Showing papers on "International health published in 1986"

The biological concept of race and its application to public health and epidemiology.

Abstract: The category of race is widely used in public health. Although its significance may be clear-cut in some practical situations, an adequate theoretical construct for the concept of race does not exist. Public health appears to lag far behind the other biological sciences in the effort to grapple with the idea of race and its implications for the nature-nurture question. This paper outlines the current anthropological and social perspective on race, and applies this view to problems of disease epidemiology. It is proposed that uncritical use of the traditional biological concept of race has distorted etiological thinking in public health and has proven an obstacle in the development of effective intervention strategies. The pragmatism of medicine and its isolation from social science may account for much of this backwardness.

Injury in America. A continuing public health problem

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Sociology as Applied to Medicine

Abstract: Part 1: Social Aspects of disease. Society and changing patterns of disease. Social determinants of health and disease. Part 2: Social factors in Medical Practice. Health and illness behaviour. The doctor-patient relationship. Hospitals and patient care. Living with chronic illness. Dying, death and bereavement. Part 3: Social structure and Health. Inequality and social class. Women and health. The health and health care of ethnic minority groups. Older people, health care and society. Part 4: The Social Process of Defining disease. The limits and boundaries of medical knowledge. Deviance, sick role and stigma. Part 5: Organisation of Health Services. Origins and development of the National Health Service. Health professions. Community care and informal caring. Health promotion and the New Public Health. Measuring health outcomes. Organizing and funding health care.

On the limits of expanding health care reform: chronic care in prepaid settings.

Abstract: Health Maintenance Organizations have become a favored vehicle for reform of the American health care system, while controlling costs and assuring quality. But for populations with a high prevalence of chronic disease--the elderly or the mentally ill--HMOs may fall short of meeting needs. Three stages of reform are proposed for adapting the principle of prepayment to better serve enrollees with chronic illness.

Health promotion: a global perspective.

Abstract: The first part of this paper reviews the work of the World Health Organizations Regional Office for Europe undertaken to clarify the relevance of health promotion for all member states and regions. This work led to a definition of "health" as the ability to realize aspirations and satisfy needs and to change or cope with the environment. Health promotion was considered to 1) involve the population as a whole in the context of everyday lives 2) be directed towards action on the determinants of health 3) combine diverse but complementary methods or approaches 4) aim for effective and concrete public participation and 5) involve health professionals. Areas covered by health promotion activities include 1) access to health 2) development of an environment conductive to health 3) strengthening of social networks and social supports 4) promoting positive health behavior and appropriate coping strategies and 5) increasing knowledge and disseminating information. The next section of the paper traces the development of the concept of health promotion from its roots in health education and the third section presents a brief history of public health to contextualize this development. The differences between the old and new approaches to public health are presented (the new role of the health sector is to ensure access to health create advocacy for health and move beyond health care through intersectoral action and public participation) and the new "forcefield" of public health that emerges from a conceptualization of health promotion is described. This forcefield illustrated as a triangle linking healthy public policy health promotion and community action works at all levels and is the framework for the development of appropriate strategies. It is concluded that in many cases public health will have to be reorganized as will the health care system as a whole. Health must be viewed as a social project linked to political responsibilities not as a medical enterprise.

Public health approaches to obesity and its management.

Abstract: Three aspects of obesity combine to make it a compelling public health problem: its seriousness, prevalence, and resistance to change (1-5). The medical risks are substantial. These have been reviewed elsewhere (1-3, 6). Often ignored in this concept of "risk" are the social and psychological hazards of obesity. These can be serious, permanent, and sometimes disabling (5, 7), and are more prominent in the eyes of obese persons than are physical com­ plications. The prevalence of obesity depends on the criteria used to define the condi­ tion, but no less than 15% of adult Americans are obese, with estimates ranging as high as 50% (1, 2). It is not a disorder that yields easily to treatment. The most intensive and costly programs delivered in clinical settings produce significant weight losses in less than half the patients (5, 8). Large-scale public health approaches reach more people, but the impact on individuals is weaker. This gloomy picture has prevailed for years, but the mood is changing. Exciting developments are taking place in conceptual approaches to obesity, in studies of hunger, satiety, and body weight regulation, and in methods for weight reduction, both in the clinic and the community.

Alcohol, Young Drivers, and Traffic Accidents

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Mexican Immigration and Health Care: A Political Economy Perspective

Abstract: This paper examines the case of Mexican immigrants in the United States and their access to medical services within a political economy of health framework. Such an approach stresses that the provision of health care is independent of health factors per se and that access to health care is not equally distributed throughout a population. The first section reviews the three major concepts influencing medical anthropologists working within a political economy framework: the social origins of illness; the allocation of health resources; and fieldwork in Third World countries. The analysis then focuses upon the reasons for limiting immigrants' access to health care, followed by an examination of the socioeconomic characteristics of Mexican immigrants, including an undocumented immigration status, which limit their access to health care. Finally, the consequences of limited access to health services are suggested, including a low utilization of preventive health services resulting from the high cost of care combined with the immigrants' generally low income, lack of medical insurance and fear of using U.S. health services.

Heal Thyself: The Health of Health Care Professionals

Abstract: Health care professionals attend to the health of others. What about their own health? Are they more or less likely to suffer the same ills that afflict those they treat? Are they at risk for any additional health problems? What effect does their health status have on the care they provide? These important questions are receiving increasing attention, as documented in this book. These concerns are not new. The inspiration for the title, "Physician, heal thyself' (Luke 4:23), traces such inquiry at least to the time of the New Testament. Self-scrutiny by the health care profession is not new either. Tradition holds that St Luke was himself a physician. Indeed, the 29 contributors to the current text are health care providers and include physicians, nurses, and dentists. Health care providers are certainly not immune to health problems. The prevailing tone of the 20 chapters of this book is that the

International Health Care Spending

Abstract: Each quarter Health Affairs tracks a significant sector of the health care sphere: national health care spending in Fall, health employment in Winter, health status and health care utilization in Spring, and health care innovation in Summer. In this quarter, Gerard F. Anderson, associate director of the Johns Hopkins Center for Hospital Finance and Management, who wrote on national medical care spending last year, updates his report In tandem with this DataWatch, George Schieber and Jean-Pierre Poullier of the Organization for Economic Cooperation and Development in Paris, present the latest data on international health spending. Lastly, Ross Mullner of the American Hos-pital Association compares data of rural and urban hospital closures.

Health status and health care utilization.

Abstract: In each issue of Health Affairs the trends of a significant quarter of the health sphere are tracked. The schedule is Fall: National Medical Care Spending; Winter: Trends in Health Manpower; Spring...

The Canadian health care system: an overview.

Abstract: I) X 3in Canada is a provincial responsibility, the "national" e n program is really made up of lo provincial and two cseA territorial plans. The provinces enacted their programs to take advantage of the so% cost-sharing of hospital and medical care costs offered by the federal government. Although universal insurance is only 25 years old, it was first discussed in 1919. However, it was not until 1945, after the depression and the second world war, that serious legislative steps were taken. Then the federal government first proposed a national system, based on the United Kingdom model. That model was rejected by the provinces because it was interpreted as a federal incursion into their jurisdictions (1). However, because hospital facilities were insufficient and, in many instances, outdated, the federal government did make planning and construction grants to the provinces. These grants established the concept of federal-provincial cost sharing for health care services. Armed with this promise, Saskatchewan followed by three additional provinces enacted universal hospital insurance plans. They then pressed the federal government to honor its 1945 funding commitment. Federal legislation was finally proclaimed in 1958, and by 1961 all the provinces enacted plans to take advantage of federal costsharing. The next year Saskatchewan adopted a universal medical care insurance plan, and six years later the federal government completed the cycle by offering cost-sharing to the provinces for universal medical care insurance. Although cost-sharing was on a 5o-50 basis, the federal legislation was written so that the subsidies were proportionally greater than 5o% of actual costs for the poorer provinces, and less than so% for the wealthier

An introduction to the U.S. health care system

Abstract: An overview of the US health care system personnel institutions - hospitals institutions - primary and ambulatory care financing and payment government and the health care system health planning - principles and practice from group medical practice to managed care national health insurance and national health care reform.