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PubMedDate not supplied

Accretion, reform, and crisis: a theory of public health politics in New York City.

Standard interpretations of the history of public health in New York City in the twentieth century describe either the decline or the growth of the importance accorded to public health activities. To the contrary, public health has, paradoxically, both declined in salience and attracted increasing resources. This article describes the politics of public health in New York City since the 1920s. First it describes events in the history of public health in the context of events in the economy and in city, state, and national politics. Then it proposes three descriptive models for arraying the data about public health politics: accretion, reform, and crisis. Next it describes how the politics of AIDS in New York City in the 1980s was a consequence of the history that produced these three political styles. Finally, it argues that the three political styles are generalizable to the history of public health throughout the United States in the twentieth century.

Financing, Organized↗

PubMed1986

Race, intelligence and political efficacy among school children.

This paper focuses on the difference in political efficacy found between black and white pre-adults, and assesses a specific explanation of this racial difference, one that combines elements of the intelligence explanation with aspects of the social-deprivation explanation as outlined by Paul Abramson. The explanation suggests that the racial difference in feelings of political effectiveness is due to intelligence which, in turn, is basically a function of the social and economic environment. Focusing on a study of 421 black and white students, it is shown that the predictions from the theory are empirically valid. Most importantly, it is demonstrated that once intelligence is controlled for, there is little or no relationship between race and political efficacy--that is, the black and white students are approximately equal in their levels of political effectiveness. Thus the study lends empirical support to this particular explanation of the racial difference in political efficacy, and suggests, more generally, that intelligence may play a significant role in the political socialization process.

Adolescent↗

PubMed1996

[Physicians and politics].

In addition to their original healing-mission, physicians gain more and more responsibility in health politics including most important aspects like education and medical ethics. Recent developments and possibilities in prenatal diagnostics, molecular biology and in-vitro-fertilization demand clearcut positions from the medical staff. Political evaluation of costs in health care systems concerns analysis of the most common factors responsible for the increasing costs. High expectations and demands of the patients are one reason, other are excessive use of new technologies, increase of the aged in the population and growing cost for liability cases. Mechanisms for the down-regulation of costs are restricted. The so called free market in health care such as premium-competition of health insurance point out more theoretical than practical aspects. The Health insurance law (KVG) by increasing the extent of services has contributed to a further increase of costs instead of lowering them. Shifting from hospitalization to out-patient treatment and reducing beds for acute services could lower hospital costs further. AIDS, Drug-politics and environmental destruction, three actual plagues, represent further political challenges for physicians. For the future a reasonable politic involving a better motivated medical corps has to be promoted. To this end first personal structures should be strengthened by help of new ethical view points. Future medicine should be complex, patient-oriented-and remain affordable. Therefore medical responsibility in political development is mandatory.

Ethics, Medical↗

PubMed2003

Do committees ru(i)n the bio-political culture? On the democratic legitimacy of bioethics committees.

Bioethical and bio-political questions are increasingly tackled by committees, councils, and other advisory boards that work on different and often interrelated levels. Research ethics committees work on an institutional or clinical level; local advisory boards deal with biomedical topics on the level of particular political regions; national and international political advisory boards try to answer questions about morally problematic political decisions in medical research and practice. In accordance with the increasing number and importance of committees, the quality of their work and their functional status are being subjected to more and more scrutiny. Besides overall criticism regarding the quality of their work, particular committees giving political advice are often suspected of being incompatible with democratic values, such as respect for affected parties, representation of diverse values and transparency in the decision-making processes. Based on the example of the German National Ethics Council, whose inauguration caused a still ongoing debate on the aims and scopes of committees in general, this paper discusses: (1) the requirements of modern democratic societies in dealing with complex scientific-technical problems; (2) the composition and organisation of committees working as political advisory boards; and (3) the appointment procedures and roles of laymen and experts, and here in particular of ethicists, who may legitimately be taken on by a committee. I will argue that bioethics committees do not necessarily endanger democratic values, but can considerably improve their realisation in democratic decision-making procedures--if, and only if, they do not act as substitutes for parliamentarian processes, but help prepare parliamentarian processes to be organised as rationally as possible.

Advisory Committees↗

PubMed2005

Understanding generations: political economy and culture in an ageing society.

Sociological understanding of generations can be enhanced by avoiding defining them rigidly as chronological cohorts but rather linking people's accounts of their generational experience with an historically informed political economy. It then becomes possible, for example, to understand the complexity of generational politics. This paper uses data on the 'War Generation' taken from the Exeter Politics of Old Age project to link an empirically based political economy of generational inequality with a cultural sociology of generations. The 'War Generation' recognizes itself and is referred to by others in terms of a common identity. It is also an historical generation; its values, attitudes and, above all, sense of national solidarity and mutual obligation were forged in the direct experience of war. But it is also divided by divergent economic interests in property and pension rights based on the historical experience of the life course by successive groups and this segmentation can be observed in political action. The political culture of the War Generation manifests both continuity and change. Understanding these dynamics requires listening to people constructing their worlds, understanding their full range of historical experiences, and analysing the conditions for their conflicts and their cohesion.

Aged↗

PubMed2006

Political economy and population health: is Australia exceptional?

BACKGROUND: It is accepted knowledge that social and economic conditions--like education and income--affect population health. What remains uncertain is whether the degree of inequality in these conditions influences population health and if so, how. Some researchers who argue that inequalities are important, say there is a relationship between political economy, inequality and population health. Their evidence comes from comparative studies showing that countries with neo-liberal political economies generally have poorer population health outcomes than those with social or Christian democratic political economies. According to these researchers, neo-liberal political economies adopt labour market and welfare state policies that lead to greater levels of inequality and poorer population health outcomes for us all. DISCUSSION: Australia has experienced considerable social and economic reforms over the last 20 years, with both major political parties increasingly adopting neo-liberal policies. Despite these reforms, population health outcomes are amongst the best in the world. SUMMARY: Australia appears to contest theories suggesting a link between political economy and population health. To progress our understanding, researchers need to concentrate on policy areas outside health--such as welfare, economics and industrial relations. We need to do longitudinal studies on how reforms in these areas affect levels of social and economic inequality, as well population health. We need to draw on social scientific methods, especially concerning case selection, to advance our understanding of casual relationships in policy studies. It is important to find out if, and why, Australia has resisted the affects of neo-liberalism on population health so we ensure our high standards are maintained in the future.

Journal Article↗

PubMed1994

Health politics and policy: survey of U.S. health administration courses.

In summary, the vast majority of graduate health administration programs in this country offer a course in health politics and policy. Most of these courses are conducted as a seminar involving class discussions, guest speakers, and student projects. Aside from these generalizations, there is little consensus regarding such matters as course content, objectives, textbooks, and readings. The findings of this survey indicate a crying need in health administration education for a basic textbook or collection of readings on health policy and politics. Such a text should cover the following: 1. Basic information on United States politics and government: our constitutional framework; the presidency; the legislative process; the role of the judiciary; state and local governments; etc. 2. Late 20th century United States political culture: why Americans hate politics and distrust politicians; government as "part of the problem"; the role of the media; the role of lobbyists; campaign financing; increased us of initiatives and referenda; etc. 3. Comparisons of the United States health care system to systems in other countries: Canada, Great Britain, Sweden, Germany, etc. 4. Case studies on traditional health policy issues: Hill-Burton, planning, cost versus access, risk segmentation, rationing, health ethics, etc. 5. Bibliography of suggested readings. A textbook or anthology of this type would provide a solid foundation for a health policy course. Instructors could then add discussion of current events, guest speakers' presentations, and selected readings on emerging issues such as health care reform. In this way the course could be grounded in sound political science theory while also meeting the students' needs for practical insights into health policy issues of the day and their own role as health care executives in influencing the outcome of those policy debates.

Curriculum↗

PubMed1995

International migration and the politics of admission and exclusion in postwar Europe.

"Although nation-states assume territorial, political and cultural boundedness, their boundaries are not uniform barriers, but rather are characterized by varying degrees of openness and closure to international migrants. The manipulation of the permeability of these boundaries constitutes the politics of admission and exclusion.... This paper provides a discussion of the complex economic, political and social forces impinging on the politics of admission and exclusion and an analysis of how these forces have been operating in a particular historical and geographical context to determine the admission of international migrants into national territory and community.... There are signs that the integration of nation-states into regional blocs such as the EC is shifting the politics of admission and exclusion practised by the dominant member countries to the supra-national scale."

Demography↗

PubMed2003

Regional differences in trends in life expectancy and the influence of the political and socioeconomic contexts in Germany.

The aim of the study is to investigate to what extent trends in life expectancy are influenced by political variables and socioeconomic characteristics that play a role at the regional level of the federal states in Germany. Data on life expectancy in males and females at birth are analyzed from 1986 to 1998 for 12 federal states in Eastern and Western Germany. These states are classified into five types of political government since 1980: (1) long-term Christian democratic, (2) long-term social democratic, (3) change from Christian to social democratic, (4) change from communist to social democratic, and (5) change from communist to Christian democratic. The study showed three main results. First, life expectancy has been directly influenced by the major political forces that determined policies in East and West Germany. Second, life expectancy was higher in federal states with predominantly Christian democratic governments than in those with predominantly social democratic governments. Third, life expectancy was strongly related to the economic power of the federal states. Because federal states characterized by a more prosperous economic situation were those with a predominantly Christian democratic government, while federal states with a less prosperous situation were mostly governed by social democrats, it is difficult to disentangle the effects of economic and political factors on life expectancy. Nevertheless, this study underlines the importance of politics and policies on such robust and more general health indicators as mean life expectancy at birth.

Christianity↗

PubMed1996

Suffering, justice, and the politics of becoming.

To suffer is to undergo, to bear, to endure. Suffering exists on the underside of agency; it is as important to ethics as agency. The experience of suffering is never entirely captured by the ethical, political, medical and spiritual categories in which it is represented. Perhaps an engagement with suffering can open up hidden connections between these domains. After examining John Caputo and Friedrich Nietzsche comparatively on the relation between suffering and ethics, this essay explores the relation of the "politics of becoming" to suffering. The politics of becoming is a paradoxical process by which a new cultural identity is drawn into being and yet is irreducible to the energies and motives that spurred its initiators to action. To exemplify and think the politics of becoming is to call into question the sufficiency of existing paradigms of morality. A critical examination of the Rawlsian model of justice brings out, for example, the insufficiency of justice to the politics of becoming. It suggests the need, first, to pursue an "ethics of engagement" between several parties drawing upon a variety of sources of ethical inspiration and, second, to cultivate "critical responsiveness" to new social movements that struggle to place new identities onto the cultural register. If the latter movements sometimes modify general understandings of suffering, identity, justice and medical practice they also indicate the role cultural thinkers can play in re-examining periodically established codes of interaction between these domains.

Altruism↗

PubMed1997

Long-term effects of political imprisonment: a group comparison study.

The study investigated the long-term effects of political imprisonment in the former German Democratic Republic. A group of non-treatment-seeking former political prisoners (n = 146) was compared with an age- and sex-matched group (n = 75). Assessments included the structured Diagnostic Interview for Psychiatric Disorders (German abbreviation: DIPS) for DSM-III-R/-IV diagnoses, a checklist of persecution and maltreatment, and other self-rated measures of post-traumatic stress disorder (PTSD), anxiety, depression, and dissociation. PTSD was assessed by the DIPS as current and lifetime diagnoses. Former political prisoners were imprisoned for 38 months on average. The former prisoners had a lower educational and lifetime occupational level than the comparison group. Results regarding diagnoses show a frequency of 30% current and 60% lifetime PTSD in the former prisoners group. Other anxiety disorders (e.g., claustrophobia, social phobia) outnumbered comorbid affective disorders. The level of dissociation was elevated in the former prisoners group. Intrusive recollections and hyperarousal were more common than avoidance/numbing symptoms. Despite differences in imprisonment duration between three historically defined eras of persecution, no differences appeared in the level of symptomatology. The results suggest that political imprisonment in the former German Democratic Republic had long-term psychological effects. Compared with an age- and sex-matched comparison group, the former political prisoners showed higher levels not only of post-traumatic symptomatology but also of other anxiety disorders and dissociation.

Adult↗

PubMedDate not supplied

Political participation behaviors of nurse-midwives.

Political participation, which is promoted by nurse-midwifery leaders, is a widely studied topic in this country. Yet, there is little data that describes political participation among health care providers such as nurse-midwives. The descriptive findings presented here are from a national survey of a random sample of members of the American College of Nurse-Midwives. The data indicate that nurse-midwives are inclined to be liberal and Democrats and they believe that individuals such as themselves can influence governmental activities. As in the general population of the country, the electoral act of voting is the predominant political activity. Nurse-midwives are more apt to demonstrate nonelectoral political behaviors in regard to women's issues. Overall, there is a general assumption that the representatives of the ACNM membership maintain the responsibility for political action.

Adult↗

PubMed2004

Adolescent voting for right-wing extremist parties and readiness to use violence in political action: parent and peer contexts.

Almost all shapes of adolescent risky and deviant behaviour take place in the context of peer-relations. The present study examined the role of parents and peer-relations with respect to two indicators of deviant political development. In the fall 1998, directly after the German parliamentary elections, 1309 East German adolescents were asked about their voting for a right-wing extremist party and their readiness to use violence in political action. Friend's voting was a strong predictor of individual voting for a right-wing extremist party, particularly when the friend was the best friend with a reciprocal nomination, and when the friends frequently communicated about political themes. In addition, voting behaviour and willingness to use violence were associated with membership in peer groups who met frequently. Finally, the violence-disposed adolescents spent more of their spare time with peers and less with their parents. Similarities of our results with the findings of research on deviant behaviour in non-political areas support the idea that deviant political behaviour could be an expression of a problematic life situation.

Adolescent↗

PubMed2005

The politics of childbirth in the context of conflict: policies or de facto practices?

The impact of warlike conditions on the lives of Palestinian women and children is far reaching. Beginning in September 2000, curfews, closures, siege and the parceling up of the country into small isolated entities have all led to a lack of access to basic maternity services, rendering pregnant women and their newborns a highly vulnerable group. Because any discussion of childbirth in the Occupied Palestinian Territories (OPT) cannot be separated from the larger historical context of international health politics, we begin with a brief review of international historical trends in childbirth policies, focusing on the relationship between discourse in the developed and developing world contexts to show how these models have intersected and diverged. We point to the similarities between the OPT and other developing countries, but also highlight the specificities that characterize the Palestinian experience today that include local political systems, medical dominance, professional group interests and the politics of gender, as well as the legacy of colonialism intertwined with an ongoing national conflict. We then provide a review of the history of childbirth in the OPT and analyze the various forces that led to the emergence of today's chaotic and contradictory de facto policies and practices. By assessing the health policy environment, we demonstrate the seeming impossibility of developing national level childbirth policies, given the current political conditions and a mix of other determinants that are not all within Palestinian control. Finally, we emphasize the importance of establishing a process as opposed to a blueprint of health policy-making based on people's immediate and long-term needs in all areas of the country. We also propose interim measures that rest on the notion of developing decentralized sub-strategies relevant to different zones of political reality and stages of system and human resource development, aiming at combining survival imperatives with those of improving women's birth experiences and women's health.

Arabs↗

PubMed2004

The political environment of HIV: lessons from a comparison of Uganda and South Africa.

Considerable interest has arisen in the role of governance or political commitment in determining the success or failure of HIV/AIDS policies in sub-Saharan Africa. During the 1990s, Uganda and South Africa both faced dramatic HIV/AIDS epidemics and also saw transformations to new political systems. However, their responses to the disease differed in many ways. This paper compares and contrasts the ways in which policy environments, particularly government structures, can impede or expedite implementation of effective HIV prevention. Four elements of these environments are discussed--the role of political leadership, the existing bureaucratic system, the health care infrastructure, and the roles assigned to non-state actors. Two common international strategies for HIV prevention, syndromic management of sexually transmitted infections and sexual behaviour change interventions, are examined in relation to these elements in Uganda and South Africa during the mid-to-late 1990s. During this period, Uganda's political system succeeded in promoting behaviour change interventions, while South Africa was more successful in syndromic management efforts. Interactions between the four elements of the policy environment were found to be conducive to such results. These elements are relatively static features of the socio-political environments, so lessons can be drawn for current HIV/AIDS policy, both in these two countries and for a wider audience addressing the epidemic.

Cross-Cultural Comparison↗

PubMed2001

Political involvement in nursing--education and empowerment.

Political apathy in the nursing profession can be attributed to numerous factors, including a lack of knowledge of the political process and public policy formation, feelings of powerlessness, and a perceived ethical conflict between professional values and political involvement. Nursing as a profession has arrived at a prestigious point in development where the word "nurse" now is synonymous with the words "patient advocate," thus giving the specialty an important image to fulfill. The public, however, will not recognize nurses as patient advocates until they begin to champion public health and social issues at the Institutional, community, and national levels. Numerous changes in health care delivery methods, together with politicians' increased involvement in health care development, have left nurses in a precarious position even though nurses are the largest group of health care workers in the United States. In this article, the first of a two-part series, the lack of knowledge of the political process and feelings of powerlessness in the nursing profession will be examined, along with their effects on political involvement among nurses.

Education, Nursing↗

PubMed1987

Political attitudes and voting among unemployed and employed youth.

This study investigated the political involvement of a sample of 1294 young people aged 17-18 years old. Seventeen per cent were employed and 83 per cent were unemployed, and the sample included males and females, blacks and white. When compared with the employed, the unemployed were more disaffected with the political system, more likely to support the Labour Party, less likely to support the Conservative Party, more likely to have voted Labour in the 1983 General Election, and less likely to have voted Conservative. Ethnic comparisons indicated that blacks were more politically disaffected than whites, were more likely than whites to express support for the Labour Party, and were more likely to vote Labour in the 1983 General Election. The only major sex difference was amongst whites, such that males were more likely to support the National Front, and females more likely to support Labour. Results are interpreted as indicating increased detachment from the main political system for some unemployed young people, and with increased attachment to Labour politics among others.

Adolescent↗

PubMed2002

Implementing the 1989 United Nations' Convention on the Rights of the Child in sub-Saharan Africa: the overlooked socioeconomic and political dilemmas.

OBJECTIVE: The aim of this article is to identify and profile some often overlooked socioeconomic and political factors that render the protection of the rights of the child, as guaranteed through the 1989 United Nations' Convention on the Rights of the Child, a distant dream in most African countries. It is argued that, in most African countries, there are other major impediments to the protection of the child's rights in addition to the frequently cited lack of adequate legislation and of political will. METHOD: The paper is a review essay and utilizes existing literature from varied sources to advance its main arguments. It draws from such documents to profile the socioeconomic and political barriers to the protection of children's rights in Africa both at the family and at the national levels. CORE ARGUMENT: The ratification of the United Nation's 1989 Convention and the passing of supportive legislation by most state governments, has not resulted in major improvements in the well-being of children. This is as a result of prevailing socioeconomic and political conditions such as social transformations within the family unit, poverty, and rampant corruption. The emergence of HIV/AIDS, civil wars and armed conflicts is a major impediment to the protection of children's rights across most of Africa. CONCLUSION: The effective implementation of the 1989 United Nations' Convention by African governments requires more than the ratification of the Convention. Governments require the political will to implement its prescriptions by passing supportive legislation. To create the necessary enabling environments, equal emphasis should be placed on the eradication of poverty, corruption and disease; and to ending armed conflicts where they exist.

Africa South of the Sahara↗