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Michelle Murcia
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Among the blank screens and muted microphones that plagued remote high school learning during the COVID-19 pandemic, I enrolled in the Sejong Korea Scholars Program (SKSP) at the Stanford Program on International and Cross-Cultural Education (SPICE) and found a completely opposite learning experience.

My passion for Korean history and geopolitics first began when I learned the Korean alphabet system, Hangul, in my history books for Advanced Placement World History. My class, however, only covered the Han Chinese Dynasty briefly before moving on to Europe. Upon asking if we would return to the Asian continent, my teacher hastily replied that we already covered what we “needed to know to pass the test.”

I needed to learn more than what my classroom provided. Then I discovered SKSP, which provided an opportunity for me to learn from top Korea scholars about various perspectives of Korean history and more. SKSP taught me the rich history of Korea that is not covered by the limited high school academic curricula. After being admitted to the program, I was also honored to accept a scholarship that covered the tuition, given my status as a low-income student.

Classes swiftly started in the spring semester. We received textbooks, log-in information, and a warm welcome. I met the faces of my peers as they voiced their passions and motivations leading them to SKSP. Alongside these top students representing 13 states, I found a rigorous environment and yet never once felt “less than” any of my peers.

SKSP provided an otherwise unattainable learning opportunity in terms of intercultural literacy, historical perspective, collaboration, critical thinking, and global awareness.

Our weekly seminars followed in a highly organized manner and had exceptional professors from across the country. We began with the three ancient kingdoms: Goguryeo, Baekje, and Silla, and then delved into post-1900s Korea, Colonial Korean history, the Korean War, the Miracle on the Han River, and the nation’s final emergence as a trillion-dollar economy.

Korean economics was especially intriguing. SKSP allowed me to converse live with leading experts like Professor Danny Leipziger from George Washington University. In his lecture, he described the factors for South Korea’s economic expansion and how they contributed to the nation’s unprecedented global accomplishments. This topic strongly influenced my final research paper on the current housing crisis in Seoul, in which I analyzed how the collaboration of public and private sectors in South Korea created a unique Jeonse, also known as “Key Money Deposit.”

On top of these experiences, the true learning came from our peer review process for our research papers. I read outstanding papers from all of my exemplary peers and observed how each student developed a unique style of incorporating evidence to defend their thesis. Some incorporated game theory and U.S sanctions in their papers.

SKSP provided an otherwise unattainable learning opportunity in terms of intercultural literacy, historical perspective, collaboration, critical thinking, and global awareness. It gave me the chance to develop into an intelligent global citizen, who is able to comprehend alternative views and pursue interests in a career in ambassadorship. As I attend university, I will pursue a double major in Korean Studies and Language and Engineering.

Dr. HyoJung Jang

HyoJung Jang, PhD

Instructor, Sejong Korea Scholars Program
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Monument dedicated to the United States Forces in the Korean War, Imjingak, South Korea
Blogs

Highlights from the 2021 Sejong Korea Scholars Program

Twenty-three students completed SPICE’s 2021 Sejong Korea Scholars Program.
Highlights from the 2021 Sejong Korea Scholars Program
High school student with a diploma standing in front of a banner
Blogs

My Experience with the Sejong Korea Scholars Program in the Midst of a Global Pandemic

The following reflection is a guest post written by Jason Lu, an alumnus of the Sejong Korea Scholars Program, which is currently accepting applications for the 2021 course.
My Experience with the Sejong Korea Scholars Program in the Midst of a Global Pandemic
Student in a red dress presenting at a podium with Stanford signage
Blogs

Coming Full Circle: The Sejong Korea Scholars Program and Stanford

The following reflection is a guest post written by Sandi Khine, an alumna of the Reischauer Scholars Program and the Sejong Korea Scholars Program, which are currently accepting applications for the 2021 courses.
Coming Full Circle: The Sejong Korea Scholars Program and Stanford
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The following reflection is a guest post written by Michelle Murcia, an alumna of the 2021 Sejong Korea Scholars Program.

Authors
Gi-Wook Shin
Haley Gordon
Hannah June Kim
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This article first appeared in the online magazine American Purpose.  

On March 9, South Koreans head to the voting booths to elect their new president. Although conventional wisdom posits that foreign affairs have little effect on voting preferences, South Koreans have defied this prediction in the past—and now, they may once again. Indeed, the atmosphere in this year’s election recalls that of 2002, when anti-American sentiments swept the South Korean presidential election. This time, it may be anti-Chinese sentiments that make an impact.


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According to our survey of over one thousand South Koreans, conducted this past January, a large majority of respondents—78 percent—indicated that Republic of Korea (ROK)-China relations will be an important consideration when deciding which presidential candidate to vote for. Given that younger South Koreans are expected to be the deciding factor in this election, it is particularly significant that the figure rises to 82 percent for respondents in their twenties. Twenty years ago, anti-American sentiments tipped the vote in favor of Roh Moo-hyun, the liberal candidate, who pledged not to kowtow to the United States. This time, how will anti-Chinese sentiment play out in Seoul? Will it work in favor of the conservatives, who tend to be tougher on China and emphasize the U.S.-ROK alliance? And what does this mean for Washington?

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Young people protesting in South Korea
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South Koreans Are Rethinking What China Means to Their Nation

A new study illuminates the potential effects of anti-Chinese sentiment in Korea.
South Koreans Are Rethinking What China Means to Their Nation
Yoon Seok-Youl
Commentary

What Does Korea’s 2022 Presidential Election Mean for Its Democracy?

The ongoing South Korean presidential race holds significant sociopolitical implications for the future of democracy as democratic backsliding has now become an undeniable reality in South Korea.
What Does Korea’s 2022 Presidential Election Mean for Its Democracy?
Members of the K-pop band BTS.
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“K-Pop Stars, Too, Should Speak Out on Human Rights Issues,” Says Stanford Sociologist Gi-Wook Shin

K-pop and North Korean human rights are the subjects of two documentaries to be released this spring to mark the 20th anniversary of Stanford University’s Korea Program, reveals Professor Gi-Wook Shin.
“K-Pop Stars, Too, Should Speak Out on Human Rights Issues,” Says Stanford Sociologist Gi-Wook Shin
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Anti-Chinese sentiment surges—especially among the young—in advance of the March 9 elections.

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3D mockup cover of APARC's volume 'South Korea's Democracy in Crisis'

Like in many other states worldwide, democracy is in trouble in South Korea, entering a state of regression in the past decade, barely thirty years after its emergence in 1987. The society that recently had ordinary citizens leading “candlelight protests” demanding the impeachment of Park Geun-hye in 2016-17 has become polarized amid an upsurge of populism, driven by persistent structural inequalities, globalization, and the rise of the information society. 

The symptoms of democratic decline are increasingly hard to miss: political opponents are demonized, democratic norms are eroded, and the independence of the courts is whittled away. Perhaps most disturbing is that this all takes place under a government dominated by former pro-democracy activists.

The contributors to this volume trace the sources of illiberalism in today’s Korea; examine how political polarization is plaguing its party system; discuss how civil society and the courts have become politicized; look at the roles of inequality, education, and social media in the country’s democratic decline; and consider how illiberalism has affected Korea’s foreign policy. 

Table of Contents

Introduction
Korea’s Democratic Decay: Worrisome Trends and Pressing Challenges
Gi-Wook Shin and Ho-Ki Kim

1. Why Is Korean Democracy Majoritarian but Not Liberal?
Byongjin Ahn

2. Uses and Misuses of Nationalism in the Democratic Politics of Korea
Aram Hur

3. The Weakness of Party Politics and Rise of Populism in Korea
Kwanhu Lee

4. The Politicization of Civil Society: No Longer Watchdogs of Power, Former Democratic Activists Are Becoming New Authoritarian Leaders 
Myoung-Ho Park

5. The Politicization of the Judiciary in Korea: Challenges in Maintaining the Balance of Power
Seongwook Heo

6. Two Divergences in Korea’s Economy and Democracy: Regional and Generational Disparities
Jun-Ho Jeong and Il-Young Lee

7. Democracy and the Educational System in Korea 
Seongsoo Choi

8. Social Media and the Salience of Polarization in Korea
Yong Suk Lee

9. Illiberalism in Korean Foreign Policy
Victor Cha

10. The Democratic Recession: A Global and Comparative Perspective
Larry Diamond

Epilogue
Korea’s 2022 Presidential Election: Populism in the Post-Truth Era
Ho-Ki Kim and Gi-Wook Shin

Media Coverage

To celebrate the publication of South Korea's Democracy in Crisis, APARC held a book launch seminar in Seoul on June 14, 2022. The event received extensive coverage in Korean media, including the following:

Desk, examination, or review copies can be requested through Stanford University Press.

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The Threats of Illiberalism, Populism, and Polarization

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Gi-Wook Shin
Ho-Ki Kim
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Shorenstein APARC, distributed by Stanford University Press
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Dong-heun Shin
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This is an English translation of an article first published by the Chosun Ilbo.
See also the coverage by
VOA Korea.


"Americans wonder why K-pop stars don't talk about universal issues such as human rights problems,” says Stanford sociologist Gi-Wook Shin, the director of the Shorenstein Asia-Pacific Research Center (APARC). “Isn’t it time for K-pop singers, too, to use their position to speak out?”

According to Shin, who is also the founding director of the Korea Program at APARC, K-pop and North Korean human rights are two aspects of Korea that particularly draw the interest of the general public in the United States. In May 2022, APARC will mark the 20th anniversary of the Korea Program. As part of the commemorative activities, the Program is producing a documentary about K-pop, followed by one that covers North Korean human rights.

"With a focus on these two issues, we hope to strengthen the Korea Program’s academic roots by linking to the field of Korean studies and to shed new light on North Korean human rights,” said Shin in a February 8th interview with Chosun Ilbo. He noted that, when seeking out topics for the documentaries to spotlight, he and his team kept in mind Silicon Valley’s strong consumer-oriented climate and the interests of students and the public.

“By creating documentaries about K-pop and North Korean human rights, I want to raise the depth and level of Americans’ understanding of Korea,” notes Shin.
Portrait of Gi-Wook Shin
Photo credit: Michael Breger.

In South Korea, the production of the documentaries is carried out by director Lee Hark-joon, a professor at Kyungil University and former TV Chosun producer-director. Lee is the creator of "Crossing Heaven’s Border," a documentary about North Korean defectors, as well as "9 Muses of Star Empire," which recorded scenes of the K-pop industry. For the forthcoming documentaries, he intends to capture footage that has not been seen on camera before, such as domestic K-pop production sites and the human rights movement in the North Korea-China border region.

To plan the creative direction of the K-pop documentary, the team at APARC has met frequently with the production crew in Korea via Zoom. Researchers of diverse origins and ethnicities participate in these meetings, but the official language is Korean. According to Shin, "Students acquire Korean even through self-study, and many are familiar with K-pop groups that I hadn’t even heard of, like aespa." He adds that "We spent two lectures on K-pop in my course on Korea last year, and there is not enough suitable video material to use for classes — this is another motivation behind producing these documentaries."

It is ironic that South Korean progressive groups, who received foreign help in their fight for human rights in the 1970s, downplay the human rights crisis in North Korea.
Gi-Wook Shin

When Shin meets with Stanford students to discuss K-pop, they ask questions such as why, if K-pop enjoys immense status, K-pop singers do not seem to talk about issues such as human rights, whether Korean singers know that crowds of demonstrators sing K-pop songs while protesting for democratization in Asian countries like Myanmar, and if K-pop will be sustainable.

While these are questions that must be answered for K-pop’s future, "Americans are reading K-pop in a very American code," explains Shin. Americans also supported the South Korean human rights movement during the time of the country's authoritarian government in the 1970s. “Now,” notes Shin, “American intellectuals constantly discuss North Korean human rights or Chinese democracy. On the other hand, it is ironic that South Korean progressive groups, who received foreign help in their fight for human rights in the 1970s, downplay the human rights crisis in North Korea."

Shin shared that he and his team are also considering plans to make a proper documentary on Korea and distribute it through Netflix, where Korean content is gaining immense popularity.

Read More

Young people protesting in South Korea
Commentary

South Koreans Are Rethinking What China Means to Their Nation

A new study illuminates the potential effects of anti-Chinese sentiment in Korea.
South Koreans Are Rethinking What China Means to Their Nation
Yoon Seok-Youl
Commentary

What Does Korea’s 2022 Presidential Election Mean for Its Democracy?

The ongoing South Korean presidential race holds significant sociopolitical implications for the future of democracy as democratic backsliding has now become an undeniable reality in South Korea.
What Does Korea’s 2022 Presidential Election Mean for Its Democracy?
North Korea Conundrum Book cover
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How to Solve the North Korean Conundrum: The Role of Human Rights in Policy Toward the DPRK

APARC's new edited volume, 'The North Korean Conundrum,' shines a spotlight on the North Korean human rights crisis and its connection to nuclear security. In the book launch discussion, contributors to the volume explain why improving human rights in the country ought to play an integral part of any comprehensive U.S. engagement strategy with the DPRK.
How to Solve the North Korean Conundrum: The Role of Human Rights in Policy Toward the DPRK
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K-pop and North Korean human rights are the subjects of two documentaries to be released this spring to mark the 20th anniversary of Stanford University’s Korea Program, reveals Professor Gi-Wook Shin.

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Haley Gordon
Hannah June Kim
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In South Korea, many have recently expressed anger at the depiction of a woman in hanbok as representing one of China’s 56 ethnic minorities during the opening ceremony for the 2022 Beijing Winter Olympics. Korean politicians and activists also criticized the act, stating that China intended to introduce Korean culture as part of its own.[1] This controversy is the latest amid mounting cultural conflict between the two nations, over the origins not only of hanbok but also of kimchi, and even historical claims to the ancient kingdom of Goguryeo.

These tensions have already brought tangible results. In March 2021, South Korean historical drama Joseon Exorcist was canceled after two episodes due to a widespread boycott among Koreans for its use of Chinese-style props, which was said to distort Korean history. The following month, protests over the proposed construction of a “Chinatown” in Gangwon province resulted in the project’s cancellation. Now, as our latest study shows, anti-Chinese sentiment in Korea has the potential to further extend to the political and national security arenas.

The results [of our January 2022 survey of over 1,000 South Koreans] suggest that anti-Chinese sentiment increasingly has the potential to spill over into the Republic of Korea’s policy and politics.

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Korean views of China have become so negative that as of 2021, according to a survey by SisaIN, they have sunk lower than views of Japan, likely for the first time since Korea and China normalized relations in 1992. Ahead of the Beijing Olympics (January 2022), we conducted a survey[2] of over 1,000 South Koreans and, similarly, found that their feelings towards China averaged just 26.5 on a scale of 0 (very negative) to 100 (very positive), compared to 30.7 for Japan and 69.1 for the United States. Moreover, 42% of our respondents supported Korea engaging in a diplomatic boycott of the Olympic Games, in line with many Koreans’ complaints that Seoul is too soft on Beijing. These results suggest that anti-Chinese sentiment increasingly has the potential to spill over into the Republic of Korea’s policy and politics.

Korea Is Not Alone

Koreans are not alone in their feelings towards China. Indeed, this trend comes amid a rising tide of anti-Chinese sentiment worldwide. A 2021 survey conducted by Pew Research Center found that unfavorable views of China had reached near historic highs in 17 advanced economies, including Japan (88%), Australia (78%), and the United States (76%), as well as Korea (77%). Our survey also found that 84% of Koreans viewed China unfavorably, demonstrating an increasing prevalence of anti-Chinese sentiments in Korea.

As in many societies, Koreans are very critical of China’s political system and its handling of COVID-19: according to Pew (2021), 92% of Koreans thought that the Chinese government does not respect the personal freedoms of its people, and 71% disapproved of China’s COVID-19 response.[3] In line with the Pew study’s findings, our survey found that 84% of Koreans believe that the Chinese government does not respect its peoples’ personal freedoms, and of respondents who reported negative feelings towards China, 66% cited the pandemic outbreak as a contributing factor.

Still, Korea Differs

Yet, Koreans also express negativity towards China over unique issues that are not shared with other peer countries. Foremost among these is Korea’s air pollution: namely, fine dust and yellow dust, which many believe comes from China. Also cause for negativity are China’s coercive actions towards Korea, such as economic retaliation for the deployment of the THAAD missile defense system.[4]

Anti-Chinese sentiment is a critique of Chinese cultural imperialism and illiberalism: few Koreans view China’s institutions as exemplary or say that their country should learn from China.

In particular, Korea is distinctive from its peers for two notable reasons. The first is Koreans’ reaction to China’s perceived cultural imperialism. Over half (55%) of our respondents who had an unfavorable view of China selected cultural conflicts between the two countries (China’s claims to kimchi and hanbok, for example) as well as China’s perceived lack of respect for Korea (62%) as contributing to their negative feelings. Historical issues also loom large for Koreans: 52% of respondents with negative sentiments say they disapprove of China due to disputes between the two countries over history (such as the Northeast Project, which claims that the ancient kingdom of Goguryeo is part of China).

The second factor that makes anti-Chinese sentiment in Korea unique is its demographic underpinnings: namely, the outspokenness of younger generations. Out of 14 countries polled by Pew in 2020, Korea was the only country in which youth (ages 18-29) had a more unfavorable view of China than those ages 50 and older:[5] 80% of youth viewed China unfavorably, compared to 68% of the oldest cohort. The 2021 SisaIN study confirmed that younger Koreans did indeed have the most negative feelings towards China, with those in their 20s holding views nearly two times more negative than those in their 50s and 60s. It is no surprise that, according to our survey, younger Koreans ages 18 through 39 were more likely to support a diplomatic boycott of the Olympics than older cohorts (45% compared to 40%). We interpret these findings as suggesting that younger Koreans who grew up with liberal, democratic values may be more critical of authoritarian, communist China than the older activists of “Generation 586,”[6] who instead grew up amid anti-American sentiments that fostered greater sympathy towards China.

 In this regard, anti-Chinese sentiment in Korea differs from the country’s past anti-American sentiment and enduring anti-Japanese sentiment. The former, especially prominent in the 1980s, represented backlash against U.S. policy and U.S. support of the Korean authoritarian dictatorship. It was not a critique of American people, culture, or institutions, which were still largely respected. Anti-Japanese sentiment is tied to the historical memory of colonial rule and strongly influenced by Korean nationalism. Despite public movements in recent years to boycott Japan and Japanese products, Koreans still import and enjoy Japanese culture, food, and fashion. In contrast, anti-Chinese sentiment is a critique of Chinese cultural imperialism and illiberalism: few Koreans view China’s institutions as exemplary or say that their country should learn from China.

Spillover to Politics and Policy

Negative views towards China have the potential to affect Korean politics. Our survey found that a large majority of respondents, 78%, indicated that among other issues both domestic and international (including housing prices, North Korea, and unemployment), ROK-China relations will be an important consideration when deciding which presidential candidate to vote for. For almost a quarter (22.4%) of respondents, this was a “very important” consideration. It is no surprise, then, that presidential candidates joined the public in expressing anger at the Olympics’ hanbok incident. Given that younger Koreans are expected to be the deciding factor in this election, it is particularly significant that 82% of respondents in their 20s said that ROK-China relations would be an important issue when voting. This atmosphere recalls that of 2002, when anti-American sentiments[7] swept the Korean presidential election between Roh Moo Hyun and Lee Hoi Chang, tipping the vote in favor of Roh. This time, however, the anti-Chinese sentiment may play out in favor of the conservatives, who tend to be tougher on China and emphasize the U.S.-ROK alliance.

This will pose a major foreign policy challenge for the new administration in Seoul, which will have to manage the bilateral relation with China in the midst of rising public sentiment against the country.

It is worth noting that in the midst of the ongoing U.S.-China rivalry, Koreans increasingly favor the United States over China. A 2019 survey by the Asan Institute for Policy Studies shows waning support for China and increasing support for the United States: in 2014, nearly 25% of Koreans supported strengthening ties with China over the United States, compared to almost 60% who favored the United States. By 2019, support for China had dropped to 18.9%, and for the United States had increased to 75%.[8] In the past, Korea has regarded China as an economic opportunity, while leaning closer to the United States for security reasons; a paradigm called “an-mi-gyung-jung” (“United States for security, China for the economy”). Now, most Koreans believe that this balancing act has run its course: we found that only 43% of Koreans agree with this paradigm to some degree, with younger Koreans showing the lowest proportion of agreement (38%).

Once regarded as a place of economic opportunities for Korea, China is increasingly losing favor as Koreans, led by young people, begin to rethink what China means to their nation – a trend akin to Koreans’ questioning of their relationship with the United States in the 1980s. This will pose a major foreign policy challenge for the new administration in Seoul, which will have to manage the bilateral relation with China in the midst of rising public sentiment against the country.

At the same time, the increase in positive attitude among Koreans towards the United States could offer an excellent opportunity for the U.S.-ROK alliance, which faced stress under the Trump and Moon administrations. The Biden administration should move quickly to fill the U.S. ambassador position in Seoul, meet with the next Korean president as soon as s/he is sworn in, and work closely with the future ROK administration to strengthen ties. Washington should not waste time, especially as a more strongly pro-alliance cohort of young Koreans grows into a political force that will shape their country’s future.


Gi-Wook Shin is the Director of the Shorenstein Asia-Pacific Research Center and the Korea Program. Haley M. Gordon is a Research Associate at the Korea Program at the Shorenstein Asia-Pacific Research Center. Hannah June Kim is an Assistant Professor in the Department of Political Science at the University of Nebraska, Omaha, and a former Shorenstein Postdoctoral Fellow in Contemporary Asia at APARC.


[1] In the past few days, Koreans have mounted more criticism of China in the Olympics, over disqualifications of two Korean short-track speed skaters that enabled Chinese athletes to medal.

[2] Between January 17 and 30, 2022, we conducted a survey of 1,017 respondents in South Korea using the survey service Lucid.

[3] These are compared to a 17-country median of 88% and 43%, respectively.

[4] Korean opinions of China plummeted following THAAD deployment, from an average of 60 out of 100 in 2016 to 37.3 in 2018 (East Asia Institute; Hankook Research).

[5] Other countries polled, in order from largest to smallest oldest-youngest difference, were the United States, Canada, the United Kingdom, Belgium, France, Australia, Germany, the Netherlands, Italy, Spain, Sweden, Denmark, and Japan.

[6] Koreans who are in their 50s, attended university in the 1980s, and were born in the 1960s.

[7] In particular, these increased following a June 2002 accident in which two Korean schoolgirls were struck and killed by U.S. troops driving back to their military base.

[8] Findings from Pew (2021) show that in Korea, contrary to most other countries, younger individuals are less likely than older cohorts to say that they prefer China to the United States for economic ties.

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President Xi and Kim Jong Un meet on a TV screen
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North Korea Is Becoming an Asset for China

Pyongyang’s Missiles Could Fracture America’s Alliances
North Korea Is Becoming an Asset for China
Protesters participate in a rally oppose a planned visit by Chinese Foreign Minister Wang Yi near the Chinese Embassy on November 25, 2020 in Seoul, South Korea.
Commentary

The Rise of Anti-Chinese Sentiments in South Korea: Political and Security Implications

APARC and Korea Program Director Gi-Wook Shin shares insights on rising anti-China sentiments in South Korea and their implications for the upcoming South Korean presidential election.
The Rise of Anti-Chinese Sentiments in South Korea: Political and Security Implications
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A new study illuminates the potential effects of anti-Chinese sentiment in Korea.

This event is made possible by generous support from the Korea Foundation and other friends of the Korea Program.

On the heels of South Korea's presidential election, an expert panel will examine the election results and their likely policy implications.

Speakers:

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portrait of Jae-ho Yeom

Jae-ho Yeom is an Emeritus Professor of Policy Studies at Korea University where he also served as the 19th President. Previously, he served as President of Korean Association for Policy Studies; President of Korean Association for Contemporary Japanese Studies; and Chief Editor of Asian Research Policy. He also served in government as a leader in Inspection and Evaluation Group at the Ministry of Planning and Budget; Chair of Policy Advisory Committee at the Ministry of Foreign Affairs; Chair of Committee for Innovation and Development at the Board of Audit and Inspection of Korea; and as Advisor for Korean Presidential Commission of Science and Technology Policy. He wrote columns in major Korean newspapers, and moderated a debate show on SBS and a 2002 presidential debate. He is regarded as a scholar who has a discerning eye on social transformations, keen understanding of changing societies and corporate social values. He received a Ph.D. in Political Science from Stanford University.

Image
portrait of Eunjung Lim

Eunjung Lim is an Associate Professor at the Division of International Studies at  Kongju National University where she also serves as Vice President for International Affairs, Dean of Institute of International Language Education, and Dean of Institute of Korean Culture and Education. Her specializations include international cooperation in the Asia-Pacific, comparative and global governance, energy, nuclear, and climate change policies of East Asian countries. Since 2018, she has served as a board member of Korea Institute of Nuclear Nonproliferation and Control, and is currently a member of Policy Advisory Committee at the Ministry of Unification. Previously Dr. Lim was an Assistant Professor at the College of International Relations, Ritsumeikan University, in Kyoto, Japan. She also taught at Johns Hopkins University, Yonsei University, and Korea University. She has been a researcher and a visiting fellow at the Center for Contemporary Korean Studies at Interfaculty Initiative in Information Studies at the University of Tokyo, the Institute of Japanese Studies at Seoul National University, the Institute of Japan Studies at Kookmin University, and Institute of Energy Economics, Japan. She received a B.A. from the University of Tokyo, an M.I.A. from Columbia University and a Ph.D. from Johns Hopkins University’s School of Advanced International Studies.

Moderator: Gi-Wook Shin, director of APARC and the Korea Program, Stanford University

Via Zoom. Register at https://bit.ly/34kA4tO

Panel Discussions
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Noa Ronkin
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As the COVID-19 pandemic remains a crucial global public health threat, pandemic control measures such as lockdowns and mobility restrictions continue to disrupt the provision of health services, leading to reduced healthcare use. Indeed, evidence shows the pandemic has emerged as a particular challenge for people with chronic conditions such as diabetes and hypertension. Yet there is limited data comparing the pandemic’s impact on access to care and the severity of chronic disease symptoms at the population level across Asia.

Now a new collaborative study, published by the Asia Pacific Journal of Public Health, addresses this limitation. The study co-authors, including APARC’s Asia Health Policy Program Director and FSI Senior Fellow Karen Eggleston, offer the first report comparing the impacts of the COVID-19 pandemic and its associated mobility restrictions on people with chronic conditions at different stages of socio-demographic and economic transitions in five Asian regions — India, China, Hong Kong, Korea, and Vietnam.

The findings show that the pandemic has disproportionately disrupted healthcare access and worsened diabetes symptoms among marginalized and rural populations in Asia. Moreover, the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19, with the resulting delayed and foregone care leading to uncertain longer-term effects.


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Unintended Adverse Consequences

Routine screening, risk factor control, and continuity of care for non-communicable diseases are a global challenge. The COVID-19 pandemic has exacerbated the challenge even further. Existing reports show the pandemic has particularly adverse impacts on essential prevention and treatment services for people with chronic conditions. These reductions in health services arose from pandemic-associated factors such as mobility restrictions, lack of public transport, and lack of health workforce.

Eggleston and a group of colleagues set out to provide evidence on how the pandemic has impacted chronic disease care in diverse settings across Asia during COVID-19-related lockdowns. Using standardized questionnaires, the researchers surveyed 5672 participants aged 55.9 to 69.3 years with chronic conditions in India, China, Hong Kong, Korea, and Vietnam. The researchers collected data on participants’ demographic and socio-economic status, comorbidities, access to healthcare, employment status, difficulty in accessing medicines due to financial and nonfinancial (COVID-19 related) reasons, treatment satisfaction, and severity of their chronic condition symptoms.

If no immediate actions are taken to mitigate pandemic impacts, the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal target 3.4 to reduce premature mortality from non-communicable diseases […] and to promote mental health and wellbeing.
Karen Eggleston et al.

The results show that the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19. Study participants with chronic conditions faced significant challenges in managing their symptoms during the pandemic. They experienced a loss of income and difficulties in accessing healthcare or medications, with the resulting delayed and foregone care leading to uncertain longer-term effects. For a nontrivial portion of participants, these factors are associated with the worsening of diabetes symptoms. The threat is twofold among people living in rural populations with limited access, availability, and affordability of healthcare services.

A Global Health Priority

The unintended adverse consequences of the COVID-19 pandemic on chronic disease care may also further aggravate inequality in health outcomes. “If the trend continues and no immediate actions are taken to mitigate pandemic impacts,” Eggleston and her colleagues caution, then “the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal (SDG) target 3.4 to reduce premature mortality from non-communicable diseases by a third relative to 2015 levels and to promote mental health and wellbeing.”

Addressing the pandemic’s unintended negative social and economic impacts on chronic disease care is a global health priority, determine the researchers. They propose several measures to help provide timely care for people with chronic conditions in resource-constrained settings. These include implementing innovations in healthcare delivery models to improve the adoption of healthy lifestyle changes and self-management of chronic disease and mild COVID-19 symptoms, increasing investment in interventions to provide social and economic support to disadvantaged populations, and strengthening primary healthcare infrastructure and support of healthcare providers.

The study was supported in part by funding from Shorenstein APARC’s faculty research award, Stanford King Center for Global Development, and a seed grant from the Stanford Center for Asian Health Research and Education.

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Strengthening the Frontline: How Primary Health Care Improves Net Value in Chronic Disease Management

Empirical evidence by Karen Eggleston and colleagues suggests that better primary health care management of chronic disease in rural China can reduce spending while contributing to better health.
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A New Validated Tool Helps Predict Lifetime Health Outcomes for Prediabetes and Type 2 Diabetes in Chinese Populations

A research team including APARC's Karen Eggleston developed a new simulation model that supports the economic evaluation of policy guidelines and clinical treatment pathways to tackle diabetes and prediabetes among Chinese and East Asian populations, for whom existing models may not be applicable.
A New Validated Tool Helps Predict Lifetime Health Outcomes for Prediabetes and Type 2 Diabetes in Chinese Populations
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Bargaining Behind Closed Doors: Why China’s Local Government Debt Is Not a Local Problem

New research in 'The China Journal' by APARC’s Jean Oi and colleagues suggests that the roots of China’s massive local government debt problem lie in secretive financing institutions offered as quid pro quo to localities to sustain their incentive for local state-led growth after 1994
Bargaining Behind Closed Doors: Why China’s Local Government Debt Is Not a Local Problem
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In the first report of its kind comparing the impacts of the pandemic on people with chronic conditions in five Asian regions, researchers including APARC’s Karen Eggleston document how the pandemic’s broad social and economic consequences negatively affected population health well beyond those directly suffering from COVID-19.

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This event is made possible by generous support from the Korea Foundation and other friends of the Korea Program.

Common sense states that foreign policy rarely becomes an issue in South Korea’s elections. However, given the unusually high anti-China sentiment among the South Korean public today, some view that it may become an “unspoken agenda” that every South Korean voter is cognizant about. As Seoul and Beijing mark their 30th diplomatic anniversary this year, their mutual attraction appears visibly moderated. Is it a temporary setback in the neighboring countries’ relationship? What choices will Kim Jong-un make under strategic competition between the U.S. and China? The panel will examine the factors that will shape and influence the future prospect of the Seoul-Beijing ties and the relationship between North Korea and China.   

Speakers:

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portrait of Seong Hyon Lee

Seong-hyon Lee is a Senior Fellow at the George H. W. Bush Foundation for U.S.-China Relations and a visiting scholar at the Fairbank Center for Chinese Studies at Harvard University. His research focuses on contemporary relations between China and South Korea. Lee received a bachelor’s degree from Grinnell College, a master’s degree from Harvard University and a PhD from Tsinghua University.

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portrait of Sheen Woo

Sheen Woo, Special Policy Advisor to the South Korean Ambassador in China, joined the Korea Program at Shorenstein APARC as a 2021-22 visiting scholar. He is a specialist in China-North Korea relations with expertise in Chinese aid and sanctions against North Korea. He has worked at and with a variety of organizations including NGOs, start-ups, art centers, and state-run think tanks in Korea and China. While at APARC, his research focus is on the development and changes of China's aid to North Korea. He holds a PhD in Management Science from Tsinghua University.

Gi-Wook Shin, director of APARC and the Korea Program, will moderate the discussion.

Via Zoom. Register at https://bit.ly/3tMDyjo

Panel Discussions
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