bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide Attempts and Self-Inflicted Injury Among a National Cohort of Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury
Authors: Oni Olurinde , Singh Vikas , Sharma Rishi , Sharma Mukut , Sharma Ram , Oehlert Mary , Thakur Hemant
Published: January 2025

Background: Suicide rates are on the rise globally. Many suicide completers are previous attempters. Risk identification of attempters will provide an opportunity for prompt and targeted intervention towards suicide prevention. The aim of this study was to determine the incidence of suicide attempt and self-inflicted injury (SASI), and its associations with deployment-related PTSD and/or TBI and attempted suicide among a large national cohort of Veterans deployed pre and post-9/11 2001 who received care from the Veterans Health Administration (VHA) between 1998 - 2014.
Methods: Clinical data from over 1,400 VHA establishments provided by the Veterans Administrations Informatics and Computing Infrastructure (VINCI) were used for descriptive and Cox regression analyses.
Results: There were 1,327,604 patients in the study - PTSD only (1,121,818), TBI only (100,033), both PTSD and TBI (105,753). The incidence of SASI in the entire cohort was 351 per 100,000 person years; PTSD only (323), TBI only (181), both PTSD and TBI (835). Compared to TBI only group, the adjusted risk for SASI was higher in the PTSD only group (HR=1.129; 95% CI =1.063 - 1.200) and much higher in those with both PTSD and TBI (HR=2.283; 95% CI =2.136 - 2.441). The risk of SASI was higher if they were younger than 50 years, divorced or separated, non-Hispanic females, homeless, suffered adult abuse and neglect, had substance use, generalized anxiety and antisocial personality disorders, and if they were in the Pre-9/11 service period. Proportion of people attempting suicide increased every year post-diagnosis of PTSD and/or TBI.
Conclusion: We recommend prioritizing resources to prevent suicide among at risk groups.
The lady at the top of the building
Authors: Vargas Iris Mónica
Published: January 2025

When the winds had made full display of their fury, on September 2017, and silence had befallen, a hurricane had only then began its onslaught. It is what happens after, what changes you, and not the roaring of the invisible, wide, spiraling mouth arriving from the sea. Years ago, when I was a little girl, my family and I experienced Hurricane Hugo. We lived then in a small barrio in the mountains of Puerto Rico. Our house was humble as was everything else around us. We didn’t have much in the way of economic resources. No common pleasures such as dinning out on Fridays or any other day of the week, no vacation trips to other countries, no fancy schools, no luxuries of any kind. A single gift each Christmas. We lived in a house that my father built all by himself, with wood that soon enough had rotten at the bottom, through which I became acquainted daily with the varied population of insects with whom we shared our surroundings. The structure we called home had one window in the front of the house. Everything else — the entire one bedroom/bathroom the house contained -- was dark. My father worked very hard, changed jobs every few years, and saved money all of his life, diligently, such that one day he could build what would become our next house: a structure made of cement that would take thirty years of work (by all of us), and patience (from all of us), to almost finish. It was that structure, a quarter of it already erected, that would help us survive after hurricane Hugo.
The PrEP recommendation: the inscribed disease in a healthy body
Authors: Wolfgang Simone , Portinari Denise
Published: January 2025

In July 2014, the World Health Organization (WHO) recommended that all gay men join the “pre exposal medication Truvada” as a valid resource to prevent HIV. The PrEP, prophylaxis consists in taking a combination of antiretroviral medication once a day, in order to prevent HIV infection. The WHO promotion of a policy that recommends all HIV negative gay men to join the PrEP, may be seen, in the context of contemporary biopolitical techniques and strategies, as a form of control and medicalization of homosexual bodies and practices. It´s important to explicit the life-related effects linked to a measure like the PrEP program, considering this as a paradigm shift in HIV/Aids strategies. The shift involves the gradual substitution of the “condom use” recommendations for the use of permanent prophylactic medications, and may be understood as a move away from the abstinence paradigm – sexual behavior control – to a more contemporary form of individual medicalized body biocontrol, as outlined by Foucault in his later texts.
This measure also exposes a delicate aspect of the social conduction of the HIV/Aids epidemics: the stigmatization related to the gay community as the ultimate risk group. Affirming that every homosexual should take the PrEP pill, may have the effect of perpetuating the idea that gay men are the main vector of this disease. Among the misconceptions that this may involve are the perpetuation of prejudice related to Aids and gay men, leading heterosexual populations to believe that they are not connected in the epidemic chain.
Assessing vulnerability to HIV of migrant female students: A Mixed method exploratory study
Authors: Gautam Vaishali , Sharma Arun Kumar , Bhasin Sanjay
Published: January 2025

Background and methodology
Female migrants have been identified to be at higher risk of HIV infection in comparison with male migrants, but the evidence is limited. The present study was conducted among novel group i.e. migrant female college student using a mixed-method approach to explore their vulnerability and risk to acquire HIV infection. Sample of 100 female migrant college students of Delhi University, of the age 18 and 23 years were selected from March 2015 to April 2016 and administered semi-closed questionnaire followed by in-depth interviews.
Results
Mean age of sexual initiation was 18.7 years. Twenty-one percent respondents had inadequate HIV related knowledge and 10% of respondents showed high-risk sexual behaviour as none used a condom consistently. Statistically, a significant association was observed between respondent’s high-risk behaviour and having friends who were sexually exposed (p < 0.005), also with respondent’s partner’s current place of residence (p
The second wave of the COVID-19 epidemic in Cuba: the sixth- and seventh-month flare-ups
Authors: Beldarraín-Chaple Enrique , Alfonso-Sánchez Ileana R. , Vidal-Ledo María
Published: January 2025

In Cuba, the first cases of COVID-19 were diagnosed on March 11, 2020, that month 212 positives were accumulated (rate 2.9 x 100,000 inhabitants), they rose to 1,325 in April (11.8 x 100,000 inhabitants), on April 24 the largest number of cases of the epidemic was reported. In May, the accumulated cases were 2083 (rate 4.9 x 100,000), they decreased in June (265, rate 2.4 x 100,000), remaining endemic for several weeks. In August and September the number of positives increased in several provinces, while other provinces went up to 100 days without reporting cases. Severe and critically ill cases increased (32 severe in June and 317 in September and 12 critical in June and 73 in September). The increase in positives in those months was related to violations of health protocols to control transmission. In August, measures were established to regulate population mobility in the capital and in four other western provinces, and cases decreased at the end of September, although they remained high in the provinces of Havana, Ciego de Ávila and Matanzas (rates of 37 , 0; 113.0 and 13.3 x 100,000 inhabitants respectively). The decrease in cases showed the relevance of the measures, which were made more flexible at the end of September due to economic needs and to reactivate social life.The objective of this work is to describe the epidemiological situation of the months of August and September 2020 during the COVID-19 epidemic in Cuba.
The Social Pandemic of COVID-19 in Latin America. Reflections from Collective Health
Authors: Jarillo Soto Edgar C.
Published: January 2025

The book is structured as a preface, followed by an initial chapter and three sections with three chapters each. The preface was written by Oliva López Arellano, a pillar of the postgraduate program from which those trained in collective health in Mexico come from (she is also the current Secretary of Health of the Mexico City Government), she situates the topic of COVID-19 in a conjunctural and historical perspective from the angle of collective health; in addition to synthesizing the approaches and contributions of each chapter. It is a significant text in itself with considerations where the theory is articulated with the reality of the Latin American context, leaving some valuable reflections open and many others with possible derivations from what is pointed out.
The Role of the Healthy and Atractive Body in the Culture of Individualism.  Body Work and the Lifestyle of the ‘New Middle Class’
Authors: Olko Dorota Zofia
Published: January 2025

Within the change in the organization of social life and the decline in the
importance of its collective regulators, issues concerning the body have
been privatized and the body began to be seen as a reflexive project.
The increasing interest in the body, ith health and image, should be situated in the context of changes in the rules that integrate the social system, which resulted in the individualism becoming basic form of sociality in Western societies.
Analysis of strategies of body work shows that they are embedded in the
lifestyle of the new middle class. The bodily practices characteristic for
the ethos of the middle class emerged as a hegemonic ones, while
obesity and negligence are presented in popculture as sins of the
working class, which serves as the legitimisation of existing inequalities.
The Predictive Model of the Fertility Pattern of Young Women (15-24 Years Old) In South Sulawesi, Indonesia
Authors: Haerana Bs. Titi , Widiastuty Lilis , Adnan Yudi , Ekasari Ranti , Sadarang Rimawati Aulia insani , Wijaya Dian Rezki , Fadila Wisnu , Basri Syahrul
Published: January 2025

Teenagers that have given birth have a high chance of a total fertility rate and prevalence. The study aimed to analyze the contribution of demographic and socio-economic factors, access to information, sexual activity, and literacy on family planning on the fertility pattern of young women (15-24 years old). This research uses 2017 data from the Indonesian Demography and Health Survey (IDHS). Data analysis performed multiple logistic regression with a predictive model. The predictors of young female fertility (15-24 years old) were marital status (aOR: 373.9, 95%CI 112.7-1239.8), age of 19-21 years old (aOR: 7.74, 95%CI 2.19-27.32), age of 22-24 years old (aOR: 4.79, 95%CI 1.61-14.32), a low education level (aOR: 2.53, 95%CI 0.94-6.82), unemployed (aOR: 2.73, 95%CI 1.14-6.55) or working in agriculture (aOR: 1.16, 95%CI 0.19-6.87), and low (aOR: 1.79, 95%CI 0.73-4.41) or medium (aOR: 1.58, 95%CI 0.42-5.87) wealth index, based on SKDI's 2017 data. There needs to be an improvement in the education access to increase job opportunities and improve the socio-economic conditions of the community. This improvement will have positive impacts in preventing adolescent marriage and decreasing the fertility rate of young women
The Role of Social Media in Covid-19
Authors: Alomiry Helial
Published: January 2025

The current narrative review aimed to evaluate the effects and role of social media in covid-19 pandemic. The examinations show that web-based media has been utilized to share perspectives, medical care, and social distancing during the Covid-19 emergency. However, social media networks have also been used in spreading bogus information to the general public during the Covid-19 pandemic. Along these lines, utilizing web-based media can be an important method for experts and governments to forestall the spread of this virus and even incomparable future emergence. The paper has contributed in many aspects like offering opportunity and remediation on the negative effects of social media during covid-19 such as the spread of misinformation to the general public. In addition, enhancement of public health practitioners’ reliance on social media as a tool for appropriate information dissemination as well as assists media personnel in understanding the gravity of the situation and the barriers to effective communication of public health messages.
The refounding of health systems in Latin America and the Caribbean. New hope from the South
Authors: Hernández Reyes Antonio
Published: January 2025

Several decades after the first wave of state reforms, we can observe the neoliberal disaster manifested in an era of intense demonstrations, protests and struggles against exclusionary policies in Latin America and the Caribbean.
In that first stage of state reform, loans from international organizations were promoted, serving as a basis for the construction of legal frameworks (constitutional reforms, laws, decrees, ministerial resolutions, among others),1,2. This facilitated the installation, in the political symbolic plane, of a structural crisis of the State in Latin American and Caribbean societies.
Racism and discrimination in the care of Totonaca women in Veracruz, Mexico: the need for intercultural competencies
Authors: Dörr Niels Michael , Dietz Gunther
Published: January 2025

Target. Racism is a health inequality that has been neglected. The objective is to examine maternal health in rural Mexico with respect to the different forms of discrimination.
Material and methods. The research is based on anthropological fieldwork carried out in the Sierra del Totonacapan region in Veracruz, Mexico.
Results. We empirically distinguish and document omissions and violations of human rights, before analyzing the sources of racism from an intersectional perspective, according to which gender, class and race constitute closely linked sources of discrimination.
Conclusions. Finally, we propose an intercultural competence approach to confront racism at its confluence with other ideologies. This approach is aimed at professionals as conscious, reflective and transforming actors of intercultural interactions.
The risk factors of obesity among adolescents during the covid-19 pandemic in the province of North Sumatera
Authors: Purnama Tri Bayu , Apriliani Apriliani , Siregar Rani Elviyanti , Hardja Bebby Alfiera Riyandina , Insani Arrafi
Published: January 2025

Objectives : The COVID-19 pandemic has resulted in low levels of physical activity in adolescents and an increase in diet and frequency of irregular eating in adolescents due to the social restrictions of the COVID-19 pandemic. Design : This research was conducted using a quantitative analytic approach with a cross-sectional study design. Participant : This study population were all adolescents aged 15-23 years at junior high school, high school, vocational high school, and university. The sample in this study were 127 adolescents. Data collection uses primary data online (Google form). The research instrument used the GPAQ (Global Physical Activity Questionnaire) questionnaire and the FFQ (Food Frequency Questionnaire) questionnaire instrument. The data analysis of this study used univariate analysis and bivariate analysis using the chi-square test. Result : The study results had a significant relationship between the history of obesity and the incidence of obesity. In adolescents during the COVID-19 pandemic (p = 0.000; PR = 3,930), there was a significant relationship between carbohydrate consumption patterns and the incidence of obesity in adolescents during the COVID-19 pandemic (p = 0.005; PR = 1.423), there was a significant relationship There is a significant difference between the pattern of consumption of vegetable protein and the incidence of obesity in adolescents during the COVID-19 pandemic (p = 0.043; PR = 2.305), there is a significant relationship between the pattern of consumption of animal protein and the incidence of obesity in adolescents during the COVID-19 pandemic (p = 0.031; PR = 2.287), and there is a significant relationship between the pattern of fast food consumption and the incidence of obesity in adolescents during the COVID-19 pandemic (p = 0.01 8; PR = 1.575).

Conclusion : This study concludes that there is a significant relationship between a history of obesity and the incidence of obesity in adolescents, there is a significant relationship between patterns of carbohydrate consumption, there is a significant relationship between patterns of consumption of vegetable protein, there is a significant relationship between patterns of animal protein, there is a significant relationship between fast food consumption patterns on the incidence of obesity in adolescents during the COVID-19 pandemic.
Health Reform and its Impact on Healthcare Workers: A Case Study of the National Clinical Hospital of Cordova, Argentina
Authors: Machado Ana Lia , Giacone Marta , Álvarez Carlos , Carri Pablo
Published: January 2025

Since the mid 1990’s, health in Argentina has no longer been considered a social function of the State but was transformed into a market commodity. Neoliberal decentralization favored the introduction of corporate methods and incentivized privatization. In practice, this led to self-management for hospitals, deregulation of social services and incorporation of private capital to the public health business. This exploratory study looks at the impact of these reforms in the public health services sector. It analyzes living and working conditions, changes produced in the organization of work and their effect on labor relations and on participation in union, political and social activities by workers at the National Clinical Hospital of Cordoba, Argentina. Data was primarily collected through an interview survey of a convenience sample of 68 workers from the non-teaching staff; this represents 10% of the total professional, administrative and maintenance staff of the hospital. The interviews demonstrate deterioration in income and living conditions. Hospital self-management for these workers led to increased competition, the fragmentation in the work spaces, tension and the distrust between co-workers, as well as increased intensity in the workload of some employees. The profile of these healthcare workers is structured and marked by silence, the resolution of the conflicts by means of individual action in the workplace, and minimal participation in social-political-union or community organizations.
Households Headed By Women and Physical Growth of Schoolchildren in Tláhuac, D.F. (Mexico)
Authors: Peña Saint Martin Florencia , López Alonso Sergio
Published: January 2025

The present work is part of a research program examining the role of the family as mediator between basic human vital functions and social macro-processes. In order to evaluate conditions affecting physical development we examined the age-normed weight and stature of 410 primary school children who were enrolled in public primary schools of the Tláhuac delegation (one of the 16 political delegations in Mexico City). All schoolchildren had received a merit scholarship for their academic performance and were from poor families. Standardization of height and weight was done using the norms of the U.S. National Center for Health Statistics.

110 of these schoolchildren (68 girls and 42 boys) lived in households led by women. Among the 48 children with growth problems 15 (31%) were from female-led households. This finding indicates that this group of students has grown up in environments that have negatively affected their growth. Among growth delayed children households headed by women were over-represented at a rate almost double that of the general
population. This data from schoolchildren with scholarships from the Tláhuac program demonstrates clearly the feminization of poverty and the structural vulnerability these women who single-handedly maintain households in conditions of poverty. At least among our subjects, we can conclude that households headed by women suffer a greater degree of poverty, that this poverty is passed on between generations and that it has a negative impact on children's wellbeing (as documented through growth parameters).
The Etiology, Concept, and Prophylaxis of Childbed Fever (excerpts)
Authors: Semmelweis Ignac
Published: January 2025

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The Brasilian health reform: A victory over the neoliberal model
Authors: Cohn Amelia
Published: January 2025

This paper sketches the panorama of changes resulting from the Health System Reforms initiated in Brazil since the mid-seventies, exploring the political and structural limitations of the process, the social and political strategies used, and current proposals for reorganizing Brazil’s “Unified Health System” (known as the SUS). The SUS is one of the world’s largest public health systems. The central theme of this analysis and presentation is that the Brazilian Health System Reform is a Latin American example of an alternative health project, democratic and universal, based on the premises of Social Security, that its implementation was feasible, and, once implemented, resistant to obstruction by conservative neoliberal forces.
A Student Perspective on ELAM and its Educational Program
Authors: Remen Razel , Holloway Lillian
Published: January 2025

The health of the world’s population is divided into two groups, those who have access to health care services and those who do not. The effects of this divide can be seen on the international level where life expectancy in Switzerland averages 80 years as opposed to 38 years in Zambia. Infant mortality rates are often used as a general indicator of health and socioeconomic conditions since rates are affected by factors such as access to prenatal health care. A direct relationship has been shown between higher income and education level and lower rates of infant mortality. This may explain in part an infant mortality rate of 4.5 per 1,000 live births in Connecticut in comparison with 12.2 in the Washington, D.C. area. A major influence in access to services is the availability of trained health care workers. The World Health Organization estimates that the world will need at least 4,250,000 additional health workers to address these health disparities3. In the face of this work force crisis we are left wondering how to fill in the gaps left by the mass exodus of health workers from developing nations to industrialized ones. Cuba has tried to address these problems by sending thousands of healthcare professionals to work in some of the most impoverished and medically underserved regions in the world. Over the years, their attempts have evolved to include training professionals from underserved areas to provide enduring sources of health care for their populations. Perhaps the most valiant of efforts was the creation of the Latin American School of Medicine in Cuba (called ELAM, Escuela Latinoamericana de Medicina), which currently is training over 10,000 students from at least 27 countries, including the United States. Despite ELAM’s impressive numbers, its founders recognized that solutions to what has become a global health care crisis depend not only on the number of physicians produced but also on how they are trained to be providers of care. To that end training is oriented toward primary care, public health and hands-on clinical experience. Perhaps no one can speak better about the training at ELAM than the actual students
Health Reform in Mexico City, 2000-2006
Authors: Laurell Asa Cristina
Published: January 2025

With the goal of fully guaranteeing the constitutional right to health protection, Mexico City’s leftist administration (2000-2006) undertook a reform to provide health services to people without insurance. The reform had four components: free medicine and health services; the introduction of a new service model (MAS); the strengthening, expansion, and improvement of services, and legislation to ensure that the city government become guarantor of this constitutional right. The reform resulted in 95% of eligible families being enrolled in free care; expansion of health care infrastructure with the construction of five new health care centers and a 1/3 increase in the number of public hospital beds in impoverished and disadvantaged areas; increased access to and use of health services particularly by the poor and for expensive interventions; and the legal guarantee of the continuity of this policy. The implementation of this new policy was made possible through an 80% budget increase, improvements in efficiency, and a successful fight against corruption. The health impact of the reform was seen in decline of mortality rates in all age groups between 1997 and 2005 (22% for child mortality, 11% for economically active age groups, and 7.9% for retired age groups) and by a 16% decline in AIDS related mortality between 2000 and 2005. This reform contrasts with the health care reform promoted by the right wing Federal government in the rest of the country; the latter was based on voluntary health insurance, cost-sharing by families, access to a limited package of services, and gradual enrollment of the population
Health in Uruguay: Progress and Challenges in the Right to Health Care Three Years after the First Progressive Government
Authors: Borgia Fernando
Published: January 2025

Using a social medicine perspective, this article describes the Frente Amplio [Broad Front] government strategies for creating a more social, productive, democratic, innovative, and culturally integrated Uruguay. This nation will recognize health as a basic human right, is concerned about the general well being of its population, and understands the need for public health reform.

The present health reform is at the heart of Uruguay’s current social, economic and political transformations, changes which have a moral-ethical and social justice dimension. The health proposal calls for substantive transformation, requiring three parallel progressive changes: in health care delivery, in health care management and in health care financing.

The current reform has created a mixed private-public Integrated National Health Care System and an increasingly well funded National Health Insurance program. The process is new and evolving, transcendent, democratic, and participatory.

Keywords: social medicine, right to health, human rights, reform, Integrated National Health Care System.
Experiences in Popular Education in Sandinista Nicaragua
Authors: Lemus Maria Felisa
Published: January 2025

Working as a doctor in the war zone, the different strategies of popular participation in health management and action are recounted, even in the midst of the war conflict. The article deals with experiences particularly in Popular Education.
Maquila Workers’ Health: Basic Issues, What is Known, and a Pilot Study in Nicaragua
Authors: López Lylliam Perpetuo , Blanco R. Luis , Aragón B. Aurora , Partanen Timo
Published: January 2025

Occupational health issues identified in maquilas include respiratory, musculoskeletal, psychological problems, and accidents. This study identifies the basic health issues, as well as the sources and investigational methods needed for drafting health standards for maquilas. It sets out conceptual guidelines, suggesting general methodological strategies appropriate for studies of workers’ health and its determinants in the maquiladora sector. The conceptual-methodological model is based on 1) a review of relevant studies, 2) a mixed methods pilot feasibility study within the community of workers and social actors of a textile maquila in Nicaragua, and 3) the conceptual-methodological integration of a literature review with the results of the pilot study.

The main issues identified are the organization of work, health, governmental regulation, family and gender, infrastructure and environment. Methodological recommendations focus on the
principle of triangulation; the use of anonymous questionnaires and focus groups to examine specific issues; individual interviews with management personnel and members of the community; and the value of family members as key informers on the impact on family, environment and community. Observation of actual work procedures is ideal but not always possible. A joint health and safety committee and a health services unit would be key instruments in the prevention of accidents and illness and in health promotion and care.
Adentro Barrio Adentro: An American Medical Student in Venezuela
Authors: Trotzky Sirr Rebecca
Published: January 2025

First hand account from Medical Student from the United States as a participant observer in Barrio Adentro community health program in Venezulea.
Venezuela's Barrio Adentro: participatory democracy, south-south cooperation and health care for all
Authors: Muntaner Carles , Armada Francisco , Chung Haejoo , Rosicar Mata , Williams-Brennan Leslie , Benach Joan
Published: January 2025

Preface In the 1990s Latin American countries, with the exception of Cuba, undertook reforms in their health systems. In general, they followed a pattern similar to that adopted in other parts of the world by pursuing a neoliberal agenda that included the promotion of changes designed to achieve greater participation of the private sector in the funding and delivery of health services. Despite the different modes of reform, all strengthened the view of health as a consumer commodity and favored abandonment of the concept of health care as a right guaranteed by the state. Most of the changes implemented corresponded to the policies of structural adjustment, in accordance with the neoliberal paradigm recommended by international financial institutions with the aim of guaranteeing payments of the external debt (1-4). After several years of application, the negative impact of neoliberal health policies has been demonstrated by its inability to improve coverage or access to health services. These consequences coincide with the general failure of neoliberalism to improve quality of life; thus, Latin America remains the region of the world with the greatest inequalities between social classes. These persistent inequalities have motivated a variety of political responses in Latin America, including proposals advocated by liberal left-wing sectors in various countries of the region that are contrary to neoliberalism and include the promotion of policies to reverse privatization of health care while asserting it as a right guaranteed by the state. The amendments to the Venezuelan health system are one of the earliest examples of this type of reform. From 1999 onward, after a decade of implementing neoliberal policies, a marked adjustment in the health system was initiated to establish health as a fundamental right guaranteed by the state in a context of broad participation of organized communities and international (“South-South”) cooperation. This article describes the primary health care reforms in Venezuela, formalized as “Misión Barrio Adentro” (Inside the Neighborhood) from 2003 onwards. We begin with an analysis of the neoliberal model that existed in Venezuela at the time changes in health policy were initiated. This is followed by an explication of Barrio Adentro in its historical, political and social context, pointing to the central role played by popular resistance to neoliberalism. We continue with a description of its operation, consolidation, analysis of the first indicators of the program’s impact on health, and the discussion of the main challenges to a guarantee of sustainability. We conclude by suggesting that Barrio Adentro not only provides a model for health care reform in other countries of the region, but that it also offers important lessons for countries throughout the world, including those with the most powerful economies.
Seize the Hospital to Serve the People: A video interview with activist Cleo Silvers
Authors: Chu Carolyn
Published: January 2025

Cleo Silvers is an activist and community/labor organizer who has been working in New York City since the 1960s. In this interview, she illustrates her background growing up in Philadelphia and how it led to experiences as a young VISTA volunteer in New York. Although her initial advocacy efforts and organizing began in the South Bronx school systems, Cleo relates how she quickly became fascinated with emerging public health issues in the Bronx and specifically with the poor care given to disadvantaged community members by local hospitals. As a community mental health worker and member of the Black Panther Party and Young Lords, Cleo played key roles in events which led to the 1970 peoples’ takeover of Lincoln Hospital (See Social Medicine, Volume 2, No 2, 2007), one of the most poorly-run city hospitals in the late 1960s. She recounts approaches and specific tactics used by community groups that helped reform the delivery of health care in previously-neglected neighborhoods of the South Bronx. This interview describes the birth of Cleo’s long-standing dedication to civil and social justice, and is an important example of how activists and workers can effectively implement change in the social conditions of their communities. This video can be viewed at: http://www.socialmedicine.org/media/
Psycho-social and Economic Evaluation of Onchocerciasis: A Literature Review
Authors: Moya Alonso Laura , Murdoch Michelle Esther , Jofre-Bonet Mireia
Published: January 2025

Background: Onchocerciasis or river blindness is a chronic parasitic disease caused by the filarial nematode Onchocerca Volvulus. It occurs in 38 countries in the world, including Africa, Latin America and the Arabian Peninsula. The infection predominantly causes visual impairment and blindness and skin disease.

Objectives: The aim of this project is to review the literature on the psycho-social and economic consequences of onchocerciasis in endemic areas. Economic evaluation studies on onchocerciasis and its control programmes were also reviewed.

Methods: Electronic searches of PUBMED and Google were made. In addition, the Cochrane Library and WHO website were searched. Different types of economic analysis were reviewed to quantify the relationship between the programme costs and impacts.

Results: Eighty papers were identified from different sources, most of which are quantitative studies or literature reviews, and only two were clinical trials.
Onchocerciasis has severe socio-economic and psychological consequences. The stigma associated with the disease may reduce marital prospects among affected individuals, disrupt social relationships and cause loss of self-confidence. Also among agricultural workers onchocerciasis has been associated with increased time away from work and reduced productivity, leading to lower income.

Discussion: Most of the papers analysed were cross-sectional studies based on data collection through questionnaires. Although there is an increasing number of published papers about the importance of the psycho-social and economic perspective of onchocerciasis, further research is still necessary to quantify and control its consequences.

Conclusion: Onchocerciasis is still a serious problem in poor countries. Infected people face physical disability and social stigma that can dramatically reduce the quality of life and land productivity. Control programmes, though costly, have been very successful and cost-effective. Priority should be given to the development of new tools to support control programmes and to enable eradication of the disease.
Should India Use Commercially Produced Ready to Use Therapeutic Foods (RUTF) for Severe Acute Malnutrition (SAM)
Authors: Prasad Vandana , Holla Radha , Gupta Arun
Published: January 2025

Globally, nearly 20 million children under five suffer from Severe Acute Malnutrition (SAM), a condition which contributes to one million child deaths annually. In India 48% of children under five years of age are stunted and 43 percent are underweight; almost 8 million suffer from SAM. Malnutrition is not a new problem in India, nor is SAM. Several hospitals and non-government organizations are engaged in community-based management of malnutrition using locally produced/procured and locally processed foods along with intensive nutrition education. These programs enable parents to meet the nutritional requirements of their children with foods that are available at low cost. The Supreme Court of India has also directed the government to universalize the Integrated Child Development Scheme and provide one hot cooked meal to children under six years of age to supplement their nutrition.
Your Health Care in Crisis: A Health/PAC Special Report [1972]
Authors: Burlage Robb
Published: January 2025

Your Health Care in Crisis:
A HEALTH/PAC Special Report

Fourth Printing, November 1972

Reproduced from the US Heath Activism History Collection
Rare Book and Manuscript Library, University of Pennsylvania

HealthPAC online
http://www.healthpaconline.net/

"This is the first in a series of pamphlets published by the Health Policy Advisory Center (Health-PAC). It analyzes the forces in the health system that prevent most Americans from getting good health care. How can that system be changed so that good health care is a right for all? Around the country emerging community and worker groups are working to transform the present health system into one that will provide high quality, low-cost, accessible health care for all. Health-PAC, an independent, non-profit research and education organization, works with and services these groups. Health-PAC has information available on patient's rights: health worker issues: community and worker struggles to change health institutions; the organization and financing of health care: Blue Cross: national health insurance proposals: and many other health care topics."
Poverty and Health in Argentina
Authors: Silva Maria Alejandra
Published: January 2025

This article examines health conditions in the rural areas of Central Argentina, the country’s main region for soy-bean production and export. Health conditions are analyzed through the concepts of emerging and re-emerging diseases in a context of increasing poverty.
Data on poverty and health was obtained from both primary sources (trade union, government officials, rural doctors and the South Watch/FA/FODEPAL/UNR working group) and secondary sources (IPEC/INDEC, IDESA, Consultora Equis, the Argentine Ministry of Employment, ILO, the Ministry of Health, the Ministry of the Environment, toxicology centers and rural doctors).
Analysis of rural health conditions gives cause for concern. There is evidence of deterioration in the social determinants of health such as an increase in rural and urban poverty associated with informal employment and child labor. At the same time lack of government epidemiological and toxicological data appears to hide or distort the reality of health conditions.
Latin American Social Medicine and the Report of the WHO Commission on Social Determinants of Health
Authors: González Guzmán Rafael
Published: January 2025

In October 2008 the Latin American Social Medicine Association (ALAMES) organized an international workshop entitled “The Social Determinants of Health.” Representatives of ALAMES’ seven regions participated in discussions of the various consultative papers prepared by the working groups of the WHO Commission on the Social Determinants of Health as well as the Commission’s final report. The workshop considered how ALAMES should respond to the work of the Commission. In this paper we summarize the main points outlined in the position paper prepared by the Organizing Committee1 as well as a synopsis of the main contributions made by each of the workshop’s study sections.
The Health Consequences of the Diversion of Resources to War and Preparation for War
Authors: Sidel Victor W. , Levy Barry S.
Published: January 2025

Armed conflict damages health in many ways. These include death and disability directly caused by war, destruction of the societal infrastructure that supports health and safety, forced migration of people both within their own country and as refugees to other countries, promotion of violence as a method to settle conflicts and disputes, and the long-term adverse effects on social relationships.

This special issue of Social Medicine examines the impact of war on human health from a geographically diverse set of countries and from diverse perspectives. Dr. Andrea Angulo Menasse, a researcher from Mexico City’s Autonomous University, documents the very personal story of how the violence of the Spanish Civil War affected one family. In her case study the trauma suffered by Spanish Republicans is traced through three generations and crosses the Atlantic Ocean as the family moves is exiled in Mexico. Dr. Sachin Ghimire from the Centre of Social Medicine and Community Health of the Jawaharlal Nehru University reports on his fieldwork in Rolpa, Nepal, the district from which the Nepal Civil War (also called the People’s War) originated in 1996. Based on 80 interviews, he documents the difficulties faced by health care workers as they negotiated the sometimes deadly task of remaining in communities where control alternated between Nepalese Special Forces and the Maoist rebels. Finally, Colombian researcher, Carlos Iván Pacheco Sánchez, from the University of Rosario in Bogota, brings an epidemiologist’s tools to examine the impact of the ongoing armed conflict in the border Department of Nariño. His discussion is informed by the current debate over health care in Colombia where a recent Constitutional Court decision has found that the current health care system violates the right to health. These three papers amply demonstrate the depth, breadth and relevance of contemporary social medicine.
The Peckham Experiment: An Introduction
Authors: Karnik Arati
Published: January 2025

“Health is everyone’s birthright; the pity is that so many lose it. In spite of our vast sickness services…the burden of ill-health in the community remains heavy…all this study of disease does not reveal to us the laws of health. It is health itself which must be studied. We must devise laboratories where we can put health, too, under a lens, look at it, discover how it behaves, and find out in what conditions it can grow and spread.”
From Health of The Individual, of the Family, of Society

The Peckham Experiment was one of the 20th century’s most innovative programs in community medicine, influencing the community health movement around the world. It was the brainchild Dr. George Scott Williamson and Dr. Innes H. Pearse, two medically trained biologists who were also a married couple. Both were researchers with experience in the early diagnosis and investigation of disease, and yet they came to the conclusion that studying disease was not the route to attaining or understanding health.
Safeguarding Primary Healthcare: A Case Study of Barbados
Authors: Rodney Patricia , Copeland Esker
Published: January 2025

The concept of primary health care has regained prominence as many countries around the globe face rising health costs and failed health systems. This study examines Barbados, a developing country in the eastern Caribbean, which has consistently included the concept of primary health care in all of its development plans. Based on the government's stated commitment to Health for All, this review was conducted to examine whether this focus has prevailed. The purpose of this paper was to identify some of the advancements or reversals of primary health care policy in Barbados.
Socialist government health policy reforms in Bolivia and Ecuador: The underrated potential of integrated care to tackle the social determinants of health
Authors: Tejerina Herland , Soors Werner , De Paepe Pierre , Aguilar Santacruz Edison , Closon Marie-Christine , Unger Jean-Pierre
Published: January 2025

Background
Selective vertical programs prevailed over comprehensive primary health care in Latin America. In Bolivia and Ecuador, socialist governments intend to redirect health policy. We outline both countries’ health system’s features after reform, explore their efforts to rebuild primary health care, identify and explain policy gaps, and offer considerations for improvement.

Methods
Qualitative document analysis.

Findings
Earlier reform left Bolivia’s and Ecuador’s population in bad health, with limited access to a fragmented health system. Today, both countries focus their policy on household and community-based promotion and prevention. The negative effects on access to care of decentralization, dual employment, vertical programming and targeting are largely left unattended. Neglecting care is understandable in the light of particular interpretations of social medicine and social determinants, international policy pressures, reliance on external funding and institutional inertia. Current policy choices preserve key elements of selective care and consolidate commodification. It might not improve health and worsen poverty.

Interpretation
Care can be considered as a social determinant on its own. Key to the accomplishment of primary care is an integrated application of family medicine, taking advantage of individual care as one of the ways to act on social determinants. It deserves a central place on the policy-makers’ priority list, in Bolivia and Ecuador as elsewhere.
Socio-anthropological analysis of bariatric surgery patients: a preliminary study
Authors: Navas López Julia
Published: January 2025

Using socio-anthropological analysis, this paper presents preliminary results of an inter-disciplinary investigation entitled “A nutritional and anthropological study of patients with type III and IV obesity undergoing bariatric surgery.” The medical ethnographic approach employed in this study has two goals: to study patients’ cultural context before and after surgical treatment and to analyze perceptions, representations, social inte-gration, stigmatization, and social control before and after surgery. The results show potential discrimination against these patients based on their group identification and a permissive environment; these ideas are manifested in the concepts of the “obesogenic society” and the “obese victim.” On the other hand, the process of medicalization provides a mechanism capable of both social inclusion and exclusion. The results of this preliminary analysis are informing ongoing work between patients and professionals in this nutritional study.
Latin American Social Medicine Association: Agenda 2009 – 2011
Authors: Heredia Miranda Nila , Rovere Mario
Published: January 2025

From the 14th to the 19th of November 2009 we spent five intense days during the Congress developing this electoral platform with the input offered by national delegations to all candidates for the General Coordinator position. The contributions by the national delegations demonstrated their interest in the future of ALAMES. It was an intensive learning experience for us made up of conversations with delegations and participants, the challenge and effort of incorporating the various mandates given to us by the pre-Congress courses, the round table discussions, the commission, the plenary and multiple conversations in coffe breaks and the corridors. We have also attempted to incorporate those declarations which seemed to generate the most enthusiasm and those commentaries which we heard over and over again in our conversations. Finally, we congratulate all those who have made this Congress so productive, so moving, and so diverse; the presence of social movements has expanded the diversity and wealth of voices heard at the Congress.
We know from previous experiences that elections are often associated with tension. Yet elections can also serve to stimulate discussion at a Congress. In our case, the election has encouraged us to create this proposal. This is a proposal which could not have been developed prior to the Congress since it is the outcome of dialogues, expectations, and discoveries made during our conversations. We offer it to the members and institutions associated with ALAMES as a roadmap for their commentary, discussion, and criticism.