Incidence Of Preventable Diseases Research Articles

Physician update: total health.

As an integrated prepaid health care system, Kaiser Permanente (KP) is in a unique position to demonstrate that affordability in health care can be achieved by disease prevention. During the past decade, KP has significantly improved the quality care outcomes of its members with preventable diseases. However, because of an increase in the incidence of preventable disease, and the potential long-term and short-term costs associated with the treatment of preventable disease, KP has developed a new strategy called Total Health to meet the current and future needs of its patients. Total Health means healthy people in healthy communities. KP's strategic vision is to be a leader in Total Health by making lives better. KP hopes to make lives better by 1) measuring vital signs of health, 2) promoting healthy behaviors, 3) monitoring disease incidence, 4) spreading leading practices, and 5) creating healthy environments with our community partners. Best practices, spread to the communities we serve, will make health care more affordable, prevent preventable diseases, and save lives.

Interventions for Improving Nutrition and Physical Activity Behaviors in Adult African American Populations: A Systematic Review, January 2000 Through December 2011

IntroductionThe incidence of preventable chronic diseases is disproportionally high among African Americans and could be reduced through diet and physical activity interventions. Our objective was to systematically review the literature on clinical outcomes of diet and physical activity interventions conducted among adult African American populations in the United States.MethodsWe used the Preferred Reporting Items for Systematic Review and Meta Analysis construct in our review. We searched Medline (PubMed and Ovid), Cochrane, and DARE databases and restricted our search to articles published in English from January 2000 through December 2011. We included studies of educational interventions with clinically relevant outcomes and excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders, that did not focus on African Americans, that provided no quantitative baseline or follow-up data, or that included no diet or physical activity education or intervention. We report retention and attendance rates, study setting, program sustainability, behavior theory, and education components.ResultsNineteen studies were eligible for closer analysis. These studies described interventions for improving diet or physical activity as indicators of health promotion and disease prevention and that reported significant improvement in clinical outcomes.ConclusionOur review suggests that nutrition and physical activity educational interventions can be successful in improving clinically relevant outcomes among African Americans in the United States. Further research is needed to study the cost and sustainability of lifestyle interventions. Further studies should also include serum biochemical parameters to substantiate more specifically the effect of interventions on preventing chronic disease and reducing its incidence and prevalence.

Coberturas vacinais e doenças imunopreveníveis no Brasil no período 1982-2012: avanços e desafios do Programa Nacional de Imunizações

Objective: to describe vaccination coverage (VC) and its homogeneity, dropout rates (DR) and the occurrence of vaccine-preventable diseases in Brazil. Methods: a descriptive cross-sectional study was conducted based on National Immunization Program (PNI) information systems data for the period 2002-2012 in order to calculate VC, its homogeneity and DR indicators, and also based on data provided by the Ministry of Health’s Communicable Diseases Coordination sector for the period 1982-2011 in order to calculate disease incidence. Results: VC was high in both routine vaccination and campaigns, resulting in the elimination or drastic reduction in preventable disease incidence, despite VC heterogeneity. Conclusion: the vaccination strategies adopted have increased vaccine availability in terms of territorial extension and, above all, in terms of population coverage. The establishment of the PNI as a public health policy priority has contributed to the reduction in vaccine-preventable disease incidence.

Long-Term Effectiveness of Parent Education Using the “Baby Oral Health” Model on the Improvement of Oral Health of Young Children

Purpose. To determine the long-term effectiveness of comprehensive education given to parents and caregivers with respect to the incidence of preventable oral diseases, utilization of dental services, and retention of knowledge related to oral health. Methods. Group presentations on oral health were conducted for caregivers of infants (n = 161) using an interactive audio-visual aid. Followup occurred at 18 months. A comparison group (n = 181) was enrolled from the same community groups. Chi-square and Fisher's exact tests were used to analyze findings. Results. There was a difference in caries incidence, knowledge levels of caregivers, and utilization of dental services (P < 0.05) when comparing the SGB to the SGFU. Conclusions. One-time exposure to parent education using a comprehensive interactive audio-visual aid has an effect on reducing caries incidence and increasing dental utilization. While most knowledge is retained by parents, there is some attrition in the information retained over an 18-month time period. This emphasizes the importance of repeated reinforcement of the same concepts over a shorter time span.

Microbial food safety in Ghana: a meta-analysis

Food safety is a crucial factor in the growth of developing countries worldwide. In this study, we present a meta-analysis of microbiological food safety publications from Ghana. The search words "Ghana food safety", "Ghana food research", and "Ghana food bacteria" were used to search for microbiological food safety publications with related abstracts or titles in PubMed, published between 1997 and 2009. We obtained 183 research articles, from which we excluded articles concerning ready-to-eat microbial fermented foods and waterborne microorganisms as well as articles without abstracts. The criteria used for analysis of these publications were based on an assessment of methodological soundness previously developed for use in the medical field, with some modifications incorporated. The most predominant bacteria in Ghanain foods are Enterobacter spp., Citrobacter spp., Klebsiella spp. and Escherichia spp., which were found to be present in 65%, 50%, 46% and 38% respectively, of the food samples considered in the studies analysed. The most contaminated food samples were macaroni, salad, and milk. Although the methodological quality of the articles was generally sound, most of them did not give directions for future research. Several did not state possible reasons for differences between studies. The microbiological food contamination in Ghana is alarming. However, we found that the downward trend in publications of microbial food safety articles is appalling. Hence a concerted effort in research on food safety is needed in Ghana to help curb the incidence of preventable food-borne disease.

The promise of the early years: How long should children wait?

The promise of the early years: How long should children wait?

An Ecological Perspective on U.S. Latinos’ Health Communication Behaviors, Access, and Outcomes

U.S. Latinos experience constrained access to formal health care resources, contributing to higher incidence of preventable diseases and chronic health conditions than the general population. The authors explore whether a rich set of informal health communication connections—to friends, family, radio, television, Internet, newspapers, magazines, churches, and community organizations—can compensate, even partially, for not having access to doctors. The authors find no evidence of any such compensatory mechanism among respondents to the Pew Hispanic Center/Robert Wood Johnson Latino Health Survey ( N = 3,899). Analyses revealed that the informal health communication ecologies of respondents with favorable immigration/nativity status and greater income, education, and language proficiencies were more diversified than those of respondents reporting less favorable social status. Further analyses revealed that diversified informal health communication ecologies related to health care access (regular doctor visits, uninterrupted health insurance, and regular health care location) and favorable health outcomes (self-ratings of general health, health-related efficacy, and knowledge of diabetes symptoms).

Pattern of Childhood Renal Diseases in Jos, Nigeria: A Preliminary Report

Background : Childhood kidney diseases remain important causes of significant morbidity and mortality in Nigeria. This is characterized by late presentation, missed diagnosis in certain cases and failure to offer renal replacement therapy to many renal failure patients who required it. Methodology : This was a retrospective study of children managed at the Jos University Teaching Hospital Jos, Nigeria, over a three- year period. Results : Acute glomerulonephritis (AGN) was the commonest renal disease (37.7%). Other conditions included chronic renal failure (20.3%), nephrotic syndrome (16%), urinary tract infection (11.6%), nephroblastoma (7.2%), hemolytic uremic syndrome (5.3%) and polycystic kidney disease (1.5%). The commonest complication of AGN was hypertensive encephalopathy. Chronic glomerulonephritis was the commonest cause of CRF (50%). Conclusions : AGN is the most common childhood renal disease in Jos, Nigeria. Improved socioeconomic and environmental conditions are needed in Nigeria to reduce the incidence of preventable renal diseases.

`Fundamental Causes' of Health Disparities

This article examines the relative impact of socioeconomic status as a `fundamental cause' of health disparities in Canada and the US. Fundamental cause theory suggests that persons of higher socioeconomic status have available a broad range of resources to benefit their health and therefore hold an advantage in warding off whatever particular threats to health exist at a given time. This leads to two predictions: (1) SES is more strongly associated with diseases that are more highly preventable than with less preventable diseases; and (2) SES has a stronger relationship to health in the US, where higher economic inequality and a lack of universal health insurance leads to a greater vying for resources. Findings indicate lower levels of SES increase the odds of experiencing a highly preventable disease relative to a less preventable disease in the US, but not in Canada, suggesting that social policies and level of economic inequality may buffer the relationship between socioeconomic resources and the incidence of preventable disease.

The State of Indigenous America Series: Ten Indian Health Policy Challenges for the New Administration in 2009

The State of Indigenous America SeriesTen Indian Health Policy Challenges for the New Administration in 2009 Donald Warne (bio) The new administration that took office in January 2009 faces numerous challenges in the area of American Indian health. Media reports have recently shined a spotlight on disparate life expectancy rates in the United States based on race, ethnicity, culture, and income. Unfortunately, American Indians suffer among the worst health disparities in the nation with alarming gaps in life expectancy. Death rates from preventable causes such as diabetes and alcoholism are dramatically higher in American Indians than in the rest of the population. Nearly a third of our people live in poverty as compared to approximately 12 percent of the rest of the country. In Arizona, the average age at death is 72.2 years for the general population, but it is 54.7 years for American Indians. Despite this gross inequality, American Indians are the only population born with a legal right to health care in this country. The treaties between the tribal nations and the federal government in which the tribes exchanged vast amounts of land and natural resources resulted in guarantees for social services including housing, education, and health care. The Bureau of Indian Affairs (BIA) and the Indian Health Service (IHS) were established to administer the federal government’s trust responsibility to provide health care and other vital services to American Indians. At the same time we have an underfunded health system, other policies such as the damming of rivers and the loss of land and resources have led to significant lifestyle changes. Less physical activity, less [End Page 7] access to healthy food, and less freedom combine with discrimination to worsen health disparities. The solutions to American Indian health disparities are in the policy-making arena. Social policies, such as the federal trust responsibility to provide health care to American Indians, have a much greater impact on health outcomes than genetics or other physical causes of disease. The new administration is in a position to change the direction of Indian health policy, and it has the opportunity to focus on policy decisions that can have a significant impact on improving Indian health status and outcomes. There are multiple areas of Indian health in need of improvement. This article is organized into ten policy areas on which the new administration must focus to improve Indian health. 1. Health Disparities Considerable health disparities exist between the American Indian (AI) and the general U.S. populations. The roots of health disparities for AI people are multifaceted: low incomes, inadequate housing, substandard educational systems, underfunded reservation schools without physical education programs or healthy food programs, poor nutrition, and cultural factors. These factors coupled with a severely underfunded health care system have led to decreased access to health care services and to the highest incidence of preventable diseases in the country. As mentioned, in the state of Arizona, the average age at death is 72.2 years for the general population, but only 54.7 years for AIs.1 Click for larger view View full resolution Figure 1. Average age at death in Arizona. Preventable diseases impact AI populations at a far greater rate than the rest of Americans. Death rates from preventable diseases among AIs are significantly greater than among non-Indians, including diabetes (249 percent greater), alcoholism (627 percent greater), accidents (204 percent greater), and suicide (72 percent greater).2 In the [End Page 8] Phoenix-area IHS, encompassing most of Arizona as well as Utah and Nevada, the rates of death due to diabetes and alcoholism are even worse than in the rest of the IHS. Click for larger view View full resolution Figure 2. Diabetes death rates (deaths per 100,000 population). Click for larger view View full resolution Figure 3. Alcohol-related death rates (deaths per 100,000 population). High rates of diabetes, subsequent depression, and alcoholism create a significant need for effective behavioral health programs and interventions. At the same time, the policy framework for attacking this inequity is quite complex, and the level of care provided to AI communities is lower, in terms of per capita funding and provision of services, compared to...

Maternal Education and Child Healthcare in Bangladesh

Child health is one of the important indicators for describing mortality conditions, health progress and the overall social and economic well being of a country. During the last 15 years, although Bangladesh has achieved a significant reduction in the child mortality rate, the levels still remain very high. The utilization of qualified providers does not lead to the desired level; only a third relies on qualified providers. This study is mainly aimed at investigating the influence of maternal education on health status and the utilization of child healthcare services in Bangladesh. This study is based on the data of the Household Income Expenditure Survey (HIES) conducted by the Bangladesh Bureau of Statistics (BBS) during 2000. The analysis of the findings reveals that 19.4% of the children under five reported sickness during 30 days prior to the survey date. Moreover, approximately one out of every thirteen children suffers from diarrhoea in the country. It is striking to note that a significant portion of the parents relied on unqualified or traditional providers for the children's healthcare because of low cost, easy accessibility and familiarity of the services. The study suggests that maternal education is a powerful and significant determinant of child health status in Bangladesh. Maternal education also positively affects the number of children receiving vaccination. In order to improve the health condition of children in Bangladesh maternal education should be given top priority. The public policies should not just focus on education alone, but also consider other factors, such as access to health facilities and quality of services. Health awareness campaign should be strengthened as part of the public health promotion efforts. More emphasis should also be given to government-NGO (Non Government Organization) partnerships that make vaccination programs successful and, thereby, reduce the incidence of preventable diseases.

The Office of the National Nurse

The American health care system is in a crisis of soaring costs and epidemics of preventable diseases; poor health literacy contributes to these problems. In spite of the need for change, the system is resistant. Efforts to address the crisis must focus on new ways of educating the public to understand their health and how to prevent illness. Nurses calling for leadership, innovation, and inspiration are uniting behind the proposal for an Office of the National Nurse to serve as the vehicle for the delivery of accurate and accessible health information to all Americans to reduce the incidence of preventable diseases.

Use of Preventive Maternal and Child Health Services by Latina Women

Some health indicators for Latinos tend to be more positive than socioeconomic status would predict. Yet, Latina women and their young children use fewer preventive health services and have a higher incidence of preventable diseases than non-Hispanic whites. The Institute of Medicine recently called for intervention research among minority subgroups to end racial and ethnic disparities in health care. To help guide future intervention research, this article presents a critique and synthesis of the peer-reviewed literature on interventions that enroll Latina women into preventive reproductive health services (prenatal care, cervical cancer screening, and child immunizations). Results are presented according to three categories of interventions: improvements within formal health care settings, outreach through lay health advisors (promotoras) and media, and interventions combining these approaches. An agenda for intervention research is proposed for preventive-care use by this population.

Support for immunization registries among parents of vaccinated and unvaccinated school-aged children: a case control study.

BackgroundImmunizations have reduced childhood vaccine preventable disease incidence by 98–100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Despite substantial resources directed towards registry development in the U.S., only 48% of children were enrolled in a registry in 2004. Parental attitudes likely impact child participation. Consequently, the purpose of this study was to assess the attitudes of parents of vaccinated and unvaccinated school-aged children regarding: support for immunization registries; laws authorizing registries and mandating provider reporting; opt-in versus opt-out registry participation; and financial worth and responsibility of registry development and implementation.MethodsA case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Children were recruited from 112 elementary schools in Colorado, Massachusetts, Missouri, and Washington. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Parental views were summarized and logistic regression models compared differences between parents of exempt and vaccinated children.ResultsSurveys were completed by 56.1% of respondents. Fewer than 10% of parents were aware of immunization registries in their communities. Among parents aware of registries, exempt children were more likely to be enrolled (65.0%) than vaccinated children (26.5%) (p value = 0.01). A substantial proportion of parents of exempt children support immunization registries, particularly if registries offer choice for participation. Few parents of vaccinated (6.8%) and exempt children (6.7%) were aware of laws authorizing immunization registries. Support for laws authorizing registries and requiring health care providers to report to registries was more common among parents of vaccinated than exempt children. Most parents believed that the government, vaccine companies or insurance companies should pay for registries.ConclusionParental support for registries was relatively high. Parental support for immunization registries may increase with greater parental awareness of the risks of vaccine preventable diseases and utility of vaccination.

Research and Educational Approaches to Reducing Health Disparities Among American Indians and Alaska Natives

Research and educational programs have the potential to improve health care. American Indians (AIs) suffer from considerable health disparities as compared with the general U.S. population, including significantly higher incidence and prevalence of preventable diseases like diabetes, alcoholism, and their complications. Underfunding of health programs, including the Indian Health Service, and lower socioeconomic status among AIs contribute to these disparities. Improvements in disease prevention and treatment potentially offered by research and health education programs could help to reduce health disparities. However, a history of nonparticipation in the research process and a history of dishonest research practices have raised barriers to conducting research in AI communities. Additional barriers are generated from a shortage of AI researchers and health care professionals. A research paradigm that includes the community as a full partner is necessary to promote research and education in AI communities and to translate health research into reductions in health disparities.

Observational study of potential risk factors of medication administration errors.

Medication administration errors (MAEs) are the second most frequent type of medication errors, as has been shown in different studies in the literature. The aims of this observational study were to assess the rate and the potential clinical significance of MAEs and to determine the associated risk factors. In two departments, Geriatric Unit (GU) and Cardiovascular-Thoracic Surgery Unit (CTSU) of Besançon University Hospital (France), MAEs were identified using the undisguised observation technique and classified according to the definitions of the American Society of Health-System Pharmacists. Injectable administration, lack of nurses's standardized protocol for the preparation and administration of drugs, incomplete or illegible prescription and nurse's workload were analysed as potential risk factors of MAEs in multivariate logistic regression analysis. During a period of 20 days, opportunities for error concerning 56 patients and 78 MAEs (58 in CTSU and 26 in GU) were observed. The medication administration error rate was 14.9%. Dose errors were the most frequent (41%) errors, followed by wrong time (26%) and wrong rate errors (1996). No potential fatal errors were observed, 8 (10%) were estimated as potentially life-threatening, 20 (26%) potentially significant and 50 (64%) potentially minor. Nurse workload and incomplete or illegible prescriptions were two independent risk factors of MAEs. According to these data, the quality of the medication administration process needs to be optimized in hospitals in order to minimize the incidence of iatrogenic preventable diseases.

South Africa: a toxicologist's goldmine.

The emerging nation of South Africa, in common with some other countries, notably Eastern Europe, is heir to decades of neglect with regards to the exposure of the majority of its population to toxic materials. In this short review, the major toxic health hazards are described. For most of these risks there are now programs in place to improve the situation, but co-ordination and financial constraints, along with the fact that the majority of the population neither live, nor work, in a controlled environment, mean that much remains to be done. The recent formation of a South African Toxicology society, which strives to bring together environmental, industrial, forensic and clinical toxicology should assist in an improvement, both in the epidemiology of toxicity in South Africa and in improved measures to reduce the incidence of preventable noncommunicable diseases related to both acute and chronic exposure to toxins. The South African scene also provides a "window' of opportunity to study the more fundamental aspects of exposure in human subjects and to couple these to animal and in vitro studies to elucidate the underlying mechanisms where these are unknown.

Economic reform and health sector policy: Lessons from structural adjustment programs

From a purely economic perspective, structural adjustment programs (SAPs) and economic reform policies are viewed as short-term austerities that lead to long-term growth and development. These intertemporal trade-offs, however, are not always acceptable in health. Unique biologic events such as intrauterine development and neural development cannot be postponed even for a short period. Health policymakers need to understand the expected and unexpected impacts of economic reform on health outcomes in individuals and on the population. The interactions are complex, involve multiple sectors, and can be better understood by looking at the experience of developing countries over almost fifteen years of SAP experience. Health care budgets may be vulnerable to reduced government spending, quality of care deteriorates, nutrition will suffer more likely in urban areas, and cost-effective preventive programs may stop if labor and capital are not properly matched. Health outcomes overall do not appear to suffer but a more detailed look, with better data, shows that the incidence of preventable diseases rises and irreversible deterioration in health status does occur within countries. To prevent this from happening in the future, health policymakers need to take a multidisciplinary focus to first understand the effects of economic reform and then to plan a coordinated response. Better data, alternative financing, and strong political leadership are also important lessons.

Progress and focus of the national childhood immunization campaign.

In response to the alarming incidence of vaccine preventable childhood diseases in the late 1960s and early 1970s a nationwide campaign to improve and maintain immunization levels for selected diseases was instituted in 1977 by the Department of Health, Education and Welfare. Another program with the goal of eliminating indigenous measles by 1982 was announced the following year. As a result of efforts in federal, state and local quarters, an overall immunization level of 90% has been reached among the school-age population for diphtheria, tetanus, pertussis, polio, measles, mumps and rubella. Although more newborns and preschool children have been vaccinated, there is a need to better protect these youngsters. With the measles case rate at an all-time low and transmission within the country drastically limited, the goal to eliminate native measles in the near future may be achievable. After nearly six years of concerted activity, immunization levels have improved so that attention has shifted to the development and implementation of a system to permanently maintain these high levels. Continuing support from the public and private sectors is vital if the campaign is to succeed.