[One Day Ten Thousand Steps, One Day One Thousand Characters] Why Implementing a 'Healthy City' Has Become an Obligation for National and Local Governments

Enforcement of Revised National Health Promotion Act
'State and Local Governments Must Strive to Realize Healthy Cities' Stated in Law

Health Indicators Vary Greatly by Local Government
Public Health Declined Following COVID-19 Pandemic

From now on, the national and local governments must spare no effort in investing budgets and manpower to create so-called ‘healthy cities.’ This follows the enforcement of the amended National Health Promotion Act, which mandates the national and local governments to create ‘healthy cities,’ effective from the 22nd. A healthy city refers to a city that continuously creates and improves its physical and social environment to promote citizens' health.

The amended National Health Promotion Act specifies that the national and local governments must strive to realize healthy cities, and the Minister of Health and Welfare must develop and distribute healthy city indicators to enable local governments to implement healthy cities. The Ministry of Health and Welfare is also authorized to provide administrative and financial support to local governments to promote the creation of healthy cities.

The reason for enforcing the amended National Health Promotion Act is the significant health disparities among regions. For example, the ‘walking practice rate,’ which refers to the proportion of people who walk at least five days a week, is 64.3% in Seoul, significantly higher than the national average of 47.9%. In contrast, Gangwon has the lowest rate at 40.6%. Currently, Sejong has the lowest smoking rate and high-risk drinking rate at 13.2% and 9.3%, respectively, while Gangwon has the highest smoking rate and high-risk drinking rate at 22.3% and 16.9%, respectively.

One of the main factors causing such wide variations in health indicators among local governments is the degree of regional health infrastructure development. The Korea Disease Control and Prevention Agency (KDCA) has emphasized the importance of devising resolution strategies tailored to the characteristics of each region, as the best and worst areas differ depending on the health indicators.

Moreover, as the COVID-19 pandemic subsides, various national health indicators are showing warning signs. According to the KDCA’s ‘2023 Community Health Survey,’ this year’s obesity rate rose to 33.7%, up 1.2 percentage points from the previous year. This year’s drinking rate (the proportion of people who drank alcohol at least once a month in the past year) and smoking rate are 58.0% and 20.3%, respectively, both increasing for the second consecutive year. The proportion of people who experienced depressive feelings severe enough to interfere with daily life for two consecutive weeks in the past year also rose to 7.3%, up 0.5 percentage points from the previous year.

Some local governments have expressed reluctance, saying, “We don’t know how to implement healthy cities.” To address this, the Ministry of Health and Welfare plans to develop standardized indicators to help local governments implement healthy cities.

The health indicators will include four categories: whether infrastructure has been established, whether public-private cooperation and local community participation are guaranteed, whether there are healthy city project plans and evaluation systems, and whether there is a healthy city-related information system. Specifically, the indicators may reflect how much budget has been invested in implementing healthy cities and the scale of organizations and personnel involved.

The Ministry of Health and Welfare, together with the Korea Health Promotion Institute, also announced plans to distribute the ‘Healthy City Indicator Utilization Guidelines’ to local governments and support the proper implementation of the legislative intent in the field through briefings and consulting.