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Sample records for university health population

  1. Dissemination research: the University of Wisconsin Population Health Institute.

    Science.gov (United States)

    Remington, Patrick L; Moberg, D Paul; Booske, Bridget C; Ceraso, Marion; Friedsam, Donna; Kindig, David A

    2009-08-01

    Despite significant accomplishments in basic, clinical, and population health research, a wide gap persists between research discoveries (ie, what we know) and actual practice (ie, what we do). The University of Wisconsin Population Health Institute (Institute) researchers study the process and outcomes of disseminating evidence-based public health programs and policies into practice. This paper briefly describes the approach and experience of the Institute's programs in population health assessment, health policy, program evaluation, and education and training. An essential component of this dissemination research program is the active engagement of the practitioners and policymakers. Each of the Institute's programs conducts data collection, analysis, education, and dialogue with practitioners that is closely tied to the planning, implementation, and evaluation of programs and policies. Our approach involves a reciprocal exchange of knowledge with non-academic partners, such that research informs practice and practice informs research. Dissemination research serves an important role along the continuum of research and is increasingly recognized as an important way to improve population health by accelerating the translation of research into practice.

  2. Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

    Science.gov (United States)

    Nandi, Arijit; Loue, Sana; Galea, Sandro

    2009-12-01

    As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

  3. Population Consultation: A Powerful Means to Ensure that Health Strategies are Oriented Towards Universal Health Coverage.

    Science.gov (United States)

    Rohrer, Katja; Rajan, Dheepa; Schmets, Gerard

    2017-01-01

    We seek to highlight why population consultations need to be promoted more strongly as a powerful means to move health reforms towards Universal Health Coverage (UHC). However, despite this increasing recognition that the "population" is the key factor of successful health planning and high-quality service delivery, there has been very little systematic reflection and only limited (international) attention brought to the idea of specifically consulting the population to improve the quality and soundness of health policies and strategies and to strengthen the national health planning process and implementation. So far, research has done little to assess the significance of population consultations for the health sector and its importance for strategic planning and implementation processes; in addition, there has been insufficient evaluation of population consultations in the health sector or health-related areas. We drew on ongoing programmatic work of World Health Organization (WHO) offices worldwide, as most population consultations are not well-documented. In addition, we analyzed any existing documentation available on population consultations in health. We then elaborate on the potential benefits of bringing the population's voice into national health planning. We briefly mention the key methods used for population consultations, and we put forward recent country examples showing that population consultation is an effective way of assessing the population's needs and expectations, and should be more widely used in strategizing health. Giving the voice to the population is a means to strengthen accountability, to reinforce the commitment of policy makers, decision-makers and influencers (media, political parties, academics, etc.) to the health policy objectives of UHC, and, in the specific case of donor-dependent countries, to sensitize donors' engagement and alignment with national health strategies. The consequence of the current low international interest for

  4. The impact of universal National Health Insurance on population health: the experience of Taiwan

    Directory of Open Access Journals (Sweden)

    Kuo Ken N

    2010-08-01

    Full Text Available Abstract Background Taiwan established a system of universal National Health Insurance (NHI in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of coverage will almost inevitably have improved access to health care, however, it cannot be assumed that it will necessarily have improved the health of the population. The aim of this study was to determine whether the introduction of National Health Insurance (NHI in Taiwan in 1995 was associated with a change in deaths from causes amenable to health care. Methods Identification of discontinuities in trends in mortality considered amenable to health care and all other conditions (non-amenable mortality using joinpoint regression analysis from 1981 to 2005. Results Deaths from amenable causes declined between 1981 and 1993 but slowed between 1993 and 1996. Once NHI was implemented, the decline accelerated significantly, falling at 5.83% per year between 1996 and 1999. In contrast, there was little change in non-amenable causes (0.64% per year between 1981 and 1999. The effect of NHI was highest among the young and old, and lowest among those of working age, consistent with changes in the pattern of coverage. NHI was associated with substantial reductions in deaths from circulatory disorders and, for men, infections, whilst an earlier upward trend in female cancer deaths was reversed. Conclusions NHI was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously.

  5. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

    Science.gov (United States)

    Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

    2010-01-01

    Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

  6. [Food habits and health-related behaviors in a university population].

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    Sánchez Socarrás, Violeida; Aguilar Martínez, Alicia

    2014-09-18

    The university population is considered a particularly vulnerable group from the nutritional point of view as it begins to take responsibility for their food and going through a critical period in the consolidation of habits and food-related behaviors. Previous studies highlight the loss of healthy dietary patterns and the need to develop educational and nutritional interventions. To analyze habits and food-related behaviors in a university population in Catalonia as a starting point to develop effective strategies for health promotion. Cross-sectional observational study of dietary habits and food-related behaviors (alcohol, tobacco and physical activity) in Catalan university students. Lunch and dinner at home were the essential meals of the surveyed students while breakfast and afternoon snack were omitted about 20% of cases. The obtained dietary pattern was characterized by an excessive consumption of red meat (84%) and poor or very poor consumption of vegetables (39.8%), cereals (92.6%) and fruit (73.9%). The consumption of alcohol was low, and the most consumed beverage was beer. The majority of students reported not being regular smokers. Among regular smokers predominated women. Alcohol consumption was also low and beer was the most consumed beverage. A considerable number of students were used to performing moderate or intense physical activity three or more times a week, although a similar proportion not perform any physical activity regularly. In the studied population, food habits that deviate from the recommendations of the Mediterranean Diet are detected in a large number of students: low consumption of fruits and vegetables, increased consumption of dairy products and a predominance in the consumption of red meat in front of poultry. These changes are in line with those that occurred in recent years in Spain and in other industrialized countries. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  7. The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy.

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    Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri

    2015-11-01

    This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Universal health coverage in the context of population ageing: What determines health insurance enrolment in rural Ghana?

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    Van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane

    2018-05-24

    Population ageing presents considerable challenges for the attainment of universal health coverage (UHC), especially in countries where such coverage is still in its infancy. Ghana presents an important case study on the effectiveness of policies aimed at achieving UHC in the context of population ageing in low and middle-income countries. It has witnessed a profound recent demographic transition, including a large increase in the number of older adults, which coincided with the development and implementation of a National Health Insurance Scheme (NHIS), designed to help achieve UHC. The objective of this paper is to examine the community, household and individual level determinants of NHIS enrolment among older adults aged 50-69 and 70 plus. The latter are exempt from NHIS premium payments. Using the Ghanaian Living Standards Survey from 2012 to 2013, determinants of NHIS enrolment for individuals aged 50-69 and 70 plus living in rural Ghana are examined through the application of multilevel regression analysis. Previous studies have mainly focused on the enrolment of young and middle aged adults and considered mainly demographic and socio-economic factors. The novel inclusion of spatial barriers within this analysis demonstrates that levels of NHIS enrolment are determined in part by the community provision of healthcare facilities. In addition, the findings imply that insurance enrolment increases with household expenditure even for those aged 70 plus who are exempt from the NHIS premium payment. Adequate and appropriate infrastructure as well as health insurance is vital to ensure movement to UHC in low and middle income countries. Overall, the results confirm that there remain significant inequalities in enrolment by expenditure quintile that future policy reform will need to address.

  9. Sexual health literacy of the student population of the University of Tasmania: results of the RUSSL Study.

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    Simpson, Steve; Clifford, Christine; Ross, Kaz; Sefton, Neil; Owen, Louise; Blizzard, Leigh; Turner, Richard

    2015-06-01

    Background Evidence suggests a varied level of sexual health literacy (SHL) among university student populations, so we evaluated the SHL among students at the University of Tasmania. Students were invited to complete an anonymous online questionnaire during August/September 2013. SHL was assessed using the ARCSHS National Survey of Australian Secondary Students & Sexual Health (ARC) and the Sexual Health Questionnaire (SHS). Predictors of literacy scores were evaluated by linear regression. The study recruited 1786 participants (8.2% of 2013 student population), of similar composition to the general university population. Female sex, older age, sexual education, and sexual experience were significant predictors of SHL. As hypothesised, students in medical/nursing disciplines had the highest SHL. Less expected were the significant differences by birthplace and religious affiliation, many of which persisted on adjustment for confounders. Compared with Australian/New Zealander students, overseas-born students had significantly lower ARC (-3.6%, Patheist-identifying students, those of Buddhist (ARC: -5.4%, P=0.014; SHS: -6.7%, P=0.002), Hindu (ARC: -8.8%, P=0.098; SHS: -12.2%, P=0.027), Muslim (ARC: -16.5%, Preligious affiliation. These findings have applications in orientation and education programs at Australian universities.

  10. The Primary Care Leadership Track at the Duke University School of Medicine: creating change agents to improve population health.

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    Sheline, Barbara; Tran, Anh N; Jackson, Joseph; Peyser, Bruce; Rogers, Susan; Engle, Deborah

    2014-10-01

    Physicians need training in community engagement, leadership, and population health to prepare them to work with partners within the community and to adapt medical care to address population health needs. With an overall goal of training primary care practitioners to be change agents for improving population health, the Duke University School of Medicine launched the Primary Care Leadership Track (PCLT) in 2011. The four-year PCLT curriculum requires students to contribute to existing community health initiatives, perform community-engaged research, and participate in leadership training. The clinical curriculum incorporates a longitudinal approach to allow students to follow patient outcomes. In addition, students regularly interact with faculty to explore population health issues, review patient cases, and adjust individual learning opportunities as needed. The first cohort of PCLT students will graduate in 2015. Prospective comparisons with traditional track students are planned on performance on standardized tests and career choices. The authors created the PCLT as a laboratory in which students can engage with the community and explore solutions to address the health of the public and the future delivery of health care. To meet the goal of training change agents, PCLT leaders need to expand opportunities for students to learn from providers and organizations that are successfully bridging the gap between medical care and public health.

  11. [A lower adherence to Mediterranean diet is associated with a poorer self-rated health in university population].

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    Barrios-Vicedo, Ricardo; Navarrete-Muñoz, Eva Maria; García de la Hera, Manuela; González-Palacios, Sandra; Valera-Gran, Desirée; Checa-Sevilla, José Francisco; Gimenez-Monzo, Daniel; Vioque, Jesús

    2014-09-15

    A higher adherence to Mediterranean diet is considered as a protective factor against the large number of deaths attributable to the main chronic degenerative diseases in developed countries. Self-rated health is established as a good indicator of population health status and as a predictor of mortality. Studies exploring the relationship between the adherence to Mediterranean diet and self-rated health are scarce, especially, in young adults. Our aim was to explore the factors related, specially the adherence to a priori-defined Mediterranean diet with self-rated health in a cohort of Spanish university students. We analyzed data from 1110 participants of Spanish DiSA-UMH (Dieta, Salud y Antropometría en universitarios de la Universidad Miguel Hernández) study. Diet was assessed using a validated food frequency questionnaire and the adherence to Mediterranean diet was calculated using the relative Mediterranean Diet Score (rMED; score range: 0-18) according to the consumption of 9 dietary components. Self-rated health was gathered from the question: "In general, how do you consider your health to be? (Excellent, good, fair, poor, very poor). Information on sociodemographic and lifestyle characteristics was also collected. Multinomial logistic regression (using relative risk ratio, RRR) was used to analyze the association between the adherence to Mediterranean diet (low rMED: 0-6 points; medium: 7-10 points; high: 11-18 points) and self-rated health (Excellent (reference), good and fair/ poor/very poor). A low, medium or high adherence to Mediterranean diet conformed to 26.8%, 58.7% and 14.4% of participants, which of them reported an excellent (23.1%), good (65.1%) and fair/poor or very poor health, respectively. In multivariate analysis, a lower adherence to Mediterranean diet was significantly (p. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  12. Infection prevention and control and the refugee population: Experiences from the University of Louisville Global Health Center.

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    Carrico, Ruth M; Goss, Linda; Wiemken, Timothy L; Bosson, Rahel S; Peyrani, Paula; Mattingly, William A; Pauly, Allison; Ford, Rebecca A; Kotey, Stanley; Ramirez, Julio A

    2017-06-01

    During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care. Using data from the University of Louisville Global Health Center's Newly Arriving Refugee Surveillance System, health issues affecting refugees from the perspective of a community member, an employee, and a patient were explored. Lack of immunity to vaccine-preventable diseases is the most widespread issue impacting almost every adult, adolescent, and child refugee resettled in Kentucky. Health issues of concern from an infection prevention and control perspective include latent tuberculosis infection, HIV, hepatitis B, hepatitis C, syphilis, and parasites. Other health conditions that may also be important include anemia, obesity, oral health, diabetes, and cardiovascular disease. Refugee resettlement provides motivation for collaborative work among those responsible for infection prevention and control in all settings, their public health partners, and those responsible for and interested in community workforce concerns. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Measuring Population Health Outcomes

    OpenAIRE

    Parrish, R. Gibson

    2010-01-01

    An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

  14. Characteristics and Predictors of Health Problems from Use among High-Frequency Cannabis Users in a Canadian University Student Population

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    Fischer, Benedikt; Dawe, Meghan; Mcguire, Fraser; Shuper, Paul A; Jones, Wayne; Rudzinski, Katherine; Rehm, Jurgen

    2012-01-01

    Aims: Assess key cannabis use, risk and outcome characteristics among high-frequency cannabis users within a university student sample in Toronto, Canada. Methods: N = 134 active universities students (ages of 18-28) using cannabis at least three times per week were recruited by mass advertisement, telephone-screened and anonymously assessed by an…

  15. Population health state

    International Nuclear Information System (INIS)

    1993-01-01

    General conception on the Chernobyl accident effect on the human health (persons took part in the emergency response, children and adults in the Chernobyl region as a whole) is given. Pattern of population disease incidence in the whole region was compared with that of contaminated regions in Russia. New method for assessment of population disease incidence in the contaminated zones due to the Chernobyl accident is proposed taking into account low dose radiation effects, territory ecological difference, medical-demographic unhomogeneity of the population and personal instability. Methods of complex mathematical analysis were used. Data on the Tula region are presented as an example. 17 figs.; 6 tabs

  16. The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: a population-based study.

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    Cheng, Shou-Hsia; Chen, Chi-Chen; Tsai, Shu-Ling

    2012-10-01

    To examine the impacts of diagnosis-related group (DRG) payments on health care provider's behavior under a universal coverage system in Taiwan. This study employed a population-based natural experiment study design. Patients who underwent coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty, which were incorporated in the Taiwan version of DRG payments in 2010, were defined as the intervention group. The comparison group consisted of patients who underwent cardiovascular procedures which were paid for by fee-for-services schemes and were selected by propensity score matching from patients treated by the same group of surgeons. The generalized estimating equations model and difference-in-difference analysis was used in this study. The introduction of DRG payment resulted in a 10% decrease (pDRG-based payment resulted in reduced intensity of care and shortened length of stay. The findings might be valuable to other countries that are developing or reforming their payment system under a universal coverage system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review.

    Science.gov (United States)

    Dawson, A J; Nkowane, A M; Whelan, A

    2015-12-18

    Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between

  18. University students' mental health: Aksaray University example

    Directory of Open Access Journals (Sweden)

    Rezzan Gündoğdu

    2013-11-01

    Full Text Available This study examines whether mental health scores of the university students differ based on gender, whether they study in their ideal majors, whether they are contended with their majors, economic condition perceived and perceptions on employment opportunity after graduation. The sample group of the study constituted 3492 students comprising 2037 female students and 1455 male students attending Faculty of Education (634, Engineering Faculty (1582, Economic and Administrative Sciences Faculty (1097, Faculty of Science and Letters (762, Medical Vocational College (540, Physical Training and Sports College (443 and Aksaray Vocational College (1452 of Aksaray University in 2010-2011 Academic Year. Symptom Checklist (SCL 90-R developed by Deragotis, (1983; eg Öner, 1997 has been used to collect data on mental health level of the students involved in the study. Statistical analysis of the data collected has been carried out using t Test, One-way Analysis of Variance (ANOVA. Significant differences have been found in students in terms of independent variants according to the general symptom average score and numerous sub-scale scores.

  19. Health and Prevention Enhancement (H-PEACE): a retrospective, population-based cohort study conducted at the Seoul National University Hospital Gangnam Center, Korea.

    Science.gov (United States)

    Lee, Changhyun; Choe, Eun Kyung; Choi, Ji Min; Hwang, Yunji; Lee, Young; Park, Boram; Chung, Su Jin; Kwak, Min-Sun; Lee, Jong-Eun; Kim, Joo Sung; Park, Sue Kyung; Cho, Sang-Heon

    2018-04-19

    The Health and Prevention Enhancement (H-PEACE) study was designed to investigate the association of diagnostic imaging results, biomarkers and the predisease stage of non-communicable diseases (NCDs), such as malignancies and metabolic diseases, in an average-risk population in Korea. This study enrolled a large-scale retrospective cohort at the Healthcare System Gangnam Center, Seoul National University Hospital, from October 2003 to December 2014. The baseline and follow-up information collected in the predisease stage of NCDs allows for evaluation of an individual's potential NCD risk, which is necessary for establishing personalised prevention strategies. A total of 91 336 health examinees were included in the cohort, and we repeatedly measured and collected information for 50.9% (n=46 484) of the cohort members. All participants completed structured questionnaires (lifestyle, medical history, mini-dietary assessment index, sex-specific variables and psychiatric assessment), doctors' physical examinations, laboratory blood and urine tests and digital chest X-ray imaging. For participants with available data, we also obtained information on specific diagnostic variables using advanced diagnostic tests, including coronary CT for coronary calcium scores, colonoscopy and brain MRI. Furthermore, 17 455 of the participants who provided informed consent and donated blood samples were enrolled into the Gene-environmental interaction and phenotype study, a subcohort of the H-PEACE, from October 2013, and we analysed genome-wide single-nucleotide polymorphism array data for 6579 of these blood samples. The data obtained from this cohort will be used to facilitate advanced and accurate diagnostic techniques related to NCDs while considering various phenotypes. Potential collaborators can access the dataset after receiving approval from our institutional review board. Applications can be submitted on the study homepage (http://en-healthcare.snuh.org/HPEACEstudy).

  20. Impact of universal health coverage on suicide risk in newly diagnosed cancer patients: Population-based cohort study from 1985 to 2007 in Taiwan.

    Science.gov (United States)

    Lin, Po-Hsien; Liao, Shih-Cheng; Chen, I-Ming; Kuo, Po-Hsiu; Shan, Jia-Chi; Lee, Ming-Been; Chen, Wei J

    2017-11-01

    National Health Insurance (NHI), launched in 1995 in Taiwan, lightens patient's financial burdens but its effect on the suicide risk in cancer patients is unclear. We aimed to investigate the impacts of the NHI on the suicide in newly diagnosed cancer patients. We identified patients with newly diagnosed cancer from the nationwide Taiwan Cancer Registration from 1985 to 2007, and ascertained suicide deaths from the national database of registered deaths between 1985 and 2009. Standardized mortality ratio (SMR) of suicide risk among patients with cancer was calculated, and the suicide risk ratios were examined by gender, age group, and prognosis. For the 916 337 registered cancer patients with 4 300 953 person-years, 2 543 died by suicide, with a suicide rate of 59.1 per 100 000 person-years. Compared to the general population, cancer patients had an SMR of 2.47 for suicide, with a higher figure for males (2.73), age 45 to 64 (2.89), and cancer of poor prognosis (3.19). The suicide risk was highest in the first 2 years after the initial diagnosis. Comparing the cohorts of the period before (1985 to 1992) and after (1996 to 2007) the launch of NHI, we saw a reduction in the SMR within the first 2 years after cancer diagnosis (20%), with more prominent reduction for females (29%), age under 45 (69%), and cancer of good prognosis (33%). A universal health coverage relieving both physical and psychological distress may account for the post-NHI reduction of immediate suicide risk in patients of newly diagnosed cancer. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Population Health and Occupational Therapy.

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    Braveman, Brent

    2016-01-01

    Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  2. SARS and Population Health Technology

    OpenAIRE

    Eysenbach, Gunther

    2003-01-01

    The recent global outbreak of SARS (severe acute respiratory syndrome) provides an opportunity to study the use and impact of public health informatics and population health technology to detect and fight a global epidemic. Population health technology is the umbrella term for technology applications that have a population focus and the potential to improve public health. This includes the Internet, but also other technologies such as wireless devices, mobile phones, smart appliances, or smar...

  3. Universal self-similarity of propagating populations.

    Science.gov (United States)

    Eliazar, Iddo; Klafter, Joseph

    2010-07-01

    This paper explores the universal self-similarity of propagating populations. The following general propagation model is considered: particles are randomly emitted from the origin of a d-dimensional Euclidean space and propagate randomly and independently of each other in space; all particles share a statistically common--yet arbitrary--motion pattern; each particle has its own random propagation parameters--emission epoch, motion frequency, and motion amplitude. The universally self-similar statistics of the particles' displacements and first passage times (FPTs) are analyzed: statistics which are invariant with respect to the details of the displacement and FPT measurements and with respect to the particles' underlying motion pattern. Analysis concludes that the universally self-similar statistics are governed by Poisson processes with power-law intensities and by the Fréchet and Weibull extreme-value laws.

  4. Universal self-similarity of propagating populations

    Science.gov (United States)

    Eliazar, Iddo; Klafter, Joseph

    2010-07-01

    This paper explores the universal self-similarity of propagating populations. The following general propagation model is considered: particles are randomly emitted from the origin of a d -dimensional Euclidean space and propagate randomly and independently of each other in space; all particles share a statistically common—yet arbitrary—motion pattern; each particle has its own random propagation parameters—emission epoch, motion frequency, and motion amplitude. The universally self-similar statistics of the particles’ displacements and first passage times (FPTs) are analyzed: statistics which are invariant with respect to the details of the displacement and FPT measurements and with respect to the particles’ underlying motion pattern. Analysis concludes that the universally self-similar statistics are governed by Poisson processes with power-law intensities and by the Fréchet and Weibull extreme-value laws.

  5. Measuring population health in Moldova: health expectancies

    Directory of Open Access Journals (Sweden)

    Cristina Avram

    2018-05-01

    Full Text Available Health measures are decisive for the development and implementation of population health policies. Monitoring health indicators can lead to improvements in health and decrease in the inequalities among subpopulations. The life expectancy at birth for the Moldovan population did not increase considerably during the last decades, due to the social and economic crisis which led to high mortality and poor health. In Moldova, no aggregated health indicators are utilized for health monitoring. Therefore, the authors calculated health indicators to assess the population health and argue their importance. Mortality and subjective data on self-perceived health and self-rated morbidity from the Household Budget Survey was used for constructing period morbidity-mortality tables. Thus, the authors applied Sullivan’s method to calculate the life expectancy in very good/good/fair health and the life expectancy without chronic morbidity for the period 2006 - 2015. The life expectancies in very good/good/fair health showed a compression of morbidity in the older ages for both sexes, and for rural and urban types of residence. The life expectancies without chronic morbidity for males and for urban dwellers demonstrated an expansion of morbidity. Although the life expectancy is slowly increasing, the trends in population health are contradictory, depending on the applied measures. The health expectancy indicators, based on self-perceived health, depict the actual situation in the population health. These indicators are becoming more essential with the ageing process and can be used for the tailoring of social and health policies and services to the real needs of the population.

  6. [Universalization of health or of social security?].

    Science.gov (United States)

    Levy-Algazi, Santiago

    2011-01-01

    This article presents an analysis of the architecture of Mexico's health system based on the main economic problem, failing to achieve a GDP growth rate to increase real wages and give workers in formal employment coverage social security. This analysis describes the relationship between social security of the population and employment status of it (either formal or informal employment) and the impact that this situation poses to our health system. Also, it ends with a reform proposal that will give all workers the same social rights, ie to grant universal social security.

  7. Population and women's health.

    Science.gov (United States)

    Abernethy, V

    1994-01-01

    Explanations of cultural patterns can be found in the economic context (carrying capacity) in which they develop. Population pressure explains the abuse of women throughout history and in modern times because overpopulation leads to devaluation of women's reproductive capacity. A cultural response to overpopulation includes practices that limit the numbers of women of reproductive age. Such practices foster son preference, which results in selective abortion, female infanticide, neglect and overwork of girls, dowry deaths, and discrimination against widows. The results of these practices are manifest in sex ratios that are culturally rather than naturally controlled and in demographic facts such as the calculation that 60 million females are missing in Asia alone (and perhaps more than 100 million worldwide). Women are also removed from a reproductive setting by being kidnapped or sold into prostitution or by being forced to adopt prostitution for economic survival. In cases where survival is threatened by environmental degradation and population growth, the most harsh cultural practices will emerge to adapt the population to the resources at hand. This situation creates an ethical dilemma posed by the problem of imposing Western values on a culture that is undertaking adaptive practices to insure its very survival. Ways to help women in these situation include limiting population growth humanely through family planning, provision of paid work to women, and creation of an environment that supports a small family ideal. Prosperity itself, through modernization, sometimes causes family sizes to increase. The most important intervention appears to be the provision of paid employment outside the home for women. On the other hand, large-scale wealth transfers and liberal immigration policies simply send signals that population pressure is a regional problem that can be alleviated by the international community. Increasing immigration to developed countries will place

  8. Population growth, poverty and health.

    Science.gov (United States)

    Kibirige, J S

    1997-07-01

    One of the most popular explanations for the many problems that face Africa is population growth. Africa's population has doubled since 1960. Africa has the highest fertility rate in the world and the rate of population growth is higher than in any other region. At the same time, Africa faces a social and economic situation that is viewed by many as alarming. Among the problems that devastate Africa is that of persistent poor health. Africa has lower life expectancy, higher mortality rates and is affected by more disease and illness conditions than any other region. Focusing on sub-Saharan Africa, this paper examines the relationship between population growth, poverty and poor health. While most analyses have focused on population growth as an original cause of poverty and underdevelopment, this paper argues that while both population growth and poor health play a significant role in exacerbating the problem of poverty, they are themselves primary consequences of poverty rather than its cause.

  9. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    Directory of Open Access Journals (Sweden)

    Denise Bryant-Lukosius

    Full Text Available ABSTRACT Objective: to examine advanced practice nursing (APN roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.

  10. [Excessive population and health].

    Science.gov (United States)

    Rivera, A A

    1995-07-01

    Population density in El Salvador is among the highest in the world. In metropolitan San Salvador and the other main cities, crowding, squatter settlements, unemployment and underemployment, scarcity of basic services, squalor, and other social pathologies appear to be increasing. Overpopulation poses an enormous challenge for development. Reflection on the benefits of family planning has been delayed in El Salvador, and in the interim there have been increases in social inequality, misery, and hunger. Family planning programs have been referred to as "neo-Malthusian" and contrary to the right to life, but in fact they promote birth spacing and free selection of methods by couples, contributing to improvement in the quality of family life. Family planning allows couples to limit their offspring to those they can adequately care for emotionally and materially. People must be shown that family planning alleviates many of humanity's problems.

  11. Future directions in population health.

    Science.gov (United States)

    Hancock, T

    1999-01-01

    The long-term health of the population will be influenced by a number of major forces in the next century. In this brief review, particular emphasis is placed on environmental and economic forces. Major global environmental changes include climate change and global warming, resource depletion, ecotoxicity and reduced biodiversity. We do not yet know the impact on longevity of lifetime exposure to a mix of persistent toxic chemicals in our environment, since it has only been widespread in the past 40-50 years. The health impacts of global warming are only just beginning to be understood and could be profound. But perhaps the most profound threat to population health is economic growth, to the extent that it undermines environmental and social sustainability. We need a new form of capitalism, one that simultaneously increases environmental, social, economic and human capital, if population health is to be maintained in the 21st century.

  12. [Universal coverage of health services in Mexico].

    Science.gov (United States)

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  13. A MODEL OF PARTNERSHIP PROJECT FOR HEALTH AND COMMUNITY DEVELOPMENT BETWEEN UNIVERSITY OF PITESTI AND A RURAL POPULATION, FROM A DISADVANTAGED GEOGRAPHICAL AREA

    Directory of Open Access Journals (Sweden)

    Constantin Ciucurel

    2016-07-01

    Full Text Available The purpose of this project aimed to apply a sanogenetic intervention on a rural population, from a disadvantaged geographical area. 50 students in Physical Therapy and 4 teachers were involved in assessment and intervention activities for optimization of the individual and collective health status of inhabitants of a village located in the Caras-Severin district, in the Cerna Mountains. The project results consisted in: a database regarding the health of the subjects; a model of therapeutic education and promoting of a healthy lifestyle among inhabitants; creating a network of social interaction among project participants; professional and transversal skills development of students; developing research skills of teachers. The activities referred to: subjects health assessment (medical diagnostic, anthropometric and physiometric measurements; recommending and implementing of programs of kinetic prophylaxis and rehabilitation; conducting activities to provide opportunities for social interaction and support. The project offered also the possibility of optimizing the students training by developing their professional skills of assessment and physiotherapeutic intervention, their transversal skills of teamwork, respect for the principles for professional ethics and self-assessment of needs for professional training and also for developing good inter-institutional relations, designed to facilitate the development of specific research activities, in benefit of both parts.

  14. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    Science.gov (United States)

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Chiang Mai University Health Worker Study aiming toward a better understanding of noncommunicable disease development in Thailand: methods and description of study population.

    Science.gov (United States)

    Angkurawaranon, Chaisiri; Wisetborisut, Anawat; Jiraporncharoen, Wichuda; Likhitsathian, Surinporn; Uaphanthasath, Ronnaphob; Gomutbutra, Patama; Jiraniramai, Surin; Lerssrimonkol, Chawin; Aramrattanna, Apinun; Doyle, Pat; Nitsch, Dorothea

    2014-01-01

    Urbanization is considered to be one of the key drivers of noncommunicable diseases (NCDs) in Thailand and other developing countries. These influences, in turn, may affect an individual's behavior and risk of developing NCDs. The Chiang Mai University (CMU) Health Worker Study aims to provide evidence for a better understanding of the development of NCDs and ultimately to apply the evidence toward better prevention, risk modification, and improvement of clinical care for patients with NCDs and NCD-related conditions. A cross-sectional survey of health care workers from CMU Hospital was conducted between January 2013 and June 2013. Questionnaires, interviews, and physical and laboratory examinations were used to assess urban exposure, occupational shift work, risk factors for NCDs, self-reported NCDs, and other NCD-related health conditions. From 5,364 eligible workers, 3,204 participated (59.7%). About 11.1% of the participants had high blood pressure (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and almost 30% were considered to be obese (body mass index ≥25 kg/m(2)). A total of 2.3% had a high fasting blood glucose level (≥126 mg/dL), and the most common abnormal lipid profile was high low-density lipoprotein (≥160 mg/dL), which was found in 19.2% of participants. The study of health workers offers three potential advantages. The first is that the study of migrants was possible. Socioenvironmental influence on NCD risk factors can be explored, as changes in environmental exposures can be documented. Second, it allows the investigators to control for access to care. Access to care is potentially a key confounder toward understanding the development of NCDs. Lastly, a study of health personnel allows easy access to laboratory investigations and potential for long-term follow-up. This enables ascertainment of a number of clinical outcomes and provides potential for future studies focusing on therapeutic and prognostic issues

  16. Progress toward universal health coverage in ASEAN.

    Science.gov (United States)

    Van Minh, Hoang; Pocock, Nicola Suyin; Chaiyakunapruk, Nathorn; Chhorvann, Chhea; Duc, Ha Anh; Hanvoravongchai, Piya; Lim, Jeremy; Lucero-Prisno, Don Eliseo; Ng, Nawi; Phaholyothin, Natalie; Phonvisay, Alay; Soe, Kyaw Min; Sychareun, Vanphanom

    2014-01-01

    The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and 'snowball' further data. We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1) financial constraints, including low levels of overall and government spending on health; 2) supply side constraints, including inadequate numbers and densities of health workers; and 3) the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should be explicitly considered to mitigate

  17. Progress toward universal health coverage in ASEAN

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: The Association of Southeast Asian Nations (ASEAN is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design: Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and ‘snowball’ further data. Results: We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1 financial constraints, including low levels of overall and government spending on health; 2 supply side constraints, including inadequate numbers and densities of health workers; and 3 the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should

  18. Accreting Binary Populations in the Earlier Universe

    Science.gov (United States)

    Hornschemeier, Ann

    2010-01-01

    It is now understood that X-ray binaries dominate the hard X-ray emission from normal star-forming galaxies. Thanks to the deepest (2-4 Ms) Chandra surveys, such galaxies are now being studied in X-rays out to z approximates 4. Interesting X-ray stacking results (based on 30+ galaxies per redshift bin) suggest that the mean rest-frame 2-10 keV luminosity from z=3-4 Lyman break galaxies (LBGs), is comparable to the most powerful starburst galaxies in the local Universe. This result possibly indicates a similar production mechanism for accreting binaries over large cosmological timescales. To understand and constrain better the production of X-ray binaries in high-redshift LBGs, we have utilized XMM-Newton observations of a small sample of z approximates 0.1 GALEX-selected Ultraviolet-Luminous Galaxies (UVLGs); local analogs to high-redshift LBGs. Our observations enable us to study the X-ray emission from LBG-like galaxies on an individual basis, thus allowing us to constrain object-to-object variances in this population. We supplement these results with X-ray stacking constraints using the new 3.2 Ms Chandra Deep Field-South (completed spring 2010) and LBG candidates selected from HST, Swift UVOT, and ground-based data. These measurements provide new X-ray constraints that sample well the entire z=0-4 baseline

  19. Minding the gaps: health financing, universal health coverage and gender.

    Science.gov (United States)

    Witter, Sophie; Govender, Veloshnee; Ravindran, T K Sundari; Yates, Robert

    2017-12-01

    In a webinar in 2015 on health financing and gender, the question was raised why we need to focus on gender, given that a well-functioning system moving towards Universal Health Coverage (UHC) will automatically be equitable and gender balanced. This article provides a reflection on this question from a panel of health financing and gender experts.We trace the evidence of how health-financing reforms have impacted gender and health access through a general literature review and a more detailed case-study of India. We find that unless explicit attention is paid to gender and its intersectionality with other social stratifications, through explicit protection and careful linking of benefits to needs of target populations (e.g. poor women, unemployed men, female-headed households), movement towards UHC can fail to achieve gender balance or improve equity, and may even exacerbate gender inequity. Political trade-offs are made on the road to UHC and the needs of less powerful groups, which can include women and children, are not necessarily given priority.We identify the need for closer collaboration between health economists and gender experts, and highlight a number of research gaps in this field which should be addressed. While some aspects of cost sharing and some analysis of expenditure on maternal and child health have been analysed from a gender perspective, there is a much richer set of research questions to be explored to guide policy making. Given the political nature of UHC decisions, political economy as well as technical research should be prioritized.We conclude that countries should adopt an equitable approach towards achieving UHC and, therefore, prioritize high-need groups and those requiring additional financial protection, in particular women and children. This constitutes the 'progressive universalism' advocated for by the 2013 Lancet Commission on Investing in Health. © The Author 2017. Published by Oxford University Press in association with The

  20. [Food habits and nutritional assessment in a university population].

    Science.gov (United States)

    Cervera Burriel, Faustino; Serrano Urrea, Ramón; Vico García, Cruz; Milla Tobarra, Marta; García Meseguer, Mariá José

    2013-01-01

    The university students are in critical period for the development of life styles which are very important for their future health. The eating behaviour of other students, the alcohol consumption, their economic situation and the ability of cooking make them change their dietary habits. In Spain there are a few studies on the quality of the diet in this population group. Most of them show Spanish students diet does not follow an adequate Mediterranean dietary pattern. To describe the dietary habits of a population of university students and to assess the quality of their diet. Cross sectional study conducted on a sample of 80 students from the Faculty of Nursing of Albacete (University of Castilla-La Mancha). Nine 24-hours follow-ups questionnaires were self-administered in three different seasons. The quality of the diet was assessed by the IAS and the MDS2. In all tests a level of significance p university students. More than 91% of the students need "diet changes" in order to acquire healthier dietary patterns. Adherence to the Mediterranean diet was only 53%. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  1. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

  2. Universal Investment in Infants and Long-Run Health

    DEFF Research Database (Denmark)

    Hjort, Jonas; Sølvsten, Mikkel; Wüst, Miriam

    This paper provides the first estimates of the long-run health effects of a universal infant health intervention. We examine the 1937 Danish home visiting program, which targeted all infants. Using administrative population data and exploiting variation in the timing of implementation across...

  3. Universal Investment in Infants and Long-Run Health

    DEFF Research Database (Denmark)

    Hjort, Jonas; Sølvsten, Mikkel; Wüst, Miriam

    2017-01-01

    This paper examines the long-run health effects of a universal infant health intervention, the 1937 Danish home visiting program, which targeted all infants. Using administrative population data and exploiting variation in the timing of implementation across municipalities, we find that treated...

  4. SARS and population health technology.

    Science.gov (United States)

    Eysenbach, Gunther

    2003-01-01

    The recent global outbreak of SARS (severe acute respiratory syndrome) provides an opportunity to study the use and impact of public health informatics and population health technology to detect and fight a global epidemic. Population health technology is the umbrella term for technology applications that have a population focus and the potential to improve public health. This includes the Internet, but also other technologies such as wireless devices, mobile phones, smart appliances, or smart homes. In the context of an outbreak or bioterrorism attack, such technologies may help to gather intelligence and detect diseases early, and communicate and exchange information electronically worldwide. Some of the technologies brought forward during the SARS epidemic may have been primarily motivated by marketing efforts, or were more directed towards reassuring people that "something is being done," ie, fighting an "epidemic of fear." To understand "fear epidemiology" is important because early warning systems monitoring data from a large number of people may not be able to discriminate between a biological epidemic and an epidemic of fear. The need for critical evaluation of all of these technologies is stressed.

  5. Health Law 2015: Individuals and Populations.

    Science.gov (United States)

    Jacobson, Peter D; Dahlen, Rachel

    2016-12-01

    In this article, we assess two particular trends in judicial doctrine that are likely to emerge in the post-ACA era. The first trend is the inevitable emergence of enterprise medical liability (EML) that will supplant tort law's unstable attempt to apportion liability between physicians and institutions. Arguments favoring EML in health law date back to the early 1980s. But health care's ongoing consolidation suggests that the time has arrived for courts or state legislatures to develop legal doctrine that more closely resembles the ways in which health care is now delivered. This would result in a more appropriate allocation of liability to the institutional level. The second judicial trend will be the convergence of health law and public health law concepts. Because the ACA arguably stimulates closer engagement between health systems and public health departments, health systems will have greater responsibility for keeping their communities healthy along with obligations for individual patient care (i.e., individuals and populations). If so, courts will need to incorporate elements from health law and public health law in resolving disputes. Copyright © 2016 by Duke University Press.

  6. [Food habits and nutritional assessment in a tunisian university population].

    Science.gov (United States)

    Cervera Burriel, Faustino; Serrano Urrea, Ramón; Daouas, Thouraya; Delicado Soria, Amalia; García Meseguer, María José

    2014-12-01

    Nutrition and health are of great importance throughout life, in particular in adulthood due to active population is included among the adults. Therefore, it is essential to assess the quality of the diet and the possible conditioning factors. The objectives of this study were to characterize food habits and assess the quality of the diet of university students from the Virtual University of Tunisia, a North African country in nutritional transition. This is a cross-sectional study performed with data collected from a sample of 54 students from this University. For each individual a questionnaire involving socio-economic and demographic data was self-reported. Food consumption was gathered by a 24 hours recall. The assessment of diet quality was conducted by Healthy Eating Index and Mediterranean Diet Score. The study revealed that the diet of this population is hypocaloric. The percentage of total energy from proteins was 18% and the percentage of total energy from carbohydrates was about 40%. The diet was high in simple sugars, saturated fat and cholesterol. Apart from oils and fat, the main source of lipids had an animal origin from meat (19%), and the fish group only provided 3% of this macronutrient. According to Healthy Eating Index classification more than 50% of students scored "poor" and more than 40% "needs improvement" about the quality of their diet. The study also showed low adherence rates to the Mediterranean diet. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  7. Realizing right to health through universal health coverage

    Directory of Open Access Journals (Sweden)

    ANJALI Singh

    2014-07-01

    Full Text Available Recognition of right to health is an essential step to work towards improvement of public health and to attain highest standard of physical and mental health of the people. Right to health in India is implicit part of right to life under Article 19 mentioned in the Constitution of India but is not recognized per se. Universal Health Coverage adopts rights based approach and principles of universality, equity, empowerment and comprehensiveness of care. The Universal Coverage Report of India makes recommendations in six identified areas to revamp the health systems in order to ensure right to health of Indians. These areas are: health financing and financial protection; health service norms; human resources for health; community participation and citizen engagement; access to medicines, vaccines and techno- logy; management and institutional reforms. This paper attempts to determine the ways inwhich Universal Health Coverage can make a contribution in realizing right to health and thus human rights in developing countries.

  8. Population Health Management for Older Adults

    Science.gov (United States)

    Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Alsgaard, Kathleen; Hawkins, Kevin; Yeh, Charlotte S.

    2016-01-01

    Background: The older adult population is expanding, living longer, with multiple chronic conditions. Understanding and managing their needs over time is an integral part of defining successful aging. Population health is used to describe the measurement and health outcomes of a population. Objectives: To define population health as applied to older adults, summarize lessons learned from current research, and identify potential interventions designed to promote successful aging and improved health for this population. Method: Online search engines were utilized to identify research on population health and health interventions for older adults. Results: Population health management (PHM) is one strategy to promote the health and well-being of target populations. Interventions promoting health across a continuum tend to be disease, risk, or health behavior specific rather than encompassing a global concept of health. Conclusion: Many existing interventions for older adults are simply research based with limited generalizability; as such, further work in this area is warranted. PMID:28680938

  9. Medicalization of global health 4: The universal health coverage campaign and the medicalization of global health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have 'a transformative effect on poverty, hunger, and disease'. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good.

  10. Health-related quality of life among online university students.

    Science.gov (United States)

    Maynard, Pamela L; Rohrer, James E; Fulton, Lawrence

    2015-01-01

    Online university students are a growing population whose health has received minimal attention. The purpose of this cross-sectional Internet survey was to identify risk factors for the health status among online university students. This online survey collected data from 301 online university students through a large, US-based participant pool and LinkedIn. Health status was measured using 3 elements of health-related quality of life (HRQOL): self-rated overall health (SRH), unhealthy days, and recent activity limitation days. All 3 measures were dichotomized. The odds of poor SRH were higher for people who reported a body mass index in the overweight and obese categories (odds ratio [OR] = 2.99, P students who are low income, in disadvantaged racial groups, who are overweight, smoke, and who do not exercise. © The Author(s) 2014.

  11. Universal health care in India: Panacea for whom?

    Science.gov (United States)

    Qadeer, Imrana

    2013-01-01

    This paper examines the current notion of universal health care (UHC) in key legal and policy documents and argues that the recommendations for UHC in these entail further abdication of the State's responsibility in health care with the emphasis shifting from public provisioning of services to merely ensuring universal access to services. Acts of commission (recommendations for public private partnership [PPPs], definition and provision of an essential health package to vulnerable populations to ensure universal access to care) and omission (silence maintained on tertiary care) will eventually strengthen the private and corporate sector at the cost of the public health care services and access to care for the marginalized. Thus, the current UHC strategy uses equity as a tool for promoting the private sector in medical care rather than health for all.

  12. 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.

  13. Healthy Universities: Mapping Health-Promotion Interventions

    Science.gov (United States)

    Sarmiento, Juan Pablo

    2017-01-01

    Purpose: The purpose of this paper is to map out and characterize existing health-promotion initiatives at Florida International University (FIU) in the USA in order to inform decision makers involved in the development of a comprehensive and a long-term healthy university strategy. Design/methodology/approach: This study encompasses a narrative…

  14. Viewpoint: Re-instating a 'public health' system under universal health care in India.

    Science.gov (United States)

    George, Mathew

    2015-02-01

    I examine possibilities for strengthening essential public health functions in the context of India's drive to implement universal health care. In a country where population health outcomes are rooted in social, political, economic, cultural, and ecological conditions, it is important to have a state mediated public health system that can modify the causes of the major public health problems. This calls for strengthening the social epidemiological approach in public health by demarcating public health functions distinct from medical care. This will be a prerequisite for the growth of the public health profession in the country, because it can offer avenues for newly trained professionals within the country to work in 'core' public health.

  15. Energy Systems and Population Health

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    to rural and urban health facilities allows increased delivery and coverage of 3 various health services and interventions such as tests and treatments, better storage of medicine and vaccines, disinfection of medical equipment by boiling or radiation, and more frequent and efficient health system encounters through mobile clinics or longer working hours; and so on. In fact, while the dominant view of development-energy-health linkages has been that improvements in energy and health are outcomes of the socioeconomic development process (e.g., the ''energy ladder'' framework discussed below), it has even been argued that access to higher quality energy sources and technologies can initiate a chain of demographic, health, and development outcomes by changing the household structure and socioeconomic relationships. For example, in addition to increased opportunities for food and income production, reduced infant mortality as a result of transition to cleaner fuels or increased coverage of vaccination with availability of refrigerators in rural clinics may initiate a process of ''demographic transition'' to low-mortality and low-fertility populations (14). Such a transition has historically been followed with further improvements in maternal and child health and increased female participation in the labor markets and other economic activities.

  16. Mitigating India's health woes: Can health insurance be a remedy to achieve universal health coverage?

    Directory of Open Access Journals (Sweden)

    B Savitha

    2016-01-01

    Full Text Available A low level of public investments in preventive health facilities and medical care facilities and health professionals has given rise to poor health status for an average Indian. Insufficient government funding for health care, inadequate and ineffective health financing mechanisms, poor delivery of health care, especially in public facilities, and excessive reliance on unregulated high-cost private providers have contributed to the poor accomplishment of Millennium Development Goals, especially in the informal sector. Sustainable Development Goals (SDGs consider health to be one of the important objectives to be achieved by all the nations in the world. This paper reappraises the current status, unmet needs, challenges, and the way forward to implement and achieve universal health coverage (UHC in India by thrusting the focus on three elements (pillars of universal access to health services. Despite seven decades of independence, India does still face the formidable challenge of providing health services to its population at an affordable cost. One of the major obstacles in reaching universal coverage and universal health entitlement of every Indian citizen has been the absence of effective health financing mechanism that promotes affordable access to weaker and vulnerable sections of the society. In this respect, health insurance certainly does have the potential to expedite the process of UHC if various stakeholders work in cohesion under the government stewardship. In rural India, the health infrastructure and workforce are inadequate to serve the unserved and underserved population. Hence, the government should invest in public health facilities while promoting pan-India health insurance to ensure and guarantee easy access and affordability for its citizens. The way forward should not only be centered on financial protection, but also to have renewed emphasis on restructuring the health-care system, ensuring the adequate availability of

  17. MENTAL HEALTH AND UNIVERSITY STUDENTS: SURVEY

    OpenAIRE

    Woodgate, Roberta

    2014-01-01

    We want to learn from university students about your experiences and perspectives on mental health and well-being in the context of being a student. Your input can help us develop evidence-based intervention programs that can help address the mental health needs of students. This survey should take 15-20 minutes to complete.

  18. Providing Universal Health Insurance Coverage in Nigeria.

    Science.gov (United States)

    Okebukola, Peter O; Brieger, William R

    2016-07-07

    Despite a stated goal of achieving universal coverage, the National Health Insurance Scheme of Nigeria had achieved only 4% coverage 12 years after it was launched. This study assessed the plans of the National Health Insurance Scheme to achieve universal health insurance coverage in Nigeria by 2015 and discusses the challenges facing the scheme in achieving insurance coverage. In-depth interviews from various levels of the health-care system in the country, including providers, were conducted. The results of the analysis suggest that challenges to extending coverage include the difficulty in convincing autonomous state governments to buy into the scheme and an inadequate health workforce that might not be able to meet increased demand. Recommendations for increasing the scheme's coverage include increasing decentralization and strengthening human resources for health in the service delivery systems. Strong political will is needed as a catalyst to achieving these goals. © The Author(s) 2016.

  19. Universal health coverage in Turkey: enhancement of equity.

    Science.gov (United States)

    Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

    2013-07-06

    Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with

  20. The determinants of fat intake in a multi-ethnic New Zealand population. Fletcher Challenge--University of Auckland Heart and Health Study Management Committee.

    Science.gov (United States)

    Swinburn, B A; Walter, L; Ricketts, H; Whitlock, G; Law, B; Norton, R; Jackson, R; MacMahon, S

    1998-06-01

    The New Zealand diet is high in total and saturated fat and this is likely to be contributing to the increasing prevalence of obesity and relatively high rates of coronary heart disease in New Zealand. The identification of subgroups with a high-fat intake will enable nutrition-related public health strategies to be better targeted. Subjects from two surveys were included in the study: 7574 employees from a large multinational workforce survey and 2447 people aged 35-84 years selected from a stratified random sample of the electoral roll in central Auckland. Fat and saturated fat intake were assessed by short questionnaire which gave a dietary fat habits (DFH) score and supplemented by a six-item food frequency questionnaire. The DFH scores were higher in males than in females at all ages, and there was an inverse relationship with age which was stronger for males. Age-adjusted scores showed significantly higher DFH scores for Maori than for Europeans. Lower socioeconomic status was associated with higher DFH scores in males. Current smoking and heavy drinking (in males) were associated with significantly higher DFH scores after controlling for socioeconomic status. The results of the limited food frequency questionnaire supported the trends in DFH scores. The subgroups with high total and saturated fat intakes which should be a priority for public health action are young and middle-aged males, Maori and lower socioeconomic status males. The clustering of high-fat intake with smoking and heavy drinking should be considered when developing preventative strategies.

  1. Mental health among students of pedagogical universities

    Directory of Open Access Journals (Sweden)

    Malinauskas R.

    2010-06-01

    Full Text Available This article deals with questions of mental health among students of pedagogical universities. There were analysed differences in the level of mental health among sporting and non-sporting students. Two methods were used in the inquiry. Stepanov's questionnaire was used to estimate the level of mental health, Gundarov's questionnaire was used to evaluate psychical satisfaction. The sample consisted of 263 sporting students (athletes and 288 non-sporting students. Results have shown that the level of mental health among sporting students was higher than the level of mental health among non-sporting students.

  2. Mental Health Literacy in Emerging Adults in a University Setting: Distinctions between Symptom Awareness and Appraisal

    Science.gov (United States)

    Gagnon, Michelle M.; Gelinas, Bethany L.; Friesen, Lindsay N.

    2017-01-01

    Despite the high prevalence of mental health concerns in university populations, students are unlikely to seek formal help. The current study examined help-seeking behaviors among emerging adults in a university setting using a mental health literacy framework. Responses from 122 university undergraduates were examined. Students ranged in age from…

  3. [HADASSAH MEDICAL ORGANIZATION - A PIONEER IN POPULATION HEALTH].

    Science.gov (United States)

    Calderon-Margalit, Ronit; Levine, Hagai; Israeli, Avi; Paltiel, Ora

    2018-03-01

    Population health is a term encompassing "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." Only recently have hospitals viewed themselves as focal points for promoting health in a community, involving themselves with population health. Hadassah Medical Organization (HMO), however, has been in the business of population health since its founding. Its early programs, promoting and delivering nutritional support, maternal-child health and other services to the Yishuv's inhabitants, showed that the HMO defined its community broadly. Hospital care came later. The HMO was established together with the Hebrew University Israel's first School of Public Health and Community Medicine in the 1960's, contributing >1200 Israeli alumni, and exposing thousands of medical students to population health. The School's founders developed Community-Oriented Primary Care, aimed at assessing and addressing health determinants and outcomes at the community level implemented in many centers worldwide. Reaching beyond Israel's borders, the School has trained a global public health workforce through its International Masters in Public Health with >820 graduates from 92 countries. HMO's researchers have made important contributions in the fields of epidemiology, health economics and policy and population health methodology as well as hospital and community quality of care. This article reviews HMO's contribution to population health at local, municipal, national and international levels. We will demonstrate the unique circumstances in Hadassah, Jerusalem and Israel which have enabled world-class research and training in population health, identifying important contributions to policy and service provision, as well as addressing future population health challenges.

  4. INTRODUCTION OF UNIVERSAL HEALTH PROGRAM IN GEORGIA: PROBLEMS AND PERSPECTIVES.

    Science.gov (United States)

    Verulava, T; Jorbenadze, R; Barkalaia, T

    2017-01-01

    Since 2013, Georgia enacted Universal Healthcare (UHC) program. Inclusion of uninsured population in the UHC program will have a positive impact on their financial accessibility to the health services. The study aims to analyze the referral rate of the beneficiaries to the health service providers before introduction and after application of the UHC program, particularly, how much it increased the recently uninsured population referral to primary health care units, and also to study the level of satisfaction with the UHC program. Research was conducted by qualitative and quantitative methods. The target groups' (program beneficiaries, physicians, personnel of the Social Service Agency) opinions were identified by means of face-to-face interviews. Enactment of the UHC programs significantly raised the population refferal to the family physicians, and the specialists. Insignificantly, but also increased the frequency of laboratory and diagnostic services. Despite the serious positive changes caused by UHC program implementation there still remain the problems in the primary healthcare system. Also, it is desirable to raise the financial availability of those medical services, which may cause catastrophic costs. In this respect, such medical services must be involved in the universal healthcare program and been expanded their scale. For the purpose of effective usage of the limited funds allocated for health care services provision, the private health insurance companies should be involved in UHC programs. This, together with the reduction of health care costs will increase a competition in the medical market, and enhance the quality of health service.

  5. Health-system reform and universal health coverage in Latin America.

    Science.gov (United States)

    Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

    2015-03-28

    Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health.

    Science.gov (United States)

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-30

    to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. analisar o papel da enfermagem com prática avançada (EPA) a nível internacional para um relatório do seu desenvolvimento na América Latina e no Caribe, para apoiar a cobertura universal de saúde e o acesso universal à saúde. análise da bibliografia relacionada com os papéis da EPA, sua implantação no mundo e a eficácia da EPA em relação à cobertura universal de saúde e acesso à saúde. dada a evidência da sua eficácia em muitos países, as funções da EPA são ideais como parte de uma estratégia de recursos humanos de atenção primária de saúde na América Latina para melhorar a cobertura universal de saúde e o acesso à saúde. Brasil

  7. Health literacy among Saudi population: a cross-sectional study.

    Science.gov (United States)

    Abdel-Latif, Mohamed M M; Saad, Sherif Y

    2017-09-12

    Health literacy is a major problem worldwide and adversely affects an individual's health. The aim of the present study was to assess health literacy level among Saudi population. A cross-sectional study was conducted among a randomly selected population (n = 500) in Saudi Arabia. The questionnaire comprised of questions pertaining to demographic characteristics, health literacy and health information. Health literacy was measured by REALM-R test. Internal reliability was determined using Cronbach's alpha coefficient. The majority of the respondents had intermediate (43.8%) and basic (34.4%) health literacy levels. A higher percentage among men had intermediate (59.8%) and basic (70.93%) health literacy levels compared with women. About 30% of respondents had difficulty in understanding health screening tests and disease treatment. More than half of participants (52.4%) had difficulty in finding health information. The REALM-R test revealed that about 42.6% of individuals with score of >6 had adequate health literacy compared with 57.4% with score of ≤6 had inadequate health literacy. The present study demonstrated that a majority of Saudi individuals had inadequate health literacy that associated with poor knowledge of health information. Our findings highlighted the importance of understanding the status of health literacy among Saudis and the need for educational programs to raise the health literacy awareness among Saudi population. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. The population health approach in historical perspective.

    Science.gov (United States)

    Szreter, Simon

    2003-03-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

  9. Population Neuroscience: Dementia Epidemiology Serving Precision Medicine and Population Health.

    Science.gov (United States)

    Ganguli, Mary; Albanese, Emiliano; Seshadri, Sudha; Bennett, David A; Lyketsos, Constantine; Kukull, Walter A; Skoog, Ingmar; Hendrie, Hugh C

    2018-01-01

    Over recent decades, epidemiology has made significant contributions to our understanding of dementia, translating scientific discoveries into population health. Here, we propose reframing dementia epidemiology as "population neuroscience," blending techniques and models from contemporary neuroscience with those of epidemiology and biostatistics. On the basis of emerging evidence and newer paradigms and methods, population neuroscience will minimize the bias typical of traditional clinical research, identify the relatively homogenous subgroups that comprise the general population, and investigate broader and denser phenotypes of dementia and cognitive impairment. Long-term follow-up of sufficiently large study cohorts will allow the identification of cohort effects and critical windows of exposure. Molecular epidemiology and omics will allow us to unravel the key distinctions within and among subgroups and better understand individuals' risk profiles. Interventional epidemiology will allow us to identify the different subgroups that respond to different treatment/prevention strategies. These strategies will inform precision medicine. In addition, insights into interactions between disease biology, personal and environmental factors, and social determinants of health will allow us to measure and track disease in communities and improve population health. By placing neuroscience within a real-world context, population neuroscience can fulfill its potential to serve both precision medicine and population health.

  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. 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.

  12. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority

    OpenAIRE

    Patel, Vikram

    2015-01-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, ...

  13. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    Science.gov (United States)

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-04

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. 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

  15. Social health insurance in Nepal: A health system departure toward the universal health coverage.

    Science.gov (United States)

    Pokharel, Rajani; Silwal, Pushkar Raj

    2018-04-10

    The World Health Organization has identified universal health coverage (UHC) as a key approach in reducing equity gaps in a country, and the social health insurance (SHI) has been recommended as an important strategy toward it. This article aims to analyze the design, expected benefits and challenges of realizing the goals of UHC through the recently launched SHI in Nepal. On top of the earlier free health-care policy and several other vertical schemes, the SHI scheme was implemented in 2016 and has reached population coverage of 5% in the implemented districts in just within a year of implementation. However, to achieve UHC in Nepal, in addition to operationalizing the scheme, several other requirements must be dealt simultaneously such as efficient health-care delivery system, adequate human resources for health, a strong information system, improved transparency and accountability, and a balanced mix of the preventive, health promotion, curative, and rehabilitative services including actions to address the social determinants of health. The article notes that strong political commitment and persistent efforts are the key lessons learnt from countries achieving progressive UHC through SHI. Copyright © 2018 John Wiley & Sons, Ltd.

  16. IMPROVING THE ELASTICITY OF HIP MUSCLES AMONG THE POPULATION OF DEBRECEN UNIVERSITY STUDENTS

    Directory of Open Access Journals (Sweden)

    Agnes Nagy

    2011-06-01

    Full Text Available Decreasing tendency of daily physical activity can be observed in the population of Debrecen University students. We started a physical education at the University of Debrecen which was called spine gymnastic. At the beginning of the semester we surveyed the health status and the health behaviour of the students focused on physical activity. The elasticity of hip muscles was also measured at the beginning and the end of the semester. After completing a 14-week spine gymnastic course, which included auto stretching and strengthening exercises, we found that all measured hip muscles improved.

  17. Orthorexia nervosa in a sample of Italian university population.

    Science.gov (United States)

    Dell'Osso, Liliana; Abelli, Marianna; Carpita, Barbara; Massimetti, Gabriele; Pini, Stefano; Rivetti, Luigi; Gorrasi, Federica; Tognetti, Rosalba; Ricca, Valdo; Carmassi, Claudia

    2016-01-01

    To investigate frequency and characteristics of orthorexic behaviours in a large university population. A total of 2826 individuals volunteered to complete an on-line anonymous form of ORTO-15 questionnaire, a self-administered questionnaire designed and validated to evaluate orthorexic symptomatology. As made in previous studies, an ORTO-15 total score lower than 35 has been used as an optimal threshold to detect a tendency to orthorexia nervosa. A specifically designed form was also used to collect socio-demographic variables. Overall, 2130 students and 696 university employees belonging to University of Pisa (Italy) were assessed. Orthorexic features had a frequency of 32.7%. Females showed a significantly higher rate of over-threshold scores on ORTO-15, a lower BMI, a higher rate of underweight condition and of vegan/vegetarian nutrition style than males. Orthorexia nervosa defined as a “fixation on healthy food”, is not formally present in DSM-5. The emergence of this condition as a new, possible prodromal of a psychological syndrome, has been recently emphasized by an increasing number of scientific articles. From our sample of university population emerged that being vegetarian or vegan, under-weight, female, student and being interested in the present study were significantly predictive of orthorexic tendency. Our data contribute to define the new conceptualization of orthorexia nervosa. Further studies are warranted in order to explore the diagnostic boundaries of this syndrome, its course and outcome, and possible clinical implications.

  18. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. Mental health in war-affected populations

    NARCIS (Netherlands)

    Scholte, W.F.

    2013-01-01

    This book addresses mental health problems in populations in nonwestern war-affected regions, and methods to mitigate these problems through interventions focusing on social reintegration. It describes a number of studies among war-affected populations in widely different areas: refugees from the

  20. Comparing population health in the United States and Canada

    Directory of Open Access Journals (Sweden)

    Huguet Nathalie

    2010-04-01

    Full Text Available Abstract Background The objective of the paper is to compare population health in the United States (US and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries. Methods Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3 was used to measure overall health-related quality of life (HRQL. Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE. Results Life expectancy in Canada is higher than in the US. For those Conclusions The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance and lower levels of social and economic inequality, especially among the elderly.

  1. Public Health Achievements and Challenges: Symposium of the University of Mostar Faculty of Health Studies.

    Science.gov (United States)

    Ravlija, Jelena; Vasilj, Ivan; Babic, Dragan; Marijanovic, Inga

    2017-05-01

    Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

  2. Mandatory universal drug plan, access to health care and health: Evidence from Canada.

    Science.gov (United States)

    Wang, Chao; Li, Qing; Sweetman, Arthur; Hurley, Jeremiah

    2015-12-01

    This paper examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Using the Canadian National Population Health Survey from 1994 to 2003 and implementing a difference-in-differences estimation strategy, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Undergraduate student mental health at Makerere University, Uganda

    Science.gov (United States)

    OVUGA, EMILIO; BOARDMAN, JED; WASSERMAN, DANUTA

    2006-01-01

    There is little information on the current mental health of University students in Uganda. The present study was carried out to determine the prevalence of depressed mood and suicidal ideation among students at Makerere University. Two student samples participated. Sample I comprised 253 fresh students admitted to all faculties at the University in the academic year 2000/2001, selected by a simple random sampling procedure. Sample II comprised 101 students admitted to the Faculty of Medicine during the academic year 2002/2003. The prevalence of depressed mood was measured using the 13-item Beck Depression Inventory (BDI). The prevalence of depressed mood (BDI score 10 or more) was significantly higher in sample I (16.2%) than sample II (4.0%). Sample I members were significantly more likely than those of sample II to report lifetime and past week suicide ideation. Thus, there is a high prevalence of mental health problems among the general population of new students entering Makerere University and this is significantly higher than for new students in the Faculty of Medicine. PMID:16757997

  4. A National Assessment of Colleges and University School Health Education Methods Courses

    Science.gov (United States)

    Fisher, Christine M.; Price, James H.; Telljohann, Susan K.; Dake, Joseph A.

    2015-01-01

    Background: Across the United States, school health education programs provide a wide variety of knowledge and skills to their students. There are currently no guidelines for school health methods courses. Methods: Using a 2-wave mailing followed by a third wave e-mail reminder, a final population of 226 university school health methods…

  5. Targeting Environmental Quality to Improve Population Health ...

    Science.gov (United States)

    Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat

  6. Subjective health complaints and psychosocial work environment among university personnel.

    Science.gov (United States)

    Moen, B E; Wieslander, G; Bakke, J V; Norbäck, D

    2013-01-01

    Questionnaires are often used to study health problems in working populations. An association between self-reported symptoms and psychosocial strain has been suggested, but results from such studies are difficult to interpret, as a gender difference might be present. The knowledge in this area is not clear. To compare the prevalence of subjective health symptoms and their relation to psychosocial work strain among men and women in different age groups, all working as university staff. A cross-sectional survey was carried out among university personnel. The questionnaire included a subjective health complaint inventory consisting of 29 items about subjective somatic and psychological symptoms experienced during the last 30 days and psychosocial work factors. Regression analyses were performed. In total, 172 (86%) of 201 eligible employees participated. Women had a higher prevalence of musculoskeletal symptoms than men. Significant differences were found between the genders for headaches, neck pain and arm pain. There was a significant relationship between musculoskeletal symptoms and work strain for both genders. This was found for both men and women below 40 years and among men above the age of 40. No significant difference was found between genders regarding pseudoneurological, gastrointestinal, allergic and flu-like symptoms. More female than male university personnel reported musculoskeletal symptoms. The musculoskeletal symptoms were associated with high work strain in both genders, but, for women, this was limited to employees under the age of 40. The cause of this gender difference is unknown.

  7. Population-based contracting (population health): part II.

    Science.gov (United States)

    Jacofsky, D J

    2017-11-01

    Modern healthcare contracting is shifting the responsibility for improving quality, enhancing community health and controlling the total cost of care for patient populations from payers to providers. Population-based contracting involves capitated risk taken across an entire population, such that any included services within the contract are paid for by the risk-bearing entity throughout the term of the agreement. Under such contracts, a risk-bearing entity, which may be a provider group, a hospital or another payer, administers the contract and assumes risk for contractually defined services. These contracts can be structured in various ways, from professional fee capitation to full global per member per month diagnosis-based risk. The entity contracting with the payer must have downstream network contracts to provide the care and facilities that it has agreed to provide. Population health is a very powerful model to reduce waste and costs. It requires a deep understanding of the nuances of such contracting and the appropriate infrastructure to manage both networks and risk. Cite this article: Bone Joint J 2017;99-B:1431-4. ©2017 The British Editorial Society of Bone & Joint Surgery.

  8. Authentic leadership in a health sciences university.

    Science.gov (United States)

    Al-Moamary, Mohamed S; Al-Kadri, Hanan M; Tamim, Hani M

    2016-01-01

    To study authentic leadership characteristics between academic leaders in a health sciences university. Cross-sectional study at a health sciences university in Saudi Arabia. The Authentic Leadership Questionnaire (ALQ) was utilized to assess authentic leadership. Out of 84 ALQs that were distributed, 75 (89.3%) were eligible. The ALQ scores showed consistency in the dimensions of self-awareness (3.45 ± 0.43), internalized moral prospective (3.46 ± 0.33) and balanced processing (3.42 ± 0.36). The relational transparency dimension had a mean of 3.24 ± 0.31 which was significantly lower than other domains. Academic leaders with medical background represented 57.3%, compared to 42.7% from other professions. Academic leaders from other professions had better ALQ scores that reached statistical significance in the internalized moral perspective and relational transparency dimensions with p values of 0.006 and 0.049, respectively. In reference to the impact of hierarchy, there were no significant differences in relation to ALQ scores. Almost one-third of academic leaders (34.7%) had Qualifications in medical education that did not show significant impact on ALQ scores. There was less-relational transparency among academic leaders that was not consistent with other ALQ domains. Being of medical background may enhance leaders' opportunity to be at a higher hierarchy status but it did not enhance their ALQ scores when compared to those from other professions. Moreover, holding a master in medical education did not impact leadership authenticity.

  9. EDITORIAL Universal health coverage: A re-emerging paradigm?

    African Journals Online (AJOL)

    admin

    of earlier initiatives in global health that include the basic health ... the availability, accessibility (geographic, economic, cultural) and appropriateness ... public good nature of health leading to new .... fragmentation and towards universal.

  10. TEL4Health research at University College Cork (UCC)

    NARCIS (Netherlands)

    Drachsler, Hendrik

    2013-01-01

    Drachsler, H. (2013, 12 May). TEL4Health research at University College Cork (UCC). Invited talk given at Application of Science to Simulation, Education and Research on Training for Health Professionals Centre (ASSERT for Health Care), Cork, Ireland.

  11. Health and disease in unacculturated Amerindian populations

    Energy Technology Data Exchange (ETDEWEB)

    Neel, J V

    1977-08-01

    The stereotype of uncontacted tribal populations is that they must reproduce at near capacity to maintain or slightly increase their numbers. This paper argues that the health of minimally contacted Amerindians, as judged by the results of physical examinations and life tables for the Yanomama of Southern Venezuela and Northern Brazil, is relatively good, with population control a feature of the Indian culture. It is further argued that the usual deterioration in health with contacts with western culture probably does not result so much from special innate susceptibilities to certain epidemic diseases and to the diets and ''stresses'' of civilization as from the epidemiological characteristics of newly contacted peoples.

  12. Methods University Health System Can Use to Expand Medicaid Coverage to Uninsured Poor Parents with Medicaid Eligible Children: Policy Analysis

    National Research Council Canada - National Science Library

    McMahon, III, Robert T

    2006-01-01

    ... and the continuing reduction in local employer-sponsored insurance. The cost for providing health care to this population has fallen to Bexar County residents through local taxes in support of the county hospital, University Health System...

  13. MD Anderson's Population Health Approaches to Cancer Prevention.

    Science.gov (United States)

    Foxhall, Lewis; Moreno, Mark; Hawk, Ernest

    2018-02-01

    Texas's size and unique population demographics present challenges to addressing the state's cancer burden. The University of Texas MD Anderson Cancer Center is one of 69 National Cancer Institute-designated cancer centers across the United States. While these centers traditionally have focused on research, education and training, and providing research-driven patient care, they are in a unique position to collaboratively advance population health through cancer control. Unlike the traditional academic model of a three-legged stool representing research, education, and patient care, MD Anderson's mission includes a fourth leg that incorporates population health approaches. MD Anderson has leveraged state- and national-level data and freely available resources to develop population-health priorities and a set of evidence-based actions across policy, public and professional education, and community-based clinical service domains to address these priorities. Population health approaches complement dissemination and implementation research and treatment, and will be increasingly needed to address the growing cancer burden in Texas and the nation.

  14. HealthATM: personal health cyberinfrastructure for underserved populations.

    Science.gov (United States)

    Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

    2011-05-01

    There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

  15. Defining Pathways and Trade-offs Toward Universal Health Coverage Comment on “Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage”

    Directory of Open Access Journals (Sweden)

    Stéphane Verguet

    2016-07-01

    Full Text Available The World Health Organization’s (WHO’s World Health Report 2010, “Health systems financing, the path to universal coverage,” promoted universal health coverage (UHC as an aspirational objective for country health systems. Yet, in addition to the dimensions of services and coverage, distribution of coverage in the population, and financial risk protection highlighted by the report, the consideration of the budget constraint should be further strengthened in the ensuing debate on resource allocation toward UHC. Beyond the substantial financial constraints faced by low- and middle-income countries, additional considerations, such as the geographical context, the underlying country infrastructure, and the architecture of health systems, determine the feasibility, effectiveness, quality and cost of healthcare delivery. Therefore, increased production and use of local evidence tied to the criteria of health benefits, equity, financial risk protection, and costs accompanying health delivery are needed so that to highlight pathways and acceptable trade-offs toward UHC.

  16. China's community-based strategy of universal preconception care in rural areas at a population level using a novel risk classification system for stratifying couples´ preconception health status.

    Science.gov (United States)

    Zhou, Qiongjie; Zhang, Shikun; Wang, Qiaomei; Shen, Haiping; Tian, Weidong; Chen, Jingqi; Acharya, Ganesh; Li, Xiaotian

    2016-12-28

    Preconception care (PCC) is recommended for optimizing a woman's health prior to pregnancy to minimize the risk of adverse pregnancy and birth outcomes. We aimed to evaluate the impact of strategy and a novel risk classification model of China´s "National Preconception Health Care Project" (NPHCP) in identifying risk factors and stratifying couples' preconception health status. We performed a secondary analysis of data collected by NPHCP during April 2010 to December 2012 in 220 selected counties in China. All couples enrolled in the project accepted free preconception health examination, risk evaluation, health education and medical advice. Risk factors were categorized into five preconception risk classes based on their amenability to prevention and treatment: A-avoidable risk factors, B- benefiting from targeted medical intervention, C-controllable but requiring close monitoring and treatment during pregnancy, D-diagnosable prenatally but not modifiable preconceptionally, X-pregnancy not advisable. Information on each couple´s socio-demographic and health status was recorded and further analyzed. Among the 2,142,849 couples who were enrolled to this study, the majority (92.36%) were from rural areas with low education levels (89.2% women and 88.3% men had education below university level). A total of 1463266 (68.29%) couples had one or more preconception risk factors mainly of category A, B and C, among which 46.25% were women and 51.92% were men. Category A risk factors were more common among men compared with women (38.13% versus 11.24%; P = 0.000). This project provided new insights into preconception health of Chinese couples of reproductive age. More than half of the male partners planning to father a child, were exposed to risk factors during the preconception period, suggesting that an integrated approach to PCC including both women and men is justified. Stratification based on the new risk classification model demonstrated that a majority of the

  17. Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries

    OpenAIRE

    Peltzer, Karl; Pengpid, Supa

    2014-01-01

    Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate...

  18. Health workers' ICT literacy in a Nigerian University Teaching Hospital

    African Journals Online (AJOL)

    This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...

  19. The Health of America's Aging Prison Population.

    Science.gov (United States)

    Skarupski, Kimberly A; Gross, Alden; Schrack, Jennifer A; Deal, Jennifer A; Eber, Gabriel B

    2018-03-23

    Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.

  20. Emerging health issues: the widening challenge for population health promotion.

    Science.gov (United States)

    McMichael, Anthony J; Butler, Colin D

    2006-12-01

    The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the

  1. Determinants of health-related lifestyles among university students.

    Science.gov (United States)

    Aceijas, Carmen; Waldhäusl, Sabrina; Lambert, Nicky; Cassar, Simon; Bello-Corassa, Rafael

    2017-07-01

    The aim of this study was to investigate students' health-related lifestyles and to identify barriers and social determinants of healthier lifestyles. An online survey, two focus groups and three in-depth interviews across 2014/2015. A stratified by school size and random sample ( n = 468) of university students answered a 67-item questionnaire comprising six scales: Rapid Assessment of Physical Activity, Rapid Eating and Activity Assessment for Patients-Short Version, CAGE, Fagerström Test for Nicotine Dependence, Warwick-Edinburgh Mental Wellbeing Scale short version, and ad hoc scale for drug use/misuse. Stratified by gender, χ 2 tests were run to test associations/estimate risks and three multivariate Logistic Regression models were adjusted. A thematic approach guided the analysis of qualitative data. A total of 60% of the respondents were insufficiently physically active, 47% had an unbalanced diet and 30% had low mental wellbeing. Alcohol drinkers versus abstinent were almost equally distributed. A total of 42% of alcohol drinkers reported getting drunk at least once a month. Smokers accounted for 16% of the respondents. Identified risk factors for suboptimal physical activity were as follows: being a woman, not using the university gym and smoking. Risk factors for unbalanced diet were low mental wellbeing and drug use. Poor mental wellbeing was predicted by unbalanced diet, not feeling like shopping and cooking frequently, and a lack of help-seeking behaviour in cases of distress. Qualitative analysis revealed seven thematic categories: transition to new life, university environment and systems, finances, academic pressure, health promotion on campus and recommendations. This study provides robust evidence that the health-related lifestyles of the student population are worrying and suggests that the trend in chronic diseases associated with unhealthy lifestyles sustained over years might be unlikely to change in future generations. University students

  2. Macroeconomic conditions and population health in Iceland

    Directory of Open Access Journals (Sweden)

    Kristín Helga Birgisdóttir

    2017-09-01

    Full Text Available Background: Results from recent research on the impact of economic cycles and population health have been mixed, with results appearing to be context-sensitive. Objective: We examine the long-term relationship between economic conditions and population health in Iceland, which has experienced some economically turbulent times in the last years and decades. Methods: We use aggregate annual data for 1981‒2014. We use three aggregate indicators of economic activity to proxy the economic cycle: unemployment rate, real GDP per capita, and real GDP. Life expectancy at birth, infant mortality, and total mortality as well as four cause-specific mortality rates were used as outcome measures. Results: Our results do not suggest a statistically significant relationship between economic conditions and total mortality, infant mortality, or life expectancy. Different responses between causes of death are found, and in some instances between genders, although statistical significance is low. We do, however, find a consistent and statistically significant relationship for females aged 45‒64, where economic downturns are associated with lower all-cause mortality. Conclusions: For the time period studied we do not find a significant relationship between economic cycles and population health, where health is proxied by mortality rates, life expectancy at birth, and infant mortality. Further studies using less extreme health outcomes, such as morbidity rates, are warranted. Contribution: This type of study has not been performed using Icelandic data before and provides a comparison to research from other countries where the relationship has been explored more. Additionally, one of the contributions of this paper is to use a variety of economic indicators as proxies for economic cycles in a study examining their relationship with population health.

  3. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority.

    Science.gov (United States)

    Patel, Vikram

    2016-07-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, acceptability and cost-effectiveness of the delivery of these interventions through a collaborative care model in low resource settings. While there are a number of barriers to scaling up this evidence, for eg, the finances needed to train and deploy community based workers and the lack of agency for people with schizophrenia, the experiences of some upper middle income countries show that sustained political commitment, allocation of transitional financial resources to develop community services, a commitment to an integrated approach with a strong role for community based institutions and providers, and a progressive realization of coverage are the key ingredients for scale up of services for schizophrenia. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  4. Monitoring intervention coverage in the context of universal health coverage.

    Directory of Open Access Journals (Sweden)

    Ties Boerma

    2014-09-01

    Full Text Available Monitoring universal health coverage (UHC focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the

  5. Predictors of leisure physical activity in a spanish university population

    Directory of Open Access Journals (Sweden)

    Ana Ponce-de-León Elizondo

    2014-06-01

    Full Text Available Objectives: To determine some predictors of leisure-time physical activity in the Spanish university environment. Participants: A total of 1340 participants (48% men, with an average age of 22 years. Variables: leisure-time physical activity practice; gender; civil status; place of residence; amount of leisuretime; leisure-time occupation; desire to perform physical activity; satisfaction with the use of leisure-time; leisure-time physical activity practice in the past; and years of physical activity practice. Method: Face-toface interviews were undertaken using a questionnaire with close-ended questions. Results: Fifty-eight percent of the subjects reported being physically inactive. Male gender, desire to perform physical activity, satisfaction with the use of leisure-time, and practice of sports in the past, were significantly associated with leisure-time physical activity. Conclusions: Physical activity practice during childhood and adolescence is the strongest predictor of current leisure-time physical activity for this university population.

  6. Physical activity and health promotion in Italian university students.

    Science.gov (United States)

    Teleman, Adele Anna; de Waure, Chiara; Soffiani, Valentina; Poscia, Andrea; Di Pietro, Maria Luisa

    2015-01-01

    Physical activity, diet plans, the mantainment of a certain Body Mass Index (BMI) and the use of various types of supplementation are common elements in the search for disease prevention, health promotion and well-being. We analyzed the data regarding Italian university students' BMI, dieting behaviour, personal body perception, exercise habits, and use of dietary supplements and of doping substances. 13.7% resulted being underweight, 75.1% was in the normal range, 9.8% was overweight, and 1.4% was obese. 11.0% were on a diet. 25.8% of the students reported never doing any type of physical activity. 0.9% admitted consuming doping substances. The percentage of overweight/obese students increases from 8.8% of the 18-21 year olds to 18.1% of the 25-30 year olds. Similarly, the prevalence of overweight/obesity was 18.5% among male population and 7.5% among the female one. The data deriving from this questionnaire showed that while the majority of university students has a BMI in the normal range, 11.2% of the study population is overweight/obese. Males present a higher risk of being overweight or obese. An important part of the population showed to be sedentary even though data coming from our study are aligned to further evidence. The most important concern arising from the questionnaire is represented by physical inactivity. Indeed, it is necessary to encourage and plan initiatives aimed at promoting physical activity in university students.

  7. Physical activity and health promotion in Italian university students

    Directory of Open Access Journals (Sweden)

    Adele Anna Teleman

    2015-06-01

    Full Text Available INTRODUCTION: Physical activity, diet plans, the mantainment of a certain Body Mass Index (BMI and the use of various types of supplementation are common elements in the search for disease prevention, health promotion and well-being. MATERIALS AND METHODS: We analyzed the data regarding Italian university students' BMI, dieting behaviour, personal body perception, exercise habits, and use of dietary supplements and of doping substances. RESULTS: 13.7% resulted being underweight, 75.1% was in the normal range, 9.8% was overweight, and 1.4% was obese. 11.0% were on a diet. 25.8% of the students reported never doing any type of physical activity. 0.9% admitted consuming doping substances. The percentage of overweight/obese students increases from 8.8% of the 18-21 year olds to 18.1% of the 25-30 year olds. Similarly, the prevalence of overweight/obesity was 18.5% among male population and 7.5% among the female one. DISCUSSION: The data deriving from this questionnaire showed that while the majority of university students has a BMI in the normal range, 11.2% of the study population is overweight/obese. Males present a higher risk of being overweight or obese. An important part of the population showed to be sedentary even though data coming from our study are aligned to further evidence. CONCLUSION: The most important concern arising from the questionnaire is represented by physical inactivity. Indeed, it is necessary to encourage and plan initiatives aimed at promoting physical activity in university students.

  8. University of Washington Center for Child Environmental Health Risks Research

    Data.gov (United States)

    Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

  9. [Public health competencies and contents in Spanish university degree programmes of Veterinary Medicine].

    Science.gov (United States)

    Davó-Blanes, María Del Carmen; Vives-Cases, Carmen; Huerta, Belén

    2017-04-19

    To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into the Veterinary Medicine degree training. The 3rd Forum of University Professors of Public Health was held at the School of Veterinary Medicine of the University of Cordoba (12-13 January 2016). Forty-two university professors and lecturers from nine Spanish universities with veterinary degrees participated in the forum. They were divided into five working groups during three working sessions to identify and classify core public health competencies for the Veterinary Medicine degree, propose public health contents for the identified competencies and organize such contents in thematic blocks. The results were discussed in different plenary sessions. The highest number of core competencies was identified in the activities related to the following public health functions: «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organized into five units: 1) Fundamentals of public health; 2) Study and research in public health; 3) Production, animal health and environment; 4) Food security; and 5) Health education. The public health core competencies and contents identified in this Forum may be considered as a starting point to update public health training programmes for future veterinary professionals. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Population ageing alongside health care spending growth

    Directory of Open Access Journals (Sweden)

    Jakovljević Mihajlo

    2017-01-01

    Full Text Available The Silver Tsunami or population ageing has become a globally widespread phenomenon. The purpose of this review is to observe its dynamics and consequences from a local Balkan perspective. The main drivers of this unique demographic evolution are extended longevity, improved early childhood survival, absorption of women into the labor markets, and consequences of sexual revolution leading to falling female fertility. This process lasting well over a century is taking its toll on contemporary societies. Major side effects are shrinking young labor force and growing pool of elderly and retired citizens in many countries. This equation tends to worsen further in the future threatening long-term financial sustainability of public social and health insurance funds. Notable health expenditure growth, accelerating worldwide since the 1960s, is to a large degree attributable to ageing itself. Growing share of senior citizens increases demand for medical services and costs of health care provision. Home-based care provided by the family caregivers presents another important reality putting a huge burden on modern communities. Serbs are no exception in this landscape. Historical demographic evolution of this nation gives a clear evidence of advanced and accelerated ageing, which is well documented in post-World War II era. This synthesis of rich published evidence shows clear upward parallel trend between the pace of population aging and the growth of health expenditure. National authorities shall be forced to consider reform of the current health care financing pattern inherited from the demographic growth era. This might be the only way to smooth out the impact of population ageing on the financial sustainability of the health system and long-term medical care in Serbia. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. OI 175014

  11. Psychedelics and mental health: a population study.

    Directory of Open Access Journals (Sweden)

    Teri S Krebs

    Full Text Available The classical serotonergic psychedelics LSD, psilocybin, mescaline are not known to cause brain damage and are regarded as non-addictive. Clinical studies do not suggest that psychedelics cause long-term mental health problems. Psychedelics have been used in the Americas for thousands of years. Over 30 million people currently living in the US have used LSD, psilocybin, or mescaline.To evaluate the association between the lifetime use of psychedelics and current mental health in the adult population.Data drawn from years 2001 to 2004 of the National Survey on Drug Use and Health consisted of 130,152 respondents, randomly selected to be representative of the adult population in the United States. Standardized screening measures for past year mental health included serious psychological distress (K6 scale, mental health treatment (inpatient, outpatient, medication, needed but did not receive, symptoms of eight psychiatric disorders (panic disorder, major depressive episode, mania, social phobia, general anxiety disorder, agoraphobia, posttraumatic stress disorder, and non-affective psychosis, and seven specific symptoms of non-affective psychosis. We calculated weighted odds ratios by multivariate logistic regression controlling for a range of sociodemographic variables, use of illicit drugs, risk taking behavior, and exposure to traumatic events.21,967 respondents (13.4% weighted reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote, or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems.We did not find use of psychedelics to be an independent risk factor for mental health problems.

  12. Indonesia's road to universal health coverage: a political journey.

    Science.gov (United States)

    Pisani, Elizabeth; Olivier Kok, Maarten; Nugroho, Kharisma

    2017-03-01

    In 2013 Indonesia, the world's fourth most populous country, declared that it would provide affordable health care for all its citizens within seven years. This crystallised an ambition first enshrined in law over five decades earlier, but never previously realised. This paper explores Indonesia's journey towards universal health coverage (UHC) from independence to the launch of a comprehensive health insurance scheme in January 2014. We find that Indonesia's path has been determined largely by domestic political concerns – different groups obtained access to healthcare as their socio-political importance grew. A major inflection point occurred following the Asian financial crisis of 1997. To stave off social unrest, the government provided health coverage for the poor for the first time, creating a path dependency that influenced later policy choices. The end of this programme coincided with decentralisation, leading to experimentation with several different models of health provision at the local level. When direct elections for local leaders were introduced in 2005, popular health schemes led to success at the polls. UHC became an electoral asset, moving up the political agenda. It also became contested, with national policy-makers appropriating health insurance programmes that were first developed locally, and taking credit for them. The Indonesian experience underlines the value of policy experimentation, and of a close understanding of the contextual and political factors that drive successful UHC models at the local level. Specific drivers of success and failure should be taken into account when scaling UHC to the national level. In the Indonesian example, UHC became possible when the interests of politically and economically influential groups were either satisfied or neutralised. While technical considerations took a back seat to political priorities in developing the structures for health coverage nationally, they will have to be addressed going forward

  13. Mental Health and the Transgender Population.

    Science.gov (United States)

    Carmel, Tamar C; Erickson-Schroth, Laura

    2016-12-01

    Although research into the physical and mental health disparities faced by transgender and gender nonconforming (TGNC) populations is becoming more popular, historically it has been limited. It is now recognized that TGNC people experience disproportionate rates of negative mental health outcomes relative to both their gender-normative, heterosexual peers, as well as their gender-normative lesbian, gay, and bisexual (LGB) peers. The theoretical basis of current transgender mental health research is rooted in the Minority Stress Model, which postulates that we live in a hetero-centric, gender-normative society that stigmatizes and discriminates against lesbian, gay, bisexual, and transgender (LGBT) people, subjecting them to chronic stress (Hendricks & Testa, 2012; Meyer, 1995). This chronic, potentially compounding stress, is responsible for the increased risk of negative mental health outcomes in LGBT populations. TGNC people, in particular, may experience more adverse outcomes than their LGB peers due to rejection and discrimination within society at large as well as within the LGB community. [Journal of Psychosocial Nursing and Mental Health Services, 54(12), 44-48.]. Copyright 2016, SLACK Incorporated.

  14. FastStats: Health of Mexican American Population

    Science.gov (United States)

    ... Submit Button NCHS Home Health of Mexican American Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

  15. Health and disease in unacculturated Amerindian populations

    Energy Technology Data Exchange (ETDEWEB)

    Neel, J.V.

    1977-08-01

    The stereotype of uncontacted tribal populations is that they must reproduce at near capacity to maintain or slightly increase their numbers. This paper argues that the health of minimally contacted Amerindians, as judged by the results of physical examinations and life tables for the Yanomama of Southern Venezuela and Northern Brazil, is relatively good, with population control a feature of the Indian culture. It is further argued that the usual deterioration in health with contacts with western culture probably does not result so much from special innate susceptibilities to certain epidemic diseases and to the diets and ''stresses'' of civilization as from the epidemiological characteristics of newly contacted peoples.

  16. Speaking of Health: Assessing Health Communication Strategies for Diverse Populations

    National Research Council Canada - National Science Library

    2002-01-01

    ... for their special competences and with regard for appropriate balance. Support for this project was provided by the Institute of Medicine. The views presented in this report are those of the Institute of Medicine Committee on Communication for Behavior Change in the 21st Century: Improving the Health of Diverse Populations and are not necessarily those of ...

  17. Adult height, nutrition, and population health

    Science.gov (United States)

    Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

    2016-01-01

    In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

  18. Mobile health interventions in Indigenous populations

    Directory of Open Access Journals (Sweden)

    Valerie Onyinyechi Umaefulam

    2017-06-01

    Full Text Available Humans are social beings and communication is vital and necessary for every cultural group which may be the primary motivator, why many populations worldwide have taken up mobile phones (1. Communication via mobile has significant cultural and identity implications for Indigenous people worldwide particularly those living in rural and hard to reach communities because due to globalization, a number of people now live away from their local communities for trade, employment, education, etc. Thus, mobile phones are devices for social networking and communication; and enables cultural connection and identification with family and friends. Its affordability, versatility of features, and portability create an opportunity for utilizing mobile technology to positively impact the health via health education, promotion, and provision of remote health services among others.

  19. Suicide Prevention Strategies for Improving Population Health.

    Science.gov (United States)

    Wilcox, Holly C; Wyman, Peter A

    2016-04-01

    Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Technical support for universal health coverage pilots in Karnataka ...

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

    Technical support for universal health coverage pilots in Karnataka and Kerala. This project will provide evidence-based support to implement universal health coverage (UHC) pilot activities in two Indian states: Kerala and Karnataka. The project team will provide technical assistance to these early adopter states to assist ...

  1. Lifestyle, Fitness and Health Promotion Initiative of the University of ...

    African Journals Online (AJOL)

    This study examined the health promotion initiative introduced by the Management of the University of Ilorin, Ngeria. In an attempt to ensure stress free academic society that would boost staff productivity and longevity, the university invested heavily on a number of lifestyle, fitness and health promotion initiatives. Descriptive ...

  2. Health Attitudes and Suicidal Ideation among University Students

    Science.gov (United States)

    Ashrafioun, Lisham; Bonar, Erin; Conner, Kenneth R.

    2016-01-01

    Objective: The purpose of this study was to examine whether positive health attitudes are associated with suicidal ideation among university students after accounting for other health risk factors linked to suicidal ideation. Participants: Participants were 690 undergraduates from a large midwestern university during fall semester 2011. Methods:…

  3. Health care financing in Nigeria: Implications for achieving universal ...

    African Journals Online (AJOL)

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms.

  4. Introduction of article-processing charges for Population Health Metrics

    Directory of Open Access Journals (Sweden)

    Murray Christopher JL

    2003-11-01

    Full Text Available Abstract Population Health Metrics is an open-access online electronic journal published by BioMed Central – it is universally and freely available online to everyone, its authors retain copyright, and it is archived in at least one internationally recognised free repository. To fund this, from November 1 2003, authors of articles accepted for publication will be asked to pay an article-processing charge of US$500. This editorial outlines the reasons for the introduction of article-processing charges and the way in which this policy will work. Waiver requests will be considered on a case-by-case basis, by the Editor-in-Chief. Article-processing charges will not apply to authors whose institutions are 'members' of BioMed Central. Current members include NHS England, the World Health Organization, the US National Institutes of Health, Harvard, Princeton and Yale universities, and all UK universities. No charge is made for articles that are rejected after peer review. Many funding agencies have also realized the importance of open access publishing and have specified that their grants may be used directly to pay APCs.

  5. Access to Medicines by Seguro Popular Beneficiaries: Pending Tasks towards Universal Health Coverage.

    Directory of Open Access Journals (Sweden)

    Edson Servan-Mori

    Full Text Available In the context of aiming to achieve universal health coverage in Mexico, this study compares access to prescribed medicines (ATPM between Seguro Popular (SP and non-SP affiliated outpatient health service users.ATPM by 6,123 users of outpatient services was analyzed using the National Health and Nutrition Survey 2012. Adjusted bi-probit models were performed incorporating instrumental variables.17.3% of SP and 10.1% of the non-SP population lacked ATPM. Two-thirds of all outpatient SP and 18.5% of all outpatient non-SP received health services at Ministry of Health facilities, among whom, 64.6 and 53.6% of the SP and non-SP population respectively reported ATPM at these facilities. Lack of medicines in health units, chronic health problems (compared to acute conditions and prescription ≥3 medicines were risk factors for non-ATPM. Adjusted models suggest that when using Ministry of Health services, the SP population has a higher probability of ATMP compared to the non-SP population.Given the aspirations of achieving universal health coverage in Mexico, it is important to increase ATPM in Ministry of Health facilities thereby ensuring basic rights to health care are met.

  6. Access to Medicines by Seguro Popular Beneficiaries: Pending Tasks towards Universal Health Coverage.

    Science.gov (United States)

    Servan-Mori, Edson; Heredia-Pi, Ileana; Montañez-Hernandez, Julio; Avila-Burgos, Leticia; Wirtz, Veronika J

    2015-01-01

    In the context of aiming to achieve universal health coverage in Mexico, this study compares access to prescribed medicines (ATPM) between Seguro Popular (SP) and non-SP affiliated outpatient health service users. ATPM by 6,123 users of outpatient services was analyzed using the National Health and Nutrition Survey 2012. Adjusted bi-probit models were performed incorporating instrumental variables. 17.3% of SP and 10.1% of the non-SP population lacked ATPM. Two-thirds of all outpatient SP and 18.5% of all outpatient non-SP received health services at Ministry of Health facilities, among whom, 64.6 and 53.6% of the SP and non-SP population respectively reported ATPM at these facilities. Lack of medicines in health units, chronic health problems (compared to acute conditions) and prescription ≥3 medicines were risk factors for non-ATPM. Adjusted models suggest that when using Ministry of Health services, the SP population has a higher probability of ATMP compared to the non-SP population. Given the aspirations of achieving universal health coverage in Mexico, it is important to increase ATPM in Ministry of Health facilities thereby ensuring basic rights to health care are met.

  7. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    Adequately equipped clinical laboratories should provide early warning signals of health risks. The Assessment categorized the laboratories at three levels relating to the type of facility, these being hospital, health center and health post. This study used results from the SARA to determine the ability to make timely diagnosis ...

  8. [Suicide Prevention and Mental Health Measures for Japanese University Students].

    Science.gov (United States)

    Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito

    2016-01-01

    According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.

  9. Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia.

    Science.gov (United States)

    Santric-Milicevic, M; Vasic, V; Terzic-Supic, Z

    2016-08-15

    In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.

  10. Accessibility to health services in the prison population in Colombia: a public health challenge

    Directory of Open Access Journals (Sweden)

    Luz Mery Mejía O

    2010-08-01

    Full Text Available This article is the result of a product of a study elaborated with the aim of systematizing the available information related to the accessibility to the health services of the prison population in the penitentiary centers. To this end, we reviewed the literature and systematic collection of the academic available material in the principal university libraries in the city of Medellin, scientific databases and the web pages of national and international organizations that have dealt with this topic. The information was systematized considering some historical references to prisons and health, the record of experiences in some countries and the current regulations for health care in the prison population in the Colombian case. We conclude that although significant progress has been made to ensure health care for the prison population, in the prison there are still obstacles and limitations that infringe the right to health of this population. Likewise, it is evidenced that it has not been considered a public health problem in the country, which it is considered a challenge to incorporate it as such.

  11. Adherence to Mediterranean diet in a Spanish university population.

    Science.gov (United States)

    García-Meseguer, María José; Burriel, Faustino Cervera; García, Cruz Vico; Serrano-Urrea, Ramón

    2014-07-01

    The aim of this work was to characterize food habits of Spanish University students and to assess the quality of their diet and some possible determinant factors according to Mediterranean food pattern among other indices. Two hundred eighty-four enrolled students during the academic year 2012-2013 participated in this survey. For each individual a questionnaire involving anthropometric measurements, types of housing, smoking habits and levels of physical activity were self-reported. Food consumption was gathered by two nonconsecutive 24 hour recalls including one weekend day. BMI within the normal range was showed by 72.5% of students and 75% of the sample reflected a sedentary lifestyle or low physical activity. The percentage of total energy from each macronutrient was approximately 17% proteins, 40% carbohydrates and 40% lipids. The ratio of polyunsaturated to monounsaturated fat only reached 0.32. Cholesterol consumption in men exceeded the intake in women by 70 mg/day but nutritional objectives were exceeded in both genders. The main source of protein had an animal origin from meat (38.1%), followed by cereals (19.4%) and dairy products (15.6%). The assessment of diet quality conducted by Healthy Eating Index (HEI) and Mediterranean Diet Score (MDS) revealed a low-intermediate score in both (51.2 ± 12.8 and 4.0 ± 1.5, respectively). The main deviations from Mediterranean pattern were a low intake of vegetables and fruit and a high consumption of meat and dairy products. According to HEI classification, 96.1% of subjects scored "poor" or "needs improvement" about the quality of their diet and only 5.3% of students achieved a high adherence to Mediterranean diet. It is necessary to foster changes toward a healthier diet pattern according to cultural context in this population for preventing cardiovascular diseases, type 2 diabetes and insulin resistance. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Universal Health Coverage and the Right to Health: From Legal Principle to Post-2015 Indicators.

    Science.gov (United States)

    Sridhar, Devi; McKee, Martin; Ooms, Gorik; Beiersmann, Claudia; Friedman, Eric; Gouda, Hebe; Hill, Peter; Jahn, Albrecht

    2015-01-01

    Universal Health Coverage (UHC) is widely considered one of the key components for the post-2015 health goal. The idea of UHC is rooted in the right to health, set out in the International Covenant on Economic, Social, and Cultural Rights. Based on the Covenant and the General Comment of the Committee on Economic, Social, and Cultural Rights, which is responsible for interpreting and monitoring the Covenant, we identify 6 key legal principles that should underpin UHC based on the right to health: minimum core obligation, progressive realization, cost-effectiveness, shared responsibility, participatory decision making, and prioritizing vulnerable or marginalized groups. Yet, although these principles are widely accepted, they are criticized for not being specific enough to operationalize as post-2015 indicators for reaching the target of UHC. In this article, we propose measurable and achievable indicators for UHC based on the right to health that can be used to inform the ongoing negotiations on Sustainable Development Goals. However, we identify 3 major challenges that face any exercise in setting indicators post-2015: data availability as an essential criterion, the universality of targets, and the adaptation of global goals to local populations. © SAGE Publications 2015.

  13. Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

    2015-04-29

    The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

  14. Pathways to health in a deprived population: relationships between smoking, mental health & physical health

    OpenAIRE

    Kemp, Kim

    2011-01-01

    Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a natio...

  15. Achieving universal health coverage in small island states: could importing health services provide a solution?

    Science.gov (United States)

    Walls, Helen; Smith, Richard

    2018-01-01

    Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

  16. Nursing challenges for universal health coverage: a systematic review

    Directory of Open Access Journals (Sweden)

    Mariana Cabral Schveitzer

    2016-01-01

    Full Text Available Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

  17. Dissemination, Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs.

    Science.gov (United States)

    Kuo, Tony; Gase, Lauren N; Inkelas, Moira

    2015-12-01

    The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system-level changes, these methods are often not strategically used by public health. More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health. Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex-systems issues. Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities. © 2015 Wiley Periodicals, Inc.

  18. Los seguros de salud mexicanos: cobertura universal incierta Mexican health insurance: uncertain universal coverage

    Directory of Open Access Journals (Sweden)

    Asa Cristina Laurell

    2011-06-01

    Full Text Available El sistema de salud mexicano se compone de la Secretaría de Salud (rectora del sector y prestador de algunos servicios, la seguridad social laboral pública, y el sector privado. Transita por un proceso de reforma iniciado en 1995 para universalizar la cobertura y separar las funciones regulación-financiamiento-prestación de servicios; reforma que después de quince años sigue inacabada y problemática. Este texto analiza crítica- y propositivamente la problemática surgida a raíz de las sucesivas reformas. El énfasis se pone en su última etapa con la introducción del "Seguro Popular" para la población sin seguridad social laboral. El análisis concibe la reforma de salud como parte de la Reforma del Estado en el marco de la reorganización neoliberal de la sociedad. A diferencia de otros países latinoamericanos este proceso no pasó por una nueva Constitución. El análisis se basa en documentos oficiales y un seguimiento sistemático de la instrumentación del Sistema de Protección Social en Salud y su impacto sobre la cobertura y acceso a los servicios. Se concluye que es improbable que se universalice la cobertura poblacional y menos el acceso a los servicios. Empero las reformas están forzando la mercantilización del sistema aún en presencia de un sector privado débil.The Mexican health system is comprised of the Department of Health, state labor social security and the private sector. It is undergoing a reform process initiated in 1995 to achieve universal coverage and separate the regulation, financing and service functions; a reform that after fifteen years is incomplete and problematic. The scope of this paper is to assess the problems that underlie the successive reforms. Special emphasis is given to the last reform stage with the introduction of the "Insurance of the People" aimed at the population without labor social security. In the analysis, health reform is seen as part of the Reform of the State in the context of

  19. INTERDISCIPLINARY MODULE IN PREVENTION AND HEALTH PROMOTION IN POPULATION HEALTH FOR OCCUPATIONAL THERAPY AND PHYSIOTHERAPY STUDENTS

    DEFF Research Database (Denmark)

    Brandt, Jørgen

    -operate towards appropriate solutions. The groups suggest and present preventive and health promotion solutions and strategies especially designed for this particular situation. The groups are supervised by an interdisciplinary team of occupational therapy and physiotherapy lecturers. In addition......PURPOSE: The purpose is to provide physiotherapy and occupational therapy students at the University College Cvu vita in Holstebro, Denmark, the opportunity to develop competences for interdisciplinary working situations concerning promotion of population health. RELEVANCE: The Danish Ministry...... of the Interior and Health participates in co-operation within the European Union on health areas, which focuses on efforts with respect to public health (Article 152 of the Treaty on EU). The curricula for both educations underline the importance of preparing the students for interdisciplinary co...

  20. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    Science.gov (United States)

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

  1. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    In this paper we explore the implications of normative principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which...

  2. Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

    Science.gov (United States)

    Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

    2014-01-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

  3. Progress towards universal health coverage in BRICS: translating economic growth into better health.

    Science.gov (United States)

    Rao, Krishna D; Petrosyan, Varduhi; Araujo, Edson Correia; McIntyre, Diane

    2014-06-01

    Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--represent some of the world's fastest growing large economies and nearly 40% of the world's population. Over the last two decades, BRICS have undertaken health-system reforms to make progress towards universal health coverage. This paper discusses three key aspects of these reforms: the role of government in financing health; the underlying motivation behind the reforms; and the value of the lessons learnt for non-BRICS countries. Although national governments have played a prominent role in the reforms, private financing constitutes a major share of health spending in BRICS. There is a reliance on direct expenditures in China and India and a substantial presence of private insurance in Brazil and South Africa. The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access. The move towards universal health coverage has been slow. In China and India, the reforms have not adequately addressed the issue of out-of-pocket payments. Negotiations between national and subnational entities have often been challenging but Brazil has been able to achieve good coordination between federal and state entities via a constitutional delineation of responsibility. In the Russian Federation, poor coordination has led to the fragmented pooling and inefficient use of resources. In mixed health systems it is essential to harness both public and private sector resources.

  4. Leveraging Existing Laboratory Capacity towards Universal Health ...

    African Journals Online (AJOL)

    Background: The provision of quality health care is influenced by ... Laboratory support is urgently needed to enhance service delivery in the ... Information generated through ... professionals using simple rapid technology have been adopted.

  5. Treatment of Bipolar Disorder in the University Student Population

    Science.gov (United States)

    Federman, Russ

    2011-01-01

    University counseling centers are faced with the challenge of effectively treating bipolar students while also utilizing brief treatment frameworks and managing high patient volumes. Potential destabilization, particularly within the elevated mood phase, poses significant behavioral management issues for university clinicians and administrators,…

  6. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    Science.gov (United States)

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC.

  7. STUDY ON THE MOTIVES FOR PSYCHOLOGICAL CONSULTATION IN A UNIVERSITY POPULATION

    Directory of Open Access Journals (Sweden)

    SILVIA QUESADA

    2004-01-01

    Full Text Available This paper is elaborated within the context of the following Investigation Project called: «Construction of apsychopathic profile of the population that consult for a Psicology service at the Health and Social ServiceDepartment of the Buenos Aires University».On it, it is described its advanced state, revealing: 1 the consulting population regarding its distribution: faculty ofbelonging, age and gender. 2 the most frequent consulting reasons, and finally, 3 the changes on these reasons ; itwill be taken into account the consults between 1998-2001.The information to be evaluated are the interviews of admission. The methodology is the quali-quantitive analysisof the data obtained through this material. The results will not be considered definitive as the project is under aprocess, that it is dued to end on December 2003.

  8. Mental health and HIV sexual risk behaviour among University of ...

    African Journals Online (AJOL)

    Mental health and HIV sexual risk behaviour among University of Limpopo students. ... Methods. A cross-sectional survey was conducted among undergraduate ... positive for post-traumatic stress disorder (PTSD), 22% reported hazardous or ...

  9. Plan for radiological security at a university health center

    International Nuclear Information System (INIS)

    Huiaman Mendoza, G.M.; Sanchez Riojas, M.M.; Felix JImenez, D.

    1998-01-01

    This work shows a radiological security plan applied to a Basic Radiological Service at a university health center. Factors taken into account were installation designs, equipment operation parameters, work procedures, image system and responsibilities

  10. HEALTH SECTOR CORRUPTION AS THE ARCHENEMY OF UNIVERSAL HEALTH CARE IN INDONESIA

    OpenAIRE

    Juwita, Ratna

    2017-01-01

    AbstractThis article argues that health sector corruption is a direct threat towards universal health care in Indonesia. Three Indonesian legal cases of health sector corruption are selected to exemplify the reality of health sector corruption and it’s detrimental effect to the realization of the right to health. This article emphasizes that corruption causes misallocation and embezzlement of the fund that hampers the State party to optimally provide universal health care for the people. This...

  11. Leadership Succession Management in a University Health Faculty

    Science.gov (United States)

    McMurray, Anne M.; Henly, Debra; Chaboyer, Wendy; Clapton, Jayne; Lizzio, Alf; Teml, Martin

    2012-01-01

    We report on a succession planning pilot project in an Australian university health faculty. The programme aimed to enhance organisational stability and develop leadership capacity in middle level academics. Six monthly sessions addressed university and general leadership topics, communication, decision-making, working with change, self-management…

  12. Enhancing Political Will for Universal Health Coverage in Nigeria.

    Science.gov (United States)

    Aregbeshola, Bolaji S

    2017-01-01

    Universal health coverage aims to increase equity in access to quality health care services and to reduce financial risk due to health care costs. It is a key component of international health agenda and has been a subject of worldwide debate. Despite differing views on its scope and pathways to reach it, there is a global consensus that all countries should work toward universal health coverage. The goal remains distant for many African countries, including Nigeria. This is mostly due to lack of political will and commitment among political actors and policymakers. Evidence from countries such as Ghana, Chile, Mexico, China, Thailand, Turkey, Rwanda, Vietnam and Indonesia, which have introduced at least some form of universal health coverage scheme, shows that political will and commitment are key to the adoption of new laws and regulations for reforming coverage. For Nigeria to improve people's health, reduce poverty and achieve prosperity, universal health coverage must be vigorously pursued at all levels. Political will and commitment to these goals must be expressed in legal mandates and be translated into policies that ensure increased public health care financing for the benefit of all Nigerians. Nigeria, as part of a global system, cannot afford to lag behind in striving for this overarching health goal.

  13. Universal Health Coverage: A burning need for developing countries

    OpenAIRE

    Zaman, Sojib Bin; Hossain, Naznin

    2017-01-01

    The term of universal health coverage (UHC) are getting popularity among the countries who have not yet attained it. Majority of the developing countries are planning to implement the UHC to protect the vulnerable citizen who cannot afford to buy the health services. Poor people living in developing countries, where there is no UHC, are bereft of getting equal health care. They have to bear a significant amount of health cost in buying different services which often causes catastrophic expend...

  14. Blending Community Service and Teaching to Open Vision Care and Eye Health Awareness to University Students

    Science.gov (United States)

    Do, Chi-wai; Chan, Lily Y. L.; Wong, Horace H. Y.; Chu, Geoffrey; Yu, Wing Yan; Pang, Peter C. K.; Cheong, Allen M. Y.; Ting, Patrick Wai-ki; Lam, Thomas Chuen; Kee, Chea-su; Lam, Andrew; Chan, Henry H. L.

    2016-01-01

    A vision care-based community service subject is offered to general university students for fulfillment of a service-learning compulsory credit requirement. Here, a professional health subject is taught in a way that caters to generalist learners. Students gain basic skills they can apply to provide vision screenings for the needy population. All…

  15. Universal health insurance through incentives reform.

    Science.gov (United States)

    Enthoven, A C; Kronick, R

    1991-05-15

    Roughly 35 million Americans have no health care coverage. Health care expenditures are out of control. The problems of access and cost are inextricably related. Important correctable causes include cost-unconscious demand, a system not organized for quality and economy, market failure, and public funds not distributed equitably or effectively to motivate widespread coverage. We propose Public Sponsor agencies to offer subsidized coverage to those otherwise uninsured, mandated employer-provided health insurance, premium contributions from all employers and employees, a limit on tax-free employer contributions to employee health insurance, and "managed competition". Our proposed new government revenues equal proposed new outlays. We believe our proposal will work because efficient managed care does exist and can provide satisfactory care for a cost far below that of the traditional fee-for-service third-party payment system. Presented with an opportunity to make an economically responsible choice, people choose value for money; the dynamic created by these individual choices will give providers strong incentives to render high-quality, economical care. We believe that providers will respond to these incentives.

  16. Eating habits and preferences among the student population of the Complutense University of Madrid.

    Science.gov (United States)

    Martínez Álvarez, Jesús-Román; García Alcón, Rosa; Villarino Marín, Antonio; Marrodán Serrano, M Dolores; Serrano Morago, Lucia

    2015-10-01

    Studying eating habits can aid in the design of specific measures that reduce the negative effects of an unhealthy diet on health. In this context, the aim of the present study was to examine the eating habits and food preferences of students and their level of satisfaction with the catering services of the university. Survey conducted during 2011 using a questionnaire that asked participants abut their sex, age and frequency of use of catering services placed on campus. Participants were also asked about their level of satisfaction with five aspects (hygiene, quality, taste of food, price and convenience of facilities) of the university catering services, what their preferred dishes were and whether they followed a special diet. Complutense University of Madrid, Spain. Nine hundred and sixty-four students (381 males; 583 females). The students used the university food service 2·3 (sd 1·3) times/week. With respect to satisfaction level, 44·1 % gave an average score (3) to the combination of surveyed aspects (hygiene, quality, taste of food, price and comfort of the dining rooms). Regarding food choices, 61·0 % of students preferred pasta dishes, followed by meat (59·1 %) and salads (32·5 %). The least popular dishes were vegetables (16·8 %), fruits (13·6 %), milk products (12·2 %) and legumes (9·8 %). Of the students, 20·1 % followed special diets. The degree of satisfaction with the university meal service was low and the most common choices of dishes and foods among students were far from the guidelines of the Mediterranean diet. It is necessary to extend policies related to diet to this sector of the population and also to the management and food offer of university canteens.

  17. Aproximación de la universidad, a la situación de salud de la población y a los servicios de salud en Cuba Rapprochement of university to population health situation and to health services in Cuba

    Directory of Open Access Journals (Sweden)

    Eduardo Joaquín Alemañy Pérez

    2011-12-01

    medicine, as an effector of services from the definitions made in the reports of Millis Comission in 1966, from the Adjunct Committee of the American Medical Association for the medical education, and the International Conference of Alma Ata in 1978. Subsequently, for decades it is approached the development of human resources in the National Health System from the revolutionary triumph. It is characterized the development of the Integral General Medicine as a specialty, in changes generated from it in the training of professionals and in the teaching-educational process. In development are described the problematic features present in curriculum, teaching and training scenarios, as well as the possible strategies of change allowing to continue with the development of a quality management in study program of the Medicine career, in training directed by the principles of a renovated primary health care; thus, authors take into account the following features: the rapprochement of school/faculty to reality of population health situation and the health services; the curricular changes strengthening the rapprochement with health reality and the organization of professional practices, the negotiation with the relevant actors in the process of change and the instances of concentration between university and the health services to develop the assistant teaching activities. The aim of present paper is to promote needed strategies of change allowing continuing with the development of the quality management of study program of the Medicine career, in the training directed by principles of an renewed and strengthen primary health care.

  18. [A glossary for health care promoting universities (an HPU glossary)].

    Science.gov (United States)

    Bravo-Valenzuela, Paulina; Cabieses, Báltica; Zuzulich, María S; Muñoz, Mónica; Ojeda, Minerva

    2013-01-01

    The health promotion in the university context emerges as an important initiative to facilitate the development of healthy lifestyle behaviors in this environment where students, faculty and university staff spend and share a significant part of their lives. The movement of Health Promoting Universities (HPU) has over 20 years of experience, but still lacks a common language that allows effective communication between those who are interested in its planning and implementation. The purpose of this paper is to develop the most relevant concepts in the context of the international movement of UPS. This document is organized into five anchor dimensions: [1]The university and health promotion, [2] The University and its social responsibility, [3] The University, inequality and inequity, [4] The University and evidence in health promotion, and [5] Strategies to develop a HPU. It is hoped that this glossary for HPU encourages the development of a common language between those who promote this initiative and come from different disciplines, and at the same time serve as a guide for practice.

  19. Health status and health systems financing in the MENA region: roadmap to universal health coverage.

    Science.gov (United States)

    Asbu, Eyob Zere; Masri, Maysoun Dimachkie; Kaissi, Amer

    2017-01-01

    Since the declaration of the Millennium Development Goals (MDGs) in 1990, many countries of the Middle East and North Africa (MENA) region made some improvements in maternal and child health and in tackling communicable diseases. The transition to the global agenda of Sustainable Development Goals brings new opportunities for countries to move forward toward achieving progress for better health, well-being, and universal health coverage. This study provides a profile of health status and health financing approaches in the MENA region and their implications on universal health coverage. Time-series data on socioeconomics, health expenditures, and health outcomes were extracted from databases and reports of the World Health Organization, the World Bank and the United Nations Development Program and analyzed using Stata 12 statistical software. Countries were grouped according to the World Bank income categories. Descriptive statistics, tables and charts were used to analyze temporal changes and compare the key variables with global averages. Non-communicable diseases (NCDs) and injuries account for more than three quarters of the disability-adjusted life years in all but two lower middle-income countries (Sudan and Yemen). Prevalence of risk factors (raised blood glucose, raised blood pressure, obesity and smoking) is higher than global averages and counterparts by income group. Total health expenditure (THE) per capita in most of the countries falls short of global averages for countries under similar income category. Furthermore, growth rate of THE per capita has not kept pace with the growth rate of GDP per capita. Out-of-pocket spending (OOPS) in all but the high-income countries in the group exceeds the threshold for catastrophic spending implying that there is a high risk of households getting poorer as a result of paying for health care. The alarmingly high prevalence of NCDs and injuries and associated risk factors, health spending falling short of the GDP

  20. Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand

    NARCIS (Netherlands)

    S. Limwattananon (Supon); S. Neelsen (Sven); O.A. O'Donnell (Owen); P. Prakongsai (Phusit); V. Tangcharoensathien (Viroj); E.K.A. van Doorslaer (Eddy)

    2013-01-01

    textabstractWe estimate the impact on health care utilization and out-of-pocket (OOP) expenditures of a major reform in Thailand that extended health insurance to one-quarter of the population to achieve universal coverage while keeping health spending below 4% of GDP. Identification is through

  1. Preparing States in India for Universal Health Coverage | IDRC ...

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

    This expanded access has the potential to become a financial burden on households. This project aims to provide the evidence needed to support the rollout of universal health care in India. The Public Health Foundation of India, in collaboration with state-level institutions and decision-makers, will carry out the research.

  2. BRICS countries and the global movement for universal health coverage

    NARCIS (Netherlands)

    Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo

    2016-01-01

    This article explores BRICS' engagement in the global movement for Universal Health Coverage (UHC) and the implications for global health governance. It is based on primary data collected from 43 key informant interviews, complemented by a review of BRICS' global commitments supporting UHC.

  3. Is universal coverage via social health insurance financially feasible ...

    African Journals Online (AJOL)

    SHI would take up an increasing proportion of total health expenditure over the simulation period and become the dominant health financing mechanism. In principle, and on the basis of the assumed policy variables, universal coverage could be reached within 6 years through the implementation of an SHI scheme based ...

  4. Human Rights and the Political Economy of Universal Health Care

    Science.gov (United States)

    2016-01-01

    Abstract Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good. PMID:28559677

  5. 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

  6. [Public health competencies and contents in pharmacy degree programs in Spanish universities].

    Science.gov (United States)

    Lumbreras, Blanca; Davó-Blanes, María Carmen; Vives-Cases, Carmen; Bosch, Félix

    2015-01-01

    To identify public health core competencies and contents in pharmacy degrees at a meeting of public health lecturers in pharmacy degrees from various public and private universities. The first Meeting of the Forum of University Teaching Staff in Pharmacy Degrees was held at the Faculty of Medicine in the Complutense University, Madrid, Spain on the 19(th) and 20(th) of November 2013. The meeting was attended by 17 lecturers. Participants brought their own teaching programs and were given two previous studies on public health competencies for analysis of public health contents and competencies in pharmacy degrees. Working groups were formed and the results were shared. The highest number of core competencies was identified in the following functions: "Assessment of the population's health needs" and "Developing health policies". The final program included basic contents organized into 8 units: Concept of Public Health, Demography, Epidemiological Method, Environment and Health, Food Safety, Epidemiology of Major Health Problems, Health Promotion and Education, and Health Planning and Management. Representation of almost all the Spanish Pharmacy Faculties and the consensus reached in the description of competences and program contents will greatly improve the quality of teaching in this area. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Performance of private sector health care: implications for universal health coverage.

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Measuring human betterment through avoidable mortality: a case for universal health care in the USA.

    Science.gov (United States)

    Hisnanick, J J; Coddington, D A

    1995-10-01

    The USA system of health care has begun a monumental change that will affect everyone, irrespective of their socioeconomic status, professional status or pre-existing health insurance status. Whatever type of plan is finally implemented through the legislative process, there will need to be a way to evaluate its success (or failure). One way to evaluate the plan's effectiveness is through its impact on human betterment as viewed by a reduction in 'avoidable mortality' for those most in need of health care; the poor and uninsured. For one USA minority population, universal health care has improved human betterment by reducing avoidable mortality, even in the face of a severe burden of poverty.

  9. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Science.gov (United States)

    Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

    2014-01-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

  10. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Directory of Open Access Journals (Sweden)

    Paul D. Juarez

    2014-12-01

    Full Text Available The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

  11. SPORT AND MENTAL HEALTH LEVEL AMONG UNIVERSITY STUDENTS

    Directory of Open Access Journals (Sweden)

    Mouloud Kenioua

    2016-06-01

    Full Text Available Purpose: study of mental health level of university student, athletes and non-athletes. Material: The tested group consisted of 160 male and female undergraduates from Ouargla University, Algeria; 80 students-athletes from Institute of Physical Education and Sports and 80 students-non-athletes from Department of Psychology, English and Mathematics. In the study we used health mental scale, adapted by Diab (2006 to Arab version scale, formed from five dimensions (Competence and self-confidence, Capacity for social interaction, Emotional maturity, Freedom from neurotic symptoms, self rating and aspects of natural deficiencies. Results: the findings indicated that university students have high level of mental health. And the mean of the responses of students-athletes group by mental health scale reached (M = 32.40, with standard deviation (STD =5.83, while the mean of the responses of students-non athletes group by mental health scale has reached (M=27.47, with standard deviation (STD=7.88. T-value, required to know significance of differences between means of students-athletes and students-non athletes has reached (T=4.51, (DF=185, p -0.01. So there are significant statistical differences between student athletes and non-athletes in their responses by mental health scale in favor of the student athletes. Conclusion:sports are beneficial in respect to mental health among university students and emphasizing the importance of the mental health of university students through its integration in the various recreational and competitive activities. Future qualitative research, covering multi-variables’ tests on mental health and others psychological characteristics could be performed in sports area.

  12. Universality in exact quantum state population dynamics and control

    International Nuclear Information System (INIS)

    Wu, Lian-Ao; Segal, Dvira; Brumer, Paul; Egusquiza, Inigo L.

    2010-01-01

    We consider an exact population transition, defined as the probability of finding a state at a final time that is exactly equal to the probability of another state at the initial time. We prove that, given a Hamiltonian, there always exists a complete set of orthogonal states that can be employed as time-zero states for which this exact population transition occurs. The result is general: It holds for arbitrary systems, arbitrary pairs of initial and final states, and for any time interval. The proposition is illustrated with several analytic models. In particular, we demonstrate that in some cases, by tuning the control parameters, a complete transition might occur, where a target state, vacant at t=0, is fully populated at time τ.

  13. The Influence of Israel Health Insurance Law on the Negev Bedouin Population — A Survey Study

    Directory of Open Access Journals (Sweden)

    Mohammed Morad

    2006-01-01

    Full Text Available The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999, a region-wide interview survey of Negev Bedouins (1997, and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met

  14. [The strategic purchasing of health services: a big opportunity for the National Universal Health System].

    Science.gov (United States)

    González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

    2015-01-01

    proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

  15. The University Life Cafe: Promoting Students' Emotional Health

    Science.gov (United States)

    Hai-Jew, Shalin

    2009-01-01

    Institutions of higher education have a vested interest in the health of their student populations, even without the traditional strictures of "in loco parentis". Student health issues involve stress management, healthy diet and exercise, the building of healthy social lives, effective relationship management, and the development of life…

  16. [A framework to support action in population mental health].

    Science.gov (United States)

    Mantoura, Pascale; Roberge, Marie-Claude; Fournier, Louise

    In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

  17. Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany

    Directory of Open Access Journals (Sweden)

    Helmer Stefanie M

    2012-12-01

    Full Text Available Abstract Background Health control beliefs were postulated to be associated with health behaviour. However, the results of studies assessing these associations suggest that they might not be universal. Among young adults associations have been reported, but the evidence is limited. The objective of this analysis was to re-examine these associations in a sample of university students in Germany. Findings Data from a multicentre cross-sectional study among university students in North Rhine-Westphalia, Germany was used (N=3,306. The Multidimensional Health Locus of Control Scale with three dimensions (one internal and two external and six aspects of health behaviour (smoking habits, alcohol use, drug consumption, being over-/ or underweight, physical activity, and importance of healthy nutrition were evaluated. Students with stronger internal locus of control paid more attention to healthy nutrition and displayed a higher level of physical activity. Individuals with a stronger belief in health professionals were less likely to use drugs and paid more attention to healthy nutrition. Furthermore, higher scores in the second external locus of control dimension (beliefs in luck or chance were associated with a higher likelihood of current smoking, lower physical activity and less attention to healthy nutrition. Conclusions Students engaged more strongly in unhealthy behaviour if they believed that luck determines health. In contrast, believing in having control over one’s own health was associated with more healthy behaviour. These findings support the need to consider health control beliefs while designing preventive strategies in this specific population.

  18. Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany.

    Science.gov (United States)

    Helmer, Stefanie M; Krämer, Alexander; Mikolajczyk, Rafael T

    2012-12-29

    Health control beliefs were postulated to be associated with health behaviour. However, the results of studies assessing these associations suggest that they might not be universal. Among young adults associations have been reported, but the evidence is limited. The objective of this analysis was to re-examine these associations in a sample of university students in Germany. Data from a multicentre cross-sectional study among university students in North Rhine-Westphalia, Germany was used (N=3,306). The Multidimensional Health Locus of Control Scale with three dimensions (one internal and two external) and six aspects of health behaviour (smoking habits, alcohol use, drug consumption, being over-/ or underweight, physical activity, and importance of healthy nutrition) were evaluated. Students with stronger internal locus of control paid more attention to healthy nutrition and displayed a higher level of physical activity. Individuals with a stronger belief in health professionals were less likely to use drugs and paid more attention to healthy nutrition. Furthermore, higher scores in the second external locus of control dimension (beliefs in luck or chance) were associated with a higher likelihood of current smoking, lower physical activity and less attention to healthy nutrition. Students engaged more strongly in unhealthy behaviour if they believed that luck determines health. In contrast, believing in having control over one's own health was associated with more healthy behaviour. These findings support the need to consider health control beliefs while designing preventive strategies in this specific population.

  19. Exploring Digital Health Use and Opinions of University Students: Field Survey Study.

    Science.gov (United States)

    Montagni, Ilaria; Cariou, Tanguy; Feuillet, Tiphaine; Langlois, Emmanuel; Tzourio, Christophe

    2018-03-15

    During university, students face some potentially serious health risks, and their lifestyle can have a direct effect on health and health behaviors later in life. Concurrently, university students are digital natives having easy access to the internet and new technologies. Digital health interventions offer promising new opportunities for health promotion, disease prevention, and care in this specific population. The description of the current use of and opinions on digital health among university students can inform future digital health strategies and interventions within university settings. The aim of this exploratory study was to report on university students' use and opinions regarding information and communication technologies for health and well-being, taking into account sociodemographic and self-rated general and mental health correlates. This field survey was conducted from March to April 2017. An informed consent form and a paper questionnaire were given to students aged 18 to 24 years in 4 university campuses in Bordeaux, France. The survey was formulated in 3 sections: (1) sociodemographic characteristics and self-rated general and mental health, (2) information about the use of digital health, and (3) opinions about digital health. Data were analyzed using descriptive statistics and tests of independence. A total of 59.8% (303/507 females) students completed the questionnaire. Concerning digital health use, 34.9% (174/498) had at least 1 health app mostly for physical activity (49.4%, 86/174) and general health monitoring (41.4%, 72/174,), but only 3.9% (20/507) of students had a wearable device. Almost all (94.8%, 450/476) had searched for Web-based health-related information at least once in the last 12 months. The most sought health-related topics were nutrition (68.1%, 324/476); pain and illnesses (64.5%, 307/476); and stress, anxiety, or depression (51.1%, 243/476). Although Wikipedia (79.7%, 357/448) and general health websites (349/448, 77

  20. Exploring Digital Health Use and Opinions of University Students: Field Survey Study

    Science.gov (United States)

    Cariou, Tanguy; Feuillet, Tiphaine; Langlois, Emmanuel; Tzourio, Christophe

    2018-01-01

    Background During university, students face some potentially serious health risks, and their lifestyle can have a direct effect on health and health behaviors later in life. Concurrently, university students are digital natives having easy access to the internet and new technologies. Digital health interventions offer promising new opportunities for health promotion, disease prevention, and care in this specific population. The description of the current use of and opinions on digital health among university students can inform future digital health strategies and interventions within university settings. Objective The aim of this exploratory study was to report on university students’ use and opinions regarding information and communication technologies for health and well-being, taking into account sociodemographic and self-rated general and mental health correlates. Methods This field survey was conducted from March to April 2017. An informed consent form and a paper questionnaire were given to students aged 18 to 24 years in 4 university campuses in Bordeaux, France. The survey was formulated in 3 sections: (1) sociodemographic characteristics and self-rated general and mental health, (2) information about the use of digital health, and (3) opinions about digital health. Data were analyzed using descriptive statistics and tests of independence. Results A total of 59.8% (303/507 females) students completed the questionnaire. Concerning digital health use, 34.9% (174/498) had at least 1 health app mostly for physical activity (49.4%, 86/174) and general health monitoring (41.4%, 72/174,), but only 3.9% (20/507) of students had a wearable device. Almost all (94.8%, 450/476) had searched for Web-based health-related information at least once in the last 12 months. The most sought health-related topics were nutrition (68.1%, 324/476); pain and illnesses (64.5%, 307/476); and stress, anxiety, or depression (51.1%, 243/476). Although Wikipedia (79.7%, 357/448) and

  1. FastStats: Health of Asian or Pacific Islander Population

    Science.gov (United States)

    ... Whooping Cough or Pertussis Family Life Marriage and Divorce Health Care and Insurance Access to Health Care ... 2015, table 1 [PDF – 2.7 MB] Leading causes of death for Asian or Pacific Islander population ...

  2. Is universal coverage via social health insurance financially feasible in Swaziland?

    Science.gov (United States)

    Mathauer, Inke; Musango, Laurent; Sibandze, Sibusiso; Mthethwa, Khosi; Carrin, Guy

    2011-03-01

    The Government of Swaziland decided to explore the feasibility of social health insurance (SHI) in order to enhance universal access to health services. We assess the financial feasibility of a possible SHI scheme in Swaziland. The SHI scenario presented is one that mobilises resources additional to the maintained Ministry of Health and Social Welfare (MOHSW) budget. It is designed to increase prepayment, enhance overall health financing equity, finance quality improvements in health care, and eventually cover the entire population. The financial feasibility assessment consists of calculating and projecting revenues and expenditures of the SHI scheme from 2008 to 2018. SimIns, a health insurance simulation software, was used. Quantitative data from government and other sources and qualitative data from discussions with health financing stakeholders were gathered. Policy assumptions were jointly developed with and agreed upon by a MOHSW team. SHI would take up an increasing proportion of total health expenditure over the simulation period and become the dominant health financing mechanism. In principle, and on the basis of the assumed policy variables, universal coverage could be reached within 6 years through the implementation of an SHI scheme based on a mix of contributory and tax financing. Contribution rates for formal sector employees would amount to 7% of salaries and the Ministry of Health and Social Welfare budget would need to be maintained. Government health expenditure including social health insurance would increase from 6% in 2008 to 11% in 2018.

  3. Population health and status of epidemiology: WHO European Region I.

    Science.gov (United States)

    Rahu, Mati; Vlassov, Vasiliy V; Pega, Frank; Andreeva, Tatiana; Ay, Pinar; Baburin, Aleksei; Bencko, Vladimír; Csépe, Péter; Gebska-Kuczerowska, Anita; Ondrusová, Martina; Ribak, Joseph

    2013-06-01

    This article of the International Epidemiological Association commissioned paper series stocktakes the population health and status of epidemiology in 21 of the 53 countries of the WHO European Region. By United Nations geographical classification, these countries belong to Eastern Europe, Western Asia and South-Central Asia. Published data were used to describe population health indicators and risk factors. Epidemiological training and research was assessed based on author knowledge, information searches and E-mail survey of experts. Bibliometric analyses determined epidemiological publication outputs. Between-country differences in life expectancy, amount and profile of disease burden and prevalence of risk factors are marked. Epidemiological training is affected by ongoing structural reforms of educational systems. Training is advanced in Israel and several Eastern European countries. Epidemiological research is mainly university-based in most countries, but predominantly conducted by governmental research institutes in several countries of the former Soviet Union. Funding is generally external and limited, partially due to competition from and prioritization of biomedical research. Multiple relevant professional societies exist, especially in Poland, the Czech Republic and Hungary. Few of the region's 39 epidemiological academic journals have international currency. The number of epidemiological publications per population is highest for Israel and lowest for South-Central Asian countries. Epidemiological capacity will continue to be heterogeneous across the region and depend more on countries' individual historical, social, political and economic conditions and contexts than their epidemiologists' successive efforts. National and international research funding, and within- and between-country collaborations should be enhanced, especially for South-Central Asian countries.

  4. Competing health policies: insurance against universal public systems

    Directory of Open Access Journals (Sweden)

    Asa Ebba Cristina Laurell

    2016-01-01

    Full Text Available Objectives: This article analyzes the content and outcome of ongoing health reforms in Latin America: Universal Health Coverage with Health Insurance, and the Universal and Public Health Systems. It aims to compare and contrast the conceptual framework and practice of each and verify their concrete results regarding the guarantee of the right to health and access to required services. It identifies a direct relationship between the development model and the type of reform. The neoclassical-neoliberal model has succeeded in converting health into a field of privatized profits, but has failed to guarantee the right to health and access to services, which has discredited the governments. The reform of the progressive governments has succeeded in expanding access to services and ensuring the right to health, but faces difficulties and tensions related to the permanence of a powerful, private, industrial-insurance medical complex and persistence of the ideologies about medicalized 'good medicine'. Based on these findings, some strategies to strengthen unique and supportive public health systems are proposed.

  5. Population Health Research: Early Description of the Organizational Shift Toward Population Health Management and Defining a Vision for Leadership.

    Science.gov (United States)

    Caldararo, Kristi L; Nash, David B

    2017-10-01

    As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient's medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one's health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management.

  6. Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: the Gates partners experience.

    Science.gov (United States)

    Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella

    2011-01-01

    Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article.

  7. Experiences with Universal Health Coverage of Maternal Health ...

    African Journals Online (AJOL)

    USER

    services does not expose the user to financial hardship‖. This is based on the .... statements of the two hospitals at inception was ―to run integrated maternal and child .... consolidated revenue for primary health care which will essentially be ...

  8. Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

    Science.gov (United States)

    Pachanee, Cha-aim; Wibulpolprasert, Suwit

    2006-07-01

    The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed.

  9. Nursing workloads in family health: implications for universal access.

    Science.gov (United States)

    de Pires, Denise Elvira Pires; Machado, Rosani Ramos; Soratto, Jacks; Scherer, Magda dos Anjos; Gonçalves, Ana Sofia Resque; Trindade, Letícia Lima

    2016-01-01

    to identify the workloads of nursing professionals of the Family Health Strategy, considering its implications for the effectiveness of universal access. qualitative study with nursing professionals of the Family Health Strategy of the South, Central West and North regions of Brazil, using methodological triangulation. For the analysis, resources of the Atlas.ti software and Thematic Content Analysis were associated; and the data were interpreted based on the labor process and workloads as theorical approaches. the way of working in the Family Health Strategy has predominantly resulted in an increase in the workloads of the nursing professionals, with emphasis on the work overload, excess of demand, problems in the physical infrastructure of the units and failures in the care network, which hinders its effectiveness as a preferred strategy to achieve universal access to health. On the other hand, teamwork, affinity for the work performed, bond with the user, and effectiveness of the assistance contributed to reduce their workloads. investments on elements that reduce the nursing workloads, such as changes in working conditions and management, can contribute to the effectiveness of the Family Health Strategy and achieving the goal of universal access to health.

  10. In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage.

    Science.gov (United States)

    Garchitorena, Andres; Miller, Ann C; Cordier, Laura F; Ramananjato, Ranto; Rabeza, Victor R; Murray, Megan; Cripps, Amber; Hall, Laura; Farmer, Paul; Rich, Michael; Orlan, Arthur Velo; Rabemampionona, Alexandre; Rakotozafy, Germain; Randriantsimaniry, Damoela; Gikic, Djordje; Bonds, Matthew H

    2017-08-01

    Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medicines and services, the use of health care increased by 65 percent for all patients, 52 percent for children under age five, and over 25 percent for maternity consultations. These effects were sustained at an average direct cost of US$0.60 per patient. The pilot interventions can become a key element of universal health care in Madagascar with the support of external donors. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project.

    Science.gov (United States)

    Blasco, Maria Jesús; Castellví, Pere; Almenara, José; Lagares, Carolina; Roca, Miquel; Sesé, Albert; Piqueras, José Antonio; Soto-Sanz, Victoria; Rodríguez-Marín, Jesús; Echeburúa, Enrique; Gabilondo, Andrea; Cebrià, Ana Isabel; Miranda-Mendizábal, Andrea; Vilagut, Gemma; Bruffaerts, Ronny; Auerbach, Randy P; Kessler, Ronald C; Alonso, Jordi

    2016-05-04

    prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.

  12. [Using the concept of universal health coverage to promote the health system reform in China].

    Science.gov (United States)

    Hu, S L

    2016-11-06

    The paper is systematically explained the definition, contents of universal health coverage (UHC). Universal health coverage calls for all people to have access to quality health services they need without facing undue financial burden. The relationship between five main attributes, i.e., quality, efficiency, equity, accountability and resilience, and their 15 action plans has been explained. The nature of UHC is belonged to the State and government. The core function is commitment with equality. The whole-of-system method is used to promoting the health system reform. In China, the universal health coverage has been reached to the preliminary achievements, which include universal coverage of social medical insurance, basic medical services, basic public health services, and the provision of essential medicines. China has completed millennium development goals (MDG) and is being stepped to the sustainable development goals (SDG).

  13. The Mental Health of University Students in the United Kingdom

    Science.gov (United States)

    Macaskill, Ann

    2013-01-01

    There are increasing concerns globally about the mental health of students. In the UK, the actual incidence of mental disturbance is unknown, although university counselling services report increased referrals. This study assesses the levels of mental illness in undergraduate students to examine whether widening participation in education has…

  14. Mental Health Assessment in Professors' Training in Two Chilean Universities

    Science.gov (United States)

    Ossa, Carlos J.; Quintana, Ingrid M.; Rodriguez, Felipe F.

    2015-01-01

    This study analyzed the evaluation of professors of pedagogy and directors programs, about the importance of mental health in vocational training, and factors that might influence this valuation. The methodology includes participation of 17 academicians (professors and belonging to the managerial staff) of two universities in southern Chile. A…

  15. Mental health and HIV sexual risk behaviour among University of ...

    African Journals Online (AJOL)

    To determine the association between mental health, substance use and HIV sexual risk behaviour among a sample of university ... analysis, HIV risk behaviour was associated with, among men, hazardous or harmful alcohol use and having screened positive for PTSD, and ..... risk behaviors among U.S. adolescents.

  16. University Response to Crisis Events Involving International Populations: The Case of Seven Directors of International Offices

    Science.gov (United States)

    Andrews, James P.

    2012-01-01

    This qualitative research study focuses on crisis events affecting university international populations. It explores how seven directors of university international offices at seven different geographical locations in Texas respond to those events. The study findings shed light on the current state of crisis preparedness in higher education from…

  17. Implementing Motivational Interviewing in an Urban Homeless Population: An Agency-University Collaboration

    Science.gov (United States)

    Crouch, Cathy; Parrish, Danielle E.

    2015-01-01

    This article describes the experiences of an agency administrator who developed a meaningful and effective collaboration with university researchers to address the needs of her client population. The initial agency-university collaboration process and its benefits are described as well as the efforts required and challenges faced when adopting and…

  18. 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.

  19. 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

  20. ROMANIAN FOOD CONSUMPTION AND ITS EFFECTS ON POPULATION'S HEALTH CONDITION

    Directory of Open Access Journals (Sweden)

    Mihaela CONSTANDACHE

    2014-04-01

    Full Text Available Public health is a top priority for the European Union. The main factor in ensuring population health is food consumption and in particular food quality. The present paper aims at analyzing Romanian population food consumption during the 1990-2012 periods, its evolution in time; it identifies its main features and their effects on population health. Amid the economic crisis the purchasing power of population is impaired leading to insufficient consumption of fresh fruits and vegetables and a low intake of vitamins, calcium, phosphorous and iron (especially in children, women and elderly people, which could be an important risk factor in the development of chronic diseases.

  1. POPULATION HEALTH AND THE RISE OF CONSUMERISM.

    Science.gov (United States)

    2015-09-01

    Earlier this summer, we convened a panel of health care executives and industry experts to consider how hospitals can balance the demands of high-value, more efficient care with the emergence of the savvy health care consumer. Their insights and words of advice are eye-opening.

  2. A proposed universal medical and public health definition of terrorism.

    Science.gov (United States)

    Arnold, Jeffrey L; Ortenwall, Per; Birnbaum, Marvin L; Sundnes, Knut Ole; Aggrawal, Anil; Anantharaman, V; Al Musleh, Abdul Wahab; Asai, Yasufumi; Burkle, Frederick M; Chung, Jae Myung; Cruz-Vega, Felipe; Debacker, Michel; Della Corte, Francesco; Delooz, Herman; Dickinson, Garth; Hodgetts, Timothy; Holliman, C James; MacFarlane, Campbell; Rodoplu, Ulkumen; Stok, Edita; Tsai, Ming-Che

    2003-01-01

    The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters. We propose the following universal medical and public definition of terrorism: The intentional use of violence--real or threatened--against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

  3. Work stress and health effects among university personnel.

    Science.gov (United States)

    Donders, N C G M; van der Gulden, J W J; Furer, J W; Tax, B; Roscam Abbing, E W

    2003-10-01

    (1) To investigate the contribution of job characteristics and personal characteristics to the explanation of health effects among university personnel; (2) to investigate the differences between scientific personnel (SP) and non-scientific personnel (NSP); (3) to investigate whether health effects occurred one after another. The well being at work of employees at a Dutch university (n=2,522) was investigated by means of a questionnaire. A model was constructed in which several job and personal characteristics were set out against health effects. The latter were assumed to occur in phases: decreased "job satisfaction" as an early effect, followed by increased "tension" and "emotional exhaustion", and possibly also by increased "perceived health complaints". The contribution of job and personal characteristics to the explanation of health effects was investigated by means of linear regression analysis, with separate analyses for SP and NSP. Positive job characteristics, especially professional expertise and work variety, contributed to the explanation of "job satisfaction". The major contributors to "tension" and "emotional exhaustion" were negative characteristics, such as work pressure. Besides the negative aspects, the major contributors to the explanation of "perceived health complaints" were sex, age and other health effects. In NSP, social support contributed to the explanation of "tension" and "emotional exhaustion", but not in SP. The explained variance of "job satisfaction" by the positive job characteristics in NSP was much higher than that in SP. To investigate whether health effects occurred one after another, we considered explained variance. Explained variance in "job satisfaction" was much higher than in "perceived health complaints". "Emotional exhaustion" and "tension" were in between. Contrary to expectations, decision latitude and social support played only minor roles. Also, the differences between SP and NSP were smaller than expected. As

  4. Promoting universal financial protection: a policy analysis of universal health coverage in Costa Rica (1940-2000).

    Science.gov (United States)

    Vargas, Juan Rafael; Muiser, Jorine

    2013-08-21

    This paper explores the implementation and sustenance of universal health coverage (UHC) in Costa Rica, discussing the development of a social security scheme that covered 5% of the population in 1940, to one that finances and provides comprehensive healthcare to the whole population today. The scheme is financed by mandatory, tri-partite social insurance contributions complemented by tax funding to cover the poor. The analysis takes a historical perspective and explores the policy process including the key actors and their relative influence in decision-making. Data were collected using qualitative research instruments, including a review of literature, institutional and other documents, and in-depth interviews with key informants. Key lessons to be learned are: i) population health was high on the political agenda in Costa Rica, in particular before the 1980s when UHC was enacted and the transfer of hospitals to the social security institution took place. Opposition to UHC could therefore be contained through negotiation and implemented incrementally despite the absence of real consensus among the policy elite; ii) since the 1960s, the social security institution has been responsible for UHC in Costa Rica. This institution enjoys financial and managerial autonomy relative to the general government, which has also facilitated the UHC policy implementation process; iii) UHC was simultaneously constructed on three pillars that reciprocally strengthened each other: increasing population coverage, increasing availability of financial resources based on solidarity financing mechanisms, and increasing service coverage, ultimately offering comprehensive health services and the same benefits to every resident in the country; iv) particularly before the 1980s, the fruits of economic growth were structurally invested in health and other universal social policies, in particular education and sanitation. The social security institution became a flagship of Costa Rica

  5. Political economy and population health: is Australia exceptional?

    Science.gov (United States)

    Boxall, Anne-marie; Short, Stephanie D

    2006-06-01

    It is accepted knowledge that social and economic conditions--like education and income--affect population health. What remains uncertain is whether the degree of inequality in these conditions influences population health and if so, how. Some researchers who argue that inequalities are important, say there is a relationship between political economy, inequality and population health. Their evidence comes from comparative studies showing that countries with neo-liberal political economies generally have poorer population health outcomes than those with social or Christian democratic political economies. According to these researchers, neo-liberal political economies adopt labour market and welfare state policies that lead to greater levels of inequality and poorer population health outcomes for us all. Australia has experienced considerable social and economic reforms over the last 20 years, with both major political parties increasingly adopting neo-liberal policies. Despite these reforms, population health outcomes are amongst the best in the world. Australia appears to contest theories suggesting a link between political economy and population health. To progress our understanding, researchers need to concentrate on policy areas outside health--such as welfare, economics and industrial relations. We need to do longitudinal studies on how reforms in these areas affect levels of social and economic inequality, as well population health. We need to draw on social scientific methods, especially concerning case selection, to advance our understanding of casual relationships in policy studies. It is important to find out if, and why, Australia has resisted the affects of neo-liberalism on population health so we ensure our high standards are maintained in the future.

  6. Population-based health funding under attack

    African Journals Online (AJOL)

    The frustrated heads of health in these top-performing three provinces ... buck' results, and for 'funding to follow functionality and service delivery'. The ... benefiting from this system, which puts medicines closer to their homes, with a targeted ...

  7. Real estate planning for population health.

    Science.gov (United States)

    McHugh, Margie

    2014-11-01

    Factors that health systems should consider when performing strategic assessments of their portfolios of ambulatory facilities include: Inventory. Location Facility condition. Service mix. Space use and capacity. Occupancy metrics. Strategic and economic opportunities.

  8. A mismatch between population health literacy and the complexity of health information

    DEFF Research Database (Denmark)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John

    2015-01-01

    skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information....

  9. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Indonesia's road to universal health coverage: A political journey

    NARCIS (Netherlands)

    Pisani, E. (Elizabeth); Kok, M.O. (Maarten Olivier); Nugroho, K. (Kharisma)

    2017-01-01

    textabstractIn 2013 Indonesia, the world's fourth most populous country, declared that it would provide affordable health care for all its citizens within seven years. This crystallised an ambition first enshrined in law over five decades earlier, but never previously realised. This paper explores

  11. Speaking of Health: Assessing Health Communication Strategies for Diverse Populations

    National Research Council Canada - National Science Library

    2002-01-01

    .... Lifestyle choices have enormous impact on our health and well being. But, how do we communicate the language of good health so that it is uniformly received-and accepted-by people from different cultures and backgrounds...

  12. The Relationship between Mental Health and Addiction to Mobile Phones among University Students of Shahrekord, Iran.

    Science.gov (United States)

    Babadi-Akashe, Zahra; Zamani, Bibi Eshrat; Abedini, Yasamin; Akbari, Hojaetolah; Hedayati, Nasim

    2014-01-01

    The risk of cell phone addiction is a social and psychological problem which has been proposed by psychologists, psychiatrists, and educational supervisors. The present study aimed to investigate the behavior of mobile phone addicts and mental health of university students of Shahrekord, Iran. This study was an applied research survey for the purposes of this study. The study population ýconsisted of all the students of Payame Noor University, Islamic Azad University, and University of Medical Sciences. The study population consisted of 296 students who were randomly selected from the target population. To collect data, two types of questionnaires were used, the Symptom Checklist-90-R(SCL-90-R) questionnaire, and the 32-point scale questionnaire of behavior associated with ýmobile phone use (Hooper and Zhou, 2007). Data analysis was performed using SPSS software, statistical analysis, frequency distribution, mean, one-way ANOVA, chi-square, and LSD (Least significance difference). The results showed that university students of Shahrekord, based on the six categories of mobile ýaddiction behaviors, were mostly placed in habitual behaviors (21.49%), addiction (21.49%), and intentional (21.49%) categories. By reviewing mental health indicators, it was found that students were affected with depressive disorder (17.30%), obsessive compulsive disorder (14.20%), and interpersonal sensitivity (13.80%). The results showed that there was a significant inverse relationship ýbetween mental health and habitual behaviors (r = -0.417), dependence (r = -0.317), addiction (r = -0.330), and incontinence (r = -0.309) in using mobile phone (P phone addiction reduced.

  13. Integrating population health into a family medicine clerkship: 7 years of evolution.

    Science.gov (United States)

    Unverzagt, Mark; Wallerstein, Nina; Benson, Jeffrey A; Tomedi, Angelo; Palley, Toby B

    2003-01-01

    A population health curriculum using methodologies from community-oriented primary care (COPC) was developed in 1994 as part of a required third-year family medicine clerkship at the University of New Mexico. The curriculum integrates population health/community medicine projects and problem-based tutorials into a community-based, ambulatory clinical experience. By combining a required population health experience with relevant clinical training, student careers have the opportunity to be influenced during the critical third year. Results over a 7-year period describe a three-phase evolution of the curriculum, within the context of changes in medical education and in health care delivery systems in that same period of time. Early evaluation revealed that students viewed the curricular experience as time consuming and peripheral to their training. Later comments on the revised curriculum showed a higher regard for the experience that was described as important for student learning.

  14. Somatic symptom profiles in the general population: a latent class analysis in a Danish population-based health survey

    Directory of Open Access Journals (Sweden)

    Eliasen M

    2017-08-01

    Full Text Available Marie Eliasen,1 Torben Jørgensen,1–3 Andreas Schröder,4 Thomas Meinertz Dantoft,1 Per Fink,4 Chalotte Heinsvig Poulsen,1,5 Nanna Borup Johansen,1 Lene Falgaard Eplov,5 Sine Skovbjerg,1 Svend Kreiner2 1Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup, 2Department of Public Health, University of Copenhagen, Copenhagen, 3Department of Clinical Medicine, Aalborg University, Aalborg, 4Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, 5Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark Purpose: The aim of this study was to identify and describe somatic symptom profiles in the general adult population in order to enable further epidemiological research within multiple somatic symptoms.Methods: Information on 19 self-reported common somatic symptoms was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark (55.4% women. The participants stated whether they had been considerably bothered by each symptom within 14 days prior to answering the questionnaire. We used latent class analysis to identify the somatic symptom profiles. The profiles were further described by their association with age, sex, chronic disease, and self-perceived health.Results: We identified 10 different somatic symptom profiles defined by number, type, and site of the symptoms. The majority of the population (74.0% had a profile characterized by no considerable bothering symptoms, while a minor group of 3.9% had profiles defined by a high risk of multiple somatic symptoms. The remaining profiles were more likely to be characterized by a few specific symptoms. The profiles could further be described by their associations with age, sex, chronic disease, and self-perceived health.Conclusion: The identified somatic symptom profiles could be distinguished by number, type, and site of

  15. Is universal health coverage the practical expression of the right to health care?

    OpenAIRE

    Ooms, Gorik; Latif, Laila A; Waris, Attiya; Brolan, Claire E; Hammonds, Rachel; Friedman, Eric A; Mulumba, Moses; Forman, Lisa

    2014-01-01

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a 'single overarching health goal' for the next iteration of the Millennium Development Goals. The present Millennium Development Goals have been criticised for being 'duplicative' or even 'competing alternatives' to international human rights law. T...

  16. Top Health Issues for LGBT Populations

    Science.gov (United States)

    ... introduction and model practices for HIV/STI prevention programming. New York: National Gay and Lesbian Task Force Policy Institute, the Fenway Institute at Fenway Community Health, and BiNet USA. 7 Brittain, D.R., Baillargeon, T., McElroy, M., Aaron, D.J., & Gyurcsik, ...

  17. South Asian populations in Canada: migration and mental health

    Science.gov (United States)

    2014-01-01

    Background South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations. Methods The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007–2011 data. Results South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant

  18. Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey.

    Science.gov (United States)

    Ernsting, Clemens; Dombrowski, Stephan U; Oedekoven, Monika; O Sullivan, Julie L; Kanzler, Melanie; Kuhlmey, Adelheid; Gellert, Paul

    2017-04-05

    Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors. A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied. It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical

  19. The effect of economic development on population health: a review of the empirical evidence.

    Science.gov (United States)

    Lange, Simon; Vollmer, Sebastian

    2017-01-01

    Economic growth is considered an important determinant of population health. Relevant studies investigating the effect of economic growth on health outcomes were identified from Google Scholar and PubMed searches in economics and medical journals. Additional resources generated through economic growth are potentially useful for improving population health. The empirical evidence on the aggregate effect of economic growth on population health is rather mixed and inconclusive. The causal pathways from economic growth to population health are crucial and failure or success in completing the pathways explains differences in empirical findings. Future research should investigate how additional resources can more effectively reach those in need and how additional resources can be used more efficiently. It is particularly relevant to understand why preventive health care in developing countries is very price elastic whereas curative health care is very health inelastic and how this understanding can inform public health policy. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Exploring the relationship between population density and maternal health coverage

    Directory of Open Access Journals (Sweden)

    Hanlon Michael

    2012-11-01

    Full Text Available Abstract Background Delivering health services to dense populations is more practical than to dispersed populations, other factors constant. This engenders the hypothesis that population density positively affects coverage rates of health services. This hypothesis has been tested indirectly for some services at a local level, but not at a national level. Methods We use cross-sectional data to conduct cross-country, OLS regressions at the national level to estimate the relationship between population density and maternal health coverage. We separately estimate the effect of two measures of density on three population-level coverage rates (6 tests in total. Our coverage indicators are the fraction of the maternal population completing four antenatal care visits and the utilization rates of both skilled birth attendants and in-facility delivery. The first density metric we use is the percentage of a population living in an urban area. The second metric, which we denote as a density score, is a relative ranking of countries by population density. The score’s calculation discounts a nation’s uninhabited territory under the assumption those areas are irrelevant to service delivery. Results We find significantly positive relationships between our maternal health indicators and density measures. On average, a one-unit increase in our density score is equivalent to a 0.2% increase in coverage rates. Conclusions Countries with dispersed populations face higher burdens to achieve multinational coverage targets such as the United Nations’ Millennial Development Goals.

  1. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

  2. Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

    Science.gov (United States)

    El Ansari, Walid; Khalil, Khalid; Stock, Christiane

    2014-01-01

    University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02), depressive mood (OR 2.20; 95% CI 1.64–2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population. PMID:25429678

  3. Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

    Directory of Open Access Journals (Sweden)

    Walid El Ansari

    2014-11-01

    Full Text Available University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall, socio-demographic characteristics (five variables, health behaviours/lifestyle factors (six variables, as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints. A sample of 2100 undergraduate students from nine institutions (six universities, three colleges located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62% reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02, depressive mood (OR 2.20; 95% CI 1.64–2.94 and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03. Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population.

  4. Lifestyle of health sciences students at Majmaah University, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Fahad Alfhaid

    2017-02-01

    Full Text Available Background We all want to live a long, happy and healthy life with an abundance of energy and vitality to perform well both mentally and physically. A healthy lifestyle is a valuable resource for reducing the incidence and impact of health problems, enabling you better to cope with life stressors, as well as improving your quality of life. Aims The study was aimed to assess the lifestyle (eating habits and physical activity of health sciences students studying at Majmaah University. Methods This cross-sectional institutional based study was conducted from 25th November 2014-3rd May 2015. A total of 450 students (370 males and 80 females aged between 18–28 years were randomly chosen. Self-reported questionnaire was used for data collection from the College of Medicine, College of Applied Medical Sciences and College of Dentistry. Results Majority of the students, 62.4 per cent, were physically inactive. Students from the College of Medicine, 40.4 per cent, were the most physically active. The most common reason that restrained the students from being active was time limitation. In addition to that, many of the participants, 29.6 per cent, have never had breakfast at home. Also, most of the participants, 42.7 per cent, were not satisfied with their eating habits. Almost one quarter of students were consuming soft drinks more than four times a day. Conclusion There is a high prevalence of sedentary lifestyle, physical inactivity and unhealthy dietary habits among health sciences students studying at Majmaah University. There is an urgent need for arranging health education programs for promoting healthy and active living among health sciences students of Majmaah University in Saudi Arabia.

  5. Population health metrics: crucial inputs to the development of evidence for health policy

    Directory of Open Access Journals (Sweden)

    Salomon Joshua A

    2003-04-01

    Full Text Available Abstract Valid, reliable and comparable measures of the health states of individuals and of the health status of populations are critical components of the evidence base for health policy. We need to develop population health measurement strategies that coherently address the relationships between epidemiological measures (such as risk exposures, incidence, and mortality rates and multi-domain measures of population health status, while ensuring validity and cross-population comparability. Studies reporting on descriptive epidemiology of major diseases, injuries and risk factors, and on the measurement of health at the population level – either for monitoring trends in health levels or inequalities or for measuring broad outcomes of health systems and social interventions – are not well-represented in traditional epidemiology journals, which tend to concentrate on causal studies and on quasi-experimental design. In particular, key methodological issues relating to the clear conceptualisation of, and the validity and comparability of measures of population health are currently not addressed coherently by any discipline, and cross-disciplinary debate is fragmented and often conducted in mutually incomprehensible language or paradigms. Population health measurement potentially bridges a range of currently disjoint fields of inquiry relating to health: biology, demography, epidemiology, health economics, and broader social science disciplines relevant to assessment of health determinants, health state valuations and health inequalities. This new journal will focus on the importance of a population based approach to measurement as a way to characterize the complexity of people's health, the diseases and risks that affect it, its distribution, and its valuation, and will attempt to provide a forum for innovative work and debate that bridge the many fields of inquiry relevant to population health in order to contribute to the development of valid

  6. Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

    Science.gov (United States)

    Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

    2017-12-01

      Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

  7. BRICS countries and the global movement for universal health coverage.

    Science.gov (United States)

    Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo

    2016-07-01

    This article explores BRICS' engagement in the global movement for Universal Health Coverage (UHC) and the implications for global health governance. It is based on primary data collected from 43 key informant interviews, complemented by a review of BRICS' global commitments supporting UHC. Interviews were conducted using a semi-structured questionnaire that included both closed- and open-ended questions. Question development was informed by insights from the literature on UHC, Cox's framework for action, and Kingdon's multiple-stream theory of policy formation. The closed questions were analysed with simple descriptive statistics and the open-ended questions using grounded theory approach. The analysis demonstrates that most BRICS countries implicitly supported the global movement for UHC, and that they share an active engagement in promoting UHC. However, only Brazil, China and to some extent South Africa, were recognized as proactively pushing UHC in the global agenda. In addition, despite some concerted actions, BRICS countries seem to act more as individual countries rather that as an allied group. These findings suggest that BRICS are unlikely to be a unified political block that will transform global health governance. Yet the documented involvement of BRICS in the global movement supporting UHC, and their focus on domestic challenges, shows that BRICS individually are increasingly influential players in global health. So if BRICS countries should probably not be portrayed as the centre of future political community that will transform global health governance, their individual involvement in global health, and their documented concerted actions, may give greater voice to low- and middle-income countries supporting the emergence of multiple centres of powers in global health. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  9. Public Health Planning for Vulnerable Populations and Pandemic Influenza

    National Research Council Canada - National Science Library

    Cameron, Wendy K

    2008-01-01

    This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic...

  10. The Pan-University Network for Global Health: framework for collaboration and review of global health needs.

    Science.gov (United States)

    Winchester, M S; BeLue, R; Oni, T; Wittwer-Backofen, U; Deobagkar, D; Onya, H; Samuels, T A; Matthews, S A; Stone, C; Airhihenbuwa, C

    2016-04-21

    In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of well-equipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Network for Global Health responds to this need by bridging researchers at more than 10 universities across the globe. In this paper we outline our framework for international and interdisciplinary collaboration, as well the rationale for our research areas, including a review of these two themes. After its initial meeting, the network has established two central thematic priorities: 1) urbanization and health and 2) the intersection of infectious diseases and NCDs. The urban population in the global south will nearly double in 25 years (approx. 2 billion today to over 3.5 billion by 2040). Urban population growth will have a direct impact on global health, and this growth will be burdened with uneven development and the persistence of urban spatial inequality, including health disparities. The NCD burden, which includes conditions such as hypertension, stroke, and diabetes, is outstripping infectious disease in countries in the global south that are considered to be disproportionately burdened by infectious diseases. Addressing these two priorities demands an interdisciplinary and multi-institutional model to stimulate innovation and synergy that will influence the overall framing of research questions as well as the integration and coordination of research.

  11. Success of the Undergraduate Public Health Program At Tulane University

    Directory of Open Access Journals (Sweden)

    Luann Ellis White

    2015-04-01

    Full Text Available Tulane University School of Public Health and Tropical Medicine (SPHTM launched the Bachelors of Science in Public Health (BSPH in 2005. The BSPH has steadily grown and comprises one third of the total enrollment in the school. A review of the organizational structure demonstrates that direct responsibility for undergraduate education by a school of public health is advantageous to the success of the program. The competency and skills-based curriculum attracts students. Outcome measures show the enrollment is steadily increasing. The majority of the BSPH graduates continue onto competitive graduate and professional degree programs. Those who seek jobs find employment related to their public health education, but outside of the traditional governmental public health agencies. The combined BSPH/MPH degree is a pipeline for students to pursue a MPH and increases the likelihood students will pursue careers in public health. The range and depth of study in the bachelors program is continually examined. Topics once within the purview of graduate education are now being incorporated into undergraduate courses. Undergraduate public health is one of a number of factors that is influencing changes in the MPH degree.

  12. Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors.

    Science.gov (United States)

    Scheil-Adlung, Xenia; Behrendt, Thorsten; Wong, Lorraine

    2015-08-31

    Health sector employment is a prerequisite for availability, accessibility, acceptability and quality (AAAQ) of health services. Thus, in this article health worker shortages are used as a tracer indicator estimating the proportion of the population lacking access to such services: The SAD (ILO Staff Access Deficit Indicator) estimates gaps towards UHC in the context of Social Protection Floors (SPFs). Further, it highlights the impact of investments in health sector employment equity and sustainable development. The SAD is used to estimate the share of the population lacking access to health services due to gaps in the number of skilled health workers. It is based on the difference of the density of the skilled health workforce per population in a given country and a threshold indicating UHC staffing requirements. It identifies deficits, differences and developments in access at global, regional and national levels and between rural and urban areas. In 2014, the global UHC deficit in numbers of health workers is estimated at 10.3 million, with most important gaps in Asia (7.1 million) and Africa (2.8 million). Globally, 97 countries are understaffed with significantly higher gaps in rural than in urban areas. Most affected are low-income countries, where 84 per cent of the population remains excluded from access due to the lack of skilled health workers. A positive correlation of health worker employment and population health outcomes could be identified. Legislation is found to be a prerequisite for closing access as gaps. Health worker shortages hamper the achievement of UHC and aggravate weaknesses of health systems. They have major impacts on socio-economic development, particularly in the world's poorest countries where they act as drivers of health inequities. Closing the gaps by establishing inclusive multi-sectoral policy approaches based on the right to health would significantly increase equity, reduce poverty due to ill health and ultimately contribute

  13. Sexual behaviours and preconception health in Italian university students

    Directory of Open Access Journals (Sweden)

    Andrea Poscia

    2015-06-01

    Full Text Available INTRODUCTION: Risky sexual behaviours have been recognized as a threat for sexual and reproductive health. AIM: This article shows the results of the "Sportello Salute Giovani" project ("Youth Health Information Desk" in relation to determining how a large sample of university students in Italy cope with preconception health, especially in the domains of sexual transmitted infections (STIs, fertility and vaccination preventable disease. METHODS: Twentythree questions of the "Sportello Salute Giovani" survey about sexual behaviour and reproductive health were analysed. Besides, results were stratified for sex, age class and socio-economic status. RESULTS: 19.7% of students have had first sexual intercourse before age 15. 21.8% of female students used emergency contraception. 66.4% of the 74.0% sexual active students reported using contraceptives, but about 32% of them used methods ineffective against STIs. A general low coverage for rubella, measles and mumps vaccination was revealed. 63.7% of men and 30.9% of woman never had urologic or gynaecological examinations. DISCUSSION: Overall, young adults in Italy are not still enough sensitized on fertility and preconception care. High schools and universities should increase awareness towards preservation of male and female fertility and preconception care.

  14. 'The university should promote health, but not enforce it': opinions and attitudes about the regulation of sugar-sweetened beverages in a university setting.

    Science.gov (United States)

    Howse, Elly; Freeman, Becky; Wu, Jason H Y; Rooney, Kieron

    2017-08-01

    The study aimed to determine the opinions and attitudes of a university population regarding the regulation of sugar-sweetened beverages in a university setting, primarily looking at differences in opinion between younger adults (under 30 years of age) and older adults (30 years of age or older). An online survey was conducted at an Australian university in April-May 2016 using a convenience sample of students and staff between the ages of 16 and 84 years. The survey included questions about consumption of sugar-sweetened beverages and level of agreement and support of proposed sugar-sweetened beverage interventions. Quantitative response data and qualitative open-ended response data were analysed. Nine hundred thirteen responses from students and staff were analysed. In this population, consumption of sugar-sweetened beverages was low and awareness of the health risks of sugar-sweetened beverages was high. Overall, the surveyed population indicated more support for interventions that require higher levels of personal responsibility. The population did support some environment-centred, population-based interventions, such as increasing access to drinking water and reducing the price of healthier beverage alternatives. However there was less support for more restrictive interventions such as removing sugar-sweetened beverages from sale. Young adults tended to be less supportive of most interventions than older adults. These findings indicate there is some support for environment-centred, population-based approaches to reduce the availability and appeal of sugar-sweetened beverages in an adult environment such as a university setting. However these results suggest that public health may need to focus less on educating populations about the harms associated with sugar-sweetened beverages. Instead, there should be greater emphasis on explaining to populations and communities why environment-centred approaches relating to the sale and promotion of sugar

  15. Stigma as a Fundamental Cause of Population Health Inequalities

    Science.gov (United States)

    Phelan, Jo C.

    2013-01-01

    Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health. PMID:23488505

  16. Politics, welfare regimes, and population health: controversies and evidence.

    Science.gov (United States)

    Muntaner, Carles; Borrell, Carme; Ng, Edwin; Chung, Haejoo; Espelt, Albert; Rodriguez-Sanz, Maica; Benach, Joan; O'Campo, Patricia

    2011-09-01

    In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  17. Occupant comfort and health in green and conventional university buildings.

    Science.gov (United States)

    Hedge, A; Miller, L; Dorsey, J A

    2014-01-01

    Green building standards are significantly impacting modern construction practices. The resulting structures are more energy efficient, but their impact on occupant health has not been widely studied. To investigate a range of indoor environment and ergonomic issues in green buildings. Retrospective post-occupancy evaluation survey of 319 occupants in two Leadership in Energy and Environmental Design (LEED) certified buildings and one conventional building on a Canadian University campus. Results show that working in the LEED buildings was a generally positive experience for their health, performance, and satisfaction. However, the LEED buildings did not always receive the highest ratings for environmental conditions or for health and productivity. Respondents indicated a range of concerns with thermal conditions, office lighting, noise and their overall workstation designs and these were not always better in the green buildings. These results highlight the need for better integration of ergonomic design into green buildings and into the LEED rating system, and these implications are discussed.

  18. Using systems science for population health management in primary care.

    Science.gov (United States)

    Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

    2014-10-01

    Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of Systems science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

  19. Income inequality and population health in Islamic countries.

    Science.gov (United States)

    Esmaeili, A; Mansouri, S; Moshavash, M

    2011-09-01

    To undertake a fresh examination of the relationship between income inequality and population health for a group of Islamic countries using recent information derived from data resource sites from the World Bank and Islamic countries. Cross-sectional data on different measures of income distribution (prosperity, health care, women's role and environment) and indicators of population health were used to illuminate this issue. The relationship between income inequality and population health for a group of Islamic countries was tested using recent information derived from data resource sites from the World Bank and Islamic countries. After consideration of previous studies, seven dependent variables were determined and tested in six equation formats. According to the equations, the urban population percentage and gross domestic product are the most important significant variables that affect life expectancy and the infant mortality rate in Islamic countries. The income distribution coefficient, regardless of the type of measure, was almost insignificant in all equations. In selected Islamic countries, income level has a positive effect on population health, but the level of income distribution is not significant. Among the other dependent variables (e.g. different measures of income distribution, health care, role of women and environment), only environment and education had significant effects. Most of the Islamic countries studied are considered to be poorly developed. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Impact of sexual health course on Malaysian university students.

    Science.gov (United States)

    Low, W Y

    2004-10-01

    A sexual health course was offered and taught by academic staff from the Faculty of Medicine, University of Malaya during semester II of every year as a university elective course to other university students apart from medical students. The course covered a wide range of topics: adolescent sexuality, family planning and pregnancy, violence against women, alternative sexual behavior, physiology of sex, sex and the disabled, gender bias in sexuality, relationship and marriage, sexual dysfunctions, clarification of sexual attitudes and STDs and AIDS. The Sexual Knowledge and Attitude Test (SKAT-II) was used to measure students' pre- and post-course scores on sexual knowledge and attitudes. Fifty-four students who completed both the pre- and post-course tests showed a significant change in sexual knowledge and their attitudes towards sexual myths and autoeroticism. Sexual knowledge was also positively correlated with age, heterosexual relations, autoeroticism and sexual myths scores. However, sexual knowledge is negatively related to religiosity and the influence of religious beliefs on one's attitudes towards sexual matters. This study showed that the sexual health course offered does have a positive impact in increasing one's knowledge and changing one's attitudes towards sexual issues.

  1. Health literacy among Danish university students enrolled in health-related study programmes.

    Science.gov (United States)

    Elsborg, Lea; Krossdal, Fie; Kayser, Lars

    2017-12-01

    It is important to address people's health literacy when providing health care. Health professionals should be aware of, and have insight into, people's health literacy when they provide health services. Health professionals need to be health literate themselves. We examined the level of health literacy in students in Denmark attending one of four full university programmes related to health and investigated how their health literacy was associated with their sociodemographic background. The health literacy level of the students was measured using the multi-dimensional Health Literacy Questionnaire (HLQ) supplemented with sociodemographic questions. The questionnaire was administrated through the students' Facebook groups. The students were enrolled in courses on health informatics, medicine, molecular biomedicine or public health. Out of a total of 7663 students, 630 responded to the questionnaire. No sex difference was found although female students scored higher than male students in domain 4 (social support for health). Students attending the public health programme tended to score higher and those attending molecular biomedicine tended to score lower in the HLQ. There was a positive correlation between HLQ scores and the educational level of the students' parents. If one of their parents was employed in the health care sector, the HLQ score tended to be higher in domains 1 and 4. Students who had been hospitalized also tended to score higher in domains 1, 5 and 6. Students' health literacy relates to their personal background and educational path. This may be of importance when planning curricula and educational activities, including cross-disciplinary courses.

  2. Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center.

    Science.gov (United States)

    Ali, Dena A

    2016-01-01

    The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann-Whitney U test, Chi-square test, and Kruskal-Wallis test. P values less than 0.05 were considered to be statistically significant ( P < 0.05). The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students ( P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior. Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.

  3. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    Science.gov (United States)

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  4. Health, family planning and population growth.

    Science.gov (United States)

    Kessler, A; Standley, C C

    1973-01-01

    Maternal age over 35, close spacing of births, parity over 4, and unwanted pregnancy are discussed as factors that are associated with increased maternal and infant mortality. The likelihood of death due to childbearing is twice as high in the 30-40 age group as in the 20-30 age group and increases 4-to five-fold in the 40+ group. Brith Birth of less than 24-30 months are associated with a two-fold increase in neonatal and infant deaths. Health objectives of large scale family planning programs are geared toward avoiding such births. This paper proposes that these objectives would result in a decrease in maternal and child deaths and thereby lead to growth. A simultaneous lowering of birth rates, however, should offset this growth.

  5. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    NARCIS (Netherlands)

    de Wolf, Antenor Hallo; Toebes, Brigit

    2016-01-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of

  6. University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

    Directory of Open Access Journals (Sweden)

    Pier Maria Furlan

    2013-09-01

    Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

  7. Occupational Health and Sleep Issues in Underserved Populations.

    Science.gov (United States)

    Kalliny, Medhat; McKenzie, Judith Green

    2017-03-01

    Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Nutritional and health challenges of pastoralist populations in Kenya ...

    African Journals Online (AJOL)

    This paper examines nutritional and health challenges facing pastoralists who inhabit fragile rangelands and are one of the most nutritionally vulnerable population groups in Kenya. The review is based on a synthesis of literature on pastoralist food security, nutrition and health status and livelihoods in Kenya's rangelands.

  9. The time dimension in measurements of population health

    NARCIS (Netherlands)

    J.A. Lauer (Jeremy)

    2009-01-01

    textabstractAs recently attested by the Millennium Declaration (United Nations, 2000), the health of populations is a concern for both governments and civil society: three of the eight Millennium Development Goals are defined in terms of health objectives. It is therefore reasonable to enquire what

  10. Performance of private sector health care: implications for universal health coverage

    OpenAIRE

    Morgan, R; Ensor, T; Waters, H

    2016-01-01

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combi...

  11. A national assessment of colleges and university school health education methods courses.

    Science.gov (United States)

    Fisher, Christine M; Price, James H; Telljohann, Susan K; Dake, Joseph A

    2015-04-01

    Across the United States, school health education programs provide a wide variety of knowledge and skills to their students. There are currently no guidelines for school health methods courses. Using a 2-wave mailing followed by a third wave e-mail reminder, a final population of 226 university school health methods instructors at school health preparation programs were surveyed. A total of 138 completed surveys (61%) were returned. The topics taught in school health education methods courses emphasized the most included aligning objectives, instruction, and assessment (79%); development of lesson plans (73%); teaching methods that engage learners (72%); and application of the National Health Education Standards and performance indicators (69%). The content taught and how the instructors assessed their students differed statistically by 1 or more of the following: whether they had a health education degree, had experience teaching in the public schools, and if their program was accredited. This study provides information regarding what school health methods instructors across the United States are teaching in their classes. Using this information as a baseline can serve as a guide for preservice faculty teaching a school health methods course. © 2015, American School Health Association.

  12. Family Planning in the Context of Latin America's Universal Health Coverage Agenda.

    Science.gov (United States)

    Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

    2017-09-27

    Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method

  13. Noise nuisance and health inequalities in Belgium: a population study

    OpenAIRE

    Schmit, C; Lorant, V

    2009-01-01

    Context Lower socioeconomic groups are more likely to live in contaminated environments. This may partly explain socioeconomic health inequalities. Aims Does noise nuisance contribute to socio-economic inequalities in subjective health? Method This research is based on the last Belgian census data carried out in 2001. We work on a 10% sample of the Belgian population. The data are processed through bivariate and multivariate analyses. We model poor subjective health in relation to exposure to...

  14. Primary care and public health: exploring integration to improve population health

    National Research Council Canada - National Science Library

    Committee on Integrating Primary Care and Public Health; Board on Population Health and Public Health Practice; Institute of Medicine

    ...; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal...

  15. Internet information-seeking in mental health: population survey.

    Science.gov (United States)

    Powell, John; Clarke, Aileen

    2006-09-01

    A major use of the of the internet is for health information-seeking. There has been little research into its use in relation to mental health. To investigate the prevalence of internet use for mental health information-seeking and its relative importance as a mental health information source. General population survey. Questions covered internet use, past psychiatric history and the 12-item General Health Questionnaire. Eighteen per cent of all internet users had used the internet for information related to mental health. The prevalence was higher among those with a past history of mental health problems and those with current psychological distress. Only 12% of respondents selected the internet as one of the three most accurate sources of information, compared with 24% who responded that it was one of the three sources they would use. The internet has a significant role in mental health information-seeking. The internet is used more than it is trusted.

  16. Exploring models for the roles of health systems' responsiveness and social determinants in explaining universal health coverage and health outcomes.

    Science.gov (United States)

    Valentine, Nicole Britt; Bonsel, Gouke J

    2016-01-01

    Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002-2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems' responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Health determinants' indicators - access to improved drinking sources, accountability, and average years of schooling - were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the Gini mattered most for inequalities in child

  17. 76 FR 59388 - Board of Regents of the Uniformed Services University of the Health Sciences

    Science.gov (United States)

    2011-09-26

    ... University of the Health Sciences AGENCY: Department of Defense, Uniformed Services University of the Health... Uniformed Services University of the Health Sciences. DATES: Tuesday, October 25, 2011, from 8:30 a.m. to 11... FURTHER INFORMATION CONTACT: Janet S. Taylor, Designated Federal Officer, 4301 Jones Bridge Road, Bethesda...

  18. Health care financing in Nigeria: Implications for achieving universal health coverage.

    Science.gov (United States)

    Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

    2015-01-01

    The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

  19. Universal health coverage in 'One ASEAN': are migrants included?

    Science.gov (United States)

    Guinto, Ramon Lorenzo Luis R; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S

    2015-01-01

    As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of

  20. Policy Choices for Progressive Realization of Universal Health Coverage Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

    Science.gov (United States)

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa; Sommanustweechai, Angkana

    2016-07-31

    In responses to Norheim's editorial, this commentary offers reflections from Thailand, how the five unacceptable trade-offs were applied to the universal health coverage (UHC) reforms between 1975 and 2002 when the whole 64 million people were covered by one of the three public health insurance systems. This commentary aims to generate global discussions on how best UHC can be gradually achieved. Not only the proposed five discrete trade-offs within each dimension, there are also trade-offs between the three dimensions of UHC such as population coverage, service coverage and cost coverage. Findings from Thai UHC show that equity is applied for the population coverage extension, when the low income households and the informal sector were the priority population groups for coverage extension by different prepayment schemes in 1975 and 1984, respectively. With an exception of public sector employees who were historically covered as part of fringe benefits were covered well before the poor. The private sector employees were covered last in 1990. Historically, Thailand applied a comprehensive benefit package where a few items are excluded using the negative list; until there was improved capacities on technology assessment that cost-effectiveness are used for the inclusion of new interventions into the benefit package. Not only cost-effectiveness, but long term budget impact, equity and ethical considerations are taken into account. Cost coverage is mostly determined by the fiscal capacities. Close ended budget with mix of provider payment methods are used as a tool for trade-off service coverage and financial risk protection. Introducing copayment in the context of fee-for-service can be harmful to beneficiaries due to supplier induced demands, inefficiency and unpredictable out of pocket payment by households. UHC achieves favorable outcomes as it was implemented when there was a full geographical coverage of primary healthcare coverage in all districts and sub

  1. The Copenhagen Oral Health Senior Cohort: design, population and dental health

    DEFF Research Database (Denmark)

    Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow

    2011-01-01

    Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe...

  2. Roads to health : multi-state modelling of population health and resource use

    NARCIS (Netherlands)

    Niessen, Louis Wilhelmus

    2002-01-01

    The book has described the dynamics of disease occurrence in populations and gives an overview of the major known health determinants of mortality decline, health risk factors and health services, and studies the health interventions options in two example diseases i.e. diabetes and stroke. We

  3. Health Promotion of University Students: contributions of community therapy.

    Directory of Open Access Journals (Sweden)

    Cintia Poleto Buzeli

    2012-01-01

    Full Text Available With this experience report of a master’s degree and two teachers of graduate Nursing School of Nursing Federal University of Mato Grosso, we sought to reflect on the Community Therapy (TC as a practice of collective care offered to students university students. Our goal is to report the experience of performing TC wheels in an academic environment, offer theoretical and methodological principles for the structuring and implementation of this practice care to college students at other universities. Was used for data collection direct observation of the wheels of TC the professional experiences as nurses and therapists community and appreciation of documents of such as the registration form filled out by the TC meetings and therapist co-therapist after each wheel TC. The reported experience has demonstrated the effectiveness of TC for the promotion of health thin this group, showing its importance as a practice for the creation and strengthening of ties between the community, the establishment of solidarity networks among students, as being a space speech and listening to their sufferings, their appreciation of life and its potential for promoting self-esteem and to encourage the development of a democract and civic consciousness.

  4. Mapping International University Partnerships Identified by East African Universities as Strengthening Their Medicine, Nursing, and Public Health Programs.

    Science.gov (United States)

    Yarmoshuk, Aaron N; Guantai, Anastasia Nkatha; Mwangu, Mughwira; Cole, Donald C; Zarowsky, Christina

    International university partnerships are recommended for increasing the capacity of sub-Saharan African universities. Many publications describe individual partnerships and projects, and tools are available for guiding collaborations, but systematic mappings of the basic, common characteristics of partnerships are scarce. To document and categorize the international interuniversity partnerships deemed significant to building the capacity of medicine, nursing, and public health programs of 4 East African universities. Two universities in Kenya and 2 in Tanzania were purposefully selected. Key informant interviews, conducted with 42 senior representatives of the 4 universities, identified partnerships they considered significant for increasing the capacity of their institutions' medicine, nursing, and public health programs in education, research, or service. Interviews were transcribed and analyzed. Partners were classified by country of origin and corresponding international groupings, duration, programs, and academic health science components. One hundred twenty-nine university-to-university partnerships from 23 countries were identified. Each university reported between 25 and 36 international university partners. Seventy-four percent of partnerships were with universities in high-income countries, 15% in low- and middle-income countries, and 11% with consortia. Seventy percent included medicine, 37% nursing, and 45% public health; 15% included all 3 programs. Ninety-two percent included an education component, 47% research, and 24% service; 12% included all 3 components. This study confirms the rapid growth of interuniversity cross-border health partnerships this century. It also finds, however, that there is a pool of established international partnerships from numerous countries at each university. Most partnerships that seek to strengthen universities in East Africa should likely ensure they have a significant education component. Universities should make

  5. 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.

  6. Health: Policy or Law? A Population-Based Analysis of the Supreme Court's ACA Cases.

    Science.gov (United States)

    Parmet, Wendy E

    2016-12-01

    This essay argues that it matters for the fate of health policies challenged in court whether courts consider health merely as a policy goal that must be subordinate to law, or as a legal norm warranting legal weight and consideration. Applying population-based legal analysis, this article demonstrates that courts have traditionally treated health as a legal norm. However, this norm appears to have weakened in recent years, a trend evident in the Supreme Court's first two decisions concerning the Affordable Care Act, NFIB v. Sebelius and Burwell v. Hobby Lobby However, in its more recent Affordable Care Act decision, King v. Burwell , the health legal norm is once again evident. Whether the Court will continue to treat health as a legal norm will prove critical to the deference and weight it grants health policies in the future. Copyright © 2016 by Duke University Press.

  7. Assessing nutrition and physical health disparisties for a college population

    Science.gov (United States)

    Rural regions are often underserved, and although the Delta region of the United States has a rich history, health disparities abound. A university located in the region has an obligation to address issues of importance to its constituents. Healthy lifestyle obstacles faced by students who hail from...

  8. Income inequality, trust, and population health in 33 countries.

    Science.gov (United States)

    Elgar, Frank J

    2010-11-01

    I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health. Individual data on trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures. Income inequality correlated with country differences in trust (r = -0.51), health expenditures (r = -0.45), life expectancy (r = -0.74), and mortality (r = 0.55). Trust correlated with life expectancy (r = 0.48) and mortality (r = -0.47) and partly mediated their relations to income inequality. Health expenditures did not correlate with life expectancy and mortality, and health expenditures did not mediate links between inequality and health. Income inequality might contribute to short life expectancy and adult mortality in part because of societal differences in trust. Societies with low levels of trust may lack the capacity to create the kind of social supports and connections that promote health and successful aging.

  9. Climate change, food, water and population health in China.

    Science.gov (United States)

    Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-10-01

    Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

  10. Tuskegee University experience challenges conventional wisdom: is integrative bioethics practice the new ethics for the public's health?

    Science.gov (United States)

    Sodeke, Stephen Olufemi

    2012-11-01

    The Tuskegee University National Center for Bioethics in Research and Health Care was established in 1999 in partial response to the Presidential Apology for the United States Public Health Service's Study of Untreated Syphilis in the Negro Male conducted in Macon County, Alabama, from 1932 to 1972. The Center's mission of promoting equity and justice in health and health care for African Americans and other underserved populations employs an integrative bioethics approach informed by moral vision. Etymological and historical analyses are used to delineate the meaning and evolution of bioethics and to provide a basis for Tuskegee's integrative bioethics niche. Unlike mainstream bioethics, integrative bioethics practice is holistic in orientation, and more robust for understanding the epistemic realities of minority life, health disparities, and population health. The conclusion is that integrative bioethics is relevant to the survival of all people, not just a privileged few; it could be the new ethics for the public's health.

  11. Universal health coverage in Rwanda: dream or reality.

    Science.gov (United States)

    Nyandekwe, Médard; Nzayirambaho, Manassé; Baptiste Kakoma, Jean

    2014-01-01

    Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors. The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing. Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.

  12. Health-Related Quality of Life in University Dance Students.

    Science.gov (United States)

    White, Hayley M; Hoch, Johanna M; Hoch, Matthew C

    2018-03-01

    Injuries are common among dancers and may negatively affect health-related quality of life (HRQL). The modified Disablement in the Physically Active Scale (mDPA) is a generic patient-reported outcome instrument that could be used when providing care to patients participating in performing arts. The objective of this pilot study was to examine the internal consistency of the mDPA and assess overall HRQL using the mDPA in university dance students. Thirty-one female university dance students completed the mDPA during one data collection session. Higher scores on the Physical Summary Component (mDPA-PSC), the Mental Summary Component (mDPAMSC), and mDPA-Total indicated increased disablement. The internal consistency was determined using Cronbachs alpha. The mDPA-Total, mDPA-PSC, and mDPAMSC scores were examined descriptively using mean and standard deviations. Individual item responses were also examined. The proportion of university dance students with clinically relevant levels of disablement on the mDPA-Total was examined using a previously established minimally clinically important difference value. The internal consistency for the mDPA-MSC (a=0.91) and mDPATotal (a=0.90) was excellent and good for the mDPA-PSC (a=0.88). A large proportion (71%) of university dance students demonstrated clinically relevant levels of disablement despite fully participating in dance-related activities. Pain, impaired motion, and stress were the greatest contributors to increased disablement in these individuals. The mDPA scores observed in this pilot study indicate that many dance students experience levels of disablement and decreased HRQL which may warrant physical and mental intervention. Clinicians providing healthcare services to performing artists should consider using the mDPA to provide patient-centered care.

  13. Assessment of dietary intake in Spanish university students of health sciences.

    Science.gov (United States)

    Correa-Rodríguez, María; Pocovi, Gabriela; Schmidt-RioValle, Jacqueline; González-Jiménez, Emilio; Rueda-Medina, Blanca

    2018-05-01

    Nutritional intake during early ages has been associated to disease onset later in life. This study aimed to assess dietary intake in Spanish university students of health sciences as compared to national recommended dietary intakes (DRIs). A cross-sectional study was conducted including 585 university students of health sciences aged 18-25 years. Dietary intake was assessed using a 72-h diet recall. A control group was selected from Spanish National Dietary Intake Survey (ENIDE) data. Intake of energy, protein, fat, fatty acids, and cholesterol was significantly lower (p<0.001) in university students compared to controls, while fiber intake showed the opposite trend (p<0.001). Total fat and carbohydrate intake was consistent with recommendations, but protein intake was lower than recommended. Intake of saturated fatty acids (SFAs) was markedly higher than nutrition goals, while intake of monounsaturated fatty acids (MUFAs) was lower. Both students and the reference control group did not reach the optimal dietary intake of iodine and vitamins D and E, while sodium intake was excessive in both groups. Dietary habits of university students were mainly characterized by low intakes of energy, protein, fats, fatty acids, and cholesterol, and high intake of fiber as compared to the general population. Intake of iodine and vitamins D and E was low, while sodium intake was excessive in both university students and the general population. Dietary interventions should be considered to prevent nutritional deficiencies and to ensure a balanced diet. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage

    Directory of Open Access Journals (Sweden)

    Alberquilla Angel

    2008-02-01

    Full Text Available Abstract Background The study of Hospitalizations for ambulatory care sensitive conditions (ACSH has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM and to detect possible differences in ACSH. Methods Cross-sectional, ecologic study, which covered all 34 health districts of the CM. The study population consisted of all individuals aged 65 years or older residing in the CM between 2001 and 2003, inclusive. Using hospital discharge data, avoidable ACSH were selected from the list of conditions validated for Spain. Age- and sex-adjusted ACSH rates were calculated for the population of each health district and the statistics describing the data variability. Point graphs and maps were designed to represent the ACSH rates in the different health districts. Results Of all the hospitalizations, 16.5% (64,409 were ACSH. Globally, the rate was higher among men: 33.15 per 1,000 populations vs. 22.10 in women and these differences were statistically significant (p Conclusion A significant variation is demonstrated in "preventable" hospitalizations between the different districts. In all the districts the men present rates significantly higher than women. Important variations in the access are observed the Primary Attention in spite of existing a universal sanitary cover.

  15. Universal health coverage for India by 2022: a utopia or reality?

    Science.gov (United States)

    Singh, Zile

    2013-04-01

    It is the obligation of the state to provide free and universal access to quality health-care services to its citizens. India continues to be among the countries of the world that have a high burden of diseases. The various health program and policies in the past have not been able to achieve the desired goals and objectives. 65(th) World Health Assembly in Geneva identified universal health coverage (UHC) as the key imperative for all countries to consolidate the public health advances. Accordingly, Planning Commission of India constituted a high level expert group (HLEG) on UHC in October 2010. HLEG submitted its report in Nov 2011 to Planning Commission on UHC for India by 2022. The recommendations for the provision of UHC pertain to the critical areas such as health financing, health infrastructure, health services norms, skilled human resources, access to medicines and vaccines, management and institutional reforms, and community participation. India faces enormous challenges to achieve UHC by 2022 such as high disease prevalence, issues of gender equality, unregulated and fragmented health-care delivery system, non-availability of adequate skilled human resource, vast social determinants of health, inadequate finances, lack of inter-sectoral co-ordination and various political pull and push of different forces, and interests. These challenges can be met by a paradigm shift in health policies and programs in favor of vulnerable population groups, restructuring of public health cadres, reorientation of undergraduate medical education, more emphasis on public health research, and extensive education campaigns. There are still areas of concern in fulfilling the objectives of achieving UHC by 2022 regarding financing model for health-care delivery, entitlement package, cost of health-care interventions and declining state budgets. However, the Government's commitment to provide adequate finances, recent bold social policy initiatives and enactments such as food

  16. Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

    Science.gov (United States)

    Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

    2014-02-01

    Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Bismarck meets Beveridge on the Silk Road: coordinating funding sources to create a universal health financing system in Kyrgyzstan.

    Science.gov (United States)

    Kutzin, Joseph; Ibraimova, Ainura; Jakab, Melitta; O'Dougherty, Sheila

    2009-07-01

    Options for health financing reform are often portrayed as a choice between general taxation (known as the Beveridge model) and social health insurance (known as the Bismarck model). Ten years of health financing reform in Kyrgyzstan, since the introduction of its compulsory health insurance fund in 1997, provide an excellent example of why it is wrong to reduce health financing policy to a choice between the Beveridge and Bismarck models. Rather than fragment the system according to the insurance status of the population, as many other low- and middle-income countries have done, the Kyrgyz reforms were guided by the objective of having a single system for the entire population. Key features include the role and gradual development of the compulsory health insurance fund as the single purchaser of health-care services for the entire population using output-based payment methods, the complete restructuring of pooling arrangements from the former decentralized budgetary structure to a single national pool, and the establishment of an explicit benefit package. Central to the process was the transformation of the role of general budget revenues - the main source of public funding for health - from directly subsidizing the supply of services to subsidizing the purchase of services on behalf of the entire population by redirecting them into the health insurance fund. Through their approach to health financing policy, and pooling in particular, the Kyrgyz health reformers demonstrated that different sources of funds can be used in an explicitly complementary manner to enable the creation of a unified, universal system.

  18. Air pollution and population health: a global challenge

    OpenAIRE

    Chen, Bingheng; Kan, Haidong

    2008-01-01

    “Air pollution and population health” is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still...

  19. Stigma in the context of schools: analysis of the phenomenon of stigma in a population of university students.

    Science.gov (United States)

    Pingani, Luca; Catellani, Sara; Del Vecchio, Valeria; Sampogna, Gaia; Ellefson, Sarah E; Rigatelli, Marco; Fiorillo, Andrea; Evans-Lacko, Sara; Corrigan, Patrick W

    2016-02-09

    Students have stereotyped views about people with mental illness. In particular, they believe that these persons are incurable, dangerous, unpredictable and responsible for their condition. This study aims to investigate the levels of public stigma in an Italian university population. The Attribution Questionnaire 27 - Italian Version (AQ-27-I) was administered to a sample of students from the Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia. After examining the psychometric characteristics of the AQ-27-I (Cronbach's Alpha and Confirmatory Factor Analysis), multiple linear regression analyses were carried out to identify the predictors of stigmatizing attitudes in this population. Three hundred and eleven students completed the questionnaire, with a response rate of 32.81 % (out of the 948 contacted by email). The AQ-27-I showed good psychometric properties with an α = .68, and the fit indices of the models that partially supported the factor structure and paths. The two variables identified as possible predictors of stigmatizing attitudes (total score of AQ-27-I) were age and time spent reading newspapers. Antistigma campaigns are needed in university contexts, targeted in particular to students in health professions.

  20. From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage?

    Science.gov (United States)

    Till, Brian M; Peters, Alexander W; Afshar, Salim; Meara, John G

    2017-01-01

    Blockchain technology and cryptocurrencies could remake global health financing and usher in an era global health equity and universal health coverage. We outline and provide examples for at least four important ways in which this potential disruption of traditional global health funding mechanisms could occur: universal access to financing through direct transactions without third parties; novel new multilateral financing mechanisms; increased security and reduced fraud and corruption; and the opportunity for open markets for healthcare data that drive discovery and innovation. We see these issues as a paramount to the delivery of healthcare worldwide and relevant for payers and providers of healthcare at state, national and global levels; for government and non-governmental organisations; and for global aid organisations, including the WHO, International Monetary Fund and World Bank Group. PMID:29177101

  1. From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage?

    Science.gov (United States)

    Till, Brian M; Peters, Alexander W; Afshar, Salim; Meara, John

    2017-01-01

    Blockchain technology and cryptocurrencies could remake global health financing and usher in an era global health equity and universal health coverage. We outline and provide examples for at least four important ways in which this potential disruption of traditional global health funding mechanisms could occur: universal access to financing through direct transactions without third parties; novel new multilateral financing mechanisms; increased security and reduced fraud and corruption; and the opportunity for open markets for healthcare data that drive discovery and innovation. We see these issues as a paramount to the delivery of healthcare worldwide and relevant for payers and providers of healthcare at state, national and global levels; for government and non-governmental organisations; and for global aid organisations, including the WHO, International Monetary Fund and World Bank Group.

  2. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    Science.gov (United States)

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

    Science.gov (United States)

    de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

    2016-09-01

    With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

  4. Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

    2011-03-05

    In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Curricular transformation of health professions education in Tanzania: the process at Muhimbili University of Health and Allied Sciences (2008-2011).

    Science.gov (United States)

    Ngassapa, Olipa D; Kaaya, Ephata E; Fyfe, Molly V; Lyamuya, Eligius F; Kakoko, Deodatus C; Kayombo, Edmund J; Kisenge, Rodrick R; Loeser, Helen; Mwakigonja, Amos R; Outwater, Anne H; Martin-Holland, Judy; Mwambete, Kennedy D; Kida, Irene; Macfarlane, Sarah B

    2012-01-01

    Tanzania requires more health professionals equipped to tackle its serious health challenges. When it became an independent university in 2007, Muhimbili University of Health and Allied Sciences (MUHAS) decided to transform its educational offerings to ensure its students practice competently and contribute to improving population health. In 2008, in collaboration with the University of California San Francisco (UCSF), all MUHAS's schools (dentistry, medicine, nursing, pharmacy, and public health and social sciences) and institutes (traditional medicine and allied health sciences) began a university-wide process to revise curricula. Adopting university-wide committee structures, procedures, and a common schedule, MUHAS faculty set out to: (i) identify specific competencies for students to achieve by graduation (in eight domains, six that are inter-professional, hence consistent across schools); (ii) engage stakeholders to understand adequacies and inadequacies of current curricula; and (iii) restructure and revise curricula introducing competencies. The Tanzania Commission for Universities accredited the curricula in September 2011, and faculty started implementation with first-year students in October 2011. We learned that curricular revision of this magnitude requires: a compelling directive for change, designated leadership, resource mobilization inclusion of all stakeholders, clear guiding principles, an iterative plan linking flexible timetables to phases for curriculum development, engagement in skills training for the cultivation of future leaders, and extensive communication.

  6. Prevalence of obesity and overweight among the college students of the campus of health sciences of the university of Pernambuco

    OpenAIRE

    Viviane Tannuri Ferreira Lima Falcão; Marcelino Leite de Miranda; Roseane Maria Cavalcanti Silva

    2012-01-01

    The high prevalence of overweight and obesity is presented, currently, as one of the most important problems of public health. Objective: first to calculate the prevalence of obesity and overweight in the adolescent college students of the campus of health and sciences of the University of PE; to identify them according to: sex, age, monthly familiar income and life style. Methods: epidemiologic study and description, quantitative transversal line with characteristics. The population who took...

  7. [Health services utilization by the immigrant population in Spain].

    Science.gov (United States)

    Regidor, Enrique; Sanz, Belén; Pascual, Cruz; Lostao, Lourdes; Sánchez, Elisabeth; Díaz Olalla, José Manuel

    2009-12-01

    To compare health services utilization between the immigrant and indigenous populations in Spain. We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography. In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas. The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.

  8. Implications of Big Data Analytics on Population Health Management.

    Science.gov (United States)

    Bradley, Paul S

    2013-09-01

    As healthcare providers transition to outcome-based reimbursements, it is imperative that they make the transition to population health management to stay viable. Providers already have big data assets in the form of electronic health records and financial billing system. Integrating these disparate sources together in patient-centered datasets provides the foundation for probabilistic modeling of their patient populations. These models are the core technology to compute and track the health and financial risk status of the patient population being served. We show how the probabilistic formulation allows for straightforward, early identification of a change in health and risk status. Knowing when a patient is likely to shift to a less healthy, higher risk category allows the provider to intervene to avert or delay the shift. These automated, proactive alerts are critical in maintaining and improving the health of a population of patients. We discuss results of leveraging these models with an urban healthcare provider to track and monitor type 2 diabetes patients. When intervention outcome data are available, data mining and predictive modeling technology are primed to recommend the best type of intervention (prescriptions, physical therapy, discharge protocols, etc.) with the best likely outcome.

  9. Assessment of university student health literacy toward Influenza

    Directory of Open Access Journals (Sweden)

    Marzieh Meraji

    2016-12-01

    Full Text Available Background and objective: Outbreak of influenza A/H1N1 become serious concern. Student in academic institutions can play effective role in prevention and control of influenza. Here paramedical faculty student health literacy toward Influenza was assessed. Methods: A cross sectional-descriptive study was conducted among 139 students in Medical Records, Physiotherapy, Radiology, Health Information Technology, Speech Therapy and Optometry discipline at paramedical faculty of Mashhad medical university in 2016. A pandemic influenza questionnaire was translated and edited. Demographic characteristics of student, level of knowledge and perception toward influenza and perception toward government and media were collected. Results: More than half of student correctly identified influenza symptoms as fever 95/1%, body ache 51/2%, cough 46/3% and headaches 43/9%.person to person transmission and contact with infected objects were recognized by 87/8% and 68/3% of student as a mode of transmission. Students Covering identified nose and mouth 87/8%, hand washing with soap and water 80/5% and throwing tissues in rubbish bin as precutions.48/6% of student believed that influenza is not fatal; despite 88/9% of student perceived influenza as serious disease. In Government and media assessment, 39% of student agreed health department and other health authorities had a good control plan, 51/4% of student agreed with transparency of necessary intervention during flu outbreak. Conclusion: This study shows that paramedical faculty student has appropriate influenza health literacy. Delivering more information about mode of transmission, high risk group and precaution intervention and playing more effective role by media is recommended. Paper Type: Research Article.

  10. A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

    Science.gov (United States)

    Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

    2017-12-13

    Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

  11. Population disparities in mental health: insights from cultural neuroscience.

    Science.gov (United States)

    Chiao, Joan Y; Blizinsky, Katherine D

    2013-10-01

    By 2050, nearly 1 in 5 Americans (19%) will be an immigrant, including Hispanics, Blacks, and Asians, compared to the 1 in 8 (12%) in 2005. They will vary in the extent to which they are at risk for mental health disorders. Given this increase in cultural diversity within the United States and costly population health disparities across cultural groups, it is essential to develop a more comprehensive understanding of how culture affects basic psychological and biological mechanisms. We examine these basic mechanisms that underlie population disparities in mental health through cultural neuroscience. We discuss the challenges to and opportunities for cultural neuroscience research to determine sociocultural and biological factors that confer risk for and resilience to mental health disorders across the globe.

  12. Difference in Health Inequity between Two Population Groups due to a Social Determinant of Health

    Science.gov (United States)

    Moonesinghe, Ramal; Bouye, Karen; Penman-Aguilar, Ana

    2014-01-01

    The World Health Organization defines social determinants of health as “complex, integrated, and overlapping social structures and economic systems” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference in prevalence of the risk factor in the two populations. The difference in health inequity could be larger than the difference in health outcomes between the two populations in some situations. Compared to health disparities which are typically measured and monitored using absolute or relative disparities of health outcomes, the methods presented in this manuscript provide a different, yet complementary, picture because they parse out the contributions of unfair and avoidable risk factors. PMID:25522048

  13. Use of Stakeholder Focus Groups to Define the Mission and Scope of a new Department of Population Health.

    Science.gov (United States)

    Tierney, William M

    2018-04-09

    The focus and funding of US healthcare is evolving from volume to value-based, and healthcare leaders, managers, payers, and researchers are increasingly focusing on managing populations of patients. Simultaneously, there is increasing interest in getting "upstream" from disease management to promote health and prevent disease. Hence, the term "population health" has both clinical and community-based connotations relevant to the tripartite mission of US medical schools. To seek broad input for the strategic development of the Department of Population Health in a new medical school at a tier 1 research university. Focus groups with facilitated consensus development. Eighty-one persons representing the Dell Medical School and other schools at the University of Texas at Austin, city/county government, community nonprofit organizations, and faculty from other local university schools along with selected national academic leaders. Focus groups with subsequent consensus development of emphases identified premeeting by participants by e-mail exchanges. The resulting departmental strategic plan included scope of work, desired characteristics of leaders, and early impact activities in seven areas of interest: community engagement and health equity, primary care and value-based health, occupational and environment medicine, medical education, health services and community-based research, health informatics and data analysis, and global health. Medical schools should have a primary focus in population, most effectively at the departmental level. Engaging relevant academic and community stakeholders is an effective model for developing this emerging discipline in US medical schools.

  14. Dental health status and oral health behavior among university students from five ASEAN countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2017-02-01

    The aim of this study was to investigate dental health status and oral health behavior and associated factors among university students in five ASEAN countries (Indonesia, Malaysia, Myanmar, Thailand and Vietnam). Using anonymous questionnaires, data were collected from 3,344 undergraduate university students (mean age 20.5, SD=1.6; 58.3% female) from five ASEAN countries. Results indicate that 27.7% of students reported to have sometimes, most of the time or always having tooth ache in the past 12 months, 39.4% reported to have one or more cavities, 20.3% did not brush their teeth twice or more times a day, and 30.9% had never been to a dentist (or did not know it). In multivariate logistic regression analysis, older age, living in a lower middle income country, consumption of chocolate or candy, having made a dental care visit, and poor mental health was associated with tooth ache in the past 12 months. Being male, being 20 to 21 years old, coming from a wealthier family background, living in a lower middle income country, frequent consumption of soft drinks, not having consulted with a dentist in the past 12 months and weak beliefs in the benefits of tooth brushing were associated with inadequate tooth brushing frequency (health status and oral health behaviors were found and various risk factors identified that can be utilized to guide interventions to improve oral health programs among university students.

  15. Career choices and global health engagement: 24-year follow-up of U.S. participants in the Indiana University-Moi University elective.

    Science.gov (United States)

    Umoren, Rachel A; Gardner, Adrian; Stone, Geren S; Helphinstine, Jill; Machogu, Emily P; Huskins, Jordan C; Johnson, Cynthia S; Ayuo, Paul O; Mining, Simeon; Litzelman, Debra K

    2015-12-01

    Global health experiences evoke a profound awareness of cultural differences, inspire learners to prioritize professional values, and provide a lens for addressing global health care challenges. This study compares the long-term career and practice choices of participants in a 2-month Indiana University-Moi University, Kenya elective from 1989-2013 with those of a control group. Global health elective (GHE) participants and a random sample of alumni without GHE experience were surveyed on their clinical practice, public health and global health activities. Responses from 176 former participants were compared with a control group of 177 alumni. GHE participants were more likely than similar controls to provide care to underserved U.S. populations (p=0.037), spend time in global health, public health, and public policy activities (p=0.005) and be involved in global health advocacy (p=0.001). Using multivariable analysis, GHE participants were more likely to be generalists (p<0.05), report that healthcare costs influenced medical decision-making (p<0.05), and provide healthcare outside the U.S. for ≥1 week/year (p<0.001). Many years out of training, GHE participants were more likely to be generalists working with underserved populations, to be cost-conscious in their healthcare decision-making, and to be involved in global health, public health or public policy. With the primary care provider shortage and need for greater awareness among providers of healthcare costs, our study shows that that global health experiences may yield broader benefits to the U.S. medical system. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Perceived health in the Portuguese population aged ? 35

    Directory of Open Access Journals (Sweden)

    João Paulo de Figueiredo

    2014-06-01

    Full Text Available OBJECTIVE : To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS : Observational study (analytical and cross-sectional with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36; health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD, Games-Howell and Conover were used in the statistical analysis. RESULTS : Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001, with chronic disease (p < 0.0001, who consumed < 3 meals per day (p ≤ 0.01, who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence and with different areas of life satisfaction. CONCLUSIONS : Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over

  17. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Contextual influences affecting patterns of overweight and obesity among university students: a 50 universities population-based study in China.

    Science.gov (United States)

    Yang, Tingzhong; Yu, Lingwei; Barnett, Ross; Jiang, Shuhan; Peng, Sihui; Fan, Yafeng; Li, Lu

    2017-05-08

    Many studies have examined childhood and adolescent obesity, but few have examined young adults and the effect of their home and current living environments on prevalence rates. The present study explores contextual factors affecting overweight and obesity among university students in China and, in particular, focuses on how the SES-obesity relationship varies across different geographical contexts. Participants were 11,673 students, who were identified through a multistage survey sampling process conducted in 50 universities. Individual data was obtained through a self-administered questionnaire, and contextual variables were retrieved from a national database. Multilevel logistic regression models were used to examine urban and regional variations in overweight and obesity. Overall the prevalence of overweight and obesity in the study sample was 9.5% (95% CI 7.7, 11.3%). After controlling for individual factors, both attributes of the home location (regional GDP per capita and rurality) and the current university location (city population) were found to be important, thus suggesting that the different origins of students affect current levels of obesity. At the individual level, while students with more financial resources were more likely to be obese, the extent of this relationship was highly dependent upon area income and city size. The results of this study add important insights about the role of contextual factors affecting overweight and obesity among young adults and indicate a need to take into account both past as well as present environmental influences when considering the role of contextual factors in models of the nutrition transition.

  19. [Role of "Health" National project in improvement of health parameters in working population].

    Science.gov (United States)

    Bykovskaia, T Iu

    2011-01-01

    The author analyzed results of "Health" National project accomplishment in Rostov region over 2006-2009. Findings are that quality of primary medical care has improved, material and technical basis of municipal health care institutions has progressed, salary of primary health care division specialists has increased. Over this period, infant mortality and mortality among able-bodied population in the region has decreased, birth rate has increased, coefficient of natural loss of population has reduced, life expectancy has increased.

  20. Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

    Science.gov (United States)

    Reis, Andreas A

    2016-06-07

    This article provides a commentary to Ole Norheim' s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). © 2016 by Kerman University of Medical Sciences.

  1. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  2. Analysis of blood glucose distribution characteristics in a health examination population in Chengdu (2007–2015)

    OpenAIRE

    Huang, Wenxia; Xu, Wangdong; Zhu, Ping; Yang, Hanwei; Su, Linchong; Tang, Huairong; Liu, Yi

    2017-01-01

    Abstract With socioeconomic growth and cultural changes in China, the level of blood glucose may have changed in recent years. This study aims to detect the blood glucose distribution characteristics with a large size of health examination population. A total of 641,311 cases (360,259 males and 281,052 females) more than 18 years old during 2007 to 2015 were recruited from the Health Examination Center at West China hospital, Sichuan University. The percentage of cases with abnormal glucose l...

  3. Population health intervention research training: the value of public health internships and mentorship.

    Science.gov (United States)

    Hamelin, Anne-Marie; Paradis, Gilles

    2018-01-01

    Better alignment between academia and public health practice and policies are critical to improve public health actions. Training of future researchers to address complex issues and to conduct transdisciplinary and collaborative research will help improve this alignment. In this paper, we describe the role of internship placements and mentorship for trainees' skills development in population health intervention research and the benefits of embedding research trainees within public health organizations. This qualitative descriptive study assessed the perceptions of the role and benefits of internships and mentorship for population health intervention research training among former doctoral and postdoctoral students, public health mentors, and senior public health managers who participated in the 4P Program, a research training program which bridges academic training and the public health system in Quebec, Canada. Two types of interviews were conducted: telephone semi-structured interviews by an external evaluator and face-to-face trainee "exit" interviews by the Program co-director. Semi-annual evaluation reports from each trainee were also reviewed. Qualitative data were subjected to a thematic analysis. Internships provided trainees with a working knowledge of the public health system and the context in which decisions and public health interventions are implemented. It was an opportunity for trainees to interact with knowledge-user partners and assess the gap between research and practice. Effective mentorship was key to help trainees interpret the public health reality and develop population health intervention research skills. Trainees learned to ask the "how" questions that are critical for in-depth understanding of complex interventions and the conditions under which they can be best implemented. Conditions of success of internships and mentorship for population health intervention research included the alignment of the interests between the trainee, the

  4. Knowledge, Awareness and Compliance with Universal Precautions among Health Care Workers at the University Hospital of the West Indies, Jamaica

    Directory of Open Access Journals (Sweden)

    K Vaz

    2010-09-01

    Full Text Available Background: Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. Objective: To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. Method: A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Results: Almost two-thirds (64.0% of the respondents were very knowledgeable of universal precautions with significantly more females (75.4% than males (42.9% (p<0.0001. More nurses (90.0%, medical doctors (88.0% and medical technologists (70% were very knowledgeable of universal precautions (p<0.0001. More respondents (92.9% who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001. 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001. Conclusions: There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  5. Knowledge, awareness and compliance with universal precautions among health care workers at the University Hospital of the West Indies, Jamaica.

    Science.gov (United States)

    Vaz, K; McGrowder, D; Alexander-Lindo, R; Gordon, L; Brown, P; Irving, R

    2010-10-01

    Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Almost two-thirds (64.0%) of the respondents were very knowledgeable of universal precautions with significantly more females (75.4%) than males (42.9%) (p<0.0001). More nurses (90.0%), medical doctors (88.0%) and medical technologists (70%) were very knowledgeable of universal precautions (p<0.0001). More respondents (92.9%) who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001). 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001). There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  6. Improving equity in health care financing in China during the progression towards Universal Health Coverage.

    Science.gov (United States)

    Chen, Mingsheng; Palmer, Andrew J; Si, Lei

    2017-12-29

    China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. We used progressivity analysis and dominance test to evaluate the financing channels of general taxation, pubic health insurance, and out-of-pocket (OOP) payments. In 2012 a survey of 8854 individuals in 3008 households recorded the socioeconomic and demographic status, and health care payments of those households. The overall Kakwani index (KI) of China's health care financing system is 0.0444. For general tax KI was -0.0241 (95% confidence interval (CI): -0.0315 to -0.0166). The indices for public health schemes (Urban Employee Basic Medical Insurance, Urban Resident's Basic Medical Insurance, New Rural Cooperative Medical Scheme) were respectively 0.1301 (95% CI: 0.1008 to 0.1594), -0.1737 (95% CI: -0.2166 to -0.1308), and -0.5598 (95% CI: -0.5830 to -0.5365); and for OOP payments KI was 0.0896 (95%CI: 0.0345 to 0.1447). OOP payments are still the dominant part of China's health care finance system. China's health care financing system is not really equitable. Reducing the proportion of indirect taxes would considerably improve health care financing equity. The flat-rate contribution mechanism is not recommended for use in public health insurance schemes, and more attention should be given to optimizing benefit packages during China's progression towards UHC.

  7. Disadvantaged populations in maternal health in China who and why?

    Directory of Open Access Journals (Sweden)

    Beibei Yuan

    2013-04-01

    Full Text Available Background: China has made impressive progress towards the Millennium Development Goal (MDG for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods: We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results: In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions: Inequity in maternal

  8. Disadvantaged populations in maternal health in China who and why?

    Science.gov (United States)

    Yuan, Beibei; Qian, Xu; Thomsen, Sarah

    2013-04-03

    China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Inequity in maternal health continues to be an issue worthy of greater programmatic and

  9. Sexual behavior and health problems in university students, University of Antioquia, 1991.

    Science.gov (United States)

    Zuloaga Posada, L; Soto Vélez, C; Vélez, D J

    1995-12-01

    Authorities at the University of Antioquia, Colombia, felt it would be advisable to institute a student orientation program aimed at preventing health problems resulting from risky sexual behavior related to new cultural trends. The purpose of the work reported in this article was to collect information on the existing situation and provide appropriate advice to the Health Division of the University Welfare Office. For this purpose a survey was conducted with the voluntary participation of 836 students enrolled in their final year of study. A survey form containing 45 questions designed to elicit demographic and sexual behavior data was self-administered anonymously by the participating students. Among the participants who were sexually active, 10.9% (17.2% of the men, 3.3% of the women) said they had contracted some variety of sexually transmitted disease (STD). The most common diagnoses were gonorrhea (42%), genital warts (23%), and genital herpes (19%). The risk of contracting STD was 4.2 times greater in those reporting sex with strangers; 3.4 times greater in those reporting four or more sexual partners; and 2.5 times greater in those reporting homosexual relations, as compared to students not practicing such behaviors. Some 28.4% of 790 survey respondents or their partners had been pregnant; 49% of these pregnancies had terminated in abortions, 77% of these being induced abortions. Only 51.3% of the survey participants reported customary use of contraceptives, those most frequently cited being condoms (by 32% of the users), pills (20%), the rhythm method (18%), and extravaginal ejaculation (17%). Generally speaking, it appears that participating students had received little sex education. To obtain information, they had turned primarily to friends and books. Those who said they had received adequate sex education at home participated somewhat less frequently in risky behaviors but appeared a little less apt to have used contraceptives and a little more apt to

  10. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    OpenAIRE

    Soc?as, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers? experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex worke...

  11. Population pressure and health risks in urban market environment: a ...

    African Journals Online (AJOL)

    Population pressure and health risks in urban market environment: a study of Bodija market, Ibadan, Nigeria. ... International Journal of Development and Management Review ... This study was directed at permanent sellers in Bodija Market, (men and women) and people who frequent the market to make purchases.

  12. World population, world health and security: 20th century trends.

    Science.gov (United States)

    Bashford, A

    2008-03-01

    The connection between infectious disease control and national security is now firmly entrenched. This article takes a historical look at another security issue once prominent in debate on foreign policy and international relations, but now more or less absent: overpopulation. It explores the nature of the debate on population as a security question, and its complicated historical relation to the development of world health.

  13. Food, Populations and Health — global Patterns and Challenges

    DEFF Research Database (Denmark)

    2016-01-01

    The present volume is based on presentations at a symposium at the Royal Danish Academy of Sciences and Letters in September 2014 with the title Food, Population and Health – global Patterns and Challenges. Food has played a fundamental role in the history of all societies over the World. Availab...

  14. Mental health first aid training for nursing students: a protocol for a pragmatic randomised controlled trial in a large university.

    Science.gov (United States)

    Crawford, Gemma; Burns, Sharyn K; Chih, Hui Jun; Hunt, Kristen; Tilley, P J Matt; Hallett, Jonathan; Coleman, Kim; Smith, Sonya

    2015-02-19

    The impact of mental health problems and disorders in Australia is significant. Mental health problems often start early and disproportionately affect young people. Poor adolescent mental health can predict educational achievement at school and educational and occupational attainment in adulthood. Many young people attend higher education and have been found to experience a range of mental health issues. The university setting therefore presents a unique opportunity to trial interventions to reduce the burden of mental health problems. Mental Health First Aid (MHFA) aims to train participants to recognise symptoms of mental health problems and assist an individual who may be experiencing a mental health crisis. Training nursing students in MHFA may increase mental health literacy and decrease stigma in the student population. This paper presents a protocol for a trial to examine the efficacy of the MHFA training for students studying nursing at a large university in Perth, Western Australia. This randomised controlled trial will follow the CONSORT guidelines. Participants will be randomly allocated to the intervention group (receiving a MHFA training course comprising two face to face 6.5 hour sessions run over two days during the intervention period) or a waitlisted control group (not receiving MHFA training during the study). The source population will be undergraduate nursing students at a large university located in Perth, Western Australia. Efficacy of the MHFA training will be assessed by following the intention-to-treat principle and repeated measures analysis. Given the known burden of mental health disorders among student populations, it is important universities consider effective strategies to address mental health issues. Providing MHFA training to students offers the advantage of increasing mental health literacy, among the student population. Further, students trained in MHFA are likely to utilise these skills in the broader community, when they

  15. Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success.

    Science.gov (United States)

    Rodney, Anna M; Hill, Peter S

    2014-10-10

    Equity should be implicit within universal health coverage (UHC) however, emerging evidence is showing that without adequate focus on measurement of equity, vulnerable populations may continue to receive inadequate or inferior health care. This study undertakes a narrative review which aims to: (i) elucidate how equity is contextualised and measured within UHC, and (ii) describe tools, resources and lessons which will assist decision makers to plan and implement UHC programmes which ensure equity for all. A narrative review of peer-reviewed literature published in English between 2005 and 2013, retrieved from PubMed via the search words, 'universal health coverage/care' and 'equity/inequity' was performed. Websites of key global health organizations were also searched for relevant grey literature. Papers were excluded if they failed to focus on equity (of access, financial risk protection or health outcomes) as well as focusing on one of the following: (i) the impact of UHC programmes, policies or interventions on equity (ii) indicators, measurement, monitoring and/or evaluation of equity within UHC, or (iii) tools or resources to assist with measurement. Eighteen journal articles consisting mostly of secondary analysis of country data and qualitative case studies in the form of commentaries/reviews, and 13 items of grey literature, consisting largely of reports from working groups and expert meetings focusing on defining, understanding and measuring inequity in UHC (including recent drafts of global/country monitoring frameworks) were included. The literature advocates for progressive universalism addressing monetary and non-monetary barriers to access and strengthening existing health systems. This however relies on countries being effectively able to identify and reach disadvantaged populations and estimate unmet need. Countries should assess the new WHO/WB-proposed framework for its ability to adequately track the progress of disadvantaged populations in terms

  16. A mismatch between population health literacy and the complexity of health information: an observational study.

    Science.gov (United States)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

    2015-06-01

    Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

  17. Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system.

    Science.gov (United States)

    Akbari, Nahid; Ramezankhani, Ali; Pazargadi, Mehrnoosh

    2013-07-01

    At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the "unmet need for family planning" have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the

  18. South Africa's universal health coverage reforms in the post-apartheid period.

    Science.gov (United States)

    van den Heever, Alexander Marius

    2016-12-01

    In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers. This article reviews both reform paths and attempts to reconcile what may appear to be very different approaches. The scale of the more recent set of proposals requires a very long reform path because in the mid-term (the next 25 years) no single scheme will be able to raise sufficient revenue to provide a universal package for the entire population. In the interim, reforms that maintain and improve existing forms of coverage are required. The earlier reform framework (1994-2008) largely addressed this concern while leaving open the final form of the system. Both reform approaches are therefore compatible: the earlier reforms addressed medium- to long-term coverage concerns, while the more recent define the long-term institutional goal. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Respiratory Health in Migrant Populations: A Crisis Overlooked

    Science.gov (United States)

    Holguin, Fernando; Moughrabieh, M. Anas; Ojeda, Victoria; Patel, Sanjay R.; Peyrani, Paula; Pinedo, Miguel; Celedón, Juan C.; Douglas, Ivor S.; Upson, Dona J.

    2017-01-01

    The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention. PMID:28146384

  20. A health promotion practicum targeting the college-age population.

    Science.gov (United States)

    Diebold, C M; Chappell, H W; Robinson, M K

    2000-01-01

    Senior and sophomore baccalaureate nursing students at the University of Kentucky developed a health promotion exposition that targeted college students. This experience gave senior students the opportunity to practice leadership and management skills, such as planning, organizing, collaborating, delegating, evaluating, and time management and conflict resolution. Sophomore students developed teaching abilities, practiced assessment and communication techniques, and increased their knowledge of health-promoting behaviors. Both groups experienced team building and demonstrated accountability. Students reported a positive learning experience that met various course objectives in an innovative way.

  1. Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Limwattananon, Supon; Patcharanarumol, Walaiporn; Thammatacharee, Jadej; Jongudomsuk, Pongpisut; Sirilak, Supakit

    2015-11-01

    Strategic purchasing is one of the key policy instruments to achieve the universal health coverage (UHC) goals of improved and equitable access and financial risk protection. Given favourable outcomes of Universal Coverage Scheme (UCS), this study synthesized strategic purchasing experiences in the National Health Security Office (NHSO) responsible for the UCS in contributing to achieving UHC goals. The UCS applied the purchaser-provider split concept where NHSO, as a purchaser, is in a good position to enforce accountability by public and private providers to the UCS beneficiaries, through active purchasing. A comprehensive benefit package resulted in high level of financial risk protection as reflected by low incidence of catastrophic health spending and impoverished households. The NHSO contracted the District Health System (DHS) network, to provide outpatient, health promotion and disease prevention services to the whole district population, based on an annual age-adjusted capitation payment. In most cases, the DHS was the only provider in a district without competitors. Geographical monopoly hampered the NHSO to introduce a competitive contractual agreement, but a durable, mutually dependent relationship based on trust was gradually evolved, while accreditation is an important channel for quality improvement. Strategic purchasing services from DHS achieved a pro-poor utilization due to geographical proximity, where travel time and costs were minimal. Inpatient services paid by Diagnostic Related Group within a global budget ceiling, which is estimated based on unit costs, admission rates and admission profiles, contained cost effectively. To prevent potential under-provisions of the services, some high cost interventions were unbundled from closed end payment and paid on an agreed fee schedule. Executing monopsonistic purchasing power by NHSO brought down price of services given assured quality. Cost saving resulted in more patients served within a finite

  2. Oral health behaviour and social and health factors in university students from 26 low, middle and high income countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2014-11-26

    Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that 67.2% of students reported to brush their teeth twice or more times a day, 28.8% about once a day and 4.0% never. Regarding dental check-up visit, 16.3% reported twice a year, 25.6% once a year, 33.9% rarely and 24.3% never. In a multivariate logistic regression analysis, being a male, coming from a wealthy or quite well off family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, depression and PTSD symptoms, tobacco use and frequent gambling, low physical activity, and low daily meal and snacks frequency were associated with inadequate tooth brushing (importance of regular tooth brushing, PTSD symptoms, illicit drug use, low physical activity, and low daily snacks frequency, skipping breakfast and inadequate fruit and vegetables consumption were associated with less than one annual dental care visit. Oral health behaviour among the students was found to be low. Various risk factors identified can be used to guide interventions to improve oral health behaviour among university students.

  3. Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2014-11-01

    Full Text Available Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8 from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that 67.2% of students reported to brush their teeth twice or more times a day, 28.8% about once a day and 4.0% never. Regarding dental check-up visit, 16.3% reported twice a year, 25.6% once a year, 33.9% rarely and 24.3% never. In a multivariate logistic regression analysis, being a male, coming from a wealthy or quite well off family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, depression and PTSD symptoms, tobacco use and frequent gambling, low physical activity, and low daily meal and snacks frequency were associated with inadequate tooth brushing (health behaviour among the students was found to be low. Various risk factors identified can be used to guide interventions to improve oral health behaviour among university students.

  4. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia

    Directory of Open Access Journals (Sweden)

    Heywood Anita E

    2012-02-01

    health-seeking and uptake of precautionary health measures in this highly mobile young adult population. Although immunisation is not an entry requirement to study at Universities in Australia, large tertiary institutions provide an opportunity to engage with young adults on the importance of travel health and provision of vaccines required for travel, including missed childhood vaccines.

  5. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia.

    Science.gov (United States)

    Heywood, Anita E; Zhang, Meng; MacIntyre, C Raina; Seale, Holly

    2012-02-17

    associated with travel and improve preventative health-seeking and uptake of precautionary health measures in this highly mobile young adult population. Although immunisation is not an entry requirement to study at Universities in Australia, large tertiary institutions provide an opportunity to engage with young adults on the importance of travel health and provision of vaccines required for travel, including missed childhood vaccines.

  6. Policy Choices for Progressive Realization of Universal Health Coverage; Comment on “Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage”

    Directory of Open Access Journals (Sweden)

    Viroj Tangcharoensathien

    2017-03-01

    Full Text Available In responses to Norheim’s editorial, this commentary offers reflections from Thailand, how the five unacceptable trade-offs were applied to the universal health coverage (UHC reforms between 1975 and 2002 when the whole 64 million people were covered by one of the three public health insurance systems. This commentary aims to generate global discussions on how best UHC can be gradually achieved. Not only the proposed five discrete tradeoffs within each dimension, there are also trade-offs between the three dimensions of UHC such as population coverage, service coverage and cost coverage. Findings from Thai UHC show that equity is applied for the population coverage extension, when the low income households and the informal sector were the priority population groups for coverage extension by different prepayment schemes in 1975 and 1984, respectively. With an exception of public sector employees who were historically covered as part of fringe benefits were covered well before the poor. The private sector employees were covered last in 1990. Historically, Thailand applied a comprehensive benefit package where a few items are excluded using the negative list; until there was improved capacities on technology assessment that cost-effectiveness are used for the inclusion of new interventions into the benefit package. Not only costeffectiveness, but long term budget impact, equity and ethical considerations are taken into account. Cost coverage is mostly determined by the fiscal capacities. Close ended budget with mix of provider payment methods are used as a tool for trade-off service coverage and financial risk protection. Introducing copayment in the context of feefor-service can be harmful to beneficiaries due to supplier induced demands, inefficiency and unpredictable out of pocket payment by households. UHC achieves favorable outcomes as it was implemented when there was a full geographical coverage of primary healthcare coverage in all

  7. India's "tryst" with universal health coverage: reflections on ethnography in Indian health policymaking.

    Science.gov (United States)

    Nambiar, Devaki

    2013-12-01

    In 2011, India stood at the crossroads of potentially major health reform. A High Level Expert Group (HLEG) on universal health coverage (UHC), convened by the Indian Planning Commission, proposed major changes in the structure and functioning of the country's health system. This paper presents reflections on the role of ethnography in policy-based social change for health in India, drawing from year-long participation in the aforementioned policy development process. It theorizes that international discourses have been (re)appropriated in the Indian case by recourse to both experience and evidence, resulting in a plurality of concepts that could be prioritized for Indian health reform. This articulation involved HLEG members exerting para-ethnographic labour and paying close attention to context, suggesting that ethnographic sensibilities can reside within the interactive and knowledge production practices among experts oriented toward policy change. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

    Science.gov (United States)

    Narayana, Muttur Ranganathan

    2016-12-01

    India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public

  9. The adaptation of the Millon Index of Personality Styles to a Peruvian population of university students

    Directory of Open Access Journals (Sweden)

    María del Pilar Sánchez López

    2002-06-01

    Full Text Available The purpose of the study was the adaptation of the MIPS (1994 toa population of 390 university students of Lima ( 188 men and 202 women. The inventory was adapted to the Spanishs poken in Peru. The psychometrical analysis revealed a reliability index of .70 as well as astructural internal validity. Most of the scales presented acceptable levels of internal consistency.The comparison with the studies carried out in Spain and USA showed that the levels of internal-consistency were similar to those found in the Spanish population and slightly below tothose found in the North American population. The analysis of the differences between the averages in each one of the se al es indicated greater discrepancies between the Peruvian populationand the Spanish, than between the Peruvian popular ion and the Nonh American.

  10. Debate: Limitations on universality: the "right to health" and the necessity of legal nationality

    Science.gov (United States)

    2010-01-01

    that stateless populations be recognized, the health of these populations be tracked, and more research conducted to further elaborate upon the connection between statelessness and access to healthcare services, and hence a universal right to health. PMID:20525334

  11. Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

    Science.gov (United States)

    Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

    2017-07-18

    In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted

  12. Physical Activity Patterns in University Students: Do They Follow the Public Health Guidelines?

    Science.gov (United States)

    Clemente, Filipe Manuel; Nikolaidis, Pantelis Theodoros; Martins, Fernando Manuel Lourenço; Mendes, Rui Sousa

    2016-01-01

    Physical activity is associated with health. The aim of this study was (a) to access if Portuguese university students meet the public health recommendations for physical activity and (b) the effect of gender and day of the week on daily PA levels of university students. This observational cross-sectional study involved 126 (73 women) healthy Portuguese university students aged 18–23 years old. Participants wore the ActiGraph wGT3X-BT accelerometer for seven consecutive days. Number of steps, time spent sedentary and in light, moderate and vigorous physical activity were recorded. The two-way MANOVA revealed that gender (p-value = 0.001; η2 = 0.038; minimum effect) and day of the week (p-value = 0.001; η2 = 0.174; minimum effect) had significant main effects on the physical activity variables. It was shown that during weekdays, male students walked more steps (65.14%), spent less time sedentary (6.77%) and in light activities (3.11%) and spent more time in moderate (136.67%) and vigorous activity (171.29%) in comparison with weekend days (p activities during weekdays than in weekend days (p physical activity in this population, focusing on the change of sedentary behaviour. PMID:27022993

  13. Domain-specific physical activity and health-related quality of life in university students.

    Science.gov (United States)

    Pedišić, Zeljko; Rakovac, Marija; Titze, Sylvia; Jurakić, Danijel; Oja, Pekka

    2014-01-01

    Information on the relationship between domain-specific physical activity (PA) and health-related quality of life (HRQoL) in the general population and specific groups is still scarce. The aim of this study was to determine the relationship between PA in work, transport, domestic and leisure-time domains and HRQoL among university students. PA and HRQoL were assessed in a random stratified sample of 1750 university students using the International Physical Activity Questionnaire - long form and 12-item Short Form Health Survey, respectively. The Spearman's rank correlations, adjusted for age, community size, personal monthly budget, body mass index, smoking habits and alcohol intake ranged from -0.11 to 0.18 in female students and -0.29 to 0.19 in male students. Leisure-time, domestic, transport-related PA and total PA were positively related to HRQoL. Inverse correlations with HRQoL were only found for work-related PA in male students. Multiple linear regression analysis showed that only leisure-time PA was related to the Physical Summary Component score (β = 0.08 for females and β = 0.10 for males, P leisure-time, transport and domestic PA with HRQoL can potentially be used to support evidence-based promotion of PA in a university setting, and as a hypothesis for future longitudinal studies on such potential causal relationships.

  14. Query Health: standards-based, cross-platform population health surveillance.

    Science.gov (United States)

    Klann, Jeffrey G; Buck, Michael D; Brown, Jeffrey; Hadley, Marc; Elmore, Richard; Weber, Griffin M; Murphy, Shawn N

    2014-01-01

    Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under

  15. Population health and urban form : a review of the literature

    International Nuclear Information System (INIS)

    2004-11-01

    A review examining the links between public health and living spaces was presented. The aim of the review was to explore whether different urban forms created communities that encouraged healthy living and resulted in a healthier population as well as to suggest avenues and approaches for further research of the subject in British Columbia. The historical links between public health and community planning were examined. A conceptual model of the linkages of urban form and population health was developed and used to identify ways in which urban form and population health are linked. Areas of concern include vehicle emissions, water quality and heat build-up as well as noise pollution. Issues concerning health inequalities related to income and access to health services were examined, as well as the role that urban form plays as a barrier to physical activity. Findings indicated that there is a strong correlation between urban form and health. Lower density urban forms that require a vehicle generated more miles travelled by car with more traffic crashes and higher risks to pedestrians and cyclists. A growing body of evidence has indicated that community contacts are scarcer in low density areas. In addition, low density dwellers seemed to have higher stress levels. Car dependent lifestyles had negative impacts on children's play, growth and development. Urban forms which promoted a range of housing options in terms of affordability, tenure and type allowed people to remain within their neighbourhoods. Disadvantaged groups fared better in denser areas where there were more public facilities. 62 refs. 1 tab., 2 figs

  16. Air pollution and population health: a global challenge.

    Science.gov (United States)

    Chen, Bingheng; Kan, Haidong

    2008-03-01

    "Air pollution and population health" is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and ozone (O(3)) to those explored in Europe and North America. The World Health Organization (WHO) published the "WHO Air Quality Guidelines (AQGs), Global Update" in 2006. These updated AQGs provide much stricter guidelines for PM, NO(2), SO(2) and O(3). Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.

  17. Building capacity for public and population health research in Africa: the consortium for advanced research training in Africa (CARTA) model

    Science.gov (United States)

    Ezeh, Alex C.; Izugbara, Chimaraoke O.; Kabiru, Caroline W.; Fonn, Sharon; Kahn, Kathleen; Manderson, Lenore; Undieh, Ashiwel S.; Omigbodun, Akinyinka; Thorogood, Margaret

    2010-01-01

    Background Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region's socio-economic and health problems. Objective and program overview We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA's program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions CARTA's focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative's goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems. PMID:21085517

  18. Building capacity for public and population health research in Africa: the consortium for advanced research training in Africa (CARTA model

    Directory of Open Access Journals (Sweden)

    Alex C. Ezeh

    2010-11-01

    Full Text Available Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the region's socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA, which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTA's program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTA's focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiative's goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems.

  19. Strategies for expanding health insurance coverage in vulnerable populations.

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-11-26

    Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012).In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies and Interrupted time series (ITS) studies that

  20. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

    Science.gov (United States)

    Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

    2017-04-01

    Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

  1. Message design strategies to raise public awareness of social determinants of health and population health disparities.

    Science.gov (United States)

    Niederdeppe, Jeff; Bu, Q Lisa; Borah, Porismita; Kindig, David A; Robert, Stephanie A

    2008-09-01

    Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well-being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities.

  2. Exploring models for the roles of health systems’ responsiveness and social determinants in explaining universal health coverage and health outcomes

    Directory of Open Access Journals (Sweden)

    Nicole Britt Valentine

    2016-03-01

    Full Text Available Background: Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. Objective: To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. Design: The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002–2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems’ responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Results: Health determinants’ indicators – access to improved drinking sources, accountability, and average years of schooling – were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the

  3. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

    Science.gov (United States)

    Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

    2017-01-01

    Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

  4. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

    Directory of Open Access Journals (Sweden)

    Sulakshana Nandi

    Full Text Available Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private and out of pocket (OOP expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members of the 2014 National Sample Survey (71st Round on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure. The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests

  5. Socioeconomic inequality in self-reported oral health status: the experience of Thailand after implementation of the universal coverage policy.

    Science.gov (United States)

    Somkotra, Tewarit

    2011-06-01

    This study aimed to quantify the extent to which socioeconomic-related inequality in self-reported oral health status among Thais is present after the country implemented the Universal Coverage policy and to decompose the determinants and their associations with inequality in self-reported oral health status in particular with the worse condition. The study employed a concentration index to measure socioeconomic-related inequality in self-reported oral health status, and the decomposition method to identify the determinants and their associations with inequality in oral health-related measures. Data from 32,748 Thai adults aged 15-75 years from the nationally representative Health &Welfare Survey and Socio-Economic Survey 2006 were used in analyses. Reports of worse oral health status of the lower socioeconomic-status group were more common than their higher socioeconomic-status counterparts. The concentration index (equaling -0.208) corroborates the finding of pro-poor inequality in self-reported worse oral health. Decomposition analysis demonstrated certain demographic-, socioeconomic-, and geographic characteristics are particularly associated with poor-rich differences in self-reported oral health status among Thai adults. This study demonstrated socioeconomic-related inequality in oral health is discernable along the entire spectrum of socioeconomic status. Inequality in perceived oral health status among Thais is present even while the country has virtually achieved universality of health coverage. The study also indicates population subgroups, particularly the poor, should receive consideration for improving oral health status as revealed by underlying determinants.

  6. Analysis of blood glucose distribution characteristics in a health examination population in Chengdu (2007-2015).

    Science.gov (United States)

    Huang, Wenxia; Xu, Wangdong; Zhu, Ping; Yang, Hanwei; Su, Linchong; Tang, Huairong; Liu, Yi

    2017-12-01

    With socioeconomic growth and cultural changes in China, the level of blood glucose may have changed in recent years. This study aims to detect the blood glucose distribution characteristics with a large size of health examination population.A total of 641,311 cases (360,259 males and 281,052 females) more than 18 years old during 2007 to 2015 were recruited from the Health Examination Center at West China hospital, Sichuan University.The percentage of cases with abnormal glucose level and the mean level of glucose were significantly increased since 2007 to 2015 overall. The percentage of cases with abnormal glucose level in males was significantly higher than that in females every year, and the percentage of cases with abnormal glucose level in aged population was higher than the young population. In addition, the mean level of glucose was higher in aged population with normal level of glucose than the young population with normal level of glucose, and the mean level of glucose was higher in males with normal level of glucose than the females with normal level of glucose.The population showed an increased level of blood glucose. Some preventive action may be adopted early and more attention can be paid to them.

  7. 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.

  8. Implementing the Health Promoting University approach in culturally different contexts: a systematic review.

    Science.gov (United States)

    Suárez-Reyes, Mónica; Van den Broucke, Stephan

    2016-03-01

    Universities represent a valuable opportunity to promote health and well-being. Based on the setting approach, the Health Promoting Universities concept has been developed in different countries and contexts. However, the implementation process remains poorly documented. This systematic review aims to describe how universities have implemented the Health Promoting University concept in different cultural contexts. Pubmed, Medline, Lilacs and Scielo were searched for articles on Health Promoting Universities, published between 1995 and 2015. Studies detailing the implementation of a Health Promoting University approach were included. Selected articles were content analysed paying attention to: (a) the definition of a Health Promoting University; (b) priority areas of action; (c) items of work; (d) coordination of the project; (e) evaluation; and (f) adaptation to the cultural context. Twelve studies were identified for in-depth analysis. Of those, three were theoretical papers, and nine were intervention studies. The programmes described in the selected studies are mostly based on the guidelines of the Edmonton Charter. They incorporated the main areas of action and items of works proposed by the Health Promoting University framework. The implementation of healthy policies and incorporation of health promotion in the curriculum are remaining challenges. Strategies to facilitate adaptation to context include: stakeholder participation in planning and implementation, adaptation of educational material and analysis of needs. The review suggests that most of the universities work towards similar goals, relying on the Health Promoting University framework, yet that the way in which initiatives are implemented depends on the context. © The Author(s) 2015.

  9. The University Environment: A Comprehensive Assessment of Health-Related Advertisements

    Science.gov (United States)

    Szymona, Katie; Quick, Virginia; Olfert, Melissa; Shelnutt, Karla; Kattlemann, Kendra K.; Brown-Esters, Onikia; Colby, Sarah E.; Beaudoin, Christina; Lubniewski, Jocelyn; Maia, Angelina Moore; Horacek, Tanya; Byrd-Bredbenner, Carol

    2012-01-01

    Purpose: Little is known about health-related advertising on university environments. Given the power of advertising and its potential effect on health behaviors, the purpose of this paper is to assess the health-related advertisement environment and policies on university campuses. Design/methodology/approach: In total, ten geographically and…

  10. Public Health and Preventive Medicine Meet Integrative Health: Applications of Competency Mapping to Curriculum Education at the University of Michigan.

    Science.gov (United States)

    Wells, Eden V; Benn, Rita K; Warber, Sara L

    2015-11-01

    The University of Michigan School of Public Health Preventive Medicine Residency (UMSPH PMR) Integrative Medicine Program (IMP) was developed to incorporate integrative medicine (IM), public health, and preventive medicine principles into a comprehensive curriculum for preventive medicine residents and faculty. The objectives of this project were to (1) increase the preventive medicine workforce skill sets based in complementary and alternative medicine and IM that would address individual and population health issues; (2) address the increasing demand for evidence-based IM by training physicians to implement cost-effective primary and secondary prevention services and programs; and (3) share lessons learned, curriculum evaluations, and best practices with the larger cohort of funded IM PMR programs. The UMSPH PMR collaborated with University of Michigan IM faculty to incorporate existing IM competencies with those already established for preventive medicine and public health residency training as the first critical step for IMP curriculum integration. Essential teaching strategies incorporated didactic and practicum methods, and made use of seasoned IM faculty, along with newly minted preventive medicine integrative teaching faculty, and PMR resident learners as IM teachers. The major components of the IMP curriculum included resident participation in IMP Orientation Sessions, resident leadership in epidemiology graduate IM seminars, resident rotations in IM month-long clinical practicums, resident participation in interprofessional health system-wide IM clinical case conferences, and PMR faculty enrollment in the renowned Faculty Scholars Program in Integrative Healthcare. This paper describes the novel interdisciplinary collaborations and key curriculum components that resulted in the IMP, as well as evaluation of strengths, weaknesses, and lessons learned. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Ambient air pollution, climate change, and population health in China.

    Science.gov (United States)

    Kan, Haidong; Chen, Renjie; Tong, Shilu

    2012-07-01

    As the largest developing country, China has been changing rapidly over the last three decades and its economic expansion is largely driven by the use of fossil fuels, which leads to a dramatic increase in emissions of both ambient air pollutants and greenhouse gases (GHGs). China is now facing the worst air pollution problem in the world, and is also the largest emitter of carbon dioxide. A number of epidemiological studies on air pollution and population health have been conducted in China, using time-series, case-crossover, cross-sectional, cohort, panel or intervention designs. The increased health risks observed among Chinese population are somewhat lower in magnitude, per amount of pollution, than the risks found in developed countries. However, the importance of these increased health risks is greater than that in North America or Europe, because the levels of air pollution in China are very high in general and Chinese population accounts for more than one fourth of the world's totals. Meanwhile, evidence is mounting that climate change has already affected human health directly and indirectly in China, including mortality from extreme weather events; changes in air and water quality; and changes in the ecology of infectious diseases. If China acts to reduce the combustion of fossil fuels and the resultant air pollution, it will reap not only the health benefits associated with improvement of air quality but also the reduced GHG emissions. Consideration of the health impact of air pollution and climate change can help the Chinese government move forward towards sustainable development with appropriate urgency. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Life and health satisfaction in the adult population of Iran.

    Science.gov (United States)

    Daroudi, Rajabali; Rashidian, Arash; Zeraati, Hojjat; Oliyaeemanesh, Alireza; Akbari Sari, Ali

    2016-01-01

    Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran. We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables. On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent. The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction.

  13. Life and health satisfaction in the adult population of Iran

    Science.gov (United States)

    2016-01-01

    OBJECTIVES Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran. METHODS We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables. RESULTS On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent. CONCLUSIONS The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction. PMID:27809456

  14. ‘The university should promote health, but not enforce it’: opinions and attitudes about the regulation of sugar-sweetened beverages in a university setting

    Directory of Open Access Journals (Sweden)

    Elly Howse

    2017-08-01

    Full Text Available Abstract Background The study aimed to determine the opinions and attitudes of a university population regarding the regulation of sugar-sweetened beverages in a university setting, primarily looking at differences in opinion between younger adults (under 30 years of age and older adults (30 years of age or older. Methods An online survey was conducted at an Australian university in April–May 2016 using a convenience sample of students and staff between the ages of 16 and 84 years. The survey included questions about consumption of sugar-sweetened beverages and level of agreement and support of proposed sugar-sweetened beverage interventions. Quantitative response data and qualitative open-ended response data were analysed. Results Nine hundred thirteen responses from students and staff were analysed. In this population, consumption of sugar-sweetened beverages was low and awareness of the health risks of sugar-sweetened beverages was high. Overall, the surveyed population indicated more support for interventions that require higher levels of personal responsibility. The population did support some environment-centred, population-based interventions, such as increasing access to drinking water and reducing the price of healthier beverage alternatives. However there was less support for more restrictive interventions such as removing sugar-sweetened beverages from sale. Young adults tended to be less supportive of most interventions than older adults. Conclusions These findings indicate there is some support for environment-centred, population-based approaches to reduce the availability and appeal of sugar-sweetened beverages in an adult environment such as a university setting. However these results suggest that public health may need to focus less on educating populations about the harms associated with sugar-sweetened beverages. Instead, there should be greater emphasis on explaining to populations and communities why environment

  15. Youth Sexual Health: Sexual Knowledge, Attitudes, and Behavior Among Students at a University in Turkey.

    Science.gov (United States)

    Saraçoğlu, Gamze Varol; Erdem, İlknur; Doğan, Sultan; Tokuç, Burcu

    2014-09-01

    To determine sexual attitudes, behavior, and knowledge of Namik Kemal University (NKU) students about sexual health and sexually transmitted infections (STIs). A sample representing 10% of the undergraduate population of NKU in 2009-2010, was studied. Of 1,500 questionnaires distributed, 1,314 (87.6%) were filled out. The mean age of the respondents (52.9% male) was 20.07±1.75 years. The rate of students who had received sexual health education was 32.0%, and 15.3% had previously used a sexual health service. Eleven percent of the female students and 50.3% of the male students had had sexual intercourse. The average age of initial sexual intercourse was 16.83±2.07 years. Of the students who had had sexual intercourse, 46.6% reported that they did not use any contraception method. The most preferred method was condoms (37.6%). The rate of contraceptive use was 58.7% in sexually educated students and 43.9% in those not educated (p=.004). The most well-known STI was AIDS (96.5%), with sexually educated students giving higher rates of correct answers about STIs (psexual health education were more knowledgeable about vital consequences of STI's, even though it is not sufficient, than sexually active students. Awareness of safe sexual practices and changes in behavior, in particular, promoting condom use should be established in higher risk youths. Deficiencies in knowledge could be addressed by adding a sexual healthtraining component to the university curriculum, and unmet requirements could be met by reorganizing medico-social centers in universities.

  16. Mental health of Russian population: new tendencies and old problems

    Directory of Open Access Journals (Sweden)

    Мihail М. Reshetnikov

    2015-03-01

    Full Text Available Contemporary situation with mental health is reviewed, and developments in psychiatry, psychotherapy and clinical psychology are monitored. Russian experience is discussed in the context of the world tendencies. In the situation of the unprecedented increase in psychopathology, insufficient attention has been paid to the crisis phenomena in psychiatry and psychology as well as the development of mental health institutions, which are still in need of specialists, and facilitation of health care programs for population. The author writes about the increase in the number of patients who need psychiatric or psychological care, lack of experts in the mental health system, low psychological culture of the population, lack of early diagnosis of predisposition to psychopathology. Multiple hypotheses on the causes of mental disorders are outlined in the paper. Among them, the theory of nervous exhaustion, the hypothesis that mental disorders are associated with impaired brain electrical activity, the theory of the special role of the frontal lobes in the emergence of psychopathology, the hypothesis of an imbalance of hormones, as an etiological factor of mental illness and others, are given account. The paper raises issues of mental disorders classification. The author also discusses the issue of chemical treatment and its isolated and uncontrolled use within mental disorders. However, the review is incomplete and tends to be an invitation for mental health specialists to further discuss the issues mentioned in the paper.

  17. Population Aging in Iran and Rising Health Care Costs

    Directory of Open Access Journals (Sweden)

    Mohammad Mirzaie

    2017-09-01

    Conclusion Based on the results of this research, it can be said that people throughout their life cycle always allocate a percentage of their total spending to health care costs, but the percentage of this allocation is different at different ages. In a way the demand for healthcare costs increases with aging, it rises significantly in the old age. At the macro level, due to an increase in the percentage of elderly in the population over the next decade, there will also be an increase in the share of health care costs.

  18. FastStats: Health of American Indian or Alaska Native Population

    Science.gov (United States)

    ... Home Health of American Indian or Alaska Native Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

  19. FastStats: Health of Black or African American non-Hispanic Population

    Science.gov (United States)

    ... Health of Black or African American non-Hispanic Population Recommend on Facebook Tweet Share Compartir Data are ... Source: Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2015, Table P-1c [ ...

  20. Universal Precautions: A Review | Buowari | Nigerian Health Journal

    African Journals Online (AJOL)

    Methodology: A review of the literature on universal precaution's using Medline and Google search engine was done. Thirty six scientific publications on universal precautions and standard precautions were reviewed and summarized. Conclusion: Universal precautions should be used whenever there may be occupational ...

  1. E-Health Literacy and Health Information Seeking Behavior Among University Students in Bangladesh.

    Science.gov (United States)

    Islam, Md Mohaimenul; Touray, Musa; Yang, Hsuan-Chia; Poly, Tahmina Nasrin; Nguyen, Phung-Anh; Li, Yu-Chuan Jack; Syed Abdul, Shabbir

    2017-01-01

    Web 2.0 has become a leading health communication platform and will continue to attract young users; therefore, the objective of this study was to understand the impact of Web 2.0 on health information seeking behavior among university students in Bangladesh. A random sample of adults (n = 199, mean 23.75 years, SD 2.87) participated in a cross-sectional, a survey that included the eHealth literacy scale (eHEALS) assessed use of Web 2.0 for health information. Collected data were analyzed using a descriptive statistical method and t-tests. Finally logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and use of Web 2.0 for seeking and sharing health information. Almost 74% of older Web 2.0 users (147/199, 73.9%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Current study support that current Web-based health information seeking and sharing behaviors influence health-related decision making.

  2. Behavioural sciences at university of health sciences: the way forward

    International Nuclear Information System (INIS)

    Khan, J.S.; Mukhtar, O.; Tabasum, S.

    2016-01-01

    Background: The association of medical ethics with teaching and training and health profession has been informal, largely dependent on role modelling and the social contract of the physicians with the community that they abide by. This study was conducted to examine the effect, if any, of introducing the subject of Behavioural Sciences on students performance in the clinical years viva voce and patient interactions components of the examinations. Methods: A prospective study on four cohorts of students at UHS from 2007 to 2012 (8,155 candidates). Reliability was calculated through Cronbach Alpha. Linear Regression Analysis was applied to determine the relationship between the scores of Basic Medical Sciences, Behavioural Sciences and Forensic medicine with the viva voce and Structured Stations marks of the Clinical Sciences in OSCE. Gender and demographics analysis was also done. Results: Cronbach Alpha was 0.47, 0.63, 0.67 and 0.53 for the Papers of Behavioural Sciences from 2007 to 2010 respectively. Poor predictive value of Behavioural Sciences for performance in the clinical years viva voce and OSCE was identified. Basic Medical Sciences and Forensic Medicine were statistically significant predictors for the performance of female candidates in all four cohorts of the study (p<0.05). In Central Punjab, Behavioural Sciences statistically significantly predicted for better performance in all four cohorts of the study (p<0.05). Conclusion: It is premature to understand the results of Behavioural Sciences teaching at University of Health Sciences (UHS). We can still safely conclude that it can only have a positive sustained effect on the healthcare delivery systems and patient care in Pakistan if it is integrated within each subject and taught and learned not as a theoretical construct but rather an evaluation of one values within the code of conduct of medical professionalism in the larger context of the societal and cultural norms. (author)

  3. Health rights knowledge among medical school students at King Abdulaziz University, Jeddah, Saudi Arabia.

    Directory of Open Access Journals (Sweden)

    Samia M Al-Amoudi

    Full Text Available Health care is a basic human right, and Saudi Arabia affirms these rights for all its citizens.To assess the knowledge of medical students regarding health rights in Saudi Arabia.This cross-sectional study was conducted at King Abdulaziz University (KAU from September 2015 through November 2015. A questionnaire written in English collected demographic data and included questions about reproductive health care and health rights of women and patients with cancer, senility, or special needs.Of the 267 participants, 184 (68.9% were female, and 252 (94.4% were Saudi. Regarding consent, 87 (32.6% and 113 (42.3% participants believed a female patient required the consent of a male guardian to receive medical treatment or surgery, respectively, in Saudi Arabia, and only 106 (39.7% knew that a female patient could provide consent for a caesarean section. Sixty-six (24.7% believed that abortion is never allowed in Islam. Only 93 (34.8% were aware that acquired immunodeficiency syndrome (AIDS and human immunodeficiency virus (HIV patients had health rights, about half (144, 53.9% knew that cancer patients have a right to full information, and most (181, 67.8% believed that a patient had the right to withhold health information from his/her family. Approximately half were aware that cancer patients have the right to free medical treatment (138, 51.7% or that health rights applied to special needs patients (137, 51.3% and senile patients (122, 45.7%.The knowledge of KAU medical students regarding health rights of certain patient populations highlights the importance of health rights education in medical school.

  4. The Virtual Health University: An eLearning Model within the Cuban Health System.

    Science.gov (United States)

    Jardines, José B

    2008-01-01

    This paper describes Cuba's experience with the Virtual Health University (VHU) as a strategic project of INFOMED, promoting creation of an open teaching-learning environment for health sciences education, through intensive and creative use of Information and Communication Technologies (ICTs) and a network approach to learning. An analysis of the VHU's main antecedents in its different stages of development provides insight into the strategic reasons that led to the establishment of a virtual university in the national health system during Cuba's so-called Special Period of economic crisis. Using the general objectives of creating, sharing, and collaborating which define the VHU's conceptual-operative framework, the three essential components (subsystems) are described: pedagogical, technological, and managerial, as well as the operative stages of educational design, technological implementation, and teaching-administrative management system. Each component of the model is analyzed in the context of global, modern university trends, towards integration of the face-to-face and distance education approaches and the creation of virtual institutions that assume the technological and pedagogical changes demanded by eLearning.

  5. Promoting universal financial protection: health insurance for the poor in Georgia--a case study.

    Science.gov (United States)

    Zoidze, Akaki; Rukhazde, Natia; Chkhatarashvili, Ketevan; Gotsadze, George

    2013-11-15

    The present study focuses on the program "Medical Insurance for the Poor (MIP)" in Georgia. Under this program, the government purchased coverage from private insurance companies for vulnerable households identified through a means testing system, targeting up to 23% of the total population. The benefit package included outpatient and inpatient services with no co-payments, but had only limited outpatient drug benefits. This paper presents the results of the study on the impact of MIP on access to health services and financial protection of the MIP-targeted and general population. With a holistic case study design, the study employed a range of quantitative and qualitative methods. The methods included document review and secondary analysis of the data obtained through the nationwide household health expenditure and utilisation surveys 2007-2010 using the difference-in-differences method. The study findings showed that MIP had a positive impact in terms of reduced expenditure for inpatient services and total household health care costs, and there was a higher probability of receiving free outpatient benefits among the MIP-insured. However, MIP insurance had almost no effect on health services utilisation and the households' expenditure on outpatient drugs, including for those with MIP insurance, due to limited drug benefits in the package and a low claims ratio. In summary, the extended MIP coverage and increased financial access provided by the program, most likely due to the exclusion of outpatient drug coverage from the benefit package and possibly due to improper utilisation management by private insurance companies, were not able to reverse adverse effects of economic slow-down and escalating health expenditure. MIP has only cushioned the negative impact for the poorest by decreasing the poor/rich gradient in the rates of catastrophic health expenditure. The recent governmental decision on major expansion of MIP coverage and inclusion of additional drug

  6. Health care financing in South Africa: moving towards universal ...

    African Journals Online (AJOL)

    Advances in Health Economics and Health. Services Research. Bingley, UK: Emerald Group. Publishing Limited, 2009: 133-156. 16. Wagstaff A. Poverty and health sector inequalities. Bull World Health Organ 2002; 80: 97-105. 17. WHO. Macroeconomics and Health: Investing in Health for Economic Development. Geneva:.

  7. Discrimination, work and health in immigrant populations in Spain.

    Science.gov (United States)

    Agudelo-Suárez, Andrés; Gil-González, Diana; Ronda-Pérez, Elena; Porthé, Victoria; Paramio-Pérez, Gema; García, Ana M; Garí, Aitana

    2009-05-01

    One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual

  8. Equity-Oriented Monitoring in the Context of Universal Health Coverage

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

    2014-01-01

    Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC

  9. University of Illinois FRIENDS Children’s Environmental Health Center

    Data.gov (United States)

    Federal Laboratory Consortium — The FRIENDS Children's Environmental Health Center at the University of Illinois, Urbana-Champaign, was established in 2001 to investigate the interactive effects of...

  10. Effectiveness of universal school-based mental health awareness programs among youth in the US: a systematic review

    Science.gov (United States)

    2016-01-01

    BACKGROUND Stigmatizing attitudes toward mental illness and low mental health literacy have been found to be barriers to seeking help for mental health related issues in adolescents. Prior research has found that it is possible to improve these outcomes using school-based mental health interventions. The purpose of this study was to review empirical literature pertaining to universal interventions addressing mental health among students enrolled in US K-12 schools, especially related to health disparities in vulnerable populations. METHODS PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K-12 school-based mental health awareness interventions in the US. Universal studies that measured knowledge, attitudes, and/or help-seeking pertinent to mental health were included. RESULTS A total of 15 studies were selected to be part of the review. There were 7 pretest/posttest case series, 5 non-randomized experimental trial, 1 Solomon 4-groups, and 2 randomized controlled trial designs (RCT). Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help-seeking, indicated statistically significant improvement. CONCLUSIONS Although results of all studies indicated some level of improvement, more research on implementation of universal school-based mental health awareness programs is needed using RCT study designs, and long-term follow up implementation. PMID:27866385

  11. Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

    Science.gov (United States)

    Sundari Ravindran, T K

    2014-05-01

    Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  12. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    Science.gov (United States)

    2016-01-01

    Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

  13. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

    Science.gov (United States)

    Hallo De Wolf, Antenor; Toebes, Brigit

    2016-12-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

  14. The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population

    DEFF Research Database (Denmark)

    Borch, Jacob Eli; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

    2006-01-01

    patterns and public economy as a consequence. We performed a cross-sectional case-control study with two visits to all clinical departments of a large university hospital in order to find in-patients with medical files labelled "penicillin allergy" or who reported penicillin allergy upon admission. Patient....... In a cohort of 3642 patients, 96 fulfilled the inclusion criteria giving a point-prevalence of alleged penicillin allergy of 5% in a hospital in-patient population. Mean time elapsed since the alleged first reaction to penicillin was 20 years. The skin was the most frequently affected organ (82.2%), maculo...

  15. Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Eggleston, Karen N

    2011-08-01

    To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system. Bivariate and multiple regression analyses of data from a cross-sectional health survey. A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey. Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418). Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale. Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes. While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

  16. Persistence of mental health problems and needs in a college student population.

    Science.gov (United States)

    Zivin, Kara; Eisenberg, Daniel; Gollust, Sarah E; Golberstein, Ezra

    2009-10-01

    Cross-sectional studies indicate a high prevalence of mental health problems among college students, but there are fewer longitudinal data on these problems and related help-seeking behavior. We conducted a baseline web-based survey of students attending a large public university in fall 2005 and a two-year follow-up survey in fall 2007. We used brief screening instruments to measure symptoms of mental disorders (anxiety, depression, eating disorders), as well as self-injury and suicidal ideation. We estimated the persistence of these mental health problems between the two time points, and determined to what extent students with mental health problems perceived a need for or used mental health services (medication or therapy). We conducted logistic regression analyses examining how baseline predictors were associated with mental health and help-seeking two years later. Over half of students suffered from at least one mental health problem at baseline or follow-up. Among students with at least one mental health problem at baseline, 60% had at least one mental health problem two years later. Among students with a mental health problem at both time points, fewer than half received treatment between those time points. Mental health problems are based on self-report to brief screens, and the sample is from a single university. These findings indicate that mental disorders are prevalent and persistent in a student population. While the majority of students with probable disorders are aware of the need for treatment, most of these students do not receive treatment, even over a two-year period.

  17. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy.

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-02-12

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for 'fake news' and 'alternative facts' with the intention of inciting fear and hatred of 'the other' and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. © 2017 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.

  18. "Health divide" between indigenous and non-indigenous populations in Kerala, India: population based study.

    Science.gov (United States)

    Haddad, Slim; Mohindra, Katia Sarla; Siekmans, Kendra; Màk, Geneviève; Narayana, Delampady

    2012-05-29

    The objective of this study is to investigate the magnitude and nature of health inequalities between indigenous (Scheduled Tribes) and non-indigenous populations, as well as between different indigenous groups, in a rural district of Kerala State, India. A health survey was carried out in a rural community (N = 1660 men and women, 18-96 years). Age- and sex-standardised prevalence of underweight (BMI populations. Multi-level weighted logistic regression models were used to estimate the predicted prevalence of morbidity for each age and social group. A Blinder-Oaxaca decomposition was used to further explore the health gap between tribes and non-tribes, and between subgroups of tribes. Social stratification remains a strong determinant of health in the progressive social policy environment of Kerala. The tribal groups are bearing a higher burden of underweight (46.1 vs. 24.3%), anaemia (9.9 vs. 3.5%) and goitre (8.5 vs. 3.6%) compared to non-tribes, but have similar levels of tuberculosis (21.4 vs. 20.4%) and hypertension (23.5 vs. 20.1%). Significant health inequalities also exist within tribal populations; the Paniya have higher levels of underweight (54.8 vs. 40.7%) and anaemia (17.2 vs. 5.7%) than other Scheduled Tribes. The social gradient in health is evident in each age group, with the exception of hypertension. The predicted prevalence of underweight is 31 and 13 percentage points higher for Paniya and other Scheduled Tribe members, respectively, compared to Forward Caste members 18-30 y (27.1%). Higher hypertension is only evident among Paniya adults 18-30 y (10 percentage points higher than Forward Caste adults of the same age group (5.4%)). The decomposition analysis shows that poverty and other determinants of health only explain 51% and 42% of the health gap between tribes and non-tribes for underweight and goitre, respectively. Policies and programmes designed to benefit the Scheduled Tribes need to promote their well-being in general but

  19. Lifestyle and Health among Spanish University Students: Differences by Gender and Academic Discipline

    Directory of Open Access Journals (Sweden)

    Vicente Martín

    2012-08-01

    Full Text Available Today the need to analyze health behaviour from a gender perspective is as imminent as ever, particularly at university, where the number of women who register is on the rise and has exceeded the number of male students worldwide. We carried out a prevalence study aimed at analyzing Spanish university students’ lifestyles and identify differences according to gender and academic discipline. Of 3,646 eligible subjects doing university courses related to health (Group A, education (Group B and other professions (Group C, 985 (27.0% participated in the study. Information was elicited about their physical activity level, disturbed eating attitudes, consumption of alcohol, tobacco and illegal substances. Prevalence and Odds Ratios (OR were calculated according to sex and kind of academic discipline. The obtained data confirmed that only 27.4% of the students were considered as sufficiently active, while 14.9% of them suffered from disturbed eating attitudes (DEA. Women were particularly less active (OR 0.46 (0.32–0.66; p < 0.0001, and more sedentary than men (OR 1.40 (1.00–1.97; p = 0.03. Binge drinking was more frequent in female than in male students (OR 1.79 (1.29–2.47; p = 0.0004. A third of the analyzed sample admitted that they had used illegal substances, while a lower consumption prevalence was found in women (OR 0.53 (0.40–0.71; p < 0.0001. The studied population was not very active (27.4%, especially women (OR = 0.45. Therefore, it seems that Spanish university students lead an unhealthy lifestyle, a situation which seems more conspicuous amongst females.

  20. Universal coverage challenges require health system approaches; the case of India.

    Science.gov (United States)

    Duran, Antonio; Kutzin, Joseph; Menabde, Nata

    2014-02-01

    This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Moving from ideas to action - developing health financing systems towards universal coverage in Africa

    Directory of Open Access Journals (Sweden)

    Musango Laurent

    2012-11-01

    Full Text Available Abstract Background Accelerating progress towards universal coverage in African countries calls for concrete actions that reinforce social health protection through establishment of sustainable health financing mechanisms. In order to explore possible pathways for moving past the existing obstacles, panel discussions were organized on health financing bringing together Ministers of health and Ministers of finance with the objective of creating a discussion space where the different perspectives on key issues and needed actions could meet. This article presents a synthesis of panel discussions focusing on the identified challenges and the possible solutions. The overview of this paper is based on the objectives and proceedings of the panel discussions and relies on the observation and study of the interaction between the panelists and on the discourse used. Summary The discussion highlighted that a large proportion of the African population has no access to needed health services with significant reliance on direct out of pocket payments. There are multiple obstacles in making prepayment and pooling mechanisms operational. The relatively strong political commitment to health has not always translated into more public spending for health. Donor investment in health in low income countries still falls below commitments. There is need to explore innovative domestic revenue collection mechanisms. Although inadequate funding for health is a fundamental problem, inefficient use of resources is of great concern. There is need to generate robust evidence focusing on issues of importance to ministry of finance. The current unsatisfactory state of health financing was mainly attributed to lack of clear vision; evidence based plans and costed strategies. Discussion Based on the analysis of discussion made, there are points of convergence and divergence in the discourse and positions of the two ministries. The current blockage points holding back budget

  2. Moving from ideas to action - developing health financing systems towards universal coverage in Africa.

    Science.gov (United States)

    Musango, Laurent; Orem, Juliet Nabyonga; Elovainio, Riku; Kirigia, Joses

    2012-11-08

    Accelerating progress towards universal coverage in African countries calls for concrete actions that reinforce social health protection through establishment of sustainable health financing mechanisms. In order to explore possible pathways for moving past the existing obstacles, panel discussions were organized on health financing bringing together Ministers of health and Ministers of finance with the objective of creating a discussion space where the different perspectives on key issues and needed actions could meet. This article presents a synthesis of panel discussions focusing on the identified challenges and the possible solutions. The overview of this paper is based on the objectives and proceedings of the panel discussions and relies on the observation and study of the interaction between the panelists and on the discourse used. The discussion highlighted that a large proportion of the African population has no access to needed health services with significant reliance on direct out of pocket payments. There are multiple obstacles in making prepayment and pooling mechanisms operational. The relatively strong political commitment to health has not always translated into more public spending for health. Donor investment in health in low income countries still falls below commitments. There is need to explore innovative domestic revenue collection mechanisms. Although inadequate funding for health is a fundamental problem, inefficient use of resources is of great concern. There is need to generate robust evidence focusing on issues of importance to ministry of finance. The current unsatisfactory state of health financing was mainly attributed to lack of clear vision; evidence based plans and costed strategies. Based on the analysis of discussion made, there are points of convergence and divergence in the discourse and positions of the two ministries. The current blockage points holding back budget allocations for health can be solved with a more evidence based

  3. The State of Mental Health of Students of Tehran Medical Sciences University in The Academic Year 2010-2011

    Directory of Open Access Journals (Sweden)

    Monavar Moradian Sorkhkalaee

    2012-10-01

    Full Text Available Background and objective: Students are the most dynamic people in the society and their health is to a great extent a prerequisite for the health of most individuals in the society. This study was conducted to investigate the state of mental health and factors which influence it in the students of Tehran University of Medical Sciences and Health Services.Materials and Methods: This descriptive-analytic study was conducted on 400 students of Tehran Medical Sciences University in the academic year 2010-2011. The number of studied subjects was determined according to the student population of each faculty and questionnaires were randomly distributed among them. The data collection tool in this study was the standard GHQ28 questionnaire. After collecting the data, analysis was done using SPSS.18 software, Chi-square test, T-test, and Regression Logestic.Results: 25.52% of the attendants were healthy and 75.47% had suspected mental disorders. Also, regarding depression, 75.53% of people suffered from mental disorders and 25.46% were healthy.Conclusion: According to the achieved results, it seems that studying at university, facing educational problems and the existing conditions at university cause an increase in the rate of mental disorder among the students of Medical Sciences University.

  4. Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.

    Science.gov (United States)

    Barnert, Elizabeth S; Coller, Ryan J; Nelson, Bergen B; Thompson, Lindsey R; Chan, Vincent; Padilla, Cesar; Klitzner, Thomas S; Szilagyi, Moira; Chung, Paul J

    2017-08-01

    Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges. Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  5. Measuring the Health of an Invisible Population: Lessons from the Colorado Transgender Health Survey.

    Science.gov (United States)

    Christian, Robin; Mellies, Amy Anderson; Bui, Alison Grace; Lee, Rita; Kattari, Leo; Gray, Courtney

    2018-05-15

    Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado. The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations. Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data. Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without. The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into

  6. Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use

    Directory of Open Access Journals (Sweden)

    Ghafouri Nasim

    2011-11-01

    Full Text Available Abstract Background In recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population. Results Out of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively. The majority of waterpipe smokers (75.5% indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6% while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002, energizing (48.5% vs. 11.4%, p = 0.001, a part of their culture (58.8% vs. 34.1%, p = 0.04, and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005. Conclusions Social and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of

  7. Strategies for expanding health insurance coverage in vulnerable populations

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), part of The Cochrane Library. www.thecochranelibrary.com (searched 2 November 2012), PubMed (searched 1 November 2012), EMBASE (searched 6 July 2012), Global Health (searched 6 July 2012), IBSS (searched 6 July 2012), WHO Library Database (WHOLIS) (searched 1 November 2012), IDEAS (searched 1 November 2012), ISI-Proceedings (searched 1 November 2012),OpenGrey (changed from OpenSIGLE) (searched 1 November 2012), African Index Medicus (searched 1 November 2012), BLDS (searched 1 November 2012), Econlit (searched 1 November 2012), ELDIS (searched 1 November 2012), ERIC (searched 1 November 2012), HERDIN NeON Database (searched 1 November 2012), IndMED (searched 1 November 2012), JSTOR (searched 1 November 2012), LILACS(searched 1 November 2012), NTIS (searched 1 November 2012), PAIS (searched 6 July 2012), Popline (searched 1 November 2012), ProQuest Dissertation &Theses Database (searched 1 November 2012), PsycINFO (searched 6 July 2012), SSRN (searched 1 November 2012), Thai Index Medicus (searched 1 November 2012), World Bank (searched 2 November 2012), WanFang (searched 3 November 2012), China National Knowledge Infrastructure (CHKD-CNKI) (searched 2 November 2012). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via Web of Science to find other potentially relevant studies. Selection criteria Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA

  8. Factors affecting utilization of University health services in a tertiary ...

    African Journals Online (AJOL)

    2013-01-16

    Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and ... evaluation of health services utilization among students in the .... African culture and health. ... Asian Am Pac Isl J.

  9. Nutritional knowledge, food habits and health attitude of Chinese university students--a cross sectional study.

    Science.gov (United States)

    Sakamaki, Ruka; Toyama, Kenji; Amamoto, Rie; Liu, Chuan-Jun; Shinfuku, Naotaka

    2005-02-09

    We have previously shown that irregular lifestyle of young Japanese female students are significantly related to their desire to be thinner. In the present study, we examined the nutritional knowledge and food habits of Chinese university students and compared them with those of other Asian populations. A self-reported questionnaire was administered to 540 students, ranging in age from 19-24 years. Medical students from Beijing University (135 men and 150 women) in Northern China and Kunming Medical College in southern China (95 men and 160 women) participated in this study. The parametric variables were analyzed using the Student's t-test. Chi-square analyses were conducted for non-parametric variables. Our results showed that 80.5% of students had a normal BMI and 16.6 % of students were underweight with the prevalence of BMI>30 obesity being very low in this study sample. Young Chinese female students had a greater desire to be thinner (62.0%) than males (47.4%). Habits involving regular eating patterns and vegetable intake were reported and represent practices that ought to be encouraged. The university and college arenas represent the final opportunity for the health and nutritional education of a large number of students from the educator's perspective. Our findings suggest the need for strategies designed to improve competence in the area of nutrition.

  10. Examination of health status of population from Uranium contaminated regions

    International Nuclear Information System (INIS)

    Milacic, S.; Jovicic, D.; Pantelic, G.; Kovacevic, R.; Pavlovic, M.; Tanaskovic, I.

    2002-01-01

    Uranium is widely distributed in the natural environment: in the soil, air and food. And thus all people on the planet inhale or ingest small quantities of uranium every day. However, depleted uranium (DU) is industrial product. It is used in medicine, aviation, astronomy, oil exploitation, as well as for military purposes for penetrating ammunition. America is not the only country that applies depleted uranium ammunition. It is a part of the military arsenal in France, England, Turkey, Israel, Russia, Saudi Arabia, Pakistan and Thailand. Depleted uranium is toxic for both humans and animals for two basic reasons: as a heavy metal, it has toxic chemical effects, and as an alpha-emitter, it also has radioactive effects. Although it is considered less radioactive than natural uranium, its toxicity is high due to high LET (linear energetic transfer) irradiation, tissue deposition (bones, kidneys, blood, lungs) and elimination time (5000 days). Radiation limit above which adverse health effects are initiated (radiation carcinogenic risk), depends on the quantity and contamination time (how much and how long), including also other factors, such as age, sex, previous health status, exposure to other materials, genetic predisposition and radiosensitivity (lack of indicators), diet and stress. According to ICRP recommendations, carcinogenic risk for the occupationally exposed individuals is minimal if the exposure is limited to the effective dose of 100 mSv for five years and not above 50 in a single year, being five times lower for general population. In average annual effective dose per population, from all sources is below 1mSv, carcinogenic risk will range from 1 per 10 000 to 1 per 100 000, and in occupationally exposed individuals exposed to maximum permitted doses (MPD), the risk of cancer with fatal outcome is below 3 per 100 000). Immediate effects of population exposure to low uranium doses do not result in evident clinical picture. Late consequences include

  11. Spiritual care may impact mental health and medication adherence in HIV+ populations

    Directory of Open Access Journals (Sweden)

    Oji VU

    2017-04-01

    Full Text Available Valerie U Oji,1–3 Leslie C Hung,3 Reza Abbasgholizadeh,1,4 Flora Terrell Hamilton,5 E James Essien,6 Evaristus Nwulia7 1Lifefountain Center Ministries Inc, Houston, TX, USA; 2Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA; 3University of Texas, College of Pharmacy, Austin, TX, USA; 4University of Houston, Houston, TX, USA; 5Administration, Family & Medical Counseling Service, Inc. (FMCS, Washington, DC, USA; 6University of Houston Institute for Community Health, Houston, TX, USA; 7Psychiatry, Howard University Translational Neuroscience Laboratory, Washington, DC, USA Objective: To explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations. Method: A systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS, major depressive disorder (MDD incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale. Results: The literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005 and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of

  12. Prevalence of Residential Dampness and Mold Exposure in a University Student Population

    Directory of Open Access Journals (Sweden)

    Mathieu Lanthier-Veilleux

    2016-02-01

    Full Text Available The impact of residential dampness or mold on respiratory health is well established but few studies have focused on university students. This study aims to: (a describe the prevalence of exposure to residential dampness or mold in university students according to socio-geographic factors and (b identify associated housing characteristics. A web survey was conducted in 2014 among the 26,676 students registered at the Université de Sherbrooke (QC, Canada. Residential dampness and mold being closely intertwined, they were considered as a single exposure and assessed using a validated questionnaire. Exposure was compared according to socio-geographic and housing characteristics using chi-square tests and logistic regressions. Among the 2097 participants included in the study (response rate: 8.1%, over 80% were tenants. Residential exposure to dampness or mold was frequent (36.0%, 95% CI: 33.9–38.1. Marked differences for this exposure were noted according to home ownership (39.7% vs. 25.5% among tenants and owners respectively; OR = 1.92%, 95% CI: 1.54–2.38. Campus affiliation, household composition and the number of residents per building were associated with exposure to dampness or mold (p < 0.01, while sex and age were not. Exposure was also associated with older buildings, and buildings in need of renovations and lacking proper ventilation (p < 0.001. This study highlights the potential risk of university students suffering from mold-related health effects given their frequent exposure to this agent. Further research is needed to fully evaluate the mold-related health impact in this at risk group.

  13. The Relationship Between Religious Beliefs and Mental Health in Students of Alborz University of Medical Sciences and Health Services and Karaj Islamic Azad University in 92-93

    Directory of Open Access Journals (Sweden)

    M. Darvishi

    2017-06-01

    Full Text Available Introduction and Goal: We as a society in transition countries grapple with issues. Including the issues of youth unemployment, the economic, social, cultural and others. The increasing tendency of students to imitate the western culture And the duplication of a part of western culture and identity today emptiness of the west And moral collapse brought and glamor that can be said for our youth no entertainment, sports and leisure programs for their healthy catchy and their needs and the vacuum created in imitation of the vulgar aspects of western culture that quickly spread in our society to our young people away from having ideas is healthy and know the distance of this group of noble and religious values. students based on academic and social issues specific pressure groups are at risk. According to Islamic texts adherence to religious beliefs can be a deterrent lot of mental illness. increased attention to this issue across the world, the importance of religion and represents a return to religion and spirituality. According to the study on health and religion is still in its infancy and mental health in ensuring the dynamics of this segment of society that is dependent on medical students is important, It seems that the implementation of such researches to improve the level of social and religious knowledge students have an important role. Methods: This cross-sectional study (descriptive - analysis, the population of all students studying medical sciences universities in Tehran and Karaj Islamic Azad form. of the population. According to the study, the sample of 377 randomly selected subjects and to prevent the loss of samples, ten percent was added to the sample (415 people and of these 404 people filled out the questionnaire responded. Three demographic information, general health and religious beliefs to collect data in order to achieve the objectives of the study were analyzed using descriptive statistics. After data collection, data

  14. National Surveys of Population Health: Big Data Analytics for Mobile Health Monitors.

    Science.gov (United States)

    Schatz, Bruce R

    2015-12-01

    At the core of the healthcare crisis is fundamental lack of actionable data. Such data could stratify individuals within populations to predict which persons have which outcomes. If baselines existed for all variations of all conditions, then managing health could be improved by matching the measuring of individuals to their cohort in the population. The scale required for complete baselines involves effective National Surveys of Population Health (NSPH). Traditionally, these have been focused upon acute medicine, measuring people to contain the spread of epidemics. In recent decades, the focus has moved to chronic conditions as well, which require smaller measures over longer times. NSPH have long utilized quality of life questionnaires. Mobile Health Monitors, where computing technologies eliminate manual administration, provide richer data sets for health measurement. Older technologies of telephone interviews will be replaced by newer technologies of smartphone sensors to provide deeper individual measures at more frequent timings across larger-sized populations. Such continuous data can provide personal health records, supporting treatment guidelines specialized for population cohorts. Evidence-based medicine will become feasible by leveraging hundreds of millions of persons carrying mobile devices interacting with Internet-scale services for Big Data Analytics.

  15. Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru.

    Science.gov (United States)

    Neelsen, Sven; O'Donnell, Owen

    2017-12-01

    Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest. The probability of getting formal health care when sick is increased by almost two fifths, but the likelihood of being unable to afford treatment is reduced by more than a quarter. Consistent with the shallow coverage offered, there is no impact on use of inpatient care. Neither is there any effect on average out-of-pocket health care expenditure, but medical spending is reduced by up to 25% in the top quarter of the distribution. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Health Needs Assessment of Plain Populations in Lancaster County, Pennsylvania.

    Science.gov (United States)

    Miller, Kirk; Yost, Berwood; Abbott, Christina; Thompson, Scottie; Dlugi, Emily; Adams, Zachary; Schulman, Meryl; Strauss, Nicole

    2017-02-01

    We performed a health needs assessment for three Plain communities in Lancaster County, Pennsylvania from a random sample of households. Compared with the general population of adults, Plain respondents were more likely to be married, to have children, and they had large families; they were more likely to drink well water, to eat fruit and vegetables, to drink raw milk, and to live on a farm. Plain respondents had better physical and mental health and were less likely to have been diagnosed with various medical conditions compared with the general population of adults in Lancaster County but Old Order Mennonite respondents were more likely to have been diagnosed compared with Old Order Amish respondents. Plain respondents usually have a regular doctor and often receive preventive care but Old Order Mennonite respondents were more likely to have a regular doctor, to receive preventive care, to have had their children vaccinated, and to receive routine dental care compared with Old Order Amish respondents. Despite their relative geographic and genetic isolation, and despite the small, relative differences noted, the health of Plain communities in Lancaster County is similar to that of other adults in the County.

  17. Commentary: improving the health of neglected populations in Latin America

    Directory of Open Access Journals (Sweden)

    Jones Danielle

    2007-01-01

    Full Text Available Abstract Neglected diseases encompass a group of pathologies that disproportionally affect resource-constrained areas of the world. In tropical and subtropical areas in Latin America, the vicious cycle of poverty, disease and underdevelopment is widespread. The burden of disease associated to neglected diseases in this region is mainly expressed through diseases such as malaria, dengue, intestinal parasitic infections, Chagas' disease, and many others. These maladies have burdened Latin America throughout centuries and have directly influenced their ability to develop and become competitive societies in the current climate of globalization. Therefore, the need for a new paradigm that integrates various public health policies, programs, and a strategy with the collaboration of all responsible sectors is long overdue. In this regard, innovative approaches are required to ensure the availability of low-cost, simple, sustainable, and locally acceptable strategies to improve the health of neglected populations to prevent, control, and potentially eliminate neglected diseases. Improving the health of these forgotten populations will place them in an environment more conducive to development and will likely contribute significantly to the achievement of the Millennium Development Goals in this area of the globe.

  18. Health behavior disparities: a universal trend or a peculiarity for the developed countries?

    Directory of Open Access Journals (Sweden)

    Andreeva, Tatiana

    2011-05-01

    Full Text Available BACKGROUND. It is generally recognized that those poorer and less educated are more likely to have unhealthy behaviors. These disparities by socio-economic status (SES are observed with regards to different behaviors known to influence health outcomes in terms of diseases and deaths. However, this consistent pattern was found in population-wide studies in developed countries, while in certain demographic groups it was not seen. So the objective was to check if the SES-behavior association pattern was present in available data collected in Ukraine.METHODS. For current study, all available datasets were considered if they included data on SES, education, and gender. Outcomes were measurements of health behaviors including use of psychoactive substances, food consumption, and physical activity.RESULTS. Prevalence of many health behaviors differs in men and women in Ukraine. More men than women use legal and illegal drugs. With regard to education and SES, Ukrainian data reveals either absence of association found in developed countries or its inverted pattern: till recently, women with university education were more likely to smoke than those less educated; teenagers from more affluent families use alcohol more likely than those from poorer ones.CONCLUSION. Inconsistency of SES-behavior association patterns in Ukraine with those seen in the West may be due to a different perception of health behaviors in people who grew up in the former Soviet Union. Behaviors pertinent to men were considered rather masculine and risky than those health-related. We theorize that the revealed absence of SES-behavior association may be because the behaviors are not perceived as those related to health which is an important resource for life. If a behavior is not known as a ‘health behavior’, the society is less likely to stratify with regard to its practicing. So, if the hypothesis is correct, there may be more disparities in younger cohorts than in older ones

  19. Perceptions of Health Students of the Lagos University Teaching ...

    African Journals Online (AJOL)

    Gender equity, equality and mainstreaming are very topical issues presently and most components of reproductive health require gender equity to succeed. Health care workers are constantly going to have to be involved in gender related issues in health. This study was conducted among health students of the College of ...

  20. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Barriers to quality health care for the transgender population.

    Science.gov (United States)

    Roberts, Tiffany K; Fantz, Corinne R

    2014-07-01

    The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  2. [Socioeconomic status and risky health behaviors in Croatian adult population].

    Science.gov (United States)

    Pilić, Leta; Dzakula, Aleksandar

    2013-03-01

    Based on the previous research, there is strong association between low socioeconomic status (SES) and high morbidity and mortality rates. Even though association between SES and risky health behaviors as the main factors influencing health has been investigated in Croatian population, some questions are yet to be answered. The aim of this study was to investigate the presence of unhealthy diet, physical inactivity, smoking and excessive drinking in low, middle, and high socioeconomic group of adult Croatian population included in the cohort study on regionalism of cardiovascular health risk behaviors. We also investigated the association between SES measured by income, education and occupation, as well as single SES indicators, and risky health behaviors. We analyzed data on 1227 adult men and women (aged 19 and older at baseline) with complete data on health behaviors, SES and chronic diseases at baseline (2003) and 5-year follow up. Respondents were classified as being healthy or chronically ill. SES categories were derived from answers to questions on monthly household income, occupation and education by using two-step cluster analysis algorithm. At baseline, for the whole sample as well as for healthy respondents, SES was statistically significantly associated with unhealthy diet (whole sample/healthy respondents: p = 0.001), physical inactivity (whole sample/healthy respondents p = 0.44/ p = 0.007), and smoking (whole sample/healthy respondents p < 0.001/p = 0.002). The proportion of respondents with unhealthy diet was greatest in the lowest social class, smokers in the middle and physically inactive in the high social class. During the follow up, smoking and physical inactivity remained statistically significantly associated with SES. In chronically ill respondents, only smoking was statistically significantly associated with SES, at baseline and follow up (p = 0.001/p = 0.002). The highest share of smokers was in the middle social class. Results of our

  3. The level of health education in the Polish population.

    Science.gov (United States)

    Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

    2013-01-01

    The study assessed factors influencing awareness of Poles concerning lifestyle factors that affect development of obesity, type 2 diabetes and cardiovascular diseases (CVD). A questionnaire survey covering awareness of lifestyle factors performed by general practitioners in 37,557 unselected patients. 96.1% of respondents believed that lifestyle has an impact on the occurrence of CVDs, especially: tobacco smoking (91.4%), excessive intake of fat (81.3%), alcohol (67.5%), salt (64.9%), and stress (64.9%). 79.0% respondents believed the smoking cessation, 77.5% weight loss and 66.8% healthy diet are most important to prevent diseases. Additionally, the belief in the need for an early weight reduction decreased with increasing BMI (82.9% with normal weight vs. 77.5% overweight and 70.4% obese). The most common source of health education was a physician (75.8%), the mass media, such as television and the press (62.0% and 64.8%, respectively), less often were educational materials (37.8%) and books (20.3 %), the Internet (3.8%) and radio (0.8%). Younger respondents presented a higher level of awareness about all analysed aspects of healthy lifestyle. The multiple regression analysis revealed that low education level and rural residence are the most important factors decreasing awareness of the lifestyle effect on health. 1. The level of knowledge about non-pharmacological methods of preventing lifestyle diseases in the Polish population is high except of the role of physical activity and daily vegetables consumption. This, however, has no impact on reducing the percentage of overweight and obese people and on increasing the tendency to pursue lifestyle changes. 2. Frustrating is the fact that more than one fifth of the study population is unaware that excessive weight reduction prevents development of cardiovascular diseases. Moreover, the convince to early weight decreases with increasing BMI. 3. The highest level of the knowledge among younger subjects reflect

  4. College's hot topics? Wildfire and Hazards' risk perception among university's population

    Science.gov (United States)

    Wuerzer, T.

    2014-12-01

    This research presents a novel perspective on college students and their risk perception in a fire prone US State; Idaho. Idaho was "top #1" in burned lands by acreage in 2012 with approximate 15% of all US burned lands; in 2013 "top #2". Past studies have conducted surveys on residents in high wildfire risk communities to learn what factors make homeowners more likely to engage in mitigation activities and therefore increase communities' resiliency. This research emphasis is on a population that deals with the threat of fire but is likely less invested through property ownership and other investment of risk; yet, equally threatened in quality of life. Are college students the left-out population in the 'planning for wildfires' and its communication process? Main hypothesis is that a college population will have a different perception and awareness (and therefore mitigation actions) than i.e. residents invested in the wild land urban interface (WUI). Dominant research methodologies in past studies are identified as surveys, focus groups, or interviews focusing on homeowners in fire prone areas that have witnessed wildfire or are exposed to increasing fire risk. Yet again, research on population that has no property ownership, investments at stake, and therefore no direct monetary values associated (but potentially non-monetary), is found little to none in these studies. The university population based study and its findings offers a contrast to current literature related to these traditional residents surveys/interviews. The study's survey and interactive spatial assessment of risk perception with allocation of perceived hazards zones promotes understanding of where risk is apparent for participants. Results are used to inform agencies such as campus emergency management, regional wild fire mitigation efforts, and to enhance public communication. Lessons learned include the challenges of a comprehensive inclusion process when mitigating for hazards and building

  5. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

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    Barthélémy Kuate Defo

    2014-05-01

    Full Text Available Background: Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective: The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results: Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1 theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2 simple summary indicators that can be used to evaluate their descriptive and predictive features; 3 marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4 the rapid decline in infant

  6. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

    Science.gov (United States)

    Kuate Defo, Barthélémy

    2014-01-01

    Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains

  7. Demographic, epidemiological, and health transitions: are they relevant to population health patterns in Africa?

    Science.gov (United States)

    Kuate Defo, Barthélémy

    2014-01-01

    Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains in life expectancy from the

  8. A university system's approach to enhancing the educational mission of health science schools and institutions: the University of Texas Academy of Health Science Education

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    L. Maximilian Buja

    2013-03-01

    Full Text Available Background: The academy movement developed in the United States as an important approach to enhance the educational mission and facilitate the recognition and work of educators at medical schools and health science institutions. Objectives: Academies initially formed at individual medical schools. Educators and leaders in The University of Texas System (the UT System, UTS recognized the academy movement as a means both to address special challenges and pursue opportunities for advancing the educational mission of academic health sciences institutions. Methods: The UTS academy process was started by the appointment of a Chancellor's Health Fellow for Education in 2004. Subsequently, the University of Texas Academy of Health Science Education (UTAHSE was formed by bringing together esteemed faculty educators from the six UTS health science institutions. Results: Currently, the UTAHSE has 132 voting members who were selected through a rigorous, system-wide peer review and who represent multiple professional backgrounds and all six campuses. With support from the UTS, the UTAHSE has developed and sustained an annual Innovations in Health Science Education conference, a small grants program and an Innovations in Health Science Education Award, among other UTS health science educational activities. The UTAHSE represents one university system's innovative approach to enhancing its educational mission through multi- and interdisciplinary as well as inter-institutional collaboration. Conclusions: The UTAHSE is presented as a model for the development of other consortia-type academies that could involve several components of a university system or coalitions of several institutions.

  9. Climate Change-Related Water Disasters' Impact on Population Health.

    Science.gov (United States)

    Veenema, Tener Goodwin; Thornton, Clifton P; Lavin, Roberta Proffitt; Bender, Annah K; Seal, Stella; Corley, Andrew

    2017-11-01

    Rising global temperatures have resulted in an increased frequency and severity of cyclones, hurricanes, and flooding in many parts of the world. These climate change-related water disasters (CCRWDs) have a devastating impact on communities and the health of residents. Clinicians and policymakers require a substantive body of evidence on which to base planning, prevention, and disaster response to these events. The purpose of this study was to conduct a systematic review of the literature concerning the impact of CCRWDs on public health in order to identify factors in these events that are amenable to preparedness and mitigation. Ultimately, this evidence could be used by nurses to advocate for greater preparedness initiatives and inform national and international disaster policy. A systematic literature review of publications identified through a comprehensive search of five relevant databases (PubMed, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, Scopus, and Web of Science) was conducted using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach in January 2017 to describe major themes and associated factors of the impact of CCRWDs on population health. Three major themes emerged: environmental disruption resulting in exposure to toxins, population susceptibility, and health systems infrastructure (failure to plan-prepare-mitigate, inadequate response, and lack of infrastructure). Direct health impact was characterized by four major categories: weather-related morbidity and mortality, waterborne diseases/water-related illness, vector-borne and zoonotic diseases, and psychiatric/mental health effects. Scope and duration of the event are factors that exacerbate the impact of CCRWDs. Discussion of specific factors amenable to mitigation was limited. Flooding as an event was overrepresented in this analysis (60%), and the majority of the research reviewed was conducted in high-income or upper

  10. Population health concerns during the United States' Great Recession.

    Science.gov (United States)

    Althouse, Benjamin M; Allem, Jon-Patrick; Childers, Matthew A; Dredze, Mark; Ayers, John W

    2014-02-01

    Associations between economic conditions and health are usually derived from cost-intensive surveys that are intermittently collected with nonspecific measures (i.e., self-rated health). This study identified how precise health concerns changed during the U.S. Great Recession analyzing Google search queries to identify the concern by the query content and their prevalence by the query volume. Excess health concerns were estimated during the Great Recession (December 2008 through 2011) by comparing the cumulative difference between observed and expected (based on linear projections from pre-existing trends) query volume for hundreds of individual terms. As performed in 2013, the 100 queries with the greatest excess were ranked and then clustered into themes based on query content. The specific queries with the greatest relative excess were stomach ulcer symptoms and headache symptoms, respectively, 228% (95% CI=35, 363) and 193% (95% CI=60, 275) greater than expected. Queries typically involved symptomology (i.e., gas symptoms) and diagnostics (i.e., heart monitor) naturally coalescing into themes. Among top themes, headache queries were 41% (95% CI=3, 148); hernia 37% (95% CI=16, 142); chest pain 35% (95% CI=6, 313); and arrhythmia 32% (95% CI=3, 149) greater than expected. Pain was common with back, gastric, joint, and tooth foci, with the latter 19% (95% CI=4, 46) higher. Among just the top 100, there were roughly 205 million excess health concern queries during the Great Recession. Google queries indicate that the Great Recession coincided with substantial increases in health concerns, hinting at how population health specifically changed during that time. © 2013 Published by American Journal of Preventive Medicine on behalf of American Journal of Preventive Medicine.

  11. Gender differences in health information behaviour: a Finnish population-based survey.

    Science.gov (United States)

    Ek, Stefan

    2015-09-01

    Narrowing the gaps in health outcomes, including those between men and women, has been a pronounced goal on the agenda of the Finnish health authorities since the mid-1980s. But still there is a huge gap in favour of women when it comes to life expectancy at birth. People's health information behaviour, that is how people seek, obtain, evaluate, categorize and use relevant health-related information to perform desired health behaviours, is a critical prerequisite to appropriate and consistent performances of these behaviours. With respect to gender, it has been noted that men often are unwilling and lack the motivation to engage with health-related information. The purpose of this study was to investigate how gender affects health information behaviour in the Finnish population aged 18-65 years. The survey data were collected via a questionnaire which was posted to a representative cross section consisting of 1500 Finnish citizens. The statistical analysis consists of ANOVA F-tests and Fisher's exact tests. The results show that women were more interested in and reported much more active seeking of health-related information, paid more attention to potential worldwide pandemics and were much more attentive as to how the goods they purchase in everyday life affect their health than men did. Women also reported receiving far more informal health-related information from close family members, other kin and friends/workmates than men did. Thus, to succeed in public health promotion and interventions the measures taken should be much more sensitive to the gender gap in health information behaviour. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Evaluation of work place stress in health university workers: A study from rural India

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    Badrinarayan Mishra

    2011-01-01

    Full Text Available Background: Healthcare providers being over-worked and under staffed are prone to poor mental health. Unhealthy work place compounds it further. Aims: This study was aimed at to assess the mental health status of a medical university employee with special reference to work place stressors. Settings and design: A cross-sectional study was designed and carried out at a Rural Health University. Materials and Methods: Both the General Health Questionnaire (GHQ-12 and Holmes-Rahe Scale were used to evaluate 406 participants. Statistical analysis: Multivariate analysis, correlation, and ANOVA by SPSS 11.0. Results: The minimum age of the participant was 19 years and the maximum 64 years, with an average age at 35.09 years. On the GHQ scale 239(58.9% recorded psychiatric morbidity out of which 201(49.5% had moderate and 38(9.3% severe morbidity. Doctors were the highest stressed group (P ≤ 0.04. Prominent work environmental stressors were poor departmental reorganization, lack of cohesiveness in department, difficult superiors and juniors (P ≤ 0.001, Pearson correlation. Stressors associated with work organization and work nature were: noninvolvement in departmental decision making and lack of proper feedback; along with; work load, lack of clarity in job, and a erratic work schedule (P ≤ 0.001 on Pearson correlation. Harassment, favoritism, discrimination, and lack of self-expression (P ≤ 0.003 were other factors responsible for work dissatisfaction. Conclusions: A high stress level was detected in the study population. The principal stressors were work environment related. Poor work culture was found to lead to job dissatisfaction among majority.

  13. Evaluation of work place stress in health university workers: a study from rural India.

    Science.gov (United States)

    Mishra, Badrinarayan; Mehta, Sc; Sinha, Nidhi Dinesh; Shukla, Sushil Kumar; Ahmed, Nadeem; Kawatra, Abhishek

    2011-01-01

    Healthcare providers being over-worked and under staffed are prone to poor mental health. Unhealthy work place compounds it further. This study was aimed at to assess the mental health status of a medical university employee with special reference to work place stressors. A cross-sectional study was designed and carried out at a Rural Health University. Both the General Health Questionnaire (GHQ)-12 and Holmes-Rahe Scale were used to evaluate 406 participants. Multivariate analysis, correlation, and ANOVA by SPSS 11.0. The minimum age of the participant was 19 years and the maximum 64 years, with an average age at 35.09 years. On the GHQ scale 239(58.9%) recorded psychiatric morbidity out of which 201(49.5%) had moderate and 38(9.3%) severe morbidity. Doctors were the highest stressed group (P ≤ 0.04). Prominent work environmental stressors were poor departmental reorganization, lack of cohesiveness in department, difficult superiors and juniors (P ≤ 0.001, Pearson correlation). Stressors associated with work organization and work nature were: noninvolvement in departmental decision making and lack of proper feedback; along with; work load, lack of clarity in job, and a erratic work schedule (P ≤ 0.001 on Pearson correlation). Harassment, favoritism, discrimination, and lack of self-expression (P ≤ 0.003) were other factors responsible for work dissatisfaction. A high stress level was detected in the study population. The principal stressors were work environment related. Poor work culture was found to lead to job dissatisfaction among majority.

  14. Evaluation of Work Place Stress in Health University Workers: A Study from Rural India

    Science.gov (United States)

    Mishra, Badrinarayan; Mehta, SC; Sinha, Nidhi Dinesh; Shukla, Sushil Kumar; Ahmed, Nadeem; Kawatra, Abhishek

    2011-01-01

    Background: Healthcare providers being over-worked and under staffed are prone to poor mental health. Unhealthy work place compounds it further. Aims: This study was aimed at to assess the mental health status of a medical university employee with special reference to work place stressors. Settings and design: A cross-sectional study was designed and carried out at a Rural Health University. Materials and Methods: Both the General Health Questionnaire (GHQ)-12 and Holmes–Rahe Scale were used to evaluate 406 participants. Statistical analysis: Multivariate analysis, correlation, and ANOVA by SPSS 11.0. Results: The minimum age of the participant was 19 years and the maximum 64 years, with an average age at 35.09 years. On the GHQ scale 239(58.9%) recorded psychiatric morbidity out of which 201(49.5%) had moderate and 38(9.3%) severe morbidity. Doctors were the highest stressed group (P ≤ 0.04). Prominent work environmental stressors were poor departmental reorganization, lack of cohesiveness in department, difficult superiors and juniors (P ≤ 0.001, Pearson correlation). Stressors associated with work organization and work nature were: noninvolvement in departmental decision making and lack of proper feedback; along with; work load, lack of clarity in job, and a erratic work schedule (P ≤ 0.001 on Pearson correlation). Harassment, favoritism, discrimination, and lack of self-expression (P ≤ 0.003) were other factors responsible for work dissatisfaction. Conclusions: A high stress level was detected in the study population. The principal stressors were work environment related. Poor work culture was found to lead to job dissatisfaction among majority. PMID:21687380

  15. Health assessment of French university students and risk factors associated with mental health disorders.

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    Antoine Tran

    Full Text Available The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms.Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs. The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression.A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly.The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by

  16. Health assessment of French university students and risk factors associated with mental health disorders.

    Science.gov (United States)

    Tran, Antoine; Tran, Laurie; Geghre, Nicolas; Darmon, David; Rampal, Marion; Brandone, Diane; Gozzo, Jean-Michel; Haas, Hervé; Rebouillat-Savy, Karine; Caci, Hervé; Avillach, Paul

    2017-01-01

    The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression. A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly. The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by implementing targeted

  17. Mental health consultations in a prison population: a descriptive study

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    Rustad Aase-Bente

    2006-06-01

    Full Text Available Abstract Background The psychiatric morbidity among prison inmates is substantially higher than in the general population. We do, however, have insufficient knowledge about the extent of psychiatric treatment provided in our prisons. The aim of the present study was to give a comprehensive description of all non-pharmacological interventions provided by the psychiatric health services to a stratified sample of prison inmates. Methods Six medium/large prisons (n = 928 representing 1/3 of the Norwegian prison population and with female and preventive detention inmates over-sampled, were investigated cross-sectionally. All non-pharmacological psychiatric interventions, excluding pure correctional programs, were recorded. Those receiving interventions were investigated further and compared to the remaining prison population. Results A total of 230 of the 928 inmates (25 % had some form of psychiatric intervention: 184 (20 % were in individual psychotherapy, in addition 40 (4 % received ad hoc interventions during the registration week. Group therapy was infrequent (1 %. The psychotherapies were most often of a supportive (62 % or behavioural-cognitive (26 % nature. Dynamic, insight-oriented psychotherapies were infrequent (8 %. Concurrent psychopharmacological treatment was prevalent (52 %. Gender and age did not correlate with psychiatric interventions, whereas prisoner category (remanded, sentenced, or preventive detention did (p Conclusion Our results pertain only to prisons with adequate primary and mental health services and effective diversion from prison of individuals with serious mental disorders. Given these important limitations, we do propose that the service estimates found may serve as a rough guideline to the minimum number of sessions a prison's psychiatric health services should be able to fulfil in order to serve the inmates psychiatric needs. The results rely on the specialist services' own estimates only. Future studies should

  18. Health care inequities in north India: role of public sector in universalizing health care.

    Science.gov (United States)

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-09-01

    Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Data from National Sample Survey 60 th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure.

  19. Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis.

    Science.gov (United States)

    Kwan, M Y; Arbour-Nicitopoulos, K P; Duku, E; Faulkner, G

    2016-08-01

    University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

  20. Patterns of multiple health risk–behaviours in university students and their association with mental health: application of latent class analysis

    Science.gov (United States)

    Kwan, M. Y.; Arbour-Nicitopoulos, K. P.; Duku, E.; Faulkner, G.

    2016-01-01

    Abstract Introduction: University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Methods: Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). Results: A three-class model based on student behavioural patterns emerged: “typical,” “high-risk” and “moderately healthy.” Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed. PMID:27556920

  1. Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis

    Directory of Open Access Journals (Sweden)

    M. Y. Kwan

    2016-08-01

    Full Text Available University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Methods: Undergraduate students (n = 837; mean age = 21 years from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep. Results: A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671 = 7.26, p < .01. Conclusion: Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

  2. Population characteristics and health care needs of Asian Pacific Americans.

    OpenAIRE

    Lin-Fu, J S

    1988-01-01

    Asian Pacific Americans are one of the smallest but fastest growing minority groups in the United States. Between 1970 and 1980, this population increased 142 percent, from 1.5 million to 3.7 million. This dramatic growth is due largely to a change in U.S. immigration policies in the mid-1960s and the continuous influx of refugees from Southeast Asia since 1975. Despite such sharp increase, Asian Pacific Americans remain one of the most poorly understood minorities, and their health care need...

  3. Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: review protocol.

    Science.gov (United States)

    Dray, Julia; Bowman, Jenny; Wolfenden, Luke; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wiggers, John

    2015-12-29

    base for the effectiveness of universal school-based resilience-focussed interventions and in doing so provide an opportunity to better inform the development of interventions to potentially prevent mental health problems in child and adolescent populations. PROSPERO CRD42015025908.

  4. Dating violence, quality of life and mental health in sexual minority populations: a path analysis.

    Science.gov (United States)

    Wong, Janet Yuen-Ha; Choi, Edmond Pui-Hang; Lo, Herman Hay-Ming; Wong, Wendy; Chio, Jasmine Hin-Man; Choi, Anna Wai-Man; Fong, Daniel Yee-Tak

    2017-04-01

    Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health. The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression). After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p violence and sexual orientation concealment were mediators, with the models showing a good fit. Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.

  5. HEALTH OF URBAN POPULATION IN MOSCOW AND BEIJING AGGLOMERETIONS

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    Svetlana M. Malkhazova

    2014-01-01

    Full Text Available The paper presents the results obtained under the joint Russian-Chinese RFBR project № 12-05-91175-ГФЕН_а aimed at assessment of the state of the environment and health of the population in urban areas in Russia and China. The paper presents the authors’ approach to a comprehensive evaluation of the impact of the environment on the populationhealth of urban agglomerations and a method of regional medico-geographical analysis. A series of analytical and synthetic maps was compiled and used for a comparative geographical analysis of medical and environmental situation in Moscow and Beijing – major metropolitan areas with different natural and socio-economic conditions. The paper discusses the influence of the environment on the state of public health and identifies the leading risk factors, both general and specific to each region.

  6. Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

    Science.gov (United States)

    Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui Thi Thu; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran Naeem; Abbas, Farhat

    2016-09-07

    Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals

  7. Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

    Directory of Open Access Journals (Sweden)

    Fauziah Rabbani

    2016-09-01

    Full Text Available Abstract Background Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910 emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC in 1978 was a critical milestone, especially for low and middle-income countries (LMICs, conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005–2008 strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. Main text The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs. Conclusion SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of

  8. Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.

    Science.gov (United States)

    Santric-Milicevic, Milena; Jankovic, Janko; Trajkovic, Goran; Terzic-Supic, Zorica; Babic, Uros; Petrovic, Marija

    2016-01-01

    The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement. To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements. Cross-sectional study. This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at pinequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.

  9. Integration of priority population, health and nutrition interventions into health systems: systematic review

    Directory of Open Access Journals (Sweden)

    Adeyi Olusoji

    2011-10-01

    Full Text Available Abstract Background Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Methods Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction and secondary (improved population coverage, access to health services, efficiency, and quality using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Results Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Conclusions Targeted priority population health interventions we identified led to improved health

  10. Integration of priority population, health and nutrition interventions into health systems: systematic review.

    Science.gov (United States)

    Atun, Rifat; de Jongh, Thyra E; Secci, Federica V; Ohiri, Kelechi; Adeyi, Olusoji; Car, Josip

    2011-10-10

    Objective of the study was to assess the effects of strategies to integrate targeted priority population, health and nutrition interventions into health systems on patient health outcomes and health system effectiveness and thus to compare integrated and non-integrated health programmes. Systematic review using Cochrane methodology of analysing randomised trials, controlled before-and-after and interrupted time series studies. We defined specific strategies to search PubMed, CENTRAL and the Cochrane Effective Practice and Organisation of Care Group register, considered studies published from January 1998 until September 2008, and tracked references and citations. Two reviewers independently agreed on eligibility, with an additional arbiter as needed, and extracted information on outcomes: primary (improved health, financial protection, and user satisfaction) and secondary (improved population coverage, access to health services, efficiency, and quality) using standardised, pre-piloted forms. Two reviewers in the final stage of selection jointly assessed quality of all selected studies using the GRADE criteria. Of 8,274 citations identified 12 studies met inclusion criteria. Four studies compared the benefits of Integrated Management of Childhood Illnesses in Tanzania and Bangladesh, showing improved care management and higher utilisation of health facilities at no additional cost. Eight studies focused on integrated delivery of mental health and substance abuse services in the United Kingdom and United States of America. Integrated service delivery resulted in better clinical outcomes and greater reduction of substance abuse in specific sub-groups of patients, with no significant difference found overall. Quality of care, patient satisfaction, and treatment engagement were higher in integrated delivery models. Targeted priority population health interventions we identified led to improved health outcomes, quality of care, patient satisfaction and access to care

  11. Conceptualising population health: from mechanistic thinking to complexity science

    Directory of Open Access Journals (Sweden)

    Jayasinghe Saroj

    2011-01-01

    Full Text Available Abstract The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS. The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  12. Conceptualising population health: from mechanistic thinking to complexity science.

    Science.gov (United States)

    Jayasinghe, Saroj

    2011-01-20

    The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  13. Attitudes and behaviors related to introduction of Electronic Health Record (EHR among Shiraz University students in 2014

    Directory of Open Access Journals (Sweden)

    Mohtaram Nematollahi

    2015-07-01

    Full Text Available Introduction: Electronic Health Record contains all the information related to the health of citizens, from before birth to death have been consistently over time is electronically stored and will be available without regard to location or time all or part of it to authorized persons. The acceptance of EHR by citizens is important in successful implementation of it. The aim of this study was to determine the attitudes and behaviors related to the introduction of electronic health records among Shiraz university student. Method:The present study is a cross-sectional descriptive survey. The study population consisted of all Shiraz University students. The data gathering tool was a questionnaire and data were analyzed in SPSS v.16 software, using descriptive statistical tests. Also, the samples, i.e. 384 students, were selected through convenient sampling. Results: The results showed that most of the students kept their medical records at home to show them to a specialist and only 15% of them were familiar with the Electronic Health Records term. The use of Electronic Health Records for Maintenance of drug prescriptions was of the most importance. Conclusion: Among the students who are educated class and the source of change, the university students’ familiarity with Electronic Health Records is too low and most of them were not even familiar with its name and it is very important to implement this system familiarize the users on how to use it sufficiently

  14. Cardiovascular health promotion in aging women: validating a population health approach.

    Science.gov (United States)

    Sawatzky, Jo-Ann V; Naimark, Barbara J

    2005-01-01

    Although cardiovascular disease is the leading cause of death in North American women, most cardiovascular research has focused on men. In addition, while there has been a recent trend toward population health promotion (PHP) and a consequent focus on the broad determinants of health, there is still a dearth of research evidence related to the promotion of cardiovascular health within this context. The purpose of this study was to explore and describe the interrelationships between the determinants of health and individual cardiovascular health/risk behaviors in healthy women, within the context of a framework for PHP. A comprehensive inventory of factors affecting the cardiovascular health of women was operationalized in a survey questionnaire, the Cardiovascular Health Promotion Profile. Physical measures were also taken on each participant (n = 206). The multivariate analyses support significant interrelationships between the population health determinants and multiple individual cardiovascular health/risk behaviors in this cohort (p PHP framework, is central to building on the body of knowledge in this area.

  15. Strengthening Health Systems of Developing Countries: Inclusion of Surgery in Universal Health Coverage.

    Science.gov (United States)

    Okoroh, Juliet S; Chia, Victoria; Oliver, Emily A; Dharmawardene, Marisa; Riviello, Robert

    2015-08-01

    Universal health coverage (UHC) has its roots in the Universal Declaration of Human Rights and has recently gained momentum. Out-of-pocket payments (OPP) remain a significant barrier to care. There is an increasing global prevalence of non-communicable diseases, many of which are surgically treatable. We sought to provide a comparative analysis of the inclusion of surgical care in operating plans for UHC in low- and middle-income countries (LMIC). We systematically searched PubMed and Google Scholar using pre-defined criteria for articles published in English, Spanish, or French between January 1991 and November 2013. Keywords included "insurance," "OPP," "surgery," "trauma," "cancer," and "congenital anomalies." World Health Organization (WHO), World Bank, and Joint Learning Network for UHC websites were searched for supporting documents. Ministries of Health were contacted to provide further information on the inclusion of surgery. We found 696 articles and selected 265 for full-text review based on our criteria. Some countries enumerated surgical conditions in detail (India, 947 conditions). Other countries mentioned surgery broadly. Obstetric care was most commonly covered (19 countries). Solid organ transplantation was least covered. Cancer care was mentioned broadly, often without specifying the therapeutic modality. No countries were identified where hospitals are required to provide emergency care regardless of insurance coverage. OPP varied greatly between countries. Eighty percent of countries had OPP of 60% or more, making these services, even if partially covered, largely inaccessible. While OPP, delivery, and utilization continue to represent challenges to health care access in many LMICs, the inclusion of surgery in many UHC policies sets an important precedent in addressing a growing global prevalence of surgically treatable conditions. Barriers to access, including inequalities in financial protection in the form of high OPP, remain a fundamental

  16. The Environmental Health Condition of The New University of Port ...

    African Journals Online (AJOL)

    Alasia Datonye

    modern health care delivery; while it provides an avenue for the treatment of ... hospitals safe for the patients, carers, health workers and the. 5 ... providing excellent medical services, manpower training and ... MATERIALS AND METHODS.

  17. Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

    Directory of Open Access Journals (Sweden)

    Sherrilene Classen

    2008-01-01

    Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long

  18. Towards Universal Health Coverage: Exploring the Determinants of ...

    African Journals Online (AJOL)

    WHO),. 2013). For example, Alatinga and Williams (2014) argue that health insurance improves the poor's access to health care and protects them against the costs of illness. With a view to reducing disparities in access to health care, in 2004 ...

  19. Paradigmatic obstacles to improving the health of populations: implications for health policy

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    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.

  20. Advancing the Integration of Population Medicine into Medical Curricula at The Warren Alpert Medical School of Brown University: A New Master's Degree Program.

    Science.gov (United States)

    Mello, Michael J; Feller, Edward; George, Paul; Borkan, Jeffrey

    2015-09-01

    Additional knowledge, attitudes and skills are required for the next generation of medical students as they expand the traditional focus on individual patients to include population-based health and scholarly investigation. The Warren Alpert Medical School of Brown University (AMS) is initiating a master's degree program as a key component of the new Primary Care-Population Medicine program at AMS leading to both a Doctorate in Medicine (MD) and Master of Science in Population Medicine (ScM) degrees in four years. The ScM is composed of a series of nine courses, integrated into the four-year MD curriculum, as well as a thesis. Additional attention will be given to leadership and quality improvement training. The goal is to produce graduates competent in the care of individual patients, panels, communities, and populations.

  1. Building research and evaluation capacity in population health: the NSW Health approach.

    Science.gov (United States)

    Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

    2016-02-01

    Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84

  2. Seeking consensus on universal health coverage indicators in the sustainable development goals.

    Science.gov (United States)

    Reddock, Jennifer

    2017-01-01

    There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

  3. How Academic Health Systems Can Achieve Population Health in Vulnerable Populations Through Value-Based Care: The Critical Importance of Establishing Trusted Agency.

    Science.gov (United States)

    Wesson, Donald E; Kitzman, Heather E

    2018-01-16

    Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve. Health systems will need the help of community entities and individuals who have the trust of the population being served to act on behalf of the health system if they are to achieve this effective working partnership. The need for these trusted agents is particularly pertinent for vulnerable and historically underserved segments of the population. In this Invited Commentary, the authors discuss ways by which health systems might identify, engage, and leverage trusted agents to improve the health of the population through value-based care.

  4. Assessing privacy risks in population health publications using a checklist-based approach.

    Science.gov (United States)

    O'Keefe, Christine M; Ickowicz, Adrien; Churches, Tim; Westcott, Mark; O'Sullivan, Maree; Khan, Atikur

    2017-11-10

    Recent growth in the number of population health researchers accessing detailed datasets, either on their own computers or through virtual data centers, has the potential to increase privacy risks. In response, a checklist for identifying and reducing privacy risks in population health analysis outputs has been proposed for use by researchers themselves. In this study we explore the usability and reliability of such an approach by investigating whether different users identify the same privacy risks on applying the checklist to a sample of publications. The checklist was applied to a sample of 100 academic population health publications distributed among 5 readers. Cohen's κ was used to measure interrater agreement. Of the 566 instances of statistical output types found in the 100 publications, the most frequently occurring were counts, summary statistics, plots, and model outputs. Application of the checklist identified 128 outputs (22.6%) with potential privacy concerns. Most of these were associated with the reporting of small counts. Among these identified outputs, the readers found no substantial actual privacy concerns when context was taken into account. Interrater agreement for identifying potential privacy concerns was generally good. This study has demonstrated that a checklist can be a reliable tool to assist researchers with anonymizing analysis outputs in population health research. This further suggests that such an approach may have the potential to be developed into a broadly applicable standard providing consistent confidentiality protection across multiple analyses of the same data. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  5. Discretionary decisions and disparities in receiving drug-eluting stents under a universal healthcare system: A population-based study.

    Directory of Open Access Journals (Sweden)

    Raymond N Kuo

    Full Text Available One of the main objectives behind the expansion of insurance coverage is to eliminate disparities in health and healthcare. However, researchers have not yet fully elucidated the reasons for disparities in the use of high-cost treatments among patients of different occupations. Furthermore, it remains unknown whether discretionary decisions made at the hospital level have an impact on the administration of high-cost interventions in a universal healthcare system. This study investigated the adoption of drug-eluting stents (DES versus bare metal-stents (BMS among patients in different occupations and income levels, with the aim of gauging the degree to which the inclination of health providers toward treatment options could affect treatment choices at the patient-level within a universal healthcare system.We adopted a cross-sectional observational study design using hierarchical modeling in conjunction with the population-based National Health Insurance database of Taiwan. Patients who received either a BMS or a DES between 2007 and 2010 were included in the study.During the period of study, 42,124 patients received a BMS (65.3% and 22,376 received DES (34.7%. Patients who were physicians or the family members of physicians were far more likely to receive DES (OR: 3.18, CI: 2.38-4.23 than were patients who were neither physicians nor in other high-status jobs (employers, other medical professions, or public service. Similarly, patients in the top 5% income bracket had a higher probability of receiving a DES (OR: 2.23, CI: 2.06-2.47, p 50% or between 25% and 50% was shown to be strongly associated with the selection of DESs (OR: 3.64 CI: 3.24-4.09 and OR: 2.16, CI: 2.01-2.33, respectively.Even under the universal healthcare system in Taiwan, socioeconomic disparities in the use of high-cost services remain widespread. Differences in the care received by patients of lower socioeconomic status may be due to the discretionary decisions of healthcare

  6. Universal Health Coverage through Community Nursing Services: China vs. Hong Kong.

    Science.gov (United States)

    Chan, Wai Yee; Fung, Ita M; Chan, Eric

    2017-01-30

    this article looks at how the development of community nursing services in China and Hong Kong can enhance universal health coverage. literature and data review have been utilized in this study. nursing services have evolved much since the beginning of the nursing profession. The development of community nursing services has expanded the scope of nursing services to those in need of, not just hospital-level nursing care, but more holistic care to improve health and quality of life. despite the one-country-two-systems governance and the difference in population and geography, Hong Kong and China both face the aging population and its complications. Community nursing services help to pave the road to Universal Health Coverage. este artigo analisa a forma como o desenvolvimento de serviços de enfermagem comunitários na China e Hong Kong pode melhorar a cobertura universal de saúde. literatura e revisão de dados foram utilizados neste estudo. serviços de enfermagem têm evoluído muito desde o início da profissão de enfermagem. O desenvolvimento dos serviços de enfermagem da comunidade ampliou o escopo dos serviços de enfermagem, para aqueles que precisam não apenas de cuidados de enfermagem de nível de hospital, mas cuidados mais holísticos para melhorar a saúde e qualidade de vida. apesar de ser "um-país-dois-sistemas" de governo, e as diferenças de população e geografia, Hong Kong e China enfrentam o envelhecimento da população e suas complicações. Os serviços de enfermagem da comunidade ajudam a pavimentar o caminho para a cobertura de saúde universal. este artículo analiza cómo el desarrollo de los servicios de enfermería comunitaria en China y Hong Kong pueden expandir la cobertura universal de salud. revisión de datos y literatura han sido utilizados en este estudio. los servicios de enfermería han evolucionado mucho desde el comienzo de la profesión. El desarrollo de los servicios de enfermería comunitaria han ampliado el alcance

  7. The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population.

    Science.gov (United States)

    Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo

    2013-05-01

    assess the utilization, efficacy, and potential cost-effectiveness of health coaching programs for a range of populations.

  8. Collaboration between the University of Michigan Taubman Health Sciences library and the University of Michigan Medical School Office of Research.

    Science.gov (United States)

    Black, Christine; Harris, Bethany; Mahraj, Katy; Schnitzer, Anna Ercoli; Rosenzweig, Merle

    2013-01-01

    Librarians have traditionally facilitated research development resulting in grants through performing biomedical literature searches for researchers. The librarians at the Taubman Health Sciences Library of the University of Michigan have taken additional steps forward by instituting a proactive approach to assisting investigators. To accomplish this, the librarians have taken part in a collaborative effort with the University of Michigan Medical School