Health Equity: May 2011

Friday, May 27, 2011

[EQ] Consultation: Draft Technical Paper for World Conference on Social Determinants of Health - comments by 3 June 2011

World Conference on Social Determinants of Health

Consultation on Draft Technical Paper from 9May - 3 June 2011

Comments welcome by Friday 3 June 2011

Conference website: www.who.int/sdhconference/

Consultation page: www.who.int/sdhconference/consultation

The World Conference on Social Determinants of Health (WCSDH) is being convened by WHO and kindly hosted and supported by the Government of the Federative Republic of Brazil.

The World Conference will take place in Rio de Janeiro from 19 to 21 October 2011.

WHO is currently undertaking a public consultation on the current draft of the Technical Paper for the Conference to elicit comments and feedback.
The Technical Paper aims to provide policy-makers with an overview of key strategies to implement action on social determinants of health to reduce health inequities and contribute to broader development, organized by the five Conference themes. The final version of this paper will inform discussions at the Conference.

Comments on this current draft are welcome by Friday 3 June 2011 and can be submitted at the Consultation webpage above.

In particular, comments are sought on whether the draft fulfils its aims to inform the five themes of the Conference, and whether any major strategies for implementation of action on social determinants have been omitted.

The main themes that will be tackled during the Conference are:

· Governance to tackle the root causes of health inequities: implementing action on social determinants of health

· The role of the health sector, including public health programmes, in reducing health inequities

· Promoting participation: community leadership for action on social determinants

· Global action on social determinants: aligning priorities and stakeholders

· Monitoring progress: measurement and analysis to inform policies on social determinants

The aim of the Conference is to bring Member States and other actors together to catalyze high level political support for national policies to address social determinants of health to reduce health inequities. Its specific objectives are to:

· strengthen political commitment by Member States to develop and implement national policies on social determinants of health to reduce health inequities;

· share experiences, challenges and technical knowledge on addressing social determinants of health, taking into account the need for strengthening governance arrangements and learning from different contexts.

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
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health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]
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[EQ] Migration and Health: A Framework for 21st Century Policy-Making

Migration and Health: A Framework for 21st Century Policy-Making

Cathy Zimmerman, Ligia Kiss, Mazeda Hossain

Gender Violence & Health Centre, Social and Mathematical Epidemiology Group, Department of Global Health & Development,
London School of Hygiene & Tropical Medicine, London, United Kingdom

PLoS Med 8(5): e1001034. doi:10.1371/journal.pmed.1001034 – May 2011

Available online at: http://bit.ly/k0nFNU

“……With an estimated 214 million people on the move internationally and approximately three-quarters of a billion people migrating within their own country, there can be little doubt that population mobility is among the leading policy issues of the 21st century [1]–[3]. Human migration is not a new phenomenon, but it has changed significantly in number and nature with the growth of globalization, including the ease of international transport and communication, the push and pull factors of shifting capital, effects of climate change, and periodic political upheaval, including armed conflict.

As a result, migrant networks that facilitate mobility and circular migration, in particular, have expanded in unprecedented ways [4],[5]. Yet, there has not been commensurate development of coordinated policy approaches to address the health implications associated with modern migration. Internationally, policy-making on migration has generally been conducted from policy sector “silos” (e.g., international aid, security, immigration enforcement, trade, and labor) that rarely include the health sector and which often have different, if not incompatible, goals [6],[7].

As discussions on “global migration governance” and “global health governance” expand, it will be increasingly important for policy-makers to engage in cross-sector coordination and move beyond narrow protectionist policy approaches, such as migrant-screening, and the simplistic view of migration as a one-way trajectory [8].

Health policy-making in the context of migration has generally been viewed either in terms of its “threats” to public health or from a rights-based approach that focuses on health hazards faced by individual migrants and the associated service challenges [9]. The former lens dates back to medieval quarantine measures and prioritizes public health security and communicable disease control, relying heavily on monitoring and screening (e.g., tuberculosis, pandemic flu). The rights-based perspective is more recent and grounded in medical ethics. It recognizes migrants' special vulnerability to, for example, interpersonal and occupational hazards, social exclusion, and discrimination, and the importance of universal access and culturally competent health care services [10]….”

Summary Points:

- Migration is a global phenomenon that influences the health of individuals and populations.

- Policy-making on migration and health is conducted within sector silos that frequently have different goals. Population mobility is wholly compatible with health-promoting strategies for migrants if decision-makers coordinate across borders and policy sectors.

- Policies to protect migrant and public health will be most effective if they address the multiple phases of the migratory process, including pre-departure, travel, destination, interception, and return. Health intervention opportunities exist at each stage.

- This article forms the introduction to a PLoS Medicine series on Migration & Health, laying out a new framework for understanding the migratory process and the five phases of migration, which are discussed in depth in five subsequent articles.

* * *
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]
Washington DC USA

Thursday, May 26, 2011

[EQ] Health in Brazil - towards sustainability and equity in health

Health in Brazil - towards sustainability and equity in health

The Lancet – Website http://bit.ly/iAayVm

May 9, 2011

“……..Brazil has made significant improvements in maternal and child health, emergency care, and in reducing the burden of infectious diseases. But the news is not all good. The country continues to have a burden of injury mortality that is different from other countries due to the large number of murders, especially using firearms. Obesity levels are increasing and caesarean section rates are the highest in the world.

Brazil now has the opportunity to move closer towards its ultimate goal of universal, equitable, and sustainable health care as enshrined in the 1988 Constitution. To highlight this opportunity, The Lancet is publishing a Series of six papers that critically examine what the country’s policies have achieved and where future challenges lie. As Cesar Victora and colleagues conclude in the final paper of the Series: “the challenge is ultimately political, requiring continuous engagement by Brazilian society as a whole to secure the right to health for all Brazilian people.”

Series Comments

Brazil: towards sustainability and equity in health

Sabine Kleinert, Richard Horton

Brazil: structuring cooperation for health

Paulo Buss

Brazil’s health-care reform: social movements and civil society

Sonia Fleury

Higher education and health care in Brazil

Naomar Almeida-Filho

The impact of the Brazil experience in Latin America

Ricardo Uauy

Series Papers

The Brazilian health system: history, advances, and challenges

Jairnilson Paim, Claudia Travassos, Celia Almeida, Ligia Bahia, James Macinko

Maternal and child health in Brazil: progress and challenges

Cesar G Victora, Estela M L Aquino, Maria do Carmo Leal, Carlos Augusto Monteiro, Fernando C Barros, Celia L Szwarcwald

Successes and failures in the control of infectious diseases in Brazil:
social and environmental context, policies, interventions, and research needs

Mauricio L Barreto, M Gloria Teixeira, Francisco I Bastos, Ricardo A A Ximenes, Rita B Barata, Laura C Rodrigues

Chronic non-communicable diseases in Brazil: burden and current challenges

Maria Inês Schmidt, Bruce Bartholow Duncan, Gulnar Azevedo e Silva, Ana Maria Menezes, Carlos Augusto Monteiro, Sandhi Maria Barreto, Dora Chor, Paulo Rossi Menezes

Violence and injuries in Brazil: the effect, progress made, and challenges ahead

Michael Eduardo Reichenheim, Edinilsa Ramos de Souza, Claudia Leite Moraes, Maria Helena Prado de Mello Jorge, Cosme Marcelo Furtado Passos da Silva, Maria Cecília de Souza Minayo

Health conditions and health-policy innovations in Brazil: the way forward

Cesar G Victora, Mauricio L Barreto, Maria do Carmo Leal, Carlos A Monteiro, Maria Ines Schmidt, Jairnilson Paim, Francisco I Bastos, Celia Almeida, Ligia Bahia, Claudia Travassos, Michael Reichenheim, Fernando C Barros,

[EQ] OECD Looks To Measure The 'Better Life'

Compendium of OECD well-being indicators

OECD May 2011

Website: http://bit.ly/iZ41bq

PDF at: http://bit.ly/jYuhRo

In terms of focus, the Compendium provides evidence on:

· the well-being of people in each country, rather than on the macro-economic conditions of economies; hence, many standard indicators of macro-economic performance (e.g. GDP, productivity, innovation) are not included in this Compendium.

· the well-being of different groups of the population, in addition to average conditions. Measures of inequalities in people‟s conditions will figure prominently in the "How‟s Life?" report but are only discussed briefly in this Compendium.

· well-being achievements, measured by outcome indicators, as opposed to well-being drivers measured by input or output indicators.

· objective and subjective aspects of people‟s well-being as both living conditions and their appreciation by individuals are important to understand people‟s well-being.

In terms of scope, the framework distinguishes between current material living conditions and quality of life, on the one hand, and the conditions required to ensure their sustainability over time, on the other

- Material living conditions (or „economic well-being‟) determine people‟s consumption possibilities and their command over resources. While this is shaped by GDP, the latter also includes activities that do not contribute to people‟s well-being (e.g. activities aimed at offsetting some of the regrettable consequences of economic development) while it excludes non-market activities that expand people‟s consumption possibilities.

- Quality of life, defined as the set of non-monetary attributes of individuals, shapes their opportunities and life chances, and has intrinsic value under different cultures and contexts.
- The sustainability of the socio-economic and natural systems where people live and work is critical for well-being to last over time. Sustainability depends on how current human activities impact on the stocks of different types of capital (natural, economic, human and social). However, suitable indicators for describing the evolution of these stocks are still lacking in many fields. For this reason, indicators of sustainability are not included in this Compendium, although some of them will feature in "How‟s Life?".

OECD Looks To Measure The 'Better Life'. "It is time to move beyond gross domestic product when measuring the success of societies, the Organization for Economic Co-operation and Development (OECD), has concluded in a change of mission for the international organization….The OECD's new Better Life Index, an amalgam of 11 indicators, including income and jobs, but also life satisfaction and safety, aims to capture the diversity of life and priorities in advanced economies.

Unlike existing composite indicators users of the new OECD index can give each of the 11 indicators a different weight according to their own preferences and see how such changes alter the league table of countries…." [Financial Times]

"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members".
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Tuesday, May 24, 2011

[EQ] Epidemiology and the People's Health Theory and Context

Epidemiology and the People’s Health Theory and Context

Krieger, Nancy, Professor, Harvard School of Public Health

Oxford Scholarship Online: May 2011

Print ISBN-13: 978-0-19-538387-4 - doi:10.1093/acprof:oso/9780195383874.001.0001

Website: http://bit.ly/ko0GOJ

“……Epidemiology is often referred to as the science of public health. However, unlike other major sciences, its theoretical foundations are rarely articulated. While the idea of epidemiologic theory may seem dry and arcane, it is at its core about explaining the people's health. It is about life and death. It is about biology and society. It is about ecology and the economy.

It is about how myriad aspects of people's lives – involving work, dignity, desire, love, play, conflict, discrimination, and injustice – become literally incorporated into our bodies and manifest in our health status, individually and collectively. And it is about essential knowledge critical for improving the people's health and minimizing inequitable burdens of disease, disability, and death. Tracing the history and contours of epidemiologic from ancient societies on through the development of – and debates within – contemporary epidemiology worldwide, this book shows how epidemiologic theory has long shaped epidemiologic practice, knowledge, and the politics of public health.

Outlining an ecosocial theory of disease distribution that situates both population health and epidemiologic theory in societal and ecologic context, it offers a more holistic picture of how we embody the human experience. This concise, conceptually rich, and accessible book is a rallying cry for a return to the study and discussion of epidemiologic theory: what it is, why it matters, how it has changed over time, and its implications for improving population health and promoting health equity. It should be required reading for all epidemiologists, or anyone involved in the study of human health and well-being….”

Table of Contents

Preface

1. Does Epidemiologic Theory Exist?

2. Health in the Balance

3. Epidemiology Emerges

4. Epidemiology Expands

5. Contemporary Mainstream Epidemiologic Theory

6. Social Epidemiologic Alternatives

7. Ecosocial Theory of Disease Distribution

8. Epidemiologic Theory Counts

Bibliography