Health Equity: 06/27/12

Wednesday, June 27, 2012

[EQ] Developmental origins of non-communicable disease: Implications for research and public health

Developmental origins of non-communicable disease:
Implications for research and public health

Robert Barouki1, Peter D Gluckman 2, Philippe Grandjean 3,4, Mark Hanson 5 and Jerrold J Heindel 6

1 INSERM UMR-S 747, Université Paris Descartes, Paris, France

2 University of Auckland New Zealand

3 Environmental Medicine, University of Southern Denmark

4 Harvard School of Public Health, Boston, MA USA

5 University of Southampton, Southampton, UK

6 National Institute of Environmental Health Sciences, Durham, NC, USA

Environmental Health - Published: 27 June 2012

Available online at: http://bit.ly/MUsK5e

“………….This White Paper highlights the developmental period as a plastic phase, which allows the organism to adapt to changes in the environment to maintain or improve reproductive capability in part through sustained health. Plasticity is more prominent prenatally and during early postnatal life, i.e., during the time of cell differentiation and specific tissue formation. These developmental periods are highly sensitive to environmental factors, such as nutrients, environmental chemicals, drugs, infections and other stressors.

Nutrient and toxicant effects share many of the same characteristics and reflect two sides of the same coin. In both cases, alterations in physiological functions can be induced and may lead to the development of non-communicable conditions. Many of the major diseases – and dysfunctions – that have increased substantially in prevalence over the last 40 years seem to be related in part to developmental factors associated with either nutritional imbalance or exposures to environmental chemicals.

The Developmental Origins of Health and Disease (DOHaD) concept provides significant insight into new strategies for research and disease prevention and is sufficiently robust and repeatable across species, including humans, to require a policy and public health response.

This White Paper therefore concludes that, as early development (in utero and during the first years of postnatal life) is particularly sensitive to developmental disruption by nutritional factors or environmental chemical exposures, with potentially adverse consequences for health later in life, both research and disease prevention strategies should focus more on these vulnerable life stages. ….”

KMC/2012/SDE
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[EQ] Citizen Engagement in Health Casebook

Citizen Engagement in Health Casebook

Ian D. Graham, Knowledge Translation and Public Outreach

Canadian Institutes of Health Research

Ottawa, Ontario Canada

Available online PDF [86p.] at: http://bit.ly/NN1hVB

“……Citizen Engagement, sometimes referred to as public involvement or participation, and societal or community engagement, is about meaningful involvement of individual citizens in policy or program development. It generally includes all of the activities organizations take to involve the communities they serve in directing policies and priorities or in their governance.

It also frequently refers to processes where members of the general public, as opposed to representatives of stakeholder groups, are the main foci of the engagement, who are meaningfully involved in two-way interactions consisting of dialogue and deliberation with the health care organization or group. Ultimately citizen engagement is about sharing decision making power and responsibility for decisions.

It is expected that the Casebook will not only increase understanding of how to engage citizens but also increase understanding of the experiences of those undertaking citizen engagement activities. The publishing of this Casebook is an important step in promoting and facilitating citizen engagement by sharing promising citizen engagement practices. …”

Content:

Foreword

Introduction

Case 1: The "public voice" informs HIV service planning at Vancouver Coastal Health

Case 2: Engaging Canadians in the development of a mental health strategy for Canada

Case 3: Campobello Island health and well-being needs assessment (2008-2009)

Case 4: Québec health and welfare commissioner's consultation forum

Case 5: The CommunityView Collaboration

Case 6: Shared challenge, shared solution: Northumberland hills hospital's collaborative budget strategy

Case 7: Our health. Our perspectives. Our solutions: Establishing a common health vision

Case 8: The use of a holistic wellness framework & knowledge networks in Métis health planning

Case 9: Canadian Blood Services' stakeholder engagement for organ and tissue donation

Case 10: Human tissue biobanking in B.C

Case 11: Share your story, shape your care — engaging Northwestern Ontario

Case 12: Consulting Ontario citizens to inform the evaluation of health technologies: The citizens' reference panel on health technologies

Case 13: The Eastern Health patient advisory council for cancer care

Case 14: The Toronto food policy council: Twenty years of citizen leadership for a healthy, equitable, and sustainable food system

KMC/2012/HSS
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[EQ] The Right Start to a Healthy Life - Levelling-up the Health Gradient Among Children Young People and Families in the EU - What Works?

The Right Start to a Healthy Life

Levelling-up the Health Gradient Among Children, Young People and Families in the European Union – What Works?

Edited by Ingrid Stegeman and Caroline Costongs

EuroHealthNet - Brussels, Belgium - March 2012

The Book (220p) – is now online in a ZIP file at: http://bit.ly/L1PJPE

“….In all EU countries there is a systematic correlation between level of health and social status – a step-wise decrease in health that comes with decreasing social position. This correlation exists amongst children and young people as well as amongst adults. These social gradients in health are harmful and unjust, particularly when it comes to children and young people, since adversity during the early years negatively impacts on health across the life-course.

This book aims to improve knowledge on what can be done to level-up gradients in health. It is based on research undertaken during GRADIENT, a project funded under the EU Seventh Framework Programme.

On the basis of concrete examples and national comparisons, it identifies measures that can be taken to level socio-economic gradients in health. It looks at:

•Political and welfare-state factors

•How universal policies on social protection, education and health systems can contribute to reducing gradients in health

•Why social community capital matters

•The importance of monitoring the distributional effects of all policies

•The Gradient Evaluation Framework

•The role of the EU in tackling social gradients in health

The book provides final recommendations for policy makers and practitioners to ensure that all children and young people in the EU get the right start to a healthy life…..”

“…..no single policy or strategy can achieve a reduction of health inequalities and contribute to levelling the health gradient. Instead, it requires cross-governmental strategies, or ‘whole-of-government’ approaches, to develop coherent policies that address unequal distribution of resources in society and improve the underlying conditions that undermine the health of large segments of the population.

Whole-of-government efforts are also necessary to develop holistic approaches to improving the life circumstances of children and young people. If schools, for example, take measures to improve equity but this is not paired with measures to improve other conditions in which children live, these will have less effect.

Similarly, measures to improve access to quality health care will have only a limited impact on reducing morbidity rates among poorer children and young people if the underlying factors that lead to ill health are not also addressed.

It follows from this that most of the policies and interventions that are effective in contributing to levelling-up socio-economic gradients in health are not health-care related. The health sector, however, has an important role to play in ensuring that available public resources are invested in the delivery of good quality health care in proportion to need. It also has a very significant role to play in increasing awareness about health inequalities and socio-economic gradients in health, and in fostering collaborations with other sectors to optimise population health across the gradient…..”

Content:

Executive Summary

chapter 1: Health inequalities among children, young people and families in the EU

chapter 2: Understanding the political context

chapter 3: Examples of policies and interventions to address the health gradient

chapter 4: Working with the community to improve child health equity

chapter 5: Evaluating policies: applying the gradient equity lens

chapter 6: What is the EU doing to address the health gradient of children, young people and families?

Conclusions and recommendations

Glossary

KMC/2012/SDE
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