This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.

Objectives: This study aimed to assess whether the current physician workforce in Korea is sufficient to meet future healthcare demands, considering demographic changes and increasing medical needs. The objective was to project the future supply and demand for physicians and identify potential regional disparities.

Methods: Data on outpatient and inpatient utilization rates were obtained from the 2018 Health Insurance Statistical Yearbook, and population projections were sourced from Statistics Korea (2017–2067). Medical demand was estimated by multiplying these utilization rates by the population projections. The supply of physicians was projected using a cohort-component model that incorporated medical school quotas and age-specific attrition rates. Two scenarios were developed to account for changes in productivity: Scenario 1 assumed a 50% decrease in productivity for physicians aged 65–75, and Scenario 2 assumed a 75% decrease. Additionally, regional projections were analyzed using data from provincial and secondary medical service areas.

Results: National-level projections suggest a looming shortage of physicians, despite an increase in medical school admissions. Both scenarios predict a physician shortage, particularly in regions such as North Gyeongsang, South Chungcheong, and Jeju Island, by 2047. In contrast, Seoul is likely to see a surplus of physicians. The regional analysis underscores substantial disparities in physician distribution, with underserved areas experiencing increasingly severe shortages.

Conclusion: The study concludes that without flexible adjustments to medical school admission quotas and healthcare delivery systems, Korea will face significant physician shortages in the coming decades. To address this, it is necessary to increase the number of physicians in underserved regions and improve the efficiency of healthcare utilization.

Citations

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  Journal of Korean Medical Science.2025;[Epub]     CrossRef