신 공중보건과 국가공중보건체계

배상수(Sang Soo Bae) 한국농촌의학 지역보건학회 2012 농촌의학·지역보건 Vol.37 No.4

The New Public Health(NPH) is a comprehensive approach to protecting and promoting the health status of each individual member and society as a whole. NHP is not so much a philosophy to broaden the understanding of public health as it is an action plan to address current public health system. This paper"s objectives include increasing public and professional awareness of the significant changes in the national public health systems of developed countries and contributing to more effective delivery of public health services in Korea. This paper reviews articles and documents concerning NPH and the public health system, and outlines of the achievements in developed countries since NPH movement began. These include the change in the definition and function of public health, expansion of public health networks, strengthening of public health policy, reorientation of public health delivery systems, promotion of workforce capacity, and the implementation of evidence-based management. To overcome the challenges facing the public health system of Korea, we must prioritize the value of population-based approach, expand the notion of a public health system to encompass all sectors that can influence health, promote a “Health in All Policies” approach, focus on an evidence-based health policy and program, develop core competencies for public health workers, and establish performance standards for public health organizations based on the core functions of public health.

근대 동아시아 위생 개념의 확산과 공공의료 담론의 형성

신규환 대한의사학회 2022 醫史學 Vol.31 No.3

If public health can be defined as “all activities to ensure universal medical use of the people and protect and promote health,” it can be said that public health emerged in the process of developing the concept of hygiene in East Asia. While traditional hygiene emphasized individual curing and longevity, modern hygiene was the state in charge of individual body and discipline. East Asian countries had to practice modern tasks in the field of hygiene and medical care in line with the construction of modern countries, and it was considered legitimate for modern countries to intervene in individual bodies. As the demand for modern national construction became stronger, interest in public health rather than personal hygiene increased. In East Asia, a new interpretation of the concept of hygiene began in Japan. Sensai Nagayo(1838-1902) newly defined the concept of ‘sanitation’ to justify the physical intervention of the modern state in Meiji period. The concept of ‘public health’ began to be used in earnest in 1890, when Ogai Mori(1862-1922) translated Western-style health protection measures for the public as public health. Since then, public health has evolved into a universal social discourse in Japan. Japan’s public health expanded to colonial Joseon, Taiwan, and China. Japan’s victory in the Sino-Japanese War led East Asian countries to believe that hygiene was the root of the Japanese nation’s power. In the early 20th century, the government of the Republic of China began to imitate the case of Japan while promoting modern education reform and institutional reform. Japanese-style ‘public health’ was transplanted into various hygiene laws and sanitary equipment. In Korea, modern hygiene was introduced and spread from the end of the 19th century to the first half of the 20th century, and the concept of ‘public health’ in Japan was mainly spreading. Public health in Japan was vaguely defined as an activity to protect and promote the health of the people, but in practice, it was focused on improving quarantine and environmental infrastructure. In response, the concept of American-style public health, which values prevention and treatment at the same time, has already begun to emerge under the Japanese colonial rule. In East Asia in the 1920s and 1930s, Japanese-style public health and American-style public health discourse competed, and measures to solve medical inequality were discussed in earnest. Interestingly, in common in East Asian countries, Actual Medical Expenses Campaigns to improve medical access at low cost and social medicine to universally provide prevention and treatment to the people have drawn attention. This was also a phenomenon caused by intensifying medical inequality as rapid urbanization and industrialization progressed in East Asian countries in the first half of the 20th century. Although it was impossible to resolve social contradictions or move toward fundamental reform of the national medical system due to the nature of the private movement, the actual medical movement further imprinted the need for public health care in the country and society. Social medicine studied the effects and relationships of the social environment on diseases and health, and studied ways to promote public health by using preventive medicine and therapeutic medicine. If social medicine was supported by state power, it was possible to go forward with practice such as State Medicine like China, otherwise it would only be a civilian movement such as the People’s Health Movement, as in colonial Korea. Liberation and the Korean War were a dramatic turning point in American-style health that led to Japanese-style hygiene. Immediately after Liberation, there was a discussion between the left and right camps over medical nationalization to enhance the publicity of medical care. The medical community was sympathetic to the nationalization of medical care, but due to the lack of medical personnel an...

신 공중보건과 국가공중보건체계

배상수,Bae, Sang Soo 한국농촌의학지역보건학회 2012 농촌의학·지역보건 Vol.39 No.4

The New Public Health(NPH) is a comprehensive approach to protecting and promoting the health status of each individual member and society as a whole. NHP is not so much a philosophy to broaden the understanding of public health as it is an action plan to address current public health system. This paper's objectives include increasing public and professional awareness of the significant changes in the national public health systems of developed countries and contributing to more effective delivery of public health services in Korea. This paper reviews articles and documents concerning NPH and the public health system, and outlines of the achievements in developed countries since NPH movement began. These include the change in the definition and function of public health, expansion of public health networks, strengthening of public health policy, reorientation of public health delivery systems, promotion of workforce capacity, and the implementation of evidence-based management. To overcome the challenges facing the public health system of Korea, we must prioritize the value of population-based approach, expand the notion of a public health system to encompass all sectors that can influence health, promote a "Health in All Policies" approach, focus on an evidence-based health policy and program, develop core competencies for public health workers, and establish performance standards for public health organizations based on the core functions of public health.

지역사회 공공보건자원과 지역사회 정신건강의 관계에서 공공보건서비스 이용률의 조절효과

김재희(Jae-Hee Kim) 한국응용과학기술학회 (구.한국유화학회) 2020 한국응용과학기술학회지 Vol.37 No.2

본 연구는 공공보건자원이 지역사회의 정신건강수준에 영향을 미치는 과정에서 공공보건서비스 이용률이 조절 역할을 하는 지를 확인하고자 수행되었다. 연구대상은 144개의 지역사회이며, 자료는 제6기 지역보건의료계획과 2015년 지역사회 건강조사에서 확보하였다. 연구변수 중 공공보건자원은 공공보건예 산, 공공정신보건예산 및 공공정신보건인력으로 구성하였으며, 정신건강수준은 스트레스 인지율, 우울감 경험률 및 자살률로 하였다. 조절효과 분석에 사용된 방법은 위계적 회귀분석이었다. 연구결과는 첫째, 공공보건서비스 이용률은 공공정신보건예산이 우울감 경험률에 영향을 미치는 과정에서 조절변수로 작용하고 있었다. 둘째, 공공정신보건인력이 우울감 경험률에 영향을 미치는 과정에서 공공보건서비스 이용률은 조절효과를 나타냈다. 셋째, 공공정신보건인력이 자살률에 영향을 미치는 과정에서도 공공보건서비스 이용 률은 조절효과를 나타냈다. 넷째, 공공보건자원의 정신건강수준에 대한 영향이 공공보건서비스 이용률이 높은 집단과 낮은 집단에 따라 다르게 나타났다. 결론적으로 공공보건자원 강화가 지역사회 정신건강수준의 향상으로 이어지도록 하기 위해 지역사회 정신건강증진 방안에 공공보건서비스 이용률 개선을 위한 내용을 포함시킬 필요가 있을 것이다. This study aimed to identify the moderating effect of public health service utilization rate between public health resources and community mental health. The subjects included 144 local communities, from the data of 6th Community Health Plan and the 2015 Community Health Survey. Public health resources were measured by public health budget, public mental health budget and public mental health personnel; and mental health was measured by rate of perceived stress, rate of depressive mood and suicide rate. The hierarchical regression analysis was used to identify the moderating effects. The results were as followed. First, the effect of public mental health budget on rate of depressive mood was moderated by public health service utilization rate. Second, the effect of public mental health personnel on rate of depressive mood was moderated by public health service utilization rate. Third, the effect of public mental health personnel on suicide rate was also moderated by public health service utilization rate. Fourth, the effect of public health resources on mental health differed between the groups with high and low public health service utilization rate. In improving community mental health, the measures to improve the public health service utilization rate should be considered to ensure that reinforcing public health resources leads to the improvement of community mental health.

급부행정의 공공성 - 한국과 일본의 공공의료법제 비교를 중심으로 -

황지혜 한국토지공법학회 2021 土地公法硏究 Vol.94 No.-

The social benefit administration(Leistungsverwaltung) is directly related to the lives of the people, such as social security, electricity, and water, and seeks high publicity. In the 1980s, privatization(Privatisierung) led to the deterioration of public service quality, which led to problems of publicity(Öffentlichkeit) in social benefit administration. It is the public health sector that has recently become more problematic. Contrary to our perception, damage caused by COVID-19 is serious in developed countries with well-equipped medical environments. According to a report published by the Lancet commission on February 2021, the reduction of public health care was cited as the reason for the most damage caused by COVID-19. This article aims to draw discussions on the publicity of public health care from the paradoxical situation where damage caused by COVID-19 is significant in U.S. and advanced medical countries of Europe. Public health care system includes Public health insurance and Public health agencies, and among them, discussions in Korea will be centered on public health agencies. Because Korea has a universal public health insurance system unlike the U.S., there seems to be little need for discussion. On the other hand, public health agency system has experienced the closure of Jinju Medical Center in 2013 and the resulting medical vacuum in Korea. Therefore, among legal institutions of public health, public health agencies will be discussed mainly, and more specifically, local medical centers that function as local central hospitals will be discussed. In order to do a more timely research, we would also discuss the relationship between the reform of local medical centers and countermeasure to the COVID-19. The main method of reforming local medical centers were the reduction of public health care through privatization(Privatisierung), which, as seen in the U.S. case, is related to countermeasure to the COVID-19. In order to develop the discussion, the writer would like to compare the legal institution of local medical center and the reform of local medical centers in Korea and Japan. The reason why Japan is a target country is because it has legal institution of local medical center that is very similar to that of Korea and experienced the most active local medical center reformation among East Asian countries. The aim of comparing legal institution of local medical center between Korea & Japan; and comparing the reform of local medical center between Korea & Japan is, in the midst of COVID-19 Pandemic, to find ways how local medical center in Korea can function as the main institution to countermeasure to COVID-19 Pandemic in Korea 급부행정은 사회보장, 전기, 수도 등 국민의 생활과 직접적으로 연관되는 것으로, 높은 공공성을 추구한다. 1980년대에 민영화 또는 사화(私化, Privatisierung)로 인해 서비스 질이 저하되면서 급부행정에서 공공성의 문제가 제기되기 시작했다. 최근 더욱 문제가 되기 시작한 것이 바로 공공의료 분야이다. 우리의 인식과 달리, 의료 환경이 잘 갖춰진 선진국에서 코로나 19에 의한 피해가 심각하기 때문이다. 2021년 2월의 랜싯 위원회 보고서(the Lancet commission report)에 의하면, 미국에서 코로나 19 피해가 가장 많이 발생한 근본적인 이유로 공공의료의 축소를 들고 있다. 본 논문은 미국을 비롯하여, 유럽의 의료 선진국에서 코로나 19 피해가 큰 역설적인 상황에서부터 공공의료의 공공성 논의를 이끌어내고자 한다. 공공의료(public health care)는 공공의료보험과 공공의료기관을 그 구성 요소로 하는데, 이 중 한국에서의 논의는 공공의료기관을 중심으로 하고자 한다. 왜냐하면 한국은 미국과 달리 보편적 공공의료보험 체계를 가지고 있기 때문에 논의의 필요성은 적어 보인다. 반면, 공공의료기관은 한국에서 2013년 진주의료원 폐업과 이로 인한 의료 공백이 꾸준히 발생하고 있는 상황이다. 따라서 공공의료 법제 중 공공의료기관을 중심으로 논하며, 더욱 구체적으로는 지역 거점 병원으로 기능하는 지방의료원을 중심으로 논하고자 한다. 또한 보다 시의적절한 연구가 되기 위하여, 지방의료원 개혁과 코로나 19 대응 간의 관계에 대해서도 논하고자 한다. 지방의료원 개혁의 주요 수단이 사화(私化)를 통한 공공의료의 축소였고, 이는 미국의 사례에서 보는 바와 같이, 코로나 19 대응과 관계가 있기 때문이다. 논문 필자는 논의를 전개하기 위해 한국과 일본의 지방의료원 법제와 지방의료원 개혁을 비교하고자 한다. 일본을 대상 국가로 하는 이유는, 한국과 매우 유사한 지방의료원 법제를 가지고 있으며, 동아시아 국가 중 가장 활발하게 지방의료원 개혁을 하고 있기 때문이다. 이와 같이 한국과 일본의 지방의료원 법제 및 지방의료원 개혁을 비교함으로써, 향후 한국에서 지방의료원이 적절하게 코로나 19에 대응할 수 있는 공공의료기관으로 기능할 수 있는 것이 기대된다. 또한 이 논의를 통해 공공의료의 확충에 기여할 수 있는 효과가 기대된다.

공중보건법학의 개념과 이념적 기초

박지용(Park, Jiyong) 한국법학원 2014 저스티스 Vol.- No.141

이 연구는 근대국가의 역할변천 과정에서 공중보건 및 공중보건법을 바라보는 관점의 변화를 역사적으로 살펴보고, 이를 토대로 공중보건법학의 개념과 그 이념적 기초를 밝히는 것을 목적으로 한다. 공중보건법학이 전문법 분야로서 자리매김하기 위해서는 구체적인 실정법의 해석론이나 사법(司法)적 구제수단에 대한 논의뿐만 아니라 헌법질서와 국가역할이라는 거시적 측면에서의 조망이 함께 요청될 것이다. 국가가 시민의 건강을 보호하고 증진시켜야 할 도덕적·헌법적 의무를 부담하게 되는 과정은 근대국가의 형성과 밀접한 관련을 맺고 있다. 초기 근대국가는 무엇보다 시민의 생명과 재산, 안전의 보장에서 그 정당성의 근거를 찾고자 하였다. 19세기 역학에 근거한 근대적 공중보건 개념이 도입되고, 산업사회의 도래에 따른 경제적 양극화의 폐해를 시정하기 위한 사회국가적 전환이 시도됨에 따라, 공중보건에 대한 국가의 역할은 양적으로 확대되었을 뿐만 아니라 질적으로도 그 성격의 변화를 겪게 된다. 종래에는 전염병과 같은 위험으로부터 사회의 안전을 보장한다는 질서유지의 관점에서 공중보건을 국가의 객관적 목표 또는 임무로 바라보았다면, 사회국가에서는 공중보건이 국가의 기본권보장의무 및 ‘건강권’이라는 주관적 권리로서 헌법상 기본권의 문제로 고양되어 있는 것이다. 다만 공중보건법학의 개념과 범위를 어떻게 파악할 것인가에 대하여는 견해의 대립이 있다. 한편에서는 현대사회에서 공중보건 문제의 다양성과 사회적 맥락을 중시하여 사회정의의 관점에서 공중보건법의 역할과 범위를 넓게 설정하는 입장이 있고, 다른 한편에서는 공중보건의 무분별한 영역확장으로 인한 사적 생활영역에 대한 국가개입의 확대와 개인 자유의 침해 가능성에 주목하여 그 역할과 범위를 한정하려는 입장이 있다. 이러한 견해 대립은 근본적으로 공중보건에 대한 국가의 개입을 바라보는 관점의 차이에서 기인하는 것이라고 할 수 있다. 이 글에서는 공중보건법학의 이념적 기초를 건강에 대한 자율과 후견의 법 패러다임의 길항관계로 파악한다. 공중보건법의 이념적 기초에 대한 논의는 공중보건과 개인의 자유와의 본질적 긴장관계에 대한 보다 깊은 성찰을 유도한다. 중요한 것은 공중보건법의 영역에서도 자율과 후견 중 어느 하나의 법 패러다임만으로는 온전한 설명이 불가능하며, 양 패러다임이 공존하면서 부단히 상호작용하고 있다는 점을 인식하는 것이다. 이는 현대사회에서 제기되는 다양한 공중보건 문제를 어느 한편의 법 패러다임에 경도되어 획일적으로 파악하는 것이 바람직하지 않다는 것을 의미한다. 그렇다면 문제의 핵심은 전염병이나 환경보건적 위험과 같은 고전적 공중보건 문제에서부터 흡연, 음주, 비만과 같이 개인과 집단의 건강에 영향을 주는 생활습관들에 관한 문제에 이르기까지 각각의 구체적이고 미시적인 주제들에서 자율과 후견의 경계선을 합리적으로 설정하는 작업일 것이다. This article attempts to explore the history of public health law in the changing role of the modern state, and to define the concept and ideological foundation of public health law. This historical, conceptional and philosophical approach makes it possible to identify an academic area of public health law as a specialized law in terms of the constitution and the purpose of the state. It has to do with a formation of the modern state and the moral and constitutional obligation to protect and promote public health. Early modern state could be justified itself from the role of protecting citizen’s lives, properties and safety. The state’s role on public health has been extended broader. This is because the modern concept of public health based on epidemiology was introduced in the 19th century, and the idea of welfare state to correct an abuses of economic polarization was widely accepted in the modern industrial society. It means the nature of state’s role on public health has been changed from the maintenance of order to the guaranteeing the subjective right to health. There is a debate about the appropriate goals and definitions of “public health” and “public health law” in the United States. It reflects competing claims about the boundaries for the legitimate exercise of state power. Lawrence Gostin points out meeting citizen’s expectation of meaningful health protection should be regarded as a duty of the government. He would see reducing health inequalities as a significant mission for public health law. However, others, for example Richard Epstein, define the goals of public health narrowly. The “old public health” theory suggest state’s interventions in public health should be restricted to contagious diseases, widespread pollution and environmental threats posed by specific pathogens. This article consider this debate as an ideological tension between autonomy and paternalism. Today the determinants of health, from social, economic, and cultural factors to biological and genetic characteristics of individuals, are very complicated and interrelated. It has meaningful implications for ideological foundations of public health law. To recognize the coexistence and interaction between two law-paradigms is very important to understand public health law, and it would be impossible to explain whole area of public health law with only one of these perspectives. The most significant question is to set the boundary line between autonomy and paternalism in each cases, such as environmental exposures or smoking, drinking, obesity and other unhealthy lifestyles.

공중위생업의 육성을 위한 기금 조성 방안

이호용(Lee, HoYong) 한양법학회 2009 漢陽法學 Vol.26 No.-

The paradigm of ‘concept of health' in public health is developing day and day. Traditionally health was concept of ‘hygiene' that meaned disease prevention through isolation from infectious disease, but it passed through concept of ‘sanitary' that meaned personal health maintenance, developed concept of ‘health promotion' that meaned national health furtherance and maintenance, recently its meaning is expanded to the concept of ‘convenience of living'. However, the concept and category of public health is larger and larger and occupies most important part of national every day life, but governmental efforts for industrial promotion of public health business is scarcely accomplished. It is not question of selection but what should be to improve quality of public health business and to make advance to high class in side of national basic rights too. In making revision bill of ‘The Management Law of Public Health Business', it is regarded three sides as follows: constitution side, action side, and finance side of administration. In this article is about finance side among these. Specially public fund as financial methods for promotion of public health business is theme of this article. Fund for promoting public health business(it is called ‘public health fund' for short) is local autonomy fund and operation fund. Main resources of this fund is surcharges that is collected against violation of ‘The Management Law of Public Health Business'. In this article I intend to study methods of building up and practical use of public health fund.

6 · 25전쟁과 한국 보건의학계 및 보건학의 형성

이동원 ( Lee Dong-won ) 동국역사문화연구소(구 동국사학회) 2020 동국사학 Vol.69 No.-

이 글은 6 · 25전쟁을 전후하여 한국 보건의학계와 보건학이 형성되는 과정을 살펴봄으로써 한국 보건의료체계의 역사성을 이해하고자 하는 시도이다. 기존의 연구들은 보건의료의 기틀을 마련한 시기로 주로 1960년대 이후를 주목했는데, 이는 일정하게 현실을 반영한 것이지만 6 · 25전쟁의 영향력과 1950년대의 변화를 상대적으로 소홀히 다루었다는 한계가 있다. 따라서 이 글은 6 · 25전쟁 이후 보건 의학계와 보건학의 형성 과정을 미군정과 유엔군 및 한국정부의 공중보건(Public Health) 활동과 미국에서 유학한 한국인 의사들의 활동 속에서 살펴보았다. 이를 통해 한범석, 윤유선, 백행인, 주인호, 김인달, 양재모, 권이혁, 구연철, 김명호, 방숙, 박재빈 등 한국인 의사들이 한국 보건의료체계 형성 과정에서 어떤 역할을 했는지 구체적으로 이해하고자 했다. 이들은 일제강점기에 경성제국대학 의 학부나 경성, 세브란스, 대구의학전문학교에서 공부하여 일본식의 ‘이론 중심 교 육’을 받았다. 그리고 해방과 6 · 25전쟁을 계기로 현장에서 임상 경험을 쌓았고, 주로 미국 유학을 통해 ‘임상 중심 교육’이라 할 수 있는 미국식 보건학을 체계적으로 학습했다. 이들은 1950년대 중후반에 이루어진 서울의대의 미네소타 프로젝트 보다 더 앞서서 미국식 보건학을 적극적으로 수용, 도입하면서 보건의학계의 1세대로서 주요 의과대학의 예방의학교실 및 보건대학원을 이끌었다. 이와 함께 미국식 공중보건학(public health)이 한국에 확고하게 자리 잡게 된 계기는 보건진료소 및 보건소의 확산과 이를 뒷받침한 공중보건원의 창설이었 다. 1953년 9월 공중보건원(School of Public Health, Korea)의 창설은 전국 단위에서 크게 증가한 보건진료소와 보건소를 뒷받침할 보건의료 인력을 양성하기 위한 것이었다. 공중보건원을 통해 미국식, 혹은 WHO식 ‘공중보건’ 개념이 전파 되었고, 이렇게 전파된 ‘공중보건’ 개념은 보건진료소 및 보건소에서의 보건의료 임상 활동을 통해 현실에서 구현되었다. 따라서 공중보건원은 한국의 보건의학계가 기존의 일본식 ‘공중위생’ 개념을 바탕으로 미국식 ‘공중보건’ 개념을 수용하여 한국식 보건학으로 자리 잡도록 하는데 크게 기여한 셈이다. This article is an attempt to understand the historical nature of the Korean health and medical system by looking at the formation process of the Korean health and medical community and health sciences before and after the Korean War. Existing studies have mainly noted the post-1960s when the foundation of health and medical care was laid, which reflects the reality to some extent, but there is a problem that the influence of the Korean War and the change of the 1950s were relatively neglected. Therefore, this article looked at the formation process of Korean health and medicine in the connection with the public health activities of the U.S. military government, U.N. forces and Korean doctors who studied abroad. I tried to understand in detail what role Korean doctors played in the formation of the Korean health care system. During the Japanese colonial period, they studied at Kyungsung Imperial University’s School of Medicine, Kyungsung, Severance, and Daegu Medical College, and received Japanese-style ‘theory-oriented education’. In addition, they gained clinical experience in the field after liberation and the Korean War, and systematically studied American-style health science, which can be called ‘clinical-oriented education,’ mainly through studying in the United States. They actively embraced and in troduced American-style health science ahead of the Minnesota project of Seoul National University, leading the preventive medicine departments and graduate schools of health at major medical schools as the first generation of health medicine. Along with this, the reason for the firm establishment of American-style public health in Korea was the spread of public health dispensaries and centers, and the creation of the School of Public Health, Korea that supported it. The establishment of the School of Public Health, Korea in September 1953 was aimed at fostering health and medical personnel to support the nationwide increase in public health dispensaries and centers. The concept of American or WHO-style ‘public health’ has been disseminated through the School of Public Health, Korea, and the concept of ‘public health’ spread in this way was realized in reality through health care clinical activities in public health dispensaries and centers. Therefore, the School of Public Health, Korea greatly contributed to the Korean health and medical community adopting the American concept of ‘public health’ based on the existing Japanese concept of ‘public hygiene’ and establishing itself as a Korean-style health science.

공공의료에 있어서 보건소장의 자격범위 확대에 관한 소고

김성태 인문사회 21 2022 인문사회 21 Vol.13 No.2

공공의료에 있어서 보건소장의 자격범위 확대에 관한 소고김 성 태* 요약: 본 논문의 연구목적은 지역보건법 시행령에서 보건소장을 오직 의사 면허를 가진 자에게만 한정하여 의사 자격을 가진 보건소장을 구하는데 어려움을 발생시켜 국가가 지금과 같은 코로나19의 국가재난 상황에서 적절한 방역대책을 시행하는데 걸림돌이 되고 있는 보건소장의 자격 범위를 확대 검토하는 것이다. 이를 위하여 국가인권위원회의 2006년, 2017년의 2차례 권고 사항과 지역보건법 시행령을 중심으로 보건소장의 자격을 살펴보았고, 감염병예방법, 의료법 등을 통하여 공공의료의 의미와 보건소장의 역할 등을 확인하였다. 그래서 본 논문에서는 지역보건법 시행령의 개정안을 통하여 의사 이외에 추가로 치과의사, 한의사와 같은 의료인에게도 보건소장이 될 수 있는 자격을 확대하여 보건소장을 안정적으로 확보하는데 주된 연구를 진행하였다. 코로나19로 인해 특히 공공의료의 중요성이 더욱 부각되고 있는 지금, 보건소 등과 같은 공공의료의 역할에 의료인을 포함하여 우리 모두가 깊은 관심을 가져야 할 것이다. 핵심어: 공공의료, 코로나19, 감염병, 지역보건법 시행령, 보건소장 □ 접수일: 2022년 3월 11일, 수정일: 2022년 3월 25일, 게재확정일: 2022년 4월 20일* 숭실대학교 국제법무학과 조교수(Professor, Soongsil Univ., Email: sungtae@ssu.ac.kr) A Study on the Expansion of the Qualifications of the Head ofthe Public Health Center in Public HealthSungtae Kim Abstract: The purpose of this study is to review the scope of qualifications of the head of the public health center, which is an obstacle to implementing appropriate containment measures in the current Covid-19 national disaster situation because the Enforcement Decree of the Regional Public Health Act limits the heads of the public health centers to only those who have a doctor’s license thereby causing difficulties in obtaining the heads of the public health centers with a doctor’s license. To this end, the qualifications of the head of the public health center were reviewed centering on the two recommendations of the National Human Rights Commission of Korea in 2006 and 2017 and the Enforcement Decree of the Regional Public Health Act, and the meaning of public health and the role of the head of the public health center were identified through the Infectious Disease Control and Prevention Act and the Medical Service Act. Therefore, in this paper, the expansion of the qualifications of healthcare workers such as dentists and oriental doctors to become the head of the public health center in addition to doctors through the revision of the Enforcement Decree of the Regional Public Health Act were reviewed thereby examining a way for public health centers to stably hire the heads of the public health centers. Now when the importance of public healthcare is being highlighted more due to Covid-19, all of us, including healthcare workers should take a profound interest in the role of public health. Key Words: Public Health, Covid-19, Infectious Disease, Enforcement Decree of the Regional Public Health Act, Head of the Public Health Center

공중보건의 역할변화와 보건소의 기능

배상수 한국보건행정학회 2001 보건행정학회지 Vol.11 No.1

Public health system and public health practice have changed over the past decades as the result of social and epidemiologic changes. New public health concept emphasizes leadership, strategical thinking, systematic planning and effective performance to identify and solve complex health problem In Korea, the role of Health Center has been expanded rapidly. However there is strong suspicion that Health Center can achieve their mission. This paper aims at understanding what is the needed functions of Health Center and which of its aspects needs improvement. The main results of this study are summarizes as follows. District Health Law does not address the core functions of Health Center. The staffs of Health Center have difficulties in prioritizing their services. The recent attempt to restructure Health Center and change delivery pattern of public health services ended with only limited success. To effectively confront threats to the public's health, the three major function of Health Center must be ${\circled}1$ modifying individual behavior and lifestyle, ${\circled}2$ improving social and economic conditions, and ${\circled}3$ reforming health policies. Better results do not come from setting new functions only; they come from understanding and improving the processes that will then leads to better outcome. We recommend that policy-makers focus economic evaluation of public health programs, building and spreading of the scientific evidence of programs, linkage of public health research and public health program. The criteria of delegation of public health service to private sector is urgently needed. Making community health information data available on a routine basis to providers, managers and researchers of public health services helps promote the efficiency of the overall operation of public health system.