bluuebunny/crossref_metadata_2025 huggingface dataset:
Polio Can Be Conquered: Science and Health Propaganda in the United States from Polio Polly to Jonas Salk
Authors: Rogers Naomi
Published: September 2009

In the 1940s and 1950s, health officials in the United States regularly published popular guides to polio prevention, therapeutic manuals for the care of paralyzed patients, and inspirational tales of the disabled polio victims overcoming social stigma and achieving success. These tracts became a potent publicity tool to popularize faith in scientific research as the best weapon in the fight against disease. The popularized polio literature combined medical theory, philosophy, public health policy, and frequently a commercial message. Long before the polio vaccines were developed, health experts—especially those employed by the National Foundation for Infantile Paralysis (NFIP)—made scientific research a public enterprise, in which even obscure scientific questions could be laid out and debated.
The Impact of Improved Nutrition on Disease Prevention
Authors: Semba Richard D.
Published: September 2009

In the 20th century, major progress was made in the near elimination of many nutritional deficiencies disorders in the United States such as rickets, pellagra, iodine deficiency, infantile scurvy, iron deficiency due to hookworm, and subclinical levels of vitamin A deficiency and folate deficiency. The vitamins and their roles in human health were characterized, and dietary requirements were established. The landmark studies of Joseph Goldberger revealed that the cause of pellagra was nutritional rather than infectious. The fortification of foodstuffs, nutrition education, home gardening, and federally supported feeding programs all were aimed at improving the nutrition of the U.S. population. The American diet also evolved in light of the newer knowledge of nutrition. Despite the tremendous advances in the 20th century, obesity and other challenges remain for nutrition and public health efforts in the 21st century.
Safer, Healthier Workers: Advances in Occupational Disease and Injury Prevention
Authors: Robbins Anthony , Landrigan Philip J.
Published: September 2009

During the 20th century, the American workforce has faced many types of job-related injury and illness, ranging from exposure to hazardous chemical agents to extreme emotional stress and trauma. Such exposures and experiences can have numerous negative health outcomes, which can manifest immediately or after varying periods of time. The range of illness caused by work is broad and can involve every organ system; diseases linked to occupation in the last century include malignant mesothelioma in workers exposed to asbestos; bladder cancer in dye workers; and pneumoconiosis in coal miners. Conditions can be either acute or chronic and are manifested through classic symptoms or subtle clinical changes. This chapter examines the epidemiology of occupational disease and injury in the United States during the 20th century; introduces heroes such as Alice Hamilton in advancing occupational medicine; and explains the successes and failures in the prevention of occupational disease and injury.
A Prejudice Which May Cloud the Mentality: The Making of Objectivity in Early Twentieth-Century Occupational Health
Authors: Sellers Christopher
Published: September 2009

Today, environmental health professionals assess hazards in the workplace or the outside air by comparing sampled levels against official Threshold Limit Values (TLV's). But before today's reliance on quantitative tools for correlating atmospheric chemical levels to disease, industrial health practices were neither primitive nor unscientific. Medical and scientific researchers wrote at once for physicians or hygienists and for those without scientific training. Their knowledge itself remained closely tied to preventive interventions as well to curative ones. A quantitative chemical approach to occupational disease took shape following World War I, with the advent of a new community of experts, centered in the public health schools, in company medical clinics and in state divisions of industrial hygiene.
The Nut Behind the Wheel: Shifting Responsibilities for Traffic Safety Since 1895
Authors: Albert Daniel M.
Published: September 2009

This chapter sets the science of safety within a historical context, revealing how permeable the boundary between science and society has been in dealing with auto safety. Over the 20th century the focus of improving safety has sometimes emphasized regulating cars, while at other times controlling drivers. Initially, the democratization of car ownership led to a focus on the driver; after World War II there arose more concern with crash survivability, and automobile and road design. Toward the end of the 20th century, concern for unsafe drivers—drunk-driving, unsafe and undertrained teenage drivers, aggressive driving, and so forth—reemerged as an important factor in reducing vehicular death and injury.
Thank You for Not Smoking: The Public Health Response to Tobacco-Related Mortality in the United States
Authors: Eriksen Michael P. , Green Lawrence W. , Husten Corinne G. , Pederson Linda L. , Pechacek Terry F.
Published: September 2009

Given the broad acceptance of the cigarette in society, the dramatic reduction in smoking over the 20th century is an extraordinary achievement. During the last third of the century, smoking rates and per capita consumption of cigarettes were cut in half, and exposure to second hand smoke declined dramatically. As a result, more than one million deaths potentially caused by tobacco were avoided, resulting in gains in life expectancy and quality. This chapter reviews the actions attributed to this achievement, including the dissemination of scientific information on the dangers of active and passive smoking, clinical strategies to help persons quit smoking, and the legal and economic strategies to create disincentives for tobacco use. The marketing of tobacco continues resulting in a continual state of action and reaction between private industry and public health. Despite the health advances, smoking remains the leading preventable cause of death for American men and women.
Epilogue: Public Health at the Dawn of the Twenty-First Century
Authors: Koplan Jeffrey P. , Thacker Stephen B.
Published: September 2009

In the 21st century, trends in demographics, climate, globalization, and technology will alter the social fabric of the United States and the world with tremendous implications for health. To position the nation for the century ahead, the country's medical, scientific, and public health leaders must devote attention and resources to at least ten tasks: 1) develop a rational and equitable approach to public health and clinical care; 2) eliminate health disparities among racial and ethnic populations; 3) focus on child development; 4) meet demands of an aging population; 5) modify lifestyles including eating and physical activity; 6) protect the environment; 7) respond to emerging infectious pathogens; 8) promote mental health; 9) prevent violence; and 10) harness new science and technology to benefit health. In the 21st century, the causes of morbidity and mortality are likely to change; public health institutions must identify and anticipate these changes through excellent science and effective practice.
The Guide to Community Preventive Services
Authors: Task Force on Community Preventive Services
Published: September 2009

This book is a primary resource on how to improve health and prevent disease in states and communities. The book uses systemic review methods to evaluate population-oriented health interventions. The recommendations of the Task Force on Community Preventive Services are explicitly linked to the scientific evidence developed during systematic reviews. This book examines the effectiveness and efficiency of interventions to combat such risky behaviors as tobacco use, physical inactivity, and violence; to reduce the impact and suffering of specific conditions such as cancer, diabetes, vaccine-preventable diseases, and motor vehicle injuries; and to address social determinants on health such as education, housing, and access to care. The chapters are grouped into three broad categories: changing risk behaviors; reducing specific diseases, injuries, and impairments; and methodological background for the book itself.
The Socioeconomically Disadvantaged
Authors: Marmot Michael , Bell Ruth
Published: September 2009

This chapter asserts that inequality in the conditions under which people live and work translates into inequalities in health, and that this inequality is unjust. It discusses that socioeconomic disadvantage is more than low income and describes the impact of social injustice on the socioeconomically disadvantaged. Lifestyle does provide a partial explanation for the social gradient in health, but lifestyle is related to socioeconomic status. The chapter describes the roots and underlying factors of social injustice and what needs to be done. It concludes that health of the population and inequalities in health are markers of how a society is meeting the needs of its members, and that society may benefit if our set of social arrangements were to move toward a situation where control over one's life and full social participation are more equitably distributed.
People With Disabilities
Authors: Groce Nora Ellen
Published: September 2009

This chapter addresses social injustice as it affects people with disabilities. Boxes in the chapter address disability and education, similarities and differences among people with different kinds of disabilities, and disability during times of disaster and political upheaval. The chapter describes the roots and underlying issues of social injustice against people with disabilities, and what needs to be done.
Incarcerated People
Authors: Drucker Ernest M.
Published: September 2009

This chapter deals with social injustice as it affects incarcerated people. It covers mass incarceration and race, collateral damages of incarceration, health of prisoners, the effects on prisoners' families and communities, economic disenfranchisement, and civic death (felony disenfranchisement). It also discusses the roots and underlying causes of this social injustice, and what needs to be done, including improving community services, providing better health services for those who are incarcerated, reforming drug law, repealing mandatory sentencing laws, assisting family members, and addressing voting disenfranchisement. The chapter asserts that reforms are needed to change drug policies to reduce criminalization of drug use, and to apply a public health model to address drug problems worldwide, replacing prosecution with effective treatment, education, and prevention.
Homeless People
Authors: Gelberg Lillian , Arangua Lisa
Published: September 2009

This chapter addresses social injustice directed to homeless people. It consider how social injustice affects the health of homeless people, including their health status, substance abuse, obesity, and sedentary lifestyle, mental health, mortality, health care access and utilization, and disparities in health status. The chapter also addresses roots and underlying issues concerning this social injustice, and what needs to be done. It concludes that consideration of the health of homeless persons globally should not be limited to addressing their health and substance abuse problems, but also should address attitudes toward the treatment of the poor worldwide, as well as welfare and housing policies.
Medical Care
Authors: Geiger H. Jack
Published: September 2009

This chapter addresses how social injustice affects medical care. It addresses the health care crisis and social justice, in terms of access, cost, and quality. The chapter concludes that universal health access through public-sector social insurance must become part of the American social contract, restoring the primacy of the interest of patients and providers in a just and equitable system.
Infectious Diseases
Authors: Mukherjee Joia S. , Farmer Paul E.
Published: September 2009

This chapter describes how social injustice affects the occurrence and severity of infectious diseases. It describes structural inequalities and the disproportionate burden of many infectious diseases on the poor. It identifies roots and underlying factors, including inadequate support for public works and infrastructure, social and economic rights, economic freedom, and access to treatment. It describes what needs to be done to address these problems. The chapter concludes that social justice in global public health requires a commitment to eliminating the structural violence that puts communities at risk and to treating the population's most heavily affected by infectious disease.
Mental Health
Authors: Muntaner Carles , Geiger-Brown Jeanne
Published: September 2009

This chapter addresses social injustice in relation to mental health, including access and quality of treatment. It describes what needs to be done, including grassroots advocacy for the rights of those with mental illness.
Environmental Health
Authors: Butler Colin D. , McMichael Anthony J.
Published: September 2009

This chapter describes social injustice in relation to environmental health. It covers the scale and distribution of environmental health hazards, the relationship between social injustice and environmental health, in terms of water contamination, air pollution, soil contamination, food contamination, and exposure to chemicals and global climate and ecosystem change. The chapter also describes the impact of globalization on environmental health. It describes what needs to be done, including achieving environmental justice, creating greater awareness of the cost of environmental hazards, harnessing sufficient political and economic will, reducing exposure to hazardous chemicals, performing epidemiologic research, and reforming organizations and institutions.
Addressing Social Injustice In A Human Rights Context
Authors: Gruskin Sofia , Braveman Paula
Published: September 2009

This chapter describes what needs to be done to address social injustice in a human rights context. It covers core concepts, human rights as legal standards and obligations of government, human rights as a conceptual framework for analysis and advocacy, and human rights as guiding principles for designing and implementing policies and programs. The chapter concludes that human rights treaties and other agreements can provide important mechanisms to strengthen accountability of governments who are moving toward greater social justice in health. It further argues that health workers should be aware that human rights norms, standards, laws, and accountability mechanisms are highly relevant tools that can enhance efforts to achieve social justice in health, both globally and within countries.
Promoting Social Justice Through Education In Public Health
Authors: Lawrence Robert S.
Published: September 2009

This chapter describes how social justice can be promoted through education in public health. It discusses principles of social justice and education in public health, including the logic of science added to moral and ethical reasons for social justice and the historical context of social justice and public health. It describes how education in public health can be used to promote social justice and puts forward an agenda for action.
Protecting Human Rights Through International And National Law
Authors: Weiss Peter , Freedman Henry A.
Published: September 2009

This chapter discusses the protection of human rights through international and national law. It describes how international and national law can reduce social injustice and provides specific examples of how law has improved social justice. It provides an agenda for action, both internationally and in the United States. The chapter asserts that enforceable economic, social, and cultural rights represent the only sure bulwark against social injustice. It concludes that lawyers must go to court, victims of social injustice must “take to the streets,” and activists must lobby their elected representatives—these are the paths for fighting social injustice and achieving human rights.
Roots of the Problem
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

This introductory chapter provides demographic information about the prevalence of disability among U.S. residents and outlines population trends suggesting rising numbers of persons with disabilities. It also reviews concerns about health care quality in the United States, drawing upon reports of the Institute of Medicine and other sources to describe worrisome quality shortfalls, especially affecting persons with chronic health conditions. It suggests that persons with disabilities confront particular risks of receiving substandard care, along a variety of dimensions of quality and access.
Defining Disability
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

Disability has numerous definitions, and different definitions conjure up varying assumptions about the lives and expectations of persons with disabilities. This chapter explores the historical roots of these definitions and the rationale for different perspectives, providing broad overviews of the medical and social models of disability. It then reviews several major definitions of disability in the United States, including those of the Social Security Administration and the Americans with Disabilities Act. It concludes by describing the definition used by the World Health Organization, which guides perspectives throughout the book.
Getting into and around Health Care Settings
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

This chapter describes the physical barriers persons with disabilities can encounter when they visit health care settings, including difficulties opening doors, inaccessible restroom facilities, and examining tables that are too high for persons to access. It also examines problems encountered by patients who have blind or low vision as they try to navigate health care settings, including staff being unaware of appropriate ways to assist them with transiting through space (e.g., use of sighted guides). The chapter presents information about relatively low use of screening and preventive services among persons with mobility problems, and relates these findings to inaccessible equipment and other access barriers. Given higher rates of obesity and overweightness among persons with disabilities, particular issues relating to access for persons who are obese are also discussed.
Etiquette during Physical Examinations and Interactions with Office Staff
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

Interpersonal interactions during physical examinations and medical procedures convey volumes about respect, empathy, and understanding. Listening and following patients' instructions, such as about transferring them from a wheelchair to examination table, can also determine the safety of both patients with disabilities and clinical staff. This chapter examines etiquette within health care settings, starting with first contacts with office staff at the check-in desk and following patients through waiting rooms and into the examining or testing room. It identifies challenges patients with disabilities face in trying to accommodate their needs for positioning and appropriate communication during clinical interactions. The chapter also discusses telephone communication for persons who are deaf or hard of hearing.
Pushing against Boundaries of the Health Care System
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

The factors outside the traditional health care system—or straddling the boundary between health care and other sectors—can often have huge implications for persons' health and well being. This chapter briefly explores four such topics: assistive technology, personal care assistance, accessible public transportation, and accessible housing. It looks at controversies about health insurance coverage of these items and services.
Using Universal Design to Accommodate All
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

Universal design is the notion of considering all potential users when designing places, information, communication, and other items, services, and policies. This book builds upon universal design concepts in its final chapters, which propose solutions to the barriers described in earlier chapters. This chapter starts this process by describing the origins and tenets of the universal design movement. Examples of basic principles of universal design include equitable use, flexibility in use, simple and intuitive use, and low physical effort in use.
Accessible Communication and Information
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

This chapter starts by considering the Americans with Disabilities Act and regulatory requirements for ensuring effective communications with persons with disabilities. It then reviews approaches for accommodating communication needs, ranging from simple approaches (such as large point fonts and Braille signage) to an increasingly sophisticated range of communication technologies for persons with a wide variety of accommodation needs. For example, the chapter describes various technologies that assist persons who are blind or who have low vision, as well as communication strategies and technologies for persons who are deaf or hard of hearing. It also describes the training and professional obligations of sign language interpreters.
Designing Accessible Health Care Settings
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

This chapter addresses the design of health care settings that are accessible to persons with physical and sensory disabilities. It starts by reviewing Americans with Disabilities Act regulations. It then discusses a process for designing accessible space, including the involvement of persons with disabilities as partners. The chapter reviews such items as lighting, acoustics, flooring, air quality, heating and cooling, emergency notification alarms, and signage as well as basic questions about the size and configuration of spaces, medical equipment, and furniture. It offers suggestions about accessible equipment, such as weight scales.
Healthy and Accessible Communities
Authors: Iezzoni Lisa I. , O'Day Bonnie L.
Published: September 2009

The community environments within which people live have enormous consequences for their health. This chapter reaches beyond health care settings into communities to explore briefly those attributes that make communities safe and welcoming to persons with disabilities, and that allow all residents to participate fully in community life. It argues that demographic imperatives force the need for greater public policy focus on making accessible built environments. With an aging population and growing rates of obesity, along with declining rates of physical fitness, planners should emphasize building environments that support independent living and promote physical activity, healthy eating, and other positive health-related behaviors. Healthy built environments can improve not only physical health but also mental health, over the life span. The chapter briefly reviews examples from other countries of efforts to construct walkable communities and discusses challenges to bringing those changes to the United States.
Car Culture, Transport Policy, and Public Health
Authors: Kjellstrom Tord , Hinde Sarah
Published: September 2009

This chapter discusses the health impacts of car reliance. The various health impacts caused by the modern private motor-vehicle-based transport system includes car crash injuries, lung and heart effects of vehicle-related air pollution, disturbance and blood pressure effects of noise, reduced physical activity and associated obesity, and community disruption from major roads. In addition, greenhouse gases, climate change, and other environmental issues are considered. While there is a convincing and growing body of evidence on these effects, further research is required to fully quantify and understand them. Moreover, comprehensive assessments of the health impacts of transport systems and the value of interventions are essential.
The Consequences of Economic Globalization on Working Conditions, Labor Relations, and Workers’ Health
Authors: Hogstedt Christer , Wegman David H. , Kjellstrom Tord
Published: September 2009

This chapter highlights the health risks of globalization without preventive systems and makes reference to the international efforts to ensure effective worker protection programs are in place. The improved global information and communications systems create new opportunities for occupational health advocacy that can help bring about such programs.
Health Impact Assessment: Toward Globalization as If Human Rights Mattered
Authors: O’Keefe Eileen , Scott-Samuel Alex
Published: September 2009

Health impact assessment (HIA) is a set of tools, methods, and processes for policy making. It does this by examining potential consequences for health of policy options. This chapter explores HIA as applied to globalization. It outlines what HIA is, points to debate about its nature, and gives an example of its use in the European Union. The European Union's use of HIA provides opportunities to examine consequences for less powerful players in global policy formation. Migrant communities in high-income regions such as the European Union can be key participants in HIAs relating to global policy.
Poverty Reduction Strategy Papers: Bold New Approach to Poverty Eradication or Old Wine in New Bottles?
Authors: Wamala Sarah , Kawachi Ichiro , Mpepo Besinati Phiri
Published: September 2009

This chapter focuses on poverty reduction strategy papers (PRSPs). PRSPs were introduced by the World Bank and International Monetary Fund (IMF) in September 1999 as a new requirement for countries to receive concessional funding and debt relief. PRSPs are national planning frameworks, and describe a country's macroeconomic, structural, and social policies and programs to promote growth and reduce poverty, as well as associated external financing needs. PRSPs may signal an improvement on structural adjustment programs (SAPs) but still have some distance to go in recognizing and addressing issues such as equity and gender disparities. Although it is too soon to appraise the outcomes of PRSPs, some skepticism has been voiced in some quarters that they are SAPs by another name.
What’s Politics Got to Do with It? Health, the G8, and the Global Economy
Authors: Schrecker Ted , Labonte Ronald
Published: September 2009

This chapter examines the pledges made by developed countries, particularly the rich club of G8 nations, to make globalization work better for the world's poor. It shows that contrary to the ringing rhetoric, they find that levels of foreign aid remain pitifully inadequate.
Assessing Quality: Today’s Data and a Research Agenda
Authors: Williams Christine G.
Published: September 2009

This chapter looks at the proximate causes of declining trust involving people's experiences with the healthcare system. Trust busters include their perceptions of the system, inadequate communication between patient and physician, disparities in healthcare access and treatment, and medical errors. It proposes building trust using the patient-centered care model which places patients as decision makers, participants, and evaluators of their own care.
Trustworthy Information: Medical Journals and the Internet
Authors: Lundberg George D.
Published: September 2009

Trustworthy information is a central requirement of a working healthcare system. This chapter describes how trust is important in medical communications, both in the published word and in medical information on the internet. It discusses the peer review system in the print journals and how the same is accomplished for the certain online sources through a code of ethics. It argues that the medical internet is fundamental to the evolving healthcare system of the future. It describes the central principles of such a system, called E-care. A list of action items for physicians to establish patient trust is included.
Trustworthy Information: The Role of the Media
Authors: Lieberman Trudy
Published: September 2009

Healthcare journalism cannot always be trusted to provide accurate and reliable healthcare information, as past history has shown. Several examples of the media reporting distorted healthcare information are detailed in this chapter. The line separating the editorial and publishing sides of media is vanishing, as the revenue needs of the media have increased. This dynamic reduces impartiality of healthcare reporting in favor of increased revenue generation. This chapter describes media reliance on so-called expert advice to provide healthcare information, in lieu of the reporter having done adequate research. It also describes tip journalism as an inadequate form of healthcare reporting.
Confusion at the Table: Can We Trust That Our Food Is Healthy?
Authors: Willett Walter C.
Published: September 2009

Eating is essentially an act of trust because we trust that the food that we eat, most of which we are not responsible for farming or processing, is safe. However, instances of food contamination and confusing dietary recommendations occur. This chapter examines to what extent we can trust the information we receive from the government and other organizations regarding food safety and health. It discusses the confusion about trans fats and carbohydrates in nutrition as an example of how dietary advice is frequently misleading, misinterpreted, and not based on strong scientific evidence.
The Changing Relationship between Health Plans and Their Members
Authors: Cutler Charles M.
Published: September 2009

Managed care organizations (MCOs) provide a unique service by monitoring and assessing areas for improvement in healthcare. A brief historical account of the development of health insurance in the U.S. contextualizes the development of MCOs. MCOs attempt to keep healthcare affordable by holding providers accountable. Employers embraced health plans in the 1990s with the expectation that they would help save money. However, critics and the public started to believe that health plans' primary interest was in saving money instead of coordinating care, improving access, and providing preventative medicine. This chapter argues that consumers are unaware of how MCOs have brought a new emphasis on transparency and accountability to the healthcare system. Instead, consumer misunderstandings about their health plan choices, the care that is covered, and the cost and quality of MCOs, have led to significant trust issues. The chapter concludes by offering suggestions of how these trust issues can be addressed by increasing communication and responsiveness between MCOs, patients, and providers.
Building Trust in a Healthcare System
Authors: Dowling Michael J.
Published: September 2009

Leaders of the healthcare industry must be active in helping to restore patient trust. Unfortunately, healthcare executives are often more focused on lobbying for higher reimbursements than building trust. Seeking higher revenue is valid within reason, but this chapter argues that healthcare organizations should focus on factors they can control, such as improving operations and hospital management. The chapter uses experiences from the North Shore-Long Island Jewish (LIJ) Health System to discuss what executives can do to build trust, without more money. The suggestions given include earning trust from employees, as well as patients; encouraging continuous learning, leadership, and innovation among employees; building personal relationships with employees; and improving all aspects of service, not just medical care.
Building Trust in the Clinician’s Office and at the Bedside
Authors: Toran Richard , King Howard
Published: September 2009

This chapter discusses how the everyday actions of physicians can affect their patients' trust. It focuses on a few basics to build trust: communication, professionalism, adherence to the paradigm of patient care, and an understanding of the healthcare environment. It points out that the current high cost of medical care is largely responsible for eroding patient trust, and suggests ways for physicians to help patients understand and reduce these costs. The chapter provides suggestions to incorporate a more psychosocial approach to the clinical interview that could help increase trust and satisfaction in the patient-physician relationship. It concludes by providing a checklist of actions physicians can take to improve the patient-physician relationship.
Conclusion: Trust in Healthcare, Trust in Society
Authors: Roberts Marc J.
Published: September 2009

Patients as consumers are playing an increasingly large role in the healthcare system and medical decision-making. This shift in roles suggests trust must be a central feature in every healthcare organization's competitive strategy in order to attract and retain patients. This chapter focuses on why trust is critical, and yet so difficult to cultivate at the organizational level; why building trust is more difficult in the healthcare sector than other industries; how trust can lead to competitive advantage; and possible responses for managers to address the trust issue. Medical care is based on scientific research, but still relies on physician intuition and judgments that may be mistaken. Instead, the healthcare industry should support well-designed studies so that physicians can provide evidence-based care. The chapter examines the two components of trust—competence and conscience—and how these two aspects exist and interact in modern medicine.
Interactive Role of Genes and the Environment
Authors: Frank John , Lomax Geoffrey , Baird Patricia , Lock Margaret
Published: September 2009

While enthusiasm for discovering genetic correlates of disease is currently widespread, it is important to view genetic mechanisms as only part of the “web of causation” of population health and as a modest component of approaches to improving population health status. This chapter argues that most common diseases in technologically advanced societies are multifactorial in origin, meaning that they are the product of complex interactions between our genetic endowment and our environment, acting over the course of a lifetime. The usefulness of genetics is also limited by the fact that there are profound difficulties in the implementation of broad-based genetic screening and intervention programs at the population level that would be required if new genetic knowledge were to radically alter disease frequency in entire societies. The chapter examines these argument with the use of several examples.
Global and Local Perspectives on Population Health
Authors: Lock Margaret , Nguyen Vinh-Kim , Zarowsky Christina
Published: September 2009

While much of the research on the impact of social conditions on health has focused on the notion of “determinants of health,” this chapter is grounded on the assumption that neither biological nor social and cultural variables should be understood as determinants of health and disease, but rather as contributing factors to disease causation. The chapter begins with an elaboration of the book's position, and continues with a presentation of three case studies: female aging and menopause, the AIDS epidemic in West Africa, and the refugee experience of Somalis in Ethiopia. It concludes that awareness of the complexity of biosocial configurations—the relationship among local bilogies, social groupings, and dominant cultural values and concepts—can guide policy choices that are responsive to the particular dynamics of population health in any given location.
Universal Medical Care and Health Inequalities: Right Objectives, Insufficient Tools
Authors: Roos Noralou P. , Brownell Marni , Menec Verena
Published: September 2009

This chapter aims to answer the question: What role does medical care play in determining population health? The Canadian health care system, with its universal medical care coverage, provides an important opportunity for assessing the impact of medical care on health. This chapter presents the findings of research examining this question in the province of Manitoba in a study that spans ten years, and reviews existing evidence on the relation between socioeconomic disparities, health care use, and health. It concludes that while a universal health care system is definitely the right policy tool for delivering care to those in need, investments in health care should not be confused with policies whose primary intent is to improve population health or reduce inequalities in health.
Work and Health: New Evidence and Enhanced Understandings
Authors: Mustard Cam , Lavis John N. , Ostry Aleck
Published: September 2009

This chapter focuses on how labor market experiences affect workers' health. It presents an integrated framework for thinking about how work may influence health, with a specific focus on the cumulative effects of labor market experiences over the work career. The evidence documenting the biological consequences of adverse work experiences is then briefly reviewed. The chapter continues with a description of significant changes in the structure and organization of work over the past two decades and their implications for the health of working-age adults. Finally, it outlines some potential implications of these labor market changes for public and private sector labor market policies and practices, based on the belief that active labor market policies are not incompatible with robust economic growth.
Income Inequality as a Determinant of Health
Authors: Ross Nancy , Wolfson Michael , Kaplan George A. , Dunn James R. , Lynch John , Sanmartin Claudia
Published: September 2009

This chapter begins by reviewing research evidence on the relationship between income and health at the individual level, and examines studies that have followed individuals through time to demonstrate the direction of the relationship. This is a fundamental starting point since the individual relationship between income and health likely underlies any analysis examining the connection between income inequality and population health. The chapter introduces research regarding this connection, and then compares the relationship between income inequality and health in jurisdictions within Canada and the United States, finding significant differences. It concludes with a series of hypotheses about why health outcomes in Canada and the United States are so different.
Reallocating Resources across Public Sectors to Improve Population Health
Authors: Stoddart Greg L. , Eyles John D. , Lavis John N. , Chaulk Paul C.
Published: September 2009

As the interconnected nature of determinants of health becomes increasingly apparent, so does the need for intersectoral policy development. A significant challenge in this regard is the need to reallocate resources between sectors within the public sector in order to apply a determinants-of-health approach to resource allocation. This chapter examines the case of the Canadian province of Prince Edward Island (PEI), one of the first governments to design an explicit mechanism to facilitate cross-sectoral reallocation. It begins with a description of policy development and implementation, and the attempt to establish a process for evaluating health reform. It then discusses the results of four related studies of cross-sectoral reallocation in PEI. Finally, it considers the modest effects of this policy and the lessons learned from the PEI experience.
Where Do We Go from Here? Translating Research to Policy
Authors: Earle Alison , Heymann Jody , Lavis John N.
Published: September 2009

The common characteristic among the determinants of population health discussed in previous chapters of this volume is that they are fundamentally aggregate-level, social factors over which a single individual has little control. Affecting these factors requires policy-level social change. However, existing research is often not used, or not used to its full potential, in policy formation. This chapter examines the issue of how to influence policy makers and other actors who are in a position to implement broad-scale policy change. It explores evidence regarding the use of research in policy development using a series of case studies, which hopefully will offer insights for the use of population health research.
Introduction
Authors: Frumkin Howard
Published: September 2009

This introductory chapter begins with a brief discussion of the conditions of schools in the U.S. and the importance of the school environment. It provides an overview of the subsequent chapters. It then discusses the various themes that recur throughout this book, including children's vulnerability to the effects of hazardous environmental exposure, the importance of a team approach to safe and healthy school environments, the positive influence of involved adults, and the complexity of policymaking.
Crowding, Class Size, and School Size
Authors: Maxwell Lorraine E.
Published: September 2009

This chapter discusses two separate but related aspects of the school environment: population, in relation to both class size and the size of the school, and crowding. Overcrowding affects the performance and well-being of both students and teachers. Regardless of school size, overcrowding is a concern if the school is beyond its intended capacity. Population issues relate to both class size and the size of the school. Crowding is both a subjective experience and a measurable condition. Crowded conditions can be alleviated by modifying school size, class size, and furniture arrangements.
Lighting
Authors: Erwine Barbara
Published: September 2009

This chapter describes the breadth of the impact that lighting has on the health, well-being, and performance of schoolchildren and staff. Good lighting design can improve health and learning as well as increase safety, reduce vandalism, lower energy use, and help students maintain visual connections with the environment. In contrast, bad lighting design contributes negatively to these issues. A holistic approach to optimal lighting includes provision of daylight and views in all classrooms and work areas, integration of daylight and electric lighting, and the addition of flexible lighting controls. Causes of lighting problems include insufficient or unbalanced light, glare, unnatural lamp characteristics, and annoying side effects. Careful planning early in the building design results in a healthy lighting system while frequent system assessment ensures consistent performance.
Food Safety
Authors: Sneed Jeannie
Published: September 2009

This chapter introduces the field of food safety as it applies to schools. Problems with food safety result from the presence of biological, chemical, or physical hazards in the food. Symptoms of foodborne illness may include nausea, vomiting, diarrhea, and, less frequently, fever or headache. Food consumed at schools may be prepared by different people and served in multiple venues. Outside vendors may also prepare and serve school meals. Best practices for food safety in the school include food safety policy and procedures, adequate facilities to support food safety, proper food safety certification, implementation of an HACCP program, and food safety education for students.
Nutrition at School
Authors: Larson Nicole , Story Mary
Published: September 2009

This chapter describes nutritional concerns for youth, the impact of school nutrition programs, the current environment in schools, tools for assessing school nutrition environments, and model efforts to improve school nutrition. A healthy school food environment can influence students to make healthful food choices, helping in turn to combat rising trends in weight problems, obesity, diabetes, and related conditions among children. Obstacles to healthy school food environments include snack bars and vending machines, a la carte food programs, and easy access to fast foods. Strategies to establish healthy food environments in schools include School Nutrition Advisory Councils, school policies, educational interventions, and the provision of attractive, healthy food choices.
Violence and Crime Prevention through Environmental Design
Authors: Schneider Tod
Published: September 2009

This chapter discusses violence and crime prevention in schools. Environmental changes can help protect schools from violence, crime, and other antisocial behavior. First-generation Crime Prevention through Environmental Design (CPTED) focuses on physical measures: improving natural surveillance, access control, and territoriality. Second-generation CPTED addresses the affective environment and promotes connectivity through a positive school climate and culture.
Emergency Management
Authors: Bellomo Angelo J.
Published: September 2009

This chapter discusses emergency management in schools. The development of a comprehensive emergency response plan is key to ensuring a rapid and effective response to school emergencies. The Incident Command System (ICS) used by fire and law enforcement authorities throughout the U.S. is easily adaptable to school use. This system can substantially improve the response capabilities of a school through the effective organization and management of personnel, and provides a framework from which school staff are assigned to work on several defined emergency teams.
Safe School Travel
Authors: Robertson H. Douglas , Tsai Jeffrey C.
Published: September 2009

The trip to school is very much a part of the school environment. Two aspects of this trip bear directly on children's health and safety: the risk of injuries during the journey and the opportunity for health promotion through physically active travel such as walking and bicycling. This chapter addresses the first set of concerns. It briefly describes the risks of school travel and offers suggestions for reducing or minimizing them. The emphasis is on “getting it right” by those who are involved. Several checklists are offered for consideration of the types of actions that might reduce the risks associated with the most common means of school travel. Much of the information in the chapter is drawn from a report published by the Transportation Research Board (TRB) of the National Research Council, titled The Relative Risks of School Travel: A National Perspective and Guidance for Local Community Risk Assessment.
The Economics of Safe and Healthy Schools
Authors: Mudarri David
Published: September 2009

The operation of schools can be viewed as a complex business operation that requires smooth functioning, good staff, sound and healthy facilities, customer satisfaction, productive outcomes, and room for creativity and ingenuity. This chapter makes the “business case” for safe and healthy schools. The first section deals with the economic evaluation of projects, policies, or proposals, and provides a review of basic concepts and analytic techniques used to conduct economic evaluations. The second section introduces some basic concepts of economic behavior and the analysis of economic demand. The chapter concludes with three case studies (two real and one hypothetical) that help illustrate the principles described here.
Health Services at School
Authors: Lear Julia Graham
Published: September 2009

Health services provided at schools represent an opportunity not only to safeguard the health of students in general but also to promote environmental health. This chapter begins with an overview of school health services, describing the people, the facilities, and the clinical services. It then turns to aspects of school health services relevant to safe and healthy environments.
Care of Asthmatic and Allergic Students
Authors: Teague W. Gerald
Published: September 2009

This chapter discusses issues associated with the care of children with asthma by school personnel. A close partnership built on open communication and preparedness is necessary among school personnel, parents, and health professionals in order to optimize outcomes for children with asthma in the school environment. School personnel should be able to recognize the signs and symptoms of an asthma attack, assess its severity, and initiate treatment. Children with asthma must have ready access to a reliever (rescue) medication that is inhaled to relieve symptoms. School professionals also have a role in prevention.