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Article

Single-Person Households among the Socially Vulnerable Elderly Population: A Comparative Study of Housing, Living Habits, and Social Environments in Selected Neighborhoods of Seoul for the Prevention of Solitary Deaths

Division of Architecture, Dankook University, Yongin 16890, Republic of Korea
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Author to whom correspondence should be addressed.
Sustainability 2024, 16(17), 7740; https://doi.org/10.3390/su16177740
Submission received: 22 May 2024 / Revised: 30 July 2024 / Accepted: 29 August 2024 / Published: 5 September 2024

Abstract

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Solitary deaths, where individuals die alone and are isolated from the society, have emerged as a major social issue in South Korea. This study aimed to analyze the characteristics, perceptions, and living environments of socially vulnerable groups at risk of solitary deaths, focusing on comparing two neighborhood areas with different housing types to understand regional differences. In-depth interviews were conducted with 100 single-person households in the low-rise residential area of Sadang 4-dong and the public rental apartment area of the Gayang 5 apartment complex. The survey analysis revealed significant regional differences in factors that could influence the prevention of solitary deaths, including the connectivity between units within buildings, visual isolation, the control of appropriate indoor environments, and the frequency of social interactions. Although the Gayang 5 apartment complex, a public rental housing which is over 30 years old, offers advantages in residential safety and building maintenance compared to the low-rise residential area, this positively impacts aspects like housing satisfaction and increased social interactions. Single-person households living in multi-family and multi-household housing in low-rise residential areas generally experience poorer living environments, highlighting the need for more detailed services. These services should include enhanced support for heating and cooling costs, strengthened care services, and improved social networks. For preventing solitary deaths, region-specific strategies and screening tools are required to tailor interventions more effectively.

1. Introduction

1.1. Background and Purpose

“Solitary death” is defined as the death of an individual who lives in isolation, separated from family, relatives, and other surrounding people, and passes away alone due to suicide, illness, or other reasons. In most cases, their bodies are discovered after a certain period of time has passed following their deaths [1]. The continuous increase in single-person households and loose social networks have led to a rise in solitary deaths, which have emerged as a major social issue in South Korea over the past decade. In response, the Ministry of Health and Welfare conducted a survey on the statuses and characteristics of solitary deaths that have occurred over the past five years, publishing the “2022 Solitary death Survey (2017–2021)”. In 2023, the “Act on the Prevention and Management of Solitary deaths” was enacted. According to the 2022 survey, the number of solitary death cases in South Korea was 2412 in 2017, 3048 in 2018, 2949 in 2019, 3279 in 2020, and 3378 in 2021, showing an increasing trend each year, with an average annual increase rate of 8.8% during the survey period. Particularly, the increase rate of solitary deaths among men is 10% per year on average and it is 5.6% among women. Overall, the number of solitary deaths among men is more than four times higher than that among women, and over 50% of these cases occur among middle-aged individuals in their 50s and 60s [2].
There are also significant differences in the occurrence of solitary deaths by region and housing type. Solitary deaths occur more frequently in metropolitan areas, and the places where they occur are mainly houses, followed by apartments and studios. More than half (50.3–65.0%) of solitary deaths occur in houses each year [2]. Generally perceived as areas with affordable housing, low-rise residential areas that are densely populated with multi-family and multi-household homes in urban centers are high-risk areas for solitary deaths. This is because these areas were developed over 30 years ago to allow basement or semi-basement spaces to be used for residential purposes and have since deteriorated, with socially vulnerable populations residing in such spaces.
In South Korea, apartments are highly preferred and are perceived as residential spaces for the middle class and above. However, in the case of permanent rental apartments, solitary deaths are prevalent even in apartment areas. The frequency of solitary deaths is higher in large cities than it is in rural areas and in small–medium-sized cities, indicating that social isolation among single-person households in urban centers is more severe. In particular, according to the results of the “Gallup World Poll” survey of OECD countries, the percentage of people without a social support system was higher in South Korea in comparison with other surveyed countries. Over the past decade, the percentage of people who reported having no one to turn to in times of difficulty ranged from 5% to 12% in Germany, the United States, and Japan, whereas in South Korea, it often exceeded 20% [3]. Additionally, according to the 2021 Social Integration Survey, the lower the household income, the more likely respondents were to report that they had no one to help them in difficult situations [4].
With the rapid aging of the population and the increase in single-person households in South Korea, the risk of solitary deaths is expected to continue rising. Local governments are creating single-person household support centers to strengthen the welfare system while also developing and distributing various IT devices to prevent solitary deaths. This study was conducted as foundational research for the development and demonstration of an AIoT-based customized system to prevent solitary deaths among socially vulnerable groups. The customized system under development is based on the concept of an Ambient Assisted Living (AAL) care system. It analyzes temperature, humidity, CO2, and light data collected by indoor environment sensors installed in living spaces to understand individual behavior patterns. Based on this analysis, it detects abnormal behavior or emergency situations, providing a personalized system.
This study aimed to investigate the characteristics, perceptions, and living environments of high-risk groups for solitary deaths among socially vulnerable populations. The focus was on deteriorated low-rise residential areas and old permanent rental apartment areas in urban centers, which have higher risks of solitary deaths compared to other regions. By comparing and analyzing the characteristics of each region, the study sought to identify factors that could directly or indirectly affect the occurrence of solitary deaths and understand the differences by gender. Through this, the study aimed to achieve an in-depth understanding of high-risk groups and their living environments, establishing a foundation for assessing regional risks and developing screening tools.
This research aligns with several Sustainable Development Goals (SDGs) set by the United Nations. Notably, it contributes to Goal 1, No Poverty, by addressing the needs of socially vulnerable populations. Goal 3, Good Health and Well-being, is supported through the identification and mitigation of factors leading to solitary deaths, thus promoting better health and reduced mortality rates. Goal 10, Reduced Inequality, is also relevant, as this study highlights disparities in living conditions among different housing types and regions, advocating for more equitable services and interventions. Finally, Goal 11, Sustainable Cities and Communities, is addressed by examining and suggesting improvements in housing and community environments to enhance the quality of life and social integration for elderly single-person households. By focusing on these SDGs, the research emphasizes the importance of inclusive, safe, and sustainable living environments for all individuals.

1.2. Scope and Method

This study, based on the significant differences in the incidence of solitary deaths by region, location, and gender, selected two different areas with the highest rates of solitary deaths in various residential types and conducted a survey targeting socially vulnerable groups perceived to be at high risk of solitary deaths. Single-person households in these socially vulnerable groups have a low social support system and a high rate of living in deteriorating, low-rise residential areas with low housing costs, such as semi-basement spaces or permanent rental apartments. Among the deteriorating low-rise residential areas in Seoul, regions such as Dongdaemun-gu, Gwanak-gu, Geumcheon-gu, and Jungrang-gu have been identified to have high rates of solitary deaths [5]. Permanent rental apartments, which began to be collectively planned in the 1990s, are most widely distributed in Gangseo-gu and Nowon-gu. In Korea, apartments are generally highly preferred and perceived as residential spaces for the middle class and above, but rental apartment areas are an exception, with solitary death rates second only to deteriorating low-rise residential areas.
The study focused on the densely populated low-rise residential area of Sadang 4-dong in Dongjak-gu and the rental apartment complex The Gayang 5 apartment complexes, managed by the SH (Seoul Housing Corporation) in Gangseo-gu. With the assistance of local comprehensive social welfare centers, participants were selected, and expert interviews and surveys were conducted. Preliminary research indicated that approximately 80–90 individuals were receiving meal-related services from each local comprehensive social welfare center. After announcing the survey and assessing the willingness of respondents, it was determined that approximately 50 single-person households per area were available to participate.
As a result, a total of 100 in-depth surveys were conducted, with 50 participants from each area. Although the sample size is smaller than that of typical surveys, the extensive nature of the survey and its focus group interview approach provided sufficient significance at this foundational stage of research. Many respondents were elderly and faced challenges related to reading, vision, or hearing. Consequently, the survey was administered in a one-on-one format where the interviewer either read the questions aloud or recorded the responses. Each survey session lasted a minimum of 20 min per participant. Efforts were made to create a comfortable environment by conducting the surveys in familiar designated locations within the social welfare centers, with social workers present to ensure a supportive atmosphere and to attentively listen to the participants’ narratives. Additionally, the adequacy of the sample size was further verified using the G*Power 3.1.9.7 program. Calculating with an effect size of 0.35, a significance level of 0.05, and a power of 0.9, the required sample size was determined to be at least 104 participants. When recalculated with a power of 0.85, at least 90 participants were required. While the study meets the minimum criteria, it is currently limited to only two regions. Future surveys that expand the sample size to include other regions could facilitate deeper discussions and enhance the generalizability of the findings.
In Sadang 4-dong, a preliminary meeting with officials at the Sadang Comprehensive Social Welfare Center was held on 4 July 2023, followed by the selection of single-person household survey participants. Surveys were conducted at the Sadang Comprehensive Social Welfare Center on August 3, 4, and 7, 2023. Additionally, on 9 August 2023, a field survey and interviews were conducted at the homes of approximately ten households receiving meal delivery services, accompanied by a social worker.
In Gayang-dong, a preliminary meeting was held with the SH Gangseo Housing Safety Center and the management office of the Gayang 5 apartment complex on 23 June, followed by site inspections of the layout and various apartment types. Home visit surveys were conducted on 18 November, and additional surveys were carried out at the Gayang 5 apartment complex Comprehensive Social Welfare Center on 21 November. After the surveys, statistical analysis was conducted using SPSS, including regional and gender comparative analysis.
The survey analysis aimed to understand the impact of predominant housing types in each area on residential satisfaction, the degree of indoor environment control, and the frequency of social interactions. Additionally, the study sought to identify the aspects in which differences between men and women occur. It also aimed to assess the lifestyle habits and degree of social isolation of the study participants. Based on these findings, the study intended to identify the key factors and conditions to prioritize when developing a system to prevent solitary deaths.

2. Previous Literature Review and Conducting a Research

2.1. Literature Review

Over the past decade, numerous studies on solitary death in South Korea have been conducted as part of policy research. These studies can be broadly divided into two categories: investigations into the actual conditions of solitary death and identification of at-risk populations, and analyses of the effectiveness of domestic and international policies aimed at preventing solitary deaths. Following the recent enactment of the Solitary Death Prevention Act, local governments are currently in the process of assessing the status of solitary deaths and developing systems to address the issue. Additionally, efforts to prevent solitary deaths through the use of IT are in their early stages.
In Seoul, the focus area of this study, solitary deaths can be explained by residential characteristics and risk groups. According to the 2022 Seoul Think Tank Council’s first policy seminar, the age characteristics of solitary death incidents vary by housing type. In rental apartments, individuals in their 70s had the highest frequency of solitary deaths. In multi-family and multi-unit housing, the frequencies were highest among those in their 50s, followed by those in their 60s and 70s. In the case of goshiwon (small, single-room accommodations), solitary deaths were more common among individuals in their 50s and 60s, indicating a relatively younger demographic. Regarding the causes of solitary death, 73.4% were due to natural causes. For men, the leading causes were diabetes, alcoholism, liver cirrhosis, and hypertension. For women, the leading causes were hypertension, frailty, and dementia [6]. Apart from Seoul, a case study analyzing 80 solitary deaths in Busan from June 2017 to the end of March 2019. This policy research was based on the analysis of the deceased’s age, gender, housing status, social network, diseases and health behaviors, economic activity, social security benefits, and the discovery process [7].
Services related to solitary deaths began with the Ministry of Health and Welfare’s establishment of a social safety net for elderly people living alone in 2007. These services include the Basic Elderly Care Service, Comprehensive Elderly Care Service, Elderly-to-Elderly Care, U-Care Service for the Elderly Living Alone, and solitary death prevention projects. Particularly, safety monitoring and emergency support through the installation of gas exposure, fire detection, and activity detection sensors, which started with the U-Care Service, are also used in the emergency safety and security service care projects for elderly and disabled individuals living alone. Additionally, the Ministry of Health and Welfare implements various care services for socially vulnerable groups through means such as living support, visits, phone calls, and social interactions [8].
Recently, there has been research on monitoring and support services utilizing various sensors, AI speakers, and robots. In the study by Hyunsoo Lee (2018) [9], personalized services for elderly individuals living alone were proposed based on their life log data. This aimed to advance beyond traditional, standardized solitary death prevention services. However, this study also focused on safety issues like falls and fires, suggesting support services that rely on sensors and devices installed in the home. Sung-Ho Sim’s (2022) study [10] aims to improve the issues of housing support projects for vulnerable groups by using an IoT environmental support system. It encompasses comprehensive life support services, including medical support, daily living support, and mobility support. Through this approach, the researcher proposed a system that not only provides customized services to users using IoT devices but also enables them to be more actively involved in the community and receive regional services. In the study by Young Yoon et al. (2022), the researchers developed and experimented with a system to remotely monitor the behavior of the elderly living alone using IoT wireless sensor devices and deep learning [11]. The results showed that falls, coughing, etc., were recognized with 80% accuracy. This research is significant in that it complements and advances the situation where there are limitations in the function of sensors alone, although systems that can automatically recognize emergencies and lifestyle habits based on sensor technology (ICT) have been studied before.
In Japan, whose population reached the status of being an aging society earlier than Korea, the increase in solitary deaths is attributed to the rise in single-person households. According to the Ministry of Health, Labor, and Welfare, 27% of households consist of single-person families, and households made up only of couples, who are potential future single-person households, account for 24%, indicating a steady increase [12]. In Japan’s solitary death prevention measures, priority is given to creating communities where elderly or single-person household occupants can safely live alone. The “Mimamori” (watchful care) service is used to prevent social isolation by checking on the well-being of individuals [13]. Currently, a continuous increase in private paid well-being services combined with IoT has been noted. This includes the potential of multi-layered care combining IoT and human interaction, as discussed by Deok-Young Lim in his study on Japan’s well-being services [14].
In developed Western countries such as Europe and the United States, it is rare to find cases where solitary death is specifically defined and addressed at a national policy level, as it is in Korea and Japan. This can be attributed to the different social circumstances, given the rapidly aging population and increasing number of single-person households in Korea and Japan. However, the issue of social isolation is addressed in the context of social welfare and integration, and there exists a field of research known as “social death”, which can encompass the issue of solitary death. Social death describes situations where a person is treated as if they are dead or nonexistent, distinguishing it from biological or physical death and occurring either before or after physical death. Králová (2015) describes the concept of social death as a “state of damaged well-being”, involving the loss of social identity, social connections, and related physical declines [15]. Research on social death spans various topics, from genocide studies to the social isolation of specific groups, long-term unemployment, social exclusion due to the death of a spouse, and retirement. Despite the varied subjects, these studies share a common theme of the collapse of social roles, ultimately leading to mental and physical disintegration [16,17,18]
As counter-concepts to social death, Card (2010) proposes “social vitality” [19], while White (2010) suggests the concept of well-being [20]. Social vitality encompasses all relationships in which individuals or groups are engaged, including educational, economic, political, and cultural social structures. On the other hand, well-being is defined across three dimensions: material (tangible welfare and living standards), social (social relationships and access to public goods), and human (household characteristics, education levels, abilities, attitudes towards life, etc.), with a significant emphasis on subjective aspects [21]. Achieving well-being across these three dimensions can support a person in moving away from social death.
A noteworthy example is the UK’s approach, where a Minister for Loneliness has been appointed to address related policies. Considering that solitary death arises from the increase in single-person households and the absence of social networks, the UK demonstrates a comprehensive approach to modern social issues. The Jo Cox Commission on Loneliness, in collaboration with non-profit organizations, conducted research and published the “Combatting loneliness one conversation at a time” report in 2017, emphasizing the measurement and countermeasures for widespread loneliness. The key content of the UK’s cross-government strategy highlights the deep connections between the feeling of loneliness and phenomena such as smoking, obesity, and early death. The government’s vision is to support individuals in forming stronger social networks [22].
A review of previous studies shows that Korea has researched many cases and the policies implemented in Japan and is creating similar policies, while Western countries address the issue of solitary death in a more comprehensive context. Despite regional or cultural differences, there is a need to use the fundamental approach of introducing the concept of social death and enhancing well-being to prevent it in the research of solitary-death-prevention systems, which provides significant implications for policy in solitary death prevention.

2.2. Conducting a Survey Questionnaire

The composition of the survey items was designed to reflect the items from previous surveys or studies on solitary deaths as much as possible, while also incorporating sections for regional and housing type comparisons, as well as the intention to use IoT-based services, which are specific to this study. First, in the previous study “Solitary Death Survey Design Study” by the Ministry of Health and Welfare, various factors were considered to comprehensively understand social and personal factors. As shown in Table 1, The survey included the following sections: ‘Access to public services’, ‘Economic activity’, ‘Household and demographic characteristics’, ‘Economic situation’, ‘Social networks’, ‘Health behaviors and psychological state’, ‘Diseases and mental health’, ‘Residential vulnerability’, and ‘Life history changes’ [23]. The specific survey items were structured as follows.
In addition to using the above survey items, as a reference, detailed content for each item was supplemented with categorized data from a study by Moon-Sun Song [24] and the research by Hyun-Soo Choi and four others [7]. Ultimately, in this study, the survey was designed with eight sections to identify the characteristics of groups at risk of solitary death. These sections are the following: basic information and personal details, living space, residence and surrounding area, physical health, overall living conditions, social interchange, awareness of public welfare, and willingness to use AAL (Ambient Assisted Living) support system services. The summary of survey items can be found in Table 2.

3. Analysis of Basic Survey Area Characteristics

3.1. Regional Characteristics

Due to the housing shortage caused by the population concentration in Seoul during the 1960s and 1970s, the permanent rental housing system was introduced in 1989. This initiative was part of a broader effort to enhance the public aspect of housing policies for low-income groups. Gangseo-gu’s Gayang-dong, along with nearby Deungchon-dong, Nowon-gu’s Sanggye-dong, and Gangnam-gu’s Irwon-dong, is one of the areas in Seoul with the highest number of public rental housing units. In 1992~93, a large-scale apartment complex was built in Gayang-dong as part of the Gayang housing district construction project, which included the areas of Gayang-dong and Yeomchang-dong. There are a total of nine complexes, from Complex 2 to Complexes 9-1 and 9-1. The rental apartment complexes in Gayang-dong range from 1000 to over 2400 households per complex, with each complex having more than ten 15-story residential buildings.
Sadang-dong began serving as a resettlement area for evictees from the northern part of the Han River starting in 1965, and it became known as a cluster of unauthorized buildings. Although there were efforts to clear the area in the mid-1970s, large-scale demolitions and new constructions began in earnest in the 1980s. As the population moved into Seoul’s city center, semi-basements and basement levels were allowed as living spaces between 1980 and 1990 to address the housing shortage, and Sadang-dong’s low-rise residential area was no exception. Like other low-rise residential areas in Seoul, Sadang-dong mainly consists of old houses over 30 years old and is densely populated with multi-family and multi-household homes. To understand the urban characteristics of each area, an analysis was conducted on building usage and types, building condition, building height, street and major public transportation systems, and the distribution of parks and green spaces. This analysis was supported by on-site visits and the use of Q-GIS. Figure 1 represents aerial photographs of the survey areas, with Gayandong on the left and sadangdon on the right.

3.1.1. Building Usage

In Gayang-dong, residential buildings are primarily apartments, with commercial buildings distributed along the main arterial roads. There is a large discount store, Homeplus, nearby, which serves as a primary shopping location. Additionally, the women’s association sets up a temporary market within the apartment complex every week to enhance convenience for residents. Within the rental apartment complexes, comprehensive social welfare centers, kindergartens, and management offices are distributed throughout the complexes, providing welfare services to residents. Sadang 4-dong is a low-rise residential area consisting of individual buildings with three–four floors. According to Korean building regulations, multi-family houses are classified as single-family homes, while multi-household houses are classified as multi-family housing. However, the two types of buildings are almost identical in appearance, differing mainly in terms of ownership. In Sadang 4-dong, there is a traditional market near the comprehensive social welfare center that is popular among residents, and commercial facilities are located along the main streets. Figure 2 depicts the uses of buildings in the survey area, clearly showing that Gayang-dong lacks single-family homes and is exclusively developed with apartment complexes. In contrast, the layout of commercial facilities along major streets in the urban structure shows a similar pattern.

3.1.2. Building Aging and Condition

The Gayang 5 apartment complex and the surrounding area were developed between 1992 and 1993, so all the buildings are over 30 years old. Many of the apartment complexes in the surrounding area also consist of buildings that are between 20 and 30 years old. In Sadang 4-dong, multi-family and multi-household buildings that are over 30 years old constitute the highest percentage, with buildings under 30 years old exhibiting a similar trend. A significant proportion of single-family houses are also over 30 years old. Although the housing types in the two areas differ, the building ages are similar. Figure 3 displays the construction years of buildings in the survey area in ten-year increments. It shows that both areas have a high level of aging, but the types of buildings are quite different.

3.1.3. Building Height and Number of Floors

In Gayang-dong, the maximum height of buildings is 15 floors, which mainly applies to the apartment buildings. Neighborhood commercial buildings mostly comprise five floors or less. In Sadang-dong, aside from the apartments and neighborhood living facilities, the majority of buildings comprise five floors or less. Sadang 4-dong, in particular, is a representative low-rise residential area with a concentration of residential buildings with two–four floors. Along the main streets, there are some distributed commercial facilities ranging from 5 to 10 floors. Figure 4 categorizes the two areas into five-story increments to display their heights, clearly showing that Gayang-dong is a high-rise, high-density area, while Sadang-dong is characterized by low-rise, high-density buildings.

3.1.4. Street and Major Transit Systems

The differences in the street systems of Gayang-dong and Sadang-dong clearly reflect the contrast between a planned apartment area and a low-rise residential area. Gayang-dong, located on flat terrain, follows a superblock format. The roads adjacent to the blocks, including the Gayang 5 apartment complex, are over 20 m wide, and each block has at least one bus stop. In contrast, Sadang-dong features some sloped areas and has access roads within blocks due to its multi-row lot structure. Like other low-rise residential areas, streets under 8 m wide are shared by pedestrians and vehicles. There are four subway stations nearby, providing easy access to Lines 4, 7, and 2. Additionally, there are numerous bus stops in the area.
Figure 5 illustrates the width of roads and the street system, with the locations of subway stations and bus stops all marked within a 500-meter radius from the subway stations. Gayang-dong features a superblock system, while Sadang-dong has a finer grid street structure. However, both areas are shown to have easy access to public transportation.

3.1.5. Park and Green Space

In Gayang-dong, each complex has at least one park located within the superblock, and linear green spaces are provided along the main roads, showcasing its characteristics as a planned city. In contrast, Sadang-dong has Gwanaksan Park located at the southwest boundary with Gwanak-gu and the National Cemetery to the northwest, due to its natural terrain. However, within the residential area of Sadang 4-dong, a shortage of neighborhood parks that residents can easily access on foot as shown in Figure 6.

3.2. Key Characteristics of Residential Spaces

3.2.1. Gayang 5 Apartment Complex

The Gayang 5 apartment complex is located at 36 Yangcheon-ro 57-gil, Seoul, and consists of a total of 16 buildings. It is the largest rental apartment complex in Gayang-dong with a total of 2412 rental units. The supply type is permanent rental, and many residents have lived there continuously since their initial move-in. As shown in Figure 7, the apartments are typically corridor-style, and all units are small, under 60 m2. Single-person households can only reside in units that are 36.3 or 46.2 m2. The maintenance of common areas and external spaces is handled by a contracted management company, and environmental improvements are made by renovating the interior before a new tenant moves in. A resident council exists, and the management office is located within the complex. Regular maintenance of the apartments ensures that building upkeep and repairs do not pose significant issues.
The 36.3 m2 floor plans consist of a combined bedroom and living room, a small bedroom, and a bathroom. The kitchen is part of the hallway leading to the bedroom. The larger bedroom, which has a balcony, faces south or east, while the smaller bedroom faces the hallway. Due to the building being over 30 years old, the bathroom is cramped, causing inconvenience in daily life. The heating system is district heating, and since the main orientation is south or southeast, there was no significant feeling of cold during our visit in November. Visits to the apartment complex were conducted twice, in summer and fall. During the summer visit, it was observed that some residents kept their front doors open for ventilation, indicating a relatively safe and open environment. However, the cleanliness of the common hallways, such as the presence of stored items, varied significantly depending on the location.

3.2.2. Sadang 4-Dong Low-Rise Residential Area

During in-depth surveys conducted in Sadang-dong, social workers visited around ten single-person households that received meal delivery services. Many of these households were found to be living in semi-basement spaces (garden-level). The ground floors of multi-family homes in Sadang-dong are mostly situated 45 cm to 90 cm below ground level. The entrances to these ground-floor units were either separated by individual gates or, if shared with other units, the entrances were completely independent from the upper floors, preventing social interaction with other residents. The access paths to these entrances were either sloped or consisted of uneven steps. In some cases, long or spacious entryways were used for other purposes or decorated with various potted plants.
Most semi-basement dwellings consisted of two bedrooms, a bathroom, and a space serving as both the living room and kitchen. The living room was primarily used as a passageway rather than being a separate reception area. Although the semi-basement level is not very deep, the protruding balconies from the upper floors shade the living spaces, and the walls limit natural ventilation, leading to mold issues in some units. Additionally, during the heavy rains in the summer of 2022, some garden-level dwellings in Sadang-dong experienced flooding. Figure 8 shows an example of a semi-basement home in Sadang-dong, where the windows are relatively smaller compared to those in Gayang-dong, and the interior condition varies significantly among individuals.
The living spaces were generally larger than those in Gayang-dong. However, level differences at the entrance and numerous thresholds and level changes within the units posed physical challenges for the elderly. The degree of maintenance and cleanliness of the living spaces varied significantly from building to building and among individuals. In densely developed, aging low-rise residential areas, the absence of a regional building management system makes it difficult to expect a consistent level of maintenance.

4. Analysis of Survey Content by Region

4.1. Overview of Survey Organization and Statistical Analysis

For the statistical analysis of the survey, frequency analysis and cross-tabulation (Chi-square test, and Fisher’s exact test if more than 20% of the cells had an expected frequency of less than 5) were conducted to compare the general questions between the two regions. To compare the satisfaction with living space and the region, a T-test was performed. Additionally, since there were gender differences in solitary deaths, a separate T-test was conducted to determine whether there were gender differences in the major survey items.

4.2. Comparative Analysis of Respondent Characteristics

Although the two regions differ significantly in housing types, the survey was conducted based on comprehensive social welfare centers, so there were no statistically significant differences in the respondents’ gender, age group, length of residence, or employment type. The survey results for the two areas regarding respondent characteristics and analysis are as presented in Table 3. In both regions, the proportion of respondents in their 80s was the highest, with Gayang-dong at 53.06% and Sadang-dong at 70.21%. The proportion of female respondents was overwhelmingly high in both regions. Both regions also had a high proportion of long-term residents, with 56.25% in Gayang-dong and 63.04% in Sadang-dong having lived there for over 20 years. However, in the Gayang 5 apartment complex, the proportion of medical aid recipients was 93.33% and the proportion of unemployed individuals was 95.92%, both significantly higher than in Sadang-dong, and these differences were statistically significant.
While both regions have many single-person households with long residence periods, there were clear differences between the regions regarding continuous residence and desire to move. In the Gayang 5 apartment complex, 91.67% of residents wished to continue living there, compared to only 62.5% in Sadang-dong. Similarly, regarding the desire to move, 10.42% of respondents in Gayang-dong and 41.30% in Sadang-dong expressed a desire to move. This indicates that the residential stability in the rental apartment area of Gayang-dong is significantly higher, which is likely to be reflected in greater residential satisfaction as well. Although residents live in rental apartments due to economic reasons, the stability and satisfaction with their living space are crucial as they form the foundation for leading a socially healthier life. This finding highlights the importance of ensuring stable and satisfactory living conditions for low-income residents to promote their overall well-being.

4.3. Living Space

To assess the living environment and satisfaction of single-person households, a total of 14 questions were surveyed, with additional questions given to understand specific situations.

4.3.1. General Information on Living Space

The questions related to residential spaces ranged from determining general information to identifying the physical characteristics of residential spaces to gleaning the degree of environmental control exerted in maintaining a comfortable environment. Since AIoT devices for measuring the environment of indoor spaces assess environmental indicators such as temperature, humidity, and illumination, it is important to understand the influence of the presence or absence of windows and the degree of control of indoor temperature. Additionally, maintaining indoor comfort is crucial, as inadequate control of indoor temperature during extreme weather conditions, such as summer heatwaves or winter cold spells, can often lead to fatal outcomes. The degree to which indoor comfort is maintained significantly impacts residents’ health and well-being.
General information on living spaces is summarized in Table 4. In Gayang-dong, all but one of the respondents were residents of the Gayang 5 permanent rental housing complex, and 87.5% of them rented with a deposit, as the complex has a general social welfare center. In Sadang-dong, 41.67% of all respondents rented with a deposit and 35.42% rented, with very few respondents living in their own homes. Sadang-dong is a dense low-rise residential area, with 43.75% of respondents living underground or semi-underground, and 22.92% of respondents answered that the main orientation of their living space was north, northwest, or northeast. In terms of the size of the living space, 52.08% of the respondents live in an apartment that is less than 33 m2, which is smaller than a single apartment in Gayang 5. Due to the structure of the apartment, there are no windows in the kitchen and restroom of apartments in Gayang 5, while apartments in Sadang-dong have windows for ventilation in the kitchen and restroom, even if they are small in size, showing a clear difference.
In terms of heating, apartments in both areas were mainly heated by underfloor heating and supplemented with electric floorboards. In terms of cooling, there were regional differences, with the highest proportion of both fans and air conditioners (46.94%) being found in the Gayang 5 apartment complex, but the highest proportion of fans alone (37.5%) being found in Sadang-dong. When asked whether the heating and cooling is comfortable, 75.51% of residents in Gayang-dong answered positively, while only 45.83% of residents in Sadang-dong answered positively. Although the number of medical benefit recipients is higher in Gayang 5, it can be seen that they actually control the indoor environment more comfortably because the housing cost is relatively low, and they receive more welfare support. In low-rise residential areas like Sadang-dong, insufficient indoor environment control can act as a factor that increases the risk of solitary deaths. Particularly, sleeping in an unheated space after consuming alcohol can lead to fatal outcomes, and such cases are frequently found among many single-person male households.

4.3.2. Satisfaction with Living Space

Table 5 shows resident satisfaction with 12 individual items related to the physical convenience and comfort of living spaces, as well as overall satisfaction. With the exception of opinions on the convenience of the bathroom and kitchen and issues with aging facilities and malfunctions, there were significant statistical differences between the two regions in all items. General information on living spaces is summarized in Table 4.
Satisfaction among residents in Gayang-dong was significantly higher, which indicates that, despite being over 30 years old, the living environment, performance, and space management of the rental apartments were superior. In the Gayang 5 apartment complex, many residents mentioned issues with the location of the washing machine due to the cramped bathroom.
Overall, despite some challenges with bathroom and kitchen convenience, Gayang-dong’s rental apartments offered superior living conditions and better management, leading to higher satisfaction among residents. On the other hand, a significant number of Sadang-dong residents live in semi-basement spaces, where the limited distance between buildings results in poor natural lighting and ventilation. The lack of natural light can contribute to feelings of depression, impacting mental health. Additionally, physical conditions such as stairs and level differences within indoor spaces can lead to safety accidents, such as falls.

4.3.3. Satisfaction with Neighborhood

Questions about safety, convenience and facility accessibility, and comfort were asked in relation to the residential area and its surroundings. As shown in Table 6, Table 7 and Table 8, apart from pedestrian safety, security facilities, and waste disposal methods, all items showed statistically significant differences. Regarding safety, respondents in Sadang-dong were more negative about soundproofing and privacy protection as shown in Table 6. This is likely due to the situation of residents living in ground-floor or semi-basement units, unlike in apartments.
The urban analysis results in Section 3.1 indicate that both regions have good accessibility to welfare centers, hospitals, commercial facilities, and public transportation. However, as shown in Table 7, there is a significant difference in residents’ satisfaction with the convenience of their residential locations and facility accessibility between the two regions. This suggests that lower satisfaction with the living spaces themselves somewhat affects overall satisfaction with the residence and surrounding area. The results in Table 8 indicate that issues such as unseparated pedestrian and vehicular spaces, a lack of green spaces, and limited common areas, which are characteristic of low-rise residential areas, are directly reflected in the survey results.

4.4. Understanding of Physical Health

The survey results regarding understanding of physical health are summarized in Table 9. In terms of subjective health assessment, respondents in Gayang-dong reported that they were in poorer health and that this affected their daily lives. However, there were no statistical differences between the two groups regarding medication treatment, disability status, or dementia. Therefore, these aspects might have been influenced by psychological or subjective factors. Additionally, since this survey did not inquire about lifetime medical history or detailed health conditions, further research on this matter is deemed necessary.
The largest number of respondents in both areas stated they visited the hospital less than 12 times a year (24.44% in Gayang-dong and 35.42% in Sadang-dong), and in Sadang-dong, 35.42% also reported visiting the hospital fewer than six times a year. Regular visits to nearby university hospitals for chronic illnesses were common, and many mentioned receiving pain treatments at local clinics such as traditional Korean medicine clinics. During the survey, it was observed that the Korean medicine clinics also serve as places for social interaction.
Regarding physical disabilities, 26.53% of respondents in Gayang-dong and 23.91% in Sadang-dong reported having disabilities, showing very similar results in both areas. Physical disabilities can worsen with aging and may become a major factor leading to solitary deaths. When asked if there was someone to accompany them to the hospital in an emergency, 61.22% of respondents in Gayang-dong and 47.92% in Sadang-dong answered affirmatively. In both regions, family members were the first choice (53.57% in Gayang-dong and 50% in Sadang-dong), followed by social workers, indicating the importance of reliance on and psychological bonds with social workers.

4.5. Understanding of Overall Living Conditions

When examining the process leading to solitary deaths, it is often found that depression or alcohol addiction prevents individuals from maintaining a regular daily routine. This gradually leads to neglecting self-care and increasing social isolation. Moreover, single-person households face various emergency situations at home, ranging from physical issues like fires and gas leaks to medical incidents such as heart attacks or falls. The survey aimed to comprehensively understand the regularity of daily life, alcohol and smoking habits, physical activity levels, mental health aspects such as depression or insomnia, the ability to handle emergency and urgent situations, and the inconveniences of living alone.
As shown in Table 10, in questions about overall daily life, such as the number of meals, issues with insomnia, experience of emergencies, concerns about urgent and emergency situations, and having someone who can provide financial support in case of problems, there were no significant differences between the two groups. Both groups reported eating more than two meals a day, mainly cooking for themselves or using welfare services such as senior dining centers. Given the high proportion of elderly respondents, 26.53% in Gayang-dong and 25.33% in Sadang-dong reported having experienced an emergency. In emergencies, 79.92% in Gayang-dong and 82.98% in Sadang-dong had someone they could turn to for help. On the other hand, 44.9% and 39.58% of respondents, respectively, reported feeling fear and burden in dealing with emergencies or urgent situations, indicating a significant psychological burden.
Feelings of depression or hopelessness were more prevalent among respondents in Gayang-dong. This trend was also observed in questions about the extent of self-harm or suicidal thoughts and problems with behavior as seen by others. This situation is similar to the more negative subjective health assessments given by respondents in Gayang-dong, as seen in Section 4.4. Residents of permanent rental housing must demonstrate that their economic situation is below a certain level or that their health is too poor to sustain employment. This requirement likely reflects their negative health evaluations. Additionally, the survey reaffirmed that mental health support is a crucial factor. Alcohol consumption and smoking were also higher in Gayang-dong, likely due to the higher number of male respondents in that area.

4.6. Understanding of Social Interactions

Since they live alone as single-person households, social interaction is a crucial aspect of preventing solitary deaths. The survey participants do receive meal-related services from local social welfare centers, which provides them with at least minimal social interaction. As shown in Table 11, in both regions, the most common response regarding interaction with family members living separately was that they rarely communicated, with 26.5% in Gayang-dong and 26.8% in Sadang-dong. The next most common responses were 4–8 times a year and 1–2 times a week, showing similar frequencies.
Regarding interaction with neighbors or visiting neighbors/friends’ homes, respondents in Gayang-dong were more active. This is likely due to more frequent interactions among neighbors living in the same apartment complex. It can be inferred that the more varied living conditions and poorer internal environments of low-rise residential areas also affect visitation. In contrast, interactions with friends outside of the neighborhood showed significant individual differences rather than group differences. In Gayang-dong, 25.53% met friends almost daily, compared to 33.33% in Sadang-dong. However, those who rarely met friends comprised 36.17% in Gayang-dong and 41.67% in Sadang-dong, indicating considerable variation based on individual preferences or circumstances. This indicates that social interaction is greatly influenced by individual tendencies, requiring more careful consideration. It confirms that promoting social interaction is a particularly challenging area.

4.7. Understanding of Public Welfare

As shown in Table 12, there were differences in the perception and satisfaction with public welfare between the two regions. Respondents living in Sadang-dong used more welfare programs and community activities and reported higher satisfaction. This indicates that user satisfaction varies depending on the number of programs and frequency of use at each welfare center. Despite all respondents benefiting from services such as senior dining centers or meal delivery services provided by the comprehensive social welfare centers, it is surprising that many said they knew little or nothing about welfare programs for single-person households or vulnerable groups.

4.8. Intent to Use the AAL Support System

The environmental data measurement devices for the AAL support system need to be installed in key areas within the living spaces and must be capable of data transmission. The necessity for an emergency system for single-person households was found to be high in both regions. As shown in Table 13, many households did not have Wi-Fi at home. There was a difference in smartphone usage and willingness to use the service between the two regions: 79.17% of respondents in Gayang-dong and 56.25% in Sadang-dong used smartphones. This indicates that, although respondents in Gayang-dong living in permanent rental housing have objectively lower income levels, property, and health status, the lower cost of rental housing and various welfare benefits provide them with more disposable income. Regarding the willingness to use the AAL support system, 59.20% of respondents in Gayang-dong expressed willingness, compared to 39.59% in Sadang-dong. In public rental apartments, it can be inferred that the experience of various forms of support has a positive effect. The standardized indoor environment also provides a conducive setting for data collection.

4.9. Analyzing Differences in Respondents by Gender

There is a higher frequency of cases of solitary death among men than among women. Therefore, a separate gender frequency analysis was conducted on key items related to overall life. As shown in Table 14, the analysis revealed that men had higher frequencies and intensities of drinking and smoking compared to women. For alcohol consumption, 57.14% of men and 89.86% of women reported not drinking at all. Among men, 14.29% drank 2–3 times a week, and 4.29% drank more than 4 times a week. Among those who drank more than twice a month, 17.86% said they consumed 5–6 drinks per session, and 10.71% said they drank 1–2 drinks per session. Regarding smoking, 86.71% of men and 14.29% of women were smokers, with significant variation in the amount smoked per individual.
Additionally, statistical analyses were conducted on factors that could affect social isolation and solitary deaths, such as feelings of depression or hopelessness, thoughts of self-harm or suicide, sleep disorders, fear of emergency situations, and willingness to use AAL systems. However, no significant differences were found between men and women in these areas. Consequently, since alcohol consumption showed the most significant gender difference and the solitary death rate among alcoholics is high, it is necessary to understand the drinking habits of single middle-aged men.
Table 15 presents the gender-based results regarding the intention to use AAL services, showing no significant differences between men and women.

4.10. Key Insights from the Seoul Solitary Death Status and Survey for Achieving the UN Sustainable Development Goals (SDGs)

4.10.1. Identifying At-Risk Groups and Tailoring Support by Gender (Aligned with SDG 3, Good Health and Well-Being, and SDG 10, Reduced Inequalities)

Research by the Seoul Welfare Foundation in 2021 found that 69.4% of the 1139 reported solitary deaths in Seoul were men, predominantly among those in in their 60s, followed by those in their 50s. This age and gender disparity underscores the critical need to focus on men’s health and social services, aligning with SDG 3’s aim to ensure healthy lives and promote well-being for all at all ages. Causes of death were primarily due to natural causes at 72.5%, unknown at 22.4%, and suicide at 4.3%. The prevalent diseases among the deceased were hypertension and diabetes, with men notably suffering from alcoholism, liver diseases, ischemic heart disease, and cerebrovascular diseases, while women were mainly affected by dementia and other mental disorders related to aging. The significant differences in the age and causes of solitary deaths between genders are evident.
Survey responses showed no significant gender differences in most categories except in alcohol consumption and smoking, which were notably higher among men. Diseases related to alcohol abuse, which are prevalent in male deaths, are critical variables in identifying at-risk groups. The gender-specific risks and outcomes indicate a need to address inequalities in health (SDG 10), ensuring that both men and women receive equitable access to health and social support systems that are responsive to their specific conditions. For men, housing issues and alcoholism are vital concerns, while support systems are crucial for women.
Men living alone in their 50s and 60s in multi-family homes or boarding houses are likely to have more severe and poorer housing conditions than survey respondents within the welfare service network. Many live alone due to divorce, job loss, or business failure, experiencing consecutive economic failures and, in the worst cases, leading to self-neglect and death in social isolation. Middle-aged Korean men tend to resist dependency on external support and are less exposed to public support systems, increasing their risk of solitary death. The proactive identification and support of at-risk groups through a triad of Administrative Welfare Centers, Single Household Support Centers, and Centers for Economic Independence for the middle-aged, along with institutional use and support of private social networks, are essential. The minimum care support that is received through landlords, who are often the closest point of contact with single-person households, can serve as one example.

4.10.2. Improving Living Environments and Housing Cost Support (Aligned with SDG 11, Sustainable Cities and Communities and SDG 3)

Surveyed single-person households mostly reside long-term in one area, with a significantly higher permanence in rental housing. The primary reason for wanting to move cited by many respondents was issues with internal facilities and space. The internal facilities of low-rise residential areas where socially vulnerable populations live are outdated, cramped, and have issues with uneven structures, daylight, ventilation, and temperature control, necessitating improvements through housing improvement projects or eco-friendly remodeling support. Issues with internal spaces can lead to emergency incidents like falls for elderly people, and problems like leaks or mold can cause respiratory diseases like pneumonia or asthma.
Meeting the need for improvements in housing infrastructure—such as better ventilation, daylight access, and temperature control—will not only enhance the sustainability and livability of these communities (SDG 11) but will also mitigate the health risks associated with poor living conditions, such as respiratory diseases and accidents. Addressing these issues is also fundamental in reducing the health disparities and enhancing the quality of life for these populations, reinforcing the commitments of SDG 3.
The high percentage of residents in single-person households in low-rise residences who are unable to afford adequate heating and cooling indicates an increased risk of solitary deaths, particularly during summer and winter due to the vulnerability of aged houses to extreme temperatures. Thus, expanding the eligibility, scope, and amount of support for the energy voucher system is necessary. In particular, the maximum support amount for summer cooling costs is currently too low, at KRW 30,000 per year, requiring reassessment given the increasing rates of heat-related illnesses indoors.

4.10.3. Customized Community Approaches and Strengthening Residential Welfare (Aligned with SDG 11 and SDG 10)

According to 2020 and 2021 data on solitary deaths in Seoul, 14.2% of cases occurred in Gangseo-gu and 12.6% of the cases occurred in Jungnang-gu, with over half of the deaths occurring in just five districts. These areas commonly house socially vulnerable populations in aged low-rise residences. The frequent occurrence of solitary deaths in these areas can psychologically affect neighbors, indicating that the issue of solitary deaths is becoming regionalized.
The frequent occurrence of solitary deaths in certain districts highlights the necessity of regionalized and customized approaches to urban planning and community welfare, which is a core aspect of SDG 11. These approaches aim to transform aged low-rise residential areas into more inclusive, safe, resilient, and sustainable environments.
Survey results also show lower residential satisfaction and ongoing environmental degradation in older low-rise residential areas compared to public rental apartment areas, with Sadang-dong being an example despite its high rents due to its favorable location in Seoul, showing economic constraints in living expenses and allowances. Residents of single-person households in low-rise areas often wish to move to affordable rental apartments but are unable to due to eligibility issues.
Increasing public-owned rental housing in low-rise areas and activating shared spaces within villages for community interaction are necessary policy approaches. Socially vulnerable populations face economic limits in engaging in social interactions in commercial facilities like cafes or restaurants, and small, walkable third places can serve as healthy social network hubs. By activating shared spaces within these communities for greater interaction and strengthening the social networks through accessible and inclusive public spaces, the strategies contribute to building social cohesion and enhancing the social fabric of these areas. Moreover, these initiatives promote reduced inequalities (SDG 10) by ensuring that all residents, regardless of their socioeconomic status, have equal opportunities to benefit from improved urban environments and social support structures. Additionally, strengthening the distribution of social and rental housing at the national level is crucial for residential welfare.

5. Conclusions

Solitary deaths can be viewed as a form of social death resulting from social isolation and the breakdown of human relationships. Various factors influence solitary deaths, including demographic factors, community factors, disease factors, welfare service factors, and social network factors, all of which involve diverse and complex variables. This study conducted a survey of 100 single-person households from socially vulnerable groups as a foundational study for developing a system to prevent solitary deaths. The statistical analysis results revealed differences between the two regions with different housing types in key areas that could directly or indirectly influence the occurrence of solitary deaths. The main findings are as follows.
Firstly, low-rise residential areas, densely populated with multi-family and multi-household homes, had poor residential environment performance due to increased density without the expansion of infrastructure such as roads, parks, and social overhead capital (SOC); these factors are attributable to their initial development as single-family home areas. Over 43% of single-person household respondents in Sadang-dong lived in basements or semi-basements, and many of their main living spaces did not face south. Although both regions have a high degree of building aging, single-person households in Sadang-dong reported significantly lower residential and regional satisfaction compared to Gayang-dong and had a higher desire to move, indicating undesirable residential stability. Frequent relocations make it difficult to establish community ties and social relationships with neighbors. Therefore, it has been confirmed that separate support and management are needed for low-rise residential areas.
Secondly, many basement or semi-basement units in Sadang-dong had separate entrances, and due to certain factors, such as the protrusion of upper balconies, the entrances were difficult to identify. This made it hard for neighbors to know whether residents were entering or exiting or if an emergency had occurred. This situation could particularly impact social interactions. Although high-rise rental apartments are uniform, they have external spaces and parks, and transitional spaces from the urban streets to individual housing units are well-structured. This creates a favorable environment for social interaction.
Thirdly, it is a reality that single-person households in Gayang-dong living in permanent rental housing have lower income levels and fewer assets compared to those in Sadang-dong. However, Gayang-dong residents reported experiencing better conditions regarding the presence and use of air conditioners and the comfort of their indoor environments. This indicates that lower rent, various government subsidies, and regularly managed residential environments by the management office are key factors in maintaining a more comfortable indoor environment. It has been found that low-rise residential areas particularly require environmental management at the regional level.
Fourthly, regarding health status, although subjective evaluations of personal health differed, about 25% of respondents in both regions reported having a disability, and 25% had experienced an emergency or urgent situation at home. Apart from family, social workers were the most commonly cited source of help during emergencies in both regions.
In terms of mental health aspects such as feelings of depression and hopelessness and thoughts of self-harm or suicide, respondents from Gayang-dong reported more difficulties. This can be inferred as a difference stemming from their life histories, and it is an aspect that should be specifically considered in the prevention of solitary deaths.
Fifthly, social activities and visiting neighbors were higher among respondents in Gayang-dong. The Gayang 5 apartment complex rental housing has elevators, and each unit is connected by a corridor, making it easier for elderly residents to move around. Although the cleanliness and organization of common spaces vary by floor and building, the fact that residents live in relatively well-maintained single-floor apartments of 36.3 m2 and receive good management services suggests that these factors facilitate easier neighbor visits.
Sixthly, residents of permanent rental housing were relatively more exposed to various social welfare services and showed a more open attitude towards using new AAL services. With a higher ownership rate of smartphones, they had greater potential access to IoT-based solitary death prevention services.
Seventhly, when further statistical analysis was conducted to understand the differences between men and women regarding overall living conditions, there were no significant gender differences except for alcohol consumption and smoking. Alcohol addiction is a critical issue as it is the second most related condition to solitary death among men, following diabetes, indicating the importance of addressing this issue.
This study confirmed significant differences between regions in factors that can influence the prevention of solitary deaths, such as urban environmental characteristics, connectivity and visual openness between households within buildings, the ability to control appropriate indoor environments, and the frequency of social interactions. Although permanent rental housing complexes that are over 30 years old showed advantages in residential safety and building maintenance, resulting in higher residential satisfaction and increased social interactions, single residents in multi-family and multi-unit housing had poorer living conditions. This indicates a need for more meticulous services such as enhanced heating and cooling subsidies, strengthened care services, and improved social networks. On the other hand, while residents of permanent rental housing are generally satisfied with various welfare benefits, including their living spaces, they are more vulnerable in terms of mental health, experiencing higher levels of depression and suicidal ideation. The study reaffirms the necessity for region-specific strategies and screening tools for the prevention of solitary deaths.
The survey was conducted focusing on individuals aged 60–80 who benefit from social welfare services, comparing two regions. This led to a limitation as only a minority of men in their 50s and 60s, who are the demographic most affected by solitary death, participated. Future research should expand both the geographical area and the age range to better understand the characteristics of the subjects and the regions, and to identify additional risk factors linked to solitary death, thereby laying the foundation for the development of a comprehensive solitary-death-prevention system.
Additionally, expanding the scope of research to include countries like Japan and Western nations could be beneficial. It would be meaningful to conduct comparative studies through surveys on the attitudes, satisfaction with life, and perceptions of loneliness among elderly individuals living alone, as well as their residential environments and welfare support. While the global trends of increasing single-person households, aging, loss of humanity in a digital society, and social isolation are similar, differences may arise from variations in culture, lifestyle, and social networks. Understanding the impact of sociocultural factors on quality of life could lead to more comprehensive policy recommendations.

Author Contributions

Conceptualization, H.-J.K. and H.J.M.; Methodology, Interview, and Survey: H.-J.K., J.-H.P. and N.-Y.P.; Statistical Analysis, J.-H.P. and N.-Y.P.; Investigation, H.-J.K.; Writing and Editing, H.-J.K. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by Korea Planning & Evaluation Institute of Industrial Technology funded by the Ministry of the Interior and Safety (MOIS, Korea) [Project Name: Development and Demonstration of AIoT-based Customized Solitary Death Prevention System for Vulnerable Groups/Project Number: RS-2023-00255160], and supported by the Korea Institute of Energy Technology Evaluation and Planning (KETEP) and the Ministry of Trade, Industry & Energy (MOTIE) of the Republic of Korea (No. 20212020800120).

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Dankook University (protocol code DKU 2024-06-015-004/28 August 2024).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data that support the findings of this study are not publicly available due to privacy and ethical restrictions and are available from the corresponding author upon reasonable request.

Acknowledgments

All figures and tables are created by authors unless otherwise noted.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. (a) Gayang 5 apartment complex location and its neighborhood; (b) Sadang 4-dong low-rise residential area location and neighborhood.
Figure 1. (a) Gayang 5 apartment complex location and its neighborhood; (b) Sadang 4-dong low-rise residential area location and neighborhood.
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Figure 2. (a) Gayang 5-dong building use map; (b) Sadang 4-dong building use map.
Figure 2. (a) Gayang 5-dong building use map; (b) Sadang 4-dong building use map.
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Figure 3. (a) Gayang 5 complex building age; (b) Sadang 4-dong building age.
Figure 3. (a) Gayang 5 complex building age; (b) Sadang 4-dong building age.
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Figure 4. (a) Gayang 5 complex area building number of floors; (b) Sadang 4-dong building number of floors.
Figure 4. (a) Gayang 5 complex area building number of floors; (b) Sadang 4-dong building number of floors.
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Figure 5. (a) Gayang 5 complex street street width and system; (b) Sadang 4-dong street width and system.
Figure 5. (a) Gayang 5 complex street street width and system; (b) Sadang 4-dong street width and system.
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Figure 6. (a) Gayang 5 complex park and green space; (b) Sadang 4-dong park and green space.
Figure 6. (a) Gayang 5 complex park and green space; (b) Sadang 4-dong park and green space.
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Figure 7. (a) Gayang 5 apartment plan (36.3 m2); (b) Gayang 5 complex welfare center and residential buildings; (c) hallways; (d) entrance way and main room ahead.
Figure 7. (a) Gayang 5 apartment plan (36.3 m2); (b) Gayang 5 complex welfare center and residential buildings; (c) hallways; (d) entrance way and main room ahead.
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Figure 8. (a) Sadang 4-dong semi-basement unit plan example; (b) door-to-door driveways; (c) main room; (d) bathroom.
Figure 8. (a) Sadang 4-dong semi-basement unit plan example; (b) door-to-door driveways; (c) main room; (d) bathroom.
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Table 1. Survey items on solitary death (Ministry of Health and Welfare, Solitary Death Survey Design Study, 2021, p. 113).
Table 1. Survey items on solitary death (Ministry of Health and Welfare, Solitary Death Survey Design Study, 2021, p. 113).
SectionsSurvey Items
Household and demographic characteristicsHousehold type
Age/Gender
Life history changesExperiencing changes in family relationships
Number of moves
Number of job changes
Residential vulnerabilityResidence types/Housing ownership
Economic activityCurrent status
Professional status
Experience of business failure
Economic situationDegree of economic hardship (subjective)
Loans/Debt
Unpaid utility and cell phone bills, etc.
Illness and mental healthChronic illnesses and diseases
Disability status
Depressive disorders
Health behaviors and psychological conditionsNutritional intake levels
Alcohol-related disorders or alcohol dependence–addiction
Psychiatric stress (work, school, etc.)
Suicide-related behaviors, such as suicidal thoughts and attempts
Perceived likelihood of solitary death
Social networksRelationship satisfaction
Interaction with family
Having a counselor or financial support for non-family concerns
Going out for non-essential purposes (a number of times)
Number of people met, texted, or called outside of family
Willingness to engage in social relationships
Public servicesSupport for public services
Table 2. Items of survey questionnaire.
Table 2. Items of survey questionnaire.
SectionsSurvey Items
Basic and personal informationGender/Age
Neighborhood Area
Years lived in a single-person household
Employment status
Reason for choosing current residence and desire to continue
Residential spaceBuilding Type/ownership
Year construction was completed
Duration of residence
Floor level of residence, size
Living space info (orientation, number of rooms, size, windows, etc.)
Heating/cooling methods and comfort level
Satisfaction with physical convenience and comfort
Residence and surrounding areaSatisfaction with safety
Satisfaction with convenience of location and access to facilities
Satisfaction with comfort
HealthHealth conditions
Medication status
Physical disability
Possession of a long-term care license
Dementia
Number of hospital visits and presence of a companion
Lifestyle in generalPrimary living space
Frequency of going out
Meal quality and regularity
Alcohol, tobacco dependence
Activity status
Emotional status
Emergencies response method
Social interchangeNumber of social interactions
Participation in group activities or gatherings
Awareness of public welfareAwareness of or participation in community programs
Desired welfare systems
Satisfaction with public welfare
Intention to use AAL support system servicesNeed for services
Ownership of smartphone/WIFI system
Intention to use service
Expectations
Table 3. Respondent characteristic and analysis.
Table 3. Respondent characteristic and analysis.
QDivisionFrequencyStatistics
1GenderSustainability 16 07740 i001x2 = 0.6916
df = 1
p = 0.4056
2AgeSustainability 16 07740 i002x2 = 2.9929
df = 2
p = 0.2239
3Years lived in a single-person householdSustainability 16 07740 i003x2 = 2.874
df = 4
p = 0.5791
4Employment
status
Sustainability 16 07740 i004x2 = 5.189
df = 1
p = 0.0227
5Employment
type
Sustainability 16 07740 i005x2 = 7.388
df = 3
p = 0.061
6Main activity of workSustainability 16 07740 i006x2 = 10.554
df = 3
p = 0.014
7Healthcare
beneficiaries
Sustainability 16 07740 i007x2 = 8.158
df = 1
p = 0.0043
8Reasons for choosing current residence
(multiple answers allowed)
Sustainability 16 07740 i008x2 = 35.189
df = 16
p = 0.004
9Desire to
continued
residence
Sustainability 16 07740 i009x2 = 11.5577
df = 1
p = 0.0007
10Willingness to
relocate
Sustainability 16 07740 i010x2 = 11.7866
df = 1
p = 0.0006
10-1Reason for wanting to relocate
(multiple answers allowed)
Sustainability 16 07740 i011x2 = 18.305
df = 7
p = 0.011
Table 4. General information on living space.
Table 4. General information on living space.
QDivisionFrequencyStatistics
1Housing typeSustainability 16 07740 i012Fisher’s accurate appraisal
p = < 0.0001
2Housing ownershipSustainability 16 07740 i013Fisher’s accurate appraisal
p = < 0.0001
3Year of constructionSustainability 16 07740 i014Fisher’s accurate appraisal
p = < 0.001
4Duration of residenceSustainability 16 07740 i015x2 = 21.0386
df = 4
p = 0.0003
5Floor levelSustainability 16 07740 i016x2 = 58.8414
df = 3
p = < 0.0001
6SizeSustainability 16 07740 i017Fisher’s accurate appraisal
p = < 0.0001
7Main orientationSustainability 16 07740 i018Fisher’s accurate appraisal
p = < 0.001
8Number of roomsSustainability 16 07740 i019Fisher’s accurate appraisal
p = < 0.0001
8-1Presence of windows in studioSustainability 16 07740 i020Fisher’s accurate appraisal
p = 0.0895
8-2Presence of windows in living roomSustainability 16 07740 i021Fisher’s accurate appraisal
p = < 0.0001
8-3②, ③, ④
→ Presence of windows in bedroom
Sustainability 16 07740 i022Fisher’s accurate appraisal
p = 0.1923
9Kitchen conditionSustainability 16 07740 i023Fisher’s accurate appraisal
p = 0.0576
9-1① → Presence of windows in kitchenSustainability 16 07740 i024Fisher’s accurate appraisal
p = 0.0109
10Bathroom locationSustainability 16 07740 i025Fisher’s accurate appraisal
p = 0.0562
10-1① → Presence of windows in bathroomSustainability 16 07740 i026x2 = 57.2101
df = 1
p = 0.0001
11Heating methodSustainability 16 07740 i027x2 = 7.464
df = 3
p = 0.059
12Cooling methodSustainability 16 07740 i028x2 = 16.318
df = 6
p = 0.012
13Heating/cooling comfort level controlSustainability 16 07740 i029x2 = 8.9621
df = 1
p = 0.0028
Table 5. Satisfaction with living space.
Table 5. Satisfaction with living space.
QPhysical Convenience and ComforttdfpAverage Satisfaction by Question (5-Point Scale)
1Size of living space and number of rooms−2.900950.005Sustainability 16 07740 i030
2Space arrangement and storage space−3.459950.001
3Convenience of bathroom and kitchen−1.809940.074
4Daylight −4.133950.000
5Natural Ventilation−4.066950.000
6Noise−3.071950.003
7Physical performance insulation, condensation, and water leakage−4.26380.60.000
8Air conditioning system−2.950940.004
9Stairs, steps, and thresholds −5.264940.000
10Interior finish and sanitary conditions−3.401950.001
11Facility aging and breakdown−1.837950.069
12Parking space−5.902950.000
13Overall satisfaction with current living space−3.821930.000
Table 6. Satisfaction with the safety of residence and its neighborhood.
Table 6. Satisfaction with the safety of residence and its neighborhood.
Question NumberSatisfaction with the Safety of Residence and NeighborhoodtdfpAverage Satisfaction by Question (5-Point Scale)
1Walking safety−1.204940.232Sustainability 16 07740 i031
2Crime prevention facilities−1.559940.122
3Soundproofing −2.583940.011
4Privacy protection−2.009940.047
5Satisfaction with safety near current residence−2.127930.036
Table 7. Satisfaction with the locational convenience.
Table 7. Satisfaction with the locational convenience.
QSatisfaction with the Locational ConveniencetdfpAverage Satisfaction by Question (5-Point Scale)
1Ease of local accessibility−4.172950.000Sustainability 16 07740 i032
2Convenience of public transportation−3.431950.001
3Distribution and number of commercial facilities−3.492950.001
4Cultural facilities−5.337950.000
5Medical facilities−4.95482.20.000
6Welfare facilities and administrative facilities−3.975930.000
7Satisfaction with the locational convenience of current residence and accessibility to facilities−4.216940.000
Table 8. Satisfaction with the comfort of residence and its surroundings.
Table 8. Satisfaction with the comfort of residence and its surroundings.
QSatisfaction with the Comfort of Residence and Its Surroundings tdfpAverage Satisfaction by Question (5-Point Scale)
1Street environment such as surrounding pedestrian paths−2.749950.007Sustainability 16 07740 i033
2Outside rest area−5.132950.000
3Greenery−4.976950.000
4Light environment (streetlights, surrounding signs, etc.)−2.427950.017
5Vehicle entry and parking environment−4.221940.000
6Common spaces such as hall/lobby/corridor space−2.596950.011
7Garbage disposal method−0.823850.413
8The overall environment around your residence−3.173950.002
9Satisfaction with the comfort of residence and surroundings−3.312940.001
Table 9. Understanding of physical health.
Table 9. Understanding of physical health.
QDivisionFrequencyStatistics
1Health conditionSustainability 16 07740 i034* Fisher’s accurate appraisal
p = < 0.0001
1-2MedicationSustainability 16 07740 i035x2 = 0.4499
df = 1
p = 0.5024
1-3Degree of limitation in daily life due to health conditionSustainability 16 07740 i036* Fisher’s accurate appraisal
p = 0.0002
2DisabilitySustainability 16 07740 i037x2 = 0.0861
df = 1
p = 0.7692
3Elderly long-term care grade holderSustainability 16 07740 i038x2 = 1.1706
df = 1
p = 0.2793
3-1→ Degree of limitation due to dementiaSustainability 16 07740 i039* Fisher’s accurate appraisal
p = 0.129
4Number of hospital visitsSustainability 16 07740 i040x2 = 9.3691
df = 4
p = 0.0525
5Presence of someone to accompany in an urgent hospital visitSustainability 16 07740 i041x2 = 1.7326
df = 1
p = 0.1881
5-1→ Someone to accompany to urgent hospital visit
(multiple answers allowed)
Sustainability 16 07740 i042x2 = 10.788
df = 10
p = 0.374
Table 10. Understanding of daily life in general.
Table 10. Understanding of daily life in general.
QDivisionFrequencyStatistics
1Time spent in residence per daySustainability 16 07740 i043Fisher’s accurate appraisal
p = < 0.0001
2Frequency of going out per one weekSustainability 16 07740 i044Fisher’s accurate appraisal
p = 0.0031
3Number of main meals per daySustainability 16 07740 i045Fisher’s accurate appraisal
p = 0.0348
3-1Method of having meals
(multiple answers allowed)
Sustainability 16 07740 i046Fisher’s accurate appraisal
p = < 0.0001
4Frequency of alcohol consumptionSustainability 16 07740 i047Fisher’s accurate appraisal
p = 0.004
4-1Amount of alcohol consumptionSustainability 16 07740 i048Fisher’s accurate appraisal
p = 0.004
4-2Frequency of consuming more than 1 bottle of soju or 4 bottles of beerSustainability 16 07740 i049Fisher’s accurate appraisal
p = 0.0112
4-3Frequency of inability to stop drinking once started over the past yearSustainability 16 07740 i050Fisher’s accurate appraisal
p = 0.0256
4-4Frequency of inability to perform usual activities due to drinking over the past yearSustainability 16 07740 i051Fisher’s accurate appraisal
p = 0.0294
5Smoking more than 5 packs (100 cigarettes) in your lifetimeSustainability 16 07740 i052Fisher’s accurate appraisal
p = < 0.0001
5-1 (1)Duration of smoking
(if you are currently quitting smoking)
Sustainability 16 07740 i053Fisher’s accurate appraisal
p = 0.0476
5-2
(1)
Duration of smoking
(if you are currently smoking)
Sustainability 16 07740 i054Fisher’s accurate appraisal
p = 0.0025
5-2
(2)
Average amount of smoking per daySustainability 16 07740 i055Fisher’s accurate appraisal
p = 0.599
6-1Number of times in a week engaging in in strenuous activitiesSustainability 16 07740 i056Fisher’s accurate appraisal
p = 0.0046
6-2Number of times in a week engaging in moderate activitySustainability 16 07740 i057Fisher’s accurate appraisal
p = 0.0004
6-3Number of times in a week engaging in walk at least 10 minSustainability 16 07740 i058Fisher’s accurate appraisal
p = < 0.0001
7-1Degree of memory decline compared to one year agoSustainability 16 07740 i059Fisher’s accurate appraisal
p = 0.0009
7-2Degree of decline in daily living compared to one year agoSustainability 16 07740 i060Fisher’s accurate appraisal
p = 0.0006
8-1Feeling distressed by daily activities
compared to usual
Sustainability 16 07740 i061Fisher’s accurate appraisal
p = 0.0011
8-2Loss of appetiteSustainability 16 07740 i062Fisher’s accurate appraisal
p = 0.0061
8-3Difficulty falling asleep, difficulty sleeping well, or sleeping too muchSustainability 16 07740 i063x2 = 1.0228
df = 3
p = 0.7957
8-4Depression/despairSustainability 16 07740 i064Fisher’s accurate appraisal
p = 0.0013
8-5A decrease in speed of movement/speech due to being nervous and restless.Sustainability 16 07740 i065Fisher’s accurate appraisal
p = 0.003
8-6Difficulty of overcoming feelings of depression, even with help and supportSustainability 16 07740 i066Fisher’s accurate appraisal
p = 0.0033
8-7Thoughts of self-harm or suicideSustainability 16 07740 i067Fisher’s accurate appraisal
p = 0.0027
9The most difficult aspect of living alone
(multiple answers allowed)
Sustainability 16 07740 i068Fisher’s accurate appraisal
p = 0.007
10Experience with physical accidents/emergenciesSustainability 16 07740 i069x2 = 0.0124
df = 1
p = 0.9113
11Existence of emergency contact networkSustainability 16 07740 i070x2 = 1.3963
df = 1
p = 0.2373
11-1Availability of emergency contact person
(multiple answers allowed)
Sustainability 16 07740 i071Fisher’s accurate appraisal
p = 0.589
12Fear and burden of handing emergenciesSustainability 16 07740 i072x2 = 0.2807
df = 1
p = 0.5963
13Availability of acquaintances in case of problemsSustainability 16 07740 i073x2 = 0.0167
df = 1
p = 0.8971
Table 11. Understanding of social interaction.
Table 11. Understanding of social interaction.
QDivisionFrequencyStatistics
1Amount of time with family members or relativesSustainability 16 07740 i074* Fisher’s accurate appraisal
p = 0.939
2Number of interactions with neighbors in your residenceSustainability 16 07740 i075* Fisher’s accurate appraisal
p = < 0.0001
3Participating of organizations, meetings, or classesSustainability 16 07740 i076x2 = 0.5343
df = 1
p = 0.4648
3-1Frequency Sustainability 16 07740 i077* Fisher’s accurate appraisal
p = 0.0021
4Number of interactions with acquaintances, excluding neighborsSustainability 16 07740 i078x2 = 2.2286
df = 4
p = 0.6938
5Number of times neighbors/acquaintances visit your home or neighbors/acquaintances visit your homeSustainability 16 07740 i079* Fisher’s accurate appraisal
p = < 0.0001
Table 12. Public welfare system awareness.
Table 12. Public welfare system awareness.
DivisionFrequencyStatistics
1Awareness of welfare systems and community programs for single-person householdsSustainability 16 07740 i080* Fisher’s accurate appraisal
p = 0.0067
2Utilization of welfare systems or community programsSustainability 16 07740 i081x2 = 12.6472
df = 1
p = 0.0004
3Satisfaction levelSustainability 16 07740 i082t = 2.32
df = 48
p = 0.0025
Table 13. AAL: intention to use support system services.
Table 13. AAL: intention to use support system services.
DivisionFrequencyStatistics
1The need for IT-based emergency and safety servicesSustainability 16 07740 i083x2 = 1.046
df = 1
p = 0.3064
2Use of smartphoneSustainability 16 07740 i084x2 = 5.7648
df = 1
p = 0.0164
3Availability of WIFI at homeSustainability 16 07740 i085x2 = 2.7
df = 1
p = 0.1003
4Intension to use AAL servicesSustainability 16 07740 i086* Fisher’s appraisal
p = 0.096
Table 14. Understanding of daily life in general by gender.
Table 14. Understanding of daily life in general by gender.
QDivisionFrequencyStatistics
Understanding of Overall Life Additional Analysis of Items on Drinking, Smoking, Depression, etc.
4Frequency of alcohol consumptionSustainability 16 07740 i087* Fisher’s accurate appraisal
p = < 0.000
4-1Amount of alcohol consumptionSustainability 16 07740 i088* Fisher’s accurate appraisal
p = < 0.000
4-2Frequency of consuming more than 1 bottle of soju or 4 bottles of beerSustainability 16 07740 i089* Fisher’s accurate appraisal
p = < 0.000
4-3Frequency of inability to stop drinking once started Sustainability 16 07740 i090* Fisher’s accurate appraisal
p = < 0.000
4-4Frequency of inability to perform usual activities due to drinking Sustainability 16 07740 i091* Fisher’s accurate appraisal
p = < 0.000
5Smoking more than 5 packs (100 cigarettes) in your lifetimeSustainability 16 07740 i092* Fisher’s accurate appraisal
p = < 0.000
5-1 (1)Duration of smoking
(if you are currently quitting smoking)
Sustainability 16 07740 i093* Fisher’s accurate appraisal
p = < 0.007
5-2
(1)
Duration of smoking
(if you are currently smoking)
Sustainability 16 07740 i094* Fisher’s accurate appraisal
p = < 0.000
5-2
(2)
Average amount of smoking per daySustainability 16 07740 i095* Fisher’s accurate appraisal
p = < 0.000
8-1Feeling distressed by daily activities
compared to usual
Sustainability 16 07740 i096* Fisher’s accurate appraisal
p = < 0.353
8-2Loss of appetiteSustainability 16 07740 i097* Fisher’s accurate appraisal
p = < 0.037
8-3Difficulty falling asleep, difficulty sleeping well, or sleeping too muchSustainability 16 07740 i098* Fisher’s accurate appraisal
p = < 0.765
8-4Depression/despairSustainability 16 07740 i099* Fisher’s accurate appraisal
p = < 0.303
8-5A decrease in speed of movement/speech Sustainability 16 07740 i100* Fisher’s accurate appraisal
p = < 0.846
8-6Difficulty overcoming feelings of depression and hopelessness, even with help and supportSustainability 16 07740 i101* Fisher’s accurate appraisal
p = < 0.429
8-7Thoughts of self-harm or suicideSustainability 16 07740 i102* Fisher’s accurate appraisal
p = < 0.495
12Fear and burden of handing emergenciesSustainability 16 07740 i103x2 = 0.693
df = 1
p = 0.498
Table 15. AAL: intention to use support system services by gender.
Table 15. AAL: intention to use support system services by gender.
QDivisionFrequencyStatistics
Additional Analysis of Intention to Use AAL Support System Services
4Intension to use AAL servicesSustainability 16 07740 i104x2 = 0.004
df = 1
p = 0.563
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MDPI and ACS Style

Kim, H.-J.; Park, J.-H.; Park, N.-Y.; Moon, H.J. Single-Person Households among the Socially Vulnerable Elderly Population: A Comparative Study of Housing, Living Habits, and Social Environments in Selected Neighborhoods of Seoul for the Prevention of Solitary Deaths. Sustainability 2024, 16, 7740. https://doi.org/10.3390/su16177740

AMA Style

Kim H-J, Park J-H, Park N-Y, Moon HJ. Single-Person Households among the Socially Vulnerable Elderly Population: A Comparative Study of Housing, Living Habits, and Social Environments in Selected Neighborhoods of Seoul for the Prevention of Solitary Deaths. Sustainability. 2024; 16(17):7740. https://doi.org/10.3390/su16177740

Chicago/Turabian Style

Kim, Ho-Jeong, Joo-Ho Park, Na-Yeon Park, and Hyeun Jun Moon. 2024. "Single-Person Households among the Socially Vulnerable Elderly Population: A Comparative Study of Housing, Living Habits, and Social Environments in Selected Neighborhoods of Seoul for the Prevention of Solitary Deaths" Sustainability 16, no. 17: 7740. https://doi.org/10.3390/su16177740

APA Style

Kim, H. -J., Park, J. -H., Park, N. -Y., & Moon, H. J. (2024). Single-Person Households among the Socially Vulnerable Elderly Population: A Comparative Study of Housing, Living Habits, and Social Environments in Selected Neighborhoods of Seoul for the Prevention of Solitary Deaths. Sustainability, 16(17), 7740. https://doi.org/10.3390/su16177740

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