As a source of livelihood , an estimate of 70 percent of households living in cities engage in handicrafts, trade or transportation services related to trade. Without a working food distribution system, people need local markets to earn money and survive. While actual monthly salary was two U.S. dollars, an average North Korean earned a total of around 15 dollars a month in 2011. Successful black-market operators and actual capitalistic success stories are rare, however, even if a few former laborers and farmers have become very rich with income of hundreds and even thousands of dollars a month. Annual studies conducted among defectors by the Seoul National University Institute for Peace and Unification Studies revealed, even if the studies may be misrepresentative of the whole population, that little more than half of them received money from the North Korean state. A significant growth of number of the people engaged in private business activities and related bribing was also noted. These markets generate an estimated number of $56.8 million annually in taxes and rent, and have become a larger part of the nation's economy than even the government would like to admit. In 2017, the
Korea Institute for National Unification estimated there were 440 government-approved markets employing about 1.1 million people. A subsequent survey by AccessDPRK, completed in 2022, found that there were at least 477 markets in the country, with 39 new markets constructed since 2011. However, the expansion of vendor stall space declined from 23,000 sq. meters of additional space in 2019 to just 630 sq. meters of additional space in 2021, reflecting the impact of the COVID-19 pandemic on the country's economy.
Food security North Korea suffered from a famine from 1994 to 1999, which killed between two and three million people from starvation and other hunger-related illnesses. The traders smuggle food across the border from China to North Korea for sale. Usually crops are the cheapest right after harvest season. In addition to the typical seasonal changes in the prices of crops, droughts in North Korea may cause severe increase in prices of foodstuffs, and harm people's ability to keep a balanced and nutritious diet. In 2015, the drought tripled the price of potatoes compared to same time in 2014. Rumors of a bad potato harvest coming also caused increase in prices. North Koreans who engage in various kinds of household business also farm private land. The poorest North Koreans, without the ability to start a food stall, usually live through subsistence farming. A significant portion of the North Korean food supply is produced illegally and privately, on small farm plots known as
sotoji (small land). Livestock stalls are a recent addition with markets in large cities being transformed into agricultural markets. Money lending and foreign currency exchange have appeared with growth of the markets. As banks do not really function in North Korea, but in name, the market stalls are used as the main platform for banking transactions. Many people use foreign currency for their savings and those selling more valuable goods often use
Chinese yuan. Taking a loan, to buy expensive goods such as bicycles, has become more common. Even private medical services have appeared in the markets with retired doctors offering their services, and with self-trained
traditional Korean medicine practicers present too. The doctors charge around 10 dollars for a diagnosis, and some doctors fill in prescriptions for people. Many of these doctors had been unable to live on their wages. Black market medical services have been around since the free health care system collapsed in the 1990s. Some officials have themselves been forced to receive help from the same doctors they are supposed to crackdown. ==Role in possible reforms==