Incheon’s status as part of the Seoul metropolitan area conceals sharp differences in access to essential and emergency care. Materials submitted to the National Assembly showed that the city recorded 46.81 deaths considered avoidable through timely treatment per 100,000 people in 2024, the highest rate among South Korea’s special and metropolitan cities. Within Incheon, the rate reached 58.7 in Dong District and 58.5 in Ongjin County, compared with 38.9 in Yeonsu District.
The divide is especially acute on islands without road links to the mainland. Among nine public health branches serving such islands, Baengnyeong and Bukdo each had only one public health doctor at the end of June. In Ganghwa County, eight public health doctors were working at branch clinics at the end of September, fewer than half of the authorized staffing level of 17.
Emergency transport does not consistently close that distance. By the end of September, 54 of 111 requests for Incheon’s doctor helicopter had been rejected or halted because of poor weather, approaching sunset or medical considerations. Of 44 patients transported by the Coast Guard from January through September, 26 required evacuation at night, when the helicopter was not operating. A transfer by vessel from Baengnyeong could take more than six hours before hospital handover, with the longest cited case lasting nine hours and nine minutes.
Transport delays meet limited hospital capacity
Capacity on the mainland also remains limited. Incheon Medical Center, designated to serve as a regional responsible medical institution, had only one specialist in eight of its 20 departments. It performed 1,083 operations last year, but none were cancer surgeries or cesarean sections. The number of maternity care institutions across Incheon also fell by 25 percent, from 40 in 2021 to 30 last year.
The figures point to overlapping shortages rather than a single transport problem: thin island staffing increases reliance on evacuation, while weather, darkness and long sea journeys can delay that evacuation, and limited specialist capacity narrows the care available after arrival. The government plans to strengthen aircraft, equipment and landing facilities for nighttime operations by 2028. Progress will depend on whether those upgrades are accompanied by additional essential-care staff at island clinics and referral hospitals.