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Biomedical subjects

R H Elling

Publications and source records attributed to R H Elling.

At least 19 recordsLinked to original sources
PubMed1995

Capital sectors and workers' health and safety in the United States.

The dual or segmented economy perspective suggests that the U.S. production system within a capitalist world-system can be divided into distinct sectors based on elements such as levels of industrial concentration, foreign involvement, and unionization. The differing organization of these sectors is argued to influence worker health and safety (WHS) outcomes. An economic segmentation model was applied to national occupational health data to examine the relationship between structural divisions in the economy and occupational hazard exposure, injury, and illness. Workers in more global industrial sectors had only average levels of hazardous exposure but a greater likelihood of occupational injury and illness than workers in other sectors of the economy. These differences are related to the structure of work in the various sectors. The findings suggest the need for (1) greater surveillance and reporting of WHS problems through the general health care system; (2) planning of economic and productive activity that takes WHS issues into account; and (3) greater worker organization and power within and between nations to improve WHS.

Adolescent↗
PubMed1994

Theory and method for the cross-national study of health systems.

The comparison of nations' health systems requires some way of categorizing them. As distinct from the topologies of Roemer, Maxwell, and others, which offer no apparent theoretical derivation, the schema suggested here derives from theory of the capitalist political economic world-system as put forth by Wallerstein and others. With the worldwide division of labor entailed in this perspective (core, semi-periphery, and periphery), combined with the strengths of workers' movements, five types of nations' health systems are identified, and illustrative comparisons are made using the contrasting case studies method. The author also discusses seeming exceptions to the general rule of capitalist dependencies with weak workers' movements having inequitous inadequate health systems.

Adolescent↗
PubMed1989

The political economy of workers' health and safety.

The paucity of social science research on workers' health and safety (WHS) is noted and a framework based on class struggle within the capitalist political economic world-system is suggested. It is hypothesized that the historical and current strengths of workers' movements within nation states will largely determine the adequacy of provisions for WHS. This hypothesis was generally confirmed through field studies in Sweden, Finland, the German Democratic Republic, the Federal Republic of Germany, the U.K. and the U.S.A. However, one key aspect, the linkages between the general health services, especially at points of first entry (sometimes inappropriately referred to as primary health care, PHC) and WHS are highly problematic in all systems. Workers and their representatives, as well as concerned WHS and public health workers should develop greater awareness, concern and understanding of this PHC-WHS problem as well as other aspects of WHS.

Europe↗
PubMed1987

Cuba and the Philippines: contrasting cases in world-system analysis.

Cuba and the Philippines are countries with broad similarities in historical background yet sharp divergences in political economic developments and relations to the capitalist world-system in recent times. U.S. economic and political interests dominated both countries during the first half of the 20th century. The changes generated by the Cuban revolution resulted in the end of U.S. power in Cuba in 1959. The Philippines, however, remain profoundly dependent on the United States. The approach taken in this article contrasts these countries, asking what the results of their divergent paths are in terms of health and health services. The ability of Cuba and the Philippines to support the primary health care (PHC) approach by fostering socioeconomic justice, authentic citizen participation, and a regionalized health system is examined. It is clear that the last 25 years of socialist-oriented development in Cuba reversed the negative effects of the previous market economy by providing improved social and health services. The success of the political economy and the fully regionalized health system, supportive of the PHC approach in Cuba, is reflected in the high-level health status of the people. In contrast, poverty, gross social and economic inequities, high prevalence of infectious disease, and inaccessible, inadequate, and uncoordinated health services persist in the Philippines after some 85 years of international and national capitalist development. The poor health status of the Philippine people is a direct reflection of this underdeveloped system.

Community Participation↗
PubMed1981

The capitalist world-system and international health.

A number of world health problems which have been discretely considered in the past are viewed in this paper as interwoven with each other and with the functioning of the capitalist political-economic world-system. Thus, climactic explanations ("tropical medicine"), and even poverty when conceived in cultural terms or as a structural problem resident entirely within a single nation, are seen as inadequate for understanding any or all of the problems discussed briefly here: poor general health levels in peripheral and semi-peripheral nations, especially rising infant mortality rates in countries such as Brazil; comerciogenic malnutrition; dumping and exploitative sale of drugs, pesticides and other products banned or restricted in core nations; genocidal and other threatening approaches to population control; export of hazardous and polluting industry to peripheral and semi-peripheral nations; similar export of human experimentation; the sale of irrelevant, high medical technology to countries lacking basic public health measures, the "brain drain", and medical imperialism. Also discounted are moralistic inveighing, complaints about inadequate information and its transfer, discussions of bureaucratic bumbling or inter-agency politics and professional rivalries, various forms of victim-blaming, and other explanations and corrective approaches which ignore class structure and the control, distribution, and expropriation of resources in nations and the world-system. The framework suggests the importance of a worldwide cultural hegemony, including a medical cultural hegemony, established by and in the service of the ruling classes. Socialist-oriented nations which are quasi-independent of the capitalist world-system are seen as suffering less from its effects. This suggests that we should conceive of world socialist health and world capitalist health, rather than any kind of unified phenomenon called "international health".

Drug Industry↗
PubMed1977

Industrialization and occupational health in underdeveloped countries.

This paper examines world political economic relationships, especially the growing disparities between "developed" and underdeveloped countries and the role of multinational corporations in exploiting the people and resources of underdeveloped lands. Workers in these lands are identified as high risk for both new and old forms of occupational health hazards. To protect themselves, workers must establish governments on their own behalf rather than client governments serving external capitalist interests.

Developing Countries↗