Demographic methods to assess food insecurity: a North Korean case study

Area of Science:

• Public Health and Nutrition
• Emergency Assessment Methodologies
• Demographic Health Studies

Background:

• Assessing malnutrition is critical in complex emergencies with famine or food insecurity.
• The Democratic People's Republic of Korea (DPRK) faces data collection restrictions impacting health status assessments.
• Despite significant international aid, direct nutritional status data for the North Korean population is limited.

Purpose of the Study:

• To explore alternative methodologies for measuring public health impacts of chronic food shortage in the DPRK.
• To review existing methods for nutritional status assessment in emergency settings.
• To analyze the North Korean food crisis (1995-2001) and available health data.

Main Methods:

• Review of nutritional assessment methods in emergencies.
• Historical analysis of the North Korean food crisis and available health data.
• Survey of 2,692 North Korean adult migrants in China to assess food security and demographic changes.

Main Results:

• Migrant households reported a decline in government rations from 120g to under 60g per person daily.
• Increased reliance on foraging and bartering for food sources was observed.
• The period 1995-1998 showed elevated household mortality, declining fertility, and increased out-migration.

Conclusions:

• The study suggests significant declines in food security among surveyed North Korean migrants.
• Evidence points towards a famine, characterized by increased mortality, reduced fertility, and population displacement.
• Alternative assessment methods are crucial for understanding public health crises in data-restricted environments.