영유아기 건강형평성을 고려한 건강증진 정책방안

Abstract

Early childhood is a critical period during which the foundations of lifelong health are established. Article 24 of the United Nations Convention on the Rights of the Child affirms every child’s right to attain the highest possible standard of physical, emotional, and social health. Given the profound influence of early development and health on outcomes across the life course, greater attention must be paid to health disparities among infants and young children arising from social and structural determinants. This study identifies factors that may contribute to early childhood health inequities and proposes policy measures to promote the health of infants and young children, grounded in multiple research methods and analytical approaches. To achieve the study’s objectives, we conducted a comprehensive review of prior research on health equity and early childhood development, examined international policy cases related to early childhood health equity, analyzed national and local government policies on health equity, surveyed parents of young children, carried out in-depth interviews with administrators of early childhood health programs, and developed indicators for monitoring health inequalities in early childhood, followed by an empirical analysis based on these indicators. Currently, the 5th National Health Promotion Plan (HP 2030) sets two overarching goals - extending healthy life expectancy and enhancing health equity - and includes 400 performance indicators across 28 domains. However, only six indicators target infants and young children including ‘infant mortality’ as a sole representative indicator focusing on immediate postnatal period. This underscores the need for comprehensive indicators that can measure and monitor health across the broader early childhood period. This study developed a final set of representative monitoring indicators for early childhood health inequalities, categorized into structural factors, intermediary factors, and early childhood development and health factors. Intermediary factors include parental characteristics such as infant deprivation experiences, maternal smoking and alcohol use, parenting stress, and depressive symptoms. Results showed disparities in infant deprivation experiences depending on parental education level and single-parent status, while emotional maltreatment, parenting stress, primary caregiver depression, and infant health screening rates varied by household income. Secondary data analyses examining the relationship between parental factors and young children’s development and health revealed that parental education and, most significantly, parenting stress were the strongest predictors of child outcomes. Additionally, a survey of 1,400 parents of infants and young children explored perceptions of health equity, efforts to promote child health, and sources of health-related information. While most parents were highly aware of children’s health rights and parental responsibilities, those with higher income and education levels were more likely to recognize the influence of socioeconomic status on child health. Parents reported high levels of concern regarding excessive media exposure, picky eating, and frequent minor illnesses. However, despite recognizing the importance of limiting media exposure, participating in health-related parenting education, and addressing mental health and stress, actual practice levels were low. These findings suggest the need for enhanced parental support in these areas. Based on these findings, several policy recommendations are proposed to promote health in early childhood. First, it is essential to raise awareness of early childhood health equity to support the implementation of health equity policies. Second, the current application-based welfare system should be improved by expanding and leveraging existing programs to strengthen access to proportionate universal services. Third, a national institution dedicated to collecting data for monitoring early childhood health inequalities in Korea should be established, and a medium- to long-term strategy should be adopted to build a comprehensive monitoring system. Lastly, to enhance parental capacity as key determinants of young children’s health, it is necessary to provide parent education programs focused on early childhood health management and support parents in strengthening their caregiving competencies.