Health Equity: 03/19/09

Thursday, March 19, 2009

[EQ] Normative Foundations of Global Health Law

Normative Foundations of Global Health Law

Jennifer Prah Ruger, Yale University - School of Medicine

Georgetown Law Journal, Vol. 96, pp. 423-43, 2008

Available online PDF [21p.] at: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1024781

“……This Essay offers a normative theory of global health law. It builds on a theory of health and social justice I have long been developing and extends this theory in evaluating the role of international law in health. This theory takes human flourishing as the end goal of a global society and proposes that global health law be examined in terms of an ethical demand for health equity.

This ethical demand will likely require legal instruments for realization, but it will also require individuals, states, and nonstate actors to internalize public ethical norms in support of global health goals.

This Essay also argues that global health law should be examined in the contexts of international relations and global public policy and that law and policy should be linked at the global and domestic levels. Philosophical underpinnings of global health law cannot be studied separately from other global and domestic tools to reach global health equity.

This Essay comprises three parts.
- Part I offers normative foundations for the future of global health law and presents a theory of global health equity.

- Part II analyzes the role of global health law in achieving health equity, examines the effectiveness and limits of international health law,
and considers the conditions necessary for the effectiveness of global health law.
- Part III offers an analysis of global health law vis-à-vis domestic health law and policy.

The Essay concludes by arguing that solutions to global health disparities and externalities require more than international treaties, conventions, and recommendations. They require domestic health policy, law, and institutional reforms establishing sustainable, government-sponsored health systems, including universal health insurance and public-health and health-care infrastructures. Thus, the success and future of global heath law depend as much on domestic health policy and law as they do on international health law itself….”

Content:

INTRODUCTION

I. THREATS TO GLOBAL HEALTH AND THE QUEST FOR GLOBAL HEALTH JUSTICE .

A. INTERNATIONAL HEALTH RELATIONS

B. THE MORAL PURPOSE OF INTERNATIONAL HEALTH RELATIONS

C. GLOBAL HEALTH EQUITY .

D. KEY FUNCTIONS IN ACHIEVING GLOBAL HEALTH EQUITY

E. ALLOCATING MORAL RESPONSIBILITY: THE ROLE OF GLOBAL AND DOMESTIC INSTITUTIONS

F. THE CENTRAL ROLE OF PUBLIC MORAL NORMS

II. ACHIEVING GLOBAL HEALTH EQUITY: WHAT ROLE FOR GLOBAL HEALTH LAW? .
A. INTERNATIONAL HEALTH LAWS

B. THE NEED FOR GLOBAL HEALTH LAW

C. EFFECTIVENESS AND LIMITS OF INTERNATIONAL HEALTH LAW

D. WHAT CONDITIONS FOR THE EFFECTIVENESS OF GLOBAL HEALTH LAW? .

III. GLOBAL HEALTH LAW, DOMESTIC HEALTH LAW, AND DOMESTIC HEALTH POLICY

A. GLOBAL AND DOMESTIC HEALTH LAW: PUBLIC MORAL NORMS AND VOLUNTARINESS . .

B. GLOBAL HEALTH LAW AND POLICY

C. DOMESTIC HEALTH LAW AND POLICY

CONCLUSION

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
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Health Organization PAHO/WHO or its country members”.
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[EQ] The Global Health Program in Action

THE GLOBAL HEALTH PROGRAM IN ACTION

2009 SUMMER EXECUTIVE COURSE - Geneva 5 - 19 JUNE 2009

Website: http://www.graduateinstitute.ch/executive/training-workshops/global-health-diplomacy.html

Dateline to apply before the 1st April!

“……..Diplomacy is undergoing profound changes in the 21st century – and global health is one of the areas in which this is most manifested. The negotiation processes that shape and manage the global policy environment for health are increasingly not only conducted between public health experts representing health ministries of nation states but include many other major players at the national level and in the global arena.

As health moves beyond its purely technical realm to become an ever more critical element in foreign policy, security policy and trade agreements, new skills are needed to negotiate global regimes and international agreements and treaties and to maintain relations with a wide range of actors. The summer course will focus on health diplomacy as it relates to health issues that cross national boundaries and are global in nature, will discuss the challenges it faces and how they have been addressed by different groups and at different levels of governance.

Target audience: Health and international relations professionals in departments of international health; health attaches; as well as staff in international organizations, NGOs, philanthropies, and the private sector….’

Course Director: Professor Dr. Ilona Kickbusch is director of the global health programme at the Graduate Institute.

Co directors:
Professor Tom Novotny Professor of Epidemiology and Biostatistics at the University of California, San Francisco. He is responsible for curriculum development in global health at the UCSF School of Medicine.

Dr. Nick Drager, As the Director of the Department of Ethics, Trade, Human Rights, and Health Law at the World Health Organization,

Dr. Gaudenz Silberschmidt, heads the International Affairs Division of the Swiss Federal Office of Public Health

Dr. Ahmed Ogwell is currently the Team Leader (Implementation Assistance and Partnerships) at the Convention Secretariat of the WHO Framework on Tobacco Control (FCTC).

Consultant: Elizabeth Mc Clintock is a Managing Partner of CMPartners (CMP) and a Director of The Bridgeway Group.

Guest faculty:
Dr. David Heymann is currently Assistant Director-General for Health Security Environment and Representative of the Director-General for Polio Eradication at the World Health Organization (WHO).

Dr. Bendetto Saraceno is the WHO Director of the Department of Mental Health and Substance Abuse.

Dr. Maria Renstrom is a Social Scientist also trained in alcohol- and drug prevention and public health. Since 2007 she is seconded as technical policy officer at the Department of Mental Health and Substance Abuse at the WHO Headquareters in Geneva.

Dr. Delon Human is the President of HEALTHDiplomats, a strategic consulting and advocacy firm based in Geneva.

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[EQ] Do Socioeconomic Gradients in Body Mass Index Vary by Race/Ethnicity, Gender, and Birthplace?

Do Socioeconomic Gradients in Body Mass Index Vary by Race/Ethnicity, Gender,

and Birthplace?

Emma V. Sannchez-Vaznaugh, Ichiro Kawachi, S. V. Subramanian, Brisa N. Sanchez, and Dolores Acevedo-Garcia

Department of Health Education, College of Health and Human Services, San Francisco State University, San Francisco, California (Emma V. Sa´nchez-Vaznaugh);
Center on Social Disparities in Health, University of California, San Francisco, San Francisco, California (Emma V. Sa´nchez-Vaznaugh);
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts (Ichiro Kawachi, Subu Subramanian, Dolores Acevedo-Garcia);
and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan (Brisa N. Sanchez).

This research was supported by the W. K. Kellogg Foundation Fellowship Program in Health Policy Research and the Center for the Advancement of Health (Washington, DC

American Journal of Epidemiology Advance Access published March 18, 2009

Available online at: http://aje.oxfordjournals.org/cgi/content/full/kwp027?ijkey=Kpp9AW3NaS6nzc3&keytype=ref

PDF [11p.] at: http://aje.oxfordjournals.org/cgi/reprint/kwp027?ijkey=Kpp9AW3NaS6nzc3&keytype=ref

“……..Despite the well-documented negative socioeconomic status (SES)gradient in body mass index (BMI; weight (kg)/height (m)²) amongwomen in developed societies, the presence and strength of thegradient is less consistent among men.

Far less clear is theSES patterning of BMI among racial/ethnic minorities and immigrants.Using data from the 2001 California Health Interview Survey,a cross-sectional representative sample of California adults,the authors examined whether the SES patterning of BMI variedacross 4 major US racial/ethnic groups (n = 37,150) by genderand birthplace.

The shape and strength of the relation betweenSES and BMI differed markedly by race/ethnicity; and withinracial/ethnic groups, it varied by gender. Irrespective of race/ethnicity,there were negative income and education gradients in BMI amongwomen; however, there was considerable variation among men.The effect of education on BMI differed by birthplace in somegroups.

A clear education gradient in BMI was found among allUS-born participants, a quadratic education pattern in BMI wasfound among foreign-born Asian men, a flat pattern was foundamong foreign-born Asian women, and no clear pattern was foundin the remaining foreign-born groups.

There is substantial heterogeneityin the contemporaneous SES gradient in BMI. US social disparitiesin BMI require simultaneous consideration of race/ethnicityand SES, but also birthplace.. ….”

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