Social epidemiology of human rights violations in North Korea: a retrospective study

Background: North Korea has been described as one of the world's most oppressive regimes. Political barriers however have preventing measuring the full magnitude and patterns of human rights problems. In epidemiological perspective, it is still unknown whether and how recent socioeconomic changes has resulted in social distribution of human rights violations in North Korean population. Methods: A retrospective, cross-sectional survey was conducted among 383 recently displaced North Korean refugees and migrants through respondent driven sampling in South Korea in 2014- 2015. Full range of human rights violations were collected by human rights violation inventory(HRVI-NK) along with political, economic and demographic profiles. Multivariate logistic regression models were performed with bivariate analyses to determine the association between human rights violations and political and socioeconomic position in adjustment of factors related to displacement. Results: The study provided detailed data on high prevalence of political and civil rights violation (89.8%) and social, economic and cultural rights violations (85.8%) in North Korea. Political status was statistically associated with increased odds of systematic denials of rights to freedom of thought and expression, movement, and rights to food. Economic position was associated with torture, arbitrary arrest, disappearance and rights to food, freedom of thought and expression. Those rights were statistically associated with rights to health and underlying determinants of health. Conclusion: The social distribution of human rights violation among individuals is associated with systematic inequalities and power imbalance in access to the political and socioeconomic resources necessary to promote human rights or prevent human rights violations.