With DPRK it seems pretty simple: Are citizens permitted to leave the country of their own accord? The answer of course is no, and that is extremely telling. Combined with choreographed & escort-only tourism, one really has to question it.
My opinion: Odds are likely that it really is a shithole in many ways and in many places (and for many reasons, sanctions included). That said, people will still live their lives within those constraints, because that's what people tend to do. We won't get accurate and verifiable information from their government about citizen health and longevity, causes of death, etc. so OP's propaganda must be taken as just that.
At some point NK's system will fall, and some historians and archeologists will get to do their thing, and we'll gain some more insights.
This was similar to a trick that a few smaller (less serious) hobby-ISPs did back in the days of 14.4k/28.8k modems to take advantage of the "reasonably priced" business plans for ISDN. They'd register multiple businesses at a single address to qualify for the plans, then balance new egress connections across the pool using squid and other magic. Fun times...