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Demographic Methods to Assess Food Insecurity: A North Korean Case Study

Published online by Cambridge University Press:  28 June 2012

W. Courtland Robinson ,
Myung Ken Lee ,
Kenneth Hill ,
Edbert Hsu  and
Gilbert Burnham
W. Courtland Robinson*
Affiliation:
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
Myung Ken Lee
Affiliation:
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
Kenneth Hill
Affiliation:
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
Edbert Hsu
Affiliation:
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
Gilbert Burnham
Affiliation:
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA
*
Johns Hopkins University, Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore MD 21205, USA E-mail: [email protected]
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Abstract

In complex emergencies, especially those involving famine and/or wide-spread food insecurity, assessments of malnutrition are critical to understanding the population's health status and to assessing the effectiveness of relief interventions. Although the Democratic People's Republic of Korea (DPRK) has benefited from some of the largest, most sustained appeals in the history of the World Food Program (WFP), the government in Pyongyang has placed restrictions on international efforts to gather data on the health and nutritional status of the affected population.

Question: Lacking direct means to assess the nutritional status of the North Korean populace, what other methodologies could be employed to measure the public health impacts of chronic food shortage?

The paper begins with a review of methods for assessing nutritional status, particularly in emergencies; a brief history of the North Korean food crisis (1995–2001), and a review of the available nutritional and health data on the DPRK. The main focus of the paper is on the results of a survey of 2,692 North Korean adult migrants in China. Recognizing certain biases and limitations, the study suggests that sample households have experienced an overall decline in food security, as evidenced by both the decline in government rations from an average of 120 grams per person per day to less than 60 grams per day, and by the increase in the percentage of households relying on foraging or bartering of assets as their principal source of food. It also is apparent that the period 1995–1998 has been marked by elevated household mortality, declining fertility, and steadily rising out-migration. Taken together, the signs point toward famine, whether that is defined as a discrete event—that is, as a regional failure in food production or distribution leading to elevated mortality from starvation and associated disease—or as a more complex social process whose sub-states include not only elevated mortality, but declining fertility, eating of alternative ‘famine foods’, transfer of assets, and the uprooting and separation of families.

Keywords

assessmentsChinacomplex emergenciesfamiliesfaminefamine foodsfertilityfoodinsecurityKoreamalnutritionmigrationmortalitynutritionreliefWorld Food Program
Type
Part II: Complex Emergencies: Research Initiatives
Information
Prehospital and Disaster Medicine , Volume 16 , Special Issue 4: Complex Emergencies , December 2001 , pp. 286 - 292
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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References

1.Noji, E (ed): The Public Health Consequences of Disaster. New York: Oxford University Press, 1997. pp 305–336.Google Scholar
2.Person-Karell, B: The Relationship Between Child Malnutrition and Crude Mortality among 42 Refugee Populations. Atlanta: Emory University, 1989.Google Scholar
3.World Health Organization: Report of the WHO Expert Committee on Physical Status: The Use and Interpretation of Anthropometry. Geneva: World Health Organization, 1995.Google Scholar
4.Goodkind, D, West, L: The North Korean famine and its demographic impact. Population and Development Review 2001;27(2):219–238.CrossRefGoogle ScholarPubMed
5.Noland, M, Robinson, S., Wang, T: Famine in North Korea: Causes and Cures. Washington, DC: Institute for International Economics, 1999.Google Scholar
6.Food and Agriculture Organization and World Food Program: Crop and Food Supply Assessment Mission to the Democratic People's Republic of Korea. Rome: Food and Agriculture Organization and World Food Program, 2001.Google Scholar
7.Katona-Apte, J, Mokdad, A: Malnutrition of children in the Democratic People's Republic of North Korea: Journal of Nutrition 1998;128:1315–1319.CrossRefGoogle ScholarPubMed
8.European Union, UNICEF, and WFP: Nutrition survey of the Democratic People's Republic of Korea. New York: UNICEF. 1998.Google Scholar
9.Robinson, WC, Lee, MK, Hill, K, Burnham, G: Mortality in North Korean migrant households. Lancet 1999;354:291–295.CrossRefGoogle ScholarPubMed
10.Collins, S, Duffield, A, Myatt, M: Assessment of Nutritional Status in Emergency-Affected Populations: Adults. Geneva: UN ACC/Subcommittee on Nutrition, 2000.Google Scholar
11.Ferro-Luzzi, A, James, W: Adult malnutrition: Simple assessment techniques for use in emergencies, British Journal of Nutrition 1996;753(10):3–10.CrossRefGoogle Scholar
12.World Food Program: On the Knife Edge of a Famine. Rome: World Food Program, 1997.Google Scholar
13.UN Department of Economic and Social Affairs: 1996 Demographic Yearbook. New York: United Nations, Department of Economic and Social Affairs, 1996.Google Scholar
14.UNICEF: The State of the World's Children 1998: Focus on Nutrition. New York: Oxford University Press. 1998.Google Scholar
15.Cox, G: The ecology of famine: An overview. In: Robson, J (ed), Famine: Its Causes, Effects and Management. New York: Gordon and Breach Science Publishers, 1981.Google Scholar
16.Blix, G, Hofvander, Y, Vahlquist, B: Famine: A Symposium Dealing with Nutrition and Relief in Times of Disaster, Stockholm: Swedish Nutrition Foundation, 1971.Google Scholar
17.Currey, B: Is famine a discrete event? Disasters 1992;16:138–144.CrossRefGoogle ScholarPubMed
18.Currey, B: The Famine Syndrome: Its definition for relief and rehabilitation in Bangladesh. In: Robson, J (ed), Famine: Its Causes Effects and Management. New York, Gordon and Breach Science Publishers, 1981.Google Scholar
19.Field, J: Understanding famine, In: Field, J (ed), The Challenge of Famine: Recent Experience, Lessons Learned, West Hartford, Connecticut: Kumarian Press. 1993.Google Scholar
20.Alamgir, M: An approach towards a theory of famine. In: Robson, J (ed), Famine: Its Causes, Effects and Management. New York, Gordon and Breach Science Publishers, 1981.Google Scholar
21.Young, H, Jaspers, S: Nutritional assessments, food security and famine, Disasters 1995;19:26–36.CrossRefGoogle ScholarPubMed
22.Dyson, T: On the demography of South Asian famines, Part I and Part II, Population Studies 1991;45:5–25,279-297.CrossRefGoogle ScholarPubMed
23.United Nations High Commissioner for Refugees: Handbook for Emergencies. Geneva: United Nations High Commissioner for Refugees, 1998.Google Scholar