A special section in the latest issue of the journal Asian Survey, coedited by APARC and the Korea Program Director Gi-Wook Shin, suggests a new framework in both social discourse and policy that reflects the varied complexities of Korea’s increasingly diverse migrants and that charts a course forward for a nation that is staring into a demographic abyss.

South Korea (hereafter Korea) is widely regarded as among the world’s most ethnically and linguistically homogeneous countries. In 1990, Korea counted only 49,000 foreigners amongst its population. But over the last two decades, the number of migrants in the country has grown dramatically, reaching 2.3 million (or 4.5% of the population) in 2018. Just as important is the growing diversity of migrants coming to Korea. In addition to unskilled workers and marriage migrants from developing countries, they increasingly include skilled migrant workers and marriage migrants from a range of developed Western countries.

These more recent migrant groups, however, do not fit into the dominant framework of Korean multiculturalism, and often remain invisible in Korean society, facing discrimination and largely left out of social discourse and government policy. For a nation that is aging faster than any other developed country and that struggles with weak global talent competitiveness, it is crucial to better understand the growing heterogeneity and complexity of migrants beyond their dichotomized depictions as Korean versus non-Korean in ethnicity and citizenship.

This is the focus of a special section in the July/August 2019 issue of the journal Asian Survey, titled Korea’s Migrants: From Homogeneity to Diversity. Coedited by APARC and the Korea Program Director Gi-Wook Shin and former Koret Fellow in Korean Studies Rennie J. Moon (now associate professor at Yonsei University’s Underwood International College), the special section collects articles that examine issues of class and highlight the contributions of migrants from both human and social capital perspectives, with an eye to a better appreciation of the values of diversity and transnationalism. “By doing so,” write Shin and Moon, “we aim to provide a better understanding of the varied experiences, realities, and complexities of Korea’s increasingly diverse migrant groups” and to “suggest a new framework in both social discourse and policy that reflects these complexities.” The articles in the special collections were originally presented and discussed at the Korea Program’s ninth annual Koret Workshop.

Diversity within Korea’s Migrant Groups

To capture the diversity and complexity of Korea’s migrants, Shin and Moon say, scholars need to examine within-group variation. The papers in the special section do so with respect to three migrant groups—marriage migrants, return migrants, and skilled labor—by focusing on nontraditional, relatively under-researched, highly skilled populations, mostly from developed countries, within those groups:

University of Sheffield scholar Sarah A. Son studies cross-border marriages between Korean men and Anglophone women, and shows that these Western women have very different experiences and social expectations compared with Asian female marriage migrants from developing countries. Western women bring greater perceived socioeconomic equality to the relationship by virtue of their economic position, education, and cultural background, and do not fit the common description of Asian female marriage migrants as representative of hypergamy (marrying a partner of higher social status). They also do not conform to the Korean state’s vision of social integration and resist its policy provisions to a greater degree than Asian marriage migrants. In fact, multiculturalism policy has failed to engage this Western migrant group.

What does it mean to be a skilled migrant returnee in Korea? Singapore Management University Research Fellow and former APARC Visiting Scholar Jane Yeonjae Lee provides an answer to this question by looking at the varying experiences and coping strategies of Korean returnees from New Zealand. She finds that, thanks to their educational and economic status, they fare better than traditional ethnic Korean return migrants, who experience hardships due to their status as unskilled labor. However, the process of skill transfer is not easy, and most of the skilled returnees are not fully accepted as Korean, experiencing some degree of alienation and disconnection based on their “overseas Korean” identities. In addition to greater social acceptance of skilled returnees, Lee argues, Korea needs a better policy mechanism for sustaining return migration.

Lastly, Shin, Moon, and former Koret Fellow in Korean Studies Joon Nak Choi (now an adjunct assistant professor at Hong Kong University of Science and Technology’s School of Business Management) focus on elite groups of skilled labor migrants, particularly foreign students studying in Korea and foreign professionals the country imports as skilled labor. The three authors aruge that Korea has largely failed to leverage the potential of these migrant groups, and that it must pay close attention paticularly to their human and social capital potential.

Migrants’ human capital stems from their specialized skills acquired through education, training, and work experience, which can benefit especially Korea’s small- and medium-sized firms. Their social capital is the value they can provide through their social ties that spread information and innovations and that form “transnational bridges” between Korea and their home countries. Social capital is especially advantageous for Korea’s large firms that compete in global markets.

The authors stress the need for Korea to develop a new policy framework, known as study-work framework, for cultivating social capital for skilled foreigners while in Korea. If Korea is to meet the challenges associated with its aging, depopulation, shrinking workforce, and weak position in the global war for mobile skilled talent, then it must “better appreciate the value of the cultural diversity [migrants] bring to its society and economy, as well as their human and social capital contributions.”

View the complete special section >>

Learn more about Shin’s and Moon’s related joint research project Migration, Cultural Diversity, and Tolerance >>

An estimated 210,000 girls may have “gone missing” due to China’s “Later, Longer, Fewer” campaign, a birth planning policy predating the One Child Policy, according to a new study led by Stanford Health Policy researchers published by the Center for Global Development.

The study looked at hundreds of thousands of births occurring before and during the “Later, Longer, Fewer” policy to measure its effect on marriage, fertility, and sex selection behavior. The policy, which began in the 1970s and preceded China's One-Child Policy, promoted later marriage, longer gaps between successive children, and having fewer children to cut the country's population. The study emphasizes that because this policy existed before ultrasound technology was widely available — and therefore before selective abortion was an option — these missing girls must have been due to postnatal neglect of infant girls, or in the extreme, infanticide.

The authors of the new study are Grant Miller, director of the Stanford Center on Global Poverty and Development, a core faculty member at Stanford Health Policy and senior fellow at the Freeman Spogli Institute for International Studies; Kimberly Babiarz, a research scholar at Stanford Health Policy; Paul Ma and Shige Song.

The researchers found that China’s “Longer, Later, Fewer” population control policy reduced total fertility rates by 0.9 births per woman and was directly responsible for an estimated 210,000 missing girls countrywide. The phenomenon of “missing girls” widely recognized in later years under the One Child Policy is largely thought due to sex-selective abortion after ultrasound technology spread across China.

“Prior research has shown that sex ratios rose dramatically under China's One-Child Policy, leading to stark imbalances in the numbers of men and women. But we’re finding that girls went missing earlier than previously thought, which can in part be directly attributed to birth planning policy that predates the One-Child Policy,” said Grant Miller, a senior fellow at the Stanford Institute for Economic Policy Research and a non-resident fellow at the Center for Global Development.

The top findings of the study include:

• The birth planning policy reduced fertility by 0.9 births per woman, explaining 28 percent of the overall decline during this period.

• The Later, Longer, Fewer policy is responsible for a roughly twofold increase in the use of “fertility stopping rules,” the practice of continuing to have children until the desired number of sons is achieved.

• The Later, Longer, Fewer policy is also responsible for an increase in postnatal neglect, from none to 0.3 percent of all female births in China during this period.

• Sex selection behavior was concentrated among couples with the highest demand for sons (couples that have more children but no sons), with sex ratios reaching 117 males per 100 female births among these couples.

“Population control strategies can have unforeseen consequences and human costs,” Miller said. “At the same time, as China debates the future of birth planning policies, it’s also important to note that family planning policy does not appear to be the largest driver of fertility.”

Opioids overdoses now kill more Americans than car accidents or guns, with more than 350,000 Americans having succumbed to the painkillers since 2000.

“The opioid misuse and overdose crisis touches everyone in the United States,” Health and Human Services Secretary Alex Azar said in this recent report. “The effects of the opioid crisis are cumulative and costly for our society — an estimated $504 billion a year in 2015 — placing burdens on families, workplaces, the health care system, states, and communities.”

Now, new research led by Stanford shows that not only have opioid-related deaths jumped fourfold in the last 20 years, but that those most affected by the epidemic, and where they live, has also shifted dramatically. In fact, the District of Columbia has had the fastest rate of increase in mortality from opioids, more than tripling every year since 2013.

“Although opioid-related mortality has been stereotyped as a rural, low-income phenomenon concentrated among Appalachian or midwestern states, it has spread rapidly, particularly among the eastern states,” writes Mathew V. Kiang, ScD, a research fellow at the Center for Population Health Sciences at the Stanford University School of Medicine, in an original investigation published in JAMA Network Open.

The study found the highest rates of opioid-related deaths and more rapid increases in mortality were observed in eight states: Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire and Ohio. Two states, Florida and Pennsylvania, had opioid-related mortality rates that were doubling every two years — and tripling in Washington, D.C.

Kiang and his co-authors, including Stanford Health Policy’s Sanjay Basu, MD, PhD,an assistant professor of medicine at Stanford Medicine, used data from the National Center for Health Statistics and corresponding population estimates from the U.S. Census. The other authors are Jarvis Chen, ScD, at the Harvard T.H. Chan School of Public Health, and Monica Alexander, PhD, in the Department of Sociology at the University of Toronto.

“It seems there has been a vast increase in synthetic opioid deaths in the eastern states and especially in the District of Columbia because illicit drugs are often tainted with fentanyl or other synthetic opioids,” Kiang said in an interview.  “People aren’t aware their drugs are laced and more potent than they expected — putting them at higher risk of overdose.”

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Synthetic opioid deaths now outnumber heroin deaths in these eastern states, which suggests fentanyl has spread to other illegal drugs and is no longer limited to heroin.

“The identification and characterization of opioid `hot spots’ — in terms of both high mortality rates and increasing trends in mortality — may allow for better-targeted policies that address the current state of the epidemic and the needs of the population,” the authors write.

The research suggests the opioid epidemic has evolved as three intertwined, but distinct waves, based on the types of opioids associated with mortality:

1. The first wave of opioid-related deaths was associated with prescription painkillers from the 1990s until about 2010.
2. From 2010 until the present, the second wave was associated with a large increase in heroin-related deaths.
3. And in the third and current wave, which began around 2013, the rapid increase is associated with illicitly manufactured synthetic opioids, such as tramadol and fentanyl.

“The evolution has also seen a wider range of populations being affected, with the spread of the epidemic from rural to urban areas and considerable increases in opioid-related mortality observed in the black population,” they write.

The Centers for Disease Control and Prevention reports that African-Americans experienced the largest increase in opioid overdose deaths among any racial group from 2016 to 2017, with a 26 percent surge.

“The identification and characterization of opioid ‘hot spots’ — in terms of both high mortality rates and increasing trends in mortality — may allow for better-targeted policies that address the current state of the epidemic and the needs of the population,” the researchers write.

States are trying to combat the epidemic by enacting policies, such as restricting the supply of prescription drugs and expanding treatment and access to the overdose-reversing drug naloxone.

“Treating opioid use as a disorder should be our top priority to curb the problem,” said Kiang. “Similarly, we have the ability that counteract the effects of an overdose — these life-saving drugs should be easily accessible and widely available.”

Under the title “Political Contestation and New Social Forces in the Middle East and North Africa,” the Program on Arab Reform and Democracy convened its 2018 annual conference on April 27 and 28 at Stanford University. Bringing together a diverse group of scholars from across several disciplines, the conference examined how dynamics of governance and modes of political participation have evolved in recent years in light of the resurgence of authoritarian trends throughout the region.

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The conference’s second panel, tilted “Situating Gender in the Law and the Economy,” featured Texas Christian University Historian Hanan Hammad, who assessed the achievements of the movement to fight gender-based violence in Egypt. Focusing on Gulf Cooperation Council states, Alessandra Gonzales, a Visiting Postdoctoral Fellow at the Stanford Institute for Economic Policy Research, analyzed the differences in female executive hiring practices across local and foreign firms. Stanford University Political Scientist and FSI Senior Fellow Lisa Blaydes presented findings from her research on women’s attitudes toward Female Genital Mutilation (FGM) in Egypt.

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The fourth panel of the conference, “The Economy, the State, and New Social Actors,” featured George Washington University Associate Professor of Geography Mona Atia, who presented on territorial restructuring and the politics governing poverty in Morocco. Amr Adly, an Assistant Professor of Political Science at the American University in Cairo, analyzed the relationship between the state and big business in Egypt after the 2013 military coup. Rice University Professor of Economics Mahmoud El-Gamal shared findings from his research on the economic determinants of democratization and de-democratization trends in Egypt during the past decade.

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The conference included a special session featuring former fellows of the American Middle Eastern Network at Stanford (AMENDS), an organization dedicated to promoting understanding around the Middle East, and supporting young leaders working to ignite concrete social and economic development in the region. AMENDS affiliates from five different MENA countries shared with the Stanford community their experiences in working toward social change in their respective countries.

How can we make sense of the tragedy in Syria? Northwestern University political scientist Wendy Pearlman has conducted open-ended interviews with more than 300 displaced Syrians across the Middle East and Europe from 2012 to 2017. She has brought together these personal stories in the acclaimed new book, We Crossed a Bridge and It Trembled: Voices from Syria (HarperCollins 2017). In a talk dated February 7, 2018, Pearlman shared a selection of voices from the book, along with her own commentary and analysis, to explain the origins and evolution of the Syrian conflict, as well as what it has been like for the ordinary people who have lived its unfolding. Co-hosted by the Program on Arab Reform and Democracy and the Abbasi Program in Islamic Studies, the talk offered a humanistic interpretation of the current conflict in Syria and how it has transformed those who have experienced it. The video of the talk is available through the link below.

In Beijing’s bustling Chaoyang District stands a multi-story building known as the Gonghe Senior Apartments: a 400-bed nursing home for middle-income seniors who are disabled or suffer from dementia. Why is Gonghe unique and why is it worth considering? Because Gonghe is a public-private partnership (PPP), a collaborative organizational structure supported by the District Civil Affairs Bureau Welfare Division that donated the land and building and the nonprofit Yuecheng Senior Living that operates the facility. And because PPPs like Gonghe might just be the right model to address the challenges surrounding elderly care in China as well as in other nations that face a looming burden of population aging.

This was a core message shared by Alan Trager, founder and president of the PPP Initiative Ltd., who spoke at a special workshop organized by Shorenstein APARC’s Asia Health Policy Program (AHPP). Focused on PPPs in health and long-term care in China, the workshop was part of a two-day convening related to the Innovation for Healthy Aging project, a collaborative research project led by APARC Deputy Director and AHPP Director Karen Eggleston that identifies and analyzes productive public-private partnerships advancing healthy aging solutions in East Asia and other regions.

The Innovation for Healthy Aging project is driven by the imperative to respond to a world that is aging rapidly. This demographic transition, reminded Trager at the opening of his talk, is a defining issue of our time, as aging is a multisectoral issue that increases the demand for health care, long-term care, and a large number of other social services. The aging challenge is exacerbated by its convergence with the rising prevalence of non-communicable diseases (NCDs), also known as chronic diseases. For while NCDs affect all age groups, they account for the highest burden among the elderly.

China: Ground Zero for Global Aging

Alan Trager discusses health and long-term care in China in the GSB's Highly Immersive Classroom

The need to advance healthy aging and NCD prevention is a matter of grave concern in China, whose older population is larger than in any other country. Moreover, the aging challenge in China is interwoven with unique social trends. In particular, filial piety—which, for thousands of years, has been a fundamental family value and a mainstay of health and elder care—is under pressure, as young people strive to balance the demands of careers, fewer children per family, and migrating to cities for school and work, without affordable housing or long-term care financing support for their parents and other elderly relatives, who often stay in rural areas.

China’s health system is yet to adapt to the shift in the disease burden and health care needs driven by the aging population. Its existing health insurance programs are insufficient for outpatient management and care of chronic conditions, and as Trager emphasized, there is a lack of investment in training geriatric medicine professionals and incorporating geriatric principles into clinical practice.

How can China meet the high demand for elder care, increase workforce capacity, and promote healthy aging?

The answer, claims Trager, lies in developing multisector, integrated solutions to the challenges posed by population aging. While system-level efforts, such as building the social protection system and sustaining universal health coverage, continue to be led by the government, PPPs can play a major role in capacity building to ensure the sustainability of such systems through the advancement of technology, human resources, and innovation. Trager shared PPP Initiative Ltd.’s recent efforts to develop PPP solutions for aging populations in China and elsewhere. The workshop was held on October 10 at the Stanford GSB’s Highly Immersive Classroom, which is equipped with advanced video conferencing technology that allows participants in Palo Alto and at the Stanford Center at Peking University to collaborate in real-time. Experts from Beijing joined the discussion and followed Trager’s presentation with comments on how to move from awareness to action.

Private Efforts, Public Value

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Public-private collaborations—or rather collaborative governance–in China as well as in the United States is the subject of an upcoming volume co-authored by Eggleston with Harvard scholars Richard Zeckhauser and John Donahue. Both Zeckhauser and Donahue joined Eggleston the following day, October 11, at an AHPP-hosted seminar to discuss this upcoming publication, titled Private Roles for Public Goals in China and the United States: Contracting, Collaboration, and Delegation.

Eggleston, Donahue, and Zeckhauser define collaborative governance as private engagement in public tasks on terms of shared discretion, where each partner bears responsibilities for certain areas. Their upcoming book explores public-private collaborations in China and the United States, two countries where public needs require solutions that far outstrip the capacities of their governments alone. Beyond considering merely health and elderly care, the book features research into public and private roles in the governance of multiple other sectors, including education, transport infrastructure, affordable housing, social services, and civil society.

At the seminar, the three scholars reviewed different models of private efforts providing public value, outlined the justifications for collaborative governance, and explained some of the conditions that make such collaborative partnerships productive and valuable. They emphasized the need to account for the unique contexts in China and the United States and to steer clear of one-size-fits-all solutions.

Imperative for the Young Generation

One thing, they all agree, applies to both countries: government collaboration with private entities is inevitable if China and the United States are to achieve their articulated goals and meet rapidly increasing demand for high-end public services.

This sentiment echoed a claim Trager made the preceding day: a tidal wave of noncommunicable diseases in an aging world is approaching us quickly and governments cannot handle it alone. Young people must care about advancing creative solutions to this pressing problem because they will be the ones who will pay for the consequences if we get it wrong.

The Korea Program invites junior faculty, post-doctoral fellows, and graduate students to apply for travel awards to attend an upcoming two-day conference organized by the Korea Program at Stanford' Asia-Pacific Research Center. The workshop titled "Future Visions: Challanges and Possibilities of Korean Studies in North America" will be held on November 1st and 2nd, 2018 at Stanford University.

The awards will cover accepted applicants' lodging, domestic airfares, and/or ground transportation. To apply for the travel awards, please submit your CV and 2-page statement as a single file by July 15 here.

About the conference:

“Future Visions: Challenges and Possibilities of Korean Studies in North America,” is designed to bring together leading scholars in the fields of language education, literature, history, social sciences, and library studies. Each panel will consist of three-four scholars who will be tasked with presenting a report on the state of the field. The purpose of the panels is to generate discussion around some of the following questions: 

Accepted applicants are expected to actively participate in discussion sessions and to engage in networking with other scholars during the 2-day conference.

Please direct questions on the conference to hjahn@stanford.edu.