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Theodore H Tulchinsky

Publications and source records attributed to Theodore H Tulchinsky.

5 recordsLinked to original sources
PubMed2003

Addition of essential micronutrients to foods--implication for public health policy in Israel.

Micronutrient deficiencies have reoccupied the center stage of public health policy with the realization that folic acid deficiency results in neural tube defects and possibly other birth defects as well as ischemic heart disease. These, in turn, have raised an older debate on food fortification policy for the elimination of iodine, iron and vitamin D deficiencies. Data from the First Israeli National Health and Nutrition Survey (MABAT 2000) provided an impetus to develop an active national nutrition policy aimed to improve the nutritional status of iodine, iron, vitamins A and D and B-vitamins, including folate. In this paper we examine some of the micronutrient deficiency issues in Israel and their implications for public health, and suggest options for the formulation of policy.

Food, Fortified↗
PubMed2003

Standardized mortality ratios by region of residence, Israel, 1987-1994: a tool for public health policy.

BACKGROUND: Standardized mortality ratios (SMRs) are used internationally to compare health status across regions and to identify high risk areas for investigation of specific diseases, for funding determination, and for planning purposes. OBJECTIVE: To ascertain regional differences in SMRs by sub-District in Israel for 1987-1994. METHOD: The indirect method of standardization of mortality rates with adjustment for age, gender, and continent of birth was used to calculate SMRs by major cause of death, by sub-District of residence for the Jewish population of Israel. RESULTS: SMRs for all causes of death ranged from regions with low rates (Petah Tikva, Sharon, Rehovot, Ashkelon, and Jerusalem) to those with high rates (Zefat/Golan, Hadera, Yizreel, Ramla, Haifa, Tel Aviv, and Be'er Sheva) (all p<0.0001). Zefat's SMRs are elevated for acute myocardial infarction, stroke, diabetes, and motor vehicle accidents (MVAs). Haifa's SMRs are high for all cardiovascular diseases, liver disease, MVAs, and lung cancer. Be'er Sheva residents had high SMRs for diabetes, liver disease, MVAs, some categories of cardiovascular disease, cervical cancer, and homicide. Yizreel had high SMRs for diabetes, hypertension, stroke, liver disease, and MVAs. Tel Aviv had elevated SMRs for septicemia, acute MI, perinatal causes, and colon, lung and breast cancer. Jerusalem (p<0.0001) and Kinneret residents (p<0.05) had low SMRs for everything except congenital anomalies. CONCLUSIONS: Regional SMR differences, adjusted for age, gender, and ethnicity, may be due to socioeconomic, nutritional, environmental, occupational, or health care factors. SMRs provide a tool to identify regions for epidemiological investigation and priorities for preventive interventions. Regional health monitoring should be undertaken routinely on mortality data, as well as other national databases, as part of national health monitoring.

Adolescent↗
PubMed2002

Developing schools of public health in countries of Eastern Europe and the Commonwealth of Independent States.

Countries of Eastern Europe and the Commonwealth of Independent States are facing a combination of difficulties in health including high rates of mortality from preventable diseases, and pressures for reform of their health care systems. The development of schools of public health is an important priority for international aid and for national government attention. This provides a challenge of integrating experience from many countries in the industrialized world and academic centers of excellence in the field of public health. Traditional departments of social hygiene within medical academies need to evolve to educate new generations of doctors to cope with challenges facing the health systems in these countries. Development of post-graduate centers of training will also be needed as independent schools of public health within single or multi-faculty universities to train health workers in a New Public Health. This paper outlines the mission of a school of public health (SPH), and the steps needed to achieve its objectives, with examples of several schools at relatively advanced and moderate levels of development. The purpose is to provide guidelines for those SPHs under development that are seeking international support and resources.

Commonwealth of Independent States↗