A 2013 projection, a sickbed of seven to eight years, and an 18-trillion-won loss

These notes discuss how to respond to pedestrian safety accidents among older people. In the society the writer describes as then recent, medical technique had greatly increased the older population, and industrialization and urbanization had raised the burden of supporting them. That “recent” is left as the writer’s framing at the time, not recast as a later official picture. According to a 2013 Statistics Korea survey of population trends, the aging share was projected to rise from 7 percent to 14 percent in seventeen years, and from 14 percent to 20 percent in about seven years. That is a 2013 projection, and is not recast as a later official total. Such growth, the writer says, called for a widening of welfare services for older people. Changes in the family system, a couple-centered nuclear family, a fall in the number of supporting relatives with low fertility, and a weakening of a culture of filial duty have gradually weakened the family’s function of caring for the old, so measures to raise the quality of life of an aging population are a natural next step.

Lifespan has lengthened with medical technique and economic growth, but Koreans, the notes say, live about seven to eight years of that lengthened life in a sickbed. That wording is left as the notes give it. A mere lengthening of life is not enough; for an old age that takes quality of life into account, attention is needed to the health problems older people experience. The government, the notes say, has established a comprehensive national plan for health promotion, in order to lengthen both average life and healthy life and so to raise the quality of life, and has selected eight main diseases for intensive management. Those eight are not named in the notes, and none is invented here.

Korea, the notes say, has the highest accidental deaths among older people in the OECD. The number of deaths from accidents does not include minor accidents, so only a visible part of the harm appears. Income lost to accidents is also estimated at 18 trillion won, and accidental death is therefore not only a serious problem of national health but also a very important economic one. Those claims stay as the notes word them. An accident greatly affects an older person’s health and quality of life. Even an older person who had been living a comparatively healthy life, once an accident happens, finds recovery delayed, physical decline and aging sped up, and activity and daily life made inconvenient. Pain from the accident, a longer period of treatment, rising medical costs, and a lower quality of life are a very serious social problem. Physical weakening from degenerative change can make even a light accident fatal, and recovery and self-care afterward are also hindered by that weakening. With the aging of the population, the health of older people is counted among the very large public-health problems that bring a rise in medical costs. A preventive measure is therefore essential, and what is effective for prevention, the writer says, is health education in the prevention of safety accidents.

Who was studied, and two attitudes among those at high risk

The writer therefore sets out to discuss, by applying Green’s PRECEDE-PROCEED model, what kind of safety education would be suitable to offer older people. The subjects of the study are older people at high risk of safety accidents, chosen among those staying at a nursing home the notes call Home A, who were (1) aged sixty-five or more, (2) not impaired in getting about, (3) not suffering from a serious disease that would interfere with daily life, and (4) not accompanied by a mental disorder. They had, though the timing and the degree differed, experienced various physical changes that come with aging. In the ratio of body composition, the share of fat had increased and tissue had decreased, and because the elasticity and flexibility of muscle tissue had declined, the speed and flexibility of movement had fallen. In the organ systems — the musculoskeletal, the cardiovascular, the respiratory, the gastrointestinal, and most of the others — they had experienced a decline of function.

A weakening of the musculoskeletal system is very closely related to falls among older people, and a weakening of gastrointestinal function becomes a cause of digestive accidents from food or drink. A decline of the immune system raises the chance that recovery after an accident will be slow, or that complications will appear. Among declines of the senses, a decline of sight raises the chance of a fall or of a pedestrian traffic accident. A decline of smell makes it harder to detect quickly a fire or various other accidents, and, together with a decline of taste, makes it harder to notice spoiled or rotten food or drink, or something that should not be eaten, such as a pesticide. A decline of nerve transmission also needs attention: a dulling of touch in the skin stands out, and the decline of touch at the fingertips and the palms is stronger than in other parts. That dulling of sensation makes a person less sensitive to pain, so an older person may be late in noticing a burn. As the sense of pain grows dull, it also becomes easy to underrate the pain of an illness or an accident, and an educator, the writer says, needs to notice the tendency of older people to speak of their pain as smaller than it is.

Accident rates among older people appear higher than among the young, the notes say. But if one attends to the fact that, even though they are physically frail, many older people do not experience an accident, interest can be moved from the question “Why is the rate of safety accidents among older people high?” to the question “Which older people are more likely to have an accident?” Among the subjects, those at high risk of accidents showed two characteristic attitudes. First, in a dangerous situation they do not actively gather information, but believe that others will protect their safety, or lean on an object thought to protect them. For example, when crossing at a crossing, even if a car is coming, they walk on because the light is blue, thinking that the car will stop and will not hit them. Second, their insight into their own capacity to change is weak. Because their ability to predict how a crisis they are in will change, and what danger will follow, is very weak, even if new information appears mid-action, or an unexpected situation arises, they tend not to stop, and want to keep a constant course of action.

A model presented in 1980, and two first steps of response

The PRECEDE model that Green and Kreuter presented in 1980, the notes say, explains health-education and health-promotion programs more comprehensively than other models, on a base of sociology, epidemiology, education, behavioral science, administration, and public health, and offers a many-sided, wide approach to the various factors that affect a final goal when a program for education is being developed. That year stays in 1980. Such an approach is a very effective method of diagnosis, in that it can classify step by step, and organize, the various complex factors that in real life will affect a person’s ultimate goal. The PRECEDE-PROCEED model, the notes say, consists of nine stages. The first is social diagnosis, which starts from the point that the social problems a community experiences are a real and accurate indicator of quality of life. It is done by assessing the problems of interest and the general needs of the target population, taking quality of life into account. A person’s health, behavior, and awareness are formed, maintained, and changed through a mutual influence with the organizations and the society in which one lives or works.

A later diagnostic focus, as the notes describe it, is to confirm in a practical way the various social problems revealed in the first stage, to concentrate on identifying health problems or factors that give rise to accidents in connection with a poor quality of life, and to calculate which accidents occur most in the target group, and in what cases the frequency of experiencing an accident rises. The notes do not clearly number the remaining stages, and a full list of nine is not invented here.

On how to respond, the notes give two first steps and does not go on to a longer protocol. If an injured person is seen, the notes say, check their condition, but do not move them carelessly. Ask people nearby for help. Those steps are left as the notes give them. The same Korean essay, at fuller length, is on CampusDown.

Sources

1. A student essay on responding to pedestrian safety accidents among older people, and on health education in prevention.
2. A 2013 Statistics Korea projection of the aging share, a sickbed of about seven to eight years, the highest OECD accidental deaths among older people, and an estimated 18-trillion-won income loss, left as the notes word them.
3. The PRECEDE-PROCEED model presented by Green and Kreuter in 1980, left in that year, and two first steps of response: check an injured person without moving them carelessly, and ask people nearby for help.

Last updated: 14 November 2026