[Medical cost and public health. Public health activities at Sawauchi Village, Iwate Prefecture (4). People who created and supported the activities].
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About 9 % of the German population is of immigrant descent. Correlations between migration and health have recently been focused on by health and social sciences in Germany. Migration due to different motivations itself strongly affects the health status of individuals and subpopulations. Therapeutic institutions on an individual level and public health services in Germany will need further development towards professional intercultural health care. An international workshop on the topic of migration and health in March 2000 illustrated the importance of the public health services and their opportunities in co-ordination of the health related multicultural variety. Migration generally was regarded being an asset to health in the community. Improvement of verbal communication skills and of the medical expert opinion practice towards culturally sensitive health care were pointed out being major objectives for the public health services as were prevention and health care programs for children and for psychosocially endangered persons within the immigrant population.
Despite the proliferation of home health agencies and increased numbers of nurses working in these settings, little is known about home health nurses or how they might differ from their public health and hospital counterparts. The authors discuss differences in monetary compensation and skill usage, as well as the relationship between compensation and retention, among hospital, home health, and public health staff nurses. The results show that these nurses receive different intrinsic and extrinsic rewards and that their reasons for remaining with their employers are similar, yet unique. Implications for nurse administrators and educators are discussed, along with recommendations for further research.
Despite the expanding literature on the importance role public policy plays in influencing the broader determinants of the public's health, profound differences exist among jurisdictions in the attention placed by the State - as represented by public health authorities and agencies - upon such activities. In this paper we examine the dominant public health models of Canada, USA, UK, and Sweden. The Canadian and USA public health communities are focused upon individualized approaches to risk management. In contrast, the UK and Swedish public health scenes are more oriented toward broader approaches to health determinants. We argue that the extent to which governments, public health agencies and public health workers concern themselves with public policy approaches to address broader determinants of health depends upon the particular model of health adhered to within each jurisdiction. And whether a health model is adopted depends upon the ideological and political context within which a nation is situated. Canada represents a situation where concerted effort to influence governmental policy directions by the public health community could reap significant benefits.
Despite Canada's reputation as a leader in health promotion and population health concepts, actual public health practice for the most part remains wedded to downstream strategies focussed on behaviour change. In Canada's largest province this has led to the implementation of a heart health promotion approach focussed on diet, activity and tobacco use. This is so despite increasing evidence that these approaches are generally ineffective, particularly for those at greatest risk. In addition, these strategies appear to divert public and governmental attention away from addressing the broader societal determinants of health. Examples of Ontario public health units that have begun to address societal determinants of health provide a counterbalance to the dominant paradigm that frames health as an individual responsibility. These new approaches focus attention upon the health-threatening effects of governments' regressive social and economic policies in a manner consistent with the best principles of health promotion.
BACKGROUND: The project 'Gender Bias - Gender Research' investigates how far gender issues are considered in German-language Public Health journals. Target is the analysis of the publication practice in Public Health in order to point out status, deficits and perspectives of gender-specific research. METHODS: We developed a standardised evaluation instrument, which covers the semantic, methodical-technical and contentual area regarding gender issues and evaluated all original contributions of the years 1990, 1995 and 1999 in the journals 'Das Gesundheitswesen', 'Sozial- und Präventivmedizin' and 'Zeitschrift für Gesundheitswissenschaften'. 268 (of 517) contributions applied to persons (in contrast to i. e. programmes, institutions) and were completely analysed. RESULTS: The main part of the contributions take women and men into account, but do not consider them continuously in all parts of the research process and in this way do not fulfil all requirements for gender-sensitive research. Gender finds most consideration on the semantic level. Less than half of the authors consider the different situation of women and men in the formulation in hypotheses, sampling, or data analysis, and only 35 % of them make reference to this in their conclusions. We found differences between the examined journals and years. CONCLUSIONS: The concerns of women and men should be considered at all levels of research. Attention should be paid to this when writing, reviewing and publishing contributions.
For the majority of European adults, who neither smoke nor drink excessively, the most significant controllable risk factors affecting their long-term health are what they eat, and how physically active they are. Scientists are supposed to clarify to policy makers and health professionals the usefulness of their health messages. However, to be able to do that, a more detailed understanding is needed of the basic mechanisms behind the effects on health of diet and physical activity and, especially, the two in combination. Further, better methods for assessment of nutrition and physical activity in the population have to be developed, and more and better baseline data have to be collected. Increased and more efficient interventions are then needed. People trained and competent in the new discipline of Public Health Nutrition are required. Through the stimulating support that the European Commission, as well as other national and international partners, are presently giving to the development of Public Health Nutrition across Europe, we can hope for an increased mobility, networking and understanding between European nutrition and physical activity professionals. This will most likely result in greater and better policy making, strategy development, implementation and evaluation. We now have a great possibility to develop the integrated field of preventive nutrition and health enhancing physical activity.
Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.
Communication is the basic precondition of a global society. At the same time, however, communication is a basic cause for today's health hazards and diseases. This is an experience of our time, it is a historical experience of social change as well. If a global society wants to survive, the existing hazards to life and health have to be understood and treated on a global scale. Apart from a "new morbidity" and chronic diseases also infectious diseases again require more and more attention even in industrialised countries. The history of public health offers an overwhelming expertise of well-established concepts for every imaginable risk, to handle infectious diseases which are either not yet or no longer controllable on an individual therapeutical level. History of medicine also shows, that the effectiveness of hygienic concepts is based on their scientific validity and the resulting predictability of their interventions. This implies, that modern hygiene has to incorporate actively the concept of molecular medicine. Every single discipline involved, i.e. hygiene/sanitation, toxicology, microbiology, bacteriology, immunology, and infectiology, has to join in interdisciplinary scientific and interventional efforts.
A right to health is not recognized in the United States Constitution. This article examines the right to health and to health care in the U.S. in terms of expert definitions of health, international human rights instruments, U.S. individualism, the U.S. Constitution, and the impact of stigmatization on health status as a violation of dignity. It argues that establishing a right to health care is a necessary but insufficient condition to protect health. A historically rooted ethos of individualism, in combination with a dominant biomedical paradigm of disease causation, underlies the resistance of the private and public sectors to the concept of health as a human right. Emerging public health knowledge about social causes of disease provides a valuable locus of intervention from which a coalition of public health and human rights advocates can advance the debate and build political will for government action.
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