Health Of Poor People Research Articles

Reducing the drivers of drug demand in English towns by understanding risk and resilience in the community and developing a framework for partnership action: a mixed methods analysis

BackgroundSubstance misuse has extensive effects on individuals and communities, ranging from the poor health of people who use drugs to the pressure placed on health care, social services, and the criminal justice system. Strategies to curtail the supply and demand of drugs and reduce these effects typically focus on supply, with less emphasis placed on the drivers of demand. We piloted and evaluated a public health approach for understanding the drivers and effects of substance misuse in a local area, and how these might be targeted for prevention through multi-agency partnership action. MethodsA cross-sectional mixed methods analysis was conducted, using multi-agency data. 3 years of data provided by criminal justice agencies (police, youth justice, and probation), drug treatment services, social care, education, and hospitals were used to profile the local demand and effect of drugs on individuals and communities in a coastal town in southern England. The experiences of local professionals who support people who misuse drugs, or people affected by drug misuse, were collected via an online survey that was disseminated to relevant partnership organisations, including homelessness charities and drug treatment providers. A public health framework identifying relevant risk and resilience factors in the community was developed by combining the multi-agency data and survey responses The methodological efficacy of this approach to inform partnership action was evaluated via a survey with the project's stakeholders. FindingsCommunity housing, mental health, and cycles entrenching substance misuse were identified as risk factors that increase individual-level, interpersonal-level, and community-level vulnerabilities to the harms of drug misuse, violence, and exploitation. Evaluation found this mixed-methods analysis for understanding risk and resilience to be a valuable approach to enable public health and community safety leaders to develop a framework for partnership action to reduce the negative effects of drug demand in the community. InterpretationAnalysis of multi-agency data helped to further a shared understanding in local partners of the drivers and effects of drug demand at a local level; and, through a public health lens, clearly identified the role that local organisations can play in minimising the harms of substance misuse and exploitation. FundingNo funding received.

Inequality in Life and Death

We argue that the COVID epidemic disproportionately affected the economic well-being and health of poor people. To disentangle the forces that generated this outcome, we construct a model that is consistent with the heterogeneous impact of the COVID recession on low- and high-income people. According to our model, two-thirds of the inequality in COVID deaths reflect preexisting inequality in comorbidity rates and access to quality health care. The remaining third stems from the fact that low-income people work in occupations where the risk of infection is high. Our model also implies that the rise in income inequality generated by the COVID epidemic reflects the nature of the goods that low-income people produce. Finally, we assess the health–income trade-offs associated with fiscal transfers to the poor and mandatory containment policies.

Pengaruh Kualitas Pelayanan Kesehatan terhadap Kepuasan Pasien Penerima Bantuan Iuran di Puskesmas Pahandut Kota Palangka Raya

The purpose of this study is to analyze the significance of the effect of service quality dimensions including reliability, responsiveness, assurance, empathy, tangibles to the level of poor people's health insurance patient satisfaction in Public Health Center of Pahandut Palangkaraya City. Based on the analysis of overall service gap dimensions, the fit between the services provided by health centers in the hope of Palangkaraya Pahandut community insurence patients there is a gap / level of satisfaction (- 10:54), these scores were categorized in groups, although not yet fully meet the expectations of patients community insurence, but service provided is good enough. Based on the results of the regression analysis above we can conclude that all the variables of service quality dimensions (Reliability, Responsiveness, Assurance, Empathy, Tangible) jointly have a significant positive effect on patient satisfaction and Public Health Center of Pahandut Palangka raya City. These results indicate that the alternative hypothesis (Ha) can be accepted and the hypothesis zero (Ho) is rejected. While the major effect is variable Assurance (1052), Reliability (1004), Tangible (1039), Responsiveness (1714), Empathy (1029) on patient satisfaction community insurence. The next is the R ² value of (0456) showed that 45.6% of patient satisfaction variables can be explained by service quality are Reliability, Responsiveness, Assurance, Empathy, and the remaining 54.4% Tangible while others described the other variables that are not included in this study model . Then, based on gap analysis (a match between expectations of the performance) of each dimension, are as follows, Responsiveness variable (-0.78) score was categorized as moderate. then followed the next variable Tangible variable (-0.88), variable Reliability (-0.57), assurance variable (-0.11), Empathy and the latter variable (-0.11). Although not yet fully provided the service as expected but the district Public Health Center of Pahandut Palangka raya City good enough but should be improved.

Value Chain Governance, Power and Negative Externalities: What Influences Efforts to Control Pig Diseases in Myanmar?

Livestock diseases are examples of negative externalities that affect livelihoods and health of poor people across the world. We investigate how the governance and power relationships along a value chain can contribute to reducing the negative effects of livestock diseases. We conducted a case study of Myanmar’s pig value chains and examined the relationship between power and efforts to minimize the risks of pig-borne diseases. We find that power relationships along the value chains are not directly linked to value chain actors’ effort to control negative externalities, unless powerful actors (1) understand the effects of negative externalities on the wider society, (2) monitor others’ practices, and (3) could hold those who generate negative externalities accountable. Satisfying these conditions requires effective coordination between governments, value chain actors and civil societies in order to mobilize value chain actors to help improve public health.

David James Purslove Barker. 29 June 1938—27 August 2013

Professor David James Purslove Barker was a physician and one of the most influential medical scientists of our time. His fetal programming hypothesis (known as the Barker Hypothesis) transformed thinking about what causes chronic diseases that are the scourge of modern society: cancer, cardiovascular disease and diabetes. The Barker Hypothesis proposed that the environment of the fetus and infant determined by maternal nutrition and exposure to infection subsequently predisposes the pathologies of later life. He challenged the idea that chronic diseases result from a combination of bad genes and unhealthy adult lifestyle. The environment of the fetus and infant, he suggested, permanently set or ‘programmed’ the body's metabolism and growth, and thereby pathologies of old age. His initially controversial, but now widely accepted, ideas have produced an explosion of research worldwide into the complex processes of nutrition and growth during intrauterine and early post-natal life and how these cause adult diseases. His discoveries created a new field of research, developmental origins of health and disease (DOHaD), influencing global scientific thinking. David believed that ‘the poorer health of people in lower socio-economic groups or living in impoverished places was linked to past and present neglect of the welfare of mothers and babies’. Tackling the epidemics of diabetes and heart disease in the Western world and in developing countries would require, he said, a shift in focus to prioritize the health and nutrition of adolescent girls, pregnant women and infants. This focus has subsequently been enshrined in global health policies and priorities.

Healthy Athletes Program as a chance for a good quality of life of persons with intellectual disability and their families in the context of health and pro-health activities

Abstract Background: One of the consequences of improperly extending the process of socialization is incorrect health education and thus, different structure of the behaviors associated with taking care of their own health. More difficult socio-economic situation of families with children with intellectual disabilities may not adequately protect the needs of family members (especially children’s) associated with health. Up to 1/3 of the cases of people with intellectual disabilities of poorer health state can result from lower socio-economic position (Emerson and Hatton, 2007). Educational failure, typical for families of children and young people with intellectual disabilities (especially mild) can result in the children not acquiring appropriate behaviors, important for health. If these behaviors are missing, consequently, can be expected to accelerate the deterioration of health. The health status of people with intellectual disabilities is worse than the state of health in the general population (Allerton, Welch, Emerson, 2011; Tample et al., 2006). The most serious consequence of the poorer health of people with intellectual disabilities is a higher mortality rate (Krahn et al, 2006). The average life expectancy of people with intellectual disabilities is 66 (excluding people with Down syndrome whose life expectancy is even shorter), and so more than 10 years shorter than of people. In so-called intellectual norm! Bearing in mind that access to the highest standard of health care for all people with disabilities is a law that was adopted on 13 December 2006 under the UN Convention on the Rights of Persons with Disabilities, Special Olympics Poland have taken the initiative leading to beneficial changes in quality of life for the players and their families in the context of health and modeling appropriate health behavior through the implementation of the Health Programme, which includes the two related projects: Healthy Athletes and Healthy Special Olympics Community.

Commentary on Binswanger et al. (2016): Multiple opportunities exist to improve the health and wellbeing of people released from prisons

Commentary on Binswanger <i>et al</i>. (2016): Multiple opportunities exist to improve the health and wellbeing of people released from prisons

Evaluation of Sewerage System Sustainability Technically Around Condominiums Areas: A Case Study in Debre Berhan, Ethiopia

Sewage discharges from centralized water-borne collection systems can pollute surface water, and discharge from sewers; septic tanks and pit toilets pollute living environment and groundwater which directly affects the health of poor people at downstream [13]. Poor sanitation facilities and low sewerage system continues to be a critical problem in rural and urban areas of Ethiopia. This study aims to evaluate the sewerage system in terms of technical aspect by identifying the cause and extent of failures on the schemes then forwarding the mitigation measures for the problem explored. This study is conducted in Debre Berhan town from February, 2014-January, 2015. In order to gather information’s for the study, the researchers used pre-prepared questionnaire (for the condominium lives), soil sampling and the other was data collection checklists (variable and context information checklists), semi open ended interview and physical instruments such as GPS, Axes soil sample bags. From the study, some important conclusions are made. The technical performance evaluation indicators show that sewerage system especially around condominium area is poorly implemented, inadequate in quantity, or poorly constructed or both. Of the total users around 31.54% have no any awareness about sewerage system operation, sanitation and hygiene. Of constructed floor drainage ditches only 24.8% have good appearance and functional, in the rest of scheme, the structure is destructed and non-functional. Only 36.47% of septic tanks, gives good function for users properly as required, in the rest of the schemes, there is many defects and problems observed. The technical problems noticed in the sample sites are includes O&M, construction, and design respectively put in the order of causing considerable failure.

Solidarity food: gain health for people and environment

Problem In the last years an increasing number of people in Italy has sought emergency food assistance because households didn’t have access to enough food for basic needs. On the other hand, food business produces an always growing quantity of still edible surplus. Problem Description In order to improve dietary choices and poor people health, Bologna Food Safety and Nutrition Service (FSNS) collaborates, since 2000, with a project of the University of Bologna, that is focused in connecting the food surplus …

Poor Health in Rich Countries: A Role for Open Access Journals

In the October editorial, the PLOS Medicine Editors argue that the health of poor people in rich countries is of global significance and discuss why Open Access journals are particularly well suited to facilitate research and commentary on this topic. Please see later in the article for the Editors' Summary.

Commentary: The developmental origins of health and disease: an appreciation of the life and work of Professor David J.P. Barker, 1938-2013

David J.P. Barker was a physician, a biologist and one of the most influential epidemiologists of our time. His ‘foetal programming hypothesis’ (‘Barker hypothesis’) transformed our thinking about the causes of diabetes, cardiovascular disease and cancer. He challenged the idea that they are explained by bad genes and unhealthy adult lifestyles, and proposed that their roots lie in the early life environment: ‘The nourishment a baby receives from its mother, and its exposure to infection after birth, determine its susceptibility to chronic disease in later life’. By permanently ‘programming’ the body’s metabolism and growth, they determine the pathologies of old age. His initially controversial, but now widely accepted, ideas have stimulated an explosion of research worldwide into early development and later disease (‘developmental origins of health and disease’ or DOHaD). David thought that ‘the poorer health of people in lower socio-economic groups or living in impoverished places is linked to neglect of the welfare of mothers and babies’. He argued that to pull back the modern epidemics of chronic disease we should prioritize the health and nutrition of girls, pregnant women and infants. David built his career in Southampton where, with Donald Acheson and Martin Gardner, the MRC Environmental Epidemiology Unit was established. He became its director in 1984. His research into the aetiology of thyroid disease, Perthes’ disease, Paget’s disease, appendicitis and chronic neurological disease led him to evidence of nutritional and infective influences in early life. He suspected that such influences caused the rapid waxing and waning of disease, for example the mysterious disappearance of rheumatic heart disease and new epidemic of coronary heart disease. The Unit’s detailed mapping of mortality (Atlas of Mortality for Selected Diseases in England and Wales, 1968-1978) led to his observation that areas with more infant mortality in 1910 had more cardiovascular deaths in 1970. He and statistician Clive Osmond confirmed strong geographical correlations between neonatal mortality and death from coronary heart disease and stroke decades later. He concluded that poor foetal nutrition was causally linked to later disease, and devoted the next three decades to a tenacious pursuit of evidence to support this. Interestingly his PhD thesis, ‘Prenatal influences and subnormal intelligence’, findings of which were published in 1966, was a harbinger of his foetal programming work. Using old birth records, he showed that people of lower birth and infant weight had more cardiovascular disease and diabetes in middle age. The latter of these papers is reprinted in this issue as part of the celebration of the centenary of the UK Medical Research Council, together with a commentary by David on his reflections on the thrifty phenotype hypothesis 20 years on. With the Helsinki Birth Cohort Group, he related patterns of childhood growth to these diseases. With colleagues in India, he showed similar relationships in developing populations. With the Dutch Hunger Winter Group in Amsterdam, he showed that exposure of mothers to famine left a legacy of ill health in their children. He collaborated with physiologists in Adelaide, Auckland and Toronto who were studying foetal development in animals, harnessing strong evidence that early life undernutrition had permanent effects on all body systems. The connections he made between the worlds of physiology and epidemiology were the forerunners of the International DOHaD Societyand congresses. There were some aspects of modern epidemiology that David disliked. He disagreed that consistency of Published by Oxford University Press on behalf of the International Epidemiological Association

GLOBAL HEALTH IMPACT: A BASIS FOR LABELING AND LICENSING CAMPAIGNS?

Most of the world's health problems afflict poor countries and their poorest inhabitants. There are many reasons why so many people die of poverty-related causes. One reason is that the poor cannot access many of the existing drugs and technologies they need. Another, is that little of the research and development (R&D) done on new drugs and technologies benefits the poor. There are several proposals on the table that might incentivize pharmaceutical companies to extend access to essential drugs and technologies to the global poor.(1) Still, the problem remains - the poor are suffering and dying from lack of access to essential medicines. So, it is worth considering a new alternative. This paper suggests rating pharmaceutical and biotechnology companies based on how some of their policies impact poor people's health. It argues that it might be possible to leverage a rating system to encourage companies to extend access to essential drugs and technologies to the poor.

Indigenous Peoples and Climate Change

There has been a growing attention on the need to take into account the effects of global climate change. This is particularly so with respect to the increasing amount of green house gas emissions from the Untied States and Europe affecting poor peoples, especially those in developing countries. In 2003, for example, the experts of several international development agencies, including the World Bank, prepared a special report titled “Poverty and Climate Change: Reducing the Vulnerability of the Poor through Adaptation” (OECD 2003). This report followed the Eighth Session of the Conference of Parties (COP8) to the United Nations Framework Convention on Climate Change (UNFCCC) in New Delhi, India in October 2002. It showed that poverty reduction is not only one of the major challenges of the 21st century, but also that climate change is taking place in many developing countries and is increasingly affecting, in a negative fashion, both the economic conditions and the health of poor people and their communities.

Developing a Health Surveillance System for People With Intellectual Disabilities in the United States

Adults with intellectual disabilities (ID) experience poorer access to quality healthcare and poorer health outcomes than people without ID. They are more likely to live with complex and poorly managed health conditions, have limited access to quality healthcare, receive cancer screenings at lower rates, be obese, have undetected vision and hearing problems, and be at risk for overuse of psychotropic medications. While health disparities appear endemic, there remains a dearth of population-based information, leading to lack of recognition of this problem by policy makers, public health, and even healthcare professionals. Efforts to address these disparities are insufficient, owing in part to the challenge of documenting the problem's scope and nature. In the U.S., nearly 4 million adults are currently estimated to have ID. In contrast to European countries and despite attention from the U.S. Surgeon General in 2002 on the poor health of people with ID, little progress has been made on obtaining related population-based data in the U.S. Substantial challenges exist relative to gathering representative data on the population with ID. In response, two international meetings of experts were convened to discuss possible approaches to gathering population-based health information on people with ID. The discussions included about whom to gather information, what data to collect, and options for how to gather the data. Authors note that efforts to improve health surveillance of people with ID in the U.S. can be enhanced through a multistage strategy. Recent healthcare reform in the U.S. sets a new context for major changes in access to and the way that our healthcare system operates. These changes highlight the need to develop accurate and reliable surveillance systems that can monitor the impact of these changes on this often neglected population.

Neglected and endemic zoonoses

Endemic zoonoses are found throughout the developing world, wherever people live in close proximity to their animals, affecting not only the health of poor people but often also their livelihoods through the health of their livestock. Unlike newly emerging zoonoses that attract the attention of the developed world, these endemic zoonoses are by comparison neglected. This is, in part, a consequence of under-reporting, resulting in underestimation of their global burden, which in turn artificially downgrades their importance in the eyes of administrators and funding agencies. The development of cheap and effective vaccines is no guarantee that these endemic diseases will be eliminated in the near future. However, simply increasing awareness about their causes and how they may be prevented-often with very simple technologies-could reduce the incidence of many endemic zoonoses. Sustainable control of zoonoses is reliant on surveillance, but, as with other public-sector animal health services, this is rarely implemented in the developing world, not least because of the lack of sufficiently cheap diagnostics. Public-private partnerships have already provided advocacy for human disease control and could be equally effective in addressing endemic zoonoses.

Working with primary care practices to improve service delivery for people with learning disabilities – a pilot study

Accessible summary People with learning disability have worse health than other people General practitioners and other people working with them were offered training on different topics such as communication and the work of the community team. Afterwards all the GP practices introduced changes which made it easier for people with learning disability to use their local surgery. SummaryThe relatively poor health of people with learning disability reflects the failure of primary care practitioners to improve the accessibility of the service they offer. This North Essex study involved evaluation of a project to work with three primary care practices to raise staff awareness, improve their training, and adapt their working practice. While GPs and other practice staff recognised their training needs, only one practice released all staff for a one day training course. Nevertheless, all practices worked to produce Practice Development Plans which resulted in improved accessibility for People with Learning Disability. The project also opened up a channel of communication between the practices and the Community Team for People with Learning Disabilities (CTPLD). This study forms one strand of a three‐part project to improve access to primary care.

Somatic poor health of people with severe functional impairments living in a rural district in Sweden

Today the cooperation between primary healthcare, hospital clinics, the social welfare service, regional social insurance authorities and jobcentres reveals a considerable number of deficiencies concerning people with long-term mental impairments. This is indicated in the ‘UN Standard Rules’1 and similar conditions are also valid for people with physical impairments. Quite a number of people with severe functional impairments do not receive help, and some are not even known to agencies responsible for rehabilitation and care.These people are vulnerable2,3 because they often do not make demands regarding their healthcare needs as other groups do. Their morbidity and mortality also appear to be higher.4-6 Therefore we hypothesise that there are deficiencies in the welfare of all vulnerable groups, but for some reason they are not given the support and service they are entitled to.

Bioethics in the context of global health programs

This work describes the Regional Program on Bioethics of the Pan American Health Organization (PAHO)/World Health Organization (WHO), as well as the Program's main achievements. The Program was established in 1994 under a three-way agreement with the University of Chile and the Government of Chile. The Program's objective is to thematically link the work of the PAHO/WHO units and representatives in each country, in close cooperation with local public and private organizations. The Program investigates such subjects as the health of poor people, priority-setting, the growth of the private sector, salaries and incentives in the public sector, investment in hospitals, health sector reform, professional education, and working together for development. Finally, the direction and heading of the Program are presented. Its efforts are carried out as promotional, support, and service activities. These activities take the form of technical assistance for personnel training, public information dissemination, ethical situation analysis in research and services, reviewing curricula and professional practice standards, and advising on specific plans and programs.