PubMed · 15744934
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David Woodhead. 2005-01-13. On engaging communities.. https://pubmed.ncbi.nlm.nih.gov/15744934/
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BACKGROUND AND PURPOSE: A survey was conducted of radiotherapy (RT) resources and utilization in a northwestern Italian Region in order to assess geographical variations in radiotherapy utilization rates, and the effects of infrastructure supply on accessibility. MATERIALS AND METHODS: The survey was conducted by analysing standardized utilization rates based on administrative records. The data were analysed at both Regional and Local Health Unit (LHU) level. RESULTS: Wide variation was found among LHUs RT utilization rates--the sex- and age-standardized rates varied from 1.8/1000 inhabitants to more than 3/1000 inhabitants. Patients resident in LHUs with no RT service showed a lower probability of accessing RT (standardized rate ratio (SRR), 0.82; 95%IC, 0.80-0.85). The utilization rate decreased in relation to the distance between a patient's residence and the nearest RT service; the reduction was greater for patients > or =70 years of age. CONCLUSION: The wide geographic variation implies lack of equity in access to services. Utilization levels decreased significantly with increasing distance from the nearest RT service, distance being a barrier to access particularly for older persons. The heterogeneous distribution of services on the Regional territory seems a relevant explanation of differences in utilization rates.
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Curriculum development in masters of public health programs that effectively meets the complex challenges of the 21st century is an important part of public health education and requires purposeful thinking. Current approaches to training the public health work-force do not adequately prepare professionals to be culturally competent in addressing health disparities. Principles of community-based participatory research highlight the importance of building relationships of mutual accountability and emphasize collegial teaching. We present background and theoretical foundations for a pedagogy of collegiality and describe specific teaching methods, classroom activities, and key assignments organized around 4 essential features: principles of community organizing, building community and valuing diversity, engaging the senses, and writing across the curriculum.