The public health impact of hunger.
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Biomedical subjects
Publications and source records attributed to V W Sidel.
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To study the effect that the decline in physicians in the National Health Service Corps (NHSC) pipeline will have on access to care for patients at sites to which NHSC physicians are assigned, a survey was sent to all NHSC physicians completing their obligated service in 1989. Seventy-four (74) percent of the respondents believed that the decreased number of NHSC doctors in the pipeline would threaten the existence of their site and 52 percent reported that no doctors or clinic sites would be able to provide free or subsidized care if their NHSC site were forced to close. Of the physicians who stated that their NHSC patients would be able to find an alternative source of care, the most commonly cited (33 percent) alternative was the local hospital emergency room. We conclude that access to care for patients at NHSC sites will be seriously impaired by the decline in physicians in the NHSC pipeline.
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Lack of information about medications coupled with high rates of utilization complicates compliance with medication regimens and increases the risk of adverse effects among older adults. We undertook a study of the efficacy of community-based interventions by pharmacists in a randomly-allocated one-half of a sample of 284 older adults considered to be at high risk for medication-related problems. Information and attitudes towards prescription and over-the-counter medications did not differ significantly between the intervention and comparison groups, either before or after the pharmacist interventions. However, visits to physicians were significantly less in the intervention group, suggesting an important if unexpected impact on health-related behavior.
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AIDS presents unique problems and opportunities in jails and prisons for epidemiological research on HIV infection and its sequelae. If correctional institutions constrain inmates' access to social benefits, means exist to protect incarcerated people's rights in health studies. A reading of federal regulations indicates that research involving prisoners should be subject to scrutiny by an institutional review board (IRB); inmates participating in IRB-approved clinical trials on AIDS-related drugs should not receive placebos alone, moreover, given that some medications are partially effective against the syndrome. As in other domains of public health and public policy, HIV infection and AIDS in prisons compel new perspectives on justice and equity.
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