PUBLIC HEALTH AND MEDICAL CARE CONDITIONS DURING THE GREEK INDEPENDENCE WAR (1821)

Roots of Iraq's maternal and child health crisis run deep

The emerging field of public health ethics

Patients With Serious Mental Illness Need Better Primary Care Integration, Health Advocacy

Individual health literacy is an established predictor of individual health outcomes. Community-level health literacy may also impact individual health, yet limited research has simultaneously considered the influence of individual and community health literacy on individual health. The study goal was to determine if community health literacy had an independent relationship with individual self-reported health beyond individual health literacy. We used data from the 2008 and 2010 Hawai'i Health Survey, a representative statewide telephone survey. Multilevel models predicted individual self-reported health by both individual and community health literacy, controlling for relevant individual-level (education, race/ethnicity, gender, poverty, insurance status, age, and marital status) and community-level variables (community poverty and community education). The sample included 11,779 individuals within 37 communities. Individual health literacy was defined by validated self-reported measurement. Communities were defined by zip code combinations. Community health literacy was defined as the percentage of individuals within a community reporting low health literacy. Census data by ZIP Code Tabulation Areas provided community-level variables. In descriptive results, 18.2 % self-reported low health literacy, and 14.7 % reported self-reported poor health. Community-level low health literacy ranged from 5.37 % to 35.99 %. In final, multilevel models, both individual (OR: 2.00; 95 % CI: 1.63-2.44) and community low health literacy (OR: 1.02; 95 % CI: 1.00-1.03) were significantly positively associated with self-reported poor health status. Each percentage increase of average low health literacy within a community was associated with an approximately 2 % increase in poor self-reported health for individuals in that community. Also associated with poorer health were lower educational attainment, older age, poverty, and non-White race. Both individual and community health literacy are significant, distinct correlates of individual general health status. Primary care providers and facilities should consider and address health literacy at both community and individual levels.

Louisiana looks back on a week of disaster

In order to study how the policy of delayed retirement, — a very important reform for healthcare system and social security system in China-influences individual health, we got data from a sample of 703 people to investigate the relationship among policy acceptability and individual wellbeing and the moderating role of individual-relevance of policy. Results showed that the demographic variables and some individual social attitudes had important effects on individual wellbeing. More importantly, after controlling the demographic characters and some social attitudes, policy acceptability of delayed retirement still affected individual wellbeing significantly. In addition, individual-relevance of policy moderated the relation between policy acceptability and individual wellbeing. When people think the policy of delayed retirement was highly individual-relevant, policy acceptability would positively predict individual wellbeing. The present research has some implications for improving individual physical and psychological health by promoting policy acceptability in healthcare system management.

Prevention and awareness of birth defects across the lifespan using examples from congenital heart defects and spina bifida.

Focus on Transformation: A Public Health Model of Mental Health for the 21st Century

In 2005 the European Society for Philosophy of Medicine and Health Care (ESPMH) initiated an annual contest for young scholars. Every year an ESPMH prize is awarded to a scholar younger than 35 years of age for a scientific contribution on ethical, epistemological, or other philosophical topics relating to medicine and health care. The first paper in this issue, ‘On the relationship between individual and population health’, has been written by the winner of this prize in 2007, Onyebuchi A. Arah. Compared to the idea of individual health, ‘population health’ is a relatively new, rather fashionable term in the field of medicine and health care. The relationship between individual and population health is partially built on the dichotomization of medicine into clinical medicine and public health. Individual and population health are often seen as absolute and independent concepts. Onyebuchi A. Arah argues that the relationship between the two is largely relative and dynamic. His argument is based on an attempt to include a population perspective on health in definitions of health, particularly by emphasizing the role of the ‘context’ component of any notion of health. The second contribution in this issue, written by Shawn H. E. Harmon, also deals with public health, but this paper is more practical in nature. After having reminded us of the fact that public health is a multidisciplinary and complex phenomenon, the author argues that public health promotion is a moral duty and that, although multiple actors are relevant and necessary to fulfilling this duty, the role of international actors is paramount. The paper especially focuses on one of the most important international organizations in this field, that is, the World Health Organization (WHO). Shawn H. E. Harmon argues that better health can and must be better promoted through a more robust interpretation of the WHO’s role. Together with other international organizations, he argues, the WHO has not yet played its necessary part in promoting ‘health for all’. The third paper, written by Rui Nunes, Guilhermina Rego and Christina Brandao, leaves the difference between individual and public health for what it is. The authors evaluate the role of independent regulatory agencies in the field of health care, as compared to the role of traditional public regulations, with regard to a fair process of equal access to health care and of setting limits to health care. In their argument Norman Daniels’ and James Sabin’s theory of accountability for reasonableness plays a central role. The authors conclude that accountability for reasonableness should be regarded as a landmark of any health care reform. The rationale for limit-setting decisions must be clearly communicated toward the public. Karin Dahlberg, Les Todres and Kathleen Galvin focus on individual health care. They critically review the common standard of ‘patient-centred’ or ‘patient-led’ health care and argue that current patient-led approaches hinder a focus on a deeper understanding of what patient-led care could be. Based on various phenomenological and existential insights they present an alternative interpretation of patient-led care which they call ‘lifeworld-led care’. A philosophy of the person, a view of well-being, and a philosophy of care should be key elements in the further development of this ‘lifeworld-led care’. With the paper of Juha Raikka, ‘The ethical and political evaluation of biotechnology strategies’, we enter a new category of topics in this issue, that is, regulatory aspects of research and new biotechnologies. Juha Raikka focuses on W. Dekkers (&) B. Gordijn UMC St Radboud Nijmegen, 114 IQ Healthcare, Section Ethics, PO Box 9101, 6500 Nijmegen, HB, The Netherlands e-mail: w.dekkers@iq.umcn.nl

Australia's political engagement on health and climate change: the MJA-Lancet Countdown indicator and implications for the future.

The consequences of Sudan’s armed conflict on public health: a closer look at the devastating impact

The sequencing of the human genome and introduction of high-speed gene expression profiling technologies are revolutionizing our understanding of the interplay of genes and the environment. This Article develops a novel and provocative framework for thinking about the implications of the genetic revolution for the U.S. environmental regulatory system. Professor Grodsky employs the concept of public health as a lens for analyzing emerging issues, and demonstrates how scientific advances may erode the distinction between public and individual health. Future claims of genetically susceptible individuals and groups may challenge the legal definition of the public to be protected by environmental law. Likewise, the Article demonstrates how the meaning of health, and legally significant threats to health, may be questioned as new techniques reveal earlier evidence of toxic harm. These developments strike at the core of the Environmental Protection Agency's public health mission. The Article analyzes and synthesizes diverse elements of the changing scientific landscape, providing a new framework for understanding the science as well as the law. Professor Grodsky examines implications for environmental standard setting, as these potentially beneficial, enormously complex, and increasingly controversial scientific developments may modify estimates of individual and public health risk attributable to toxic exposure. The Article also sounds a cautionary note. It evaluates scientific roadblocks that must be overcome if the new science is to benefit law and regulation rather than generate scientific uncertainty. This new, exciting, and potentially perilous terrain in environmental law has only begun to be perceived by policymakers.

This study estimated how patterns of substance use are related to work status, public program use, and well-being among a sample of female caregivers and children. This study assessed work, public program use, and well-being measures as a function of substance use among 1,623 female caregivers of children aged zero to four or ten to 14 who participated in the Welfare of Children and Families study and lived in low- and moderate-income neighborhoods in Boston, Chicago, and San Antonio. Data were analyzed from baseline interviews that were conducted from March through December 1999 and from follow-up interviews that were conducted 11 to 26 months after baseline (average of 16 months). Substance use patterns were placed into three categories: light or no substance use reported in both interviews, moderate or heavy substance use (that is, moderate or heavy use in both interviews or increased substance use during the study period), and reduced substance use during the study period. Among caregivers who reduced their substance use, measures of work status, receipt of income assistance, mental health symptoms, and reports of child behavior problems were not significantly different at follow-up from those of caregivers with light or no substance use. At follow-up, compared with caregivers with light or no substance use, those with moderate or heavy substance use were significantly less likely to experience improvements in mental health symptoms and to see improvements in their children's behavioral problems. Caregivers with moderate or heavy substance use were more likely to be "detached" (p=.051)--that is, neither working nor collecting income assistance--although this difference was only marginally significant. Caregivers with increased substance use fared poorly on measures of well-being and work. Policies that promote, rather than impede, reductions in substance use are more likely to promote self-sufficiency and well-being.

The Drinking Water State Revolving Fund Helps Ground Water Systems Deliver Public Health Protection

Home visiting: A lifeline for families during the COVID-19 pandemic