billion won in the creation of neighborhood parks. Eco-parks, natural parks, and sports parks will be created, and landowners will be fairly compensated for all lands obtained for the parks. Small neighborhood parks, such as small-sized theme parks and gardens for local communities, will be created on lands, which are presently idle. This plan is carefully guided by the “The Citizen’s Committee for Green Seoul” first established in 1995. 8.3.2. HANGANG RENAISSANCE The Seoul Metropolitan Government has recently announced the HANgang Renaissance Master Plan, including designation of eight riverside areas for special development, and construction of international sea ferry terminals leading to the West Sea at riverside areas in Yongsan and Yeouido. The master plan also asks to provide more paths to the river for easier accessibility for people and systematic management of riverside sceneries. Riverside concrete embankments will be removed in stages as part of the eco-network plan. 31 HEALTHY CITY, SEOUL. Republic of Korea The long-term master plan, which has been prepared for 10 months for the entire city with the focus on the Hangang, will be carried out based on continuity and sustainability. Under the master plan, Seoul City will concentrate on the following eight factors: Reorganization of the urban space structure centered on the Hangang, Formation of waterfront towns, Improvement of riverside sceneries, Establishment of a ferry route leading to the West Sea, Establishment of eco-network centered on the Hangang, Development of more paths leading to the Hangang, Launch of programs linking riverside historic sites, and Construction of riverside parks with unique themes. It appears that the plan to establish a ferry route leading to the West Sea stands out as the most important. It will be developed in conjunction with the Seoul-Incheon Canal Project propelled by the central Government. Seoul City will build international sea ferry terminals leading to the West Sea at riverside areas in Yongsan and Yeouido, complementing the business and culture infrastructure in the areas. It has not been fixed whether to build only one international sea ferry terminal either in Yongsan or in Yeouido or two terminals in the two areas. The decision will be made in consideration of various relevant factors. Seoul Mayor Oh, Se-hoon asked the central Government to push ahead with the Seoul-Incheon Canal Project, as the city's plan should go side by side with the project. 32 SEOUL, A HEALTHY CITY. Republic of Korea The city government also plans to form waterfront towns in Magok and Yongsan as part of the plan to make Seoul a pleasant and attractive waterfront city, in addition to designation of eight riverside areas for special development, i.e. Magok, Seobuichon-dong, Sangam, Yeouido, Banpo, Ttukseom, Jamsil and Ichon-dong. The development plan includes construction of canals leading to the Hangang. Ferries serving routes along the canals can carry commuters. The mid- and long-term development plan will be carried out by attracting private funds or as public development projects. Efforts will also be made to make the Hangang a more pleasant and beautiful place, including removal of concrete embankments by stages (i.e. an 18km section out of the 62km-long embankments) to help it restore its status as a natural stream and establishing a South-North ecology network. The city government plans to provide more diversified means that will help people approach riverside areas conveniently, including making it more convenient to transfer between subways or buses for those areas, and increasing bike roads and other paths, which lead to those paths. Riverside parks in Yeouido, Nanji, Ttukseom and Banpo will be rearranged to display unique themes. Programs will be carried out to improve the appearance of bridges, their piers, nearby parks and retaining walls both during the day and at night. The city government is planning to invest a total of 672.6 billion won in the master plan until 2010, including 33 relevant individual projects whose work was commenced in 2006. The master plan also asks for promotion of long-term projects by 2030 with meticulous preparation. 33 HEALTHY CITY, SEOUL. Republic of Korea 8.3.3. CHEONG-GYE-CHEON RECONSTRUCTION The Cheong-Gye-Cheon stream, which used to flow through Seoul, was covered in the 1960s, to allow additional roads. The Seoul Metropolitan Government restored the Cheong-Gye-Cheon stream to revive the old image of the city. The stream is now a popular civic attraction for citizens and visitors as places for rest and pleasure. The project started in 2003 and was completed by the end of 2005 with an estimated total budget of 386.7 billion KWON (US $411.1 million). More information can be found at http://cheonggye.seoul.go.kr. Cheong Gye Cheon Road (before) Cheong Gye Cheon Stream (after) 8.4. ROADS In parallel to the increase in cars (see Chapter 8.1) a lot of investment has been put into improving and expanding the road system in and around Seoul. The following chart shows the changes in the road system between 1997 and 2002. Chart 27: Length of roads (paved and unpaved) (Seoul Statistical Yearbook, 2007) 34 SEOUL, A HEALTHY CITY. Republic of Korea 8.5. NEW TOWN DEVELOPMENT PROJECT The New Town Project can be defined as a re-development project for existing towns in Gangbuk, the relatively underdeveloped northern part of Seoul. It is implemented in order to solve problems wherein private sector-lead development had so far concentrated on housing, without due consideration for urban infrastructure, creating a resultantly abusive development pattern. This project is under way with five purposes: 1) solving the problem of inter-regional disparity, 2) prevention of abusive development, 3) solutions to the housing problem, 4) solutions for the educational environment by attracting good schools, 5) job creation and economic stimulus effect The principal philosophy of New Town Development is the realization of humanism. It is the development of an integration of people and their urban environment, not just a city that has become a tool. The integration of nature with a multi-functioning future space structure, wherein sophistication, beauty, and living convenience co-exist harmoniously, opens through New Town development philosophies. The purpose of Seoul’s New Town Development Projects is to reduce the inequality gap between “rich” and “poor” areas in Seoul. The Government will promote underdeveloped areas and develop them into “new towns” of various types. The “heart (the center)” of the selected underprivileged districts will by the area of development. With three areas for pilot programs, a total of 22 new town areas have been chosen and under development. In the Fiscal year 2007 the City’s budget allocated to the New Town Development Project was 174.9 billion KWON (US $ 19 million) 9. ENVIRONMENT Seoul Metropolitan government established the “ Citizens’ Committee for a Green Seoul” in 1995, recognizing the importance of tackling environmental problems in collaborative efforts between Seoul’ s citizens, civic groups and the industry. The committee has about 100 members, including environmental experts, representatives of industry and civic groups, city council members, and officers of the Seoul Metropolitan Government. The Committee holds more than 100 meetings each year and has been carrying out various projects, including the implementation of the “ Seoul Agenda 21.” It has also been conducting evaluations and consultations on the sustainability of major administrative plans 35 HEALTHY CITY, SEOUL. Republic of Korea and projects of the Seoul Metropolitan Government, holding competitions for participation in Seoul Metropolitan Government’ s projects, and producing publications on the environment. The information presented in this part of the City Profile is taken primarily from the “ Seoul Green Vision 21” website. 9.1. Waste Management The total amount of waste produced in Seoul is increasing. The following two charts show the amount of household waste produced. Chart 28: Total amount of domestic waste produced (tons/day) (Seoul Statistical Yearbook, 2007) Seoul’ s efforts regarding the establishment of a waste management system are remarkable9. The following chart shows Seoul’ s waste management system: Chart 29: Seoul Metropolitan Government's waste management system. (http://smg.metro.seoul.kr:9002/waste/) 36 SEOUL, A HEALTHY CITY. Republic of Korea The Waste Management Division, the Waste Facilities Division under the control of the Office of Environment, and the Waste Disposal Divisions at the district level are responsible for waste management in Seoul. The waste disposal workforce is under the direct supervision of each district Office. In 1995, a regulation was passed that requires all households and businesses to buy standardized, district-specific waste bags, which facilitate waste recycling. The bags are specified for domestic and public use and for businesses. An increase in the amount of recycled waste is observed for domestic, industrial and construction waste. The following chart shows the amount of waste, which was recycled, burned and dumped into landfill sites. Chart 30: Domestic waste disposal (tons/day) (Seoul Statistical Yearbook, 2007) Of the domestic waste produced in 2005, about 65% was recycled, 25% dumped into landfill sites and about 10% was burned. 9.2. WATER SUPPLY AND CONSUMPTION The entire Seoul’ s population is supplied with public tap water. To meet the demand for tap water, 90% of the water intake occurs at the five intake pumping stations along the upstream Han River and 10% of the water intake occurs at Paldang Dam. A total of eight purification plants produce an average of 4.03 million tons of clean tap water daily10. The total amount of water supplied to the city is 3.35 million m3 per day in 2006. Most of the water supplied to the city goes to domestic use (66%). 37 HEALTHY CITY, SEOUL. Republic of Korea Chart 31: Consumption of supplied water in 2005 (Seoul Statistical Yearbook, 2007) The Han River is the source of drinking water for the citizens of Seoul. At five locations along the upper reaches of the Han River, water is collected for tap water. Every month, 26 indicators of water quality at 40 points along the Han River are examined. In November 2000, Seoul city’ s water system was granted ISO14001 certification, an international standard for tap water production. The city government is also striving to make timely response to the change in environment. In preparation of the water shortage in the future, the Water Management Bureau will be newly established to overlook all tasks related with water. All sewage from households and workplaces flows through sewage pipes into drainage systems installed along rivers. The wastewater is treated at sewage treatment plants before being discharged into the Han River. A total of 6.11 million tons of domestic sewage is treated per day at four treatment plants, which cover a specific drainage area. All industrial wastewater is now prevented from directly flowing into the Han River and its tributaries, which has lead to a gradual improvement of the water quality. 9.3. AIR POLLUTION11 The topography and geographical proximity of Seoul worsens the city’ s pollution problem. Because Seoul is surrounded by high mountains the air circulation throughout the city is poor. Seoul’ s increasing population, combined with the air pollution blowing in from rapidly industrializing China, have exacerbated the air pollution conditions of Seoul. In order to make the air of Seoul cleaner, the Seoul Metropolitan Government enacted environmental standards and an ordinance for pollutant emission standards in 1999, which are much stricter than the central government standards. Improving air quality is one of the five key projects of current administration of Seoul Metropolitan Government. 38 SEOUL, A HEALTHY CITY. Republic of Korea Large-sized diesel-powered vehicles account for only 1.7% of all vehicles in the Republic of Korea, but they emit 22.2% of the total volume of air-polluting substances from all vehicles. In order to reduce air pollution caused by emissions from diesel vehicles, Seoul city will replace all city buses with Compressed Natural Gas (CNG)-powered buses. These buses produce no smoke and 65% less ozone-generating substances. In 1999, Seoul city established the legal framework needed to provide CNG buses, including tax incentives and financial support for their purchase. The first 51 CNG buses were in service in 2000, and as of 2006, 43% of the city buses were powered by CNG. All city buses will be powered by CNG by 2010. Chart 32: Increase in Seoul’s CNG buses (http://smg.metro.seoul.kr:9002/air/index.html) In order to reduce ozone-generating substances at the source, the NOx emission standards for new small-sized diesel vehicles was tightened (from 1,40 g/km in 1999 to 1,06 g/km in 2000 and 0,78 g/km in 2002). The Seoul Metropolitan Government has also announced plans to demand all diesel-powered trucks install the devices by 2008, while drivers who fail to make the changes will be fined. Under the scheme, all diesel-powered trucks over seven years old and weighing more than 3.5 tons will have to be retro-fitted with diesel particulate filters by the end of 2008. Auto repair and maintenance shops and other such businesses are encouraged to improve facilities to reduce VOC emissions. In order to minimize the health dangers due to the generation of ozone to citizens, Seoul city installed automatic air pollution monitoring devices at 27 locations around the city, and it broadcasts ozone alerts whenever the ozone level exceeds 0.12 ppm for an hour or longer. When an ozone alert is in effect, citizens are advised to refrain from going out and participating in outdoor sports activities and the like. The C40 Summit Organization Committee will be created within the Air Quality Control Division to efficiently prepare for the climate change-related C40 Summit to be held in Seoul in May 2009. 39 HEALTHY CITY, SEOUL. Republic of Korea 10. EDUCATION 10.1. EDUCATION SYSTEM The basic education ladder is a singular track composed of six years of elementary school, three years of middle school, three years of high school and four more years of college or university schooling. The primary and secondary Education Law stipulates that six years of primary education and three years of middle school education are mandatory. 10.2. NUMBER OF SCHOOLS, STUDENTS AND TEACHERS There were a total of 2,641 schools in Seoul with a total of 2,527,166 students and 91,083 teachers in 2005. The number of students per teacher was 27.7 in 2006. The number of schools in Seoul is decreasing, due to the decreasing student population. However, the number of teachers has been increasing since 1999. Chart 33: Number of schools (Seoul Statistical Yearbook, 2007) Chart 34: Number of students and teachers (Seoul Statistical Yearbook, 2007) 40 SEOUL, A HEALTHY CITY. Republic of Korea On average, the number of students per teacher was 13.3 in kindergartens, while the student-teacher ratio was 22.2 in elementary schools. The ratio was 18.5, 15.6, and 11.9 in middle schools, general high schools, and vocational high schools, respectively. The ratio for colleges and universities was 32.3. Because of the decreasing number of students and the increasing number of teachers, the student-teacher ratio is decreasing. 10.3. SCHOOL HOURS The minimum number of school days for elementary school, middle school and high school is the same at 220 days per year. However, the unit hour of instruction is 40 minutes in elementary schools, 45 minutes middle schools and 50 minutes in high schools. 10.4. SCHOOL ENROLMENT AND LITERACY RATE In 2003, 127.228 children newly entered elementary school. The percentage of enrolment was 92.0%8. According to the Human Development Report by the United Nations Development Program (UNDP), the adult literacy rate in Korea was 97.9% in 200212. 10.5. TUITION FEES Since elementary and middle school education is compulsory, there is no tuition. However, the tuition for high school is KWON 1,450,800 (US$ 1,544)13. There is also a tuition fee for higher education, i.e. for colleges and universities. The fees vary by university. The following table shows the average tuition fees per year (2 semesters) by subject and by type of University. Table 5: Average tuition fee for Korean Universities by subject (Korean Educational Development Institute, 2003) National / Public Humanities and Social Science Natural Sciences and Physical Education Engineering and Arts Medicine and Dentistry Pharmacy Junior College KWON 1,155,950 1,271,250 1,412,600 816,000 684,000 1,281,000 US $ 987 1,085 1,207 697 585 1,095 Private KWON 2,955,500 5,319,050 5,366,500 7,310,750 6,742,400 4,237,000 US $ 2,525 4,545 4,586 6,248 5,762 3,621 41 HEALTHY CITY, SEOUL. Republic of Korea 10.5.1. COMPOSITION OF MONEY SPENT ON EDUCATION An average of KWON 354,000 (US$ 387) was spent on education in Seoul per student and month in 2004 according to the National Statistical Office. Among the money spent on education, most of the money was spent on school tuition and extracurricular tuition. Chart 35: Composition of money spent on education per student in 2004 (National Statistical Office, 2007) 10.6. PRIVATE INSTITUTIONS (“HAG-KWON”) Many students in Korea attend private institutions called “Hag-Kwon” after regular school hours to enhance their education. According to the Seoul Education Statistical Yearbook of 2004, there are 11,382 private institutions in Seoul, and 4,765 among them specialized in entrance exam, certification and supplementary courses. As seen in the chart above, the majority of the money spent on education was for these private institutions. 10.7. PUBLIC LIBRARIES There were a total of 56 public libraries, including the National Library and the Library of Congress in Seoul in 2005. A total of 33,189,542 people used the libraries in 2006.8 11. CRIME AND VIOLENCE (POLICE) In general, Seoul is considered a “safe city.” Seoul has two police offices, 32 police stations, and 452 police branch offices. The total number of cases has gradually decreased over the years from 410,054 cases in 2001 to 346,810 in 2006. Violent offenses were highest, although the number of cases has significantly decreased. While the number of cases of theft (defined as stealing without a violent act) also decreased, the number of cases of intellectual offenses has sharply increased. 42 SEOUL, A HEALTHY CITY. Republic of Korea Chart 36: Cases of crimes committed (2001-2006) (Seoul Metropolitan Police, 2007) 12. HEALTH STATUS 12.1. ADULT MORTALITY The following chart shows the mortality rates by age group per 100,000 population. Chart 37: Mortality rates by age groups (deaths/100.000) in 2006 (National Statistical Office, 2007) In 2006, among the 38,117 total deaths in Seoul, the leading cause of death was cancer, accounting for about 29.7 % of all deaths. Although more detailed data are not available for Seoulites, trends can be observed through national level data. Lung, stomach, liver, and colon & rectum cancers showed highest death rates with gender differences. While lung and liver cancer were top two cancer sites for males, stomach and lung were for females. 43 HEALTHY CITY, SEOUL. Republic of Korea Chart 38: Top 10 leading causes of mortality in 2006. (National Statistical Office, 2007) 12.2. INFANT AND CHILD MORTALITY The total number of infant deaths in Seoul was 319 (184 boys and 135 girls) in 2006. Almost half of the infant deaths were due to conditions originating in the peri-natal period. Most of these cases were due to respiratory problems (lack of oxygen) at birth. External causes such as accidents and injury accounted for 3.8 % of infant mortality in the year 2006. Chart 39: Leading causes of death among infants (aged < 12 months) in 2006 (National Statistical Office, 2007) 44 SEOUL, A HEALTHY CITY. Republic of Korea For children aged 1 - 9, external causes of death (including injury, poisoning, and accidents) continued to be the leading cause of deaths in 2006. The second leading causes of deaths differed in each category. “Congenital maldeformations & chromosomal abnormalities” and “Neoplasm” were the second leading causes of death for children aged 1-4 and children aged 5-9, respectively. Chart 40: Leading causes of death among children aged 1-9 (percent of total deaths: 280) in 2006 (National Statistical Office, 2003) The following chart shows the distribution of external causes of death for children aged 1-9. Of the total number of children, who died in 2002, 53 children died due to transport accidents, 14 from exposure to smoke, fire and flames, 10 children drowned to death, 21 died due to falls and 13 children were killed. Chart 41: External causes of death among children aged 1-9 (National Statistical Office, 2003) 45 HEALTHY CITY, SEOUL. Republic of Korea 12.3. MORBIDITY The chronic disease with the highest prevalence rate was hypertension (49.7 persons / 1,000 population were diagnosed with hypertension). The chart below shows doctor-diagnosed prevalence of chronic diseases by gender. Chart 42: Prevalence of chronic diseases by gender in Seoul, 2005. (Seoulite Public Health Indicator Survey, 2006). The top three major chronic diseases listed in descending order of prevalence were: hypertension, arthritis, and diabetes among adults. The following table shows the prevalence rates for the major chronic diseases by age groups. Table 6: Prevalence of the top three chronic diseases for the indicated age groups (persons/1.000 population) (Seoulites Public Health Indicator Survey, 2006) Ages 30 ~ 39 40 ~ 49 50 ~ 59 60 ~ 69 70 and above 1 Hypertension ( 5.7) 2 Arthritis ( 4.4) 3 Diabetes ( 3.7) Hypertension ( 37.3) Hypertension (119.1) Hypertension (248.7) Hypertension (311.7) Diabetes ( 19.6) Arthritis ( 66.0) Arthritis (171.5) Arthritis (242.3) Arthritis ( 16.7) Diabetes ( 56.2) Diabetes (111.2) Diabetes (137.1) 46 SEOUL, A HEALTHY CITY. Republic of Korea 12.4. OBESITY Due to the rapid economic developments, changing lifestyles and the introduction of “western-style” foods to Korea, and especially to urban areas, the obesity rates have been increasing. The following chart shows the prevalence of obesity (Body Mass Index (BMI) of 25 and over) of adult Seoulites over the past years. The obesity prevalence among Seoulites was slightly lower in 2005 than in 2001, however, the prevalence (60.4%) of overweight (23 < BMI < 25) is a source of significant concern14. Research has shown that obesity-related chronic diseases start to appear at lower BMI in Asian populations than in other populations. Chart 43: Obesity prevalence (BMI > 25) (Seoul Survey, 2006) It must also be noted that despite the increasing prevalence of obesity, under-nutrition remains a problem in Seoul due to food insecurity, the cause of which is not food availability, but rather food affordability. 12.5. PERCEIVED HEALTH AND WELL-BEING When asked about their subjective health status, most Seoulites (63.7%) consider themselves to be in either “excellent” or “good” health. About twice as many men than women perceive their health status to be “excellent.” Seoulites’ subjective health status and its trend have been stable over years. Chart 44: Seoulite's perceived health status (Seoulites Public Health Indicator Survey, 2005) 47 HEALTHY CITY, SEOUL. Republic of Korea 13. HEALTH BEHAVIOURS 13.1. SMOKING The prevalence of smoking among Korean males is one of the highest in the world. According to the 2005 Seoulites Public Health Indicator Survey, 47% of Seoul’s male population reported to smoke every day. It is said that the high smoking prevalence among men is due to the fact that men received a monthly ration of cigarettes during the compulsory military service in the past. Now the military provides free antismoking education. Due to extensive national anti-tobacco campaigns the rates have been decreasing in both men and women every year, whereas a much stronger decrease is being observed in men. The anti-tobacco campaigns have been extended to smoking-free bus stops and smoking-free apartment complex in Seoul. One concern over smoking is that smoking behaviors are now being initiated at younger age and among more young female students. Chart 45: Prevalence of smoking (aged 19 and over) (Seoulites Public Health Indicator Survey, 2006) 13.2. ALCOHOL CONSUMPTION A total of 70% of Seoulites reported that they drank at least one shot during past year in 2005 (Seoulites Public Health Indicator Survey, 2006). As seen in smoking behavior, significant gender differences also exist in alcohol consumption behavior. More males consume alcohol more often in larger quantity. The chart below shows the gender difference in consumption 48 SEOUL, A HEALTHY CITY. Republic of Korea frequency. Among those who reported alcohol consumption past year, 60% females drank less than once a month. Excessive drinking is also more prevalent among males (16.7%) than females (2.3%). Excessive drinking was defined as drinking more often than once a week and drinking more than five cans of beer for males or three cans of beer for females. Chart 46: Frequency of alcohol consumption (aged 19 and over) (Seoulites Public Health Indicator Survey, 2006) Significant efforts have been poured into anti-drinking campaign. These efforts have begun to result in decreasing alcohol consumption rates and in changing drinking behaviors. 13.3. PHYSICAL ACTIVITY Many Seoulites (52.6%) reported physical activity as a way to maintain their health (2006 Seoul Survey, 2007), however, the level of physical activity among Seoulites does not appear high. About 40% of Seoulites answered that they participated in some kind of exercises in the 2005 Seoulites Public Health Indicator Survey, however; only 11.4% of them indicated regular exercise at the medium level. The regular medium-level exercise is defined as participating in exercises to cause light perspiration at least three times per week for 15 minutes at one setting. Males show a slightly higher level of exercise than females, while the level of regular medium-level exercise did not differ by gender. The most popular exercise among Seoulites was walking, followed by going to a health club, mountain climbing, running, etc. Ball sports such as soccer was mostly enjoyed by males, while aerobics was mostly enjoyed by females. 49 HEALTHY CITY, SEOUL. Republic of Korea Chart 47: Prevalence of various exercises (aged 19 and over) (2005 Seoulites Public Health Indicator Survey, 2006) 13.4. Nutrition Only 52.7% of Seoulites indicated that they regularly consume three meals a day (2005 Seoulites Public Health Indicator Survey, 2007). Breakfast is the meal most often skipped, with only 22% reported consuming regular breakfast. Food consumption pattern has changed over the years; the current food consumption pattern is close to that of western countries. That is, animal food consumption has increased, while plan food consumption has decreased. As seen in the chart below, the increase of meat and product consumption over the last 20 years is remarkable. Although the degree of increase is smaller than that of meat and products, the increase of milk and dairy products consumption is also notable. Chart 48: Foods to increase consumption (left) and foods to decrease consumption (right), 1980 ~ 2005. (2005 Korea Health and Nutrition Survey, 2007)* * The 2005 Korea Health and Nutrition Survey was conducted during early Spring, while other years were done during last Fall. This change of season is believed to be the reason of the significant fall of fruit consumption from 2001 to 2005. 50 SEOUL, A HEALTHY CITY. Republic of Korea The level of food insecurity, not having sufficient foods because of economic reasons, was low at 1.4% among people in Seoul. Food insecurity level is similar across age groups, but it is higher in the older population. 13.5. PERSONAL HEALTH MANAGEMENT Even though most Seoulites indicated that they do not exercise regularly, 52.6% of Seoulites indicated that they exercise to maintain their health. Next popular methods to maintain their health were diet modification and getting sufficient rest and sleep. Chart 49: Personal Health Management (aged 19 and over) (2006 Seoulites Public Health Indicator Survey, 2007) 13.6. ORAL HEALTH When asked whether they saw a dentist last year, 34% of Seoulites answered “yes” (2005 Seoulites Public Health Indicator Survey, 2007). No gender difference was observed. Although preventive dental visit is important for oral health, only 15.3% of those who saw a dentist last year cited preventive reasons for their visit. 13.7. BREASTFEEDING RATE Breastfeeding rates in Korea were among the lowest in the world, however recently the rates have been increasing. According to the 2005 Seoulites’ Public Health Indicator Survey (2006), 36.8% of mothers were exclusively breastfeeding their babies and 42.3% were practicing partial breastfeeding. 51 HEALTHY CITY, SEOUL. Republic of Korea 14. Mental Health Mental health has become more important with economic development and it has gained much interest from public health professionals and the general population, but efforts to improve mental health status is in its early stages. A total of 13.1% of Seoulites reported that they feel severe stress in their daily lives, while 17.9% answered they do not feel stressed. Males tended to feel more stress than female and people in their 40s showed the highest level of stress. Depression severe enough to disturb daily life was experienced by 7.5% of Seoulites in the past year. About 6% answered that they thought about committing suicide, and 6% of them actually tried to carry it out. The level of social support was high in 70~ 94% across age groups and the level was lowest in the elderly population (2005 Seoulite Public Health Indicator Survey, 2006). 15. Abortion In Korea, abortion is prohibited by the “Criminal Law” and the “Maternal & Child Health Act,” but in the past the Korean Planned Parenthood policy in the 1960s allowed abortion as a method to slow population growth. Nowadays, families want to have few children, and if they have a child, they still prefer to have sons. Thus selective abortion is still being performed. According to the 2005 Seoulites’ Public Health Indicator Survey (2006), 9.8% of married women aged between 19 and 49 reported to have an abortion past two years. The rate was much higher in 45% among young women (19~ 29 years of age). 16. HEALTH SERVICES AND INFRASTRUCTURE 16.1. [NATIONAL] HEALTH INSURANCE SYSTEM15 A substantial change has taken place in the Korean health sector with the enactment and promulgation of the National Health Insurance Act (NHIA) in 1997. The NHI is financed through contributions from the insured, their employers and through government subsidies. All Korean citizens are covered either by an “employee insurance” or a “self-employed insurance.” Koreans abroad as well as foreigners who live in Korea can opt for a “self-employed insurance” coverage. In 2006, the NHI covered 47.4 million insured throughout the Republic of Korea. Of these 18.6 million had an “employee insurance” and 29.1 million had a “self-employed insurance. 52 SEOUL, A HEALTHY CITY. Republic of Korea (i.e. family members) of those who were “employee insured” were also be covered. There were about 1.66 dependents per insured employee under the “employee insurance” and 1.84 dependents per insured person under the “self-employed insurance.” In Seoul, 10,011,134 citizens were covered by NHI. Of these, 5,902,220 have an “employee insurance” and 4,108,914 have a “self-employed insurance.” There were 3,530,984 dependents to 2,371,236 insured, i.e. 1.49 dependents per insured person 16. 16” Dependents 16.2. MEDICAL PERSONNEL AND HOSPITAL BEDS The number of physicians per 1.000 population is 2.11 for the year 2006, which is relatively high, compared to other countries. Chart 50: Number of medical personnel per 1,000 population (Seoul Statistical Yearbook, 1996 ~ 2007) The number of physicians per 1.000 population has steadily increased since the year 1995, from 1.51 to 2.11 in 2006. The number of nurses per 1.000 population has also increased from 1.60 in 1995 to 2.51 in 2006. The number of beds per 1.000 population increased from 4.90 beds per 1.000 population in 1995 to 6.40 per 1.000 population in 2006. 53 HEALTHY CITY, SEOUL. Republic of Korea Chart 51: Change in number of beds per 1.000 population (Seoul Statistical Yearbook, 1996 ~ 2007) The following chart shows the distribution of beds by medical facilities in Seoul per 1.000 population. The general trends have not changed over years. Chart 52: Distribution of beds by medical facility (Seoul Statistical Yearbook, 2007) 16.3. MUNICIPAL HOSPITALS Seoul has 12 municipal hospitals. Eight of these municipal hospitals are operated by a trust charged by Seoul City and one by a special corporation. The remaining three hospitals are operated fully by Seoul City. These three municipal hospitals and one operated by a trust have different focus areas: Children’s Hospital (Children’s Hospital: http://childhosp.seoul.go.kr/, accessed January, 2008): Provides services in pediatrics, neural psychology, dentistry and rehabilitation services for disabled children as well as other children in general. 54 SEOUL, A HEALTHY CITY. Republic of Korea Tuberculosis and Communicable Disease, and Elderly Health (Seobuk Hospital, http://sbhosp.seoul.go.kr/, accessed January, 2008): Provides services for Tuberculosis patients (240 beds) and for the elderly (290 beds). Mental Hospital (Eunpyung Hospital, http://ephosp.seoul.go.kr/, accessed January, 2008): provides mental health services in general psychology, addiction-psychology, children-adolescent psychology, elderly psychology and rehabilitation psychology (341 beds). General Hospital (Unlike the three hospitals above that are operated by Seoul City, this hospital is run by a trust. This hospital, however, receives financial aids from the City.) (Dongbu Hospital, http://dbhosp.go.kr/, accessed January, 2008): Provides medical services to Seoul citizens including the homeless and the poor. Seoul Medical Center (http://www.seoulmc.or.kr/index.asp, Accessed January, 2008) works as a hub for six municipal hospitals. The six hospitals include four above mentioned hospitals, Boramae Hospitals (http://www.brmh.co.kr/main.asp, Accessed January, 2008) operated by Seoul National University Hospitals to provide quality medical care to low-income populations, and Seoul Bukbu Geriatrics Hospital (http://www.bbhosp.go.kr/, Accessed January, 2008). Seoul also supports a dental hospital for the disabled and four mental hospitals. 16.4. PUBLIC HEALTH CENTERS Each of the 25 districts in Seoul operates a Public Health Center. The Centers are supervised by the Division of Public Health Policy. There are a total of 2,290 licensed personnel in the 25 Public Health Centers (PHC) in Seoul as of August of 2007. Each Public Health Center, employs about 6-9 doctors and 1~2 dentist(s). Of the 25 PHCs, 17 PHCs employ Traditional Korean Medicine doctors. The average number of total employees, including public health workers and administrative workers, is 92 per PHC. The PHCs received their budget from three sources: the central government, the city and the district government. The amount of budget depends on the size and income of the district as well as the type of programs the PHC plans to implement in the coming year. The PHC submits a proposal with the planned programs and certain government institutes, e.g. the Korean Institute for Health and Social Affairs of the Korean Center for Disease Control and Prevention decide on the amount of the budget granted to the PHCs. 55 HEALTHY CITY, SEOUL. Republic of Korea 16.4.1. HEALTH SERVICES PROVIDED BY THE PUBLIC HEALTH CENTERS The Public Health Centers serve in the following 16 main areas: • • • • • • • • • • • • • • • • Health promotion, health education, oral health and nutrition Prevention, management and care for infectious disease Maternal health and family planning Elderly health Public hygiene and food hygiene Guidance to medical professionals and institutions Guidance to medical technicians, information managers and ophthalmologists Emergency medicine Guidance to public health doctors, public health clinicians and public health sub-centers Pharmacists and drug management Mental health Visiting services to homes and other public facilities Medical treatment, health examinations and chronic disease management Clinical trials and health examination Rehabilitation Research on health promotion for enhancing community health 16.4.2. HEALTH PROMOTION IN PUBLIC HEALTH CENTERS In 1995 the Korean Health Promotion Fund, which is financed exclusively from ear-marked tobacco taxes, was established. In 2002, 100 of the total 242 Public Health Centers in the Republic of Korea, received funds from the Korean Health Promotion Fund to develop and implement health promotion projects in the four designated areas of tobacco, alcohol, nutrition and physical activity. In Seoul, eleven Public Health Centers were selected and received an average of KWON 11 million (US $ 10,170) for health promotion projects in 2002-2003. As of 2007, all 25 Public Health Centers implemented programs in the four areas, supported by the Korean Health Promotion Fund. The amount of funds received by 25 Public Health Centers for health promotion programs has significantly grown to a total of KWON 1.1 billion (US $ 1.26 million). The PHCs are to match the funds with the budget from their district governments, therefore the total budget for health promotion programs in 2007 was KWON 2.2 billion. Although health promotion programs were run in selected areas among the four designated areas during the 2002-2003 pilot stage, all 25 PHCs are currently running programs in all of the four areas. 56 SEOUL, A HEALTHY CITY. Republic of Korea 16.5. HEALTH RELATED NGO’S The Seoul Metropolitan Government supports about 120 NGOs financially17. Of these, about 50 are related to health and social support. Examples of health-related NGOs supported by the Seoul Metropolitan Government include: • • • • Citizens Coalition Against Abortion (www.prolife.or.kr, accessed January 2008) Life Share Association (www.lisa.or.kr, accessed January 2008) No Smoking Citizen’ s Group (www.nosmokingnara.org, accessed January 2008) Hanbeot: the Minority Supporter (www.hanbeot.or.kr, accessed January 2008) Examples of other NGOs in Seoul: • • • • • • Korea Sex Education Centre (www.ksec.or.kr, accessed January 2008) Korea Federation for HIV/AIDS Prevention (www.aidskorea.org, accessed January 2008) Seoul Dental Association (www.sda.or.kr, accessed January 2008) Seoul Medical Association (www.sma.or.kr, accessed January 2008) Seoul Nurses Association (www.seoulnurse.or.kr, accessed January 2008) Seoul Dietitian Association (http://seoul.dietitian.or.kr/, accessed January 2008) 16.6. COMMUNITY CENTERS Until 2006, almost all of the 522 Dongs (communities) in Seoul had a “ Dong-Office.” These Dong-Offices were renamed to “ Community Centers.” This name is more representative of their actual function, since the Community Centers are comparable to grassroots level centers, which offer rooms for social gatherings, libraries, but also counseling services and provide excellent entry points into the community. 16.7. HEALTH PROMOTION NETWORKS Currently there are no health-related networks in place, which are comparable to, for example, a “ Health Promoting Schools” or a “ Health Promoting Workplace” network. With the initiation of the Healthy Cities Project, however, the Healthy City Seoul team has been striving to establish such networks in Seoul. Because of the educational and the work cultures in Seoul, approaching schools, worksites and other settings to make them aware of the role they play in promoting the health and quality of life of Seoulites has not been easy. Gradually, various projects to promote health in various settings have been implemented. 57 HEALTHY CITY, SEOUL. Republic of Korea 17. SUMMARY This City Profile provides background information about Seoul and its infrastructure. It presents the demographic characteristics and trends and the current health status of Seoulites. The profile also summarizes the city’ s policies as well as other factors that could contribute to or hinder Seoul’ s efforts in achieving better physical and social environments, and in promoting health awareness and knowledge, in order to enable its citizens to attain their highest possible level of health and quality of life. Seoul’ s profile and the developments the city is experiencing is very similar to other growing urban areas. Demographic data show that Seoul’ s population is growing older and older and that Seoul is becoming an “ aged society.” The number of births is decreasing, fewer couples are getting married and the number of divorces is on the rise, due to changing, modernized life styles. Vital statistics have improved and the life expectancy of both men and women has increased. Morbidity patterns have shifted and now show a higher prevalence of chronic, non-communicable disease, e.g. hypertension, as opposed to infectious, communicable diseases. Remarkable about Korea in general - and the country’ s capital in particular - is its very rapid economic development in the past two decades. The city’ s Gross Regional Domestic Product has experienced a 6-fold increase since 1985. Along with Seoul’ s economic development came new jobs, which attracted more and more people into the city. Urban planning had to take the growing population into consideration. New housing had to be built, more water and electricity was needed, traffic and transportation systems had to be expanded - all of these changes are visible when looking at the time trends of such urban indicators. It is also visible that the city’ s rapid economic development left some Seoulites behind and that urban planning could not keep up with the pace of some developments, as seen in the large percentage of sub standard housing. Seoul’ s new policy directions show that the city is trying to catch up on previously neglected social issues. It is not a new phenomenon that the development of social and health-related services comes after economic development. Seoul is another example of this phenomenon. When reviewing Seoul’ s Vision of Mr. Oh’ s administration and its priority projects, it becomes apparent that “ health” or “ health promotion” is still not an explicit focus. Even though some of the projects can contribute to an increased quality of life and health status of Seoul’ s citizens, this is realized by few Government divisions. To further strengthen the concept of “ health promotion” and “ prevention,” the relatively new Healthy Cities Project has 58 SEOUL, A HEALTHY CITY. Republic of Korea been trying to increase the awareness among political and community level stakeholders and citizens. When looking at the distribution of the budget available for “ Social Welfare,” which includes the health-related budget, it is striking to see that a smallest portion of the budget is allocated to the prevention of communicable diseases. Even more striking is the fact that there is no budget directly allocated to the prevention of non-communicable diseases, which are on the rise, as mentioned above. In March 2003, a “ Health Promotion Team” was established within the Division of Public Health and the Healthy Cities Project was initiated. These two developments were hoped to set the stage for an increased budget available for the prevention of non-communicable diseases. This profile shows that there is an abundance of on-going and recently initiated action. The information provided in this City Profile may appear overwhelming, and the link between some of the issues mentioned in this document and Seoul’ s efforts to improve the health and quality of life of its citizens may not be obvious. The Healthy City project has been working to find the link between the various issues and the health and quality of life of Seoulites and to modify the relationship to improve the health and quality of life of Seoulites. Next chapter illustrates achievements the Healthy City project has accomplished. 59 HEALTHY CITY, SEOUL. Republic of Korea 18. REFERENCES References used, but not directly citied: WHO Regional Office for Europe (1995). Documenting the Urban Health Situation: Tools for Healthy Cities. (Available from: ttp://www.euro.who.int/document/hcp/docurbheasit.pdf, accessed June, 2004) WHO Regional Office for Europe (undated). City Health Profiles: how to report on health in your city. (Available from: http://www.euro.who.int/document/wa38094ci.pdf, accessed: June 2004) WHO Regional Office for Europe (undated). Measuring Health: A step in the development of city health profiles. (Available from: http://www.euro.who.int/document/WA95096GA.pdf, accessed June 2004) WHO Regional Office for Europe (1998). City Health Profiles: a review of progress. (Available from: http://www.euro.who.int/document/e59736.pdf, accessed: June 2004) WHO Regional Office for Europe (undated). Revised Baseline Healthy Cities Indicators. (Available from: http://www.euro.who.int/document/hcp/ehcpquest.pdf, accessed: June 2004) Takano T (Editor) (2003). Healthy Cities and Urban Policy Research. London and New York, Spon Press, Taylor & Francis Group. References citied in the text 1. McMichael AJ. (2000). The Urban Environment and Health in a World of Increasing Globalization: Issues for Developing Countries. Bulletin of the World Health Organization. 78 (9): 1117-1126. 2. Information about WHO Global Health Promotion Conference can be obtained from http://www.who.int/hpr/ncp/hp.conferences.shtml, accessed November 2007. 3. Information available at URL: www.korea.net, Accessed November 2007. 4. National Registration Office. 2007. 5. Korean National Statistical Office. 2007. 6. Seoul Metropolitan Government. 2007. 60 SEOUL, A HEALTHY CITY. Republic of Korea 7. More information about the Seoul Metropolitan Council can be obtained from: http://www.smc.seoul.kr/eng_site/index.jsp, accessed December 2007. 8. Seoul Statistical Yearbook. 2007. 9. Detailed information about Seoul’s Waste Management System can be obtained from: http://smg.metro.seoul.kr:9002/waste/part1.html, accessed June 2004 10. Information available at URL: http://smg.metro.seoul.kr:9002/water/upgrading/index.html, accessed June 2004 11. Information available at URL: http://smg.metro.seoul.kr:9002/air/index.html, accessed June 2004 12. The Human Development Report 2004, United Nations Development Program. 2004 13. Seoul Metropolitan Office of Education. 2004 14. Seoul Survey. 2006. 15. 2003 National Health Insurance Cooperation Korea. 2001. Document available at URL : http://unpan1.un.org/intradoc/groups/public/documents/APCITY/UNPAN009456.pdf, accessed July 2004 16. National Health Insurance Cooperation, 2003 http://www.nhic.or.kr/wbm/wbmb/index.html, accessed June 2004 17. Hankuk University of Foreign Studies. Institute of Social Sciences and the Korean Institute of NGO Studies. “Study on the competence of NGOs and evaluation of public services.” 2004 61