Mortality of major health problems in North Korean refugees

Background: This study aims to report the health level for the latest North Korean refugees (NKRs) by comparing the age-adjusted death rate of NKRs and South Korean population (SKP) from cancer, cardiovascular disease (CVD) and suicide. 

Methods: This study data used the Korean national health insurance service database for research and statistics and Korean death cause cumulative database. The population of the study were 22,351 NKRs and SKP adults aged 20 or older 2003-2018. Death rate per 1000 or 100000 person-years of all-cause, cancer, CVD and suicide were estimated in NKRs. In addition, the sex and age specific death rates of NKRs and SKP, sex and age-standardized death rate were estimated and compared.

Results: The death rate per 100000 people person-years (PYs), NKRs was 219 in all-causes, 70 per 100000 PYs in cancer, 36 per 100000 PYs in CVD, and 24 per 100000 PYs in suicide. Age-adjusted death rate per 100000 comparisons were NKR 273.2 and SKP 668.0 in all-cause, NKR 95.9 and SKP 185.4 in cancer, NKR 44.5 and SKP 150.6 in CVD, and NKR 10.3 and SKP 33.7 in suicide.

Conclusion: This result showed that SKP had a high mortality of cancer, CVD and suicide than SKP. However, the mortality rate of men in NKR was higher than that of women, and in particular, the mortality rate of men from cancer was higher than that of SKP. Therefore, health promotion and redesign of health plans are necessary to reduce the early death of NKRs.