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PubMed1995

Industrialization and environmental health in Poland.

There has been enormous pollution and biodegradation of environment in Poland as the consequence of industrialization developed regardless the principles of sustainable development. In the recent years, the decrease of total emission of air pollution caused by gases and dust, the decrease of emission of unprocessed sewage and industrial waste can be seen. These facts are the consequences of economic recession which have appeared in Poland along with economic transformation. However, there is still significant escalation of environmental pollution, in so-called areas of ecological hazards. There are heavily industrialized and urbanized areas covering about 10% of the total country area but inhabited by over 30% of the total country population. The significant environmental pollution goes together with deterioration of the country's health situation what can be seen in shortening the average lifetime expectancy, increased frequency of cardiovascular diseases and cancers and higher infants death rate in comparison to other European countries. Considering the complexity of the factors affecting the population's health status, the basis of the health and environmental policy conceived in order to stop and alter the unwanted health condition tendencies and the environmental quality have been shown here.

Environmental Health↗
PubMed1999

Recession and well-being.

In this paper we address two related questions: how much do economic recessions affect the aggregate well-being of a population, and by what means? Using data from the 1973-77 Quality of Employment Panel of full-time workers who experienced the 1974-75 recession (N = 830), we answer these questions by using an analytic procedure that allows us to determine the percentage of total aggregate (mean) change in well-being attributable to various changes in sociodemographic statuses, labor market positions, and job characteristics. Results from this procedure showed significant increases in the mean levels of distress and dissatisfaction for this sample and that the largest percentages of change were accounted for by changes in job characteristics: about 20 percent of the total change in distress and 47 percent of the total change for dissatisfaction. In particular, increased job demands and increasingly inadequate pay made substantial contributions, with the latter alone accounting for a quarter of the total change in dissatisfaction. Unemployment experiences also contributed substantial, but smaller, percentages to the change in distress (10 percent).

Adult↗
PubMed2005

The impact of changes in Finland's health care system.

The most important reform in Finnish health care in the last decade occurred at the beginning of 1993 as part of a broader change to the entire state subsidy system. This reform reduced central government control and increased the freedom of the municipalities in the provision of health services. In addition, an unusually severe economic recession in the early 1990s affected Finnish health care. Currently, the most important economic decisions in the health care system are made by the 432 municipalities, which decide annually the amount of money to be devoted to health care as well as dividing resources in different sectors within the area of health. The changes in measures of productivity (based on activity-based measures in output) in the system are more closely associated with direct economic constraints (of municipalities) than with changes in financial incentive structures. Studies on equity in utilisation indicate that the Finnish health care system met the challenges of the 1991--1994 recession. Inequity in utilisation still prevails, however, and can be partly explained by the specific characteristics of the Finnish health care system. In future one needs to take more careful account of the rather unusual incentives that affect the behaviour of political decision-makers, providers and patients.

Financial Management↗
PubMedDate not supplied

Reform, change, and continuity in Finnish health care.

This article describes some essential aspects of the Finnish political and governmental system and the evolution of the basic institutional elements of the health care system. We examine the developments that gave rise to a series of health care reforms and reform proposals in the late 1980s and early 1990s and relate them to changes in health care expenditure, structure, and performance. Finally, we discuss the relationship between policy changes, reforms, and health system changes and the strength of neo-institutional theory in explaining both continuity and change. Much of the change in Finnish health care can be explained by institutional path dependency. The tradition of strong but small local authorities and the lack of legitimate democratic regional authorities as well as the coexistence of a dominant Beveridge-style health system with a marginal Bismarckian element explain the specific path of Finnish health care reform. Public responsibility for health care has been decentralized to smaller local authorities (known as municipalities) more than in any other country. Even an exceptionally deep economic recession in the early 1990s did not lead to systems change; rather, the economic imperative was met by the traditional centralized policy pattern. Some of the developments of the 1990s are, however, difficult to explain by institutional theory. Thus, there is a need for testing alternative theories as well.

Decision Making, Organizational↗
PubMed1989

Economic growth in the U.S. dental sector, 1950-1986.

Previous research has shown that over the period 1950 through 1977 the dental sector experienced a faster rate of economic growth than did the economy at large. This study extends the period of analysis through 1986. The findings show that dentistry maintained its economic strength relative to the economy. The annual growth rate for dentistry of 4.8 percent was significantly greater (p less than 0.001) than the 3.3 percent rate for the economy. In addition, inflation has been less in dentistry, and growth in the dental sector was not adversely affected by the economic recession of 1978-1984.

Economics, Dental↗
PubMed2005

Impact of the effect of economic crisis and the targeted motorcycle safety programme on motorcycle-related accidents, injuries and fatalities in Malaysia.

In 1997, a Motorcycle Safety Programme (MSP) was introduced to address the motorcycle-related accident problem. The MSP was specifically targeted at motorcyclists. In addition to the MSP, the recent economic recession has significantly contributed to a reduction of traffic-related incidents. This paper examines the effects of the recent economic crisis and the MSP on motorcycle-related accidents, casualties and fatalities in Malaysia. The autocorrelation integrated moving average model with transfer function was used to evaluate the overall effects of the interventions. The variables used in developing the model were gross domestic product and MSPs. The analysis found a 25% reduction in the number of motorcycle-related accidents, a 27% reduction in motorcycle casualties and a 38% reduction in motorcycle fatalities after the implementation of MSP. Findings indicate that the MSP has been one of the effective measures in reducing motorcycle safety problems in Malaysia. Apart from that, the performance of the country's economy was also found to be significant in explaining the number of motorcycle-related accidents, casualties and fatalities in Malaysia.

Accidents, Traffic↗
PubMed1987

Patterns of migration from Europe to Israel: Jewish migration, 1919-1984.

"An analysis was made from data published by Israel's Central Bureau of Statistics (1985) on Jewish immigrants by period of immigration and country of birth. Five periods of immigration are included in the study: 1919-May 14, 1948, May 15, 1948-1960, 1961-1964, 1965-1971, 1972-1979, and 1980-1984." The results show that although immigration from Europe has played a major role during this period of time, it has decreased significantly in the 1980s "as a result of several factors--restrictions on the number of Jews permitted to leave the USSR, the establishment of the United States and Canada as immigration destinations preferable to Israel, and the economic recession in Israel...." (SUMMARY IN FRE)

Asia↗
PubMed1996

Adapt or die?

The worldwide economic recession and the concomitant limited stock of finances have had an influence on the available money of every household and have also inhibited the improvement of socio-economic conditions and medicine. The Reconstruction and Development Programme (RDP) has the objective of improving the living conditions of the people with regard to housing, education, training and health care. The latter seems to be a major problem which has to be addressed with the emphasis on the preventive and promotional aspects of health care. A comprehensive health care system did not come into being property in the past because of the maldistribution of health care services, personnel and differences in culture and health care beliefs and values. The question that now arises, is how to render a quality health care service within the constraints of inadequate financing and resources. A comprehensive literature study has been done with reference to quality health care and financing followed by a survey of existing health services and finances. Recommendations are made about minimum requirements to be accepted if one were to adapt rather than die in terms of the provision of healthcare: the decentralization and rationalization of the administration of health care, the stress on and realization of effective and efficient primary health care, the acceptance of participative management in health providing organizations, the provision of financial management training for health care managers and the application of management accounting principles for the improvement of the efficiency and effectiveness of management.

Financing, Organized↗
PubMed2005

Charcoal-burning suicide in post-transition Hong Kong.

BACKGROUND: Charcoal-burning, a new suicide method, emerged in Hong Kong during the latest economic recession. Within 2 months charcoal-burning had become the third most common suicide method. AIMS: To examine the characteristics of suicides by charcoal-burning, and to delineate the pathways linking macro-level economic and social changes with the subjective experiences of those surviving a charcoal-burning suicide attempt. METHOD: Both quantitative and qualitative methods were used. In the coroner's records study, the first 160 cases of suicide by charcoal-burning were compared with a control group. In the ethnographic enquiry, we interviewed 25 consecutive informants who had survived serious suicide attempt using charcoal-burning. RESULTS: People who completed suicide by the charcoal-burning method were more likely to have been economically active and physically healthy, and were less likely to have had pre-existing mental illness. Charcoal-burning suicide was associated with overindebtedness. Media reports were pivotal in linking overindebtedness and financial troubles with charcoal-burning. CONCLUSIONS: The political economy of suicide by charcoal-burning illustrated how historical, socio-economic and cultural forces shaped the lived experience that preceded suicide.

Air Pollution, Indoor↗
PubMed2000

Solidarity in Swedish welfare--standing the test of time?

Swedish welfare has for decades served as a role model for universalistic welfare. When the economic recession hit Swedish economy in the beginning of the 1990s, a period of more than 50 years of continuous expansion and reforms in the welfare sector came to an end. Summing up the past decade, we can see that the economic downturn enforced rationing measures in most parts of the welfare state, although most of this took place in the beginning of the decade. Today, most of the retrenchment has stopped and in some areas we can see tendencies of restoration--but more so in financial benefits than in the caring sectors. In the article this process is discussed as a process of reallocation where general principles of solidarity become manifest. Various levels of decision making are discussed within the context of socio-political action. Current transitions in Swedish health care are described with respect to coverage rates, content, marketization and distribution. Basic principles of distribution are highlighted in order to analyse the meaning of social solidarity in a concrete allocative setting. The significance of popular opinion--it's shifts and determinants--is also considered. The article concludes with a discussion of how the (once salient) features of universalism in welfare and health care provision have been affected by the developments in the past decade in Sweden.

Aged↗
PubMed1994

Population migration and the spread of types 1 and 2 human immunodeficiency viruses.

Over 14 million people are estimated to be infected with the human immunodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migration of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business purposes, and the drug trade. In sub-Saharan Africa, between 1960 and 1980, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The result was a massive migration of rural inhabitants to urban centers concomitant with the spread of HIV-1 to large population centers. With the associated demographic, economic, and social changes, an epidemic of sexually transmitted diseases and HIV-1 was ignited. Migratory patterns were also responsible for the spread of endemic HIV-2 to neighboring West African countries and eventually to Europe, the Americans, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to population density and inherent risk behaviors. Thus, the migration of poor, rural, and young sexually active individuals to urban centers coupled with large international movements of HIV-infected individuals played a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasing the population at risk through increased urban migration, disruption of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled.

Behavior↗
PubMed2001

[Clinical laboratory's trends in the 21st century].

The new century presents numerous challenges and opportunities for the clinical laboratory scientists. Japan's economic recession has affected health care system directly. Clinical laboratories in particular have been hard hit financially. Laboratory people have striven for financial efficiency and balance within their own fields but now must broaden their view beyond this familiar field to the wider sphere of economics and medicine as whole. As laboratory professionals, we must be able to anticipate and respond to the current changes in disease frequencies, the fewer number of children in the nation, the health needs of the aging society, and the resulting economic implications. We, Japanese scientists, bring into the 21st century two major achievements. One is establishment of a fully automated laboratory system equipped with a transfer module. The second is reduced variation in inter-laboratory test results. Greater uniformity in the test results has been provided for by the supply of certified and calibrated reference materials as well as the dissemination of standard procedure for the measurement of catalytic amounts of enzymes published by the Japan Society of Clinical Chemistry(JSCC). Advances in the fields of diagnostic imaging were marvelous and received widespread attention. No less important were advances in high sensitivity immunoassay systems molecular biology-based diagnostic systems, and miniaturization of laboratory systems. The immediate future of laboratory medicine will be built upon these advanced technologies.

Blood Glucose↗
PubMed2004

The impact of healthcare reform in the Netherlands.

In 1987, the Dekker committee proposed managed competition as the dominant principle for reforming healthcare in The Netherlands. Considerable progress has been made in implementing the Dekker proposal, such as risk-adjusted capitation of Sick Funds, yearly open enrollment and selective contracting with providers. The centre-right government, which came to power in 2003, plans to implement the final steps in the coming years, which will drastically change pharmaceutical policies and shift power from central government to regional actors in healthcare. The current price reference system, which was initiated in 1991, has failed in containing expenditure or providing incentives towards efficiency. For new drugs, which can not be clustered in the price reference system or for which the producer wants a premium price, a pharmacoeconomic study and budget impact analysis is formally required from 2005 onwards. This fourth hurdle may limit access to new drugs, which contribute considerably to expenditure or for which relative efficiency is above a certain cost-effectiveness threshold. In line with the Dekker principle, insurance companies are expected to step into the market and initiate policies to reduce costs. However, the government seems somewhat reluctant to abandon instruments belonging to old supply-side regulation. Given the current healthcare cost explosion, which coincides with an economic recession, it remains to be seen whether politicians will really shift the power to the insurers and not return to traditional cost-containment policies.

Drug Utilization Review↗
PubMed1995

[Trend analysis for interprefectural migration in Japan, 1954-1993].

"In this paper, our main aim is to examine long-term trends of Japanese interprefectural migration after the War by using a Markov migration model.... We observed dependence of in- and out-migration on the size of populations by prefecture.... Major findings based on the time-series observation of stationary distributions by year are as follows: First from [the 1950s] to 1970 migrants tended to concentrate [on] densely populated industrialized prefectures (Tokyo, Osaka and Aichi), but after that during [the 1970s] populations have redistributed to provincial prefectures. Reconcentration of population to [the] Tokyo area again occurred around [the mid-1980s, but] it ceased at the beginning of the [1990s] in accordance with economic recession.... It can be concluded that [the] recent Japanese interprefectural migration system has lost its potential power to redistribute populations." (SUMMARY IN ENG)

Asia↗
PubMed1979

How the AHA meets the challenge of change.

The American Hospital Association and its member institutions have always adapted, and must continue to adapt, to change. Socioeconomic developments that must be reckoned with include the energy crisis, an economic recession, and the growth of consumer consciousness. Political developments include the growing similarity of the two major political parties, increased fiscal conservatism, and an antigovernment mood.

American Hospital Association↗
PubMed1992

Some current factors restricting the potential of private general practice.

This background paper focuses on two or three aspects which, in the writer's opinion, are crucial to the healthy development of general dental practice, although the rapidly progressing health reforms have already altered the relevance of some comments made. The first aspect is equitable access, especially for the financially disadvantaged in this time of economic recession. The ability and inclination of providers to treat the financially disadvantaged has not currently been matched by the political will of funders, even though an effective system could simply be organised. Access problems also apply to the elderly. A smooth transitional system of oral health care should exist for every aging patient, whether economically, physically, and mentally healthy, or in a state of total dependence, and this should be an integral part of general dental practice management. Generally it is not. Secondly, the fragmentation of the New Zealand dental workforce, and the lack of a real team approach have hindered the logical development of oral health services and prevented many possible options from being offered. Dialogue to reduce the fragmentation must continue, hopefully to a successful conclusion. Perhaps the catalyst for meaningful change may be contained in the current health reforms. Certainly opportunities for change have been clearly signalled.

Dental Auxiliaries↗
PubMed2001

Quality of life among children aged 2-17 years in the five Nordic countries. Comparison between 1984 and 1996.

BACKGROUND: The aim of the study was to analyse children's quality of life (QoL) in the five Nordic countries from 1984 to 1996, a period in which major economic recessions occurred. METHODS: The study design was cross-sectional based on a random sample of 3000 children in each country, aged 2 to 17 years, totalling 15,000 in 1984 and 15,000 in 1996. The data were collected by mailed questionnaires. QoL was analysed for three spheres of life: external, interpersonal, personal including both factual and perceived variables. The external sphere represented the socio-economic conditions for the child's family, the interpersonal sphere the structure and the function of the child's social networks and the personal sphere the psychological well-being of the child. RESULTS: The total QoL for Nordic children from 1984 to 1996 increased, but there were differences in the development of QoL between the countries. The objective QoL became better, at the same time the subjective QoL worsened, except in Denmark and Iceland. The external QoL became better, whereas the interpersonal QoL was nearly unchanged but there were differences in the development between countries. The personal QoL worsened slightly except for children in Iceland. The ranking between countries changed. Danish children had the highest subjective and Norwegian children the highest objective and external QoL. Swedish children had the highest personal QoL. Children 7-12 years had the highest QoL. Girls had a tendency to higher QoL in all ages. CONCLUSION: Nordic children still enjoy a high standard of living in spite of economic constraints, and the prerequisites for a high QoL are fulfilled. Further research is suggested for clarifying the complex background of these results.

Adolescent↗
PubMed2005

Incidence of note-leaving remains constant despite increasing suicide rates.

Suicide notes (SN) are potentially valuable sources of information about the psychological states of the suicidal person. It was hypothesized that there was a significant relation between suicide rate and note-leaving rate and that the incidence of note-leaving was increased during prolonged economic recession. During 21 years (1981-2001) in Kobe, of a total of 18 558 violent deaths, 5161 were due to suicide (27.8%), with 3417 male cases (66.2%) and 1754 female cases (33.8%). For each year the annual suicide rates and note-leaving rates were calculated, and this represents the percentage of committed suicides in which SN were left, among all suicide victims. In spite of the prolonged economic slump, the note-leaving rate remained almost constant (23.4-36.2%). Pearson's correlation coefficient showed no significant correlation between suicide rate and note-leaving rates (r = 0.27, P = 0.23). The finding that the incidence of note-leaving remains constant despite increasing suicide rates may suggest that the reasons for suicide do not affect note-leaving. There are cross-cultural, ethnic, and racial variations in suicidal behaviors. Although this finding may be specific in Japan, further studies of SN are needed to help clarify the suicidal states of mind.

Communication↗