Korean Journal of Health Equity
- E-ISSN : 2982-8007
- Publisher : The Korean Society for Equity in Health
- CCL :
- KOREAN
- E-ISSN2982-8007
Latest Articles
Vol.4 No.1
15papers in this issue.
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Digital Health and Artificial Intelligence as a Socio-Technical Regime: A Critical Analysis
Sangyun Lee
pp.9-16
https://doi.org/10.23163/KJHE.PUB.4.1.9
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Abstract
Expectations for digital health are high worldwide. The World Health Organization has consolidated these expectations and projected that digital technology will shape the future of global health. However, critical discussions often take place only in the context of regulating new technologies, or within an ethical context that calls for “good” digital health. Critical approaches to digital health and artificial intelligence must go beyond debates on science and technology ethics or the regulation of new technologies. Actors, structures, and technologies should be read in a political-economic and social context, and critical practice should be planned on that basis. The key issue is not whether to adopt a specific technology. What matters is political debate and democratic participation and decision-making processes over the conditions under which technology expands or constrains whose rights. Social control mechanisms for technology are needed.
Junhewk Kim
pp.17-33
https://doi.org/10.23163/KJHE.PUB.4.1.17
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Background: With the rapid increase in the aging population and care needs, the deployment of Social Care Robots (SCR) is expanding. However, existing individualistic ethical frameworks or top-down robot ethics principles have limitations in reflecting the specificity of care, which relies on interdependence and context. This study aims to examine how the relational and reciprocal framework of ethics of care is applied to the design, deployment, use, and governance of SCRs and to discuss its practical implications. Method: This study followed the JBI methodology for scoping reviews and reported findings in accordance with PRISMA-ScR guidelines. A Human-AI Collaboration approach was adopted, utilizing a LLM as an auxiliary tool for search strategy formulation and literature screening to enhance efficiency and comprehensiveness. Literature search and selection resulted 16 final articles and subjected to inductive thematic analysis. Result: The analysis categorized the application of care ethics to SCRs into two metathemes. First, Relational Supplementation (the practical dimension) emphasizes that SCRs should complement rather than replace human relationships, while respecting autonomy and cultural contexts. Second, Technical Supplementation (the fabrication dimension) focuses on embedding ethical values during the development phase and addressing issues of trust, vulnerability, and privacy. Discussion: From the perspective of care ethics, SCRs must be redefined not as tools for cost reduction or labor substitution, but as social supplements that support existing care relationships. Consequently, the ethical utilization of SCRs requires an approach that views them as public goods, supported by substantial social infrastructure and public responsibility.
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A Multi-Agent-Based Personalized Health Feedback System for Climate Change Response: A Review of Prerequisites and Expected Effects from a Health Equity Perspective
Yejin Kim ; Sojin An ; Whanhee Lee
pp.34-42
https://doi.org/10.23163/KJHE.PUB.4.1.34
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The accelerating climate crisis—heat waves, cold waves, and air pollution—is exacerbating health inequalities among vulnerable populations including the elderly and people with disabilities. While digital healthcare technology has gained attention as a potential solution, fragmented information and high digital entry barriers often exclude those most in need. This paper proposes a multi-agent-based personalized health feedback system as an alternative that moves beyond existing information-providing digital healthcare. The system features agents acting as a doctor, pharmacist, and environmental health expert, who comprehensively interpret personal health and environmental exposure data to deliver personalized feedback. This paper discusses the potential of this system to contribute to promoting health equity by mitigating the individual gap in capacity to respond to health risks. Simultaneously, it critically examines the ethical and structural challenges, including accountability, accessibility, and the relationship with human care. This paper ultimately argues that, if properly designed, the system can reduce individual disparities in health risks response by integrating environmental, medical, and medication data—expanding protection for vulnerable groups and enabling community-level public health interventions.
Chae-Young Han ; Eun-Kyung Shin ; Boyoung Jeon
pp.43-54
https://doi.org/10.23163/KJHE.PUB.4.1.43
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This study analyzed the educational domains and stages in which AI-based education was applied in healthcare university education, the methods of AI application, and the types of learner-generative AI interactions. It also aimed to understand educational outcomes and the current status of ethical considerations. Steps 1–5 of the scoping literature review procedure proposed by Arksey and O’Malley (2025) were applied, and literature search, selection, and analysis were conducted according to the PRISMA-ScR guidelines. A search of domestic and international academic databases yielded 1,326 articles, of which 18 were finally included in the analysis after a step-by-step selection process. The analysis revealed that research on generative AI in education increased after 2023, primarily in theoretical education and classroom activities. Learner-AI interactions were interactive and feedbackfocused, and while cognitive and emotional outcomes were positive, technical outcomes related to performance and skill application showed limited effects. The use of generative AI in healthcare university education has been expanding, focusing on learning support. This suggests the need for future educational design that integrates it with practical training and incorporates ethics and equity considerations.
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Connected Devices and Disconnected Care: Strengthened Care Governmentality by Digital/AI Care
Jimin Gim ; Kyung-min Kim
pp.55-75
https://doi.org/10.23163/KJHE.PUB.4.1.55
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As facility-centred policies have become apparent to have limitations, there has been a societal demand for a paradigm shift towards integrated community care. This transition is being formalised through the implementation of so-called “smart care” policies, being integrated with strategies for the advancement of the digital/AI industries. This study critically examines how these digital/AI care policies, rather than reflecting on the ethics, justice, and relational dimensions of care, are reiterating and even elevating the existing market-centered paradigm, prioritising cost reduction, efficiency, profitability, and labour productivity. Digital/AI care has eroded three core layers of relational justice, including temporality, subjectivity, and responsibility. By prioritizing outcomes and fostering the belief that the care process can be compressed, automated, and streamlined, these technologies bypass the ‘temporality of the process’ that is indispensable for relational engagement. The intervention of digital technology and artificial intelligence (AI) reduces the mutual ‘subjectivity’ of the human actors involved in the care relationship to mere technological objects. Consequently, algorithmic and AI-driven decision-making serves to conceal the ‘responsibility’ of states and corporations within the opacity of the technical system. Rather than merely being dismantled through digital mediation, these dimensions are reorganized as the core mechanisms that constitute ‘care governmentality.’ Digital/AI care policies has been shown to restrict the social discourse on care to matters pertaining to the adoption, development and investment of digital technologies. This is, in essence, a manifestation of a capitalist epistemology, which hinders the ability to address fundamental issues. In conclusion, this paper critiques the perspective of digital/AI care policies, which regard technology as neutral and instrumental, effectively operating as a form of governmentality. The text puts forward the argument that there should be a shift towards an ethics that focuses on the relational dimension of care.
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The Rights of the “Affected person”: A Human Rights-Based Approach to Artificial Intelligence ― An Interview with Yeo-Kyoung Chang, Institute for Digital Rights
Seong-Yi Kim
pp.76-83
https://doi.org/10.23163/KJHE.PUB.4.1.76
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This article is an interview with Yeo-Kyoung Chang, executive director of the Institute for Digital Rights, to find out a desirable legal and institutional approach to artificial intelligence as the Framework Act on Artificial Intelligence comes into effect in January 2026. The legislative process for the Framework Act on Artificial Intelligence is progressing rapidly, led by the Ministry of Science and Technology and industry, and sufficient discussions have not been held with information human rights experts and civil society. The biggest problem with Korea’s Artificial Intelligence Framework Act is that it exempts users such as hospitals and companies that directly use AI. At the heart of a human rights-based approach to AI is the concept of the “affected person.” This approach establishes those who are actually affected by AI systems (e.g., patients using cancer diagnostic tools or potential AI recruiters) as rights holders, beyond AI developers and users. This human rights-based approach proposes three layers of rights: first, the right to data, including the right to know about AI learning and the right to opt out; second, the right to receive explanations and documentation of algorithms, along with the right to regulatory investigation; and third, the right to long-term impacts across sectors. For effective human rights impact assessments, the democratic participation of those affected must be guaranteed. The intervention of the National Human Rights Commission, rather than a single ministry driven by industry perspectives, is essential. Furthermore, to counter the power structures of big tech companies, cross-sectoral civil society solidarity and the establishment of an independent research environment are urgently needed.
Hyun Mee Kim
pp.84-90
https://doi.org/10.23163/KJHE.PUB.4.1.84
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This article examines the crisis of social reproduction generated by neoliberal development from an ecological perspective and argues for a “care transition” that repositions care as a core political principle. Climate change and environmental degradation produce unequal health outcomes that are differentially embodied along lines of class, gender, and migratory status, constituting forms of ecological dispossession. Drawing on feminist political economy, posthumanist theory, and ecological care, the article conceptualizes health inequalities as outcomes of entangled social and ecological crises. It highlights the interdependence of human and non-human life and calls for a reorganization of social reproduction that integrates ecological sustainability, care justice, and democratic responsibility.
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Structural Determinants of Health, Community Power Building, and Advancing Health Equity in South Korea
Jonathan C. Heller ; Hyun-Hee Heo
pp.91-106
https://doi.org/10.23163/KJHE.PUB.4.1.91
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Health inequities in South Korea persist despite overall gains in life expectancy and a universal health insurance system. This perspective applies scholarship on the structural determinants of health to analyze how societal rules and power dynamics produce and maintain health inequities in South Korea. Moving beyond depoliticized approaches to the social determinants of health, structural determinants were recently defined as written and unwritten rules—values and norms, governance arrangements, laws and budgets, and institutional practices—shaped by those with power and reciprocally reinforcing existing power hierarchies. Drawing on national and international evidence, we examine three interrelated forms of structural oppression that underlie contemporary health inequities in South Korea: structural economic exploitation, structural regional inequity, and structural sexism. We illustrate how growth-first economic norms, concentrated corporate power, weak labor protections, market-oriented healthcare governance, metropolitan-centered resource allocation, and gendered labor and care regimes translate into unequal health outcomes by income, employment status, region, and gender. We argue that these inequities persist not due to a lack of technical solutions, but because prevailing power dynamics limit meaningful changes to the rules that shape health-relevant conditions. To demonstrate how power can be contested and reshaped, we present a brief case study of healthcare policymaking in South Korea, highlighting the role of civil society organizations, labor movements, and community-based initiatives in challenging healthcare commodification and seeking to expand democratic control over health governance, while also revealing the limits of reforms that fail to redistribute decision-making power. Advancing health equity therefore requires strategies that intentionally build community power, democratize governance, and reconfigure institutional rules alongside improvements in community conditions. Repositioning public health as a project of political and structural transformation is essential to achieving sustainable equity in South Korea.
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Housing and Health Equity in South Korea: A Review of Empirical Evidence, Gaps, and Future Research Directions
Gum-Ryeong Park ; Seo-hyun Kang ; Chaewon Yang
pp.107-116
https://doi.org/10.23163/KJHE.PUB.4.1.107
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A growing body of research has documented a well-established link between housing and health outcomes. However, in the Korean context, there has been limited attention to how these housing factors are interconnected and for whom their effects are most salient. This paper highlights the need to reconceptualize housing as a multidimensional condition of housing insecurity/precarity. From this perspective, the paper highlights importance of examining how housing insecurity intersects with socioeconomic and demographic characteristics (e.g., income, employment status, and gender) to cause unequal health consequences across populations. Building on this intersectional approach, housing–health research can contribute to the evaluation of housing interventions to determine whether they lead to measurable improvements in health outcomes. Such efforts provide critical insights for repositioning housing policy as a central instrument for advancing health equity.
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How Should Socioeconomic Inequalities in Health Be Explained?: The Development of Explanatory Frameworks
Young-Ho Khang
pp.117-143
https://doi.org/10.23163/KJHE.PUB.4.1.117
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“How should socioeconomic inequalities in health be explained” is a central question for both health inequality research and policy. In this review, I examined the development of explanatory frameworks for socioeconomic inequalities in health since the publication of the Black Report. I first summarized epidemiological debates on the relationship between socioeconomic position and health, including issues of causality, selection, and confounding, then discussed key explanatory frameworks and associated empirical evidence concerning material factors, psychosocial mechanisms, and lifecourse approaches. In addition, I presented criticisms on the conventional focus on relative explanatory power regarding the mediation of health inequalities and emphasized the importance of absolute perspectives on inequality reduction and policy focused simulation studies. The role of health behaviors—often regarded as having limited explanatory value for health inequality frameworks—was re-examined. The review further addressed fundamental cause hypothesis and structural-political frameworks to illuminate the broader social structures that generate and sustain health inequalities. Finally, I identified both the limitations and the potential of explanatory frameworks for health inequalities in informing health equity policy and called for more more policy-oriented research. This review argued that investigations into explanatory frameworks for health inequalities extend beyond identifying mechanisms and function as tools for ethical judgement and policy intervention.
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Decomposition of Mortality Measures Derived from Life Table–Based Functions: Application of Stepwise Replacement and Contour Decomposition Using R
Ikhan Kim
pp.144-156
https://doi.org/10.23163/KJHE.PUB.4.1.144
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Decomposition methods have been widely used to quantify the contributions of specific factors, such as age groups or causes of death, to mortality differences between populations or to temporal changes in mortality within the same population. However, when summary measures of mortality are derived from nonlinear functions, the application of traditional additive decomposition methods becomes problematic. Since the early 2000s, life table–based indicators of lifespan variation, in addition to age-standardized mortality rates and life expectancy, have been increasingly utilized, creating a demand for generalized decomposition methods applicable to a wide range of mortality indicators. Among the two major approaches to generalized decomposition, this study introduces the stepwise replacement algorithm and examines its practical application using illustrative data. Furthermore, for settings involving two populations observed at two time points, we present the contour replacement decomposition method, which extends the stepwise replacement algorithm to quantify contributions to both cross-sectional mortality differences between populations at the initial time point and differences in mortality change trajectories between populations over time.