WorldWideScience

Sample records for policy ontario health

  1. Making health system performance measurement useful to policy makers: aligning strategies, measurement and local health system accountability in ontario

    NARCIS (Netherlands)

    Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

    2010-01-01

    This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking

  2. How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand

    Directory of Open Access Journals (Sweden)

    Tim Tenbensel

    2017-06-01

    Full Text Available Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence.

  3. Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation

    Directory of Open Access Journals (Sweden)

    Taryn Orava

    2017-09-01

    Full Text Available Introduction: Provincial, national and international public health agencies recognize the importance of school nutrition policies that help create healthful environments aligned with healthy eating recommendations for youth. School-wide support for healthy living within the pillars of the comprehensive school health (CSH framework (social and physical environments; teaching and learning; healthy school policy; and partnerships and services has been positively associated with fostering improvements to student health behaviours. This study used the CSH framework to classify, compare and describe school support for healthy eating during the implementation of the Ontario School Food and Beverage Policy (P/PM 150. Methods: We collected data from consenting elementary and secondary schools in a populous region of Ontario in Time I (2012/13 and Time II (2014. Representatives from the schools completed the Healthy School Planner survey and a food environmental scan (FES, which underwent scoring and content analyses. Each school’s support for healthy eating was classified as either “initiation,” “action” or “maintenance” along the Healthy School Continuum in both time periods, and as “high/increased,” “moderate” or “low/decreased” within individual CSH pillars from Time I to Time II. Results: Twenty-five school representatives (8 elementary, 17 secondary participated. Most schools remained in the “action” category (n = 20 across both time periods, with varying levels of support in the CSH pillars. The physical environment was best supported (100% high/increased support and the social environment was the least (68% low/decreased support. Only two schools achieved the highest rating (maintenance in Time II. Supports aligned with P/PM 150 were reportedly influenced by administration buy-in, stakeholder support and relevancy to local context. Conclusion: Further assistance is required to sustain comprehensive support for healthy

  4. Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation.

    Science.gov (United States)

    Orava, Taryn; Manske, Steve; Hanning, Rhona

    2017-09-01

    Provincial, national and international public health agencies recognize the importance of school nutrition policies that help create healthful environments aligned with healthy eating recommendations for youth. School-wide support for healthy living within the pillars of the comprehensive school health (CSH) framework (social and physical environments; teaching and learning; healthy school policy; and partnerships and services) has been positively associated with fostering improvements to student health behaviours. This study used the CSH framework to classify, compare and describe school support for healthy eating during the implementation of the Ontario School Food and Beverage Policy (P/PM 150). We collected data from consenting elementary and secondary schools in a populous region of Ontario in Time I (2012/13) and Time II (2014). Representatives from the schools completed the Healthy School Planner survey and a food environmental scan (FES), which underwent scoring and content analyses. Each school's support for healthy eating was classified as either "initiation," "action" or "maintenance" along the Healthy School Continuum in both time periods, and as "high/increased," "moderate" or "low/decreased" within individual CSH pillars from Time I to Time II. Twenty-five school representatives (8 elementary, 17 secondary) participated. Most schools remained in the "action" category (n = 20) across both time periods, with varying levels of support in the CSH pillars. The physical environment was best supported (100% high/increased support) and the social environment was the least (68% low/decreased support). Only two schools achieved the highest rating (maintenance) in Time II. Supports aligned with P/PM 150 were reportedly influenced by administration buy-in, stakeholder support and relevancy to local context. Further assistance is required to sustain comprehensive support for healthy eating in Ontario school food environments.

  5. Mental Health Consultation Among Ontario's Immigrant Populations.

    Science.gov (United States)

    Islam, Farah; Khanlou, Nazilla; Macpherson, Alison; Tamim, Hala

    2017-11-16

    To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644). Amongst those who reported past-year mental health consultation, 57.89% of Ontario immigrants contacted their primary care physician, which was significantly higher than the proportion who consulted their family doctor from Canadian-born populations (45.31%). The factors of gender, age, racial/ethnic background, education level, working status, food insecurity status, self-perceived health status, smoking status, alcohol drinking status, years since immigration, and age at time of immigration were significantly associated with past-year mental health consultation for immigrant populations. Ontario's adult immigrant populations most commonly consult their family doctor for mental health care. Potential exists for expanding the mental health care role of primary care physicians as well as efforts to increase accessibility of specialized mental health services. Integrated, coordinated care where primary care physicians, specialized mental health professionals, social workers, and community educators, etc. working together in a sort of "one-stop-shop" may be the most effective way to mitigate gaps in the mental health care system. In order to effectively tailor mental health policy, programming, and promotion to suit the needs of immigrant populations initiatives that focus on

  6. Emotional tone of ontario newspaper articles on the health effects of industrial wind turbines before and after policy change.

    Science.gov (United States)

    Deignan, Benjamin; Hoffman-Goetz, Laurie

    2015-01-01

    Newspapers are often a primary source of health information for the public about emerging technologies. Information in newspapers can amplify or attenuate readers' perceptions of health risk depending on how it is presented. Five geographically distinct wind energy installations in Ontario, Canada were identified, and newspapers published in their surrounding communities were systematically searched for articles on health effects from industrial wind turbines from May 2007 to April 2011. The authors retrieved 421 articles from 13 community, 2 provincial, and 2 national newspapers. To measure the emotional tone of the articles, the authors used a list of negative and positive words, informed from previous studies as well as from a random sample of newspaper articles included in this study. The majority of newspaper articles (64.6%, n = 272) emphasized negative rather than positive/neutral tone, with community newspapers publishing a higher proportion of negative articles than provincial or national newspapers, χ(2)(2) = 15.1, p < .001. Articles were more likely to be negative when published 2 years after compared with 2 years before provincial legislation to reduce dependence on fossil fuels (the Green Energy Act), χ(2)(3) = 9.7, p < .05. Repeated public exposure to negative newspaper content may heighten readers' health risk perceptions about wind energy.

  7. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  8. Adaptation to climate change in the Ontario public health sector

    Science.gov (United States)

    2012-01-01

    Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

  9. The effect of Ontario's transmission system policies on cogeneration projects

    International Nuclear Information System (INIS)

    Carr, J.

    1999-01-01

    The impact that the establishment of transmission tariffs would have on the viability of cogeneration projects in Ontario was discussed. The proposal to establish such tariffs on the basis of a 'postage stamp' rate would ensure that all electricity users have access to electricity at the same price. However, this would unfairly penalize short-haul transmission transactions and would possibly result in the inappropriate location of new generation facilities. Electricity users would ultimately be burdened with these inefficiencies. This presentation also discussed another public policy which proposes to determine what parts of the electricity system should have their costs recovered at postage stamp rates. The costs would include not only transmission charges but also distribution and generation costs. The restructuring of Ontario Hydro into the Ontario Power Generation Company (OPGC) and the Ontario Hydro Services Company (OHSC) and its impact on the cogeneration projects was also discussed

  10. Institutional Diversity in Ontario's University Sector: A Policy Debate Analysis

    Science.gov (United States)

    Piché, Pierre G.; Jones, Glen A.

    2016-01-01

    In order to meet the demands in a cost-effective manner of an emerging knowledge society that is global in scope, structural higher education policy changes have been introduced in many countries with a focus on systemic and programmatic diversity. There has been an ongoing debate about institutional diversity in Ontario higher education,…

  11. Feminism and women's health professions in Ontario.

    Science.gov (United States)

    Adams, Tracey L; Bourgeault, Ivy Lynn

    2003-01-01

    Historically, prevailing gender ideologies were an important element in both the exclusionary strategies employed by male occupational groups and the countervailing responses by female groups. The way in which evolving gender ideologies, and feminism in particular, influence the continuing struggle for greater status and recognition by female professions, however, remains to be fully explored. In this paper, we examine the impact and the role of feminism and feminist ideologies within three female professional projects: nursing, dental hygiene and midwifery in Ontario. We argue that feminism provides an ideology of opposition that enables leaders in these professions to battle against professional inequalities by laying bare the gender inequalities that underlie them. Framing their struggles in feminist terms, female professions also seek recognition for the uniquely female contribution they make to the health care division of labour. At the same time, there exists a tension between ideals of feminism and ideals of professionalism, that has the potential to undermine female professional projects.

  12. Analyzing the Safeguarding Our Communities Act: Patch for Patch Return Policy in Ontario

    Directory of Open Access Journals (Sweden)

    Soo-Min Kim

    2018-04-01

    Full Text Available Fentanyl is prescribed to patients suffering from severe chronic pain. Transdermal patches are the best mode of delivery for patients who have developed tolerance for opioids. However, used patches still contain fentanyl that can be extracted and misused, with potentially severe consequences. To address this issue, patients who are prescribed fentanyl patches in Ontario are now required to return previously dispensed patches to receive new patches under the Safeguarding Our Communities Act: Patch for Patch (P4P Return Policy. The problem is significant in Ontario because the province has the largest annual dispense rate of high-dose prescription fentanyl (112 units per 1,000 population in Canada even though the prevalence rate of chronic pain is lower than the national reported range (16.6% in Ontario versus 19.6 to 21.9% in other provinces, according to Gomes et al. 2014. The primary goal of this reform is to instill responsible use of fentanyl patches, and to improve safety for patients and the public by having a central disposal process. The reform was modeled after a community initiative that was pioneered in North Bay after receiving great support from health professional colleges and communities that voluntarily integrated the program prior to the introduction of Bill 33. Preliminary data suggest that the P4P policy is positively received by health professionals, although ongoing evaluation is needed to assess the effectiveness of the policy in reducing misuse and abuse of prescribed fentanyl patches.

  13. Ontario's Clean Air Action Plan : protecting environmental and human health in Ontario

    International Nuclear Information System (INIS)

    2004-01-01

    Ontario's Clean Air Action Plan was launched in June 2000 in an effort to improve air quality and comply with the Canada-Wide Standards for Particulate Matter and Ozone. This paper describes Ontario's approach to reducing smog. Smog-related air pollution is linked to health problems such as premature death, respiratory and heart problems. Smog also contributes to environmental problems such as damage to forests, agricultural crops and natural vegetation. The two main ingredients of smog are ground level ozone and particulate matter. In order to reduce the incidence of smog, the following four key smog-causing pollutants must be reduced: nitrogen oxides, volatile organic compounds, sulphur dioxide and particular matter. This paper includes the 2001 estimates for Ontario's emissions inventory along with Ontario's smog reduction targets. It was noted that approximately half of all smog in Ontario comes from sources in the midwestern United States. The province of Ontario is committed to replacing coal-fired power plants with cleaner sources of energy. It is also considering emission caps for key industrial sectors. The key players in reducing smog include municipalities, industry, individuals, the federal government and programs that reduce emissions in the United States. 3 figs., 8 tabs., 1 appendix

  14. Economic instruments for environmental policy making in Ontario

    International Nuclear Information System (INIS)

    Barg, S.; Duraiappah, A.; Van Exan, S.

    2000-01-01

    The conditions and approaches required for a successful implementation of economic instruments in Ontario are reviewed. The advantages and disadvantages of economic instruments are discussed, as are some design issues. Some best practices and practical experiences from Canada, the United States, and Europe are examined through the use of nine specific case studies. Each one highlights a different environmental challenge, such as energy efficiency, air pollution, water pollution, waste management along with the solutions that were implemented. The situations described were not all successful, but there is much to be learned from unsuccessful episodes. Lessons learned from the review of the case studies were presented. The points to ponder when using economic instruments in Ontario were highlighted. The command and control policy instrument must be kept in context when considering economic instruments. The reasons that underline the preference of the economic theory for economic instruments are discussed. The different types of economic instruments are described, and the considerations related to the design and comparison of economic instruments is briefly discussed. The authors concluded with several points to ponder: there are a number of options available, details must not be neglected, consultation with the interested parties is important, there is a need for frequent reassessment, and using a number of instruments is helpful. 55 refs., tabs., figs

  15. Canadian federalism and the Canadian health care program: a comparison of Ontario and Quebec.

    Science.gov (United States)

    Palley, H A

    1987-01-01

    The Quebec and Ontario health insurance and health service delivery systems, developed within the parameters of federal regulations and national financial subsidies, provide generally universal and comprehensive basic hospital and medical benefits and increasingly provide for the delivery of long-term care services. Within a framework of cooperative federalism, the health care systems of Ontario and Quebec have developed uniquely. In terms of vital statistics, the health of Ontario and Quebec residents generally is comparable. In viewing expenditures, Quebec has a more clearly articulated plan for providing accessible services to low-income persons and for integrating health and social services, although it has faced some difficulties in seeking to achieve the latter goal. Its plans for decentralized services are counter-balanced by a strong provincial role in health policy decision-making. Quebec's political culture also allows the province to play a stronger role in hospital planning and in the regulation of physician income than one finds in Ontario. These political dynamics allow Quebec an advantage in control of costs. In Ontario, in spite of some recent setbacks, physician interests and hospital sector interests play a more active role in health system bargaining and are usually able to influence remuneration and resource allocation decisions more than physician interests and hospital sector interests in Quebec.

  16. Smoke and mirrors: used oil management policy in Ontario

    International Nuclear Information System (INIS)

    Valiante, U.

    1997-01-01

    The burning of used oil for space heating is a practice that has been increasing since 1992 when the waste fuel regulation was amended to give northern generators without access to used oil collection an option for managing their used oil. In 1996, about 10 million litres of used oil was burned in Ontario at over 600 locations, in garages, automotive repair facilities, industrial locations and greenhouses. The modified space heaters that burn used motor oils operate without pollution controls. In addition to emissions associated with pollution from uncontrolled combustion, used oil fired space heaters burn what should be a reusable commodity that is high in value added chemical and energy content. A comparison of emissions in grams per 1000 hours of use of a used oil heater and a natural gas heater was presented. It was suggested that as the preferred environmental strategy, the Ontario government should encourage used oil collectors and re-refiners to make used oil management convenient, accessible, and cost-effective in order to protect the health of communities in which used oil is generated

  17. Public awareness of income-related health inequalities in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Shankardass Ketan

    2012-05-01

    Full Text Available Abstract Introduction Continued action is needed to tackle health inequalities in Canada, as those of lower income continue to be at higher risk for a range of negative health outcomes. There is arguably a lack of political will to implement policy change in this respect. As a result, we investigated public awareness of income-related health inequalities in a generally representative sample of Ontarians in late 2010. Methods Data were collected from 2,006 Ontario adults using a telephone survey. The survey asked participants to agree or disagree with various statements asserting that there are or are not health inequalities in general and by income in Ontario, including questions pertaining to nine specific conditions for which inequalities have been described in Ontario. A multi-stage process using binary logistic regression determined whether awareness of health inequalities differed between participant subgroups. Results Almost 73% of this sample of Ontarians agreed with the general premise that not all people are equally healthy in Ontario, but fewer participants were aware of health inequalities between the rich and the poor (53%–64%, depending on the framing of the question. Awareness of income-related inequalities in specific outcomes was considerably lower, ranging from 18% for accidents to 35% for obesity. Conclusions This is the first province-wide study in Canada, and the first in Ontario, to explore public awareness on health inequalities. Given that political will is shaped by public awareness and opinion, these results suggest that greater awareness may be required to move the health equity agenda forward in Ontario. There is a need for health equity advocates, physicians and researchers to increase the effectiveness of knowledge translation activities for studies that identify and explore health inequalities.

  18. Report of a Study of Ontario Medical School Admissions Policies and Practices, 1975.

    Science.gov (United States)

    Council of Ontario Universities, Toronto.

    Presented are the results of a study of admissions policies and practices in the five Ontario schools of medicine. The study consists of a review of published information and a detailed examination of 1975 statistics from the Ontario Medical School Application Service, supplemented by a series of interviews with medical school admissions officers,…

  19. Policy communities and allocation of internalized cost : negotiation of the Ontario acid rain program, 1982-1985

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, D.C.

    1997-12-31

    The process of allocating the internalized cost of environmental protection amongst industrial concerns and governments was studied. The issue was addressed by reviewing the literature on the treatment of externalities by economists, and the literature describing the approach to policy analysis by the the policy communities. An examination of a case study in which the cost of sulphur dioxide emission reductions was allocated amongst the major Ontario sources during the development of the 1985 national and Ontario acid rain programs was presented. The study provided an insight into issues regarding Canadian environmental policy and policy communities theory and practice. The Ontario allocation was negotiated by Ontario alone, even though it was part of a national program. The environmental movement also had no role in this Ontario policy decisions. The power to influence the Ontario cabinet belonged to MOE, Inco, and Ontario Hydro through negotiations and compromise, which conforms to the basic premise of the policy communities approach.

  20. Small wind turbine energy policies for residential and small business usage in Ontario, Canada

    International Nuclear Information System (INIS)

    Heagle, A.L.B.; Naterer, G.F.; Pope, K.

    2011-01-01

    This paper examines the social barriers, policies, and incentive programs for residential and small business small wind (RBSW) projects, particularly in Ontario, Canada, as well as comparisons with California, US, and the United Kingdom. The alignment between socio-political and community acceptance is considered for its impact on market acceptance of the technology. Barriers inhibiting social acceptance of RBSW projects include adequate capacity factor, cost effectiveness, wind variability, audio-esthetics impact, health and safety, procedural fairness, and transparency. A review of the policies for implementation of small wind projects in each location is presented. Strategies to overcome barriers to social acceptance are examined, along with recommendations for the increased implementation of RBSW projects worldwide. Recommendations to increase social acceptance and subsequent implementation of RBSW projects include the collaboration of government agencies, industry and community members, during RBSW implementation processes, and the provision of consistent, long-term, supportive policies and incentive programs for project owners. - Highlights: → This paper examines the social barriers, policies, and incentive programs for residential and small business small wind (RBSW) projects, particularly in Ontario, Canada, as well as comparisons with California, US, and the United Kingdom. → Barriers inhibiting social acceptance of RBSW projects include adequate capacity factor, cost effectiveness, wind variability, audio-esthetics impact, health and safety, procedural fairness, and transparency. → Recommendations to increase social acceptance and subsequent implementation of RBSW projects include the collaboration of government agencies, industry and community members, during RBSW implementation processes, and the provision of consistent, long-term, supportive policies and incentive programs for project owners.

  1. Bringing Policy and Practice To the Table: Young Women’s Nutritional Experiences In An Ontario Secondary School

    Directory of Open Access Journals (Sweden)

    Sarah Gray

    2015-10-01

    Full Text Available In recent years, media, health organizations and researchers have raised concern over the health of Canadian children and adolescents. Stakeholders have called on the government to confront the problem. Schools are seen as an ideal site for developing and implementing large-scale interventions because of the ease of access to large groups of children and adolescents. Within Ontario, new nutrition policies, such as the School Food and Beverage Policy (2011 have been implemented in an attempt to change the current health status of children and adolescents. The purpose of this study was to examine the eating behaviours and nutrition knowledge of young women in an Ontario secondary school.  Semi-structured interviews were used to examine the reproduction, negotiation and resistance to the nutrition messages received by young women within the school environment. The interviews revealed the influence of parents, the inability of apply learned knowledge and the ineffectiveness of the school environment.

  2. (Re)Thinking the Adoption of Inclusive Education Policy in Ontario Schools

    Science.gov (United States)

    Massouti, Ayman

    2018-01-01

    The purpose of this article is to advance a proposal for the analysis of how inclusive education policies in Ontario schools are adopted. In particular, I use the notion of "Policy Enactment" to re-conceptualize the processes of putting inclusive education policies into practice. The argument is that the traditional…

  3. Implementing Indigenous Education Policy Directives in Ontario Public Schools: Experiences, Challenges and Successful Practices

    Directory of Open Access Journals (Sweden)

    Emily Milne

    2017-08-01

    Full Text Available The Ontario Ministry of Education has declared a commitment to Indigenous student success and has advanced a policy framework that articulates inclusion of Indigenous content in schooling curriculum (Ontario Ministry of Education, 2007. What are the perceptions among educators and parents regarding the implementation of policy directives, and what is seen to encourage or limit meaningful implementation? To answer these questions, this article draws on interviews with 100 Indigenous (mainly Haudenosaunee, Anishinaabe, and Métis and non-Indigenous parents and educators from Ontario Canada. Policy directives are seen to benefit Indigenous and non-Indigenous students. Interviews also reveal challenges to implementing Indigenous curricular policy, such as unawareness and intimidation among non-Indigenous educators regarding how to teach material. Policy implications are considered.

  4. Just in Time: How Evidence-on-Demand Services Support Decision Making in Ontario's Child and Youth Mental Health Sector

    Science.gov (United States)

    Notarianni, Maryann; Sundar, Purnima; Carter, Charles

    2016-01-01

    Using the best available evidence to inform decision making is important for the design or delivery of effective health-related services and broader public policy. Several studies identify barriers and facilitators to evidence-informed decision making in Canadian health settings. This paper describes how the Ontario Centre of Excellence for Child…

  5. Children in Need of Protection: Reporting Policies in Ontario School Boards

    Science.gov (United States)

    Shewchuk, Samantha

    2014-01-01

    A clear, well defined policy can help empower school personnel to make informed decisions on how to handle cases of suspected child abuse. This article presents an analysis of (N = 64) school board child abuse reporting policies and procedures in Ontario and explored what training, resources, and support school boards state they will provide to…

  6. Omitted Costs, Inflated Benefits: Renewable Energy Policy in Ontario

    Science.gov (United States)

    Gallant, Parker; Fox, Glenn

    2011-01-01

    The government of Ontario has adopted wind energy development as an alternative energy source. It enacted the Green Energy and Economy Act, May 2009, with the intention to fast track the approval process regarding industrial wind turbines. The Act legislated a centralized decision making process while removing local jurisdictional authority.…

  7. Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

    Science.gov (United States)

    Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

    2015-05-03

    Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

  8. Costs of health care across primary care models in Ontario

    OpenAIRE

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-01-01

    Background The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients? primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Methods Utilization data for a one year period was measured using administrative databases for a 1...

  9. The Economics of Renewable Electricity Policy in Ontario

    OpenAIRE

    Donald N. Dewees

    2013-01-01

    Economic evaluation of green or renewable power should compare the cost of renewable power with the cost savings from displaced fossil generation plus the avoided harm from reduced emissions of air pollution and greenhouse gases. We use existing estimates of the values of the harm and we calculate cost savings from renewable power based on wholesale spot prices of power in Ontario and steady-state estimates of the cost of new gas generation to estimate the value or affordability of various fo...

  10. The opioid crisis: past, present and future policy climate in Ontario, Canada.

    Science.gov (United States)

    Morin, Kristen A; Eibl, Joseph K; Franklyn, Alexandra M; Marsh, David C

    2017-11-02

    Addressing opioid use disorder has become a priority in Ontario, Canada, because of its high economic, social and health burden. There continues to be stigma and criticism relating to opioid use disorder and treatment options. The result has been unsystematic, partial, reactive policies and programs developed based on divergent points of view. The aim of this manuscript is to describe how past and present understandings, narratives, ideologies and discourse of opioid use, have impacted policies over the course of the growing opioid crisis. Assessing the impact of policy is complex. It involves consideration of conceptual issues of what impacts policy change. In this manuscript we argue that the development of polices and initiatives regarding opioids, opioid use disorder and opioid agonist treatment in the last decade, have been more strongly associated with the evolution of ideas, narratives and discourses rather than research relating to opioids. We formulate our argument using a framework by Sumner, Crichton, Theobald, Zulu, and Parkhurs. We use examples from the Canadian context to outline our argument such as: the anti- drug legislation from the Canadian Federal Conservative government in 2007; the removal of OxyContin™ from the drug formulary in 2012; the rapid expansion of opioid agonist treatment beginning in the early 2000s, the unilateral decision made regarding fee cuts for physicians providing opioid agonist treatment in 2015; and the most recent implementation of a narcotics monitoring system, which are all closely linked with the shifts in public opinion and discourse at the time of which these policies and programs are implemented. We conclude with recommendations to consider a multifactorial response using evidence and stakeholder engagement to address the opioid crisis, rather than a reactive policy approach. We suggest that researchers have an important role in shaping future policy by reframing ideas through knowledge translation, formation of

  11. Costs of health care across primary care models in Ontario.

    Science.gov (United States)

    Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey

    2017-08-01

    The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the

  12. Stroke rehabilitation in ontario: an opportunity for health care transformation.

    Science.gov (United States)

    Meyer, Matthew J; Meyer, John P; Foley, Norine; Salter, Katherine; McClure, J Andrew; Teasell, Robert

    2011-11-01

    In this article, Ontario's stroke rehabilitation system is used to exemplify the challenges faced by rehabilitation and healthcare systems across Canada who are attempting to provide quality care to patients in the face of increasing demands. Currently, Ontario's rehabilitation system struggles in its efforts to provide accessible and comprehensive care to patients recovering from stroke. We begin our exploration by identifying both the primary stakeholders and the underlying factors that have contributed to the current challenges. The framework put forward in the Canadian Medical Association's recommendations for transformation is then used to suggest a vision for a more patient-focused system incorporating three key principles: a broader perspective, a patient-first approach, and greater unity. The use of health information technology, proper incentives, and greater accountability are discussed as mechanisms to improve the quality and efficiency of care.

  13. The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario.

    Science.gov (United States)

    Tarasuk, Valerie; Cheng, Joyce; Gundersen, Craig; de Oliveira, Claire; Kurdyak, Paul

    2018-01-01

    To determine the relationship between household food insecurity status over a 12-month period and adults' use of publicly funded health care services in Ontario for mental health reasons during this period. Data for 80,942 Ontario residents, 18 to 64 years old, who participated in the Canadian Community Health Survey in 2005, 2007-2008, 2009-2010, or 2011-2012 were linked to administrative health care data to determine individuals' hospitalizations, emergency department visits, and visits to psychiatrists and primary care physicians for mental health reasons. Household food insecurity over the past 12 months was assessed using the Household Food Security Survey Module. Logistic regression models were used to estimate the odds of mental health service utilization in the past 12 months by household food insecurity status, adjusting for sociodemographic factors and prior use of mental health services. In our fully adjusted models, in comparison to food-secure individuals, the odds of any mental health care service utilization over the past 12 months were 1.15 (95% confidence interval [CI], 1.04 to 1.29) for marginally food-insecure individuals, 1.39 (95% CI, 1.19 to 1.42) for moderately food-insecure individuals, and 1.50 (95% CI, 1.35 to 1.68) for severely food-insecure individuals. A similar pattern persisted across individual types of services, with odds of utilization highest with severe food insecurity. Household food insecurity status is a robust predictor of mental health service utilization among working-age adults in Ontario. Policy interventions are required to address the underlying causes of food insecurity and the particular vulnerability of individuals with mental illness.

  14. Mount Sinai Hospital's approach to Ontario's Health System Funding Reform.

    Science.gov (United States)

    Chalk, Tyler; Lau, Davina; Morgan, Matthew; Dietrich, Sandra; Beduz, Mary Agnes; Bell, Chaim M

    2014-01-01

    In April 2012, the Ontario government introduced Health System Funding Reform (HSFR), a transformational shift in how hospitals are funded. Mount Sinai Hospital recognized that moving from global funding to a "patient-based" model would have substantial operational and clinical implications. Adjusting to the new funding environment was set as a top corporate priority, serving as the strategic basis for re-examining and redesigning operations to further improve both quality and efficiency. Two years into HSFR, this article outlines Mount Sinai Hospital's approach and highlights key lessons learned. Copyright © 2014 Longwoods Publishing.

  15. Countering school bullying: An analysis of policy content in Ontario and Saskatchewan

    Directory of Open Access Journals (Sweden)

    Ginette Diane Roberge

    2011-08-01

    Full Text Available The incidence of extreme school violence as a direct consequence of bullying among peers, exacerbated by vast media attention, has caused educational institutions worldwide to put bullying intervention and prevention strategies into operation. This study focused on an overview of two provincewide antibullying incentives in the Canadian provinces of Ontario and Saskatchewan, and an analysis of the quality of their respective antibullying policies. An itemized list of beneficial practices for bullying intervention and prevention originated from Smith, Smith, Osborn and Samara (2008’s scoring scheme. The scoring scheme was adapted to the current study by linking research-based program elements that have been found to be effective in reducing school bullying to a content analysis of both provincial frameworks. The final scoring scheme comprised a total of 39 criterions, divided into five categories: Defining Bullying Behaviors, Establishing a Positive School Climate, Disseminating, Monitoring and Reviewing Policy, Reporting and Responding to Bullying, and Involving the Broader Community. Results showed that policies contained a total average of 60% of the criterions in Ontario, and 59% in Saskatchewan. The conclusion of this study observes from policy lenses key essentials of bullying intervention and prevention initiatives in elementary and secondary educational settings. Recommendations are proposed to bridge the gap between areas that have received extensive attention and areas that have received less treatment in bullying intervention and prevention endeavors, using the content of Ontario and Saskatchewan policies as a basis for discussion.

  16. Quality-based procedures in Ontario: exploring health-care leaders' responses.

    Science.gov (United States)

    Baxter, Pamela; Cleghorn, Laura; Alvarado, Kim; Cummings, Greta; Kennedy, Deborah; McKey, Colleen; Pfaff, Kathy

    2016-01-01

    To examine health-care leaders' initial response to the implementation of orthopaedic quality based procedures (QBPs) in hospitals across Ontario, Canada. In 2012, Ontario, Canada shifted 91 hospitals to a patient-based funding (PBF) approach. This approach funds health-care organisations based on the number of patients treated with select procedures known as QBPs. An exploratory descriptive design was employed to better understand health-care leaders' early implementation experiences. Seventy organisational leaders from 20 hospitals participated in six focus groups and four interviews to discuss their initial responses to the implementation of two QBPs (primary unilateral hip replacement and primary unilateral knee replacement). Qualitative data underwent content analysis. Three key major themes emerged; (1) responding to change, (2) leading the change and (3) managing the change. Within each of these themes, barriers and benefits were identified. Leaders are accepting of PBF and QBPs. However, challenges exist that require further exploration including the need for a strong infrastructure, accurate and timely clinical and financial data, and policies to prevent unintended consequences. Implementing QBPs requires careful planning, adequate and appropriate resources, vertical and horizontal communication strategies, and policies to ensure that unintended consequences are avoided and positive outcomes achieved. © 2014 John Wiley & Sons Ltd.

  17. Sor/88-391, 21 July 1988, uranium mines (Ontario) occupational health and safety regulations, amendment

    International Nuclear Information System (INIS)

    1988-08-01

    These Regulations (SOR/84-435) were made to establish uniformity in the laws governing occupational health and safety in mines in the Province of Ontario. To ensure conformity, the legal references in the Regulations have been amended to accord with the 1987 amendment of the Ontario Occupational Health and Safety Act [fr

  18. Cost analysis of public health influenza vaccine clinics in Ontario.

    Science.gov (United States)

    Mercer, Nicola J

    2009-01-01

    Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

  19. Ontario's Experience of Wind Energy Development as Seen through the Lens of Human Health and Environmental Justice.

    Science.gov (United States)

    Songsore, Emmanuel; Buzzelli, Michael

    2016-07-06

    The province of Ontario has shown great commitment towards the development of renewable energy and, specifically, wind power. Fuelled by the Green Energy Act (GEA) of 2009, the Province has emerged as Canada's leader in wind energy development (WED). Nonetheless, Ontario's WED trajectory is characterized by social conflicts, particularly around environmental health. Utilizing the Social Amplification of Risk Framework, this paper presents an eight-year longitudinal media content analysis conducted to understand the role Ontario's media may be playing in both reflecting and shaping public perceptions of wind turbine health risks. We find that before and after the GEA, instances of health risk amplification were far greater than attenuations in both quantity and quality. Discourses that amplified turbine health risks often simultaneously highlighted injustices in the WED process, especially after the GEA. Based on these findings, we suggest that Ontario's media may be amplifying perceptions of wind turbine health risks within the public domain. We conclude with policy recommendations around public engagement for more just WED.

  20. Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease (COPD) Using an Ontario Policy Model

    Science.gov (United States)

    Chandra, K; Blackhouse, G; McCurdy, BR; Bornstein, M; Campbell, K; Costa, V; Franek, J; Kaulback, K; Levin, L; Sehatzadeh, S; Sikich, N; Thabane, M; Goeree, R

    2012-01-01

    Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-Term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation throughout the airways, parenchyma, and pulmonary vasculature. The inflammation causes repeated cycles of injury and repair in the airway wall— inflammatory cells release a variety of chemicals and lead to cellular damage. The inflammation process also contributes to the loss of elastic recoil pressure

  1. AMO's [Association of Municipalities of Ontario] policy on refillable beverage containers

    Energy Technology Data Exchange (ETDEWEB)

    1992-04-01

    The policy of the Association of Municipalities of Ontario (AMO) regarding refillable beverage containers is explained, and a response is made to the Ontario Soft Drink Association (OSDA's) top-up offer to municipalities. A background and overview is presented of current and historical policy on beverage containers, including measures enacted by other provinces and countries. AMO strongly urges the provincial government to increase the presence of refillable containers, first because reuse is preferrable to recycling, and second because Ontario's current recycling systems are not self-sufficient or sustainable in their present form. Refillable plastic bottles offer an opportunity for change in waste management similar to the Blue Box recycling initiative. It is recommended that the entire beverage industry voluntarily, or legislated by the provincial government, provide refillable containers as a consumer option and institute a deposit system to collect these containers. This system will promote full-cost accounting. OSDA's offer to top up Blue Box operating costs is rejected with the caveat of short-term financial agreements. The refillable concept should also be expanded to other packaged products. 2 tabs.

  2. Reductions in non-medical prescription opioid use among adults in Ontario, Canada: are recent policy interventions working?

    Science.gov (United States)

    Fischer, Benedikt; Ialomiteanu, Anca; Kurdyak, Paul; Mann, Robert E; Rehm, Jürgen

    2013-02-14

    Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the world's highest PO use levels. In Ontario, Canada's most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010. We compared the prevalence of NMPOU in the Ontario general adult population (18 years+) in 2010 and 2011 based on data from the 'Centre for Addiction and Mental Health (CAMH) Monitor' (CM), a long-standing annual telephone interview-based representative population survey of substance use and health indicators. While 'any PO use' (in past year) changed non-significantly from 26.6% to 23.9% (Chi2 = 2.511; df = 1; p =  0.113), NMPOU decreased significantly from 7.7% to 4.0% (Chi2 = 14.786; df = 1; p policy interventions, alongside extensive media reporting, focusing on NMPOU and PO-related harms, and may mean that these interventions have shown initial effects. However, other casual factors could have been involved. Thus, it is necessary to systematically examine whether the observed changes will be sustained, and whether other key PO-related harm indicators (e.g., treatment admissions, accidental mortality) change correspondingly in order to more systematically assess the impact of the policy measures.

  3. Ontario's changing electrical sector : implications for air quality and human health

    International Nuclear Information System (INIS)

    Perrota, K.; De Leon, F.

    1999-03-01

    Concerns regarding the changes to Ontario's electricity sector and the impacts that these changes may have on the environment and public health are discussed. Two of the major changes include the implementation of the Nuclear Asset Optimization Plan, and the introduction of competition to Ontario's electrical market. Both changes could have profound impacts on air quality in Toronto and the rest of Ontario. This report recommends that the Ontario Minister of Environment and the Ontario Minister of Energy, Science and Technology establish: a regulatory framework to ensure that competition in Ontario's electrical sector does not lead to greater reliance on coal-fired generating stations and further degradation of air quality, human health and the environment in Toronto and the rest of southern Ontario; annual air emission caps for the entire electrical sector to limit the volume of air pollutants released each year; a renewable energy standard which defines the percentage of electricity that must be generated with renewable energies by electrical suppliers serving Ontario consumers; and a public benefit fund to support the promotion of energy conservation and the development of renewable energies with a surcharge on the transmission of electricity. 35 refs., 5 tabs

  4. Staff perceptions of community health centre team function in Ontario.

    Science.gov (United States)

    Rayner, Jennifer; Muldoon, Laura

    2017-07-01

    To examine perceptions of different staff groups about team functioning in mature, community-governed, interprofessional primary health care practices. Cross-sectional online survey. The 75 community health centres (CHCs) in Ontario at the time of the study, which have cared for people with barriers to access to traditional health services in community-governed, interprofessional settings, providing medical, social, and community services since the 1970s. Managers and staff of primary care teams in the CHCs. Scores on the short version of the Team Climate Inventory (with subscales addressing vision, task orientation, support for innovation, and participative safety), the Organizational Justice Scale (with subscales addressing procedural justice and interactional justice), and the Organizational Citizenship Behavior Scale, stratified by staff group (clinical manager, FP, nurse practitioner [NP], registered nurse, medical secretary, social worker, allied health provider, counselor, outreach worker, and administrative assistant). A total of 674 staff members in 58 of 75 (77%) CHCs completed surveys. All staff groups generally reported positive perceptions of team function. The procedural justice subscale showed the greatest variation between groups. Family physicians and NPs rated procedural justice much lower than nurses and administrators did. This study provides a unique view of the perceptions of different groups of staff in a long-standing interprofessional practice model. Future research is needed to understand why FPs and NPs perceive procedural justice more negatively than other team members do, and whether such perceptions affect outcomes such as staff turnover and health outcomes for patients. Copyright© the College of Family Physicians of Canada.

  5. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

    Science.gov (United States)

    Leung, Zee; Middleton, Dean; Morrison, Karen

    2012-05-16

    There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

  6. Exploring Implementation of the Ontario School Food and Beverage Policy at the Secondary-School Level: A Qualitative Study.

    Science.gov (United States)

    Vine, Michelle M; Elliott, Susan J; Raine, Kim D

    2014-09-01

    The purpose of this study was to explore the implementation of the Ontario School Food and Beverage Policy (P/PM 150) from the perspective of secondary-school students. This research, informed by the ANGELO framework, undertook three focus groups with secondary students (n = 20) in 2 school boards representing both high- and low-income neighbourhoods in fall 2012. Focus groups were transcribed verbatim for subsequent analysis. Key themes were generated deductively from the research objectives and inductively as they emerged from transcripts. Perceived impacts of P/PM 150 included high-priced policy-compliant food for sale, lower revenue generation, and food purchased off-campus. Limited designated eating spaces, proximity to external, nonpolicy-compliant food, and time constraints acted as key local level barriers to healthy eating. Pricing strategies are needed to ensure that all students have access to nutritious food, particularly in the context of vulnerable populations. Recognition of the context and culture in which school nutrition policies are being implemented is essential. Future research to explore the role of public health dietitians in school nutrition policy initiatives and how to leverage local resources and stakeholder support in low income, rural and remote populations is needed.

  7. The new health policy

    National Research Council Canada - National Science Library

    Gauld, Robin

    2009-01-01

    ... Gauld brings together in one volume a comprehensive picture of the health policy challenges facing contemporary developed world health systems, as well as the strategies for tackling these. Individual chapters analyze: Challenges in health care funding and organization Quality and patient safety The application of information te...

  8. Federalism and health policy.

    Science.gov (United States)

    Nathan, Richard P

    2005-01-01

    This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.

  9. The Daily Physical Activity (DPA) policy in Ontario: is it working? an examination using accelerometry-measured physical activity data.

    Science.gov (United States)

    Stone, Michelle R; Faulkner, Guy E J; Zeglen-Hunt, Laura; Bonne, Jennifer Cowie

    2012-01-01

    In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article. Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes. Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight. The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.

  10. Returns to Investment in Ontario University Education, 1960-1990, and Implications for Tuition Fee Policy. Discussion Series, Issue 5.

    Science.gov (United States)

    Stager, David A. A.

    This analysis of Ontario's returns to investment and implications for tuition fee policy updates a 1989 publication titled "Focus on Fees." The paper examines: data on public and private return on investment (ROI) from university education, pattern of ROI rates over time, and impact of tuition fee levels on estimated ROI for various…

  11. Survey of parental-leave policies and experiences in Ontario academic departments of psychiatry.

    Science.gov (United States)

    Stewart, D E; Richardson, B; Lent, B

    1998-11-01

    To analyze psychiatrists' self-reports on a survey of faculty parental leaves conducted in 5 Ontario faculties of medicine. A self-report questionnaire was mailed to all Ontario academic medical faculty members requesting information on demographics, parenting status, knowledge of parental-leave policies, personal and collegial experience of recent parental leave, and opinions about ideal parental-leave policies. The survey yielded a 48.6% response rate (3104 respondents). Of the respondents, 318 (10.2%) were academic psychiatrists and 113 (35.5%) of them had or adopted children since 1990. Of the 113 recent parents, 59 (53.2%) did not know their official university parental-leave policy. Fifty-one (48.1%) psychiatrists had recently taken parental leave (30 female, 21 male). Of these, females (26, 86.7%) were more likely than males (0%) to take more than 8 weeks' leave (P = 0.001). The income paid during parental leave was highly variable. Although 192 (64.4%) psychiatrists recommended that temporary replacements be hired and 175 (59.1%) recommended that the replacements be paid from a common faculty risk pool, replacements were hired for only 7 (13.7%) recent leaves. This replacement rate for psychiatry parental leaves was the second lowest of 8 medical specialties. Several leave takers felt that the leave negatively affected their research (32, 32.7%), administration (24, 23.3%), overall career course (23, 21.5%), colleagues' workload (27, 26.2), clinical work (19, 18.3%), teaching (18, 17.3%) and colleagues' attitudes toward them (11, 10.4%). Although 220 (71.5%) academic psychiatrists recommended paid leave to the primary caregiver for 16 or more weeks, 88 (28.6%) recommended less than the 17-week national standard. For secondary caregivers, 202 (66.0%) academic psychiatrists recommended a paid leave of 1-8 weeks, but 63 (20.6%) recommended paid leave for less than 1 week. One hundred and fifty-four psychiatrists (53.1%) recommended that parental-leave income

  12. Neighbourhood variation and inequity of primary health service use by mothers from London-Middlesex, Ontario.

    Science.gov (United States)

    Holtz, Catherine; Gilliland, Jason; Thind, Amardeep; Wilk, Piotr; Campbell, M Karen

    2014-01-01

    Primary health service use (P-HSU) may be influenced by contextual characteristics and is equitable when driven by need. Contextual effects and inequity of maternal P-HSU were determined. Participant data from a London-Middlesex, Ontario, prenatal cohort were linked by residential address to contextual characteristics. Multilevel logistic regression estimated contextual effects and tested for effect measure modification of need factors. Maternal P-HSU varied between neighbourhoods. The effect of obesity was different for rural mothers living in low- (OR = 0.26) and middle-income households (OR = 0.15) and for urban mothers living in high-income households (OR = 2.82). The effect of having a health condition was greatest in mothers with three or more children (OR = 2.41). Differences in maternal P-HSU exist between neighbourhoods, and enabling factors modified need factors' effects, identifying subgroups of mothers with inequitable P-HSU. RESULTS have the potential to inform Canadian health policy with regard to contextual effects and inequity of P-HSU.

  13. Adolescent Tobacco and Cannabis Use: Young Adult Outcomes from the Ontario Child Health Study

    Science.gov (United States)

    Georgiades, Katholiki; Boyle, Michael H.

    2007-01-01

    Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…

  14. Social Media Technology and Public Health in Ontario: Findings from a Planning Meeting Exploring Current Practices and Future Research Directions.

    Science.gov (United States)

    Booth, Richard; McMurray, Josephine; Regan, Sandra; Kothari, Anita; Donelle, Lorie; McBride, Susan; Sobel, Annette; Hall, Jodi; Fraser, Robert; Foisey, Lyndsay

    2017-01-01

    In the province of Ontario, many of the public health units (PHUs) now possess and use social media as part of their daily health promotion and communication operations. To explore this topic, a planning meeting was held to generate deeper insights toward the use of these forms of technology for preventative services delivery. The planning meeting was held with 50 participants, comprising representatives from 20 of the 36 PHUs in Ontario, interested academics, students and government representatives. A nominal group technique (NGT) was used to build consensus related to future research needs, as related to public health and social media. Participants generated a range of insights around the use of social media, including the need for: leadership buy-in and resource allocation; social media policy and governance structure; performance measurement and evaluation; practices related to engagement with program recipients and addressing the lack of resources faced by many health units. Future research priorities were also generated, related to evaluating the cost-benefit of social media activities and understanding behaviour change implications. Further research is needed to evaluate the functionality, leadership and competency requirements and impact(s) of these new forms of health communication technology within public health service delivery. Copyright © 2017 Longwoods Publishing.

  15. Race and Culture in the Secondary School Health and Physical Education Curriculum in Ontario, Canada: A Critical Reading

    Science.gov (United States)

    Petherick, LeAnne

    2018-01-01

    Purpose: The purpose of this paper is to explore issues of race and culture in health education in the secondary school health and physical education (HPE) curriculum in Ontario, Canada. Design/methodology/approach: Using Ontario's secondary school curriculum as a point of analysis, this paper draws from critical race theory and a whiteness lens…

  16. Ontario pharmacists practicing in family health teams and the patient-centered medical home.

    Science.gov (United States)

    Dolovich, Lisa

    2012-04-01

    The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

  17. Legal requirements for human-health based appeals of wind energy projects in ontario.

    Science.gov (United States)

    Engel, Albert M

    2014-01-01

    In 2009, the government of the province of Ontario, Canada passed new legislation to promote the development of renewable energy facilities, including wind energy facilities in the province. Throughout the legislative process, concerns were raised with respect to the effect of wind energy facilities on human health. Ultimately, the government established setbacks and sound level limits for wind energy facilities and provided Ontario residents with the right to appeal the approval of a wind energy facility on the ground that engaging in the facility in accordance with its approval will cause serious harm to human health. The first approval of a wind facility under the new legislation was issued in 2010 and since then, Ontario's Environmental Review Tribunal as well as Ontario's courts has been considering evidence proffered by appellants seeking revocation of approvals on the basis of serious harm to human health. To date, the evidence has been insufficient to support the revocation of a wind facility approval. This article reviews the legal basis for the dismissal of human-health based appeals.

  18. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    NARCIS (Netherlands)

    Tawfik-Shukor, Ali R.; Klazinga, Niek S.; Arah, Onyebuchi A.

    2007-01-01

    BACKGROUND: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this

  19. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    NARCIS (Netherlands)

    A.R. Tawfik-Shukor (Ali); N.S. Klazinga (Niek); O.A. Arah (Onyebuchi)

    2007-01-01

    textabstractBackground: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support

  20. Continuing education for primary health care nurse practitioners in Ontario, Canada.

    Science.gov (United States)

    Baxter, Pamela; DiCenso, Alba; Donald, Faith; Martin-Misener, Ruth; Opsteen, Joanne; Chambers, Tracey

    2013-04-01

    The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. The mental health status of ethnocultural minorities in Ontario and their mental health care.

    Science.gov (United States)

    Grace, Sherry L; Tan, Yongyao; Cribbie, Robert A; Nguyen, Han; Ritvo, Paul; Irvine, Jane

    2016-02-26

    Mental disorders are a leading cause of disability and early mortality. The objective of this study was to describe and compare psychosocial indicators and mental health service use among ethnoculturally-diverse Ontarians. This is a cross-sectional analysis of the Ontario Health Study pilot investigation. Residents were mailed an invitation to one of 3 assessment centres (urban, rural and northern sites) from March 2009 to July 2010. Participants had an interview with a nurse and completed a questionnaire on a touchscreen kiosk. The questionnaire included sociodemographic items, and scales assessing symptoms of depressive symptoms (CES-D) and anxiety (GAD-7), social support (Lubben Social Network Scale), stressful life events, and mental health service use. Eight thousand two hundred thirty-five residents participated, among whom 6652 (82.4 %) self-reported their ethnocultural background as White, 225 (2.8 %) as South Asian, 222 (2.8 %) East Asian, 214 (2.7 %) Southeast Asian, 197 (2.4 %) Black, and 28 (0.3 %) as Aboriginal. Based on their sociodemographic characteristics, participants from these ethnocultural minority groups were matched to White participants. Black participants reported significantly greater stressful life events than White participants (p = .04), particularly death (p divorce (p = .002) and financial difficulties (p < .001). East Asian participants reported significantly less social support than their White counterparts (p < .001), and this was not confounded by measurement variance. Mental health service use was significantly lower in all ethnocultural minorities except Aboriginals, when compared to White participants (p = .001). There is a high burden of psychosocial distress in several preponderant ethnocultural minorities in Ontario; many of whom are not accessing available mental health services.

  2. eHealth Policy

    CERN Document Server

    Capello, Fabio

    2014-01-01

    The rising of a new technological era has brought within it opportunities and threats the health systems worldwide have to deal with. In such a changed scenario the role of decision-makers is crucial to identify the real and perceived needs of the population and those areas on intervention in which eHealth can help to improve the quality and efficacy of care. Therefore, in-depth analysis of the state of the art both in industrialized and in developing countries is paramount. Many in fact are constraints that mine the designing and implementation of electronic systems for health. Only if policymakers understand the real implication of eHealth and the complexities of the human being, working model could be introduced. Otherwise the systems proposed will follow the same schemes that have produced failures so far. It implies also that the mutated role of the patient had to be known, together with his expectations and needs. Nevertheless, in a globalize world, a policy for eHealth have to consider also those facto...

  3. Research for health policy

    National Research Council Canada - National Science Library

    Bell, Erica

    2010-01-01

    ... Explicit, implicit, and pragmatic dimensions of policy-maker's needs and context 31 Constraints on policy-makers 32 Deciphering trade-offs 33 The policy-problem: deciphering uncertainty and the problem of innovation 34 A tool for deciphering policy problems 35 The different components of the policy problem 37 Recommended reading 38 Case studies in...

  4. Social responses to wind energy development in Ontario: The influence of health risk perceptions and associated concerns

    International Nuclear Information System (INIS)

    Songsore, Emmanuel; Buzzelli, Michael

    2014-01-01

    This study documents and analyzes the role of health risk perceptions and other associated concerns of wind energy development (henceforth WED) in Ontario. Drawing on the risk society framework, we conduct a longitudinal media content analysis to document and analyze perceptions of and responses to WED over a nine year period. Attention is paid to temporal variations in responses relative to Ontario's Green Energy Act (2009) (henceforth GEA); legislation aimed at the rapid expansion of renewable energy. The study reveals that the most radical forms of resistance to WED on health grounds are driven by perceived injustices in the treatment of potential at-risk citizens and citizens with health concerns. The GEA is fuelling these perceptions of injustices in subtle and nuanced ways, particularly by acting as a major confounder to health risk concerns. Contrary to several existing studies, we problematize the use of financial incentives to foster the development of wind energy. We also provide policy recommendations which include the need for increased public engagement in the WED process, the importance of using third party health and environmental assessments to inform developments as well as the need for post-development strategies to address ongoing community concerns. - Highlights: • We analyze health risk perception-based responses to wind energy development. • Health risks concerns are a major driver of public resistance to wind energy. • Perceptions of injustices strongly fuel resistance to wind energy on health grounds. • Acceptance of turbines does not imply successful coexistence with turbines. • Using financial benefits to promote social acceptance could be problematic

  5. Adequacy of the ophthalmology workforce under Ontario's Local Health Integration Networks.

    Science.gov (United States)

    Lin, Tony; Xu, Mark; Hooper, Philip L

    2016-06-01

    To determine the current distribution of ophthalmologists across Ontario's Local Health Integration Networks (LHINs) and the influence on LHIN-specific cataract surgery wait times. Cross-sectional study. Ophthalmologists listed in the College of Physicians and Surgeons (CPSO) database and the Canadian population. A list of ophthalmologists and their practice locations were obtained from the CPSO website. The total population count for Ontario was obtained from the Statistics Canada census. The population counts for the population aged 65 years and older were generated using the Canadian Socioeconomic Information Management System (CANSIM) table 109-5425. Cataract surgery wait times were obtained from the Ontario Ministry of Health. Statistical analysis was completed using Microsoft Excel using StatPlus software. There are currently 3.28 ophthalmologists per 100 000 total population in Ontario. LHIN-specific ratios ranged from 8.87 (Toronto Central) to 1.67 (Central West), with 3 out of 14 LHINs having met the previously recommended ratio of 3.37. Median cataract surgery wait times ranged from 30 to 72 days. Although the number of cataract surgeries performed was positively correlated with the population aged 65 years and older (p < 0.001), there was no statistically significant association between wait times and number of cataract cases per 1000 population (p = 0.41). Although Ontario appears to have a sufficient number of ophthalmologists overall, there is significant variation in the distribution of the ophthalmology workforce at the LHIN level. This variation did not appear to significantly influence LHIN-specific cataract surgery wait times. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  6. Global Health and Foreign Policy

    Science.gov (United States)

    Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

    2010-01-01

    Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health. PMID:20423936

  7. Global health and foreign policy.

    Science.gov (United States)

    Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

    2010-01-01

    Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

  8. Social determinants of health and retention in HIV care in a clinical cohort in Ontario, Canada.

    Science.gov (United States)

    Rachlis, Beth; Burchell, Ann N; Gardner, Sandra; Light, Lucia; Raboud, Janet; Antoniou, Tony; Bacon, Jean; Benoit, Anita; Cooper, Curtis; Kendall, Claire; Loutfy, Mona; Wobeser, Wendy; McGee, Frank; Rachlis, Anita; Rourke, Sean B

    2017-07-01

    Continuous HIV care supports antiretroviral therapy initiation and adherence, and prolongs survival. We investigated the association of social determinants of health (SDH) and subsequent retention in HIV care in a clinical cohort in Ontario, Canada. The Ontario HIV Treatment Network Cohort Study is a multi-site cohort of patients at 10 HIV clinics. Data were collected from medical charts, interviews, and via record linkage with the provincial public health laboratory for viral load tests. For participants interviewed in 2009, we used three-category multinomial logistic regression to identify predictors of retention in 2010-2012, defined as (1) continuous care (≥2 viral loads ≥90 days in all years; reference category); (2) discontinuous care (only 1 viral load/year in ≥1 year); and (3) a gap in care (≥1 year in 2010-2012 with no viral load). In total, 1838 participants were included. In 2010-2012, 71.7% had continuous care, 20.9% had discontinuous care, and 7.5% had a gap in care. Discontinuous care in 2009 was predictive (p Health Ontario Laboratories; REB: Research Ethics Board; SDH: social determinants of health; US: United States.

  9. Health Policy and Dementia.

    Science.gov (United States)

    Powell, Tia

    2018-02-01

    The anticipated number of persons with dementia continues to grow, and the US has insufficiently planned to provide and pay for care for this large population. A number of significant clinical trials aiming to prevent or cure dementia, including Alzheimer's disease, have not demonstrated success. Because of the lack of efficacious treatments, and the fact that brain changes associated with dementia may begin decades before symptoms, we can predict that efforts to cure or prevent dementia will not succeed in time for millions of people in the baby boomer generation. Because of the anticipated increase in people suffering with dementia in the coming years, US health policy must address major gaps in how to provide and pay for dementia care. Reliance on Medicaid and Medicare as currently structured will not sustain the necessary care, nor can families alone provide all necessary dementia care. Innovative forms of providing long-term care and paying for it are crucially needed.

  10. Developing Indicators for the Child and Youth Mental Health System in Ontario.

    Science.gov (United States)

    Yang, Julie; Kurdyak, Paul; Guttmann, Astrid

    2016-01-01

    When the Government of Ontario launched a comprehensive mental health and addictions strategy, the Institute for Clinical Evaluative Sciences (ICES) was tasked with developing a scorecard for ongoing monitoring of the child and youth mental health system. Using existing administrative and survey-based healthcare and education data, researchers at ICES developed a scorecard consisting of 25 indicators that described at-risk populations, child and youth mental healthcare and relevant outcomes. This scorecard is the first in Canada to report on performance indicators for the child and youth mental health system and provides a model for monitoring child and youth mental health using routinely collected administrative data.

  11. Creating a cultural analysis tool for the implementation of Ontario's civil mental health laws.

    Science.gov (United States)

    Dhand, Ruby

    2016-01-01

    Ethno-racial people with mental health disabilities experience multiple inequities and differential outcomes when interacting with Ontario's civil mental health laws. Given the increasing multi-racial population in Ontario, there is a need to develop mechanisms to address these intersecting issues. Other countries that have created evaluative tools for mental health legislation include the United Kingdom and Australia. Australia's Rights Analysis Tool, the United Kingdom's Race Equality Impact Assessment, the Scottish Recovery Tool, and the World Health Organization's Mental Health and Human Rights checklist are examples of evaluative tools developed for mental health legislation. Such a tool does not exist in Canada, let alone in Ontario specifically. Thus, this study developed a Cultural Analysis Tool (CAT) consisting of specific and meaningful thematic questions that can be used by practitioners when addressing issues of culture and equity for ethno-racial people with mental health disabilities interacting with Ontario's civil mental health laws. It is hoped that the CAT, and the research underlying its development, will enable practitioners to critically question whether cultural and intersecting concerns are being appropriately addressed within an ethno-racial client's case and, furthermore, how equitable outcomes can be achieved. This article describes and analyzes the methodology, research and qualitative data used to develop the CAT. It then presents and examines the CAT itself. The qualitative data was drawn from thirty-five semi-structured interviews with seven members of each of the following groups: (1) ethno-racial people with mental health disabilities including in-patients and ex-patients, (2) lawyers who practice in the area of mental health law, (3) health care professionals including psychiatrists, nurses and social workers, (4) service providers such as front-line case workers at mental health agencies and (5) adjudicators, government advisors

  12. Public Policy and Health Informatics.

    Science.gov (United States)

    Bell, Katherine

    2018-04-05

    To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Discursive Policy Webs in a Globalisation Era: A Discussion of Access to Professions and Trades for Immigrant Professionals in Ontario, Canada

    Science.gov (United States)

    Goldberg, Michelle P.

    2006-01-01

    This article explores the link between discourse and policy using a discursive web metaphor. It develops the notion of policy as a discursive web based on a post-positivist framework that recognises the way multiple discourses from multiple voices interact in a complex web of power relationships to influence reality. Using Ontario's Access to…

  14. How do people attribute income-related inequalities in health? A cross-sectional study in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Aisha Lofters

    Full Text Available CONTEXT: Substantive equity-focused policy changes in Ontario, Canada have yet to be realized and may be limited by a lack of widespread public support. An understanding of how the public attributes inequalities can be informative for developing widespread support. Therefore, the objectives of this study were to examine how Ontarians attribute income-related health inequalities. METHODS: We conducted a telephone survey of 2,006 Ontarians using random digit dialing. The survey included thirteen questions relevant to the theme of attributions of income-related health inequalities, with each statement linked to a known social determinant of health. The statements were further categorized depending on whether the statement was framed around blaming the poor for health inequalities, the plight of the poor as a cause of health inequalities, or the privilege of the rich as a cause of health inequalities. RESULTS: There was high agreement for statements that attributed inequalities to differences between the rich and the poor in terms of employment, social status, income and food security, and conversely, the least agreement for statements that attributed inequalities to differences in terms of early childhood development, social exclusion, the social gradient and personal health practices and coping skills. Mean agreement was lower for the two statements that suggested blame for income-related health inequalities lies with the poor (43.1% than for the three statements that attributed inequalities to the plight of the poor (58.3% or the eight statements that attributed inequalities to the privilege of the rich (58.7%. DISCUSSION: A majority of this sample of Ontarians were willing to attribute inequalities to the social determinants of health, and were willing to accept messages that framed inequalities around the privilege of the rich or the plight of the poor. These findings will inform education campaigns, campaigns aimed at increasing public support

  15. Alternative health care consultations in Ontario, Canada: A geographic and socio-demographic analysis

    Directory of Open Access Journals (Sweden)

    Eby Jeanette

    2011-06-01

    Full Text Available Abstract Background An important but understudied component of Canada's health system is alternative care. The objective of this paper is to examine the geographic and socio-demographic characteristics of alternative care consultation in Ontario, Canada's largest province. Methods Data is drawn from the Canadian Community Health Survey (CCHS Cycle 3.1, 2005 for people aged 18 or over (n = 32,598 who had a consultation with an alternative health care provider. Four groups of consultations are examined: (1 all consultations (2 massage therapy (3 acupuncture, and (4 homeopath/naturopath. Descriptive statistics, mapping and logistic regression modeling are employed to analyze the data and to compare modalities of alternative health care use. Results In 2005, more than 1.2 million adults aged 18 or over consulted an alternative health care provider, representing about 13% of the total population of Ontario. The analysis revealed a varied geographic pattern of consultations across the province. Consultations were fairly even across the urban to rural continuum and rural residents were just as likely to consult a provider as their urban counterparts. From a health perspective, people with a chronic condition, lower health status and self-perceived unmet health care needs were more likely to see an alternative health provider. Women with chronic conditions such as fibromyalgia, high blood pressure, chronic fatigue syndrome and chemical sensitivities were more likely to see an alternative provider if they felt their health care needs were not being met. Conclusions The analysis revealed that geography is not a factor in determining alternative health care consultations in Ontario. By contrast, there is a strong association between these consultations and socio-demographic characteristics particularly age, sex, education, health and self-perceived unmet health care needs. The results underscore the importance of women's health needs as related to

  16. Characterizing the Use of Telepsychiatry for Patients with Opioid Use Disorder and Cooccurring Mental Health Disorders in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Brittanie LaBelle

    2018-01-01

    Full Text Available Rural patients with opioid use disorder (OUD face a variety of barriers when accessing opioid agonist therapy (OAT and psychiatric services, due to the limited supply of physicians and the vast geographic area. The telemedicine allows for contact between patients and their physician—regardless of physical distance. Objective. We characterize the usage of telemedicine to deliver psychiatric services to patients with OUD in Ontario, as well as traits of treatment-seeking patients with opioid dependence and concurrent psychiatric disorders. Methodology. A retrospective cohort study was conducted using an administrative database for patients who received psychiatric services via telemedicine between 2008 and 2014 and who also had OUD. Results. We identified 9,077 patients with concurrent opioid use and other mental health disorders who had received psychiatric services via telemedicine from 2008 to 2014; 7,109 (78.3% patients lived in Southern Ontario and 1,968 (21.7% in Northern Ontario. Telemedicine was used more frequently to provide mental health services to patients residing in Northern Ontario than Southern Ontario. Conclusion. Telemedicine is increasingly being utilized throughout Ontario for delivering mental health treatment. There is an opportunity to increase access to psychiatric services for patients with opioid dependence and concurrent psychiatric disorders through the use of the telemedicine.

  17. Trade policy and public health.

    Science.gov (United States)

    Friel, Sharon; Hattersley, Libby; Townsend, Ruth

    2015-03-18

    Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

  18. School Health: Policy Issues.

    Science.gov (United States)

    Baker, Constance M.

    1994-01-01

    Despite data suggesting a relationship between investment in children's health and improved academic performance, school health financing is inadequate, inequitable, and fragmented. Strategies for improving school health programs include leadership from the nursing profession; collaboration among health professionals; consolidation of funding…

  19. African Health Sciences: Editorial Policies

    African Journals Online (AJOL)

    Provide a high quality journal in which health and policy and other ... and publication in the region including alternative means of health care financing, the ... by the African Health Journals Partnership Project that is funded by the US National ...

  20. Public Policy and Economic Efficiency in Ontario's Electricity Market: 2002 to 2011

    Science.gov (United States)

    Olmstead, Derek E. H.

    A competitive wholesale electricity market began operation in Ontario in 2002. The institutional features and development process are described, and the outcomes associated with certain features are assessed. First, a six-equation model of the market is specified and estimated. The results are used to undertake analysis of the province's renewable energy program. The impacts of the program on consumers' and producers' surplus, as well as the resulting degree of carbon dioxide (CO2) emission-abatement, are estimated. These results are used to infer the per-unit cost of CO 2 abatement resulting from the program. Under the assumption that the renewable-fuelled energy displaces coal-fuelled energy from the market, the estimated cost is approximately 93/tonne of CO2; under the alternative assumption that natural gas-fuelled generation is displaced, the estimated cost is 207/tonne of CO2. Comparison to costs observed in other markets and jurisdictions reveals the program to cost approximately one order of magnitude greater than elsewhere. It is concluded that Ontario pays substantially more for emission abatement than is necessary or, alternatively, that Ontario achieves substantially less abatement than is feasible for each dollar of economic resources expended. Second, the market model is also used to assess the treatment of electricity exports with respect to the so-called global adjustment charge. The analysis reveals that the current practise of exempting exports from the charge is not socially optimal from a total surplus-maximisation standpoint. That objective would be achieved if global adjustment was allocated to exports at approximately 32% of the rate at which it is applied to Ontario-based consumers, a result consistent with a Ramsey-type inverse elasticity rule. Third, the forward market unbiasedness hypothesis is assessed in the context of the market for financial transmission rights (FTR). Issues related to left-censoring of payouts at $0 and overlapping

  1. Assessing Ontario's Personal Support Worker Registry

    Directory of Open Access Journals (Sweden)

    Audrey Laporte

    2013-08-01

    Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.

  2. Making health policy

    National Research Council Canada - National Science Library

    Buse, Kent; Mays, Nicholas; Walt, Gill

    2012-01-01

    ... understanding of the inevitable limits of individual health care and of the need to complement such services with effective public health strategies. Major improvements in people's health will come from controlling communicable diseases, eradicating environmental hazards, improving people's diets and enhancing the availability and qua...

  3. Active offer of health services in French in Ontario: Analysis of reorganization and management strategies of health care organizations.

    Science.gov (United States)

    Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

    2018-01-01

    The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Public Health Follow-up of Suspected Exposure to Echinococcus multilocularis in Southwestern Ontario.

    Science.gov (United States)

    Trotz-Williams, L A; Mercer, N J; Walters, J M; Wallace, D; Gottstein, B; Osterman-Lind, E; Boggild, A K; Peregrine, A S

    2017-09-01

    In the 3 years since the first report of canine alveolar echinococcosis (AE) in Ontario, three additional cases have been diagnosed in the province. Of the four cases reported to date, three have had no known history of travel outside the province. It is possible that this development is an indication of previously unrecognized environmental contamination with Echinococcus multilocularis eggs in some areas of the province. If so, there is the potential for an emerging threat to human health. This article describes a local public health department's investigation of the possible exposure to E. multilocularis of a number of individuals who had had contact with the latest of the four cases of canine AE, and summarizes a comprehensive decision process that can be used by public health departments to assist in the follow-up of such exposures. © 2016 Blackwell Verlag GmbH.

  5. Mental health and substance use among bisexual youth and non-youth in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Lori E Ross

    Full Text Available Research has shown that bisexuals have poorer health outcomes than heterosexuals, gays, or lesbians, particularly with regard to mental health and substance use. However, research on bisexuals is often hampered by issues in defining bisexuality, small sample sizes, and by the failure to address age differences between bisexuals and other groups or age gradients in mental health. The Risk & Resilience Survey of Bisexual Mental Health collected data on 405 bisexuals from Ontario, Canada, using respondent-driven sampling, a network-based sampling method for hidden populations. The weighted prevalence of severe depression (PHQ-9 ≥ 20 was 4.7%, possible anxiety disorder (OASIS ≥ 8 was 30.9%, possible post-traumatic stress disorder (PCL-C ≥ 50 was 10.8%, and past year suicide attempt was 1.9%. With respect to substance use, the weighted prevalence of problem drinking (AUDIT ≥ 5 was 31.2%, and the weighted prevalence of illicit polydrug use was 30.5%. Daily smoking was low in this sample, with a weighted prevalence of 7.9%. Youth (aged 16-24 reported significantly higher weighted mean scores on depression and post-traumatic stress disorder, and higher rates of past year suicidal ideation (29.7% vs. 15.2% compared with those aged 25 and older. The burden of mental health and substance use among bisexuals in Ontario is high relative to population-based studies of other sexual orientation groups. Bisexual youth appear to be at risk for poor mental health. Additional research is needed to understand if and how minority stress explains this burden.

  6. The role of taxation policy and incentives in wind-based distributed generation projects viability. Ontario case study

    International Nuclear Information System (INIS)

    Albadi, M.H.; El-Saadany, E.F.

    2009-01-01

    Taxation policy and incentives play a vital role in wind-based distributed generation projects viability. In this paper, a thorough techno-economical evaluation of wind-based distributed generation projects is conducted to investigate the effect of taxes and incentives in the economic viability of investments in this sector. This paper considers the effects of Provincial income taxes, capital cost allowance (CCA), property taxes, and wind power production Federal incentives. The case study is conducted for different wind turbines and wind speed scenarios. Given turbine and wind speed data, the Capacity Factor (CF) of each turbine and wind speed scenario was calculated. Net Present Value (NPV) and Internal Rate of Return (IRR) for different scenarios were then used to assess the project's viability considering Ontario Standard Offer Program (SOP) for wind power. (author)

  7. Health Reform Requires Policy Capacity

    Directory of Open Access Journals (Sweden)

    Pierre-Gerlier Forest

    2015-05-01

    Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility

  8. Comparative Health Policy

    DEFF Research Database (Denmark)

    Blank, Robert H; Burau, Viola; Kuhlmann, Ellen

    A broad-ranging introduction to the provision, funding and governance of health care across a variety of systems. This revised fifth edition incorporates additional material on low/middle income countries, as well as broadened coverage relating to healthcare outside of hospitals and the ever...

  9. Changes to Ontario's electricity market could be harmful to your health

    International Nuclear Information System (INIS)

    1998-09-01

    Mounting concerns that electricity deregulation will increase the use of coal-fired power generation to produce low-cost electricity are discussed. The Ontario Medical Association has issued warnings that pollutants such as sulphur dioxide, nitrogen oxides, particulate matter, mercury and carbon dioxide cause asthma, bronchitis and cancer in humans. In the environment, they cause smog, acid rain and climate change. In a deregulated electricity market, industries and municipal utilities will have the choice to purchase power from any domestic or foreign supplier. It is considered likely that many will choose to purchase electricity from the cheapest suppliers. These happen to be coal-fired generating stations, which are also the highest polluters. It was argued that the health and environmental costs of making this choice would be very high. A way to mitigate these harmful effects is for the government of Ontario to establish pollution limits for all the electricity sold in the province - limits that will actually reduce air pollution. figs

  10. Ontario's energy policy : what are the new government's plans and how will they impact generation adequacy?

    International Nuclear Information System (INIS)

    Chuddy, B.

    2004-01-01

    Key market developments concerning the supply of electricity were identified in this paper, as well as details of legislation and commodity price changes. Major market issues such as volatile pricing, domestic supply shortfall and resource adequacy were examined. Factors contributing to current challenges were identified as being: limited generation investment; generation outages at time of system stress; volatile pricing to small consumers and price caps; lack of a conservation culture; and, cost overruns and growing debt. It was recommended that greater involvement of Local Distribution Companies (LDCs) in power procurement was desirable in order to address needs for stable default supplies as well as consolidation issues. Announcements of the Ontario Ministry of Energy were presented along with a series of questions posed by current market conditions. It was concluded that significant stakeholder input is desirable, as well as greater security in contracting entities, market structure and government resolve. tabs, figs

  11. Enabling the participation of marginalized populations: case studies from a health service organization in Ontario, Canada.

    Science.gov (United States)

    Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R

    2017-08-01

    We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Analyzing public health policy: three approaches.

    Science.gov (United States)

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  13. Implementation of a health care policy: An analysis of barriers and facilitators to practice change

    OpenAIRE

    Watt, Susan; Sword, Wendy; Krueger, Paul

    2005-01-01

    Abstract Background Governments often create policies that rely on implementation by arms length organizations and require practice changes on the part of different segments of the health care system without understanding the differences in and complexities of these agencies. In 2000, in response to publicity about the shortening length of postpartum hospital stay, the Ontario government created a universal program offering up to a 60-hour postpartum stay and a public health follow-up to moth...

  14. Antimicrobial Resistance and Antimicrobial Use Associated with Laboratory-Confirmed Cases of Campylobacter Infection in Two Health Units in Ontario

    Directory of Open Access Journals (Sweden)

    Anne E Deckert

    2013-01-01

    Full Text Available AIM: A population-based study was conducted over a two-year period in the Perth District (PD and Wellington-Dufferin-Guelph (WDG health units in Ontario to document antimicrobial resistance and antimicrobial use associated with clinical cases of laboratory-confirmed campylobacteriosis.

  15. An examination of the health information seeking experiences of women in rural Ontario, Canada

    Directory of Open Access Journals (Sweden)

    C.N. Wathen

    2006-01-01

    Full Text Available Introduction. Women are active information seekers, particularly in the context of managing health for themselves and their families. Rural living may present particular challenges and opportunities for women in their health information seeking. Method. Forty women living in a rural part of Ontario, Canada were interviewed using a semi-structured interview guide. They were asked about their health information seeking for both chronic and acute concerns. Analysis. Interview transcripts were organized using NVivo software (version 6 and analysed using a coding scheme iteratively developed by both authors. Results. Emerging themes included: the context of rural living, information and health literacy, the role of unanticipated information intermediaries in the search process, and the mis-match between assumptions made by 'the system' about sources of information, and women's lived realities. Conclusion. . There are unique challenges and enablers to health information seeking for women living in rural areas, including the role of formal, informal and ICT-based information intermediaries, the availability to women of required literacies for health information seeking and uptake. Research findings such as those presented in this paper can assist in better understanding both the contexts of information seeking, as well as the preferences and behaviour of those with information needs.

  16. Occupational health and safety issues in Ontario sawmills and veneer/plywood plants: a pilot study.

    Science.gov (United States)

    Verma, Dave K; Demers, Cecil; Shaw, Don; Verma, Paul; Kurtz, Lawrence; Finkelstein, Murray; des Tombe, Karen; Welton, Tom

    2010-01-01

    A pilot study was conducted within the Ontario sawmill and veneer/plywood manufacturing industry. Information was collected by postal questionnaire and observational walk-through surveys. Industrial hygiene walk-through surveys were conducted at 22 work sites, and measurements for wood dust, noise, and bioaerosol were taken. The aim of the study was to obtain data on the current status regarding health and safety characteristics and an estimate of wood dust, noise, and bioaerosol exposures. The occupational exposure to wood dust and noise are similar to what has been reported in this industry in Canada and elsewhere. Airborne wood dust concentration ranged between 0.001 mg/m³ and 4.87 mg/m³ as total dust and noise exposure ranged between 55 and 117 dB(A). The study indicates the need for a more comprehensive industry-wide study of wood dust, noise, and bioaersols.

  17. Occupational Health and Safety Issues in Ontario Sawmills and Veneer/Plywood Plants: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Dave K. Verma

    2010-01-01

    Full Text Available A pilot study was conducted within the Ontario sawmill and veneer/plywood manufacturing industry. Information was collected by postal questionnaire and observational walk-through surveys. Industrial hygiene walk-through surveys were conducted at 22 work sites, and measurements for wood dust, noise, and bioaerosol were taken. The aim of the study was to obtain data on the current status regarding health and safety characteristics and an estimate of wood dust, noise, and bioaerosol exposures. The occupational exposure to wood dust and noise are similar to what has been reported in this industry in Canada and elsewhere. Airborne wood dust concentration ranged between 0.001 mg/m3 and 4.87 mg/m3 as total dust and noise exposure ranged between 55 and 117 dB(A. The study indicates the need for a more comprehensive industry-wide study of wood dust, noise, and bioaersols.

  18. Achieving the economic potential for industrial cogeneration in Ontario: A financial perspective on electric utility policy

    International Nuclear Information System (INIS)

    Diemer, S.G.; Cain, S.R.

    1993-01-01

    The impact of private vs public ownership regimes on the magnitude of achievable industrial cogeneration capacity in Ontario is assessed. Estimates of technical and economic potential are presented for several industrial subsectors and heat demand categories, showing that nearly all of the technically feasible 7,600 MW is also economically efficient given a value of power of at least 4 cents/kWh in 1991 dollars. Using financial data and investment criteria specific to the two forms of ownership, the project evaluation model points to a significantly larger quantum of financial (achievable) potential with public rather than private development of industrial cogeneration. At avoided costs and associated buyback rates of 4 and 5 cents/kWh, the achievable cogeneration capacities are ca 2,400 and 7,600 MW under public ownership and 132 and 3,000 MW under private ownership. Ratepayer savings are significant: the full economic potential can be achieved through public ownership at a buyback rate of 5 cents/kWh; under private ownership, a comparable capacity requires a 6 cents buyback rate, reflecting additional ratepayer costs of nearly $600 million annually. 1 fig., 4 tabs

  19. Policy, politics and public health.

    Science.gov (United States)

    Greer, Scott L; Bekker, Marleen; de Leeuw, Evelyne; Wismar, Matthias; Helderman, Jan-Kees; Ribeiro, Sofia; Stuckler, David

    2017-10-01

    If public health is the field that diagnoses and strives to cure social ills, then understanding political causes and cures for health problems should be an intrinsic part of the field. In this article, we argue that there is no support for the simple and common, implicit model of politics in which scientific evidence plus political will produces healthy policies. Efforts to improve the translation of evidence into policy such as knowledge transfer work only under certain circumstances. These circumstances are frequently political, and to be understood through systematic inquiry into basic features of the political economy such as institutions, partisanship and the organization of labour markets. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  20. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

    Science.gov (United States)

    Baiden, Philip; Fallon, Barbara

    2018-05-01

    Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice

  1. Building evaluation capacity in Ontario's public health units: promising practices and strategies.

    Science.gov (United States)

    Bourgeois, I; Simmons, L; Buetti, D

    2018-03-26

    This article presents the findings of a project focusing on building evaluation capacity in 10 Ontario public health units. The study sought to identify effective strategies that lead to increased evaluation capacity in the participating organizations. This study used a qualitative, multiple case research design. An action research methodology was used to design customized evaluation capacity building (ECB) strategies for each participating organization, based on its specific context and needs. This methodological approach also enabled monitoring and assessment of each strategy, based on a common set of reporting templates. A multiple case study was used to analyze the findings from the 10 participating organizations and derive higher level findings. The main findings of the study show that most of the strategies used to increase evaluation capacity in public health units are promising, especially those focusing on developing the knowledge, skills, and attitudes of health unit staff and managers. Facilitators to ECB strategies were the engagement of all staff members, the support of leadership, and the existence of organizational tools and infrastructure to support evaluation. It is also essential to recognize that ECB takes time and resources to be successful. The design and implementation of ECB strategies should be based on organizational needs. These can be assessed using a standardized instrument, as well as interviews and staff surveys. The implementation of a multicomponent approach (i.e. several strategies implemented simultaneously) is also linked to better ECB outcomes in organizations. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. [Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

    Science.gov (United States)

    Ulrich, Lisa-R; Pham, Thuy-Nga Tia; Gerlach, Ferdinand M; Erler, Antje

    2017-07-11

    The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners. In 2014, the German Advisory Council on the Assessment of Developments in the Health Care System highlighted the importance of regional, integrated care with community-based primary care centres at its core, providing comprehensive, population-based, patient-centred primary care with adequate access to general practitioners for a given geographical area. Such centres exist already in Ontario, Canada; within Family Health Teams (FHT), family physicians work hand-in-hand with pharmacists, nurses, nurse practitioners, social workers, and other allied health professionals. In this article, the Canadian model of FHT will be introduced and we will discuss which components could be adapted to suit the German primary care system. © Georg Thieme Verlag KG Stuttgart · New York.

  3. A policy instruments working paper on reducing CO2 emissions from the transportation sector in Ontario

    International Nuclear Information System (INIS)

    1995-11-01

    The cost effectiveness of policy instruments for reducing CO 2 emissions from transportation was studied. Cost effectiveness analyzed the impact of the policy instruments in reducing CO 2 emissions against the costs that were incurred while obtaining CO 2 reductions. The approach to defining sustainable transportation was identified which integrates three different visions of the transportation challenge: (1) changing urban form to reduce the need for transportation, (2) advancing technology to reduce the ecological impact of transportation, and (3) changing prices of transportation so that users pay for the full social and environmental costs of their decisions. The general consensus was that while fuel tax on gasoline for automobiles appeared to be the most cost effective option available, all revenue generating options, (e.g.,parking pricing, reference energy factor-related rebates, full cost road pricing and taxation) rated higher on the cost effectiveness indexes than any of the other policy instruments considered. refs., tabs., figs

  4. Dangerousness and mental health policy.

    Science.gov (United States)

    Hewitt, J L

    2008-04-01

    Mental health policy development in the UK has become increasingly dominated by the assumed need to prevent violence and alleviate public concerns about the dangers of the mentally ill living in the community. Risk management has become the expected focus of contemporary mental health services, and responsibility has increasingly been devolved to individual service professionals when systems fail to prevent violence. This paper analyses the development of mental health legislation and its impact on services users and mental health professionals at the micro level of service delivery. Historical precedence, media influence and public opinion are explored, and the reification of risk is questioned in practical and ethical terms. The government's newest proposals for compulsory treatment in the community are discussed in terms of practical efficacy and therapeutic impact. Dangerousness is far from being an objectively observable phenomenon arising from clinical pathology, but is a formulation of what is partially knowable through social analysis and unknowable by virtue of its situation in individual psychic motivation. Risk assessment can therefore never be completely accurate, and the solution of a 'better safe than sorry' approach to mental health policy is ethically and pragmatically flawed.

  5. Lessons learned from Ontario wind energy disputes

    Science.gov (United States)

    Fast, Stewart; Mabee, Warren; Baxter, Jamie; Christidis, Tanya; Driver, Liz; Hill, Stephen; McMurtry, J. J.; Tomkow, Melody

    2016-02-01

    Issues concerning the social acceptance of wind energy are major challenges for policy-makers, communities and wind developers. They also impact the legitimacy of societal decisions to pursue wind energy. Here we set out to identify and assess the factors that lead to wind energy disputes in Ontario, Canada, a region of the world that has experienced a rapid increase in the development of wind energy. Based on our expertise as a group comprising social scientists, a community representative and a wind industry advocate engaged in the Ontario wind energy situation, we explore and suggest recommendations based on four key factors: socially mediated health concerns, the distribution of financial benefits, lack of meaningful engagement and failure to treat landscape concerns seriously. Ontario's recent change from a feed-in-tariff-based renewable electricity procurement process to a competitive bid process, albeit with more attention to community engagement, will only partially address these concerns.

  6. Trade policy and health: from conflicting interests to policy coherence.

    Science.gov (United States)

    Blouin, Chantal

    2007-03-01

    Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base.

  7. Macropsychology, policy, and global health.

    Science.gov (United States)

    MacLachlan, Malcolm

    2014-11-01

    In this article I argue for the development of a macro perspective within psychology, akin to that found in macroeconomics. Macropsychology is the application of psychology to factors that influence the settings and conditions of our lives. As policy concerns the strategic allocation of resources—who gets what and why?—it should be an area of particular interest for macropsychology. I review ways in which psychology may make a contribution to policy within the field of global health. Global health emphasizes human rights, equity, social inclusion, and empowerment; psychology has much to contribute to these areas, both at the level of policy and practice. I review the sorts of evidence and other factors that influence policymakers, along with the content, process, and context of policymaking, with a particular focus on the rights of people with disabilities in the low- and middle-income countries of Africa and Asia. These insights are drawn from collaborations with a broad range of practitioners, governments, United Nations agencies, civil society organizations, the private sector and researchers. Humanitarian work psychology is highlighted as an example of a new area of psychology that embraces some of the concerns of macropsychology. The advent of "big data" presents psychology with an opportunity to ask new types of questions, and these should include "understanding up," or how psychological factors can contribute to human well-being, nationally and globally. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  8. End of life discussion in an academic family health team in Kingston, Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Reta French

    2013-01-01

    Full Text Available Background: End-of-life (EOL discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been discussed. Objectives and Methods: The objective of this study was to explore the prevalence of EOL discussions in non-terminal adult patients, the perceived barriers to such discussions and suggested methods for improvement. A study mixed-methods study was performed by a group of PGY1 family medicine residents in an academic health team in Kingston, Ontario. Results: EOL discussion was performed in a very small proportion of non-terminal patient encounters. Compared with attending physicians, residents were less likely to discuss EOL issues and reported more perceived barriers. Conclusion: Our findings reflect the need for an early and open approach in conducting EOL discussion for non-terminal healthy patients.

  9. Bringing Policy and Practice to the Table: Young Women's Nutritional Experiences in an Ontario Secondary School

    Science.gov (United States)

    Gray, Sarah K.

    2015-01-01

    In recent years, media, health organizations and researchers have raised concern over the health of Canadian children and adolescents. Stakeholders have called on the government to confront the problem. Schools are seen as an ideal location for developing and implementing large-scale interventions because of the ease of access to large groups of…

  10. Problem Gambling Among Ontario Students: Associations with Substance Abuse, Mental Health Problems, Suicide Attempts, and Delinquent Behaviours.

    Science.gov (United States)

    Cook, Steven; Turner, Nigel E; Ballon, Bruce; Paglia-Boak, Angela; Murray, Robert; Adlaf, Edward M; Ilie, Gabriela; den Dunnen, Wendy; Mann, Robert E

    2015-12-01

    This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.

  11. The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams.

    Science.gov (United States)

    Ashcroft, Rachelle; McMillan, Colleen; Ambrose-Miller, Wayne; McKee, Ryan; Brown, Judith Belle

    2018-05-01

    Primary health care systems are increasingly integrating interprofessional team-based approaches to care delivery. As members of these interprofessional primary health care teams, it is important for social workers to explore our experiences of integration into these newly emerging teams to help strengthen patient care. Despite the expansion of social work within primary health care settings, few studies have examined the integration of social work's role into this expanding area of the health care system. A survey was conducted with Canadian social work practitioners who were employed within Family Health Teams (FHTs), an interprofessional model of primary health care in Ontario emerging from a period of health care reform. One hundred and twenty-eight (N = 128) respondents completed the online survey. Key barriers to social work integration in FHTs included difficulties associated with a medical model environment, confusion about social work role, and organizational barriers. Facilitators for integration of social work in FHTs included adequate education and competencies, collaborative engagement, and organizational structures.

  12. Australia's national men's health policy: masculinity matters.

    Science.gov (United States)

    Saunders, Margo; Peerson, Anita

    2009-08-01

    The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

  13. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    Directory of Open Access Journals (Sweden)

    Gore Dana

    2012-08-01

    Full Text Available Abstract Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered, blueprints (or frameworks to tailor developed programs, and building blocks (resources to develop programs. Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the

  14. Prioritizing Sleep Health: Public Health Policy Recommendations.

    Science.gov (United States)

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. © The Author(s) 2015.

  15. Lone workers attitudes towards their health: views of Ontario truck drivers and their managers.

    Science.gov (United States)

    McDonough, Beatrice; Howard, Michelle; Angeles, Ricardo; Dolovich, Lisa; Marzanek-Lefebvre, Francine; Riva, John J; Laryea, Stephanie

    2014-05-14

    Truck driving is the second most common occupation among Canadian men. Transportation of goods via roads is of crucial importance for the Canadian economy. The industry is responsible annually for $17 billion in GDP and is projected to increase by 28% over the next 10 years. Recruitment is an issue with 20% of drivers projected to retire or leave the profession in the next 10 years. Despite the reliance on transport truck drivers for the delivery of goods which affects Canada's economy and daily living of residents, little is known about the health care needs of this large cohort of primarily male lone workers from a drivers' perspective. Transport truck drivers are independent workers whose non traditional workplace is their tractor, the truck stops and the journey on the road.The objective of this study was to obtain a contextually informed description of lifestyle issues, health and disease risk factors experienced by drivers and perceived by their managers in the truck driving occupation. Using a grounded theory approach, 4 focus groups were conducted with drivers (n = 16) and managers (n = 10) from two trucking companies in Southwestern Ontario to identify the lived experience of the drivers as it relates to preventable risks to health and wellness. A semi structured guided interview was used to explore the lifestyle context of transport truck driving and organizational aspects of the occupation (workplace culture, working conditions and health and wellness promotion). The predominant themes described stress, workplace, communication, lifestyle, driving culture, family, and fatigue concerns. In terms of the transportation work environment, drivers and managers were aware of the profession's potential to foster lifestyle related chronic diseases but described challenges in making the profession more amenable to a healthy lifestyle. Workplace environmental determinants are significant in shaping health behaviours. Chronic disease health risks were the

  16. Health as foreign policy: harnessing globalization for health.

    Science.gov (United States)

    Fidler, David P

    2006-12-01

    This paper explores the importance for health promotion of the rise of public health as a foreign policy issue. Although health promotion encompassed foreign policy as part of 'healthy public policy', mainstream foreign policy neglected public health and health promotion's role in it. Globalization forces health promotion, however, to address directly the relationship between public health and foreign policy. The need for 'health as foreign policy' is apparent from the prominence public health now has in all the basic governance functions served by foreign policy. The Secretary-General's United Nations (UN) reform proposals demonstrate the importance of foreign policy to health promotion as a core component of public health because the proposals embed public health in each element of the Secretary-General's vision for the UN in the 21st century. The emergence of health as foreign policy presents opportunities and risks for health promotion that can be managed by emphasizing that public health constitutes an integrated public good that benefits all governance tasks served by foreign policy. Any effort to harness globalization for public health will have to make health as foreign policy a centerpiece of its ambitions, and this task is now health promotion's burden and opportunity.

  17. Self-reported teamwork in family health team practices in Ontario

    Science.gov (United States)

    Howard, Michelle; Brazil, Kevin; Akhtar-Danesh, Noori; Agarwal, Gina

    2011-01-01

    Abstract Objective To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Design Cross-sectional study using a mailed survey. Setting Family health teams in Ontario. Participants Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Main outcome measures Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. Results The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Conclusion Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams. PMID:21571706

  18. Understanding health policy leaders' training needs.

    Directory of Open Access Journals (Sweden)

    Carey Roth Bayer

    Full Text Available We assessed the training needs of health policy leaders and practitioners across career stages; identified areas of core content for health policy training programs; and, identified training modalities for health policy leaders.We convened a focus group of health policy leaders at varying career stages to inform the development of the Health Policy Leaders' Training Needs Assessment tool. We piloted and distributed the tool electronically. We used descriptive statistics and thematic coding for analysis.Seventy participants varying in age and stage of career completed the tool. "Cost implications of health policies" ranked highest for personal knowledge development and "intersection of policy and politics" ranked highest for health policy leaders in general. "Effective communication skills" ranked as the highest skill element and "integrity" as the highest attribute element. Format for training varied based on age and career stage.This study highlighted the training needs of health policy leaders personally as well as their perceptions of the needs for training health policy leaders in general. The findings are applicable for current health policy leadership training programs as well as those in development.

  19. Moving towards a new vision: implementation of a public health policy intervention

    Directory of Open Access Journals (Sweden)

    Ruta Valaitis

    2016-05-01

    Full Text Available Abstract Background Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public’s health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers’, managers’ and senior managements’ perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. Methods Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups and 2011 (senior management interviews involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. Results Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues’ empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals

  20. Complementarities or contradictions? Scoping the health dimensions of "flexicurity" labor market policies.

    Science.gov (United States)

    Afzal, Zabia; Muntaner, Carles; Chung, Haejoo; Mahmood, Qamar; Ng, Edwin; Schrecker, Ted

    2013-01-01

    Flexicurity, or the integration of labor market flexibility with social security and active labor market policies, has figured prominently in economic and social policy discussions in Europe since the mid-1990s. Such policies are designed to transcend traditional labor-capital conflicts and to form a mutually supportive nexus of flexibility and security within a climate of intensified competition and rapid technological change. International bodies have marketed flexicurity as an innovative win-win strategy for employers and workers alike, commonly citing Denmark and The Netherlands as exemplars of best practice. In this article, we apply a social determinants of health framework to conduct a scoping review of the academic and gray literature to: (a) better understand the empirical associations between flexicurity practices and population health in Denmark and (b) assess the relevance and feasibility of implementing such policies to improve health and reduce health inequalities in Ontario, Canada. Based on 39 studies meeting our full inclusion criteria, preliminary findings suggest that flexicurity is limited as a potential health promotion strategy in Ontario, offers more risks to workers' health than benefits, and requires the strengthening of other social protections before it could be realistically implemented within a Canadian context.

  1. The future of European health policies.

    Science.gov (United States)

    Koivusalo, Meri Tuulikki

    2005-01-01

    The role of the European Union in health policies is changing. The European social model is under threat due to shifts in E.U. policies on liberalization of service provision, limited public budgets, a focus on the health sector as a productive sector in the context of broader European policies and the Lisbon strategy, and changes in the context of the new Constitutional Treaty. These changes are evident in a new reflection paper on European health strategy and its focus. E.U. health policies are at a critical juncture. The danger is that the current processes will lead European health policies and the health systems of member states more in the direction of U.S. health policies and the commercialization of health systems than toward improvement of the current situation.

  2. Local enactments of national health promotion policies

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    organisational levels. Visiting, observing and interviewing 15 policy workers from 10 municipalities during a two-year period, this study investigated what happened to a Danish national health promotion policy as it was put into practice and managed in the Danish municipalities. The analysis reveals...... the concrete enactments and their locally experienced effects, our understanding of national public health policies risks becoming detached from praxis and unproductive. Public health policy-makers must pay methodological and analytical attention to the policies' multimodality and their concrete locally......Governments of welfare states are firmly committed to public health, resulting in a substantial number of public health policies. Given the multi-level structure of most welfare systems, the influence of a public health policy is related to its ability to spread geographically and move across...

  3. Full cost accounting for decision making at Ontario Hydro

    International Nuclear Information System (INIS)

    Plagiannakos, T.

    1996-01-01

    Ontario Hydro's approach to full cost accounting (FCA) was outlined in response to questions raised earlier, in another forum, regarding Ontario Hydro's views on FCA. FCA was defined as an evaluation framework (as opposed to an accounting system) which tries to account for the internal (private) as well as the external (environment and human health) costs and benefits and integrate them into business decisions. When the external impacts cannot be monetized, qualitative evaluations are used based on the damage costing approach, which Ontario Hydro prefers to the cost of control method recommended by its critics. In general, however, Ontario Hydro is not opposed to FCA in so far as it puts the Utility in a better position to make more informed decisions, improve environmental cost management, avoid future costs, enhance revenue, improve environmental quality, contribute to environmental policy, and contribute to sustainable development. 1 fig

  4. A Population-Based Study of Postpartum Mental Health Service Use by Immigrant Women in Ontario, Canada.

    Science.gov (United States)

    Vigod, Simone; Sultana, Anjum; Fung, Kinwah; Hussain-Shamsy, Neesha; Dennis, Cindy-Lee

    2016-11-01

    Postpartum mental disorders are twice as common among immigrant women compared to nonimmigrant women in developed countries. Immigrant women may experience barriers to access and use of postpartum mental health services, but little is known about their service use on a population level. We described postpartum mental health service use of immigrant mothers living in Ontario, Canada, comparing to a referent group of mothers who were either born in Canada or had lived in Ontario or another Canadian province since 1985. Among all women in Ontario, Canada, delivering a live infant from 2008 to 2012 (n = 450,622), we described mental health service use within 1 year postpartum, including mental health physician visits, psychiatric emergency department visits, and psychiatric hospitalization. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) comparing immigrant women to the referent group were adjusted for maternal age, parity, income, rurality, mental health services in prior 2 years, and maternal and newborn health. Immigrant women (n = 123,231; 27%) were less likely to use mental health services than women in the referent group (14.1% vs. 21.4%; aOR, 0.59; 95% CI, 0.58 to 0.61), including for physician-based (13.9% vs. 21.1%; aOR, 0.59; 95% CI, 0.58 to 0.61) and emergency department (0.6% vs. 1.3%; aOR, 0.63; 95% CI, 0.57 to 0.68) services. Hospitalization risk was lower among immigrants (0.20% vs. 0.33%) but became similar after covariate adjustment (aOR, 0.92; 95% CI, 0.79 to 1.06). Underuse of postpartum mental health services may be contributing to the high burden of postpartum mental disorders among immigrant women. © The Author(s) 2016.

  5. Making health policy: networks in research and policy after 1945.

    Science.gov (United States)

    Berridge, Virginia

    2005-01-01

    Science and policy in health and medicine have interacted in new ways in Britain since 1945. The relationship between research and policy has a history. The changing role of social medicine, the rise of health services research and "customer contractor" policies in government have been important. The relationship between research and policy has been analysed by different schools of thought. This chapter categorises them as several groups: "evidence-based", "journalism", "sociology of scientific knowledge" and "science policy studies". The chapters in the book illuminate aspects of these changing relationships. The role of chronic disease epidemiology, of new networks in public health, of media-focussed activism, and of health technology and its advocates have been more important than political interest.

  6. Finding Common Ground: A Critical Review of Land Use and Resource Management Policies in Ontario, Canada and their Intersection with First Nations

    Directory of Open Access Journals (Sweden)

    Fraser McLeod

    2015-01-01

    Full Text Available This article provides an in-depth analysis of selective land use and resource management policies in the Province of Ontario, Canada. It examines their relative capacity to recognize the rights of First Nations and Aboriginal peoples and their treaty rights, as well as their embodiment of past Crown–First Nations relationships. An analytical framework was developed to evaluate the manifest and latent content of 337 provincial texts, including 32 provincial acts, 269 regulatory documents, 16 policy statements, and 5 provincial plans. This comprehensive document analysis classified and assessed how current provincial policies address First Nation issues and identified common trends and areas of improvement. The authors conclude that there is an immediate need for guidance on how provincial authorities can improve policy to make relationship-building a priority to enhance and sustain relationships between First Nations and other jurisdictions.

  7. Need for Oral Health Policy in India

    African Journals Online (AJOL)

    implementation of National Oral Health Policy in India in order to expand the oral health care to ... Professional dental organizations can also support government programs to .... who can play effective role in providing oral health care services.

  8. Trading our health: Ontario Power Generation's plan to violate its air pollution reduction commitment

    International Nuclear Information System (INIS)

    Gibbons, J.; Bjorkquist, S.

    1999-01-01

    Amid growing concerns about nitrogen oxide (Nox) emissions, the Ontario Clean Air Alliance is recommending in this report that the Ontario government restrict Nox emissions from Ontario Power Generation (OPG) in the year 2000 and not let the corporation meet its emissions cap by on a net basis by retiring Pilot Emission Reduction Trading (PERT) Nox emission reduction credits. Instead the alliance believes the Ontario government should require OPG to achieve emissions compliance by curtailing coal-fired electricity exports, purchasing renewable and natural-gas electricity and promoting energy efficiency. OPG's inventory of PERT Nox reduction credits are assessed against whether they will cause an increase in the year 2000 as a result of trading. Ontario Power Generation's Nox emissions are a central chemical component of acid rain and smog and are produced from its coal-fired electricity generators. The utility would like to achieve Nox reductions by establishing demand management programs which would reduce the demand for electricity by 5200 megawatts (MW), by purchasing 3100 MW of non-utility generation and by undertaking combustion process modifications at its Lambton and Nanticoke coal-fired generating stations. It has not met its 2000 demand management and non-utility generation targets, and specifically, as of December 31, 1998, Ontario Hydro's successor companies demand management programs have only reduced electricity demand by approximately 1300 MW. Furthermore, the successor companies will have only approximately 1700 MW of non-utility generation capacity under contract by December 31, 1999. The report describes the criteria for ensuring that Nox emissions trading will not lead to a net increase in Ontario's emissions in any given year, and a description is included of why the 'Draft Rules for Emission Trading in Ontario' rules do not meet these criteria. Permitting OPG to use its PERT credits to meet its Nox cap, will allow them to increase coal

  9. Current approaches to the European Health Policy

    Directory of Open Access Journals (Sweden)

    Anda CURTA

    2010-06-01

    Full Text Available The purpose of this paper is to identify the key elements that define the new European health policy. We observed that the health policy actually appeared to be an enclave within the integration process. The development of health policy in the new Member States followed a common pattern. Therefore, the European health policy reflected a general desire on behalf of the members to have more clarity of the rules in this area, given the different interpretation of the rules by different Member States.The Lisbon Treaty does not bring substantive changes regarding the public health policy, therefore the Member States shall keep their competence in defining the organization and financing this domain. However, the EU2020 Strategy states that “Europe faces a moment of transformation”. Therefore, the “Europeanization” of health policy could lead to the positive developments that all EU citizens are expecting.

  10. Population mental health: evidence, policy, and public health practice

    National Research Council Canada - National Science Library

    Cohen, Neal L; Galea, Sandro

    2011-01-01

    ... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

  11. Childhood Diabesity: International Applications for Health Education and Health Policy

    Science.gov (United States)

    Pinzon-Perez, Helda; Kotkin-Jaszi, Suzanne; Perez, Miguel A.

    2010-01-01

    Health policy has a direct impact on health education initiatives, health care delivery, resource allocation, and quality of life. Increasing rates in the epidemics of obesity and obesity-dependent diabetes mellitus (aka diabesity) suggest that health policy changes should be included in health education and disease prevention strategies. Health…

  12. Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

    Science.gov (United States)

    Shakya, Yogendra; Gagnon, Anita J; Cole, Donald C; Rashid, Meb; Blake, Jennifer; Dastoori, Parisa; Moineddin, Rahim; Ray, Joel G; Urquia, Marcelo L

    2018-01-01

    Objectives Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes. Design This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data. Setting and participants Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014. Primary outcomes Numerous adverse maternal and perinatal health outcomes. Results Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers. Conclusions Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration

  13. Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

    Science.gov (United States)

    Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

    2014-02-24

    Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

  14. Public health human resources: a comparative analysis of policy documents in two Canadian provinces

    Science.gov (United States)

    2014-01-01

    Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

  15. Leprosy: International Public Health Policies and Public Health Eras

    Directory of Open Access Journals (Sweden)

    Niyi Awofeso

    2011-09-01

    Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

  16. State health policy for terrorism preparedness.

    Science.gov (United States)

    Ziskin, Leah Z; Harris, Drew A

    2007-09-01

    State health policy for terrorism preparedness began before the terrorist attacks on September 11, 2001, but was accelerated after that day. In a crisis atmosphere after September 11, the states found their policies changing rapidly, greatly influenced by federal policies and federal dollars. In the 5 years since September 11, these state health policies have been refined. This refinement has included a restatement of the goals and objectives of state programs, the modernization of emergency powers statutes, the education and training of the public health workforce, and a preparation of the health care system to better care for victims of disasters, including acts of terrorism.

  17. Big Data for Public Health Policy-Making: Policy Empowerment.

    Science.gov (United States)

    Mählmann, Laura; Reumann, Matthias; Evangelatos, Nikolaos; Brand, Angela

    2018-04-04

    Digitization is considered to radically transform healthcare. As such, with seemingly unlimited opportunities to collect data, it will play an important role in the public health policy-making process. In this context, health data cooperatives (HDC) are a key component and core element for public health policy-making and for exploiting the potential of all the existing and rapidly emerging data sources. Being able to leverage all the data requires overcoming the computational, algorithmic, and technological challenges that characterize today's highly heterogeneous data landscape, as well as a host of diverse regulatory, normative, governance, and policy constraints. The full potential of big data can only be realized if data are being made accessible and shared. Treating research data as a public good, creating HDC to empower citizens through citizen-owned health data, and allowing data access for research and the development of new diagnostics, therapies, and public health policies will yield the transformative impact of digital health. The HDC model for data governance is an arrangement, based on moral codes, that encourages citizens to participate in the improvement of their own health. This then enables public health institutions and policymakers to monitor policy changes and evaluate their impact and risk on a population level. © 2018 S. Karger AG, Basel.

  18. Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada.

    Science.gov (United States)

    Chiu, Maria; Amartey, Abigail; Wang, Xuesong; Kurdyak, Paul

    2018-01-01

    The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. We found that self-reported physician-diagnosed mood and anxiety disorders and mental health service use were generally lower among South Asian, Chinese, and black respondents compared to white respondents. Chinese individuals reported the weakest sense of belonging to their local community and the poorest self-rated mental health and were nearly as likely to report suicidal thoughts in the past year as white respondents. Among those self-reporting fair or poor mental health, less than half sought help from a mental health professional, ranging from only 19.8% in the Chinese group to 50.8% in the white group. The prevalence of mental health factors and mental health service use varied widely across ethnic groups. Efforts are needed to better understand and address cultural and system-level barriers surrounding high unmet needs and to identify ethnically tailored and culturally appropriate clinical supports and practices to ensure equitable and timely mental health care.

  19. Health and Wellness Policy Ethics

    Directory of Open Access Journals (Sweden)

    Frank J. Cavico

    2013-01-01

    Full Text Available This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.

  20. Health and Wellness Policy Ethics

    Science.gov (United States)

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  1. Ontario's Poverty Reduction Strategy: A Critical Discourse Analysis.

    Science.gov (United States)

    Benbow, Sarah; Gorlick, Carolyne; Forchuk, Cheryl; Ward-Griffin, Catherine; Berman, Helene

    2016-01-01

    This article overviews the second phase of a two-phase study which examined experiences of health and social exclusion among mothers experiencing homelessness in Ontario, Canada. A critical discourse analysis was employed to analyze the policy document, Realizing Our Potential: Ontario's Poverty Reduction Strategy, 2014-2019. In nursing, analysis of policy is an emerging form of scholarship, one that draws attention to the macro levels influencing health and health promotion, such as the social determinants of health, and the policies that impact them. The clear neo-liberal underpinnings, within the strategy, with a focus on productivity and labor market participation leave little room for an understanding of poverty reduction from a human rights perspective. Further, gender-neutrality rendered the poverty experienced by women, and mothers, invisible. Notably, there were a lack of deadlines, target dates, and thorough action and evaluation plans. Such absence troubles whether poverty reduction is truly a priority for the government, and society as a whole.

  2. Implementation of a health care policy: An analysis of barriers and facilitators to practice change

    Directory of Open Access Journals (Sweden)

    Sword Wendy

    2005-08-01

    Full Text Available Abstract Background Governments often create policies that rely on implementation by arms length organizations and require practice changes on the part of different segments of the health care system without understanding the differences in and complexities of these agencies. In 2000, in response to publicity about the shortening length of postpartum hospital stay, the Ontario government created a universal program offering up to a 60-hour postpartum stay and a public health follow-up to mothers and newborn infants. The purpose of this paper is to examine how a health policy initiative was implemented in two different parts of a health care system and to analyze the barriers and facilitators to achieving practice change. Methods The data reported came from two studies of postpartum health and service use in Ontario Canada. Data were collected from newly delivered mothers who had uncomplicated vaginal deliveries. The study samples were drawn from the same five purposefully selected hospitals for both studies. Questionnaires prior to discharge and structured telephone interviews at 4-weeks post discharge were used to collect data before and after policy implementation. Qualitative data were collected using focus groups with hospital and community-based health care practitioners and administrators at each site. Results In both studies, the respondents reflected a population of women who experienced an "average" or non-eventful hospital-based, singleton vaginal delivery. The findings of the second study demonstrated wide variance in implementation of the offer of a 60-hour stay among the sites and focus groups revealed that none of the hospitals acknowledged the 60-hour stay as an official policy. The uptake of the offer of a 60-hour stay was unrelated to the rate of offer. The percentage of women with a hospital stay of less than 25 hours and the number with the guideline that the call be within 48 hours of hospital discharge. Public health

  3. Employers' paradoxical views about temporary foreign migrant workers' health: a qualitative study in rural farms in southern Ontario.

    Science.gov (United States)

    Narushima, Miya; Sanchez, Ana Lourdes

    2014-09-10

    The province of Ontario hosts nearly a half of Canada's temporary foreign migrant farm workers (MFWs). Despite the essential role played by MFWs in the economic prosperity of the region, a growing body of research suggests that the workers' occupational safety and health are substandard, and often neglected by employers. This study thus explores farm owners' perceptions about MFWs occupational safety and general health, and their attitudes towards health promotion for their employees. Using modified grounded theory approach, we collected data through in-depth individual interviews with farm owners employing MFWs in southern Ontario, Canada. Data were analyzed following three steps (open, axial, and selective coding) to identify thematic patterns and relationships. Nine employers or their representatives were interviewed. Four major overarching categories were identified: employers' dependence on MFWs; their fragmented view of occupational safety and health; their blurring of the boundaries between the work and personal lives of the MFWs on their farms; and their reluctance to implement health promotion programs. The interaction of these categories suggests the complex social processes through which employers come to hold these paradoxical attitudes towards workers' safety and health. There is a fundamental contradiction between what employers considered public versus personal. Despite employers' preference to separate MFWs' workplace safety from personal health issues, due to the fact that workers live within their employers' property, workers' private life becomes public making their personal health a business-related concern. Farmers' conflicting views, combined with a lack of support from governing bodies, hold back timely implementation of health promotion activities in the workplace. In order to address the needs of MFWs in a more integrated manner, an ecological view of health, which includes the social and psychological determinants of health, by employers

  4. Health Policy as a Specific Area of Social Policy

    Directory of Open Access Journals (Sweden)

    Dominika Pekarová

    2017-08-01

    Full Text Available Purpose and Originality: The aim of the article was to analyse the work of the health policy which is a very specific part of social policy. In the work we focus on its financing, which is a very important issue in the health care. We try to show, what is the role of the state in the health care system as well as the creation of resources and control costs in the health sector. The work is finding such as financing health care in Slovakia and in other selected countries, and which could be changed for the best operation. Method: The analysis was carried out on the basis of the information which I drew from books and Internet resources. The work is divided into two parts. Contains 9 tables and 3 charts. The first chapter is devoted to a general description of social policy, its funding, with a focus on health policy than its specific area. The second chapter analyses the financing systems of health policy in Slovakia and in selected countries. Results: The results showed that the Slovak health care makes is trying hard to catch up with the level of the best health care systems. However, there are countries, which are doing much worse than us, in terms of funding. Society: It is important to properly invest money but also communication between states. To get help on health and to ensure that citizens know states the best conditions of health care. Limitations / further research: This work is focused on how to bring closer health care and its financing in several different countries economically. IN doing so some other aspects such as what is best level of services, etc. were put aside.

  5. Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study.

    Science.gov (United States)

    Vine, Michelle M; Harrington, Daniel W; Butler, Alexandra; Patte, Karen; Godin, Katelyn; Leatherdale, Scott T

    2017-04-20

    We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta. Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years. Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.

  6. Child maltreatment and educational attainment in young adulthood: results from the Ontario Child Health Study.

    Science.gov (United States)

    Tanaka, Masako; Georgiades, Katholiki; Boyle, Michael H; MacMillan, Harriet L

    2015-01-01

    There is increasing evidence for the adverse effects of child maltreatment on academic performance; however, most of these studies used selective samples and did not account for potential confounding or mediating factors. We examined the relationship between child physical abuse (PA; severe and non-severe) and sexual abuse (SA) and educational attainment (years of education, failure to graduate from high school) with a Canadian community sample. We used data from the Ontario Child Health Study (N = 1,893), a province-wide longitudinal survey. Potential confounding variables (family socio-demographic and parental capacity) and child-level characteristics were assessed in 1983, and child abuse was determined in 2000-2001 based on retrospective self-report. Results showed that PA and SA were associated with several factors indicative of social disadvantage in childhood. Multilevel regression analyses for years of education revealed a significant estimate for severe PA based on the unadjusted model (-0.60 years, 95% CI = [-0.45, -0.76]); estimates for non-severe PA (0.05 years, CI = [-0.15, 0.26]) and SA (-0.25 years, CI = [-0.09, -0.42]) were not significant. In the adjusted full model, the only association to reach significance was between severe PA and reduced years of education (-0.31 years, CI = [-0.18, -0.44]). Multilevel regression analyses for failure to graduate from high school showed significant unadjusted estimates for severe PA (OR = 1.77, 95% CI = [1.21, 2.58]) and non-severe PA (OR = 1.61, CI = [1.01, 2.57]); SA was not associated with this outcome (OR = 1.40, CI = [0.94, 2.07]). In the adjusted full models, there were no significant associations between child abuse variables and failure to graduate. The magnitude of effect of PA on both outcomes was reduced largely by child individual characteristics. These findings generally support earlier research, indicating the adverse effects of child maltreatment on educational attainment. Of particular note

  7. The association between income source and met need among community mental health service users in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Bondy, Susan J; Durbin, Janet

    2012-10-01

    We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

  8. Health policy, health systems research and analysis capacity ...

    African Journals Online (AJOL)

    Introduction: Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology.

  9. Health SA Gesondheid: Editorial Policies

    African Journals Online (AJOL)

    Health SA Gesondheid - Journal of Interdisciplinary Health Sciences is an open ... on issues related to public health, including implications for practical applications and ... researchers to showcase their work whilst upholding the standards of health ... improvement of health safety and service delivery; management and ...

  10. First Nations Women in Northern Ontario: Health, Social, and Community Priorities

    Directory of Open Access Journals (Sweden)

    Christine Simard

    2011-05-01

    Full Text Available This article reports on data from women dwelling in First Nations communities regarding (1 baseline statistics about women’s circumstances, needs, interests, and opportunities for community engagement, and 2 information about women’s present status, experience, interest, and other questions of social, economic,and health status. Two hundred twenty-six women from 35 First Nations communities completed the survey. This paper focuses on the main findings from the survey, which fall into 4 thematic areas. Theme 1 consists of demographic information as provided by participants. Theme 2 consists of social information such as housingand education. Theme 3 includes information about participants’ top community health concerns. Theme 4 examines participants’ community involvement. Use of the survey in directing women's social policy isdiscussed.

  11. Framing health and foreign policy: lessons for global health diplomacy.

    Science.gov (United States)

    Labonté, Ronald; Gagnon, Michelle L

    2010-08-22

    Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do

  12. Framing health and foreign policy: lessons for global health diplomacy

    Directory of Open Access Journals (Sweden)

    Labonté Ronald

    2010-08-01

    Full Text Available Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are

  13. Assessment of health risks of policies

    International Nuclear Information System (INIS)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

    2014-01-01

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

  14. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  15. 78 FR 7784 - Health Information Technology Policy Committee Nomination Letters

    Science.gov (United States)

    2013-02-04

    ... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Nomination Letters.... SUMMARY: The American Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT Policy Committee) and gave the Comptroller General responsibility for...

  16. Health inequality - determinants and policies

    DEFF Research Database (Denmark)

    Diderichsen, Finn; Andersen, Ingelise; Manual, Celie

    2012-01-01

    The review ”Health inequality – determinants and policies” identifies key-areas to be addressed with the aim to reduce the social inequality in health. The general life expectancy has steadily been increasing, but the data reveals marked social inequalities in health as well as life expectancy....... The review seeks to identify the causes of this social inequality. The analysis finds 12 areas of great importance for the inequality in health. This is i.e. early child development, schooling and education, the health behavior of the population, and the role of the health system. Within each of the 12 areas...

  17. Health policy in a globalising world

    National Research Council Canada - National Science Library

    Fustukian, Suzanne; Buse, Kent; Lee, Kelley

    2002-01-01

    ... reform since the 1980s 97 KELLEY LEE AND HILARY GOODMAN viiviii Contents 7 The globalisation of health sector reform policies: is 'lesson drawing' part of the process? 120 BARBARA MCPAKE 8 Cost-...

  18. Sociopolitical determinants of international health policy.

    Science.gov (United States)

    De Vos, Pol; Van der Stuyft, Patrick

    2015-01-01

    For decades, two opposing logics have dominated the health policy debate: a comprehensive health care approach, with the 1978 Alma Ata Declaration as its cornerstone, and a private competition logic, emphasizing the role of the private sector. We present this debate and its influence on international health policies in the context of changing global economic and sociopolitical power relations in the second half of the last century. The neoliberal approach is illustrated with Chile's health sector reform in the 1980s and the Colombian reform since 1993. The comprehensive "public logic" is shown through the social insurance models in Costa Rica and in Brazil and through the national public health systems in Cuba since 1959 and in Nicaragua during the 1980s. These experiences emphasize that health care systems do not naturally gravitate toward greater fairness and efficiency, but require deliberate policy decisions. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  19. Seven Foundational Principles of Population Health Policy.

    Science.gov (United States)

    Bhattacharya, Dru; Bhatt, Jay

    2017-10-01

    In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

  20. Applying Behavioral Economics to Public Health Policy

    Science.gov (United States)

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  1. Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

    Science.gov (United States)

    O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

    2016-06-01

    Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

  2. Energy, economic and environmental discourses and their policy impact: The case of Ontario's Green Energy and Green Economy Act

    International Nuclear Information System (INIS)

    Winfield, Mark; Dolter, Brett

    2014-01-01

    This paper examines the debates around the Ontario's Green Energy and Green Economy Act (GEGEA) as an energy and economic development strategy through comparative public policy and discourse analysis approaches. The evidence regarding the economic impacts of the GEGEA is found to be almost entirely based on the results of economic modeling exercises. Critics and supporters of the legislation have arrived at very different conclusions through such exercises. These outcomes are similar to those seen in other jurisdictions pursuing renewable energy initiatives, such as Feed In Tariffs (FITs), renewables obligations and portfolio standards. A discourse analysis approach is employed to examine the reasons for the different conclusions being reached over the impacts of renewable energy initiatives. Differences in modeling approaches and assumptions are found to reflect differences in ideational perspectives on the part of the modelers with respect to the appropriate roles of markets and the state and the relationship between economic development and environmental sustainability in public policy. The paper concludes with suggestions regarding the gathering and availability of information regarding economic development in the renewable energy sector, and a discussion of potential ways to strengthen future efforts to understand the economic and environmental impact of renewable energy initiatives. - Highlights: • The discourse surrounding renewable energy initiatives is embedded within wider ideological debates. • The information that underpins the debates in Ontario is the result of economic modelling, not empirical data. • All of the existing modelling efforts suffer from significant shortcomings. • FITS are seen as politically feasible mechanisms for correcting biases in favour of conventional technologies. • The province's long-term commitment of renewable energy development is now uncertain

  3. Ecological public health and climate change policy.

    Science.gov (United States)

    Morris, George P

    2010-01-01

    The fact that health and disease are products of a complex interaction of factors has long been recognized in public health circles. More recently, the term 'ecological public health' has been used to characterize an era underpinned by the paradigm that, when it comes to health and well-being, 'everything matters'. The challenge for policy makers is one of navigating this complexity to deliver better health and greater equality in health. Recent work in Scotland has been concerned to develop a strategic approach to environment and health. This seeks to embrace complexity within that agenda and recognize a more subtle relationship between health and place but remain practical and relevant to a more traditional hazard-focused environmental health approach. The Good Places, Better Health initiative is underpinned by a new problem-framing approach using a conceptual model developed for that purpose. This requires consideration of a wider social, behavioural etc, context. The approach is also used to configure the core systems of the strategy which gather relevant intelligence, subject it to a process of evaluation and direct its outputs to a broad policy constituency extending beyond health and environment. This paper highlights that an approach, conceived and developed to deliver better health and greater equality in health through action on physical environment, also speaks to a wider public health agenda. Specifically it offers a way to help bridge a gap between paradigm and policy in public health. The author considers that with development, a systems-based approach with close attention to problem-framing/situational modelling may prove useful in orchestrating what is a necessarily complex policy response to mitigate and adapt to climate change.

  4. Health, nutrition, and public policy

    NARCIS (Netherlands)

    Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.

    2010-01-01

    The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing

  5. Ontario perspective on interregional markets

    International Nuclear Information System (INIS)

    Shalaby, A.

    2003-01-01

    On May 1, 2002, wholesale and retail electricity markets in Ontario were opened to competition. The industry structure has been completely unbundled into separate entities for power generation, distribution and transmission. There are currently 20 generators, 90 distributors and 4 transmitters in Ontario. Trade with neighbouring jurisdictions has increased and now accounts for 10 to 15 per cent of demand on summer peak days. Import/export capability with the United States (northeast and midwest) and other Canadian provinces (Quebec and Manitoba) is 4,000 to 6,000 MW. Ontario has not had new generation or transmission capacity in several years and the heat waves of summer 2002 resulted in a heavier power demand than forecasted. The province had to rely heavily on power imports resulting in high and volatile electricity prices. In response to customer complaints, the Ontario government froze retail rates and in a recent policy directive announced a public ownership policy for transmission with further consultation on improving supply competition in Ontario. FERC order 888 and the increased role of independent power producers has improved trading opportunities between Canada and the United States. The presentation highlighted recent trade trends and outlined the specific impact of the Standard Market Design on Canadian markets. It was noted that Ontario should work on ensuring power reliability, transmission planning, inter-regional coordination, and joint investments with neighbouring jurisdictions. 9 figs

  6. Health care policy at a crossroads?

    DEFF Research Database (Denmark)

    Lassen, Inger Marie; Strunck, Jeanne; Ottesen, Aase Marie

    2018-01-01

    analyse and discuss how political discourse moments (Rancière 1999; Gamson 1992; Carvalho 2008) influence the contents of the national health quality strategies and how variation in the construal of patient roles and agency indicate discursive struggle in Danish national health care policy. Underlying...

  7. Social Change and Health Policy in Venezuela

    Directory of Open Access Journals (Sweden)

    Nuramy J. Gutiérrez

    2008-07-01

    Full Text Available This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.

  8. Mental health policy: Options for South Africa

    Directory of Open Access Journals (Sweden)

    Y. G. Pillay

    1993-03-01

    Full Text Available This paper emphasizes the need for mental health professionals to become involved in developing mental health policies in South Africa. In particular, it examines three options that are currently the focus of attention with respect to national health options, i.e. a free market system, a national health service (NHS and a national health insurance system (NHIS. While the paper does not provide support for any one of these options it does attempt to investigate some of the implications of each option for the funding and delivery of mental health care.

  9. [Workplace health promotion in public health policies in Poland].

    Science.gov (United States)

    Puchalski, Krzysztof; Korzeniowska, Elzbieta

    2008-01-01

    In this paper the author analyses how far in Poland the idea of workplace health promotion (WHP) does exist in the area of public health understood in its broadest sense. The analysis encapsulates the following issues: (a) the national legislative policy, (b) strategies, programs and projects concerning health issues launched or coordinated by the state or local administration, (c) grassroots initiatives for health promotion supported by local and regional administration, (d) civic projects or business strategies for health. In addition, the author emphasizes the marginalization of workplace health promotion and lack of cohesive policy in this field as well as, the fact that health problems of the working population arising from current demographic, technological, economic and social changes that could be dealt with through developing and implementing WHP projects are not yet fully perceived by public health policy makers.

  10. Study of the health effects of low-level exposure to environmental radiation contamination in Port Hope, Ontario

    International Nuclear Information System (INIS)

    Steele, R.; Lees, R.E.M.; Roberts, J.H.

    1984-06-01

    From 1939 to 1948 residues from radium production at Eldorado Nuclear Ltd.'s plant in Port Hope, Ontario were disposed of in and around the town of Port Hope. In 1980 a study was set up to determine the health effects of these residues. This report concerns phase two a case- control study of lung cancer in the exposed population. Doses for the 118 cases and controls were reconstructed to give the final year of exposure, the residences occupied during the period of exposure, and the total estimated exposure for various latency periods. Statistical analysis of the data gathered could not give coherent results or show an identifiable increased risk of lung cancer from elevated alpha radiation levels due to the confounding effect of cigarette smoking. Ninety percent of the cases of lung cancer found were attributable to smoking

  11. Policy for better mental health

    OpenAIRE

    Richard Layard

    2014-01-01

    Treating mental illness should be a top national priority, especially as proven psychological therapies effectively cost nothing. Richard Layard explains how CEP research has led to a new deal for mental health - but much remains to be done. Mental illness has much greater economic costs than physical illness - but evidence-based ways of treating mental health problems have no net cost to the Exchequer.

  12. Housing Characteristics and their Influence on Health-Related Quality of Life in Persons Living with HIV in Ontario, Canada: Results from the Positive Spaces, Healthy Places Study

    OpenAIRE

    Rourke, Sean B.; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W.; Dunn, James; Hambly, Keith

    2012-01-01

    Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and...

  13. Changes in smoking during pregnancy in Ontario, 1995 to 2010: results from the Canadian community health survey.

    Science.gov (United States)

    Brown, Hilary K; Wilk, Piotr

    2014-10-01

    The objectives of this study were (1) to examine changes in smoking behaviour across time in pregnant women in Ontario (relative to non-pregnant women and men) and (2) to assess whether, among pregnant women, changes across time vary as a function of sociodemographic characteristics. This study used data from the Canadian Community Health Survey. The study sample included 15- to 49-year-old residents of Ontario. Multivariable logistic regression, with interactions between time period and the characteristic of interest, was used to examine whether changes varied across time according to (1) group (pregnant women, non-pregnant women, men; two-year intervals, 2001 to 2010) and (2) pregnant subgroup (maternal age, maternal marital status, maternal education; 1995 to 2000 [n = 3745], 2001 to 2005 [n = 5084], and 2006 to 2010 [n = 2900]). A decrease in the prevalence of smoking across time was seen in all groups but was smaller in pregnant women than in non-pregnant women (23.5% vs. 30.8%). Among pregnant women, interactions between time period and maternal age, maternal marital status, and maternal education were statistically significant. The prevalence of smoking during pregnancy decreased in older, married, and more highly educated women, but increased in younger women (by 8.2%) and less educated women (by 12.8%). Although the prevalence of smoking during pregnancy decreased in unmarried women, the change was smaller than in married women. Although the prevalence of smoking in pregnant women is decreasing over time, the decrease is smaller than that in non-pregnant women. Pregnant subgroups particularly resistant to change include younger, unmarried, and less educated mothers. These findings suggest there are subgroups that should be targeted more deliberately by public health interventions.

  14. Consumer attitudes toward health policy and knowledge about health legislation.

    Science.gov (United States)

    Riska, E; Taylor, J A

    1978-01-01

    Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

  15. Ontario electricity rates and industrial competitiveness

    International Nuclear Information System (INIS)

    2006-01-01

    Industrial electricity prices in Ontario rose significantly after the opening of the competitive Ontario electricity market in 2002, thereby widening the gap between industrial electricity prices in Ontario and those in other Canadian provinces. Navigant Consulting Ltd. conducted this study at the request of the Association of Major Power Consumers in Ontario (AMPCO) to research and compare current and historical electricity prices in Ontario and other jurisdictions in North America. The study provided an independent analysis of how industrial electricity prices in Ontario compare to those in other jurisdiction in which AMPCO members operate. It also formed the basis for comparing the impacts of electricity policy on the economic competitiveness of major power consumers in Ontario. The relative electricity intensity in the United States, Ontario and other Canadian provinces was reviewed for specific industries, including forest products, steel manufacturing, petroleum refining, chemical manufacturing and cement manufacturing. Publicly available aggregate data from Statistics Canada and the United States Bureau of the Census was then used to compare average electricity prices for industrial customers in Ontario. The data confirmed that Ontario has experienced a decline in its competitive price advantage in industrial electricity. Delivered industrial electricity prices in Ontario have increased by more than 60 per cent since 2001. Industrial electricity prices in Ontario rose above those in Quebec, Manitoba, British Columbia and New Brunswick. In addition, industrial electricity prices in Ontario rose above those in competing states such as Ohio and Illinois, in part due to the increase in the value of the Canadian dollar. It was concluded that the price increase may lead to a greater decline in economic output in Ontario compared to competing jurisdictions. 2 tabs., 14 figs., 1 appendix

  16. Broadening health policy education in medical school

    Directory of Open Access Journals (Sweden)

    Nur A

    2018-02-01

    Full Text Available Ahmed Nur, Aqib Chaudry, Amar SodhaFaculty of Medicine, Imperial College London, London, UKWe read with great interest the article by Malik et al1 exploring medical studentparticipation in health policy roles. As medical students who recently completed anintercalated degree in healthcare management at Imperial College London, we spent alarge proportion of our time learning about health policy. Thus, we can offer a uniqueperspective on this issue.    We firstly commend the authors for identifying factors that act as barriers to medical student involvement in health policy roles. Noteworthy barriers impacting student involvement included: a lack of knowledge regarding health policy, an unawareness of opportunities available, and a lack of time. It was found that 43% identified lack of time as a barrier to their involvement in health policy.1 Bicket et al similarly found that time commitments and opportunity costs were the main drawbacks for students not pursuing their interests in leadership roles in medical school.2View the original paper by Malik and colleagues.

  17. Allocation of authority in European health policy.

    Science.gov (United States)

    Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

    2012-11-01

    Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Ontario's uranium mining industry

    International Nuclear Information System (INIS)

    Runnalls, O.J.C.

    1981-01-01

    This report traces the Ontario uranium mining industry from the first discovery of uranium north of Sault Ste. Marie through the uranium boom of the 1950's when Elliot Lake and Bancroft were developed, the cutbacks of the 1960s, the renewed enthusiasm in exploration and development of the 1970s to the current position when continued production for the domestic market is assured. Ontario, with developed mines and operational expertise, will be in a position to compete for export markets as they reopen. The low level of expenditures for uranium exploration and the lack of new discoveries are noted. The report also reviews and places in perspective the development of policies and regulations governing the industry and the jurisdictional relationships of the Federal and Provincial governments

  19. Circulation policies in health science libraries.

    Science.gov (United States)

    Watkins, C; Coker, N C

    1970-10-01

    There is general agreement that library policies have considerable influence on the use of libraries. Medical school (health science) libraries of this country were surveyed as to their policies in respect to whether faculty and student use were regulated by a single policy, circulation regulations, hours library was accessible to users, accessibility of reserve material, interlibrary loan, policy on overdue material, and exit control. THE LIBRARIES WERE THEN DIVIDED INTO THREE GROUPS, HIGH, MIDDLE, AND LOW ACCORDING TO THE FOLLOWING CHARACTERISTICS: size of student body, size of faculty, size of holdings, size of library staff, annual budget, and annual circulation. Our findings would indicate that schools falling in a high category based upon these criteria tend to be more restrictive in their policies and to have different regulations for faculty and students than do schools in the low category.These findings warrant further study.

  20. Health economics and health policy: experiences from New Zealand.

    Science.gov (United States)

    Cumming, Jacqueline

    2015-06-01

    Health economics has had a significant impact on the New Zealand health system over the past 30 years. In this paper, I set out a framework for thinking about health economics, give some historical background to New Zealand and the New Zealand health system, and discuss examples of how health economics has influenced thinking about the organisation of the health sector and priority setting. I conclude the paper with overall observations about the role of health economics in health policy in New Zealand, also identifying where health economics has not made the contribution it could and where further influence might be beneficial.

  1. Social Media, Health Policy, and Knowledge Translation.

    Science.gov (United States)

    Roland, Damian

    2018-01-01

    Social media has been cited as a methodology for reducing the knowledge translation gap, creating communities of practice, and reducing traditional hierarchical divisions. Social movements have also embraced social media as a means of spreading their aims and reaching wide audiences. However, its impact on health policy is seldom considered. The author examines the complexity of clinicians' use of social media to influence policy and how policy and government groups may use social media to help their own objectives. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  2. Global health: governance and policy development.

    Science.gov (United States)

    Kelley, Patrick W

    2011-06-01

    Global health policy is now being influenced by an ever-increasing number of nonstate and non-intergovernmental actors to include influential foundations, multinational corporations, multi-sectoral partnerships, and civil society organizations. This article reviews how globalization is a key driver for the ongoing evolution of global health governance. It describes the massive increases in bilateral and multilateral investments in global health and it highlights the current global and US architecture for performing global health programs. The article closes describing some of the challenges and prospects that characterize global health governance today. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Privacy policies for health social networking sites

    Science.gov (United States)

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data. PMID:23599228

  4. Privacy policies for health social networking sites.

    Science.gov (United States)

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data.

  5. Experiences and attitudes towards evidence-informed policy-making among research and policy stakeholders in the Canadian agri-food public health sector.

    Science.gov (United States)

    Young, I; Gropp, K; Pintar, K; Waddell, L; Marshall, B; Thomas, K; McEwen, S A; Rajić, A

    2014-12-01

    Policy-makers working at the interface of agri-food and public health often deal with complex and cross-cutting issues that have broad health impacts and socio-economic implications. They have a responsibility to ensure that policy-making based on these issues is accountable and informed by the best available scientific evidence. We conducted a qualitative descriptive study of agri-food public health policy-makers and research and policy analysts in Ontario, Canada, to understand their perspectives on how the policy-making process is currently informed by scientific evidence and how to facilitate this process. Five focus groups of 3-7 participants and five-one-to-one interviews were held in 2012 with participants from federal and provincial government departments and industry organizations in the agri-food public health sector. We conducted a thematic analysis of the focus group and interview transcripts to identify overarching themes. Participants indicated that the following six key principles are necessary to enable and demonstrate evidence-informed policy-making (EIPM) in this sector: (i) establish and clarify the policy objectives and context; (ii) support policy-making with credible scientific evidence from different sources; (iii) integrate scientific evidence with other diverse policy inputs (e.g. economics, local applicability and stakeholder interests); (iv) ensure that scientific evidence is communicated by research and policy stakeholders in relevant and user-friendly formats; (V) create and foster interdisciplinary relationships and networks across research and policy communities; and (VI) enhance organizational capacity and individual skills for EIPM. Ongoing and planned efforts in these areas, a supportive culture, and additional education and training in both research and policy realms are important to facilitate evidence-informed policy-making in this sector. Future research should explore these findings further in other countries and contexts.

  6. Health policy. Who's got the master card?

    Science.gov (United States)

    Robinson, Ray

    2002-09-26

    The last decade has seen huge shifts away from the command and control model which dominated health policy since the foundation of the NHS. The current Labour government Initially favoured a system based on collaboration and partnership working but the incentives to achieve this were not sufficiently strong. Competition is now once again openly cited as a driver for improved performance. Political demands mean that command and control are likely to remain key features of government health policy. But this, in turn, is likely to place major limitations on the local autonomy pledged by the government.

  7. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

    Science.gov (United States)

    Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

    2016-06-01

    Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

  8. Comparing the risk associated with psychosocial work conditions and health behaviours on incident hypertension over a nine-year period in Ontario, Canada.

    Science.gov (United States)

    Smith, Peter M; Mustard, Cameron A; Lu, Hong; Glazier, Richard H

    2013-01-07

    Hypertension is an increasingly important health concern in Canada. This paper examines the risks associated with psychosocial working conditions compared to health behaviours on the risk of hypertension over a 9-year period in Ontario, Canada. We used data from Ontario respondents to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Information Plan database covering physician services and the Canadian Institute for Health Information database for hospital admissions. We focused on labour market participants aged 35 to 60, who had not been previously diagnosed with hypertension, were not self-employed, and were working more than 10 hours per week, more than 20 weeks in the previous 12 months (N = 6,611). Subjects were followed for a nine-year period to ascertain incidence of hypertension. Low job control was associated with an increased risk of hypertension among men, but not among women. The population attributable fraction associated with low job control among males was 11.8% in our fully adjusted model. There was no consistent pattern of increased risk of hypertension across different levels of health behaviours. Primary prevention efforts to reduce the incidence of hypertension predominantly target modifiable health behaviours. Evidence from this longitudinal cohort suggests that modifiable characteristics of the work environment should also be considered in the design of cardiovascular disease prevention programs, in particular for male labour market participants.

  9. Health impact assessment of Ontario's green energy and green economy act. The roles of environmental informatics in sustainability

    International Nuclear Information System (INIS)

    Rattle, Robert

    2013-01-01

    Renewable energy received a boost in Ontario, Canada with the Green Energy and Green Economy Act (GEGEA), ushering in a new Feed-in-Tariff (FIT) program modelled on programs from Germany, Spain, Denmark and other jurisdictions. Information about lessons learned elsewhere has clearly benefited the Ontario experience. Part of the Ontario program included streamlining the impact assessment process to facilitate the swift development of provincial renewable energy capacities. In this context, the GEGEA has been remarkably successful, generating renewable energy sector capacities, resources, projects and their spin-off benefits in Ontario, along with more sustainable electricity system. Environmentalists along with industry continue to laud the benefits of renewable energy and the GEGEA, and with good reason. Renewable energy generation in Ontario has grown from to 2 per cent in 2012 and is expected to reach 10 per cent in 2013. (orig.)

  10. Self-reported teamwork in family health team practices in Ontario: organizational and cultural predictors of team climate.

    Science.gov (United States)

    Howard, Michelle; Brazil, Kevin; Akhtar-Danesh, Noori; Agarwal, Gina

    2011-05-01

    To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Cross-sectional study using a mailed survey. Family health teams in Ontario. Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams.

  11. Health policy 2016: implications for geriatric urology.

    Science.gov (United States)

    Suskind, Anne M; Clemens, J Quentin

    2016-03-01

    The US healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore, will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. The Affordable Care Act has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination and risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues.

  12. 78 FR 42945 - Health Information Technology Policy Committee Vacancy

    Science.gov (United States)

    2013-07-18

    ... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Vacancy AGENCY... American Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy... its 20 members. ARRA requires that one member have expertise in health information privacy and...

  13. 78 FR 24749 - Health Information Technology Policy Committee Appointment

    Science.gov (United States)

    2013-04-26

    ... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Appointment AGENCY... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee to make recommendations on the implementation of a nationwide health information technology...

  14. Health Policy Training: A Review of the Literature.

    Science.gov (United States)

    Heiman, Harry J; Smith, L Lerissa; McKool, Marissa; Mitchell, Denise N; Roth Bayer, Carey

    2015-12-23

    The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.

  15. Health Policy Training: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Harry J. Heiman

    2015-12-01

    Full Text Available The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s, health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.

  16. Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

    Science.gov (United States)

    Shain, Martin

    2011-01-01

    While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

  17. The use of 'arms-length' organizations for health system change in Ontario, Canada: some observations by insiders.

    Science.gov (United States)

    Pink, George H; Leatt, Peggy

    2003-01-01

    During the past decade, there has been substantial health system reform in the United States, United Kingdom, New Zealand, and many other countries. For the most part, Canada has not pursued 'big bang' health system change but rather a variety of strategies to achieve incremental change. In this paper, we present the ways in which three arms-length organizations have been used by government to effect incremental system change in Ontario during the past several years. We observe that, (1) the influence of politics and political interference can be reduced through an arms-length organization; (2) an arms-length organization with the power to make decisions entails more political risk for government and encounters more scrutiny and criticism by providers and the media than an organization with the power to recommend only; (3) an arms-length organization with a limited lifespan faces more delaying tactics by adversely affected parties than an organization without a limited lifespan; (4) an arms-length organization with perceived influence may attract causes that are not related to its mandate; (5) the importance and difficulty of communicating complex information about system change to a wide variety of audiences cannot be overstated; (6) system change informed by the use of expert opinion encounters less provider resistance and may result in better decisions; and (7) the reputation of the Chair and the perceived competence and experience of the CEO are critical success factors in the success of an arms-length organization.

  18. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

  19. Elder women's perceptions around optimal perinatal health: a constructivist grounded-theory study with an Indigenous community in southern Ontario.

    Science.gov (United States)

    Kandasamy, Sujane; Vanstone, Meredith; Oremus, Mark; Hill, Trista; Wahi, Gita; Wilson, Julie; Davis, A Darlene; Jacobs, Ruby; Anglin, Rebecca; Anand, Sonia Savitri

    2017-05-18

    Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone. Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film). Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women

  20. Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

    Science.gov (United States)

    Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

    2003-01-01

    Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.

  1. Human resources for health policies: a critical component in health policies

    Directory of Open Access Journals (Sweden)

    Dussault Gilles

    2003-04-01

    Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources

  2. Data Speak: Influencing School Health Policy through Research

    Science.gov (United States)

    Ryberg, Jacalyn Wickline; Keller, Teresa; Hine, Beverly; Christeson, Elisabeth

    2003-01-01

    School nurses occupy a unique position in relation to school health policy. In addition to facing the demands of promoting and maintaining the health of students, they collect the information that is used to document the implementation of school health policy. Effective school health policy is guided by reliable, credible data regarding what…

  3. Health Policy, Ethics, and the Kansas Legislative Health Academy

    Science.gov (United States)

    Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St. Peter, Robert

    2015-01-01

    We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945

  4. Health policy, ethics, and the Kansas Legislative Health Academy.

    Science.gov (United States)

    Blacksher, Erika; Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St Peter, Robert

    2015-03-01

    We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views.

  5. Knowledge, attitude, willingness and readiness of primary health care providers to provide oral health services to children in Niagara, Ontario: a cross-sectional survey.

    Science.gov (United States)

    Singhal, Sonica; Figueiredo, Rafael; Dupuis, Sandy; Skellet, Rachel; Wincott, Tara; Dyer, Carolyn; Feller, Andrea; Quiñonez, Carlos

    2017-01-01

    Most children are exposed to medical, but not dental, care at an early age, making primary health care providers an important player in the reduction of tooth decay. The goal of this research was to understand the feasibility of using primary health care providers in promoting oral health by assessing their knowledge, attitude, willingness and readiness in this regard. Using the Dillman method, a mail-in cross-sectional survey was conducted among all family physicians and pediatricians in the Niagara region of Ontario who have primary contact with children. A descriptive analysis was performed. Close to 70% (181/265) of providers responded. More than 90% know that untreated tooth decay could affect the general health of a child. More than 80% examine the oral cavity for more than 50% of their child patients. However, more than 50% are not aware that white spots or lines on the tooth surface are the first signs of tooth decay. Lack of clinical time was the top reason for not performing oral disease prevention measures. Overall, survey responses show a positive attitude and willingness to engage in the oral health of children. To capitalize on this, there is a need to identify mechanisms of providing preventive oral health care services by primary health care providers; including improving their knowledge of oral health and addressing other potential barriers.

  6. Towards health in all policies for childhood obesity prevention

    NARCIS (Netherlands)

    A.-M. Hendriks (Anna-Marie); S.P.J. Kremers (Stef); J.S. Gubbels (Jessica); H. Raat (Hein); N.K. de Vries (Nanne); M.W.J. Jansen (Maria W.)

    2013-01-01

    textabstractThe childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from

  7. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study

    Directory of Open Access Journals (Sweden)

    Gonzalez Andrea

    2012-09-01

    Full Text Available Abstract Background Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI; however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties and family level (parental income and education, parental mental and physical health, and family functioning on BMI in early adulthood. Methods We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4–16 years enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21–35 years. Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. Results At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. Conclusion Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

  8. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study.

    Science.gov (United States)

    Gonzalez, Andrea; Boyle, Michael H; Georgiades, Katholiki; Duncan, Laura; Atkinson, Leslie R; MacMillan, Harriet L

    2012-09-09

    Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4-16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21-35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.

  9. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2015-09-04

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. © 2016 by Kerman University of Medical Sciences.

  10. The Politics of Healthy Policies: Redesigning health impact assessment to integrate health in public policy

    NARCIS (Netherlands)

    M.P.M. Bekker (Marleen)

    2007-01-01

    textabstractPublic health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal

  11. Social Relationships and Health: A Flashpoint for Health Policy

    Science.gov (United States)

    Umberson, Debra; Montez, Jennifer Karas

    2011-01-01

    Social relationships—both quantity and quality—affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the population level. Studies show that social relationships have short- and long-term effects on health, for better and for worse, and that these effects emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. This article describes key research themes in the study of social relationships and health, and it highlights policy implications suggested by this research. PMID:20943583

  12. Phases of capitalism, welfare states, medical dominance, and health care in Ontario.

    Science.gov (United States)

    Coburn, D

    1999-01-01

    There has been a lacuna in previous studies of medicine and health care of concepts or structures relating changes in health care with their contextualizing social structures. That is, there is a need to more adequately account for health care and social structure in terms of dynamic rather than static concepts. This article reports the application of a general schema outlining the transformation of capitalism through the phases of entrepreneurial, monopoly, and global capitalism, first presented by Ross and Trachte, to help understand both the changing role of medicine in Canada and the historical trajectory of the development of health insurance. These related events are shown to be partly reflective of the transformed class dynamic involved in a changing capitalist mode of production. The recent history of challenges to medicare in Canada as well as evidence of the declining power of medicine are both related directly and indirectly to the increased power of business and the decline in the relative autonomy of the state accompanying globalization. The application of the phases of capitalism sequence does roughly fit the Canadian instance although some modifications will be required to account for the specifics of the Canadian case. The schema also helps resolve two previously competing class arguments about the rise of health insurance in Canada.

  13. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    Science.gov (United States)

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  14. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  15. Primary health care and public policy.

    Science.gov (United States)

    Mangelsdorf, K L; Luna, J; Smith, H L

    1988-01-01

    The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

  16. Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies.

    Science.gov (United States)

    McDaniel, Patricia A; Malone, Ruth E

    2018-02-01

    To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion. From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants' opinions about why an employer would stop hiring smokers and their support (or not) for such a policy. Most employers excluded from employment those using all forms of nicotine. Several explained their adoption of the policy as a natural extension of a smoke-free campus and as consistent with their identity as health care organizations. They regarded the policy as promoting health. No employer mentioned engaging in a community dialogue before adopting the policy or reported efforts to track the policy's impact on rejected applicants. Community members understood the cost-saving appeal of such policies, but most opposed them. They made few exceptions for health care organizations. Policy decisions undertaken by health care organizations have influence beyond their immediate setting and may establish precedents that others follow. Nonsmoker-only hiring policies may fit with a health care organization's institutional identity but may not be congruent with community values or promote public health.

  17. Towards a sustainable electricity system for Ontario : interim report

    International Nuclear Information System (INIS)

    2004-04-01

    More changes have occurred in Ontario's electricity sector in the past 5 years than over the preceding 9 decades since the creation of Ontario Hydro Electric Power Commission in 1906. The province's nuclear generating facilities were taken out of service in 1997 for safety and maintenance overhauls. The existing nuclear facilities, which account for 28 per cent of the province's generating capacity, will reach the end of their operational lifetimes by 2018. The government of Ontario also announced the phasing out of Ontario Power Generation's coal-fired plants by 2007 due to the environmental health impacts of their operation. These changes have ignited debate over the province's future electricity needs and how they might be met. This study examined by how much electricity demand in Ontario could be reduced through the adoption of energy efficient technologies, fuel switching, cogeneration and demand response measures. It also examined how much future supply could be obtained from renewable energy sources such as wind, the upgrading of existing hydroelectric facilities, and the development of new solar, biomass and small-scale hydro facilities. It also examined how to accommodate the remaining grid demand and which public policies should be adopted to maximize efficiency and other demand side measures. The impacts of the policies were simulated using the Canadian Integrated Modelling System (CIMS) computer model developed by the Energy and Materials Research Group at Simon Fraser University. The CIMS simulations were conducted under the assumptions that barriers to cogeneration would be removed, financial incentives would be provided along with innovative financing programs. The study revealed that capital investments of $18.2 billion over the 2005-2020 period would be required to reduce peak demand of 12,300 MW relative to the business and usual forecast through efficiency, fuel switching and cogeneration. 13 refs., 8 tabs

  18. Information Management at a Health Services Research Organization in Toronto, Ontario, Canada: Moving from Identifiable Data to Coded Data

    Directory of Open Access Journals (Sweden)

    Lisa Thurairasu

    2017-04-01

    The processing practices used at the organization comply with Canadian privacy laws such as the Personal Health Information Protection Act (PHIPA as well as organizational policies and Research Ethics Board approvals. The approaches used to conceal individual identities yet allow linkage to various data sources can be modelled by other health agencies, ministries, and non-health related organizations that work with sensitive data but face challenges in maintaining both privacy and research quality. Our organization strives to make processing as efficient as possible and create maximum linkability to the various data sources in house while upholding privacy and confidentiality.

  19. Public Health and International Drug Policy

    Science.gov (United States)

    Csete, Joanne; Kamarulzaman, Adeeba; Kazatchkine, Michel; Altice, Frederick; Balicki, Marek; Buxton, Julia; Cepeda, Javier; Comfort, Megan; Goosby, Eric; Goulão, João; Hart, Carl; Horton, Richard; Kerr, Thomas; Lajous, Alejandro Madrazo; Lewis, Stephen; Martin, Natasha; Mejía, Daniel; Mathiesson, David; Obot, Isidore; Ogunrombi, Adeolu; Sherman, Susan; Stone, Jack; Vallath, Nandini; Vickerman, Peter; Zábranský, Tomáš; Beyrer, Chris

    2016-01-01

    Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of

  20. An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

    Science.gov (United States)

    Manassis, Katharina; Ickowicz, Abel; Picard, Erin; Antle, Beverley; McNeill, Ted; Chahauver, Anu; Mendlowitz, Sandra; Monga, Suneeta; Adler-Nevo, Gili

    2009-01-01

    Objective: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by…

  1. Haemoglobinopathies in Europe: health & migration policy perspectives.

    Science.gov (United States)

    Aguilar Martinez, Patricia; Angastiniotis, Michael; Eleftheriou, Androulla; Gulbis, Beatrice; Mañú Pereira, Maria Del Mar; Petrova-Benedict, Roumyana; Corrons, Joan-Lluis Vives

    2014-07-01

    Major haemoglobinopathies (MH), such as thalassaemia syndromes (Thal) and sickle cell disorders (SCD), are genetic defects associated with chronic anaemia and other complications. In Europe, MH are rare diseases (RD) but their prevalence is significantly growing in many countries due to mobility and migration flows. This creates a growing health problem in the EU that has not yet been effectively addressed by Member States (MS) authorities. The present study has been conducted with the aim of: (i) providing an overview of policies for MH in 10 EU member states (MS) (ii) analysing the challenges linked to these RD due to growing requirements imposed by population, mobility and migration trends and (iii) identifying gaps, proposing improvements on existing policies, or developing new ones to fit the identified needs. The study has been undertaken by a group of members of the European Network for Rare and Congenital Anaemias (ENERCA) and the Thalassaemia International Federation (TIF), in collaboration with the public affairs firm Burson-Marsteller Brussels. Data from 10 EU countries have been gathered using targeted desk research and one-to-one interviews with local stakeholders, including healthcare professionals, patients and public health officers/providers. 1. MH are the most common RD in all the 10 countries, 2. Data on prevalence, overall burden, trends, and clinical follow up costs are lacking in most countries. 3. Neonatal screening practices show a wide variation across and within countries. 4. Awareness on MH and their related complications is very low, exception made of Italy, Greece, Cyprus and UK, 5. No disaggregated data is available to understand the impact of mobility and migration on the prevalence of haemoglobinopathies, and how healthcare delivery systems should adapt to respond to this situation. 6. Targeted policy measures and/or actions are generally lacking and/or delayed. Ten policy recommendations have been drawn from this study, building on

  2. Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study

    Science.gov (United States)

    Durbin, Anna; Moineddin, Rahim; Lin, Elizabeth; Steele, Leah S; Glazier, Richard H

    2015-01-01

    Objective While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requires considering the effects of interacting factors. This study assessed the inter-relationship between recent immigration status, living in deprived areas and service use for non-psychotic mental health disorders. Study design Matched population-based cross-sectional study. Setting Ontario, Canada, where healthcare use data for 1999–2012 were linked to immigration data and area-based material deprivation scores. Participants Immigrants in urban Ontario, and their age-matched and sex-matched long-term residents (a group of Canadian-born or long-term immigrants, n=501 417 pairs). Primary and secondary outcome measures For immigrants and matched long-term residents, contact with primary care, psychiatric care and hospital care (emergency department visits or inpatient admissions) for non-psychotic mental health disorders was followed for 5 years and examined using conditional logistic regression models. Intersectionality was investigated by including a material deprivation quintile by immigrant status (immigrant vs long-term resident) interaction. Results Recent immigrants in urban Ontario were more likely than long-term residents to live in most deprived quintiles (immigrants—males: 22.8%, females: 22.3%; long-term residents—both sexes: 13.1%, pimmigrants than for long-term residents. Immigrants used less mental health services than long-term residents. Conclusions This study adds to existing research by suggesting that immigrant status and deprivation have a combined effect on recent immigrants’ care use for non-psychotic mental health disorders. In settings where immigrants are over-represented in deprived areas, policymakers focused on increasing

  3. Malaysia's social policies on mental health: a critical theory.

    Science.gov (United States)

    Mubarak, A Rahamuthulla

    2003-01-01

    This article aims to review the social policies on mental health and mental illness in Malaysia. Using critical theory, major policy issues pertaining to mental health and mental illness such as mental health legislation, prevalence rates and quality of services available to the people with mental health problems are discussed in detail. Implications of these issues on persons with mental health problems are critically evaluated. The paper highlights that the other countries in ASEAN region also require similar review by policy literature.

  4. Housing characteristics and their influence on health-related quality of life in persons living with HIV in Ontario, Canada: results from the positive spaces, healthy places study.

    Science.gov (United States)

    Rourke, Sean B; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W; Dunn, James; Hambly, Keith

    2012-11-01

    Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables-including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing-and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

  5. [Overview of acupuncture development in Ontario Canada].

    Science.gov (United States)

    Wang, Fang; Wu, Bin-jiang

    2012-04-01

    The history of acupuncture in Ontario, Canada was traced, and the current status as welI as the prospection were introduced in this paper. Statistics showed that the history of acupuncture in Ontario started in the 1880s, and it was only popular in China Town and Chinese community. In the 1970s, it gradually merged into the mainstream of the society, and entered into a growing period. With the tide of Chinese immigration in the 1980s and 1990s, acupuncture matured rapidly. In 2006, the "Traditional Chinese Medicine Act" was passed in Ontario, it was considered as a milestone in the history of acupuncture. At present, just like the other 23 health care professions, acupuncture has already be included into the legislation system, and become a component of Ontario's health care system. At the same time, the law and regulation may also promote the establishment of "pure Chinese Medicine" in Ontario.

  6. Health and safety matters! Associations between organizational practices and personal support workers' life and work stress in Ontario, Canada.

    Science.gov (United States)

    Zeytinoglu, Isik U; Denton, Margaret; Brookman, Catherine; Davies, Sharon; Sayin, Firat K

    2017-06-21

    The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada. The purpose of this paper is to present evidence on the associations between PSWs' life and work stress and organizational practices of full-time and guaranteed hours, and PSWs' perceptions of support at work and preference for hours. Data come from our 2015 survey of 1543 PSWs. Dependent variables are life and work stress. Independent variables are: objective organizational practices of full-time and guaranteed hours, and subjective organizational practices of perceived support at work, and preferred hours of work. Descriptive statistics, correlations and ordinary least square regression analyses with collinearity tests are conducted. Organizational practices of employing PSWs in full-time or guaranteed hours are not associated with their life and work stress. However, those who perceive support from their organizations are also the ones reporting lower life and work stress. In addition, those PSWs perceiving support from their supervisor report lower work stress. PSWs would like to work in their preferred hours, and those who prefer to work more hours report lower life and work stress, and conversely, those who prefer to work less hours report life and work stress. For PSWs in home and community care, perceived support from their organizations and supervisors, and employment in preferred hours are important factors related to their life and work stress.

  7. From heterogeneity to harmonization? Recent trends in European health policy

    Directory of Open Access Journals (Sweden)

    Thomas Gerlinger

    2007-01-01

    Full Text Available In the European Union (EU, health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.

  8. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Ontario regulatory update

    International Nuclear Information System (INIS)

    Thompson, P.

    1998-01-01

    This paper provides a summary of recent events which when combined add up to a gradual but unmistakable movement of the energy sector in Ontario towards a fully competitive market. Some of the events precipitating this movement towards competition include the passing of the Energy Competition Act of 1998 (Bill 35), electricity deregulation, regulatory reform of the natural gas sector, and changes to the consumer protection legislation. The role of the Ontario Energy Board was also updated to bring it in line with the demands of the competitive marketplace. Among the new roles that the Board will assume are to facilitate competition, to maintain fair and reasonable rates, and to facilitate rational expansion. Another objective is to provide opportunities for including energy efficiency in government policies. Implications of the changes in the OEB's mandate for market participants were also discussed, including (1) regulated gas sales and delivery mechanisms, (2) transactional services, (3) contract restructuring, (4) consumer protection, (5) supervision of competitive market participants, and (6) market surveillance

  10. [The ALANAM statement on public health policy].

    Science.gov (United States)

    Goic, Alejando; Armas, Rodolfo

    2010-12-01

    The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a

  11. Manifestations of integrated public health policy in Dutch municipalities.

    Science.gov (United States)

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Ontario Hydro's nuclear program

    International Nuclear Information System (INIS)

    McCredie, J.

    1984-01-01

    This report briefly describes Ontario Hydro's nuclear program, examining the design and construction status, and the future from Ontario Hydro's perspective. Ontario Hydro relies heavily on nuclear power. Nuclear fuel was responsible for approximately 34% of Ontario Hydro's energy production in 1983. The nuclear proportion was supplied by twelve operating units located: NPD, Douglas Point, Pickering A and B. It is expected that by approximately 1992, 65% of the total energy needs will be generated through nuclear power

  13. Are Sexual and Reproductive Health Policies Designed for All?

    DEFF Research Database (Denmark)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-01-01

    BACKGROUND: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity fo...

  14. Globalisation, health and foreign policy: emerging linkages and interests

    Science.gov (United States)

    Owen, John Wyn; Roberts, Olivia

    2005-01-01

    A discussion of the growing links between the issues of globalisation, health and foreign policy. This article examines the effect this has on health, development and foreign policy communities in the UK and internationally and considers what steps the policy community must take to address the challenges and opportunities of this new relationship. PMID:16053520

  15. Towards Health in All Policies for Childhood Obesity Prevention

    Directory of Open Access Journals (Sweden)

    Anna-Marie Hendriks

    2013-01-01

    Full Text Available The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

  16. Towards health in all policies for childhood obesity prevention.

    Science.gov (United States)

    Hendriks, Anna-Marie; Kremers, Stef P J; Gubbels, Jessica S; Raat, Hein; de Vries, Nanne K; Jansen, Maria W J

    2013-01-01

    The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

  17. Adapting public policy theory for public health research: A framework to understand the development of national policies on global health.

    Science.gov (United States)

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-03-01

    National policies on global health appear as one way that actors from health, development and foreign affairs sectors in a country coordinate state action on global health. Next to a burgeoning literature in which international relations and global governance theories are employed to understand global health policy and global health diplomacy at the international level, little is known about policy processes for global health at the national scale. We propose a framework of the policy process to understand how such policies are developed, and we identify challenges for public health researchers integrating conceptual tools from political science. We developed the framework using a two-step process: 1) reviewing literature to establish criteria for selecting a theoretical framework fit for this purpose, and 2) adapting Real-Dato's synthesis framework to integrate a cognitive approach to public policy within a constructivist perspective. Our framework identifies multiple contexts as part of the policy process, focuses on situations where actors work together to make national policy on global health, considers these interactive situations as spaces for observing external influences on policy change and proposes policy design as the output of the process. We suggest that this framework makes three contributions to the conceptualisation of national policy on global health as a research object. First, it emphasizes collective action over decisions of individual policy actors. Second, it conceptualises the policy process as organised interactive spaces for collaboration rather than as stages of a policy cycle. Third, national decision-making spaces are opportunities for transferring ideas and knowledge from different sectors and settings, and represent opportunities to identify international influences on a country's global health policy. We discuss two sets of challenges for public health researchers using interdisciplinary approaches in policy research. Copyright

  18. Policies and interventions on employment relations and health inequalities.

    Science.gov (United States)

    Quinlan, Michael; Muntaner, Carles; Solar, Orielle; Vergara, Montserrat; Eijkemans, Gerry; Santana, Vilma; Chung, Haejoo; Castedo, Antía; Benach, Joan

    2010-01-01

    The association between certain increasingly pervasive employment conditions and serious health inequalities presents a significant policy challenge. A critical starting point is the recognition that these problems have not arisen in a policy vacuum. Rather, policy frameworks implemented by governments over the past 35 years, in conjunction with corporate globalization (itself facilitated by neoliberal policies), have undermined preexisting social protection policies and encouraged the growth of health-damaging forms of work organization. After a brief description of the context in which recent developments should be viewed, this article describes how policies can be reconfigured to address health-damaging employment conditions. A number of key policy objectives and entry points are identified, with a summary of policies for each entry point, relating to particular employment conditions relevant to rich and poor countries. Rather than trying to elaborate these policy interventions in detail, the authors point to several critical issues in relation to these interventions, linking these to illustrative examples.

  19. Policy Capacity Meets Politics; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Patrick Fafard

    2015-10-01

    Full Text Available It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise.

  20. Policy Capacity Meets Politics: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Fafard, Patrick

    2015-07-22

    It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise. © 2015 by Kerman University of Medical Sciences.

  1. Intersectoral action on SDH and equity in Australian health policy.

    Science.gov (United States)

    Fisher, Matthew; Baum, Frances E; MacDougall, Colin; Newman, Lareen; McDermott, Dennis; Phillips, Clare

    2017-12-01

    Intersectoral action between public agencies across policy sectors, and between levels of government, is seen as essential for effective action by governments to address social determinants of health (SDH) and to reduce health inequities. The health sector has been identified as having a crucial stewardship role, to engage other policy sectors in action to address the impacts of their policies on health. This article reports on research to investigate intersectoral action on SDH and health inequities in Australian health policy. We gathered and individually analysed 266 policy documents, being all of the published, strategic health policies of the national Australian government and eight State/Territory governments, current at the time of sampling in late 2012-early 2013. Our analysis showed that strategies for intersectoral action were common in Australian health policy, but predominantly concerned with extending access to individualized medical or behavioural interventions to client groups in other policy sectors. Where intersectoral strategies did propose action on SDH (other than access to health-care), they were mostly limited to addressing proximal factors, rather than policy settings affecting the distribution of socioeconomic resources. There was little evidence of engagement between the health sector and those policy sectors most able to influence systemic socioeconomic inequalities in Australia. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Family Economic Security Policies and Child and Family Health.

    Science.gov (United States)

    Spencer, Rachael A; Komro, Kelli A

    2017-03-01

    In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

  3. Positioning women's and children's health in African union policy-making: a policy analysis

    Directory of Open Access Journals (Sweden)

    Toure Kadidiatou

    2012-02-01

    Full Text Available Abstract Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010. This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA; action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs, and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames

  4. Positioning women's and children's health in African union policy-making: a policy analysis.

    Science.gov (United States)

    Toure, Kadidiatou; Sankore, Rotimi; Kuruvilla, Shyama; Scolaro, Elisa; Bustreo, Flavia; Osotimehin, Babatunde

    2012-02-16

    With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010).This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and impact. AU policies related

  5. Implementing Health Policy: Lessons from the Scottish Well Men's Policy Initiative.

    Science.gov (United States)

    Douglas, Flora; van Teijlingen, Edwin; Smith, Cairns; Moffat, Mandy

    2015-01-01

    Little is known about how health professionals translate national government health policy directives into action. This paper examines that process using the so-called Well Men's Services (WMS) policy initiative as a 'real world' case study. The WMS were launched by the Scottish Government to address men's health inequalities. Our analysis aimed to develop a deeper understanding of policy implementation as it naturally occurred, used an analytical framework that was developed to reflect the 'rational planning' principles health professionals are commonly encouraged to use for implementation purposes. A mixed-methods qualitative enquiry using a data archive generated during the WMS policy evaluation was used to critically analyze (post hoc) the perspectives of national policy makers, and local health and social care professionals about the: (a) 'policy problem', (b) interventions intended to address the problem, and (c) anticipated policy outcomes. This analysis revealed four key themes: (1) ambiguity regarding the policy problem and means of intervention; (2) behavioral framing of the policy problem and intervention; (3) uncertainty about the policy evidence base and outcomes, and; (4) a focus on intervention as outcome . This study found that mechanistic planning heuristics (as a means of supporting implementation) fails to grapple with the indeterminate nature of population health problems. A new approach to planning and implementing public health interventions is required that recognises the complex and political nature of health problems; the inevitability of imperfect and contested evidence regarding intervention, and, future associated uncertainties.

  6. [A comparative study of primary care health promotion practices in Florianópolis, Santa Catarina State, Brazil, and Toronto, Ontario, Canada].

    Science.gov (United States)

    Heidemann, Ivonete Teresinha Schulter Buss; Cypriano, Camilla da Costa; Gastaldo, Denise; Jackson, Suzanne; Rocha, Carolina Gabriele; Fagundes, Eloi

    2018-01-01

    The study aimed to compare the experiences with the organization of universal public healthcare systems in relation to health promotion in primary care units in Florianópolis, Santa Catarina State, Brazil, and Toronto, Ontario, Canada. This was a descriptive exploratory study with a qualitative approach in primary care units. Data were collected with semi-structured interviews containing questions on health promotion practices, with 25 health professionals in Florianópolis and 10 in Toronto. The data were discussed using thematic analysis, identifying the practices, difficulties, and facilities in health promotion. In the two cities, 60% of health professionals and health administrators had not received any specific knowledge on health promotion during their training. As for health promotion skills, health professionals in Toronto identified them with autonomy and social determinants, while in Florianópolis they were related to health education and community participation. In both cities, health promotion practices are targeted to individual and collective activities. The motivation to act comes from interdisciplinarity and the demands raised by the population. Health promotion is a relevant form of care and stimulus for individual and community autonomy, in light of social determinants. Such practices aim at comprehensive health for the community, but there are limits in the teams that still conduct disease-centered activities. Resources are limited, requiring inter-sector actions to improve quality of life. Healthcare centers on the hegemonic model, and progress is needed to achieve a positive approach to health and social determinants.

  7. Developing a holistic policy and intervention framework for global mental health.

    Science.gov (United States)

    Khenti, Akwatu; Fréel, Stéfanie; Trainor, Ruth; Mohamoud, Sirad; Diaz, Pablo; Suh, Erica; Bobbili, Sireesha J; Sapag, Jaime C

    2016-02-01

    There are significant gaps in the accessibility and quality of mental health services around the globe. A wide range of institutions are addressing the challenges, but there is limited reflection and evaluation on the various approaches, how they compare with each other, and conclusions regarding the most effective approach for particular settings. This article presents a framework for global mental health capacity building that could potentially serve as a promising or best practice in the field. The framework is the outcome of a decade of collaborative global health work at the Centre for Addiction and Mental Health (CAMH) (Ontario, Canada). The framework is grounded in scientific evidence, relevant learning and behavioural theories and the underlying principles of health equity and human rights. Grounded in CAMH's research, programme evaluation and practical experience in developing and implementing mental health capacity building interventions, this article presents the iterative learning process and impetus that formed the basis of the framework. A developmental evaluation (Patton M.2010. Developmental Evaluation: Applying Complexity Concepts to Enhance Innovation and Use. New York: Guilford Press.) approach was used to build the framework, as global mental health collaboration occurs in complex or uncertain environments and evolving learning systems. A multilevel framework consists of five central components: (1) holistic health, (2) cultural and socioeconomic relevance, (3) partnerships, (4) collaborative action-based education and learning and (5) sustainability. The framework's practical application is illustrated through the presentation of three international case studies and four policy implications. Lessons learned, limitations and future opportunities are also discussed. The holistic policy and intervention framework for global mental health reflects an iterative learning process that can be applied and scaled up across different settings through

  8. Proceedings of the Ontario Energy Association's 2004 annual conference

    International Nuclear Information System (INIS)

    2004-01-01

    The Ontario Energy Association (OEA) is a unique trade association that represents key participants in Ontario's converging natural gas and electricity industries. Its members include energy producers, transmitters, distributors, marketers, and retailers. This conference provided a forum to discuss the role of energy policy and energy conservation in promoting competitive and efficient gas and electricity markets in Ontario. The conference featured 15 presentations, of which 3 have been catalogued separately for inclusion in this database

  9. Social Media for Public Health: An Exploratory Policy Analysis

    OpenAIRE

    Fast, Ingrid; Sørensen, Kristine; Brand, Helmut; Suggs, L. Suzanne

    2017-01-01

    Background: To accomplish the aims of public health practice and policy today, new forms of communication and education are being applied. Social media are increasingly relevant for public health and used by various actors. Apart from benefits, there can also be risks in using social media, but policies regulating engagement in social media is not well researched. This study examined European public health-related organizations' social media policies and describes the main components of exist...

  10. The health care cost of dying: a population-based retrospective cohort study of the last year of life in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Peter Tanuseputro

    Full Text Available Coordinated and appropriate health care across sectors is an ongoing challenge, especially at the end-of-life. Population-level data on end-of-life health care use and cost, however, are seldom reported across a comprehensive array of sectors. Such data will identify the level of care being provided and areas where care can be optimized.This retrospective cohort study identified all deaths in Ontario from April 1, 2010 to March 31, 2013. Using population-based health administrative databases, we examined health care use and cost in the last year of life.Among 264,755 decedents, the average health care cost in the last year of life was $53,661 (Quartile 1-Quartile 3: $19,568-$66,875. The total captured annual cost of $4.7 billion represents approximately 10% of all government-funded health care. Inpatient care, incurred by 75% of decedents, contributed 42.9% of total costs ($30,872 per user. Physician services, medications/devices, laboratories, and emergency rooms combined to less than 20% of total cost. About one-quarter used long-term-care and 60% used home care ($34,381 and $7,347 per user, respectively. Total cost did not vary by sex or neighborhood income quintile, but were less among rural residents. Costs rose sharply in the last 120 days prior to death, predominantly for inpatient care.This analysis adds new information about the breadth of end-of-life health care, which consumes a large proportion of Ontario's health care budget. The cost of inpatient care and long-term care are substantial. Introducing interventions that reduce or delay institutional care will likely reduce costs incurred at the end of life.

  11. Health policy making for street children: challenges and strategies.

    Science.gov (United States)

    Abdi, Fatemeh; Saeieh, Sara Esmaelzadeh; Roozbeh, Nasibeh; Yazdkhasti, Mansoureh

    2017-08-17

    Background The phenomenon of street children is a bio-psychological and social issue that not only harms children, but also endangers the health of a society. In line with the national programs for the development and promotion of street children's health in Iran, health policy making and essential strategies for this group of children will be presented in this paper. This paper will discuss the main issues and challenges of street children's health and, also, health policy and guidelines for this population. Methods In this review study, the keywords; street children, health, challenges, policy, and health policy making were searched through PubMed, SID, Iranmedex, World Health Organization (WHO), Emro, the Cochran Library, Medline and Google scholar to collect data. The search resulted in 84 related resources from which 48 cases that were more relevant to this research and covered the issue more comprehensively, were used. All data published during 2002-2015 have been included in this paper. Results Key concepts including street children and their health, health policy, strategies to improve the health of street children, health policy approaches for street children, the WHO's strategies, and social support program for street children must be considered in the health policy making processes for street children, as precise identification of the relevant information makes planning more effective in health policy making for this group of children. Conclusion The phenomenon of street children is a growing problem in the world and it has turned into a serious concern in many countries including Iran. The findings of this study can be used for identifying necessary measures in order to use research outcomes more effectively in policy making processes and reforming street children's health policies in Iran.

  12. A Social Work Approach to Policy: Implications for Population Health.

    Science.gov (United States)

    Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L

    2017-12-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

  13. A Social Work Approach to Policy: Implications for Population Health

    Science.gov (United States)

    Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.

    2017-01-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535

  14. Reviewing and reforming policy in health enterprise information security

    Science.gov (United States)

    Sostrom, Kristen; Collmann, Jeff R.

    2001-08-01

    Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center, TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG), examined military policies and regulations relating to computer-based information systems and medical records management. Using a system of templates and matrices created for the purpose, P3WG identified gaps and discrepancies in DoD and service compliance with the proposed Health Insurance Portability and Accountability Act (HIPAA) Security Standard. P3WG represents an unprecedented attempt to coordinate policy review and revision across all military health services and the Office of Health Affairs. This method of policy reform can identify where changes need to be made to integrate health management policy and IT policy in to an organizational policy that will enable compliance with HIPAA standards. The process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains.

  15. Evidence-Informed Health Policies in Eastern Mediterranean Countries: Comparing Views of Policy Makers and Researchers

    Science.gov (United States)

    El-Jardali, Fadi; Lavis, John N.; Jamal, Diana; Ataya, Nour; Dimassi, Hani

    2014-01-01

    The objective of this paper is to conduct comparative analysis about the views and practices of policy makers and researchers on the use of health systems evidence in policy making in selected Eastern Mediterranean countries. We analysed data from two self-reported surveys, one targeted at policy makers and the other at researchers. Results show a…

  16. Associations among socioeconomic status, patterns of care and outcomes in breast cancer patients in a universal health care system: Ontario's experience.

    Science.gov (United States)

    Kumachev, Alexander; Trudeau, Maureen E; Chan, Kelvin K W

    2016-03-15

    The Canadian health care system provides equitable access to equivalent standards of care. The authors investigated to determine whether patients with breast cancer who had different socioeconomic status (SES) received different care and had different overall survival (OS) in Ontario, Canada. Women who were diagnosed with breast cancer between 2004 and 2009 were identified from the Ontario Cancer Registry and linked to provincial databases to ascertain patient demographics, screening, diagnosis, treatment patterns, and survival. SES was defined as neighborhood income by postal code and was divided into income quintiles (Q1-Q5; with Q5 the highest SES quintile). Univariable and multivariable analyses were used to examine the associations between: 1) SES and mammogram screening and breast cancer treatments, and 2) SES and OS. In total, 34,776 patients with breast cancer who had information on disease stage available at diagnosis were identified. Seventy-six percent of women were aged >50 years. Patients with higher SES were more likely to be diagnosed at an earlier stage (Q5 [44.3%] vs Q1 [37.7%]; odds ratio [OR], 1.31; 95% confidence interval [CI], 1.23-1.41; P cancer stage at diagnosis, adjuvant chemotherapy, trastuzumab, radiotherapy and surgery types, higher SES remained associated with better OS (P = .0017). In a universal health care system, higher SES is associated with greater screening and treatments and with better OS after adjusting for screening, cancer stage at diagnosis, and treatments. © 2015 American Cancer Society.

  17. Corporate philanthropy, political influence, and health policy.

    Directory of Open Access Journals (Sweden)

    Gary J Fooks

    Full Text Available The Framework Convention of Tobacco Control (FCTC provides a basis for nation states to limit the political effects of tobacco industry philanthropy, yet progress in this area is limited. This paper aims to integrate the findings of previous studies on tobacco industry philanthropy with a new analysis of British American Tobacco's (BAT record of charitable giving to develop a general model of corporate political philanthropy that can be used to facilitate implementation of the FCTC.Analysis of previously confidential industry documents, BAT social and stakeholder dialogue reports, and existing tobacco industry document studies on philanthropy.The analysis identified six broad ways in which tobacco companies have used philanthropy politically: developing constituencies to build support for policy positions and generate third party advocacy; weakening opposing political constituencies; facilitating access and building relationships with policymakers; creating direct leverage with policymakers by providing financial subsidies to specific projects; enhancing the donor's status as a source of credible information; and shaping the tobacco control agenda by shifting thinking on the importance of regulating the market environment for tobacco and the relative risks of smoking for population health. Contemporary BAT social and stakeholder reports contain numerous examples of charitable donations that are likely to be designed to shape the tobacco control agenda, secure access and build constituencies.Tobacco companies' political use of charitable donations underlines the need for tobacco industry philanthropy to be restricted via full implementation of Articles 5.3 and 13 of the FCTC. The model of tobacco industry philanthropy developed in this study can be used by public health advocates to press for implementation of the FCTC and provides a basis for analysing the political effects of charitable giving in other industry sectors which have an impact on

  18. Enhancing Evidence-Based Public Health Policy: Developing and Using Policy Narratives.

    Science.gov (United States)

    Troy, Lisa M; Kietzman, Kathryn G

    2016-06-01

    Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.]. Copyright 2016, SLACK Incorporated.

  19. Policy space for health and trade and investment agreements.

    Science.gov (United States)

    Koivusalo, Meri

    2014-06-01

    New trade agreements affect how governments can regulate for health both within health systems and in addressing health protection, promotion and social determinants of health in other policies. It is essential that those responsible for health understand the impacts of these trade negotiations and agreements on policy space for health at a national and local level. While we know more about implications from negotiations concerning intellectual property rights and trade in goods, this paper provides a screening checklist for less-discussed areas of domestic regulation, services, investment and government procurement. As implications are likely to differ on the basis of the organization and structures of national health systems and policy priorities, the emphasis is on finding out key provisions as well as on how exemptions and exclusions can be used to ensure policy space for health. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. How federalism shapes public health financing, policy, and program options.

    Science.gov (United States)

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

  1. Presidential Immigration Policies: Endangering Health and Well-being?

    DEFF Research Database (Denmark)

    Ó Cathaoir, Katharina Eva; O Gostin, Lawrence

    2017-01-01

    President Trump has issued executive orders transforming US immigration policy, potentially harming patient health and well-being. Are the president’s orders lawful and ethical, and what are the effects on the health system?......President Trump has issued executive orders transforming US immigration policy, potentially harming patient health and well-being. Are the president’s orders lawful and ethical, and what are the effects on the health system?...

  2. About public health policies in the new century

    OpenAIRE

    Franco G., Alvaro

    2010-01-01

    Several subjects of public health policies are analyzed from different points of view, bearing in mind the line of coherence of their universal, global and integral character. Themes such as "Health for All", understood as a universal policy at the close of this century, are included. Around it other recent approaches are considered which are also related between them: the subject of health promotion in its broad vision from the guidelines of the Ottawa (Canada) letter, and the public health ...

  3. Social media for public health: an exploratory policy analysis.

    Science.gov (United States)

    Fast, Ingrid; Sørensen, Kristine; Brand, Helmut; Suggs, L Suzanne

    2015-02-01

    To accomplish the aims of public health practice and policy today, new forms of communication and education are being applied. Social media are increasingly relevant for public health and used by various actors. Apart from benefits, there can also be risks in using social media, but policies regulating engagement in social media is not well researched. This study examined European public health-related organizations' social media policies and describes the main components of existing policies. This research used a mixed methods approach. A content analysis of social media policies from European institutions, non-government organizations (NGOs) and social media platforms was conducted. Next, individuals responsible for social media in their organization or projects completed a survey about their social media policy. Seventy-five per cent of institutions, NGOs and platforms had a social media policy available. The primary aspects covered within existing policies included data and privacy protection, intellectual property and copyright protection and regulations for the engagement in social media. Policies were intended to regulate staff use, to secure the liability of the institution and social responsibility. Respondents also stressed the importance of self-responsibility when using social media. This study of social media policies for public health in Europe provides a first snapshot of the existence and characteristics of social media policies among European health organizations. Policies tended to focus on legal aspects, rather than the health of the social media user. The effect of such policies on social media adoption and usage behaviour remains to be examined. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  4. Province of Ontario nuclear emergency plan. Pt. 1

    International Nuclear Information System (INIS)

    1986-06-01

    The Province of Ontario Nuclear Emergency Plan has been developed pursuant to Section 8 of the Emergency Plans Act, 1983. This plan replaces the Province of Ontario Nuclear Contingency Off-Site Plan (June 1980) which is no longer applicable. The wastes plan includes planning, preparation, emergency organization and operational responsibilities and policy

  5. Evaluation of self-swabbing coupled with a telephone health helpline as an adjunct tool for surveillance of influenza viruses in Ontario

    Directory of Open Access Journals (Sweden)

    D. McGolrick

    2016-09-01

    Full Text Available Abstract Background Calls to a telephone health helpline (THHL have been previously evaluated for the ability to monitor specific syndromes, such as fever and influenza-like-illness or gastrointestinal illness. This method of surveillance has been shown to be highly correlated with traditional surveillance methods, and to have potential for early detection of community-based illness. Self-sampling, or having a person take his/her own nasal swab, has also proven successful as a useful method for obtaining a specimen, which may be used for respiratory virus detection. Methods This study describes a self-swabbing surveillance system mediated by a nurse-led THHL in Ontario whereby syndromic surveillance concepts are used to recruit and monitor participants with influenza-like illness. Once recruited, participants collect a nasal specimen obtained by self-swabbing and submit for testing and laboratory confirmation. Enumeration of weekly case counts was used to evaluate the timeliness of the self-swabbing surveillance system through comparison to other respiratory virus and influenza surveillance systems in Ontario. The operational efficiency of the system was also evaluated. Results The mean and median number of days between the day that a participant called the THHL, to the day a package was received at the laboratory for testing were approximately 10.4 and 8.6 days, respectively. The time between self-swab collection and package reception was 4.9 days on average, with a median of 4 days. The self-swabbing surveillance system adequately captured the 2014 influenza B season in a timely manner when compared to other Ontario-based sources of influenza surveillance data from the same year; however, the emergence of influenza B was not detected any earlier than with these other surveillance systems. Influenza A surveillance was also evaluated. Using the THHL self-swabbing system, a peak in the number of cases for influenza A was observed approximately

  6. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy.

    Science.gov (United States)

    Lavoie, Josée G

    2013-12-27

    Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.

  7. Ontario Hydro's DSP update

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Ontario Hydro's Demand/Supply Plan (DSP), the 25 year plan which was submitted in December 1989, is currently being reviewed by the Environmental Assessment Board (EAB). Since 1989 there have been several changes which have led Ontario Hydro to update the original Demand/Supply Plan. This information sheet gives a quick overview of what has changed and how Ontario Hydro is adapting to that change

  8. Mandating influenza vaccinations for health care workers: analysing opportunities for policy change using Kingdon's agenda setting framework.

    Science.gov (United States)

    Jackson-Lee, Angela; Barr, Neil G; Randall, Glen E

    2016-09-29

    The consequences of annual influenza outbreaks are often underestimated by the general public. Influenza poses a serious public health threat around the world, particularly for the most vulnerable populations. Fortunately, vaccination can mitigate the negative effects of this common infectious disease. Although inoculating frontline health care workers (HCWs) helps minimize disease transmission, some HCWs continue to resist participating in voluntary immunization programs. A potential solution to this problem is government-mandated vaccination for HCWs; however, in practice, there are substantial barriers to the adoption of such policies. The purpose of this paper is to identify the likelihood of adopting a policy for mandatory immunization of HCWs in Ontario based on a historical review of barriers to the agenda setting process. Documents from secondary data sources were analysed using Kingdon's agenda setting framework of three converging streams leading to windows of opportunity for possible policy adoption. The problems, politics, and policies streams of Kingdon's framework have converged and diverged repeatedly over an extended period (policy windows have opened and closed several times). In each instance, a technically feasible solution was available. However, despite the evidence supporting the value of HCW immunization, alignment of the three agenda setting streams occurred for very short periods of time, during which, opposition lobby groups reacted, making the proposed solution less politically acceptable. Prior to the adoption of any new policies, issues must reach a government's decision agenda. Based on Kingdon's agenda setting framework, this only occurs when there is alignment of the problems, politics, and policies streams. Understanding this process makes it easier to predict the likelihood of a policy being adopted, and ultimately implemented. Such learning may be applied to policy issues in other jurisdictions. In the case of mandatory influenza

  9. 77 FR 27774 - Health Information Technology Policy Committee Vacancy

    Science.gov (United States)

    2012-05-11

    ... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Vacancy AGENCY... American Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy.... ADDRESSES: GAO: [email protected] . GAO: 441 G Street NW., Washington, DC 20548. FOR FURTHER INFORMATION...

  10. Health in All (Foreign) Policy: challenges in achieving coherence.

    Science.gov (United States)

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Relationships between work outcomes, work attitudes and work environments of health support workers in Ontario long-term care and home and community care settings.

    Science.gov (United States)

    Berta, Whitney; Laporte, Audrey; Perreira, Tyrone; Ginsburg, Liane; Dass, Adrian Rohit; Deber, Raisa; Baumann, Andrea; Cranley, Lisa; Bourgeault, Ivy; Lum, Janet; Gamble, Brenda; Pilkington, Kathryn; Haroun, Vinita; Neves, Paula

    2018-03-22

    Our overarching study objective is to further our understanding of the work psychology of Health Support Workers (HSWs) in long-term care and home and community care settings in Ontario, Canada. Specifically, we seek novel insights about the relationships among aspects of these workers' work environments, their work attitudes, and work outcomes in the interests of informing the development of human resource programs to enhance elder care. We conducted a path analysis of data collected via a survey administered to a convenience sample of Ontario HSWs engaged in the delivery of elder care over July-August 2015. HSWs' work outcomes, including intent to stay, organizational citizenship behaviors, and performance, are directly and significantly related to their work attitudes, including job satisfaction, work engagement, and affective organizational commitment. These in turn are related to how HSWs perceive their work environments including their quality of work life (QWL), their perceptions of supervisor support, and their perceptions of workplace safety. HSWs' work environments are within the power of managers to modify. Our analysis suggests that QWL, perceptions of supervisor support, and perceptions of workplace safety present particularly promising means by which to influence HSWs' work attitudes and work outcomes. Furthermore, even modest changes to some aspects of the work environment stand to precipitate a cascade of positive effects on work outcomes through work attitudes.

  12. Promoting LGBT health and wellbeing through inclusive policy development.

    Science.gov (United States)

    Mulé, Nick J; Ross, Lori E; Deeprose, Barry; Jackson, Beth E; Daley, Andrea; Travers, Anna; Moore, Dick

    2009-05-15

    In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.

  13. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  14. State health agencies and the legislative policy process.

    Science.gov (United States)

    Williams-Crowe, S M; Aultman, T V

    1994-01-01

    A new era of health care reform places increasing pressure on public health leaders and agencies to participate in the public policy arena. Public health professionals have long been comfortable in providing the scientific knowledge base required in policy development. What has been more recent in its evolution, however, is recognition that they must also play an active role in leading and shaping the debate over policy. A profile of effective State legislative policy "entrepreneurs" and their strategies has been developed to assist health agencies in developing such a leadership position. Based on the experiences of State legislative liaison officers, specific strategies for dealing with State legislatures have been identified and are organized into five key areas--agency organization, staff skills, communications, negotiation, and active ongoing involvement. A public health agency must be organized effectively to participate in the legislative policy process. Typically, effective agencies centralize responsibility for policy activities and promote broad and coordinated participation throughout the organization. Playing a key role in the agency's political interventions, the legislative liaison office should be staffed with persons possessing excellent interpersonal skills and a high degree of technical competence. Of central importance to effective legislative policy entrepreneurship is the ability to communicate the agency's position clearly. This includes setting forward a focused policy agenda, documenting policy issues in a meaningful manner, and reaching legislators with the proper information. Once a matter is on the legislative agenda, the agency must be prepared to negotiate and build broad support for the measure. Finally, public health agencies must be active policy players. To take advantage of new opportunities for action, the public health (policy) leader must monitor the political environment continually.By working to anticipate and formulate

  15. Social policies and the pathways to inequalities in health

    DEFF Research Database (Denmark)

    Whitehead, M; Burström, B; Diderichsen, Finn

    2000-01-01

    in relation to the identified policy entry points. Overall, in Britain, around 50% of the health disadvantage of lone mothers is accounted for by the mediating factors of poverty and joblessness, whereas in Sweden these factors only account for between 3% and 13% of the health gap. The final section discusses......The aim of this study is to contribute to the emerging field of health inequalities impact assessment. It develops further a conceptual framework that encompasses the policy context as well as the pathways leading from social position to inequalities in health. It then uses this framework...... the implications of the findings for future policy intervention and research in the two countries....

  16. Food and beverage policies and public health ethics.

    Science.gov (United States)

    Resnik, David B

    2015-06-01

    Government food and beverage policies can play an important role in promoting public health. Few people would question this assumption. Difficult questions can arise, however, when policymakers, public health officials, citizens, and businesses deliberate about food and beverage policies, because competing values may be at stake, such as public health, individual autonomy, personal responsibility, economic prosperity, and fairness. An ethically justified policy strikes a reasonable among competing values by meeting the following criteria: (1) the policy serves important social goal(s); (2) the policy is likely to be effective at achieving those goal(s); (3) less burdensome options are not likely to be effective at achieving the goals; (4) the policy is fair.

  17. Policy Watch: The Federal Employees Health Benefits Plan

    OpenAIRE

    Roger Feldman; Kenneth E. Thorpe; Bradley Gray

    2002-01-01

    This short feature describes the Federal Employees Health Benefits Plan (FEHBP), which provides health insurance benefits to active and retired federal employees and their dependents. The article discusses the FEHBP as a touchstone for research on employment-based health insurance and as a touchstone for health policy reform.

  18. From mental health policy development in Ghana to implementation ...

    African Journals Online (AJOL)

    schizophrenia, alcohol use disorders and bi-polar disorder account for a third of years ... Objective: This paper identifies the key barriers to mental health policy implementation in Ghana and suggests ways of overcoming them. Method: The ... of health workers trained and supervised in mental health care, and mental health ...

  19. Shifting from policy relevance to policy translation: do housing and neighborhoods affect children's mental health?

    Science.gov (United States)

    Osypuk, Theresa L

    2015-02-01

    The impact of housing and neighborhood context on children's mental health, as addressed by Flouri et al. (Soc Psychiatry Psychiatr Epidemiol, 2014), is an important, understudied topic in social epidemiology. Although the vast majority of this body of research has been descriptive, generating translational research is essential. This article offers guidance on interpreting evidence from observational studies for translation into policy, related to three policy-relevant elements of housing: receipt of affordable housing subsidies, the target population to which results generalize, and operationalization and modeling of neighborhood context. Policy translation is imperative for understanding which levers outside the health sector can be manipulated to change fundamental causes of mental health related to housing and neighborhood. Shifting from policy relevance to policy translation may be challenging, especially for understanding social causation in observational studies, but it is a necessary shift for improving population health.

  20. Climate Change, Public Health, and Policy: A California Case Study

    Science.gov (United States)

    Smith, Jason A.

    2018-01-01

    Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California’s progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions. PMID:29072936

  1. Climate Change, Public Health, and Policy: A California Case Study.

    Science.gov (United States)

    Ganesh, Chandrakala; Smith, Jason A

    2018-04-01

    Anthropogenic activity will bring immediate changes and disruptions to the global climate with accompanying health implications. Although policymakers and public health advocates are beginning to acknowledge the health implications of climate change, current policy approaches are lagging behind. We proposed that 4 key policy principles are critical to successful policymaking in this arena: mainstreaming, linking mitigation and adaptation policy, applying population perspectives, and coordination. We explored California's progress in addressing the public health challenges of climate change in the San Joaquin Valley as an example. We discussed issues of mental health and climate change, and used the San Joaquin Valley of California as an example to explore policy approaches to health issues and climate change. The California experience is instructive for other jurisdictions.

  2. Economics and Health Reform: Academic Research and Public Policy.

    Science.gov (United States)

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act. © The Author(s) 2015.

  3. Macroeconomic policies and increasing social-health inequality in Iran.

    Science.gov (United States)

    Zaboli, Rouhollah; Seyedin, Seyed Hesam; Malmoon, Zainab

    2014-08-01

    Health is a complex phenomenon that can be studied from different approaches. Despite a growing research in the areas of Social Determinants of Health (SDH) and health equity, effects of macroeconomic policies on the social aspect of health are unknown in developing countries. This study aimed to determine the effect of macroeconomic policies on increasing of the social-health inequality in Iran. This study was a mixed method research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect the data along with a multiple attribute decision-making method for the quantitative phase of the research in which the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed for prioritization. The NVivo and MATLAB softwares were used for data analysis. Seven main themes for the effect of macroeconomic policies on increasing the social-health inequality were identified. The result of TOPSIS approved that the inflation and economic instability exert the greatest impact on social-health inequality, with an index of 0.710 and the government policy in paying the subsidies with a 0.291 index has the lowest impact on social-health inequality in the country. It is required to invest on the social determinants of health as a priority to reduce health inequality. Also, evaluating the extent to which the future macroeconomic policies impact the health of population is necessary.

  4. World Health Organization global policy for improvement of oral health--World Health Assembly 2007

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2008-01-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income...... countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and the necessary actions for the improvement of oral health. The strategy is that oral disease prevention...... and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject...

  5. Financing and funding health care: Optimal policy and political implementability.

    Science.gov (United States)

    Nuscheler, Robert; Roeder, Kerstin

    2015-07-01

    Health care financing and funding are usually analyzed in isolation. This paper combines the corresponding strands of the literature and thereby advances our understanding of the important interaction between them. We investigate the impact of three modes of health care financing, namely, optimal income taxation, proportional income taxation, and insurance premiums, on optimal provider payment and on the political implementability of optimal policies under majority voting. Considering a standard multi-task agency framework we show that optimal health care policies will generally differ across financing regimes when the health authority has redistributive concerns. We show that health care financing also has a bearing on the political implementability of optimal health care policies. Our results demonstrate that an isolated analysis of (optimal) provider payment rests on very strong assumptions regarding both the financing of health care and the redistributive preferences of the health authority. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Framing and the health policy process: a scoping review.

    Science.gov (United States)

    Koon, Adam D; Hawkins, Benjamin; Mayhew, Susannah H

    2016-07-01

    Framing research seeks to understand the forces that shape human behaviour in the policy process. It assumes that policy is a social construct and can be cast in a variety of ways to imply multiple legitimate value considerations. Frames provide the cognitive means of making sense of the social world, but discordance among them forms the basis of policy contestation. Framing, as both theory and method, has proven to generate considerable insight into the nature of policy debates in a variety of disciplines. Despite its salience for understanding health policy debates; however, little is known about the ways frames influence the health policy process. A scoping review using the Arksey and O'Malley framework was conducted. The literature on framing in the health sector was reviewed using nine health and social science databases. Articles were included that explicitly reported theory and methods used, data source(s), at least one frame, frame sponsor and evidence of a given frame's effect on the health policy process. A total of 52 articles, from 1996 to 2014, and representing 12 countries, were identified. Much of the research came from the policy studies/political science literature (n = 17) and used a constructivist epistemology. The term 'frame' was used as a label to describe a variety of ideas, packaged as values, social problems, metaphors or arguments. Frames were characterized at various levels of abstraction ranging from general ideological orientations to specific policy positions. Most articles presented multiple frames and showed how actors advocated for them in a highly contested political process. Framing is increasingly an important, yet overlooked aspect of the policy process. Further analysis on frames, framing processes and frame conflict can help researchers and policymakers to understand opaque and highly charged policy issues, which may facilitate the resolution of protracted policy controversies. © The Author 2016. Published by Oxford

  7. Ontario electricity industry restructuring

    International Nuclear Information System (INIS)

    1999-01-01

    The objective of Ontario's electricity industry restructuring was described as an effort to enhance Ontario's competitiveness. It is believed that restructuring can be accomplished without an increase in electricity rates. In a series of charts, the report provides the timeline of restructuring from the time of the Macdonald report in 1995 to the beginning of open competition in Ontario electricity markets. It oulines the principles underlying the financial restructuring and the financial results of restructuring, including the size of the stranded debt ($ 7.8 billion). It lists the changes that have occurred since October 1998, explains some key factors in valuing the successor companies and profiles the Ontario Electricity Financial Corporation. Restructuring of the industry is expected to have a neutral to positive impact on Ontario's fiscal position. The residual stranded debt of $7.8 billion will be retired through revenues generated by the electricity sector, without recourse to the Provincial Treasury. 9 figs

  8. Market surveillance in Ontario

    International Nuclear Information System (INIS)

    Chandler, H.

    2002-01-01

    On May 1, 2002 both wholesale and retail electricity markets in Ontario were opened to competition. Wholesale electricity market sales of 150 TWh were valued at over $11 billion with 27,500 MW in service installed capacity and 4,000 to 6,000 MW import/export capability with strong interconnections to the Quebec, the Midwest and the Northeast. The key players in Ontario's electricity market are the Ontario Energy Board (OEB), the Independent Electricity Market Operator (IMO), Ontario Power Generation, and Hydro One. The OEB regulatory framework includes licensing and front line, daily monitoring of whole sale market. Serious capacity problems in Ontario have manifested themselves in tight supply and demand situations and highly volatile prices. The paper included graphs of available reserves for 1996 to 2002, HOEP trends and frequency, HOEP comparison, and a sensitivity to demand forecast. 1 tab., 6 figs

  9. Ontario energy review

    International Nuclear Information System (INIS)

    1990-03-01

    This publication provides a review of the developments in Ontario in relation to the national and international energy scene. Ontario is the largest energy consumer in Canada and is highly dependent on external energy sources. Several developments have significantly altered the Ontario energy scene. Oil and gas markets have become deregulated and market forces increasingly determine prices. A free trade agreement with the United States makes Ontario even more affected by international markets. Oil and gas prices have fallen from the high levels of the 1980s, but energy efficiency and conservation continue to be extremely important because they affect economic performance and the environment. In the next few years the greatest challenges will be to continue improving energy efficiency, to reduce the impact of energy on the environment, and to ensure the availability of sufficient energy supplies for future needs. This review contains statistics on energy in Ontario and explains them for the non-specialist. (7 tabs., figs.)

  10. Constructing public oral health policies in Brazil: issues for reflection.

    Science.gov (United States)

    Soares, Catharina Leite Matos

    2012-01-01

    This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF); the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente). From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS) and the Family Health Strategy.

  11. The Ontario Mother and Infant Study (TOMIS III: A multi-site cohort study of the impact of delivery method on health, service use, and costs of care in the first postpartum year

    Directory of Open Access Journals (Sweden)

    Landy Christine

    2009-04-01

    Full Text Available Abstract Background The caesarean section rate continues to rise globally. A caesarean section is inarguably the preferred method of delivery when there is good evidence that a vaginal delivery may unduly risk the health of a woman or her infant. Any decisions about delivery method in the absence of clear medical indication should be based on knowledge of outcomes associated with different childbirth methods. However, there is lack of sold evidence of the short-term and long-term risks and benefits of a planned caesarean delivery compared to a planned vaginal delivery. It also is important to consider the economic aspects of caesarean sections, but very little attention has been given to health care system costs that take into account services used by women for themselves and their infants following hospital discharge. Methods and design The Ontario Mother and Infant Study III is a prospective cohort study to examine relationships between method of delivery and maternal and infant health, service utilization, and cost of care at three time points during the year following postpartum hospital discharge. Over 2500 women were recruited from 11 hospitals across the province of Ontario, Canada, with data collection occurring between April 2006 and October 2008. Participants completed a self-report questionnaire in hospital and structured telephone interviews at 6 weeks, 6 months, and 12 months after discharge. Data will be analyzed using generalized estimating equation, a special generalized linear models technique. A qualitative descriptive component supplements the survey approach, with the goal of assisting in interpretation of data and providing explanations for trends in the findings. Discussion The findings can be incorporated into patient counselling and discussions about the advantages and disadvantages of different delivery methods, potentially leading to changes in preferences and practices. In addition, the findings will be useful to

  12. Multisector Health Policy Networks in 15 Large US Cities

    Science.gov (United States)

    Leider, J. P.; Carothers, Bobbi J.; Castrucci, Brian C.; Hearne, Shelley

    2016-01-01

    Context: Local health departments (LHDs) have historically not prioritized policy development, although it is one of the 3 core areas they address. One strategy that may influence policy in LHD jurisdictions is the formation of partnerships across sectors to work together on local public health policy. Design: We used a network approach to examine LHD local health policy partnerships across 15 large cities from the Big Cities Health Coalition. Setting/Participants: We surveyed the health departments and their partners about their working relationships in 5 policy areas: core local funding, tobacco control, obesity and chronic disease, violence and injury prevention, and infant mortality. Outcome Measures: Drawing on prior literature linking network structures with performance, we examined network density, transitivity, centralization and centrality, member diversity, and assortativity of ties. Results: Networks included an average of 21.8 organizations. Nonprofits and government agencies made up the largest proportions of the networks, with 28.8% and 21.7% of network members, whereas for-profits and foundations made up the smallest proportions in all of the networks, with just 1.2% and 2.4% on average. Mean values of density, transitivity, diversity, assortativity, centralization, and centrality showed similarity across policy areas and most LHDs. The tobacco control and obesity/chronic disease networks were densest and most diverse, whereas the infant mortality policy networks were the most centralized and had the highest assortativity. Core local funding policy networks had lower scores than other policy area networks by most network measures. Conclusion: Urban LHDs partner with organizations from diverse sectors to conduct local public health policy work. Network structures are similar across policy areas jurisdictions. Obesity and chronic disease, tobacco control, and infant mortality networks had structures consistent with higher performing networks, whereas

  13. Transforming Ontario's Power Generation Company

    International Nuclear Information System (INIS)

    Manley, J.; Epp, J.; Godsoe, P.C.

    2004-01-01

    The OPG Review Committee was formed by the Ontario Ministry of Energy to provide recommendations and advice on the future role of Ontario Power Generation Inc. (OPG) in the electricity sector. This report describes the future structure of OPG with reference to the appropriate corporate governance and senior management structure. It also discusses the potential refurbishing of the Pickering A nuclear generating Units 1, 2 and 3. The electricity system in Ontario is becoming increasingly fragile. The province relies heavily on electricity imports and the transmission system is being pushed to near capacity. Three nuclear generating units are out of service. The problems can be attributed to the fact that the electricity sector has been subjected to unpredictable policy changes for more than a decade, and that the largest electricity generator (OPG) has not been well governed. OPG has had frequent senior management change, accountability has been weak, and cost overruns have delayed the return to service of the Pickering nuclear power Unit 4. It was noted that the generating assets owned and operated by OPG are capable of providing more than 70 per cent of Ontario's electricity supply. Decisive action is needed now to avoid a potential supply shortage of about 5,000 to 7,000 megawatts by 2007. In its current state, OPG risks becoming a burden on ratepayers. Forty recommendations were presented, some of which suggest that OPG should become a rate-regulated commercial utility focused on running and maintaining its core generating assets. This would require that the government act as a shareholder, and the company operate like a commercial business. It was also emphasized that the market must be allowed to bring in new players. refs., tabs., figs

  14. Ethiopian Journal of Health Development: Editorial Policies

    African Journals Online (AJOL)

    AIDS, TB and STI; community involvement and inter-sectoral approaches to primary health care; drug supply and distribution; socioeconomic factors related to health and health services, medical geography, broader topics on scientific work on ...

  15. Health care models guiding mental health policy in Kenya 1965 - 1997

    Directory of Open Access Journals (Sweden)

    Jenkins Rachel

    2010-04-01

    Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.

  16. A ten-year history: the Cancer Quality Council of Ontario.

    Science.gov (United States)

    Anas, Rebecca; Bell, Robert; Brown, Adalsteinn; Evans, William; Sawka, Carol

    2012-01-01

    One of the longest-established quality oversight organizations in Canadian healthcare, the Cancer Quality Council of Ontario (CQCO) is an advisory group formed in 2002 by the Ministry of Health and Long-Term Care. Although quasi-independent from Cancer Care Ontario (CCO), the council was established to provide advice to CCO and the ministry in their efforts to improve the quality of cancer care in the province. The council is composed of a multidisciplinary group of healthcare providers, cancer survivors and experts in the areas of oncology, health system policy and administration, governance, performance measurement and health services research. Its mandate is to monitor and report publicly on the performance of the Ontario cancer system and to motivate improvement through national and international benchmarking. Since its formation, the council has played an evolving role in improving the quality of care received by Ontario cancer patients. This article will briefly describe the origins and founding principles of the CQCO, its changing role in monitoring quality and its relationship with CCO. Copyright © 2012 Longwoods Publishing.

  17. Public health policies to encourage healthy eating habits: recent perspectives.

    Science.gov (United States)

    Gorski, Mary T; Roberto, Christina A

    2015-01-01

    There is an urgent need to address unhealthy dietary patterns at the population level. Poor diet and physical inactivity are key drivers of the obesity pandemic, and they are among the leading causes of preventable death and disability in nearly every country in the world. As countries grapple with the growing obesity prevalence, many innovative policy options to reduce overeating and improve diet quality remain largely unexplored. We describe recent trends in eating habits and consequences for public health, vulnerabilities to unhealthy eating, and the role for public health policies. We reviewed recent public health policies to promote healthier diet patterns, including mandates, restrictions, economic incentives, marketing limits, information provision, and environmental defaults.

  18. Mental Health Disorders and Publicly Funded Service Use by HIV Positive Individuals: A Population-Based Cross-Sectional Study in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Brown, Hilary K; Antoniou, Tony; Sirotich, Frank; Bansal, Symron; Heifetz, Marina; Roesslein, Kay; Lunsky, Yona

    2017-12-01

    We compared use of community and hospital-based mental health and addiction (MH&A) services by adults with and without HIV. This population-based study examined the probability and intensity of MH&A service use by individuals with (n = 5095) and without HIV (n = 2,753,091) in Ontario, Canada between 2013 and 2014. Adults with HIV were more likely than HIV-negative adults to use MH&A primary and psychiatric care, and to have MH&A emergency department visits and hospital admissions; they also used more of each service. Use of MH&A hospital services was particularly high for persons in the HIV group compared to the no HIV group.

  19. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland.

    Science.gov (United States)

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-01-01

    Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.

  20. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland

    Science.gov (United States)

    Clavier, Carole; Potvin, Louise

    2017-01-01

    Background Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Methods Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Results Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Conclusion Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making. PMID:28589007

  1. The Ontario Energy Marketers Association

    International Nuclear Information System (INIS)

    Baker, W.F.C.

    1998-01-01

    An overview of the role of the Ontario Energy Marketers Association (OEMA) and its future orientation was presented. Participants in the OEMA include agents, brokers, marketers, local distribution companies, public interest representatives, associations and government representatives. The role of the OEMA is to encourage open competition for the benefit and protection of all energy consumer and market participants. As well, the OEMA serves as a forum for key industry stakeholders to resolve market issues outside the regulatory arena, set standards and codes of practice, establish customer education programs, and develop industry input into public policy making

  2. Evironmental health policy in ukraine after the Chernobyl accident

    International Nuclear Information System (INIS)

    Page, G.W.; Bobyleva, O.A.; Naboka, M.V.

    1995-01-01

    The 1986 accident at the Chernobyl nuclear power plant in Ukraine produced severe environmental health problems. This paper reports on the environmental health conditions in Ukraine after the accident and the health policy approaches employed to respond to the environmental conditions and health problems. Crisis conditions and a period of rapid change in Ukraine contributed to the difficulties of developing and implementing policy to address serious environmental health problems. Despite these difficulties, Ukraine is taking effective action. The paper describes the primary environmental health problem areas and the efforts taken to solve them. The effect of intense public fear of radiation on policymaking is described. The paper discusses the ability of public fear to distort health policy towards certain problems, leaving problems of greater importance with fewer resources. 35 refs., 1 fig

  3. A randomised controlled study to evaluate the effectiveness of targeted occupational health and safety consultation or inspection in Ontario manufacturing workplaces.

    Science.gov (United States)

    Hogg-Johnson, Sheilah; Robson, Lynda; Cole, Donald C; Amick, Benjamin C; Tompa, Emile; Smith, Peter M; van Eerd, Dwayne; Mustard, Cameron

    2012-12-01

    From 2004 to 2008, the prevention system in Ontario, Canada ran the High Risk Firm Initiative, an injury-experience based targeted consultation or inspection programme. Our objective was to establish whether prevention system targeting of firms was effective in improving injury outcomes. Randomised controlled parallel groups. Population included all manufacturing firms registered with the Ontario Workplace Safety & Insurance Board in 2005. Firms ranked between the 2nd and 10th percentile on a composite measure of occupational health and safety performance were randomised to three study arms in 2006: targeted for Health & Safety Association (HSA) consultation, targeted for Ministry of Labour (MOL) inspection, or services as usual. Data included firm characteristics (sector, size, years in business, region, branches), work injury claims 2002-2008 and measures of consulting and inspecting activity. Negative binomial generalised estimating equations modelled claim and disability day rates by study arm and year, controlling for firm characteristics. Among 2153 firms, firm characteristics and 2002-2005 rates of work injury claims and disability days were similar across arms. Firm outcomes were significantly different from year to year, but study arm by year interactions were insignificant indicating similar trends for all three study arms. 83% of HSA targeted firms were contacted and 63% engaged while 75% of MOL targeted firms were inspected with orders written in 56%. Consultation and enforcement programmes as implemented were not sufficient to reduce work injury outcomes over 21 month follow-up. Lack of benefit could be due to non-specific firm selection methods, limited firm participation in interventions, low intervention intensity or insensitivity of available outcomes.

  4. Pharmaceutical expenditure forecast model to support health policy decision making

    OpenAIRE

    R?muzat, C?cile; Urbinati, Duccio; Kornfeld, ?sa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aball?a, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    Background and objective: With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project ‘European Union (EU) Pharmaceutical expenditure forecast’ – http://ec.europa.eu/health/healthcare/key_documents/index_en.htm).Methods: A model was built to assess policy sc...

  5. Tobacco control, global health policy and development: towards policy coherence in global governance

    Science.gov (United States)

    Collin, Jeff

    2015-01-01

    The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

  6. Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

    Science.gov (United States)

    de Leeuw, Evelyne

    2017-03-20

    Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

  7. Informed policies for Europe’s health workforce of tomorrow.

    NARCIS (Netherlands)

    Batenburg, R.

    2010-01-01

    Although it is widely acknowledged that health workforce planning is critical for health care systems, it is probably one of the least strategically planned resources. One could argue that there are good reasons for this: demand and supply of the health labour market are in constant flux, and policy

  8. Shaping Public Health Education, Research, and Policy in the Arab ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Shaping Public Health Education, Research, and Policy in the Arab World. While the Arab World has enjoyed substantial economic progress, there has been little improvement in ensuring equitable access to health care. In most countries, the majority of people have limited access to basic health services. These are ...

  9. African Health Economics and Policy Research Capacity Building ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    African Health Economics and Policy Research Capacity Building and Dissemination. As African countries move toward universal health coverage, it is clear there is a shortage of African experts with applied research skills in health financing such as fiscal space analysis, needs-based resource allocation methods, and ...

  10. Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions.

    Science.gov (United States)

    Béland, Daniel; Katapally, Tarun R

    2018-01-14

    Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  11. Mental Health in Education. Policy Update. Vol. 24, No. 8

    Science.gov (United States)

    Hofer, Lindsey

    2017-01-01

    Positive school climate has been linked to higher test scores, graduation rates, and fewer disciplinary referrals. Yet state policy discussions on student supports often fail to address a key lever for improving school climate: robust school-based mental health services. This National Association of State Boards of Education (NASBE) policy update…

  12. Engaging trainees in shaping the future of health policy.

    Science.gov (United States)

    Atkinson, Stephen; Sachedina, Nabihah; King, Judith; Mak, Matthew; Morganstein, Louise; Mytton, Oliver T; Thomas, Justyn

    2011-04-01

    This paper presents an analysis of the views and ideas generated at a recent health policy discussion for doctors in training. This provides an illustration of the creativity and enthusiasm that trainees can bring to the policy sphere by providing unique insights and a fresh perspective.

  13. Integrating Occupational Safety and Health into TAFE Courses: Policy Guidelines.

    Science.gov (United States)

    Hill, Graham L.; Mageean, Pauline

    Intended to help administrators, curriculum developers, and teachers integrate occupational health and safety into Australian vocational courses on bricklaying, metal fabrication, and horticulture, this document suggests specific policies and provides further amplification concerning three general policies for that integration. The three general…

  14. Policy conflicts : Market-oriented reform in health care

    NARCIS (Netherlands)

    Dolfsma, W.A.; Mcmaster, R.

    From an institutionalist perspective, we identify five sources of policy conflict. Each may explain why policies intended to obtain particular goals for an institutionalized practice may have unintended consequences. We illustrate by analyzing attempts at introducing market-oriented reform in health

  15. Learning from games : Stakeholders’ experiences involved in local health policy

    NARCIS (Netherlands)

    Spitters, H.P.E.M.; van de Goor, L.A.M.; Juel Lau, C.; Sandu, P.; Eklund Karlsson, L.; Jansen, J.; van Oers, J.A.M.

    2018-01-01

    Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a 'policy game'. The focus on specific problems facilitates relationships between the

  16. Immigration and Health: Law, Policy, and Ethics.

    Science.gov (United States)

    Parmet, Wendy E; Sainsbury-Wong, Lorianne; Prabhu, Maya

    2017-03-01

    Immigration poses numerous challenges for health professionals and public health lawyers. This article reviews these challenges. We begin by offering some background on immigration and health and then explain some of the reasons why immigrants are less likely than natives to have health insurance. Next we turn to a discussion of some of the particular challenges relating to the health care of refugees. We conclude by analyzing and rejecting some of the arguments that are made for discriminating against immigrants with respect to the provision of public health benefits and services.

  17. Multinational surveys for monitoring eHealth policy implementations

    DEFF Research Database (Denmark)

    Gilstad, Heidi; Faxvaag, Arild; Hyppönen, Hannele

    2014-01-01

    Development of multinational variables for monitoring eHealth policy implementations is a complex task and requires multidisciplinary, knowledgebased international collaboration. Experts in an interdisciplinary workshop identified useful data and pitfalls for comparative variable development...

  18. Technology Opportunities: Implementation of Deployment Health Policy in Operational Theaters

    National Research Council Canada - National Science Library

    Martinez-Lopez, Lester

    2004-01-01

    It is U.S. policy that medical and personnel information systems be designed, integrated, and utilized with military medical surveillance to protect the physical and mental health of Service members throughout...

  19. Policy research institutions and the health SDGs: Open data ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Policy research institutions and the health SDGs: Open data platforms for ... This exercise will provide the opportunity to raise awareness of the SGDs and the ... IDRC is supporting research that studies the most effective ways to empower ...

  20. Analysis of maternal and child health policies in Malawi: The ...

    African Journals Online (AJOL)

    report and discuss how a mixed qualitative research method was applied for analyzing maternal ... maternal and child health policies, we adopted a mixed qualitative research method ..... types of samples were used in order to capture different.

  1. Building policy leadership among HIV/AIDS health workers | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-21

    Apr 21, 2016 ... Health workers need research, leadership, and policy skills to help ... the regions hardest hit by the pandemic, by building these skills among ... Nowhere in the world has AIDS had a more devastating effect than in Africa.

  2. Building policy leadership among HIV/AIDS health workers | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Learn more: Read a journal article on the reliability of data collected by community health workers for policy and planning in Kenya. Read project summaries​ of the Teasdale-Corti Global Research Partnership Program (PDF, 275KB) ...

  3. [Latin-American public policy regarding social determinants of health].

    Science.gov (United States)

    García-Ramírez, Jorge A; Vélez-Álvarez, Consuelo

    2013-01-01

    The study was aimed at identifying Latin-American countries' public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries' databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization's concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.

  4. Sparking investment in Ontario's power generation industry

    International Nuclear Information System (INIS)

    Allen, J.

    2004-01-01

    This paper discusses the business strategy needed to spark investment in Ontario's power generation industry. It examines the process of decision making and investing in an uncertain environment. The paper suggests that any strategy based on one view of the future courts trouble and that strategic flexibility can prepare for what cannot be predicted. Finally the paper suggests that Ontario needs to create a stable policy and regulatory environment that allows investors to fulfill reasonable expectations and investors need to place bets that provide the flexibility to respond quickly to changing market conditions

  5. [The contributions of local authorities to regional public health policy].

    Science.gov (United States)

    de Maria, Florence; Grémy, Isabelle

    2009-01-01

    Local authorities in France are key players in shaping public health policy by their action on the determinants of health and through their actions aimed at specific population groups. Since the public health act of 9 August 2004 establishing the first regional public health plans, their level of involvement and role continues to grow as coordinators, funders and project managers within the greater Paris metropolitan region. Their active participation in regional policy to improve population health and reduce inequalities in health has led to a better organization of the public health programs implemented (in terms of visibility, dialogue, coordination, transparency, and better awareness of context and integration of local issues). Their participation is also a source of innovation resulting in the proposal and use of new approaches (such as the development of health surveillance and observation for advising the local decision-making process). Within the current context of the "Hospitals, patients, health and territories" bill, which entrusts the governance of regional health policy to a specific agency, the role given to local authorities in this new organizational structure must be clearly defined to take into account all of their existing and potential contributions to public health policy.

  6. The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

    Science.gov (United States)

    Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

    2015-01-01

    The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

  7. Policy challenges in modern health care

    National Research Council Canada - National Science Library

    Mechanic, David

    2005-01-01

    ... for the Obesity Epidemic KENNETH E. WARNER 99 8 Patterns and Causes of Disparities in Health DAVID R. WILLIAMS 115 9 Addressing Racial Inequality in Health Care SARA ROSENBAUM AND JOEL TEITELBAU...

  8. Turning health research into policy | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    His principal research interests include knowledge transfer and exchange in public policy-making environments and the politics of healthcare systems. Lavis wrote the report that ... and new members of the Board of Governors. IDRC's Board of Governors congratulates Jean Lebel on his appointment as President and CEO.

  9. Climate Change and Public Health Policy.

    Science.gov (United States)

    Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

    2017-03-01

    Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

  10. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  11. Let's dance: Organization studies, medical sociology and health policy.

    Science.gov (United States)

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Gold Medal for Finnish Health in All Policies Book

    Directory of Open Access Journals (Sweden)

    Ray Lewis

    2014-02-01

    Full Text Available This article is a review of the book “Health in All Policies: Seizing opportunities, implementing policies” edited by Kimmo Leppo, Eeva Ollila, Sebastián Peña, Matthias Wismar, and Sarah Cook. This book (printed and online publication was published by the Finnish Ministry of Social Affairs and Health, Finland in 2013 (1. The book is freely available at http://www.euro.who.int/__data/assets/pdf_file/0007/188809/Health-in-All-Policies-final.pdf. The main features, structure, and highlighted contents of the book are briefly sketched out in this review. The book promotes understanding of a Health in All Policies (HiAP approach, the history, and the scientific evidence of effectiveness available to apply the HiAP concept in order to overcome challenges faced by policy-makers. HiAP is a relatively novel approach which arises from the traditional idea that health is not only medicine (2. The book offers lessons to policy-makers and managers on how to apply the HiAP approach. It further highlights the health sector’s role in developing healthy public policies. In addition, the book provides examples of structures to foster collaboration, coherence, and participation among stakeholders from different government portfolios and responsibilities. The book further provides invaluable insights for politicians, researchers, and civil society advocates.

  13. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    Science.gov (United States)

    Ney, Steven

    2012-04-01

    Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

  14. Success Strategies for Linguistically Competent Healthcare: The Magic Bullets and Cautionary Tales of the Active Offer of French-Language Health Services in Ontario.

    Science.gov (United States)

    Farmanova, Elina; Bouchard, Louise; Bonneville, Luc

    2018-01-01

    An active offer of French-language health services (FLHS) was introduced in several Canadian provinces to help create an environment that will anticipate the needs of Francophones in their community and will stimulate the demand for services in French. For the active offer to be implemented, changes in how health services are organized and managed at both organizational and system levels must be introduced. In this perspective paper, we identify several success strategies and potential pitfalls with regards to the implementation of the active offer of FLHS primarily at the level of healthcare organization. Our recommendations are based on a recent health services research study exploring reorganization and management strategies for the delivery of the active offer of FLHS in Ontario and insights from a focus group with healthcare administrators conducted as part of this research. We propose a ";wrap-around strategy" called organizational health literacy to help reorient organizational culture and improve management and sustainability of the active offer of FLHS. These strategies have relevance for advocates and professionals working to promote an active offer of FLHS, including healthcare administrators, human resource professionals, quality-improvement specialists and others. © 2018 Longwoods Publishing.

  15. Health policy--why research it and how: health political science.

    Science.gov (United States)

    de Leeuw, Evelyne; Clavier, Carole; Breton, Eric

    2014-09-23

    The establishment of policy is key to the implementation of actions for health. We review the nature of policy and the definition and directions of health policy. In doing so, we explicitly cast a health political science gaze on setting parameters for researching policy change for health. A brief overview of core theories of the policy process for health promotion is presented, and illustrated with empirical evidence. The key arguments are that (a) policy is not an intervention, but drives intervention development and implementation; (b) understanding policy processes and their pertinent theories is pivotal for the potential to influence policy change; (c) those theories and associated empirical work need to recognise the wicked, multi-level, and incremental nature of elements in the process; and, therefore, (d) the public health, health promotion, and education research toolbox should more explicitly embrace health political science insights. The rigorous application of insights from and theories of the policy process will enhance our understanding of not just how, but also why health policy is structured and implemented the way it is.

  16. Migrant integration policies and health inequalities in Europe.

    Science.gov (United States)

    Giannoni, Margherita; Franzini, Luisa; Masiero, Giuliano

    2016-06-01

    Research on socio-economic determinants of migrant health inequalities has produced a large body of evidence. There is lack of evidence on the influence of structural factors on lives of fragile groups, frequently exposed to health inequalities. The role of poor socio-economic status and country level structural factors, such as migrant integration policies, in explaining migrant health inequalities is unclear. The objective of this paper is to examine the role of migrant socio-economic status and the impact of migrant integration policies on health inequalities during the recent economic crisis in Europe. Using the 2012 wave of Eurostat EU-SILC data for a set of 23 European countries, we estimate multilevel mixed-effects ordered logit models for self-assessed poor health (SAH) and self-reported limiting long-standing illnesses (LLS), and multilevel mixed-effects logit models for self-reported chronic illness (SC). We estimate two-level models with individuals nested within countries, allowing for both individual socio-economic determinants of health and country-level characteristics (healthy life years expectancy, proportion of health care expenditure over the GDP, and problems in migrant integration policies, derived from the Migrant Integration Policy Index (MIPEX). Being a non-European citizen or born outside Europe does not increase the odds of reporting poor health conditions, in accordance with the "healthy migrant effect". However, the country context in terms of problems in migrant integration policies influences negatively all of the three measures of health (self-reported health status, limiting long-standing illnesses, and self-reported chronic illness) in foreign people living in European countries, and partially offsets the "healthy migrant effect". Policies for migrant integration can reduce migrant health disparities.

  17. On Health Policy and Management (HPAM: Mind the Theory-Policy-Practice Gap

    Directory of Open Access Journals (Sweden)

    David Chinitz

    2014-12-01

    Full Text Available We argue that the field of Health Policy and Management (HPAM ought to confront the gap between theory, policy, and practice. Although there are perennial efforts to reform healthcare systems, the conceptual barriers are considerable and reflect the theory-policy-practice gap. We highlight four dimensions of the gap: 1 the dominance of microeconomic thinking in health policy analysis and design; 2 the lack of learning from management theory and comparative case studies; 3 the separation of HPAM from the rank and file of healthcare; and 4 the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking the field of HPAM by embracing broader perspectives, e.g. ethics, urban health, systems analysis and cross-national analyses of healthcare systems.

  18. A health app developer's guide to law and policy: a multi-sector policy analysis.

    Science.gov (United States)

    Parker, Lisa; Karliychuk, Tanya; Gillies, Donna; Mintzes, Barbara; Raven, Melissa; Grundy, Quinn

    2017-10-02

    Apps targeted at health and wellbeing sit in a rapidly growing industry associated with widespread optimism about their potential to deliver accessible and cost-effective healthcare. App developers might not be aware of all the regulatory requirements and best practice principles are emergent. Health apps are regulated in order to minimise their potential for harm due to, for example, loss of personal health privacy, financial costs, and health harms from delayed or unnecessary diagnosis, monitoring and treatment. We aimed to produce a comprehensive guide to assist app developers in producing health apps that are legally compliant and in keeping with high professional standards of user protection. We conducted a case study analysis of the Australian and related international policy environment for mental health apps to identify relevant sectors, policy actors, and policy solutions. We identified 29 policies produced by governments and non-government organisations that provide oversight of health apps. In consultation with stakeholders, we developed an interactive tool targeted at app developers, summarising key features of the policy environment and highlighting legislative, industry and professional standards around seven relevant domains: privacy, security, content, promotion and advertising, consumer finances, medical device efficacy and safety, and professional ethics. We annotated this developer guidance tool with information about: the relevance of each domain; existing legislative and non-legislative guidance; critiques of existing policy; recommendations for developers; and suggestions for other key stakeholders. We anticipate that mental health apps developed in accordance with this tool will be more likely to conform to regulatory requirements, protect consumer privacy, protect consumer finances, and deliver health benefit; and less likely to attract regulatory penalties, offend consumers and communities, mislead consumers, or deliver health harms. We

  19. Leaders' mental health at work: Empirical, methodological, and policy directions.

    Science.gov (United States)

    Barling, Julian; Cloutier, Anika

    2017-07-01

    While employees' mental health is the focus of considerable attention from researchers, the public, and policymakers, leaders' mental health has almost escaped attention. We start by considering several reasons for this, followed by discussions of the effects of leaders' mental health on their own leadership behaviors, the emotional toll of high-quality leadership, and interventions to enhance leaders' mental health. We offer 8 possible directions for future research on leaders' mental health. Finally, we discuss methodological obstacles encountered when investigating leaders' mental health, and policy dilemmas raised by leaders' mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Health impact assessment of Ontario's green energy and green economy act. The roles of environmental informatics in sustainability

    Energy Technology Data Exchange (ETDEWEB)

    Rattle, Robert

    2013-07-01

    Renewable energy received a boost in Ontario, Canada with the Green Energy and Green Economy Act (GEGEA), ushering in a new Feed-in-Tariff (FIT) program modelled on programs from Germany, Spain, Denmark and other jurisdictions. Information about lessons learned elsewhere has clearly benefited the Ontario experience. Part of the Ontario program included streamlining the impact assessment process to facilitate the swift development of provincial renewable energy capacities. In this context, the GEGEA has been remarkably successful, generating renewable energy sector capacities, resources, projects and their spin-off benefits in Ontario, along with more sustainable electricity system. Environmentalists along with industry continue to laud the benefits of renewable energy and the GEGEA, and with good reason. Renewable energy generation in Ontario has grown from to 2 per cent in 2012 and is expected to reach 10 per cent in 2013. (orig.)

  1. Green power opportunities for Ontario

    International Nuclear Information System (INIS)

    Elwell, C.; Rotenberg, E.; Torrie, R.; Poch, D.; Allen, G.

    2002-02-01

    Green energy is defined as the energy generated from renewable and environmentally benign sources. In this document, the authors demonstrated that Ontario possesses the potential to reduce energy waste on an economic basis while generating sufficient green energy to enable the province to decommission its coal burning power plants. In turn, this would lead to a more sustainable energy economy and a lesser reliance on nuclear generation. It was determined that a three-fold policy would enable the province to achieve this goal. First, there is a need to remove hidden subsidies to polluting forms of generation. The second aspect of this policy is the implementation of a robust Demand Side Management Program, and the third aspect calls for the reform of the price of electricity that includes all costs. In this manner, all forms of generation would compete on an equal footing. The authors identified an alternative to immediate price reform in the form of a legislated Renewable Portfolio Standard. A growing percentage of new renewable electricity in the supply portfolio offered by electricity providers would be required by the Renewable Portfolio Standard. It was suggested that the Ontario government adopt this measure before the opening of the electricity market in May 2002, as strong support for the measure is present. 13 refs

  2. A Third Way for Health Policy?

    OpenAIRE

    Alexander D. Peden

    2014-01-01

    Economics has hit the mainstream in the last decade with popular books like Freakonomics and The Undercover Economist reaching the masses. These authors have used their toolkits far beyond the narrow scope of money and finance and answered questions pertaining to anything from social policy to demographics to crime. Their appeal has largely been their ability to explain that small underlying forces can have major impacts, intended or otherwise, on many different areas of society. One recent b...

  3. Social, state and political society: Reflections on Mental Health Policy

    Directory of Open Access Journals (Sweden)

    Sofia Laurentino

    2014-06-01

    Full Text Available This article intends to develop a historical, theoretical and critical debate about mental health, as a social policy, resulting from the dialectical relationship between state and civil society. The adopted methodology is qualitative, consisting on a bibliographical and reflexive review, through which it aims to evaluate positions of various authors on the subject. A discussion of the historical development of the Mental Health policy in Brazil was made, emphasizing the presence of various social movements, such as the Workers in Mental Health Movement, the Sanitary Reform Movement, the Psychiatric Reform Movement and the Anti-Asylum Movement. Therefore, it is verified that society has great ability to fight for effective social policies, in order to mitigate the destructive effects of capitalism. It is concluded that, although social policy is incapable of overcoming the social order, it includes significant changes to the recognition and assurance of rights to the people deprived of wealth and power in society.

  4. Bathymetry of Lake Ontario

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Ontario has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  5. Reciprocity in global mental health policy

    OpenAIRE

    White, Ross; Sashidharan, S.P.

    2014-01-01

    In an attempt to address inequalities and inequities in mental health provision in low\\ud and middle-income countries the WHO commenced the Mental Health Gap Action\\ud Programme (mhGAP) in 2008. Four years on from the commencement of this\\ud programme of work, the WHO has recently adopted the Comprehensive Mental\\ud Health Action Plan 2013-2020. This article will critically appraise the strategic\\ud direction that the WHO has adopted to address mental health difficulties across the\\ud globe. ...

  6. Pro-poor health policies in poverty reduction strategies.

    Science.gov (United States)

    Laterveer, Leontien; Niessen, Louis W; Yazbeck, Abdo S

    2003-06-01

    Since 1999, the International Monetary Fund and World Bank have required low-income countries soliciting for debt relief and financial support to prepare a Poverty Reduction Strategy Paper (PRSP). The objective of this study is to arrive at a systematic assessment of the extent to which the first batch of interim PRSPs actually addresses the health of the poor and vulnerable. A literature study was used to design and test a semi-quantitative approach to assess the pro-poor focus of health policies in national documents. The approach was applied to the existing interim proposals for 23 Highly Indebted Poor Countries. Results show that a majority of proposals lack country-specific data on the distribution and composition of the burden of disease, a clear identification of health system constraints and an assessment of the impact of health services on the population. More importantly, they make little effort to analyze these issues in relation to the poor. Furthermore, only a small group explicitly includes the interests of the poor in health policy design. Attention to policies aiming at enhancing equity in public health spending is even more limited. Few papers that include expenditure proposals also show pro-poor focused health budgets. We conclude that our systematic assessment of a new international development policy instrument, PRSP, raises strong concerns about the attributed role of health in development and the limited emphasis on the poor, the supposed primary beneficiaries of this instrument. There is a need and an opportunity for the international development community to provide assistance and inputs as poor countries shift their policy thinking from an interim stage to fully developed national policies. This paper presents a menu of analytical and policy options that can be pursued.

  7. Nursing shaping and influencing health and social care policy.

    Science.gov (United States)

    Fyffe, Theresa

    2009-09-01

    This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.

  8. The Mass Media Influence on the Impact of Health Policy

    Directory of Open Access Journals (Sweden)

    Cătălin BABA

    2007-02-01

    Full Text Available The theme of this study is a distinct examination of the issues regarding health policy, social representations and mass media. The analysis of the mass media influence on the impact of health policy leads to a portrayal of the related programs and the way they are received by citizens through mass media. Owing to the mass media quality to be an indicator of democracy it is very important to study its role in setting people daily agenda considering how it is able to maintain and create trends merely through recurrent messages. The issues frequently conveyed by media industry influences citizens’ interest with regard to community, producing effects on public policy. We must bear in mind that the more persistent in media they are, the more relevant for community this issues will be. The authors of the study put forward a method through which diverse programmes can be analysed. A comparative analysis of mass media and citizens’ social representations and its findings provide information about the influence between them. According to agenda setting theory and many international studies on health policy the authors conclude that mass media institution highly influence the impact of the health policy in health. Moreover, it is important to mention that the impact refers to all the stages of a policy-making: beginning with the problem identification and ending with the evaluation of the implementation process.

  9. A review of UK housing policy: ideology and public health.

    Science.gov (United States)

    Stewart, J

    2005-06-01

    The aim of this paper is to review UK public health policy, with a specific reference to housing as a key health determinant, since its inception in the Victorian era to contemporary times. This paper reviews the role of social and private housing policy in the development of the UK public health movement, tracing its initial medical routes through to the current socio-economic model of public health. The paper establishes five distinct ideologically and philosophically driven eras, placing public health and housing within liberal (Victorian era), state interventionist (post World War 1; post World War 2), neoliberal (post 1979) and "Third Way" (post 1997) models, showing the political perspective of policy interventions and overviewing their impact on public health. The paper particularly focuses on the contemporary model of public health since the Acheson Report, and how its recommendations have found their way into policy, also the impact on housing practice. Public health is closely related to political ideology, whether driven by the State, individual or partnership arrangements. The current political system, the Third Way, seeks to promote a sustainable "social contract" between citizens and the State, public, private and voluntary organizations in delivering community-based change in areas where health inequalities can be most progressively and successfully addressed.

  10. Evaluating the implementation of health and safety innovations under a regulatory context: a collective case study of Ontario's safer needle regulation.

    Science.gov (United States)

    Chambers, Andrea; Mustard, Cameron A; Breslin, Curtis; Holness, Linn; Nichol, Kathryn

    2013-01-22

    Implementation effectiveness models have identified important factors that can promote the successful implementation of an innovation; however, these models have been examined within contexts where innovations are adopted voluntarily and often ignore the socio-political and environmental context. In the field of occupational health and safety, there are circumstances where organizations must adopt innovations to comply with a regulatory standard. Examining how the external environment can facilitate or challenge an organization's change process may add to our understanding of implementation effectiveness. The objective of this study is to describe implementation facilitators and barriers in the context of a regulation designed to promote the uptake of safer engineered medical devices in healthcare. The proposed study will focus on Ontario's safer needle regulation (2007) which requires healthcare organizations to transition to the use of safer engineered medical devices for the prevention of needlestick injuries. A collective case study design will be used to learn from the experiences of three acute care hospitals in the province of Ontario, Canada. Interviews with management and front-line healthcare workers and analysis of supporting documents will be used to describe the implementation experience and examine issues associated with the integration of these devices. The data collection and analysis process will be influenced by a conceptual framework that draws from implementation science and the occupational health and safety literature. The focus of this study in addition to the methodology creates a unique opportunity to contribute to the field of implementation science. First, the study will explore implementation experiences under circumstances where regulatory pressures are influencing the organization's change process. Second, the timing of this study provides an opportunity to focus on issues that arise during later stages of implementation, a phase

  11. Values in Health Policy – A Concept Analysis

    Directory of Open Access Journals (Sweden)

    Lida Shams

    2016-11-01

    Full Text Available Background Despite the significant role “values” play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of “values” and other concepts such as principles, criteria, attitudes, and beliefs. Methods An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of “value in health policy-making” were extracted. We also identified similarities and differences that exist between and within them. Results We identified eight major attributes of “value in health policy-making”: ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra

  12. Organisational Factors Affecting Policy and Programme Decision Making in a Public Health Policy Environment

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2015-01-01

    Organisational factors can affect the success of interventions aimed at increasing research use. Research is needed to identify organisational factors affecting research use in specific public health policy contexts. Qualitative interviews with decision makers from a specific public health context identified a range of organisational factors that…

  13. Policy indicators for health and nature. 25 years of international research and policy on acidification

    International Nuclear Information System (INIS)

    Van Hinsberg, A.; Van der Hoek, D.C.J.; Wiertz, J.; Van Bree, L.

    2004-01-01

    25 years of international cooperation between research and policy resulted in effect indicators for health and nature by means of which environmental targets can be adjusted. At the same time those indicators increased the coherence of targets in the field of nature and health [nl

  14. Assessing the financial positions of Ontario`s new electricity companies

    Energy Technology Data Exchange (ETDEWEB)

    Connell, T. [Standard and Poor`s, Toronto, ON (Canada)

    1999-11-01

    This paper describes the methodology, including the criteria factors, comparable ratings and key credit issues used in assessing the financial positions of Ontario Power Generation Inc., and the Ontario Hydro Services Company. The rating criteria factors include both business factors (such as ownership structure, regulation, service area, operations, management, etc.,) and financial factors (e.g. financial policies and guidelines, recent financial performance, margin analysis, capital structure and borrowing plans, financial projections and sensitivities). Key credit issues include considerations of competitive dynamics, nuclear portfolio performance (for Genco), regulatory changes, cost control, capital spending program, retail business exposure, future financial performance. Comparisons are made with corresponding positions of comparable entities in Australia, Finland, New Zealand, the UK, and the USA. In the case of Ontario Power Generation Inc., the company is assessed to have significant advantages initially, but various uncertainties over the medium term warrant a more cautious view of the credit profile. For the Ontario Hydro Services Company the business risks appear to be low and moderate leverage entails a strong, stable credit profile. The overall assessment of the two companies is that while certain questions such as the workability and credibility of the new industry structure, the problem of stranded debt and questions about the liquidity of market participants remain unsolved, Ontario Power Generation Inc., and the Ontario Hydro Services Company ratings compare favorably with ratings of global industry peers.

  15. Reading level of privacy policies on Internet health Web sites.

    Science.gov (United States)

    Graber, Mark A; D'Alessandro, Donna M; Johnson-West, Jill

    2002-07-01

    Most individuals would like to maintain the privacy of their medical information on the World Wide Web (WWW). In response, commercial interests and other sites post privacy policies that are designed to inform users of how their information will be used. However, it is not known if these statements are comprehensible to most WWW users. The purpose of this study was to determine the reading level of privacy statements on Internet health Web sites and to determine whether these statements can inform users of their rights. This was a descriptive study. Eighty Internet health sites were examined and the readability of their privacy policies was determined. The selected sample included the top 25 Internet health sites as well as other sites that a user might encounter while researching a common problem such as high blood pressure. Sixty percent of the sites were commercial (.com), 17.5% were organizations (.org), 8.8% were from the United Kingdom (.uk), 3.8% were United States governmental (.gov), and 2.5% were educational (.edu). The readability level of the privacy policies was calculated using the Flesch, the Fry, and the SMOG readability levels. Of the 80 Internet health Web sites studied, 30% (including 23% of the commercial Web sites) had no privacy policy posted. The average readability level of the remaining sites required 2 years of college level education to comprehend, and no Web site had a privacy policy that was comprehensible by most English-speaking individuals in the United States. The privacy policies of health Web sites are not easily understood by most individuals in the United States and do not serve to inform users of their rights. Possible remedies include rewriting policies to make them comprehensible and protecting online health information by using legal statutes or standardized insignias indicating compliance with a set of privacy standards (eg, "Health on the Net" [HON] http://www.hon.ch).

  16. NUDGING FOR HEALTH: ON PUBLIC POLICY AND DESIGNING CHOICE ARCHITECTURE

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a ‘nudge unit’ with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives. PMID:24081425

  17. Nudging for health: on public policy and designing choice architecture.

    Science.gov (United States)

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a 'nudge unit' with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives.

  18. [Tobacco control policies and perinatal health].

    Science.gov (United States)

    Peelen, M J; Sheikh, A; Kok, M; Hajenius, P; Zimmermann, L J; Kramer, B W; Hukkelhoven, C W; Reiss, I K; Mol, B W; Been, J V

    2017-01-01

    Study the association between the introduction of tobacco control policies in the Netherlands and changes in perinatal outcomes. National quasi-experimental study. We used Netherlands Perinatal Registry data (now called Perined) for the period 2000-2011. We studied whether the introduction of smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign in January 2004, and extension of the smoke-free law to the hospitality industry accompanied by another tax increase and media campaign in July 2008, was associated with changes in perinatal outcomes. We studied all singleton births (gestational age: 24+0 to 42+6 weeks). Our primary outcome measures were: perinatal mortality, preterm birth and being small-for-gestational-age (SGA). Interrupted time series logistic regression analyses were performed to investigate changes in these outcomes occurred after the introduction of the aforementioned tobacco control policies (ClinicalTrials.gov: NCT02189265). Among 2,069,695 singleton births, 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births were observed. The policies introduced in January 2004 were not associated with significant changes in any of the primary outcome measures. A -4.4% (95% CI: -6.4 to -2.4; p hospitality industry, a further tax increase and another media campaign. This translates to an estimated over 500 cases of SGA being averted per year. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to include bars and restaurants, in conjunction with a tax increase and media campaign in 2008.

  19. A Third Way for Health Policy?

    Directory of Open Access Journals (Sweden)

    Alexander D. Peden

    2014-01-01

    Full Text Available Economics has hit the mainstream in the last decade with popular books like Freakonomics and The Undercover Economist reaching the masses. These authors have used their toolkits far beyond the narrow scope of money and finance and answered questions pertaining to anything from social policy to demographics to crime. Their appeal has largely been their ability to explain that small underlying forces can have major impacts, intended or otherwise, on many different areas of society. One recent book following this trend is Nudge, published in 2008 by University of Chicago academics Richard Thaler and Cass Sunstein. The book has attracted acclaim from both journals and the press, with The Financial Times naming it as one of the best business books for 2008. Nudge coins the term ‘choice architecture’, referring to the manner in which a range of alternatives is presented, which the authors contend is commonly overlooked as an integral part of many decisions we all face during the course of our day-to-day lives (1. When people take the time to judiciously research all alternatives before them, or use their reflective systems in the parlance of the book, they generally make objectively good decisions. Unfortunately, in practice people cannot or do not take the time to do so and instead use their automatic or gut thinking systems, leading to inferior outcomes. The first section of the book then compellingly demonstrates the evidence of its importance in a multitude of situations. There are many lessons to be learned along the way, applicable to both policy-makers and those who wish to critically examine some of their own choices in life. Among these, lessons is the fact that a large percentage of the population will stick with an easy default option without consideration of better alternatives, even when considering a life-altering decision such as retirement planning. There are even examples of people who fail to take advantage of subsidies to

  20. Global Health Systems and Policy Development: Implications for Health Literacy Research, Theory and Practice.

    Science.gov (United States)

    Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane

    2017-01-01

    Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.

  1. Building Capacity in Health Systems and Policy Analysis in sub ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Building Capacity in Health Systems and Policy Analysis in sub-Saharan Africa. Since 2005, the Bill and Melinda Gates Foundation has been financing the master's program in health and population at the Institut supérieure des sciences de la population (ISSP), Université de Ouagadougou, Burkina Faso. However, after ...

  2. Moving Maternal, Newborn, and Child Health Evidence into Policy in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project brings together and supports the uptake of maternal and child health research evidence into policies and practices in West Africa. A part of the Innovating for Maternal and Child Health in Africa program, the project's impact will be felt at the national and regional levels in Ghana, Mali, Nigeria, and Senegal.

  3. Moving Maternal, Newborn, and Child Health Evidence into Policy in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project brings together and supports the uptake of maternal and child health research evidence into policies and practices in East Africa. A part of the Innovating for Maternal and Child Health in Africa program, the project's impact will be felt at the national and regional levels in East Africa, specifically in Ethiopia, Malawi ...

  4. The birth of mindpolitics : Understanding nudging in public health policy

    NARCIS (Netherlands)

    Peeters, Rik; Schuilenburg, Marc

    2017-01-01

    This article addresses the question: 'In what ways have nudging and other behavioural techniques entered the realm of policymaking for public health and what does that mean for the way contemporary society is governed?' In our genealogy of Dutch public health policy, we have identified four periods:

  5. The birth of mindpolitics: Understanding nudging in public health policy

    NARCIS (Netherlands)

    Peeters, Rik; Schuilenburg, Marc

    This article addresses the question: 'In what ways have nudging and other behavioural techniques entered the realm of policymaking for public health and what does that mean for the way contemporary society is governed?' In our genealogy of Dutch public health policy, we have identified four periods:

  6. Reproductive Health Policies in Peru: Social Reforms and Citizenship Rights

    Directory of Open Access Journals (Sweden)

    Stéphanie Rousseau

    2007-05-01

    Full Text Available The article analyzes the case of reproductive health policy-making in Peru in the context of recent social policy reforms. Health-sector reforms have only partially redressed Peruvian women’s unequal access to family planning, reproductive rights and maternal care. The main sources of inequalities are related to the segmented character of the health-care system, with the highest burden placed on the public sector. The majority of women from popular classes, who are not protected by an insurance plan, are dependent upon what and how public services are provided. Simultaneously, the continuing role of conservative sectors in public debates about reproductive health policy has a strong impact on public family planning services and other reproductive rights.

  7. Municipal green fleet management in Ontario: best practices manual 2008

    Energy Technology Data Exchange (ETDEWEB)

    Felder, M.

    2008-07-01

    When households, institutional and commercial buildings, industry, and especially auto transportation use fossil fuel based energy, they generate carbon dioxide emissions. Considering the environmental concerns and the soaring fuel prices, this could be the opportunity for the municipal fleet operator to assume a leadership position regarding environmental issues and look for new cost efficiencies. To begin, a meticulous examination of the fuel expenditures, a good management approach of fleet operations and a clearly defined system or guidance for lowering fleet fuel costs would be helpful for municipal fleet managers. This document is involved in a pilot program aimed at helping Ontario municipalities understand and promote fleet efficiencies and obtain related environmental benefits. Existing and cost-effective automotive fleet management policies and practices that can mitigate pollution causing global warming are given in this guide. These policies and practices also allow money savings and contribute to a better workplace health and livability of the community. This document is based on the experience of fleet management experts and local governments in Ontario. 54 refs.

  8. Applications of system dynamics modelling to support health policy.

    Science.gov (United States)

    Atkinson, Jo-An M; Wells, Robert; Page, Andrew; Dominello, Amanda; Haines, Mary; Wilson, Andrew

    2015-07-09

    The value of systems science modelling methods in the health sector is increasingly being recognised. Of particular promise is the potential of these methods to improve operational aspects of healthcare capacity and delivery, analyse policy options for health system reform and guide investments to address complex public health problems. Because it lends itself to a participatory approach, system dynamics modelling has been a particularly appealing method that aims to align stakeholder understanding of the underlying causes of a problem and achieve consensus for action. The aim of this review is to determine the effectiveness of system dynamics modelling for health policy, and explore the range and nature of its application. A systematic search was conducted to identify articles published up to April 2015 from the PubMed, Web of Knowledge, Embase, ScienceDirect and Google Scholar databases. The grey literature was also searched. Papers eligible for inclusion were those that described applications of system dynamics modelling to support health policy at any level of government. Six papers were identified, comprising eight case studies of the application of system dynamics modelling to support health policy. No analytic studies were found that examined the effectiveness of this type of modelling. Only three examples engaged multidisciplinary stakeholders in collective model building. Stakeholder participation in model building reportedly facilitated development of a common 'mental map' of the health problem, resulting in consensus about optimal policy strategy and garnering support for collaborative action. The paucity of relevant papers indicates that, although the volume of descriptive literature advocating the value of system dynamics modelling is considerable, its practical application to inform health policy making is yet to be routinely applied and rigorously evaluated. Advances in software are allowing the participatory model building approach to be extended to

  9. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  10. Purchasing power: business and health policy change in Massachusetts.

    Science.gov (United States)

    Bergthold, L A

    1988-01-01

    As in many states around the country, health care costs in Massachusetts had risen to an unprecedented proportion of the state budget by the early 1980s. State health policymakers realized that dramatic changes were needed in the political process to break provider control over health policy decisions. This paper presents a case study of policy change in Massachusetts between 1982 and 1988. State officials formulated a strategy to mobilize corporate interests, which were already awakening to the problems of high health care costs, as a countervailing power to the political monopoly of provider interests. Once mobilized, business interests became organized politically and even became dominant at times, controlling both the policy agenda and its process. Ultimately, business came to be viewed as a permanent part of the coalitions and commissions that helped formulate state health policy. Although initially allied with provider interests, business eventually forged a stronger alliance with the state, an alliance that has the potential to force structural change in health care politics in Massachusetts for years to come. The paper raises questions about the consequences of such alliances between public and private power for both the content and the process of health policymaking at the state level.

  11. Energy policy and the public health

    International Nuclear Information System (INIS)

    Wade, B.

    1979-01-01

    The various aspects of the nuclear fuel cycle and its effect on public health are described. For the U.K., it is shown that the maximum doses to an individual of the general public are well below the ICRP standards. For nuclear workers, the standard mortality ratio rate for UKAEA and BNFL workers is less than the national average and considerably less than that for miners, quarrymen and other industrial employees. The radiological risk to the general public from nuclear plant accidents is very small compared to the general hazards of life. In conclusion, the hazards involved in nuclear technology are no different in kind or in scale to those of existing technologies and indeed the radiological effects on health are better understood than the health risks associated with other technologies. (U.K.)

  12. Policy Capacity for Health Reform: Necessary but Insufficient; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Owen Adams

    2016-01-01

    Full Text Available Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government. I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a A means of “policy governance” that would promote an approach to cooperative federalism in the health arena; (b The ability to overcome the ”policy inertia” resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  13. Global warming: Towards a strategy for Ontario

    International Nuclear Information System (INIS)

    1990-01-01

    A discussion paper is provided as background to a proposed public review of a strategy for Ontario's response to global warming. Global warming arises from the generation of greenhouse gases, which come from the use of fossil fuels, the use of chlorofluorocarbons, and deforestation. Energy policy is the backbone of achieving climate stability since the burning of fossil fuels releases most of the greenhouse gases, mainly carbon dioxide. Canada is, by international standards, a very energy-intensive country and is among the world's largest emitters of carbon dioxide on a per capita basis. Ontario is the largest energy-using province in Canada, and fossil fuels represent over 80% of provincial energy use. A proposed goal for Ontario is to provide leadership in stabilizing atmospheric concentrations of the greenhouse gases, while minimizing the social, economic, and environmental costs in Ontario of adapting to global warming. A proposed first step to address global warming is to achieve reductions in expected emissions of the greenhouse gases, especially carbon dioxide, so that levels by the year 2000 are lower than in 1989. Current policies and regulations helping to reduce the greenhouse effect include some of the current controls on automotive emissions and the adoption by the provincial electric utility of targets to reduce electricity demand. New initiatives include establishment of minimum energy efficiency standards and reduction of peak-day electricity use. Action steps for future consideration are detailed in the categories of greenhouse gas emissions reductions, carbon dioxide absorption, and research and analysis into global warming

  14. Seven steps to an energy efficient Ontario

    International Nuclear Information System (INIS)

    2003-01-01

    The future of the electricity market in Ontario is examined in light of the recent debate concerning deregulation. This report focuses on measures that would have to be taken to ensure that there will be sufficient electricity available to serve the needs of Ontario. Increasing supply, or decreasing demand are discussed as the obvious answers to the problem at hand. The report concludes that: (1) mechanisms to encourage Demand Side Management and Demand Response have all but disappeared since the opening of the competitive electricity market in Ontario, (2) the current market structure does nothing to stimulate increased supply, nor does it encourage measures to reduce demand; as such, the result is an unsustainable situation. The report further concludes that Demand Side Management and Demand Response programs are essential components of the success of Ontario's evolving electricity market, and recommends programs that are designed and implemented in a manner that dovetail with parallel policies dealing with supply challenges. Seven essential elements of such a policy are discussed. These are: (1) vision and a clear set of goals for demand side management; (2) appropriate market drivers, principles and pricing incentives; (3) a central co-ordinating authority for managing demand side management; (4) appropriate implementation agents to manage programs and processes; (5) incentives to motivate change; (6) widespread education of the market; and (7) appropriate tactics to enable demand side management in sectors

  15. The labor impacts of policy change in health care: how federal policy transformed home health organizations and their labor practices.

    Science.gov (United States)

    Szasz, A

    1990-01-01

    Health care organizations are highly labor-intensive; policies designed to stimulate organizational change are likely to have labor impacts. This paper examines the labor effects of policy change in home health care. Major federal home care policy trends since 1980 have spurred the evolution of the typical home care provider toward greater organizational and market rationality. Greater managerial sophistication has introduced changes in management/labor relations. Survey data from the 1986 DRG Impact Study are used to show how the pressure of cost-containment policies has pushed agencies to cut labor costs by increasing workloads, managerial supervision, and control of the work process. Research on the effects of recent policy change in health care has to date focused primarily on potential client effects. Labor impacts are rarely examined and are poorly understood at the time that policy is made. Findings in this article suggest that these issues deserve greater, more systematic attention, because unanticipated labor impacts may prove to be significant impediments to the realization of intended policy goals.

  16. How are health equity aspects articulated in the public health policy documents in Saudi Arabia

    DEFF Research Database (Denmark)

    Eklund Karlsson, Leena; Saleh, Faten; Azam, Shadi

    2015-01-01

    was not explicitly used in these documents but the idea of equity was implicitly communicated by addressing objectives for tackling poverty and guaranteeing that all social groups share the benefits of growth and improvement of quality of life. Conclusions: The state’s role to protect health and provide health care......Background: Inequities in health exist all over the world showing systematic differences in health between different socioeconomic groups. Healthy public policies (i.e. integrating health perspectives in all sector policies) address inequities in health and are means by which governments show...... their will to promote equity. Saudi Arabia (KSA) is one of the Arab countries that report health equity as part of its mission statement. However, analyses of the equity aspects of public health and social policies are lacking from KSA. The aims of the study were to identify policy documents in KSA relevant to public...

  17. CrowdHEALTH: Holistic Health Records and Big Data Analytics for Health Policy Making and Personalized Health.

    Science.gov (United States)

    Kyriazis, Dimosthenis; Autexier, Serge; Brondino, Iván; Boniface, Michael; Donat, Lucas; Engen, Vegard; Fernandez, Rafael; Jimenez-Peris, Ricardo; Jordan, Blanca; Jurak, Gregor; Kiourtis, Athanasios; Kosmidis, Thanos; Lustrek, Mitja; Maglogiannis, Ilias; Mantas, John; Martinez, Antonio; Mavrogiorgou, Argyro; Menychtas, Andreas; Montandon, Lydia; Nechifor, Cosmin-Septimiu; Nifakos, Sokratis; Papageorgiou, Alexandra; Patino-Martinez, Marta; Perez, Manuel; Plagianakos, Vassilis; Stanimirovic, Dalibor; Starc, Gregor; Tomson, Tanja; Torelli, Francesco; Traver-Salcedo, Vicente; Vassilacopoulos, George; Wajid, Usman

    2017-01-01

    Today's rich digital information environment is characterized by the multitude of data sources providing information that has not yet reached its full potential in eHealth. The aim of the presented approach, namely CrowdHEALTH, is to introduce a new paradigm of Holistic Health Records (HHRs) that include all health determinants. HHRs are transformed into HHRs clusters capturing the clinical, social and human context of population segments and as a result collective knowledge for different factors. The proposed approach also seamlessly integrates big data technologies across the complete data path, providing of Data as a Service (DaaS) to the health ecosystem stakeholders, as well as to policy makers towards a "health in all policies" approach. Cross-domain co-creation of policies is feasible through a rich toolkit, being provided on top of the DaaS, incorporating mechanisms for causal and risk analysis, and for the compilation of predictions.

  18. Semantically Enriched Data Access Policies in eHealth.

    Science.gov (United States)

    Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

    2016-11-01

    Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

  19. Using Standardized Health Consumer Indicators as a Policy Development Tool

    Directory of Open Access Journals (Sweden)

    Cătălin Ovidiu BABA

    2007-06-01

    Full Text Available This study describes the relations between the European Union standardized health indicators and the community-based health policy. One of the goals of the European Commission is to provide standardized information on health in order to make it comparable at a trans-national level. Hence, numerous projects aimed at developing health indicators, and improving databases relating to these were supported by the Program of Community Action in the Field of Public Health. In this paper the authors argue that standardized health indicators can provide more than a prototype for a future health monitoring system. Bearing in mind that the production of comparable information on health is based upon four different tasks (the analysis of data needs in a specific area, definition of indicators and quality assurance, reporting and analysis, and promotion of the results the authors assert that all of these tasks are important steps towards the development of community-based health policy. Thus, the main objective of this study is to analyze their utility as premises for policy development.

  20. Can conditional health policies be justified? A policy analysis of the new NHS dental contract reforms.

    Science.gov (United States)

    Laverty, Louise; Harris, Rebecca

    2018-06-01

    Conditional policies, which emphasise personal responsibility, are becoming increasingly common in healthcare. Although used widely internationally, they are relatively new within the UK health system where there have been concerns about whether they can be justified. New NHS dental contracts include the introduction of a conditional component that restricts certain patients from accessing a full range of treatment until they have complied with preventative action. A policy analysis of published documents on the NHS dental contract reforms from 2009 to 2016 was conducted to consider how conditionality is justified and whether its execution is likely to cause distributional effects. Contractualist, paternalistic and mutualist arguments that reflect notions of responsibility and obligation are used as justification within policy. Underlying these arguments is an emphasis on preserving the finite resources of a strained NHS. We argue that the proposed conditional component may differentially affect disadvantaged patients, who do not necessarily have access to the resources needed to meet the behavioural requirements. As such, the conditional component of the NHS dental contract reform has the potential to exacerbate oral health inequalities. Conditional health policies may challenge core NHS principles and, as is the case with any conditional policy, should be carefully considered to ensure they do not exacerbate health inequities. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Integrating health law and health policy: a European perspective

    NARCIS (Netherlands)

    Legemaate, Johan

    2002-01-01

    Health law is intended to create an environment in which the promotion of health goes hand in hand with the protection of individual rights and the general principles of equality and justice. Over the years, the importance of health law has grown, both at national and international level. As health

  2. Public health: disconnections between policy, practice and research

    Directory of Open Access Journals (Sweden)

    Kok Gerjo

    2010-12-01

    Full Text Available Abstract Background Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed. Method A qualitative descriptive research was conducted by literature search. We analyzed the four steps of the policy, practice and research work cycles. Next, we interpreted the main conflicting aspects as disconnections for each step. Results There are some conspicuous differences that strengthen the niche character of each domain and hamper integration and collaboration. Disconnections ranged from formulating priorities in problem statements to power roles, appraisal of evidence, work attitudes, work pace, transparency of goals, evaluation and continuation strategies and public accountability. Creating awareness of these disconnections may result in more compatibility between researchers, policy makers and practitioners. Conclusion We provide an analysis that can be used by public health services-related researchers, practitioners and policy makers to be aware of the risk for disconnections. A synthesis of the social, practical and scientific relevance of public health problems should be the starting point for a dialogue that seeks to

  3. Advancing public health obesity policy through state attorneys general.

    Science.gov (United States)

    Pomeranz, Jennifer L; Brownell, Kelly D

    2011-03-01

    Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity.

  4. Analysis of selected policies towards universal health coverage in Uganda: the policy implementation barometer protocol.

    Science.gov (United States)

    Hongoro, Charles; Rutebemberwa, Elizeus; Twalo, Thembinkosi; Mwendera, Chikondi; Douglas, Mbuyiselo; Mukuru, Moses; Kasasa, Simon; Ssengooba, Freddie

    2018-01-01

    Policy implementation remains an under researched area in most low and middle income countries and it is not surprising that several policies are implemented without a systematic follow up of why and how they are working or failing. This study is part of a larger project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda. It seeks to support policymakers monitor the implementation of vital programmes for the realisation of policy goals for Universal Health Coverage. A Policy Implementation Barometer (PIB) is proposed as a mechanism to provide feedback to the decision makers about the implementation of a selected set of policy programmes at various implementation levels (macro, meso and micro level). The main objective is to establish the extent of implementation of malaria, family planning and emergency obstetric care policies in Uganda and use these results to support stakeholder engagements for corrective action. This is the first PIB survey of the three planned surveys and its specific objectives include: assessment of the perceived appropriateness of implementation programmes to the identified policy problems; determination of enablers and constraints to implementation of the policies; comparison of on-line and face-to-face administration of the PIB questionnaire among target respondents; and documentation of stakeholder responses to PIB findings with regard to corrective actions for implementation. The PIB will be a descriptive and analytical study employing mixed methods in which both quantitative and qualitative data will be systematically collected and analysed. The first wave will focus on 10 districts and primary data will be collected through interviews. The study seeks to interview 570 respondents of which 120 will be selected at national level with 40 based on each of the three policy domains, 200 from 10 randomly selected districts, and 250 from 50 facilities. Half of the respondents at

  5. Health policy considerations for our sexual minority patients.

    Science.gov (United States)

    O'Hanlan, Katherine A

    2006-03-01

    Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality. They have each endorsed laws that confer equality to sexual minorities, including nondiscrimination in employment, medical insurance coverage, adoption, and access to civil marriage. The American College of Obstetricians and Gynecologists (ACOG), by virtue of its history of advocacy for women's health, is in a position to promote policy and make similar recommendations, recognizing that sexual minority women's health and their family issues are an integral component of taking care of all women. The College should review the policies of America's premier mental health associations and consider including sexual orientation and gender identity in its own nondiscrimination policy, and ACOG should issue a policy statement in support of laws to provide safety from violence and discrimination, equal employment opportunities, equal health insurance coverage, and equal access to civil marriage.

  6. Politics of environmental regulation: acid rain in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Hogarth Wood, G P

    1984-01-01

    This study looks at the case of the Ontario government and Inco Limited in order to explain political responses to the acid rain issue and to generalize about the dynamics of environmental regulation. Existing accounts of the acid rain situation neglect a systematic explanation of the political processes that guide the selection of policy. This reflects a tendency in Canadian public policy analysis generally. Most literature in this field is both apolitical and atheoretical. In addition, most models of public policy focus attention on a narrow range of policy determinants, making the models inappropriate as exclusive guides for public policy analysis. This study follows an approach that assumes that no variable can, a priori, be viewed as the primary determinant of a policy choice. Instead, relevant features of the economic, social, and political environment surrounding the policy process have to be examined in addition to that process itself. Accordingly, a number of potential influences on the acid rain policy outcome in Ontario are explored: the economic structure of Ontario, political-geographic factors, the role of science and technology, political power in the province, political values and attitudes, the institutional structure of Ontario politics, and finally, the policy process itself. This exercise points to the overriding influence of the political system environment, particularly the economic structure of the province, in explaining the policy choice. The findings of this study can be extended to explain regulatory responses to the issue in other political jurisdictions.

  7. Population health and medicine: Policy and financial drivers.

    Science.gov (United States)

    Lavigne, Jill E; Brown, Jack; Matzke, Gary R

    2017-09-15

    The financial and policy levers of population health and potential opportunities for pharmacists are described. Three long-standing problems drive the focus on population health: (1) the United States suffers far worse population health outcomes compared with those of other developed nations that spend significantly less on healthcare, (2) the U.S. healthcare system's focus on "sick care" fails to address upstream prevention and population health improvement, and (3) financial incentives for healthcare delivery are poorly aligned with improvements in population health outcomes. The Patient Protection and Affordable Care Act of 2010 (ACA) was arguably the first major healthcare legislation since 1965 and had 3 main strategies for improving population health: expand health insurance coverage, control healthcare costs, and improve the healthcare delivery system. Federal and state legislation as well as Medicare and Medicaid financing strategies have designated mechanisms to reward advances in population outcomes since the passage of the ACA. States are responsible for many of the factors that affect population health, and a bipartisan effort that builds upon state and federal collaboration will likely be needed to implement the necessary health policy initiative. Population health issues affect productivity in the United States; conversely, improvements in population health may increase productivity, helping to offset the rising federal debt. Employers are in a position to improve population health and consequently help reduce the federal debt by addressing lifestyle, chronic disease, poverty, and inequality. National pharmacy organizations, regulatory bodies, and journal editors need to collectively agree to a threshold of quality and rigor for publication and endorsement. Knowledge of the policy and financial drivers of population health may both support pharmacists' efforts to improve population outcomes and identify opportunities for professional advancement

  8. Cogeneration markets in Ontario

    International Nuclear Information System (INIS)

    Poredos, S.

    1993-01-01

    Cogeneration offers a key strategy which supports global competitiveness for Ontario businesses, encourages energy efficiency and environmental protection, and offers natural gas utilities and producers stable long-term incremental markets. By supporting cogeneration projects, electric utilities will benefit from increased flexibility. Natural gas is the fuel of choice for cogeneration, which can in most cases be easily integrated into existing operations. In Ontario, electric demand grew along with the gross domestic product until 1990, but has decreased with the recent economic recession. The provincial utility Ontario Hydro is resizing itself to stabilize total rate increases of 30% over the last three years and supporting reduction of its high debt load. Rate increases are supposed to be limited but this may be difficult to achieve without further cost-cutting measures. Cogeneration opportunities exist with many institutional and industrial customers who are trying to remain globally competitive by cutting operating costs. In general, cogeneration can save 20% or more of total annual energy costs. Due to excess capacity, Ontario Hydro is not willing to purchase electric power, thus only electric load displacement projects are valid at this time. This will reduce overall savings due to economies of scale. In southwestern Ontario, Union Gas Ltd. has been successful in developing 40 MW of electric displacement projects, providing a total load of 5 billion ft 3 of natural gas (50% of which is incremental). Over 3,000 MW of technical cogeneration potential is estimated to exist in the Union Gas franchise area

  9. Haemoglobinopathies in Europe: health & migration policy perspectives

    OpenAIRE

    Aguilar Martinez, Patricia; Angastiniotis, Michael; Eleftheriou, Androulla; Gulbis, Beatrice; Mañú Pereira, Maria Del Mar; Petrova-Benedict, Roumyana; Corrons, Joan-Lluis Vives

    2014-01-01

    BACKGROUND: Major haemoglobinopathies (MH), such as thalassaemia syndromes (Thal) and sickle cell disorders (SCD), are genetic defects associated with chronic anaemia and other complications. In Europe, MH are rare diseases (RD) but their prevalence is significantly growing in many countries due to mobility and migration flows. This creates a growing health problem in the EU that has not yet been effectively addressed by Member States (MS) authorities. The present study has been conducted wit...

  10. Healthy kids: Making school health policy a participatory learning process

    DEFF Research Database (Denmark)

    Stjernqvist, Nanna Wurr; Bruselius-Jensen, Maria; Høstgaard Bonde, Ane

    enjoyed having a voice in school matters and to deal with real life during health education. Teachers were very positive towards the integration of school health policy work into teaching the curriculum in Danish, Maths and Biology. However, the transferring from the classroom to the organizational levels....... Methods The presented model works at two levels - the classroom and the organizational level – and is based on four phases, namely: Investigation – Vision – Action – Change, viewed as an iterative process. Pupil perspectives and learning is the basis in all four phases based on a set of health education...... was weakhindering sustainable health changes. Conclusion Findings indicate that integrating school policy processes into the teaching of curriculum might pave the way for schools to engage in health promotion. But further knowledge on how to likewise engage the staff on an organisational level is needed....

  11. Development of an Internet Security Policy for health care establishments.

    Science.gov (United States)

    Ilioudis, C; Pangalos, G

    2000-01-01

    The Internet provides unprecedented opportunities for interaction and data sharing among health care providers, patients and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality and integrity of information. This paper defines the basic security requirements that must be addressed in order to use the Internet to safely transmit patient and/or other sensitive Health Care information. It describes a suitable Internet Security Policy for Health Care Establishments and provides the set of technical measures that are needed for its implementation. The proposed security policy and technical approaches have been based on an extensive study of the related recommendations from the security and standard groups both in EU amid USA and our related work and experience. The results have been utilized in the framework of the Intranet Health Clinic project, where the use of the Internet for the transmission of sensitive Health Care information is of vital importance.

  12. Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities

    Science.gov (United States)

    Carter-Pokras, Olivia; Offutt-Powell, Tabatha; Kaufman, Jay S.; Giles, Wayne; Mays, Vickie

    2013-01-01

    Purpose Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the U.S. and abroad through a “social determinants of health” lens. Methods To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the U.S., Canada, and New Zealand, and drew upon the scientific literature. Results Resulting examples covered a wide range of topic areas. Three areas selected for their contributions to policy were: 1) epidemiology's role in definition and measurement, 2) the study of housing and asthma, and 3) the study of food policy strategies to reduce health disparities. While epidemiologic research has done much to define and quantify health inequalities, it has generally been less successful at producing evidence that would identify targets for health equity intervention. Epidemiologists have a role to play in measurement and basic surveillance, etiologic research, intervention research, and evaluation research. However, our training and funding sources generally place greatest emphasis on surveillance and etiologic research. Conclusions: The complexity of health disparities requires better training for epidemiologists to effectively work in multidisciplinary teams. Together we can evaluate contextual and multilevel contributions to disease and study intervention programs in order to gain better insights into evidenced-based health equity strategies. PMID:22626003

  13. The potential of solar PV in Ontario

    International Nuclear Information System (INIS)

    McMonagle, R.

    2005-01-01

    Canada has lagged behind other industrialized nations in the growth of solar energy markets. Currently, over 78 per cent of the global market for solar energy is for grid-connected applications where power is fed into the electrical distribution network. Less than 3.5 per cent of the Canadian solar market is grid-connected. This report investigated the potential size of the photovoltaic (PV) market in Ontario given adequate support from both governments and utilities. The forecast was based on sustainable growth levels that the solar industry as a whole might maintain over an extended period of time. It was suggested that it is technically feasible to install over 3000 MW of PV in single, detached homes in the province, which could generate over 3200 GWh each year. If the right policy conditions were put in place, the technical potential for PV on all buildings in Ontario is over 14,000 MW by 2025, which would generate over 13,000 GWh annually. Support mechanisms such as the Advanced Renewable Tariff (ART) or Standard Offer Contracts (SOC) will enable the PV industry to build capacity. Future markets for PV include new homes, commercial buildings and the existing housing stock. With a properly designed system, it is forecasted that the deployment of PV by 2025 could result in the involvement of 400,000 homes with over 1200 MW of installed capacity and over 290 MW installed annually by 2025. Recommendations to Ontario Power Authority's (OPA) report supply mix report focused on the use of SOCs as the appropriate support mechanism to start building solar capacity in Ontario, as projections using SOCs would see Ontario following the growth patterns of other nations. It was concluded that the OPA report does not acknowledge the current growth rates of PV globally, nor does it fully consider the potential of PV in Ontario. 9 refs., 8 figs

  14. Implementing Montessori Methods for Dementia™ in Ontario long-term care homes: Recreation staff and multidisciplinary consultants' perceptions of policy and practice issues.

    Science.gov (United States)

    Ducak, Kate; Denton, Margaret; Elliot, Gail

    2018-01-01

    Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

  15. The Role of Policies in Supporting the Diffusion of Solar Photovoltaic Systems: Experiences with Ontario, Canada’s Renewable Energy Standard Offer Program

    Directory of Open Access Journals (Sweden)

    Chris Adachi

    2009-12-01

    Full Text Available Traditionally, high initial capital costs and lengthy payback periods have been identified as the most significant barriers that limit the diffusion of solar photovoltaic (PV systems. In November, 2006, the Ontario Power Authority (OPA introduced the Renewable Energy Standard Offer Program (RESOP, offering owners of solar PV systems with a generation capacity under 10 MW a 20 year contract to sell electricity back to the grid at a guaranteed rate of CAD $0.42/kWh. While it is the intent of incentive programs such as the RESOP to begin to lower financial barriers in order to increase the uptake of solar PV systems, there is no guarantee that the level of participation will in fact rise. The "on-the-ground" manner in which consumers interact with such an incentive program ultimately determines its effectiveness. This paper analyzes the relationship between the RESOP and solar PV system consumers. Experiences of current RESOP participants are presented, wherein the factors that are either hindering or promoting utilization of the RESOP and the adoption of solar PV systems are identified.

  16. Health policy in Denmark: leaving the decentralized welfare path?

    Science.gov (United States)

    Vrangbaek, Karsten; Christiansen, Terkel

    2005-01-01

    In this article, we investigate developments in Danish health care policy. After a short presentation of its historical roots, we focus on the decades after the administrative reform of 1970, which shaped the current decentralized public health care system. Theories of path dependency and institutional inertia are used to explain the relative stability in the overall structure, and theories of policy process and reform are used to discuss gradual changes within the overall framework. Although comprehensive reforms have not taken place in Denmark, many gradual changes may pave the way for more radical changes in the future. The political climate currently seems to be more favorable toward structural reform than in the past.

  17. Health Policy and Management: in praise of political science. Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

    Science.gov (United States)

    Hunter, David J

    2015-03-12

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. © 2015 by Kerman University of Medical Sciences.

  18. Health Policy and Management: In Praise of Political Science; Comment on “On Health Policy and Management (HPAM: Mind the Theory-Policy Practice Gap”

    Directory of Open Access Journals (Sweden)

    David J Hunter

    2015-06-01

    Full Text Available Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems.

  19. The Case for "Environment in All Policies": Lessons from the "Health in All Policies" Approach in Public Health.

    Science.gov (United States)

    Browne, Geoffrey R; Rutherfurd, Ian D

    2017-02-01

    Both public health, and the health of the natural environment, are affected by policy decisions made across portfolios as diverse as finance, planning, transport, housing, education, and agriculture. A response to the interdependent character of public health has been the "health in all policies" (HiAP) approach. With reference to parallels between health and environment, this paper argues that lessons from HiAP are useful for creating a new integrated environmental management approach termed "environment in all polices" (EiAP). This paper covers the theoretical foundations of HiAP, which is based on an understanding that health is strongly socially determined. The paper then highlights how lessons learned from HiAP's implementation in Finland, California, and South Australia might be applied to EiAP. It is too early to learn from evaluations of HiAP, but it is apparent that there is no single tool kit for its application. The properties that are likely to be necessary for an effective EiAP approach include a jurisdiction-specific approach, ongoing and strong leadership from a central agency, independent analysis, and a champion. We then apply these properties to Victoria (Australia) to demonstrate how EiAP might work. We encourage further exploration of the feasibility of EiAP as an approach that could make explicit the sometimes surprising environmental implications of a whole range of strategic policies. Citation: Browne GR, Rutherfurd ID. 2017. The case for "environment in all policies": lessons from the "health in all policies" approach in public health. Environ Health Perspect 125:149-154; http://dx.doi.org/10.1289/EHP294.

  20. Developing policy analytics for public health strategy and decisions-the Sheffield alcohol policy model framework.

    Science.gov (United States)

    Brennan, Alan; Meier, Petra; Purshouse, Robin; Rafia, Rachid; Meng, Yang; Hill-Macmanus, Daniel

    This paper sets out the development of a methodological framework for detailed evaluation of public health strategies for alcohol harm reduction to meet UK policy-makers needs. Alcohol is known to cause substantial harms, and controlling its affordability and availability are effective policy options. Analysis and synthesis of a variety of public and commercial data sources is needed to evaluate impact on consumers, health services, crime, employers and industry, so a sound evaluation of impact is important. We discuss the iterative process to engage with stakeholders, identify evidence/data and develop analytic approaches and produce a final model structure. We set out a series of steps in modelling impact including: classification and definition of population subgroups of interest, identification and definition of harms and outcomes for inclusion, classification of modifiable components of risk and their baseline values, specification of the baseline position on policy variables especially prices, estimating effects of changing policy variables on risk factors including price elasticities, quantifying risk functions relating risk factors to harms including 47 health conditions, crimes, absenteeism and unemployment, and monetary valuation. The most difficult model structuring decisions are described, as well as the final results framework used to provide decision support to national level policymakers in the UK. In the discussion we explore issues around the relationship between modelling and policy debates, valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions. We reflect on the approach taken and outline ongoing plans for further development.

  1. Tobacco Retail Outlets and Vulnerable Populations in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton

    2013-12-01

    Full Text Available Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1 whether tobacco outlets are more likely to be located in vulnerable areas; and (2 what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level. There was one tobacco retail outlet for every 1,000 people over age 15 in Ontario. Density of outlets varied by public health unit, and was associated with the number of smokers. Tobacco outlets were more likely to be located in areas that had high neighbourhood deprivation, in both rural and urban areas. Outlets were less likely to be located in areas with high immigrant populations in urban areas, with the reverse being true for rural areas. Overall, 65% of tobacco retailers were located within 500 m of a school. The sale of tobacco products is ubiquitous, however, neighbourhoods with lower socio-economic status are more likely to have easier availability of tobacco products and most retailers are located within walking distance of a school. The results suggest the importance of policies to regulate the location of tobacco retail outlets.

  2. Data Resources for Conducting Health Services and Policy Research.

    Science.gov (United States)

    Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert

    2018-04-01

    Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.

  3. Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis.

    Science.gov (United States)

    Rawal, Lal B; Joarder, Taufique; Islam, Sheikh Md Shariful; Uddin, Aftab; Ahmed, Syed Masud

    2015-05-20

    Retention of human resources for health (HRH), particularly physicians and nurses in rural and remote areas, is a major problem in Bangladesh. We reviewed relevant policies and provisions in relation to HRH aiming to develop appropriate rural retention strategies in Bangladesh. We conducted a document review, thorough search and review of relevant literature published from 1971 through May 2013, key informant interviews with policy elites (health policy makers, managers, researchers, etc.), and a roundtable discussion with key stakeholders and policy makers. We used the World Health Organization's (WHO's) guidelines as an analytical matrix to examine the rural retention policies under 4 domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and 16 sub-domains. Over the past four decades, Bangladesh has developed and implemented a number of health-related policies and provisions concerning retention of HRH. The district quota system in admissions is in practice to improve geographical representation of the students. Students of special background including children of freedom fighters and tribal population have allocated quotas. In private medical and nursing schools, at least 5% of seats are allocated for scholarships. Medical education has a provision for clinical rotation in rural health facilities. Further, in the public sector, every newly recruited medical doctor must serve at least 2 years at the upazila level. To encourage serving in hard-to-reach areas, particularly in three Hill Tract districts of Chittagong division, the government provides an additional 33% of the basic salary, but not exceeding US$ 38 per month. This amount is not attractive enough, and such provision is absent for those working in other rural areas. Although the government has career development and promotion plans for doctors and nurses, these plans are often not clearly specified and not implemented effectively. The government is

  4. Health policy programs realised in Poland in 2016-2017

    Science.gov (United States)

    Kurowska, Patrycja; Królak, Anna; Giermaziak, Wojciech

    2018-01-01

    Health Policy Program (Program Polityki Zdrowotnej – PPZ) is a state policy tool for engaging local government units into the mechanism of granting provision of health services. Authors show areas in which self-governments most often took preventive health care actions and describe legislative changes in the Act on provision of health services. The aim of the article is to quantitative and qualitative statement of PPZ prepared in Poland in 2016 and 2017, as well as presenting changing legal situation in the scope of evaluation of these projects. Authors use descriptive method, presenting changes of legal status. The article includes data available in the Bulletin of Public Information by The Agency for Health Technology Assessment. 590 programs were analyzed (239 from 2016 and 351 from 2017). In 2016 – 67% of submitted programs were given a positive opinion and in 2017 – 71%. The most of positively evaluated PPZ submitted by local government units (53% in 2016; 47% in 2017) referred to prevention of infectious diseases by vaccines. On the basis of analyses conducted, significant differences were observed in the implementation of the PPZ in various regions of Poland. In the recent years a big improvement in the quality of planned self-government health programs is observed. It is suggested that due to the regulation defining the model of the health policy program and the model of the final report, this trend will continue.

  5. From "Public Health" to "Safeguarding Children": British Health Visiting in Policy, Practice and Research

    Science.gov (United States)

    Peckover, Sue

    2013-01-01

    This study examines the location of British health visiting in contemporary policy discourses concerned with public health and safeguarding children. It argues that professional identity and orientation can be understood through health visiting's long history of public health work with children and families, which has included an engagement with…

  6. Which way for federalism and health policy?

    Science.gov (United States)

    Holahan, John; Well, Alan; Wiener, Joshua M

    2003-01-01

    The current balance of responsibility between states and the federal government for low-income people's health coverage has achieved a great deal. It covers many of the neediest people, supports the safety net, responds to emerging needs, and supports some experimentation. However, it leaves more than forty million people uninsured, allows excessive variation across states, places unsustainable pressure on state budgets, creates tension between the two levels of government, and yields too few benefits from experimentation. This mixed record argues for a significant simplification of and increase in eligibility for public programs, with the federal government either providing extra funds to states to meet these needs or assuming full responsibility for insuring the poor.

  7. Measuring Social Capital in Hamilton, Ontario

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Simone, Dylan

    2012-01-01

    Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

  8. The city, territoriality and networks in mental health policies

    Directory of Open Access Journals (Sweden)

    Luciana Assis Costa

    2014-09-01

    Full Text Available The understanding of territory, made evident by a decentralized, local based, and non-institutionalized mental health model, is a fundamental element in building a renewed network. The objective of this essay is to understand how mental health policies gradually favor local actions, organized in terms of territories, to develop strategies of care that support the new model of mental health. From this perspective, the aim of this research is to reflect on the possibilities of establishing new social relations that can, in fact, widen the sense of community belonging in the daily living of those presenting mental health conditions. This study draws from theoretical concepts and frameworks of the social sciences, describing the diverse positions held by the main schools of urban sociology with regards to the understanding of territories. The multiple conceptions of territories and their relations to mental health are analyzed. Historical data about mental health in Brazil show a heterogeneous development of mental health policies in different areas of the country. Finally, social inclusion in the cities depends on an effective expansion of territory-based mental health services, as well as an amplification of the access to consumer goods and services not necessarily connected to health care, but to basic social and civil rights. Hopefully, new rules of social interaction will not be restricted to the mental health universe, but will promote new encounters in the urban space, with respect for differences and appreciation of diversity.

  9. Ecosystem change and human health: implementation economics and policy.

    Science.gov (United States)

    Pattanayak, S K; Kramer, R A; Vincent, J R

    2017-06-05

    Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  10. Using social media to engage nurses in health policy development.

    Science.gov (United States)

    O'Connor, Siobhan

    2017-11-01

    To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software. The framework approach aided thematic analysis to draw out themes. Sixty-four people took part in the Twitter chat (#CNOScot) and posted 444 tweets. Nurses called for investment in technology, nursing research, education and mental health. Primary care and advanced practice roles to support older adults with complex health and social care needs were also seen as vital to develop further. Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice but some groups risk being excluded using this digital medium. Nursing leaders should consider social media as one of many engagement strategies to ensure nurses and other stakeholders participate in policy debate that informs health strategy development. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  11. Ontario Hydro decontamination experience

    Energy Technology Data Exchange (ETDEWEB)

    Lacy, C S; Patterson, R W; Upton, M S [Chemistry and Metallurgy Department, Central Production Services, Ontario Hydro, ON (Canada)

    1991-04-01

    Ontario Hydro currently operates 18 nuclear electric generating units of the CANDU design with a net capacity of 12,402 MW(e). An additional 1,762 MW(e) is under construction. The operation of these facilities has underlined the need to have decontamination capability both to reduce radiation fields, as well as to control and reduce contamination during component maintenance. This paper presents Ontario Hydro decontamination experience in two key areas - full heat transport decontamination to reduce system radiation fields, and component decontamination to reduce loose contamination particularly as practised in maintenance and decontamination centres. (author)

  12. Ontario Hydro decontamination experience

    International Nuclear Information System (INIS)

    Lacy, C.S.; Patterson, R.W.; Upton, M.S.

    1991-01-01

    Ontario Hydro currently operates 18 nuclear electric generating units of the CANDU design with a net capacity of 12,402 MW(e). An additional 1,762 MW(e) is under construction. The operation of these facilities has underlined the need to have decontamination capability both to reduce radiation fields, as well as to control and reduce contamination during component maintenance. This paper presents Ontario Hydro decontamination experience in two key areas - full heat transport decontamination to reduce system radiation fields, and component decontamination to reduce loose contamination particularly as practised in maintenance and decontamination centres. (author)

  13. Public health metaphors in Australian policy on asylum seekers.

    Science.gov (United States)

    Koutroulis, Glenda

    2009-02-01

    To analyse the way in which a public health metaphor has been incorporated into Australian political practice to justify the exclusion or mistreatment of unwelcome non-citizens, giving particular attention to recent asylum seekers. Starting with a personal experience of working in an immigration detention centre and then drawing on media reports and published scholarship, I critique political rhetoric and policy on asylum seekers, arguing that the significance of a public health metaphor lies in its effectiveness in persuading the public that refugees and asylum seekers are a moral contaminant that threatens the nation and has to be contained. Acceptance of the metaphor sanctions humanly degrading inferences, policies and actions. Public health professionals therefore have a responsibility to challenge the political use of public health and associated metaphors. Substituting the existing metaphor for one that is more morally acceptable could help to redefine refugees and asylum seekers more positively and promote compassion in political leaders and the community.

  14. Ontario Hydro statistical yearbook 1990

    International Nuclear Information System (INIS)

    1990-01-01

    Ontario Hydro was created in 1906 by a special statute of the Province of Ontario. It is a financially self-sustaining corporation without share capital. The yearbook is a compilation of financial data detailed by financial statements and sales and revenue figures for the year 1990. It is broken down by municipalities served in Ontario

  15. Ontario Hydro statistical yearbook 1990

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-12-31

    Ontario Hydro was created in 1906 by a special statute of the Province of Ontario. It is a financially self-sustaining corporation without share capital. The yearbook is a compilation of financial data detailed by financial statements and sales and revenue figures for the year 1990. It is broken down by municipalities served in Ontario.

  16. Waterpipe tobacco smoking impact on public health: implications for policy

    Directory of Open Access Journals (Sweden)

    Martinasek MP

    2015-08-01

    Full Text Available Mary P Martinasek,1 Linda M Gibson-Young,2 Janiece N Davis,3 Robert J McDermott41Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, 2College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, 3Department of Health – Palm Beach County, West Palm beach, FL, 4Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USABackground: Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods: Identification of Clean Indoor Air Acts (CIAAs from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results: States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion: Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.Keywords: health policy, waterpipe tobacco, hookah smoking, tobacco regulation

  17. Social policy and costs of social protection and health

    OpenAIRE

    Koukoufilippou, Ioannis; Papavasileiou, Evanthia; Koinis, Aristotelis

    2016-01-01

    ABSTRACT The understanding of theoretical models and typologies of social systems is a prerequisite for the study and policy formulation in the health sector. The analysis of health expenditure in Greece in relation to the European Union-15 (EU-15) countries, is the first step for policymakers. Through literature review and Eurostat databases (ESSPROS) and the OECD (OECD), compiled and presented the necessary statistical and theoretical data reveal deviations of Greece from the average of...

  18. Wellness programme and health policy development at a large faith ...

    African Journals Online (AJOL)

    The study's primary recommendations include: taking its employees' cultural and social norms into consideration; addressing issues related to capacity and ... list of recommendations for other resource-constrained NGOs that also wish to develop and implement wellness programmes and health policies in their workplace.

  19. Locating regional health policy: Institutions, politics, and practices

    Science.gov (United States)

    Riggirozzi, Pia; Yeates, Nicola

    2015-01-01

    Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy. PMID:26635495

  20. Analyzing the influence of institutions on health policy development ...

    African Journals Online (AJOL)

    ... on health policy development in Uganda: A case study of the decision to abolish user fees. ... Methods: An explanatory case study informed by analytical frameworks from the ... Multiple data sources were used including: academic literature, key ... However, prevalent informal institutions such as “Big Man” presidentialism ...

  1. Policy research institutions and the health SDGs: Building ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This is one of four pilot projects exploring the feasibility of a Think Heath Initiative, a prospective program that would support evidence-based policy engagement on the health-related Sustainable Development Goals (SDGs). The project will undertake seven national SDG scoping studies, one each for Ethiopia, Kenya, ...

  2. Health Policy 2016 – Implications for Geriatric Urology

    Science.gov (United States)

    Suskind, Anne M.; Clemens, J. Quentin

    2016-01-01

    Purpose of Review The U.S. healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. Recent Findings The Affordable Care Act (ACA) has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Summary Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination, risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues. PMID:26765043

  3. "No place like home": Gender, family, and the politics of home care in post-world war II Ontario.

    Science.gov (United States)

    Struthers, James

    2003-01-01

    Since the early 1990s home care increasingly has emerged as a favoured policy response to the growing costs which an aging population poses for our health care system. This paper explores the early history of home care for the elderly in Ontario during the first three decades after World War II. It demonstrates that policy debates over the merits of home versus institutional care for the elderly, and community-based over hospital-based approaches to home care are not recent phenomenon but have been on going since the 1940s within the public health and social services sector. The paper examines why home care failed for so long to develop beyond the margins of Ontario's highly institutionalized health care system. It also explores how earlier visions of community-based home care, designed to help the elderly age in place, increasingly were obscured by an exclusive preoccupation with home care's "cost effectiveness" as an alternative to hospital or residential care, a rationale which discounted home care's costs to unpaid and principally female care givers. The paper concludes that the Ontario health ministry's systematic devaluing of caregiving and home maker skills, the fear of undermining the family's willingness to provide care, as well as the failure to develop effective mechanisms for integrated regional health care planning, also impeded the progress of home care's development before the 1980s.

  4. Risk policies and risk perceptions: a comparative study of environmental health risk policy and perception in six European countries

    NARCIS (Netherlands)

    Bröer, C.; Moerman, G.; Spruijt, P.; van Poll, R.

    2014-01-01

    This paper explores the influence that health risk policies have on the citizens’ perceptions of those health risks. Previously, detailed mixed methods research revealed that noise annoyance policies shaped noise perception. This idea is now applied to nine different environmental health risks in

  5. Ontario's energy action plan

    International Nuclear Information System (INIS)

    2003-07-01

    In the fall of 2002, the government of Ontario announced an action plan designed to ensure stable electricity prices while additional electricity generating capacity is built. The action plan included a strategy for encouraging major private sector investments in wind, solar and other renewable energy sources. The strategies for new renewable energy projects include: property tax incentives, business income tax incentives, and sales tax rebates. Initiatives to increase supply include: Toronto's Portland 550 megawatt, natural gas-fired generating station, Niagara Falls' Beck Tunnel Project, and Windsor's 580 megawatt natural gas-fired generating station. The government is promoting energy conservation by reducing its electricity consumption by 10 per cent, and setting a target where 20 per cent of electricity consumed in the province must be from renewable energy sources. The use of interval meters by Ontario residents is being encouraged. A provincial sales tax rebate is being offered to customers buying select energy efficient appliances. In its commitment to environmental protection, the Ontario government is phasing out coal, offering rebates for solar energy systems, implementing measures to reduce acid rain, and investing $3.25 billion over ten years to renew and expand public transit. In Chatham, Ontario, a plant producing ethanol from corn was built, and others are planned for other parts of the province. Tax incentives are also offered for alternative fuel users. 1 ref., 1 tab

  6. Crisis, neoliberal health policy, and political processes in Mexico.

    Science.gov (United States)

    Laurell, A C

    1991-01-01

    The Mexican case represents an orthodox neoliberal health policy in the context of the structural adjustment adopted by the Mexican government in 1983. The social costs of this strategy are very high, including an increase in unemployment, wage depression, regressive redistribution of wealth, and profound changes in social policies. These transformations are reflected in the health sector, where the four main axes of neoliberal policy--expenditure restrictions, targeting, decentralization, and privatization--have been implemented. This represents a change in social policy from a model based on citizens' social rights and the state's obligation to guarantee them, to a model characterized by selective public charity. This strategy has been imposed on society as a result of the Mexican corporative political regime based on a state party system. Since 1985, however, there has been a growing process of independent organization of civil society. This led in the presidential elections of 1988 to the defeat of the candidate of the governing party by the candidate of a popular-democratic opposition front. Although the government party imposed its candidate through electoral fraud, social mobilization against neoliberal policies continues in the midst of an important political crisis that can only be resolved by profound democratization of Mexican society.

  7. Health financing for universal coverage and health system performance: concepts and implications for policy.

    Science.gov (United States)

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  8. Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada.

    Science.gov (United States)

    Cai, Jiaoli; Guerriere, Denise N; Zhao, Hongzhong; Coyte, Peter C

    2017-07-18

    The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations.

  9. Beyond leadership: political strategies for coordination in health policies.

    Science.gov (United States)

    Greer, Scott L; Lillvis, Denise F

    2014-05-01

    Health in All Policies (HiAP) promises to improve population health by harnessing the energies and activities of various sectors. Nevertheless, it faces well-documented bureaucratic obstacles and appears to require intersectoral governance if it is to be established. The basic problems of establishing intersectoral governance for HiAP are known to public administration and political science. On reading that literature, we find that the difficulty of establishing intersectoral governance for HiAP breaks down into two kinds of problems: that of establishing coordinated actions at all (coordination); and ensuring that they endure in changed political circumstances (durability). We further find that policymakers' solutions fall into three categories: visible ones of political will (e.g., plans and targets); bureaucratic changes such as the introduction of Health Impact Assessment or reorganization; and indirect methods such as data publication and support from outside groups to put pressure on the government. It can seem that Health in All Policies, like much of public health, depends on effective and committed policymakers but is vulnerable to changing political winds. The three kinds of strategies suggest how policymakers can, and do, create intersectoral governance that functions and persists, expanding the range of effective policy recommendations. Copyright © 2014. Published by Elsevier Ireland Ltd.

  10. Halting the obesity epidemic: a public health policy approach.

    Science.gov (United States)

    Nestle, M; Jacobson, M F

    2000-01-01

    Traditional ways of preventing and treating overweight and obesity have almost invariably focused on changing the behavior of individuals, an approach that has proven woefully inadequate, as indicated by the rising rates of both conditions. Considering the many aspects of American culture that promote obesity, from the proliferation of fast-food outlets to almost universal reliance on automobiles, reversing current trends will require a multifaceted public health policy approach as well as considerable funding. National leadership is needed to ensure the participation of health officials and researchers, educators and legislators, transportation experts and urban planners, and businesses and nonprofit groups in formulating a public health campaign with a better chance of success. The authors outline a broad range of policy recommendations and suggest that an obesity prevention campaign might be funded, in part, with revenues from small taxes on selected products that provide "empty" calories-such as soft drinks-or that reduce physical activity-such as automobiles.

  11. What Should Guide Health Policy? A Perspective Beyond Politics.

    Science.gov (United States)

    Kirch, Darrell G; Ast, Cori

    2017-09-01

    As the U.S. electorate has become increasingly polarized, these divisions are poised to shape legislative and regulatory work in the years ahead. For those whose focus is on the public goods of health care for all, the advancement of science through rigorous research, and the contribution of higher education to the continual improvement of the nation's workforce, there is profound uncertainty about the future. There are several pressing questions facing the nation and academic medicine, including the future of affordable, accessible insurance; acceptance of scientific evidence; sustainable learning and teaching methodologies; and the well-being and preparation of the nation's health workforce to care for an increasingly diverse nation. For those in academic medicine and policy making alike, the authors propose a framework, grounded in scientific evidence and guided by clinical ethics, for designing and evaluating health policy solutions for these and other pressing questions.

  12. Health and schooling: evidence and policy implications for developing countries.

    Science.gov (United States)

    Gomes-neto, J B; Hanushek, E A; Leite, R H; Frota-bezzera, R C

    1997-01-01

    Health and education are typically viewed as distinct topics from both the research and policy perspectives. Accordingly, the direct interactions between health status and education have been neglected in both research and policy making. The authors use survey data collected from students during the 1980s in Piaui, Ceara, and Pernambuco states as part of an evaluation of a major educational intervention program, EDURURAL, to investigate the complementarities of health with school attainment and cognitive achievement. A series of anthropometric measures for individual students in rural northeast Brazil are used in educational performance models. The promotion models and value-added achievement models both demonstrate the importance of students' visual acuity. Poor vision systematically leads to higher drop-out rates, more grade repetition, and lower achievement. The achievement models also point to the role of good nutrition.

  13. Health imperatives in foreign policy: the case of Malaysia.

    Science.gov (United States)

    Barraclough, Simon; Phua, Kai-Lit

    2007-03-01

    Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.

  14. Environmental Health: Advancing Emancipatory Policies for the Common Good.

    Science.gov (United States)

    Valentine-Maher, Sarah K; Butterfield, Patricia G; Laustsen, Gary

    Human health is substantially impacted by the state of the environment, and environmental degradation has a disproportionate impact on persons with less immediate access to financial and social power. This article calls for upstream nursing action to address the natural environment in order to turn about health injustices and improve health for all. Such action would move nursing towards a greater actualization of the nursing environmental domain. The health impacts of climate change, air and water quality, and toxic chemical exposure are substantiated and specific policy leadership recommendations are proposed. Recommended actions include work to build environmental health literacy and empowerment, advocacy for regulatory protection and enforcement, and environmental engagement within health care systems.

  15. Retailers test Ontario market

    International Nuclear Information System (INIS)

    Kishewitsch, S.

    2000-01-01

    In anticipation of the full opening of the Ontario electricity market in November 2000, some of the newly-licensed electricity retailers are reported to be ready to begin testing the market early, hoping that all the uncertainties that still exist about pricing will be worked out in time. Among those jumping in now is Direct Energy Marketing, a retailer which claims 800,000 households in Ontario as electricity supply customers, as well as a wholesale gas marketing business. Direct Energy began retail electrical marketing on April 3, 2000, starting cautiously with small commercial operations as the initial target. Greengrid Electric, another of the new marketers, planned to begin marketing in mid-April, offering 100 per cent renewable-sourced electricity. Provident Energy Management, one of the new marketers whose licence is still pending, hopes to begin direct marketing as soon as its licence is confirmed. Another marketer ready to go as soon its license is issued is the former Sault Ste. Marie Hydro, now reorganized as PUC Energies Inc. PUC has the advantage of having a firm contract with a NUG (non-utility generator), Great Lakes Power, signed while PUC was still a municipal electric utility. As far as the other potential marketers are concerned, caution overrides opportunity for the present. Principal concerns are uncertainty over the retail settlement code, the electronic business data transfer system, transmission and distribution tariffs, whether existing non-utility generator contracts will allow for supply to another party, and over how quickly Ontario Power Generation Inc's (successor to Ontario Hydro) market power will be ratcheted down. Many of the potential marketers feel that despite the Ontario government's desire to see more competition, the power mitigation agreement, as it now reads, leaves little room for the small retailer to compete

  16. Retailers test Ontario market

    Energy Technology Data Exchange (ETDEWEB)

    Kishewitsch, S.

    2000-04-01

    In anticipation of the full opening of the Ontario electricity market in November 2000, some of the newly-licensed electricity retailers are reported to be ready to begin testing the market early, hoping that all the uncertainties that still exist about pricing will be worked out in time. Among those jumping in now is Direct Energy Marketing, a retailer which claims 800,000 households in Ontario as electricity supply customers, as well as a wholesale gas marketing business. Direct Energy began retail electrical marketing on April 3, 2000, starting cautiously with small commercial operations as the initial target. Greengrid Electric, another of the new marketers, planned to begin marketing in mid-April, offering 100 per cent renewable-sourced electricity. Provident Energy Management, one of the new marketers whose licence is still pending, hopes to begin direct marketing as soon as its licence is confirmed. Another marketer ready to go as soon its license is issued is the former Sault Ste. Marie Hydro, now reorganized as PUC Energies Inc. PUC has the advantage of having a firm contract with a NUG (non-utility generator), Great Lakes Power, signed while PUC was still a municipal electric utility. As far as the other potential marketers are concerned, caution overrides opportunity for the present. Principal concerns are uncertainty over the retail settlement code, the electronic business data transfer system, transmission and distribution tariffs, whether existing non-utility generator contracts will allow for supply to another party, and over how quickly Ontario Power Generation Inc's (successor to Ontario Hydro) market power will be ratcheted down. Many of the potential marketers feel that despite the Ontario government's desire to see more competition, the power mitigation agreement, as it now reads, leaves little room for the small retailer to compete.

  17. Influence of macrosocial policies on women's health and gender inequalities in health.

    Science.gov (United States)

    Borrell, Carme; Palència, Laia; Muntaner, Carles; Urquía, Marcelo; Malmusi, Davide; O'Campo, Patricia

    2014-01-01

    Gender inequalities in health have been widely described, but few studies have examined the upstream sources of these inequalities in health. The objectives of this review are 1) to identify empirical papers that assessed the effect of gender equality policies on gender inequalities in health or on women's health by using between-country (or administrative units within a country) comparisons and 2) to provide an example of published evidence on the effects of a specific policy (parental leave) on women's health. We conducted a literature search covering the period from 1970 to 2012, using several bibliographical databases. We assessed 1,238 abstracts and selected 19 papers that considered gender equality policies, compared several countries or different states in 1 country, and analyzed at least 1 health outcome among women or compared between genders. To illustrate specific policy effects, we also selected articles that assessed associations between parental leave and women's health. Our review partially supports the hypothesis that Nordic social democratic welfare regimes and dual-earner family models best promote women's health. Meanwhile, enforcement of reproductive policies, mainly studied across US states, is associated with better mental health outcomes, although less with other outcomes. Longer paid maternity leave was also generally associated with better mental health and longer duration of breastfeeding.

  18. Human rights and correctional health policy: a view from Europe.

    Science.gov (United States)

    Rogan, Mary

    2017-03-13

    Purpose Correctional healthcare should promote the protection of human rights. The purpose of this paper is to bring a discussion of human rights into debates on how such policy should be best organized. Design/methodology/approach The paper achieves its aim by providing an analysis of European prison law and policy in the area of prison health, through assessing decisions of the European Court of Human Rights, as well as policies created by the European Committee for the Prevention of Torture. Findings The paper describes the position of the European Court of Human Rights on the topics of access to healthcare, ill health and release from prison, mental illness in prison, and the duty to provide rehabilitative programming for those seeking to reduce their level of "risk." It also argues that human rights law can be a source of practical reform, and that legal frameworks have much to offer healthcare leaders seeking to uphold the dignity of those in their care. Originality/value This paper will provide a rare example of the engagement of human rights law with correctional health policy. It provides practical recommendations arising out of an analysis of European human rights law in the area of prisons.

  19. Trends in public health policies addressing violence against women

    Directory of Open Access Journals (Sweden)

    Kattia Rojas Loría

    2014-08-01

    Full Text Available OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia.

  20. Trends in public health policies addressing violence against women

    Science.gov (United States)

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-01-01

    OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820

  1. Cross currents : hydroelectricity and the engineering of northern Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Manore, J.L. [Calgary Univ., AB (Canada)

    1999-05-01

    The history of hydroelectric development in northern Ontario was reviewed and analysed with special emphasis on the developments along the Mattagami and Abitibi Rivers. The objective was to examine the important factors that shaped modern hydroelectric development in Canada. System builders, the privately owned Nesbitt Thomson Company, the publicly owned Hydro Electric Power Corporation of Ontario and the eventual evolution of the single power system under Ontario Hydro are chronicled. Broad historical themes such as the technological impacts, regionalism, indigenous rights, plus environmental and economic issues are examined, in addition to an appreciation of the importance of electricity in the manufacturing sector of Ontario, the impact of hydroelectric development on the northern environment and on the northern First Nations, who rely on rivers for their subsistence. Until fairly recently, government policies and interpretations of law often excluded the recognition of Aboriginal uses of river systems, thereby limiting First Nations` peoples ability to practice traditional ways of life. In essence, the book is an account of how the northeastern power system in Ontario shaped the social, political and natural environments and how the development of northeastern power sources by southern power developers shaped the regional interactions between Ontario`s north and south. refs., figs.

  2. [Research on social determinants of health and health inequalities: evidence for health in all policies].

    Science.gov (United States)

    Borrell, Carme; Malmusi, Davide

    2010-12-01

    This article aims to review conceptual frameworks and some principles to be considered in research on social determinants of health and health inequalities. Some indicators of research on these issues in Spain are described. General expenditure on research and development in Spain is far from the Organisation for Economic Co-operation and Development mean. In addition, both globally and within Spain, the scientific production on health inequalities is very low, especially compared with other research areas. The budget for research on health inequalities is also reduced. A striking example is provided by analysis of the projects funded by the Marató de TV3, which seems to have little interest in funding research on health inequalities. However, both the scientific production and project financing on health inequalities have increased in the last decade. Finally, to advance research on health inequalities and its contribution to the incorporation of health in all policies, recommendations are made, which include redefining priorities, ensuring resources and promoting knowledge translation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Health system strengthening in Cambodia-a case study of health policy response to social transition.

    Science.gov (United States)

    Grundy, John; Khut, Qiu Yi; Oum, Sophal; Annear, Peter; Ky, Veng

    2009-10-01

    Cambodia, following decades of civil conflict and social and economic transition, has in the last 10 years developed health policy innovations in the areas of health contracting, health financing and health planning. This paper aims to outline recent social, epidemiological and demographic health trends in Cambodia, and on the basis of this outline, to analyse and discuss these policy responses to social transition. Sources of information included a literature review, participant observation in health planning development in Cambodia between 1993 and 2008, and comparative analysis of demographic health surveys between 2000 and 2005. In Cambodia there have been sharp but unequal improvements in child mortality, and persisting high maternal mortality rates. Data analysis demonstrates associations between location, education level and access to facility based care, suggesting the dominant role of socio-economic factors in determining access to facility based health care. These events are taking place against a background of rapid social transition in Cambodian history, including processes of decentralization, privatization and the development of open market economic systems. Primary policy responses of the Ministry of Health to social transition and associated health inequities include the establishment of health contracting, hospital health equity funds and public-private collaborations. Despite the internationally recognized health policy flexibility and innovation demonstrated in Cambodia, policy response still lags well behind the reality of social transition. In order to minimize the delay between transition and response, new policy making tactics are required in order to provide more flexible and timely responses to the ongoing social transition and its impacts on population health needs in the lowest socio-economic quintiles.

  4. Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam

    Directory of Open Access Journals (Sweden)

    Bui Thi Thu Ha

    2015-11-01

    Full Text Available Background Maternal health remains a central policy concern in Vietnam. With a commitment to achieving the Millennium Development Goal (MDG 5 target of maternal mortality rate (MMR of 70/100 000 by 2015, the Ministry of Health (MoH issued the National Plan for Safe Motherhood (NPSM 2003-2010. In 2008, reproductive health, including safe motherhood (SM became a national health target program with annual government funding. Methods A case study of how SM emerged as a political priority in Vietnam over the period 2001-2008, drawing on Kingdon’s theory of agenda-setting was conducted. A mixed method was adopted for this study of the NPSM. Results Three related streams contributed to SM priority in Vietnam: (1 the problem of high MMR was officially recognized from high-quality research, (2 the strong roles of policy champion from MoH in advocating for the needs to reducing MMR as well as support from government and donors, and (3 the national and international events, providing favorable context for this issue to emerge on policy agenda. Conclusion This paper draws on the theory of agenda-setting to analyze the Vietnam experience and to develop guidance for SM a political priority in other high maternal mortality communities.

  5. Advanced health biotechnologies in Thailand: redefining policy directions.

    Science.gov (United States)

    Velasco, Román Pérez; Chaikledkaew, Usa; Myint, Chaw Yin; Khampang, Roongnapa; Tantivess, Sripen; Teerawattananon, Yot

    2013-01-02

    Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these-such as diabetes, cancer, and inherited inborn metabolic diseases-have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D), and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E). The establishment of a specialised institution to fill the gaps in this area is warranted. The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.

  6. Advanced health biotechnologies in Thailand: redefining policy directions

    Directory of Open Access Journals (Sweden)

    Velasco Román Pérez

    2013-01-01

    Full Text Available Abstract Background Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Methods Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Results Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D, and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E. The establishment of a specialised institution to fill the gaps in this area is warranted. Conclusion The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.

  7. Women's perspectives on the ethical implications of non-invasive prenatal testing: a qualitative analysis to inform health policy decisions.

    Science.gov (United States)

    Vanstone, Meredith; Cernat, Alexandra; Nisker, Jeff; Schwartz, Lisa

    2018-04-16

    Non-Invasive Prenatal Testing (NIPT) is a technology which provides information about fetal genetic characteristics (including sex) very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women's social and ethical values. We approach the need for ethical policy-making by studying the use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area.

  8. Examination of disparity in access to mental health services among people living with HIV and comorbid depression in Ontario

    DEFF Research Database (Denmark)

    Choi, Stephanie; Boyle, Eleanor; Cairney, John

    2014-01-01

    respectively during a year followed by the baseline. For those who were depressed, we found that non-English speakers were two times less likely (OR:0.48;95%CI:0.31-0.77) to use of primary mental health services and were having 37%(IRR:0.63;95%CI:0.42-0.98) fewer encounters when compared to their English...... on the Center for Epidemiologic Studies Depression Scale(Scores> ) or the Kessler Psychological Distress Scale(Scores>=23). The use of primary and specialty mental health services was measured during the 12 months followed by the assessment at the baseline. Logistic and Negative binominal regression models were...... speaking counterparts. For accessing specialist care, we found that those who were identified as homosexual/gay, non-English speakers, immigrants, having low income and residing in rural area were two times less likely to use these services. However, being a homosexual/gay, being an immigrant, and having...

  9. Paradigmatic obstacles to improving the health of populations: implications for health policy

    Directory of Open Access Journals (Sweden)

    McKinlay John B.

    1998-01-01

    Full Text Available While there are promising developments in public health, most interventions (both at the individual and community levels remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy -what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect -appropriate unto the intervention level must be the evaluation method thereof.

  10. 42 CFR 100.2 - Average cost of a health insurance policy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2... VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining..., less certain deductions. One of the deductions is the average cost of a health insurance policy, as...

  11. [Policy analysis: study of public policy of environmental health in a metropolis of northeastern Brazil].

    Science.gov (United States)

    Lyra, Tereza Maciel; Araújo Júnior, José Luiz do Amaral Correa de

    2014-09-01

    The analysis of health policies has improved in Brazil despite a plethora of different methodological approaches. Based on the model developed by Walt and Gilson in 1994, the Environmental Health Program (EHP) of Recife as a policy based on the Health Promotion principles of the Unified Health System (SUS) and Agenda 21 was analyzed. An attempt was made to understand the context during the development and implementation of the EHP, the drafting process and which actors influenced the EHP agenda content and proposal. A qualitative case study was conducted, with semi-structured interviews with key actors. In terms of context, the findings include the influence of the municipal election, the socio-sanitary characteristics of Recife, the choice of the Secretary of Health and the management teams, acceptance by the technicians and the funding increase. In terms of the process, the acceptance of the managers must be stressed. Regarding the actors, the managers, sector technicians, non-sectorial actors with viability studies stood out. The content of the EHP coincided with the SUS and Health Promotion principles. Implementation was influenced by the dengue fever epidemic (2002), and cultural institutional factors that put pressure on the order of implementation of the planned actions.

  12. Trade liberalization, social policies and health: an empirical case study.

    Science.gov (United States)

    McNamara, Courtney

    2015-10-12

    This study investigates the health impacts of a major liberalization episode in the textile and clothing (T&C) sector. This episode triggered substantial shifts in employment across a wide range of countries. It is the first study to empirically link trade liberalization to health via changes in employment and offers some of the first empirical insights on how trade liberalization interacts with social policies to influence health. Data from 32 T&C reliant countries were analysed in reference to the pre- and post-liberalization periods of 2000-2004 and 2005-2009. Fuzzy-set qualitative comparative analysis (fsQCA) was used to examine the association between countries' a) level of development b) labour market and welfare state protections c) T&C employment changes and d) changes in adult female and infant mortality rates. Process tracing was used to further investigate these associations through twelve in-depth country studies. Results from the fsQCA relate changes in employment after the phase-out to both changing adult female and infant mortality rates. Findings from the in-depth country studies suggest that the worsening of adult female mortality rates is related to workers' lack of social protection, both in the context of T&C employment growth and loss. Overall, it is found that social protection is often inaccessible to the type of workers who may be the most vulnerable to processes of liberalization and that many workers are particularly vulnerable due to the structure of social protection policies. Social policies are therefore found to both moderate pathways to health and influence the type of health-related pathways resulting from trade liberalizing policies.

  13. Measuring efficiency in health care: analytic techniques and health policy

    National Research Council Canada - National Science Library

    Smith, Peter C; Street, Andrew; Jacobs, Rowena

    2006-01-01

    ... the efficiency of systems and organisations, including data envelopment analysis and stochastic frontier analysis, and also presents some promising new methodological approaches. Such techniques offer the prospect of many new and fruitful insights into health care performance. Nevertheless, they also pose many practical and methodological c...

  14. The influence of cholinesterase inhibitor therapy for dementia on risk of cardiac pacemaker insertion: a retrospective, population-based, health administrative databases study in Ontario, Canada.

    Science.gov (United States)

    Huang, Allen R; Redpath, Calum J; van Walraven, Carl

    2015-04-28

    Cholinesterase inhibitors are used to treat the symptoms of dementia and can theoretically cause bradycardia. Previous studies suggest that patients taking these medications have an increased risk of undergoing pacemaker insertion. Since these drugs have a marginal impact on patient outcomes, it might be preferable to change drug treatment rather than implant a pacemaker. This population-based study determined the association of people with dementia exposed to cholinesterase inhibitor medication and pacemaker insertion. We used data from the Ontario health administrative databases from January 1, 1993 to June 30, 2012. We included all community-dwelling seniors who had a code for dementia and were exposed to cholinesterase inhibitors (donezepil, galantamine, and rivastigmine) and/or drugs used to treat co-morbidities of hypertension, diabetes, depression and hypothyroidism. We controlled for exposure to anti-arrhythmic drugs. Observation started at first exposure to any medication and continued until the earliest of pacemaker insertion, death, or end of study. 2,353,909 people were included with 96,000 (4.1%) undergoing pacemaker insertion during the observation period. Case-control analysis showed that pacemaker patients were less likely to be coded with dementia (unadjusted OR 0.42 [95%CI 0.41-0.42]) or exposed to cholinesterase inhibitors (unadjusted OR 0.39 [95%CI 0.37-0.41]). That Cohort analysis showed patients with dementia taking cholinesterase inhibitors had a decreased risk of pacemaker insertion (unadj-HR 0.58 [0.55-0.61]). Adjustment for patient age, sex, and other medications did not notably change results, as did restricting the analysis to incident users. Patients taking cholinesterase inhibitors rarely undergo, and have a significantly reduced risk of, cardiac pacemaker insertion.

  15. Health promotion in Danish schools: local priorities, policies and practices.

    Science.gov (United States)

    Simovska, Venka; Nordin, Lone Lindegaard; Madsen, Katrine Dahl

    2016-06-01

    This article discusses the findings from a study mapping out the priorities, policies and practices of local authorities concerning health promotion (HP) and health education (HE) in primary and lower secondary schools in Denmark. The aim of the study was to identify the gaps, tensions and possibilities associated with the demand to increase the quality and effectiveness of HP in schools. The recent national school reform, which emphasizes the importance of health and well-being while simultaneously increasing the focus on performance and accountability in terms of subject proficiency and narrowly defined academic attainment, provides the broader political context for the study. Data were generated through a structured online survey administered to all 98 Danish municipalities. Respondents were educational consultants or others representing the administrative units responsible for the municipality's schools. The findings were discussed within the conceptual framework of Health Promoting Schools. The study points to a potential tension between the health and education sectors, despite evidence of intersectoral collaboration. While there is a strong policy focus on health and well-being in schools, it is disconnected from the utilization of the HE curriculum by the municipal consultants. The study also points to a lack of professional development opportunities for teachers in the field of HP in schools. On the basis of these findings and theoretical perspectives used, we argue that HP in schools needs to (re)connect with the core task of the school, education, and to integrate both health and education goals in local priorities, policies and practices. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Managing Madness: Mental Health and Complexity in Public Policy

    Directory of Open Access Journals (Sweden)

    Ian Hickie

    2013-09-01

    Full Text Available This paper explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that

  17. Deregulation experiences in Alberta and Ontario

    International Nuclear Information System (INIS)

    Axford, D.

    2003-01-01

    A brief introduction of Nexen Chemicals, one of the largest producers of sodium chlorate in the world, was offered, and a map displaying its locations throughout the world was displayed. Nexen is one of Canada's largest independent oil and gas producers, while Nexen Marketing is involved in the marketing of natural gas in North America. In January 2001, the deregulated market opened in Alberta. High natural gas prices, generation shortages, high prices in California and an upcoming provincial election all combined to complicate the situation. A high degree of volatility characterized the market. A chart displaying weekly average Alberta power and gas prices from Jan 2002 to 13 Oct 2002 was shown. In Ontario, the market opened in May 2002, and the demand growth rate was in the 1 to 2 per cent range. The author indicated that approximately 20 per cent of homeowners in Ontario have signed deals with retailers, contrary to Alberta where very few have done so. A similar chart displaying weekly average Ontario power prices was presented. The issues in Ontario are: consistency in policy, increase market transparency, transmission / distribution price flexibility, overall transmission / distribution to industrial consumers high, and increasing costs of the system operator. In Alberta, the issues are: government intent, congestion management issues, and billing settlement errors that continue. The opportunities offered by a deregulated market include process responsiveness which is rewarded, the ability to look in forward prices when prices fit margin requirement, and gives companies the opportunity to participate in the development of the market. Various charts were also displayed to further illustrate the market in both Alberta and Ontario. figs

  18. National health insurance policy in Nepal: challenges for implementation

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-08-01

    Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  19. [The dialogues between anthropology and health: contributions to public policies].

    Science.gov (United States)

    Langdon, Esther Jean

    2014-04-01

    In order to examine the development of anthropological paradigms and their dialogue with medicine, I divide the discussion into two general, but non-exclusive, approaches: one that focuses on health and disease as social and cultural experience and construction, and another that examines health from an interactional and political perspective. For the first approach, I focus on North American and French theories that find resonance in the anthropological dialogue in Brazil. For the second political approach, the discussion originates in the dialogue among anthropologists in Latin America who have been developing models to contribute to an interdisciplinary approach necessary for health policies and intervention in health. The concepts of practices in self-care and intermedicality, among others, are explored due to their contribution in anthropology to public policies in health. These anthropologists have argued that health practices should be understood through the notions of autonomy, collectivity, agency and praxis, as opposed to the notions of the biomedical perspective characterized as being universalist, biological, individualist and a-historical.

  20. Financing national policy on oral health in Brazil in the context of the Unified Health System

    Directory of Open Access Journals (Sweden)

    Gilberto Alfredo Pucca Junior

    2010-01-01

    Full Text Available This article discusses the model of oral health care implemented in the Unified Health System of Brazil in the last decade. This model was conceived as a sub-sector policy that, over the years, has sought to improve the quality of life of the Brazilian population. Through a chronological line, the study presents the National Policy on Oral Health as a counter-hegemonic patient care model for the dentistry practices existing in the country before this policy was implemented. The reorganization of the levels of oral health care, the creation of reference facilities for secondary and tertiary care, through Centers of Dental Specialties and Regional Dental Prosthesis Laboratories, and the differential funding and decentralized management of financial resources were able to expand the actions of oral health for more than 90 million inhabitants. The evolution shown after the deployment of the National Oral Health Policy, as of 2004, demonstrates the greater integration of oral health care under the Unified Health System and provides feedback information to help this policy to continue to be prioritized by the Federal Government and receive more support from the state and local levels in the coming years.

  1. Australian Government health advisory groups and health policy: seeking a horse, finding a camel.

    Science.gov (United States)

    Russell, Lesley M; Boxall, Anne-Marie; Leeder, Stephen R

    2008-11-17

    Since its election, the Rudd Labor Government has created 10 new advisory bodies in the health portfolio, in addition to the 100 or more that were already established. An expansive and devolved advisory system could improve the health policy-making process, but only if it is integrated into the processes of government. We outline eight simple and practical measures that, if implemented, would make Australia's health advisory system more transparent and effective. Past experience shows that the most important factor governing the impact of health policy advisory bodies is political leadership.

  2. Information Flow and Health Policy Literacy: The Role of the Media

    Directory of Open Access Journals (Sweden)

    Sophya Yumakulov

    2012-08-01

    Full Text Available People increasingly can and want to obtain and generate health information themselves. With the increasing do-it-yourself sentiment comes also the desire to be more involved in one’s health care decisions. Patient driven health-care and health research models are emerging; terms such as participatory medicine and quantified-self are visible increasingly. Given the health consumer’s desire to be more involved in health data generation and health care decision making processes the authors submit that it is important to be health policy literate, to understanding how health policies are developed, what themes are discussed among health policy researchers and policy makers, to understand how ones demands would be discussed within health policy discourses. The public increasingly obtains their knowledge through the internet by searching web browsers for keywords. Question is whether the “health consumer” to come has knowledge of key terms defining key health policy discourses which would enable them to perform targeted searches for health policy literature relevant to their situation. The authors found that key health policy terms are virtually absent from printed and online news media which begs the question how the “health consumer” might learn about key health policy terms needed for web based searches that would allow the “health consumer” to access health policy discourses relevant to them.

  3. Policy Entrepreneurs and the Design of Public Policy: The Case of the National Health Insurance Law in Israel

    Directory of Open Access Journals (Sweden)

    NISSIM COHEN

    2012-07-01

    Full Text Available How do policy entrepreneurs implement in practice the things theory suggests they should do? This article suggests various insightsinto the influence of policy entrepreneurs on the formulation of public policy. Using a broad definition of the concept of policyentrepreneur, the article identifies the main characteristics of entrepreneurial activities, describes various strategies that the policyentrepreneur may employ, and develops a model of successful and effective policy entrepreneurship. Using an analysis of the designof the Israel National Health Law of 1994 as a case study, the article emphasizes the importance of policy entrepreneurs in thepublic policy arena and provides several insights into the conditions for their activity, their motivations and main strategies.

  4. Learning from games: Stakeholders’ experiences involved in local health policy

    DEFF Research Database (Denmark)

    Spitters, Hilde; van de Goor, Ien; Juel Lau, Cathrine

    2018-01-01

    Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a ‘policy game’. The focus on specific problems facilitates relationships between...... the stakeholders and stimulates cross-sectoral policymaking. The present study explores stakeholders’ learning experiences with respect to the collaboration process in public health policymaking. This was achieved via their game participation, carried out in real-life stakeholder networks in the Netherlands...... the collaboration processes in local policymaking. Specific learning experiences were related to: (i) the stakeholder network, (ii) interaction and (iii) relationships. The game also increased participant’s understanding of group dynamics and need for a coordinator in policymaking. This exploratory study shows...

  5. The short-term impact of Ontario's generic pricing reforms.

    Directory of Open Access Journals (Sweden)

    Michael R Law

    Full Text Available Canadians pay amongst the highest generic drug prices in the world. In July 2010, the province of Ontario enacted a policy that halved reimbursement for generic drugs from the public drug plan, and substantially lowered prices for private purchases. We quantified the impact of this policy on overall generic drug expenditures in the province, and projected the impact in other provinces had they mimicked this pricing change.We used quarterly prescription generic drug dispensing data from the IMS-Brogan CompuScript Audit. We used the price per unit in both the pre- and post-policy period and two economics price indexes to estimate the expenditure reduction in Ontario. Further, we used the post-policy Ontario prices to estimate the potential reduction in other provinces.We estimate that total expenditure on generic drugs in Ontario during the second half of 2010 was between $181 and $194 million below what would be expected if prices had remained at pre-policy level. Over half of the reduction in spending was due to savings on just 10 generic ingredients. If other provinces had matched Ontario's prices, their expenditures over during the latter half of 2010 would have been $445 million lower.We found that if Ontario's pricing scheme were adopted nationally, overall spending on generic drugs in Canada would drop at least $1.28 billion annually--a 5% decrease in total prescription drug expenditure. Other provinces should seriously consider both changes to their generic drug prices and the use of more competitive bulk purchasing policies.

  6. Increasing Incidence and Prevalence of World Health Organization Groups 1 to 4 Pulmonary Hypertension: A Population-Based Cohort Study in Ontario, Canada.

    Science.gov (United States)

    Wijeratne, D Thiwanka; Lajkosz, Katherine; Brogly, Susan B; Lougheed, M Diane; Jiang, Li; Housin, Ahmad; Barber, David; Johnson, Ana; Doliszny, Katharine M; Archer, Stephen L

    2018-02-01

    The World Health Organization recognizes 5 groups of pulmonary hypertension (PH), categorized by pathogenesis or comorbidity: 1-pulmonary arterial hypertension 2-left-heart disease, 3-lung disease and hypoxia 4-chronic thromboembolic disease, and 5-miscellaneous. The epidemiology of PH, apart from group 1, is largely unknown. We describe incidence, prevalence, comorbidities, mortality and prescribing patterns for groups 1 to 4 PH from 1993 to 2012. Case definitions are based on hospitalizations and emergency department visits, using the Institute for Clinical Evaluative Sciences data, which comprises linked databases of universal coverage health service records for Ontario residents. This cohort included 50 529 patients with PH. The annual incidence of adult PH increased from 2003 to 2012 from 24.1 to 28.7 cases/100 000 population and the annual prevalence from 1993 to 2012 from 99.8 to 127.3 cases/100 000 population, respectively. The most common form of adult PH was group 2, alone (34.2%) or combined with group 3 PH (29.3%). A diagnosis of PH increased the 1-year standardized mortality ratio 7.2-fold. Mortality in adults with PH was 13.0%, 36.4%, and 62.4%, at 30 days, 1 year, and 5 years, respectively. Mortality was highest in groups 2 and 3 and lowest in group 1. PH was present in only 3.6% of people with left heart disease, 0.7% with lung disease, and 1.4% with thromboembolic disease, suggesting that PH is a relatively rare complication of these common diseases. Children (age<16 years) accounted for 3.6% of the cohort. In children group 1 PH was most common (65.2%), and 5-year mortality was lower (21.4%) than in adults. Group 1-specific PH therapies were increasingly prescribed over time and paradoxically were often used in patients who seemed to have group 2, PH based on diagnostic codes indicating left heart disease. The incidence and prevalence of adult PH are increasing. Groups 2 and 3 are the most common and lethal forms of PH. This study identifies an

  7. Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development.

    Science.gov (United States)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-08-12

    Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group's involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could

  8. Domestic violence against women, public policies and community health workers in Brazilian Primary Health Care.

    Science.gov (United States)

    Signorelli, Marcos Claudio; Taft, Angela; Pereira, Pedro Paulo Gomes

    2018-01-01

    Domestic violence creates multiple harms for women's health and is a 'wicked problem' for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe; 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system.

  9. Big Data: transforming drug development and health policy decision making.

    Science.gov (United States)

    Alemayehu, Demissie; Berger, Marc L

    The explosion of data sources, accompanied by the evolution of technology and analytical techniques, has created considerable challenges and opportunities for drug development and healthcare resource utilization. We present a systematic overview these phenomena, and suggest measures to be taken for effective integration of the new developments in the traditional medical research paradigm and health policy decision making. Special attention is paid to pertinent issues in emerging areas, including rare disease drug development, personalized medicine, Comparative Effectiveness Research, and privacy and confidentiality concerns.

  10. A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

    Science.gov (United States)

    Silveira, Jose; Mckenzie, Kwame

    2016-01-01

    Background: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. Method: A qualitative pilot study using semi-structured interviews with thematic analysis. Results: Participants identified 10 themes of incentives and disincentives influencing quality treatment of CMDs in a collaborative primary care setting: high service demands, clinical presentation, patient-centred care, patient attributes, education, physician attributes, organizational, access to mental health resources, psychiatry and physician payment model. Conclusion: An understanding of the incentives and disincentives influencing care is essential to achieve greater integration and capacity for care for the treatment of CMDs in primary care. PMID:27585029

  11. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting.

    Science.gov (United States)

    Bloomrosen, Meryl; Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

    2011-01-01

    Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input-output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies.

  12. European health inequality through the 'Great Recession': social policy matters.

    Science.gov (United States)

    van der Wel, Kjetil A; Saltkjel, Therese; Chen, Wen-Hao; Dahl, Espen; Halvorsen, Knut

    2018-05-01

    This paper investigates the association between the Great Recession and educational inequalities in self-rated general health in 25 European countries. We investigate four different indicators related to economic recession: GDP; unemployment; austerity and a 'crisis' indicator signifying severe simultaneous drops in GDP and welfare generosity. We also assess the extent to which health inequality changes can be attributed to changes in the economic conditions and social capital in the European populations. The paper uses data from the European Social Survey (2002-2014). The analyses include both cross-sectional and lagged associations using multilevel linear regression models with country fixed effects. This approach allows us to identify health inequality changes net of all time-invariant differences between countries. GDP drops and increasing unemployment were associated with decreasing health inequalities. Austerity, however, was related to increasing health inequalities, an association that grew stronger with time. The strongest increase in health inequality was found for the more robust 'crisis' indicator. Changes in trust, social relationships and in the experience of economic hardship of the populations accounted for much of the increase in health inequality. The paper concludes that social policy has an important role in the development of health inequalities, particularly during times of economic crisis. © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  13. Commentary: Moving towards policy coherence in trade and health.

    Science.gov (United States)

    Walls, Helen; Baker, Phillip; Smith, Richard

    2015-11-01

    International trade has brought economic benefits to many countries, but the association of trade and investment liberalisation with poor health outcomes concerns the public health community. The need to secure more 'healthy' trade is a recognised priority, especially as countries move from global to regional/bilateral trade agreements - with greater public health risks. However, a transition towards 'healthier trade' may be hindered by worldview differences between the trade and health communities. There is a tendency for health actors to perceive trade as a threat to population health, and for trade actors to view health as a constraint to trade objectives of reducing barriers to cross-border commercial flows and economic growth. Unless such differing worldviews can be aligned, finding ways forward for addressing public health in trade policy is likely to be difficult. Moving forward will involve understanding the values and drivers of the respective groups, and developing solutions palatable to their various interests. Given the power imbalances between the two areas, it is likely that the health community will have to make the first moves in this respect. This article outlines the key issues involved and suggests areas where such moves have been, and may be made.

  14. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull 2007; 6(6.000: 501-514

  15. Health Manpower Planning and Employment Policies for Turkey

    Directory of Open Access Journals (Sweden)

    Bulent Kilic

    2007-12-01

    Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull. 2007; 6(6: 501-514

  16. The health-promoting nurse as a health policy career expert and entrepreneur.

    Science.gov (United States)

    Whitehead, Dean

    2003-11-01

    A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.

  17. Colombian drugs policy. The dose for personal and health rights

    Directory of Open Access Journals (Sweden)

    Juan Camilo Fischer Rodríguez

    2013-07-01

    Full Text Available This article is a review of Colombian law on drugs, with special emphasis on the so-called dose for personal and health rights that relate to the use of legal or illegal drugs. A brief contextualization of international treaties on drugs is presented, as well as presenting some cases representing the current debate on trade control measures and use of illegal drugs. The article argues that in the international and Colombian debate there are no homogeneous positions, and the repressive policies towards illegal drug use coexist with approaches from the public health that point to the recognition of the rights of people who use legal or illegal substances.

  18. Determinants of evidence use in Public Health Policy making

    DEFF Research Database (Denmark)

    van de Goor, Ien; Hämäläinen, Riitta-Maija; Syed, Ahmed

    2017-01-01

    The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities...... evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users' characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable...

  19. The ecology of work and health: Research and policy directions for the promotion of employee health

    OpenAIRE

    Stokols, D; Pelletier, KR; Fielding, JE

    1996-01-01

    This article identifies new research and policy directions for the field of worksite health in the context of the changing American workplace. These directions are viewed from an ecological perspective on worksite health and are organized around three major themes: (1) the joint influence of physical and social environmental factors on occupational health, (2) the effects of nonoccupational settings (e.g., households, the health care system) on employee well-being and the implications of rece...

  20. Knowledge integration in One Health policy formulation, implementation and evaluation.

    Science.gov (United States)

    Hitziger, Martin; Esposito, Roberto; Canali, Massimo; Aragrande, Maurizio; Häsler, Barbara; Rüegg, Simon R

    2018-03-01

    The One Health concept covers the interrelationship between human, animal and environmental health and requires multistakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multicriteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, we propose that knowledge integration becomes a key feature of all stages in the development of related policies. We suggest several ways in which such integration could be promoted.

  1. Assessing the privacy policies in mobile personal health records.

    Science.gov (United States)

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs.

  2. Communicating contentious health policy: lessons from Ireland's workplace smoking ban.

    Science.gov (United States)

    Fahy, Declan; Trench, Brian; Clancy, Luke

    2012-05-01

    The Irish workplace smoking ban has been described as possibly a tipping point for public health worldwide. This article presents the first analysis of the newspaper coverage of the ban over the duration of the policy formation process. It adds to previous studies by analyzing how health communication strategists engaged, over time, with a newsworthy topic, viewed as being culturally controversial. It analyzes a sample of media content (n = 1,154) and firsthand accounts from pro-ban campaigners and journalists (n = 10). The analysis shows that the ban was covered not primarily as a health issue: Economic, political, social, democratic, and technical aspects also received significant attention. It shows how coverage followed controversy and examines how pro-ban campaigners countered effectively the anti-ban communication efforts of influential social actors in the economic and political spheres. The analysis demonstrates that medical-political sources successfully defined the ban's issues as centrally concerned with public health.

  3. Public health terminology: Hindrance to a Health in All Policies approach?

    Science.gov (United States)

    Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

    2018-02-01

    National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

  4. Challenges and opportunities for policy decisions to address health equity in developing health systems: case study of the policy processes in the Indian state of Orissa

    Directory of Open Access Journals (Sweden)

    Gopalan Saji S

    2011-11-01

    Full Text Available Abstract Introduction Achieving health equity is a pertinent need of the developing health systems. Though policy process is crucial for planning and attaining health equity, the existing evidences on policy processes are scanty in this regard. This article explores the magnitude, determinants, challenges and prospects of 'health equity approach' in various health policy processes in the Indian State of Orissa - a setting comparable with many other developing health systems. Methods A case-study involving 'Walt-Gilson Policy Triangle' employed key-informant interviews and documentary reviews. Key informants (n = 34 were selected from the departments of Health and Family Welfare, Rural Development, and Women and Child Welfare, and civil societies. The documentary reviews involved various published and unpublished reports, policy pronouncements and articles on health equity in Orissa and similar settings. Results The 'health policy agenda' of Orissa was centered on 'health equity' envisaging affordable and equitable healthcare to all, integrated with public health interventions. However, the subsequent stages of policy process such as 'development, implementation and evaluation' experienced leakage in the equity approach. The impediment for a comprehensive approach towards health equity was the nexus among the national and state health priorities; role, agenda and capacity of actors involved; and existing constraints of the healthcare delivery system. Conclusion The health equity approach of policy processes was incomprehensive, often inadequately coordinated, and largely ignored the right blend of socio-medical determinants. A multi-sectoral, unified and integrated approach is required with technical, financial and managerial resources from different actors for a comprehensive 'health equity approach'. If carefully geared, the ongoing health sector reforms centered on sector-wide approaches, decentralization, communitization and involvement of