All Issue

2025 Vol.32, Issue 6 Preview Page

Research Article

Physical Fitness and Health-Related Quality of Life Among North Korean Defectors: Focusing on the Jangmadang and Arduous March Generations

북한이탈주민의 세대별 체력 수준과 건강 관련 삶의 질: 장마당 세대 및 고난의 행군 세대를 중심으로

Do-Hee Kim1
,
Jung-Woo Oh23
,
Yeon-Soo Kim34
,
Yunmin Han3
,
Younghwan Choi3
,
Joo-Young Lee156*
김 도희1
,
오 정우23
,
김 연수34
,
한 윤민3
,
최 영환3
,
이 주영156*
1Research Institute of Human Ecology, Seoul National University, Seoul, Korea
2Baengnyeong High School, Incheon, Korea
3Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
4Institute of Sport Science, Seoul National University, Seoul, Korea
5Department of Fashion and Textiles, College of Human Ecology, Seoul National University, Seoul, Korea
6Graphene Research Center for Convergence Technology, Advanced Institute of Convergence Technology, Suwon, Korea
1서울대학교 생활과학연구소
2백령고등학교
3서울대학교 체육교육과
4서울대학교 스포츠과학연구소
5서울대학교 의류학과
6차세대융기원 그래핀융합기술센터
*Corresponding Author
31 December 2025. pp. 753-768
PDF XML Citation
Abstract

This study investigated the physical characteristics, fitness levels, and health-related quality of life of North Korean defectors (NKDs), focusing on generational differences between the Jangmadang (JMD) and Arduous March generations (AMG). The results of anthropometric measurements, physical fitness tests, and the HINT-8 evaluation completed by 25 subjects (14 males, 11 females; 14 JMD, 11 AMG) were interpreted using national reference data from the Korean National Physical Fitness Award and the Korea National Health and Nutrition Examination Survey. NKDs showed lower physique and fitness levels than South Korean norms: male height averaged 168.4±3.6 cm (JMD) and 169.7±2.1 cm (AMG), while female height was 156.0±2.0 cm (JMD) and 156.2±5.9 cm (AMG), with corresponding Z values of –1.4 to –0.4. Body weight was also lower in both sexes (Z = –1.2 ~ –0.1). Grip strength averaged 40.8±4.4 kg (JMD) and 40.0±8.6 kg (AMG) in males, and 24.4±4.3 kg (JMD) and 26.8±3.5 kg (AMG) in females (Z = –0.9 ~ +0.2). Cross sit-ups were lower in both sexes (Z = –0.9 ~ –0.6). Overall, 84% did not meet the 3rd-grade criteria of the national fitness standards. Despite these deficits, mean HINT-8 indices remained relatively high (0.82–0.87). JMD males reported fewer problems with stair climbing and depression than AMG males (p < 0.05). Composite fitness scores correlated with HINT-8 only in AMG (ρ = 0.726, p = 0.011). These findings suggest that health promotion strategies for NKDs should consider generational differences: physical function recovery for AMG and psychosocial support for JMD. This study provides foundational data for preparing integrated health support systems for future Korean unification.

Keywords
North Korean defectors
Physical fitness
Health-related Quality of Life Instrument with 8 Items (HINT-8)
Jangmadang generation
Arduous March generation
References
1

Baek, N. S., & Kwon, K. D. (2018). Quality of life among North Korean defectors-an importance-satisfaction level analysis (ISA). Crisisonomy, 14(1), 173-191.

10.14251/crisisonomy.2018.14.1.173
2

Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports, 100(2), 126-131.

3

Cho, M. (Principal Investigator). (2017, May). Valuation of Korean Health-related Quality of Life Instrument with 8 items (HINT-8) (Final Report, National R&D Project No. 11-1352000-001563-01). University of Ulsan Industry-University Cooperation Foundation; Ministry of Health & Welfare; Korea Centers for Disease Control and Prevention.

4

Cho, S. W., Lee, S. H., Koh, E. S., Kim, S. E., & Kim, S. J. (2015). Characteristics of body composition and muscle strength of North Korean refugees during South Korean stay. Endocrinology and Metabolism, 30(4), 551-556. https://doi.org/10.3803/EnM.2015.30.4.551

10.3803/EnM.2015.30.4.551
5

Choi, S. K., Park, S. M., & Joung, H. (2009). Development of a comprehensive health promotion program for North Korean young adult defectors in South Korea. J Korean Soc Sch Health, 22(1), 73-83.

6

Goodkind, D. (2001). The North Korean famine and its demographic impact. Population and Development Review, 27(4), 699-723. Retrieved September 22, 2025, from https://www.jstor.org/stable/2695207

10.1111/j.1728-4457.2001.00219.x
7

Hanssen, U., & Song, J. W. (2019). Marketization in North Korea: Scenarios for economic, political and social change (UI Paper No. 1-2019). The Swedish Institute of International Affairs. Retrieved July 12, 2025, from https://www.ui.se/globalassets/ui.se-eng/publications/ui-publications/ui-paper-no.-1-2019.pdf

8

Jeon, W. T. (2000). Issues and problems of adaptation of North Korean defectors to South Korean society: an in-depth interview study with 32 defectors. Yonsei Medical Journal, 41(3), 362-371.

10.3349/ymj.2000.41.3.362
9

Jeong, H., Lee, S. K., & Kim, S. G. (2017). Changes in body weight and food security of adult North Korean refugees living in South Korea. Nutrition Research and Practice, 11(4), 307-318. https://doi.org/10.4162/nrp.2017.11.4.307

10.4162/nrp.2017.11.4.307
10

Jo, J., & Ha, J. (2018). Clothing acculturation of North Korean female defectors in South Korea. Fashion and Textiles, 5(1), 10. https://doi.org/10.1186/s40691-018-0127-3

10.1186/s40691-018-0127-3
11

Jun, M. G., & Han, S. H. (2023). The relationship between physical activity and health-related quality of life in Korean adults: The Eighth Korea National Health and Nutrition Examination Survey. Healthcare (Basel), 11(21), 2861. https://doi.org/10.3390/healthcare11212861

10.3390/healthcare11212861
12

Jung, K. S., Kim, T. B., & Choi, S. J. (2023). The emergence and characteristics of North Korea's Jangmadang generation: Marketization, culture, and changing social identities. North Korean Studies Review, 19(2), 45-78. Retrieved August 30, 2025, from https://nk.ac.kr/wp-content/uploads/2023/05/%EA%B9%80%ED%83%9D%EB%B9%88-%EC%84%A0%EC%83%9D%EB%8B%98.pdf

13

Kim, B. Y., & Kim, S. H. (2016). Effects of Human Capital on the Economic Adjustment of North Korean Defectors. Seoul Journal of Economics, 29(4), 485-512.

14

Kim, J. Y., Kim, K. J., Kim, K. J., Choi, J., Seo, J., Lee, J. B., ... & Kim, S. G. (2023). Effect of a Wearable Device-Based Physical Activity Intervention in North Korean Refugees: Pilot Randomized Controlled Trial. Journal of medical Internet research, 25, e45975. https://doi.org/10.2196/45975

10.2196/45975
15

Kim, J., Jo, M. W., Lee, H. J., Ahn, S. H., Son, B. H., Lee, J. W., & Lee S. B. (2021). Validity and reliability of the Health-Related Quality of Life Instrument with 8 Items (HINT-8) in Korean breast cancer patients. Osong Public Health and Research Perspectives, 12(4), 254-263. https://doi.org/10.24171/j.phrp.2021.0005

10.24171/j.phrp.2021.0005
16

Kim, J., Lee, H. J & Jo, M. W. (2022). Health-related Quality of Life Instrument With 8 Items for Use in Patients With Type 2 Diabetes Mellitus: A Validation Study in Korea. Journal of Preventive Medicine and Public Health, 55(3), 234-242. https://doi.org/10.3961/jpmph.22.020

10.3961/jpmph.22.020
17

Kim, J., Park, E. C., Nam, C. M., & Park, S. (2018). Prevalence of general and central obesity and associated factors among North Korean refugees in South Korea. International Journal of Environmental Research and Public Health, 15(4), 811. https://doi.org/10.3390/ijerph15040811

10.3390/ijerph15040811
18

Kim, S. Y. (2024). Millennial North Korea: Forbidden Media and Living Creatively with Surveillance. Stanford University Press. Retrieved September 10, 2025, from https://www.sup.org/books/asian-studies/millennial-north-korea/excerpt/introduction-excerpt

10.1515/9781503640887
19

Kim, T. (2023). A study on heterogeneity among the young generation in North Korea: Focusing on perceptions of individualism, capitalism, South Korea, and South Korea-centered unification. Modern North Korean Studies, 26(2), 171-210. https://doi.org/10.17321/rnks.2023.26.2.005

10.17321/rnks.2023.26.2.005
20

Korea Disease Control and Prevention Agency. (2019). Korea National Health and Nutrition Examination Survey (KNHANES) VIII-1. Cheongju: Author.

21

Korea Disease Control and Prevention Agency. (2023). The 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII-3). Cheongju: Author.

22

Kwak, T. H. (2018). North Korea’s sixth nuclear test and international responses: Implications for inter-Korean relations and U.S. policy. Korea Observer, 49(1), 1-25.

23

Lamar, J. (2001). Mortality in North Korea rises by 40% in seven years. BMJ, 323(7324), 1272. https://doi.org/10.1136/bmj.323.7324.1272a

10.1136/bmj.323.7324.1272a
24

Lee, D. (2006). The North Korean famine and food shortage (Doctoral dissertation). Harvard University.

25

Lee, H. J., Kim, S. Y., Ahn, J., Kim, S. H., Jo, M. W., & Ock, M. (2019). PNS252 Development and validation of health-related quality of life instrument with 8 items for general population. Value in Health, 22, S329. https://doi.org/10.1016/j.jval.2019.04.1607

10.1016/j.jval.2019.04.1607
26

Lee, Y. H., Lee, W. J., Kim, Y. J., Cho, M. J., Kim, J. H., Lee, Y. J., ... & Robinson, C. (2012a). North Korean refugee health in South Korea (NORNS) study: study design and methods. BMC Public Health, 12(1), 172. https://doi.org/10.1186/1471-2458-12-172

10.1186/1471-2458-12-172
27

Lee, Y., Lee, M. K., Chun, K.-H., Lee, Y. K., & Yoon, S. J. (2012b). The health status of North Korean refugees in South Korea: The Korea National Health and Nutrition Examination Survey (NORNS) study. BMC Public Health, 12, 172. https://doi.org/10.1186/1471-2458-12-172

10.1186/1471-2458-12-172
28

Lindencrona, F., Ekblad, S., & Hauff, E. (2008). Mental health of recently resettled refugees from the Middle East in Sweden: The impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Social Psychiatry and Psychiatric Epidemiology, 43(2), 121-131. https://doi.org/10.1007/s00127-007-0280-2

10.1007/s00127-007-0280-2
29

Ministry of Culture, Sports and Tourism, & Korea Institute of Sport Science. (2023). 2023 National Physical Fitness Survey Statistics Report. Seoul: Author.

30

Moon, W. J. (2009). The origins of the Great North Korean famine: Its dynamics and normative implications. North Korean Review, 5(1), 105-122. http://www.jstor.org/stable/43910265

10.3172/NKR.5.1.105
31

Pak, S. (2004a). A study of North Korean biological standards of living using anthropometric data from North Korean escapees. In 2nd International Conference on Economics and Human Biology, Munich, June (pp. 2-6).

32

Pak, S. (2004b). The biological standard of living in two Koreas. Economics & Human Biology, 2(3), 511-521. https://doi.org/10.1016/j.ehb.2004.09.001

10.1016/j.ehb.2004.09.001
33

Park, K., Cho, Y., & Yoon, I. J. (2009). Social inclusion and length of stay as determinants of health among North Korean refugees in South Korea. International Journal of Public Health, 54(3), 175-182. https://doi.org/10.1007/s00038-009-8048-y

10.1007/s00038-009-8048-y
34

Park, S. (2000). An assessment of the long-term effects of food crisis on children's growth and development in North Korea. Korean Cult Anthropol, 33, 207-240.

35

Schwekendiek, D. (2009). Height and weight differences between North and South Korea. Journal of Biosocial Science, 41(1), 51-55. https://doi:10.1017/S002193200800299X

10.1017/S002193200800299X
36

Schwekendiek, D., & Pak, S. (2009). Recent growth of children in the two Koreas: a meta-analysis. Economics & Human Biology, 7(1), 109-112. https://doi.org/10.1016/j.ehb.2009.01.001

10.1016/j.ehb.2009.01.001
37

Seo, S., Shin, S., & Yoo, B. (2015). A study on the relationship between health-related fitness and quality of life in female North Korean refugees. Journal of Wellness, 10(1), 311-321.

38

Shin, J. E., Choi, J. S., Choi, S. H., & Yoo, S. Y. (2021). The effect of postmigration factors on quality of life among North Korean refugees living in South Korea. International Journal of Environmental Research and Public Health, 18(21), 11036. https://doi.org/10.3390/ijerph182111036

10.3390/ijerph182111036
39

Statistics Korea. (2023). Number of North Korean defectors (by year). e-Nara Index. Retrieved March 22, 2025, from https://www.index.go.kr/unity/potal/main/EachDtlPageDetail.do?idx_cd=1694

40

Statistics Korea. (2024). Number of North Korean defectors by year and gender (2019-2023). Retrieved November 19, 2025, from https://www.index.go.kr/unity/potal/main/EachDtlPageDetail.do?idx_cd=1694

41

Wang, B. R., Yu, S., Noh, J. W., & Kwon, Y. D. (2014). Factors associated with self-rated health among North Korean defectors residing in South Korea. BMC Public Health, 14(1), 999. https://doi.org/10.1186/1471-2458-14-999

10.1186/1471-2458-14-999
Information
  • Publisher :The Korean Society of Living Environmental System
  • Publisher(Ko) :한국생활환경학회
  • Journal Title :Journal of The Korean Society of Living Environmental System
  • Journal Title(Ko) :한국생활환경학회
  • Volume : 32
  • No :6
  • Pages :753-768
  • Received Date : 2025-10-02
  • Revised Date : 2025-11-19
  • Accepted Date : 2025-11-21
  • DOI :https://doi.org/10.21086/ksles.2025.12.32.6.753
Journal Informaiton Journal of The Korean Society of Living Environmental System Journal of The Korean Society of Living Environmental System
Online Submission & Review System
  • NRF
  • KOFST
  • crossref crossmark
  • crossref cited-by
  • crossref funder-registry
  • crosscheck
  • orcid
  • open access
  • ccl
Journal Informaiton Journal Informaiton - close