Health Equity: November 2008

Tuesday, November 25, 2008

[EQ] Challenges to maternal and child health in the US, Health Policy 11-2008

Overcoming social and health inequalities among U.S. women of reproductive age
—Challenges to the nation's health in the 21st century

Shahul H. Ebrahim^a^, ^c^, ^, John E. Anderson^a^, ^c, Rosaly Correa-de-Araujo^b^, ^c, Samuel F. Posner^a^, ^c and Hani K. Atrash^a^, ^c

^aCenters for Disease Control and Prevention, Atlanta, GA, USA
^bAgency for Healthcare Research and Quality, Rockville, MD, USA
^cUS Department of Health and Human Services, USA

Health Policy (2008), doi:10.1016/j.healthpol.2008.09.011
Available online 21 November 2008. Health Policy

To frame the discussion of the nation's health within the context of maternal and child health.
Methods We used national data or estimates to assess the burden of 46 determinants.

Results During 2002–2004, U.S. women of reproductive age experienced significant challenges from macrosocial determinants, to health care access, and to their individual health preservation. Two-thirds of women do not consume recommended levels of fruits and vegetables. Overall, 29% experienced income poverty, 16.3% were uninsured. About one in four women of reproductive age lived with poor social capital. Compared with white women of reproductive age, non-white women reported higher levels of dissatisfaction with the health care system and race-related discrimination. Among all U.S. women, chronic diseases contributed to the top nine leading causes of disability adjusted life years. About one-third of women had no prophylactic dental visits in the past year, or consumed alcohol at harmful levels and smoked tobacco. One in three women who had a child born recently did not breast feed their babies. Demographics of women who are at increased risk for the above indicators predominate among the socioeconomically disadvantaged.

Conclusions

At least three-fourths of the U.S. women of reproductive age were at risk for poor health of their own and their offspring. Social intermediation and health policy changes are needed to increase the benefits of available health and social sector interventions to women and thereby to their offspring.

“……..We have shown that both supply and demand obstacles and macrosocial issues overwhelm the efforts to improve health of women and children in the U.S. As a next step in evidence development, analysis of laboratory data on national prevalence of infectious and environmental challenges among women of childbearing age would be helpful.

At the supply level, preconception care is preventive medicine for maternal and child health, and increasing its universal availability should be a national priority.
At the individual level, healthy lifestyle messages may be more meaningful when presented with its intergenerational benefits and in a supportive social environment. Individual level efforts should begin in childhood, incorporated into the school curricula and school activities.
At the policy level, as has been suggested at the global level (http://www.who.int/entity/social_determinants/final_report/csdh_finalreport_2008.pdf ) greater emphasis should be given to macrosocial determinants of health also in the U.S. In summary, achieving further improvement in maternal and child health in the U.S. will be determined largely by how the nation reduces the barriers to health care, promote healthy lifestyles, and reduce disparities that women face in achieving optimal health……”

Article Outline

1. Introduction

2. Data and analyses

2.1. Data sources

2.2. Definitions of indicators

2.2.1. Reproductive health status of women

2.2.2. Burden of disease among women

2.2.3. Individual level risk factors and predictors of poor health

2.3. Health care access and uptake of prevention

2.3.1. Macrosocial determinants

2.4. Analyses

2.5. Data limitations

3. Results

3.1. Reproductive status of women

3.2. Burden of Disease among women

3.3. Individual level risk factors and predictors of poor health

3.4. Health care access and uptake of prevention

3.5. Macrosocial determinants

4. Discussion

5. Conclusions

Contributions

Conflicts of interest

References

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[EQ] Canada Gairdner Global Health Award

Canada Gairdner Global Health Award

Website: http://www.gairdner.org/awards/nominati/thegaird

Nominations for 2009 should be received no later than December 31, 2008

The Canada Gairdner Global Health Award is directed at health issues pertaining to developing countries. It recognizes those who have made major scientific advances in any one of four areas:
- basic science,
- clinical science or
- population health or
- environmental health.

These advances must have, or have potential to make a significant impact on health outcomes in the developing world. Nominations for leadership and administration, however outstanding, do not fall within the parameters of this award.

The long-term goal of this prize is to reward and stimulate members of the global scientific and medical community to undertake research that will lead to advances valuable to the health of nations.

The Global Health Award consists of $100,000 (CDN), a framed certificate with appropriate citation and a specially designed sculpture.

Purpose and Conditions
The purpose for the Canada Gairdner Global Health Award is the recognition of individual whose seminal scientific work constitutes a discovery or a highly tangible achievement toward improving our knowledge of and application to global health, and also to generate scientific momentum in the field as well as augmenting public awareness.

1. The Prize will be valued at $100,000 each.

2. The Prize is to be used by the recipient for personal use.

3. A Global Health Advisory Committee will be responsible for selecting a short list of candidates for presentation to the Medical Advisory Board.

4. The Board of Directors of the Gairdner Foundation will approve the selection of the winner.

5. Awards are made to residents of any country without restriction of gender, race, religion, creed or nationality.

6. The Prize may be presented either at the time of Canada Gairdner International Awards in October or at a special event in Ottawa in the spring.

7. The first Prize will be given on October 29, 2009, on the occasion of the Foundation's 50th Anniversary Awards Dinner in Toronto.

Nominations

1. The Gairdner Foundation will invite those in the international scientific health and medical community to nominate candidates for the Canada Gairdner Global Health Award.

2. Nomination letters should describe the key role of the nominee (s) in relevant successful advances and should be accompanied by a full curriculum vitae with a complete mailing address and at least two supporting letters that detail a major discovery or sustained advance.

3. The work of the nominee should be compared with that of others in the field, together with clearly articulated reasons why this work distinguishes the nominee’s work from others in the same scientific topic.

4. If two or three are nominated to share the Prize, the reasons why it should be shared must be clearly delineated.

5. A call for nominations will be published on The Gairdner Foundation website and suitably advertised in appropriate scientific journals.

6. Nominations will be held for up to 3 years, but must be updated annually.

Selection Process

1. The Gairdner Foundation President will form a Gairdner Foundation/ International Global Health Award Advisory Committee consisting of at least five members.

2. The Advisory Committee will reflect international composition in the field of Global Health with a clear understanding of the basic clinical and social science issues in global and population health.

3. The President of The Gairdner Foundation will appoint the Chairman and members of the Advisory Committee.

4. The Advisory Committee will meet in person or via teleconference to review all nominations and consult together as necessary, with an agenda and attachments (if any) mailed for receipt by each no less than ten days in advance.

5. The Advisory Committee will normally select the recipient no later than January of the year in which the award is to be made.

6. The selection will be submitted to the Medical Advisory Board for final selection and to The Gairdner Foundation Board of Directors for formal approval no later than January 31st of the award year.

7. All selections are final and not subject to review or challenge.

Announcement

1. A formal announcement of the awardee will be made at least three months prior to the annual Canada Gairdner Foundation awards presentation.

2. The Gairdner Foundation will insure that a prime time slot is allotted for prize presentation and a major lecture by the awardee.

3. The lecture may be given as a keynote before a full Symposium as it is anticipated that the Prize will be an incentive to have a state-of-the art symposium on advances in global health studies.

4. Logistics for presentation ceremony for Canada Gairdner Global Health Award will be the responsibility of the Gairdner Foundation.

Please submit in electronic format (MS Word or PDF) to nominations@gairdner.org and follow up hard copy to:

John H. Dirks, MD President & Scientific Director The Gairdner Foundation
44 Charles Street West Suite 4706 Toronto, ON M4Y 1R8 Phone: 416-596.9996 Fax: 416-596-9992 E-Mail: nominations@gairdner.org

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[EQ] Welfare state regimes and income-related health inequalities: a comparison of 23 European countries

Welfare state regimes and income-related health inequalities:
a comparison of 23 European countries

T. A. Eikemo^1,2,3, C. Bambra⁴, K. Joyce⁴ and Espen Dahl⁵

1 Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
2 SINTEF Health Research, Trondheim, Norway
3 Department of Public Health, Erasmus MC, The Netherlands
4 Department of Geography, Wolfson Research Institute, Durham University, Durham, UK
5 Health Sciences and Social Welfare, Oslo University College, Oslo, Norway

Available online at: http://eurpub.oxfordjournals.org/cgi/content/full/18/6/593

“………..Studies focusing on individual health differences within wealthynations have shown that there is a strong and consistent gradientalong the whole income hierarchy.^1,2 It might, therefore, beexpected that income-related health inequalities would be smallerin the Scandinavian countries than elsewhere given their relativelygenerous and universal welfare provision and the strong emphasisthey place on equality of outcomes, such as income.³

However,from the few studies that have investigated health inequalitiesby European region, the Scandinavian countries do not performas well on this in relation to other countries as might be expectedgiven their relative standing in terms of overall populationhealth and income inequalities. In fact, previous studies ofthe association between self-assessed health and relative incomeposition in the wider European context have suggested that suchhealth inequalities are perhaps not actually the smallest inthe Scandinavian countries.^4–8

Instead, these empiricalstudies have almost consistently reported that income-relatedhealth inequalities are smallest in the Central European countries(particularly in Germany). In addition, they have reported thatthey are largest in the UK.

More recently, the comparative literature on income-relatedhealth inequalities has utilized the concept of welfare stateregimes. It is widely acknowledged that welfare states are importantdeterminants of health and health inequalities as they mediatethe extent, and impact, of socio-economic position on health…..”

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[EQ] Education For All Global Monitoring Report focuses on inequalities

Education For All Global Monitoring Report focuses on inequalities

Overcoming inequality: why governance matters

UNESCO - Paris, 25 November, 2008

The failure of governments across the world to tackle deep and persistent inequalities in education is consigning millions of children to lives of poverty and diminished opportunity, according to a report published by UNESCO today

Website: http://portal.unesco.org/en/ev.php-URL_ID=44116&URL_DO=DO_TOPIC&URL_SECTION=201.html

Launched at the International Conference on Education (Geneva, Switzerland) the annual assessment of the Education For All campaign is entitled “Overcoming inequality: why governance matters”.

Press release - ENG | FRA | SPA | ARA | CHI | RUS

Summary - ENG | FRA | SPA

“……in many countries governance reforms have two major defects: a lack of attention to tackling inequality and a tendency to apply blueprints, in particular in turning to the private sector to solve public sector problems. New approaches to education governance are needed.
The Report pinpoints areas where government action is necessary:

Commit to the reduction of disparities based on wealth, location, ethnicity, gender and other indicators for disadvantage. Governments should develop well defined targets for reducing disparities and monitor progress towards their achievement.

Sustain political leadership to reach education targets and tackle inequality through clear policy objectives and improved coordination within government and beyond (civil society, the private sector and marginalized groups).

Strengthen policies for reducing poverty and deep social inequalities which hinder progress towards education for all. Governments should integrate education planning into wider poverty-reduction strategies.

Raise quality standards in education and work to ensure that disparities in learning achievement between regions, communities and schools are reduced.

Increase national education spending, especially in developing countries that chronically under invest in education.

Put equity at the centre of financing strategies in order to reach disadvantaged children through more accurate estimates of the costs of reducing disparities and the development of incentives for reaching the most marginalized.

Full Report online:

· Highlights

· Overview

· Chapters

1. Education for all: human right and catalyst for development

2. The Dakar goals: monitoring progress and inequality

3. Raising quality and strengthening equity: why governance matters

4. Increasing aid and improving governance

5. Policy conclusions and recommendations

· Annex

1. The Education for All Development Index

2. Global and regional patterns in education decision-making

3. Statistical tables

4. Aid tables

5. Glossary

6. References

7. Abbreviations

8. Index

Regional Fact Sheets

· Arab States | ARA

· Central Asia and Central and Eastern Europe | RUS

· East Asia and the Pacific

· Latin America and the Caribbean | SPA

· South and West Asia

· Sub-Saharan Africa

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