Epidemiology

Getting Health Reform Right: A Guide to Improving Performance and Equity

Marc Roberts, William Hsiao, Peter Berman, Michael Reich

This book provides a framework for developing and analyzing health sector reforms, based on international experience. It offers practical guidance and stresses the need to take account ... More

This book provides a framework for developing and analyzing health sector reforms, based on international experience. It offers practical guidance and stresses the need to take account of each country's economic, administrative, and political circumstances. The book explains how to design effective government interventions in five areas—financing, payment, organization, regulation, and behavior—to improve the performance and equity of health systems around the world. There are a number of critical features in the book's approach to health-sector reform. The first is to see the health sector as a means to an end. Reformers should judge their systems by the consequences, to define problems in terms of performance deficiencies, and to assess proposed solutions by whether they promise to remedy those deficiencies. This approach leads to an analytically rigorous method for problem definition, causal diagnosis, and policy development. This kind of method has often been lacking in health reforms efforts, and its lack is partially responsible for the disappointing results. A second major feature of the book's approach is a commitment to combining international experience with deep sensitivity to local circumstances. A third feature of this study is that the book puts forward a multidisciplinary approach to the problems of health-sector reform. Finally, the book argues that health-sector policy inevitably involves ethical choices. Less

Global Inequalities at Work: Work's Impact on the Health of Individuals, Families, and Societies

Jody Heymann (ed.)

This book is the first to fill in the gaps in the map of occupational health by creating a picture that is truly global, both geographically and in its coverage of the impact of work on ... More

This book is the first to fill in the gaps in the map of occupational health by creating a picture that is truly global, both geographically and in its coverage of the impact of work on the health of individuals, families, and societies. Leaders from universities, international organizations, and nongovernmental organizations bring expertise from six continents to this book. Drawing from studies done around the world, this book critically examines the manifold ways in which work is affecting health. The first part covers the wide range of risks—physical, chemical, biological, and social—to the health of individual employees in agricultural, industrial, and post-industrial workplaces. Part II provides a detailed analysis of how working conditions can dramatically influence the health and welfare of workers' family members including children, elderly parents, and the disabled in both the developing and industrial world. Part III examines the relationships between work and health at the societal level by focusing on two examples: the ways in which working conditions affect income inequalities and health, and the ways in which they influence gender inequalities and health. Part IV investigates the new challenges to and opportunities for improving the relationships between work and health that are presented by a rapidly globalizing economy. Less

Global Public Health: A New Era

Robert Beaglehole, Ruth Bonita (eds)

This book provides an account of the international state of public health, including an agenda for improving the practice of the discipline across the world. It addresses three major ... More

This book provides an account of the international state of public health, including an agenda for improving the practice of the discipline across the world. It addresses three major issues, presented in distinct sections: the changing global context for public health; the state of public health theory and practice in both developed and developing countries; and strategies for strengthening the practice of public health in the 21st century. Part one surveys the complex old and new challenges facing public health practitioners, and then summarizes the state of health globally using new data based on measures of the Global Burden of Disease developed by the Word Health Organization, and other groups, to better describe population health states and trends. Part two presents the first detailed review of the global state of public health. It analyses the public health situation in all regions of the world. Six chapters cover Europe, North and Latin America, and Australia and New Zealand, including a new chapter focusing on the UK. Three chapters cover China, India, and Sub-Saharan Africa. The lessons from these chapters are surprisingly similar: the challenges are great; the public health workforce and infrastructure have long been neglected; and much needs to be done to reinvigorate the practice of public health. The third section covers several cross cutting themes, including the developing field of international public health ethics and the central and neglected role of the public in strengthening the practice of public health. The final chapter summarizes the major themes of the book and explores the opportunities for building the capacity of the public health workforce to respond to the major global health needs. Despite the enormity of the challenges facing public health practitioners, especially in low and middle income countries, the tone adopted in the final section of this book is relatively optimistic. Less

Globalization and Health

Ichiro Kawachi, Sarah Wamala (eds)

Globalization is breaking down of economic, political, cultural, demographic, and social barriers across the world at an astonishing pace. The topic of globalization has caused ... More

Globalization is breaking down of economic, political, cultural, demographic, and social barriers across the world at an astonishing pace. The topic of globalization has caused passionate debate in many circles including academic journals, the popular media, and even on the streets. This new world order is marked by new actors, new rules of governance, new forms of communication, and the global movement of populations. Health is an exquisitely sensitive mirror of social conditions, and this book argues that the assessment of health is an important criterion for evaluating and monitoring the progress of globalization. This book provides an analysis of the most serious global threats to health, the tools that can be used to evaluate them, and the international agencies established to respond to them. Medical threats such as infectious diseases, obesity, tobacco use, and global climate change are discussed, but the book also expands its scope to include socio-political health impacts such as economic inequality. The complex role of organizations such as the World Health Organization, the International Monetary Fund, and the World Bank is also analyzed, as is the increasing interconnectedness of health and non-health actors. Is this blurring of boundaries really beneficial to the public's health, or have these actors abandoned health issues for power politics? Less

The Guide to Community Preventive Services: What works to promote health?

Task Force on Community Preventive Services

Stephanie Zaza, Peter A. Briss, Kate W. Harris (eds)

This book is a primary resource on how to improve health and prevent disease in states and communities. The book uses systemic review methods to evaluate population-oriented health ... More

This book is a primary resource on how to improve health and prevent disease in states and communities. The book uses systemic review methods to evaluate population-oriented health interventions. The recommendations of the Task Force on Community Preventive Services are explicitly linked to the scientific evidence developed during systematic reviews. This book examines the effectiveness and efficiency of interventions to combat such risky behaviors as tobacco use, physical inactivity, and violence; to reduce the impact and suffering of specific conditions such as cancer, diabetes, vaccine-preventable diseases, and motor vehicle injuries; and to address social determinants on health such as education, housing, and access to care. The chapters are grouped into three broad categories: changing risk behaviors; reducing specific diseases, injuries, and impairments; and methodological background for the book itself. Less

Health Care Regulation in America: Complexity, Confrontation, and Compromise

Robert I. Field

This book is a guide to the regulatory maze that governs health care. Regulation shapes all aspects of America's fragmented health care system, from the flow of dollars to the ... More

This book is a guide to the regulatory maze that governs health care. Regulation shapes all aspects of America's fragmented health care system, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, and almost one-sixth of the national economy, depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement. The book recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, the book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus—professions, institutions, financing arrangements, drugs and devices, public health, business relationships, and research. The system thrives on confrontation between competing interests but survives by engendering compromise. The book shows that health care regulation is an inexorable force that has actually served to nurture the enterprise of American health care. Less

Health Impact Assessment

John Kemm, Jayne Parry, Stephen Palmer (eds)

Health effects are often overlooked when planning development projects ranging from new runways at major airport sites to developing water supply systems to improve sanitation. Health ... More

Health effects are often overlooked when planning development projects ranging from new runways at major airport sites to developing water supply systems to improve sanitation. Health Impact Assessment (HIA) is the assessment of the health effects, positive or negative, of a project, programme, or policy. It is therefore concerned with the health of populations and attempts to predict the future consequences for health of decisions which have not yet been implemented. HIA is a new and growing field with numerous schools of thought and areas of controversy. This book provides an overview of the concepts, theory, techniques, and applications of HIA to aid all those preparing projects or carrying out assessments. It draws on examples and thinking from many different disciplines and many parts of the world. It identifies the areas of agreement and the questions remaining unanswered. It maps a confused field and signposts possible directions for future progress. HIA is intended to help decision makers in all areas foresee the consequences of their decisions, to ensure the consequences are considered and reduce the risk of population health being damaged through some indirect and unintended consequence of a decision. Less

Health Impact Assessment: Past Achievement, Current Understanding, and Future Progress

John Kemm (ed.)

Health Impact Assessment (HIA) is a process which helps decision making by predicting the consequences for health of choosing different options in terms of policies, plans, and projects. ... More

Health Impact Assessment (HIA) is a process which helps decision making by predicting the consequences for health of choosing different options in terms of policies, plans, and projects. There is growing interest among health professionals, planners, and politicians in using HIA to help safeguard and improve the health of populations and reduce health inequalities. This book explores the past development of HIA, its current practice, and possible future. Written in two parts, the first section provides an overview describing the various ways in which an HIA can be done. Practical in emphasis, it describes how HIA can be applied in different contexts to meet the needs of different decision makers and answer a variety of questions. It deals not only with the many good reasons for using HIA but also critically examines the weaknesses of current practice. The second part consists of chapters demonstrating the various pressures and legislative frameworks that have shaped the evolution of HIA. The aim is to illustrate the range of views about the reasons for doing HIA and how it should be done, and to reveal how the practice of HIA has been adapted to suit different cultures and help decision making in varying situations. Less

Health Measurement Scales: A practical guide to their development and use

David L. Streiner, Geoffrey R. Norman

This book covers in detail how to develop a measurement scale: a questionnaire or instrument, with specific applications in health sciences. Its organization follows the steps developers ... More

This book covers in detail how to develop a measurement scale: a questionnaire or instrument, with specific applications in health sciences. Its organization follows the steps developers will go through during the process beginning with how the individual items are developed, and the various biases that can affect responses (e.g., social desirability, yea-saying, framing). It then discusses different response options, such as Likert scales, adjectival scales, visual analogue scales, Harter scales, and face scales, and the advantages and disadvantages of each. The book then explains how to select the best items in the set, using various psychometric criteria; and how to combine the individual items into a scale. There is much discussion of reliability and validity, from both a theoretical and statistical perspective, with a separate chapter on generalizability theory. Although the perspective is that of classical test theory, there is also an in-depth presentation of item response theory. It concludes with a discussion of ethical issues that may be encountered in developing and using scales; and presents guidelines for reporting the results of the scale development process. In the appendices there is a comprehensive guide to finding existing scales, and a brief introduction to exploratory and confirmatory factor analysis. Less