Thursday, March 29, 2012

[EQ] Primary Care and Public Health: Promoting Integration to Improve Population Health

Primary Care and Public Health:
Promoting Integration to Improve Population Health


Board on Population Health and Public Health Practice (BPH)
US National Academy of Sciences 2012

Available online at: http://t.co/NC3ckflo


“…………
Primary care and public health have critical roles in providing for the health and well-being of communities across the nation. Although they each share a common goal, historically they have operated independently of each other.
However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health. 
The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs.

The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards….”

The review informed the development of a set of principles that the committee believes are essential for successful integration of primary care and public health:

- a shared goal of population health improvement;

- community engagement in defining and addressing population health needs;

- aligned leadership that

— bridges disciplines, programs, and jurisdictions to reduce fragmentation and foster continuity,

— clarifies roles and ensures accountability,

— develops and supports appropriate incentives, and

— has the capacity to manage change;

- sustainability, key to which is the establishment of a shared infrastructure and building for enduring value and impact; and

- the sharing and collaborative use of data and analysis.

 

KMC/2012/HSS
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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;
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“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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[EQ] Monitoring Inequalities in the Health Workforce: The Case Study of Brazil

Monitoring Inequalities in the Health Workforce:
The Case Study of Brazil 1991–2005

Angelica Sousa1,2*, Mario R. Dal Poz1,3, Cristiana Leite Carvalho4

1 Department for Health Systems Policies and Workforce, World Health Organization, Geneva, Switzerland,
2 Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts, United States of America,
3 Institute of Social Medicine, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil,

4 Dental School, Pontifical Catholic University, Minas Gerais, Brazil

PLoS ONE 7(3): e33399. March 27, 2012

Available online at: http://bit.ly/GVD1vg

Both the quantity and the distribution of health workers in a country are fundamental for assuring equitable access to health services. Using the case of Brazil, we measure changes in inequalities in the distribution of the health workforce and account for the sources of inequalities at sub-national level to identify whether policies have been effective in decreasing inequalities and increasing the density of health workers in the poorest areas between 1991 and 2005.

Methods:
With data from Datasus 2005 and the 1991 and 2000 Census we measure the Gini and the Theil T across the 4,267 Brazilian Minimum Comparable Areas (MCA) for 1991, 2000 and 2005 to investigate changes in inequalities in the densities

of physicians; nurse professionals; nurse associates; and community health workers by states, poverty quintiles and urban-rural

stratum to account for the sources of inequalities.

Results:
We find that inequalities have increased over time and that physicians and nurse professionals are the categories of health workers, which are more unequally distributed across MCA. The poorest states experience the highest shortage of health workers (below the national average) and have the highest inequalities in the distribution of physicians plus nurse professionals (above the national average) in the three years. Most of the staff in poor areas are unskilled health workers.

Most of the overall inequalities in the distribution of health workers across MCA are due to inequalities within states, poverty quintiles and rural-urban stratum.

Discussion:
This study highlights some critical issues in terms of the geographical distribution of health workers, which are accessible to the poor and the new methods have given new insights to identify critical geographical areas in Brazil. Eliminating the gap in the health workforce would require policies and interventions to be conducted at the state level focused in poor and rural areas….”

 

KMC/2012/SDE
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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]
Washington DC USA

“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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PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
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IMPORTANT: This transmission is for use by the intended
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recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
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any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.