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[Citizenship, community participation, and health as seen by health care professionals: a case study in public health services].

This paper deals with the subject of citizenship and people's participation in the health area through an analysis of ideas pertaining to a specific group: health care professionals working in Basic Health Care Clinics in the 3.1 Programmatic Area of the City of Rio de Janeiro (Brazil). The article analyzes their views on the subject and presents them in light of health-related legislation in the Brazilian constitution. It also analyzes the professionals' role vis-à-vis users in raising community awareness that health care is one of their basic rights. Field data from qualitative social research methodology showed a significant heterogeneity in the professionals' conceptions, dividing them into two groups: those belonging to teaching institutions and those working in institutions providing health care. This analysis shows the strategic role that day-to-day relationships between professionals and the community can play in the social change process and the establishment of social rights. It also discusses the viability of this process in view of the discovery of the subjective involvement of the health professionals who promote this process.

English Abstract↗

Monitoring health status, access to health care, and compliance behavior in a large urban community: a report from the Los Angeles health survey.

This article summarizes results from 2 health surveys conducted in Los Angeles County in 1974 and 1977. The original objective of this analysis was to identify aggregate changes in the health status of this population, in access as measured by the use/disability ratio, and in self-reported compliance with medical regimens. Additionally, we have suggested that this study illustrates the value of local population surveys for health policy--particularly in regard to recent Health Systems Agencies legislation. Substantial correspondence was found between the health status characteristics of both samples and national estimates, particularly for the prevalence of chronic illness. We also found a 3-year trend of increasing disability that is consisted with national data. However, unlike the national estimates, we found evidence of improved access relative to disability, and a corresponding reduction in the traditional income differential. Analysis of self-reported compliance showed little change over time, with Anglos and the middle and upper socioeconomic groups reporting less compliance with their doctors' recommendations.

Adolescent↗

Health impact assessment: a tool to help policy makers understand health beyond health care.

Health impact assessment (HIA)--a combination of methods to examine formally the potential health effects of a proposed policy, program, or project--has received considerable interest over the past decade internationally as a practical mechanism for collaborating with other sectors to address the environmental determinants of health and to achieve more effectively the goals of population health promotion. Demand for HIA in the United States seems to be growing. This review outlines the common principles and methodologies of HIA and compares different approaches to HIA. Lessons learned from the related field of environmental impact assessment and from experience with HIA in other countries are examined. Possible avenues for advancing both the field and the broader goals of population health promotion are outlined.

Decision Making, Organizational↗

School health centers and other integrated school health services. Committee on School Health.

This statement offers guidelines on the integration of expanded school health services, including school-based and school-linked health centers, into community-based health care systems. Expanded school health services should be integrated so that they enhance accessibility, provide high-quality health care, link children to a medical home, are financially sustainable, and address both long- and short-term needs of children and adolescents.

Adolescent↗