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PubMed1997

The effect of universal health insurance on health care utilization in Taiwan. Results from a natural experiment.

CONTEXT: The government of Taiwan introduced universal health insurance to cover all citizens in 1995. This national health insurance program was proposed to assure the accessibility to health care at reasonable cost. Evaluation of the consequences, including health care utilization and expenditure, is crucial for policy adjustment. OBJECTIVES: To evaluate the effect of Taiwan's national health insurance on health care utilization. DESIGN: Cohort survey conducted before and after the implementation of the national health insurance program. PARTICIPANTS: A total of 1021 randomly selected Taiwanese adults. MAIN OUTCOME MEASURES: Physician visits in the 2 weeks prior to the survey and hospital admissions and emergency department visits in the immediate past year. RESULTS: After the introduction of universal health insurance, the newly insured consumed more than twice the amount of outpatient physician visits (0.21 vs 0.48, P<.05) and hospital admissions (0.04 vs 0.11, P<.05) than before universal health insurance was implemented, bringing them to the same amount of health care contacts as the previously insured group. The newly insured also experienced an insignificant increase in emergency department visits. In contrast, the previously insured group had a small but statistically significant increase in outpatient visits (0.48 vs 0.59, P<.05) and insignificant changes in hospital admissions and emergency department visits. CONCLUSION: The universal health insurance removed some barriers to health care for those newly insured. The copayment design in the insurance scheme seemed to have an insignificant effect on curbing medical care utilization. Taiwanese health policy analysts should seriously consider the growth of health care expenditures since the implementation of universal health insurance.

Adult↗
PubMed2000

Mass media interventions: effects on health services utilisation.

BACKGROUND: The mass media frequently cover health related topics, are the leading source of information about important health issues, and are targeted by those who aim to influence the behaviour of health professionals and patients. OBJECTIVES: To assess the effects of mass media on the utilisation of health services. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE, EMBASE, Eric, PsycLit, and reference lists of articles. We hand searched the journals Communication Research (February 1987 to August 1996), European Journal of Communication (1986 to 1994), Journal of Communication (winter 1986 to summer 1996), Communication Theory (February 1991 to August 1996), Critical Studies in Mass Communication (March 1984 to March 1995) and Journalism Quarterly (1986 to summer 1996). SELECTION CRITERIA: Randomised trials, controlled clinical trials, controlled before-and-after studies and interrupted time series analyses of mass media interventions. The participants were health care professionals, patients and the general public. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Seventeen studies were included. All used interrupted time series designs. Fourteen evaluated the impact of formal mass media campaigns, and three of media coverage of health related issues. The overall methodological quality was variable. Six studies did not perform any statistical analysis, and seven used inappropriate statistical tests (ie not taking into account the effect of time trend). All of the studies apart from one concluded that mass media was effective. These positive findings were confirmed by our re-analysis in seven studies. The direction of effect was consistent across studies towards the expected change. The pooled effect sizes for studies assessing the impact of mass media on similar aspects of care revealed an effect upon the utilisation of health services that could not be explained by chance alone, ranging from -1.96 (95%CI -1. 19 to -2.73) for campaigns promoting immunisation programmes, to -1. 12 (95%CI -0.49 to -2.36) for those concerning cancer screening. REVIEWER'S CONCLUSIONS: Despite the limited information about key aspects of mass media interventions and the poor quality of the available primary research, there is evidence that these channels of communication may have an important role in influencing the use of health care interventions. Those engaged in promoting better uptake of research information in clinical practice should consider mass media as one of the tools that may encourage the use of effective services and discourage those of unproven effectiveness.

Health Education↗
PubMed2001

Health literacy: addressing the health and education divide.

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.

Community Health Planning↗
PubMed2003

Does preventive health care have a chance in the changing health sector in Tanzania?

OBJECTIVE: To investigate the status and practice of preventive health care (relative to curative) in the health delivery system at the time when the health sector reforms are taking place. DESIGN: A cross-sectional, descriptive study. SETTING: The study was conducted in Morogoro District between January and May 1999. SUBJECTS: Eighty six medical personnel and two hospital administrators from thirty four health facilities. The health facilities included twenty five dispensaries, five health centres and four hospitals. Care was also taken to include health facilities owned by various institutions and organisations, including governmental and non-governmental. RESULTS: Generally, preventive health received little attention compared to the curative health measures whereby more than 80% of the medical personnel in some of the facilities were assigned to curative services. Health personnel reported to spend an average of up to six hours per day providing curative services such as chemotherapy, surgical treatment, psychotherapy and radiography. On the contrary, they spent about four hours or less on providing child immunisation and education on nutrition, health and family planning. As expected, the type of ownership of a health facility influenced the extent to which preventive measures were included. For example, while all the government owned facilities did provide child immunisation, nutrition education and family planning services, some non-governmental facilities were lacking such services. CONCLUSION: It is obvious that while the provision of curative health care can be left to the hands of the private suppliers, that of preventive health care needs strong government involvement. It is suggested that deliberate efforts be taken to shift resources from curative to preventive measures. One way in which such a strategy can be attained is for the government to set, as a condition for private operators, a minimum level of preventive measures to be provided by every operator before a permit is issued. However, caution should be taken to ensure that such deliberations do not discourage investors in the health sector.

Cross-Sectional Studies↗
PubMed2002

Summary health statistics for U.S. adults: National Health Interview Survey, 1998.

OBJECTIVES: This report presents health statistics from the 1998 National Health Interview Survey for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, poverty status, and region of residence for chronic condition prevalence, health status and limitations in activity, health care access and utilization, health behaviors, and attitudes toward acquired immunodeficiency syndrome (AIDS). Health statistics by education, income, health insurance coverage, marital status, and place of residence are also presented for health status and limitations in activity, health care access and utilization, health behaviors, and knowledge and attitudes toward AIDS. SOURCE OF DATA: The NHIS is a multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the National Center for Health Statistics, Centers for Disease Control and Prevention, and is representative of the civilian noninstitutionalized U.S. population. Data are collected during face-to-face interviews with adults present at the time of the interview. Also, the self-reported health information for adults in this report was obtained from one randomly selected adult per family. HIGHLIGHTS: In 1998, 65% of adults 18 years of age and over reported excellent or very good health. However, 17% of adults less than 65 years of age had no health insurance coverage, and 14% of adults did not have a usual place of medical care. Twelve percent of adults had ever been told by a doctor or health professional that they had heart disease and 19% had been told on two or more visits that they had hypertension. Nearly a quarter of adults were current smokers, and 23% were former smokers. Sixty percent did not engage in any leisure-time vigorous physical activity, and based on estimates of body mass index, 35% were overweight and 20% were obese.

Absenteeism↗
PubMed2006

Identification of health problems at 18 months of age--a task for physicians or child health nurses?

BACKGROUND: Several studies have questioned the rationality of repeated routine health examinations by physicians during the first years of life. The aim of the present study was to evaluate the population-based 18-month health examination and compare the yield of new health problems identified by physicians in 1994 with the yield identified by child health centre (CHC) nurses in 2000. METHODS: Two populations of children were invited to their 18-month health examination during one year, the first in 1994 and the second in 2000. In 1994 the population consisted of 4075 and in 2000 of 2968 children who were registered in Uppsala county, Sweden, for census purposes in December 31 each year. Data from a county health register as well as child health records and information regarding referrals were analysed to categorize the health problems by type, severity and action taken. RESULTS: On the whole few new verified health problems were detected by the health examinations at the 18 month health examinations: 2.3% in 1994 and 1.7% in 2000. In 1994, when the physicians carried out the examinations, the most common health problems were somatic problems, particularly moderate transient infections. In 2000, when the nurses carried out the examinations, the dominant problems were speech problems. Peculiarly enough a couple of children with the same severe health problems, gluten allergy and problems in the autistic spectrum, were identified both in 1994 and in 2000. In addition the nurses in 2000 identified seven children with severe speech problems. No additional severe health problems were identified by the physicians in 1994. CONCLUSIONS: According to the present study, there is no evidence that health examinations carried out by nurses are of lower quality in detecting health problems than those carried out by physicians. The organization and content of the health surveillance programme ought to be reconsidered with respect to available resources and importance of the close relationship established between nurse and family already in the newborn period.

Clinical Competence↗
PubMed1998

Role of childhood health in the explanation of socioeconomic inequalities in early adult health.

STUDY OBJECTIVE: To examine the contribution of childhood health to the explanation of socioeconomic inequalities in health in early adult life. DESIGN: Retrospective data were used, which were obtained from a postal survey in the baseline of a prospective cohort study (the Longitudinal Study on Socio-Economic Health Differences in the Netherlands). Adult socioeconomic status was indicated by educational level, while health was indicated by perceived general health. Childhood health was measured by self reported periods of severe disease in childhood. Relations were analysed using logistic regression models. The reduction in odds ratios of "less than good" perceived general health for different educational groups after adjustment for childhood health was used to estimate the contribution of childhood health. SETTING: The population of the city of Eindhoven and surroundings in the south east of the Netherlands in 1991. PARTICIPANTS: 2511 respondents, aged 25-34 years, men and women, of Dutch nationality, were included in the analysis. MAIN RESULTS: There was a clear association between childhood health and adult health, as well as an association between childhood health and adult socioeconomic status. Approximately 5% to 10% of the increased risk of the lower socioeconomic groups of having a "less than good" perceived general health can be explained by childhood health. CONCLUSIONS: Childhood health contributes to the explanation of socioeconomic inequalities in early adult health. Although this contribution is not very large, it cannot be ignored and has to be interpreted largely in terms of selection on health.

Adolescent↗
PubMedDate not supplied

Angina patients' ratings of current health and health without angina: associations with severity of angina and comorbidity.

OBJECTIVE: To investigate the relationship between chronic stable angina patients' ratings of two health states (current health and health free of angina), the difference between these two ratings (the "anticipated gain"), and measures of anginal severity and comorbidity. DESIGN: Cross-sectional interviews and questionnaires. SETTING: Out-patient clinics and medical inpatient service of a Veterans Affairs Medical Center. PARTICIPANTS: Patients with chronic stable angina with no prior history of a revascularization procedure attending clinic appointments (n = 44) or electively admitted for cardiac catheterization (n = 11). Measurements. Ratings of current health and health free of angina using a verbal rating scale in which 0 = death and 100 = perfect health, the MOS SF-36, the Index of Coexistent Disease (a validated measure of comorbidity), and a question on the severity of anginal symptoms. RESULTS: Mean (95% CI) rating of current health was 61.8 (59.2, 64.4) and that of health free of angina was 77.0 (74.5, 79.5). Median anticipated gain between the two health ratings was 10.0 (range 0-80). Correlations between ratings for both health states and subscales of the SF-36 were positive, with some reaching statistical significance. In regression models with rating of current health, rating of life without angina, and anticipated gain as the dependent variables, severity of comorbidity was highly significant in all three, whereas severity of angina was significant only in the current-health rating model. Severity of comorbidity had much greater explanatory power in all three models than did severity of angina. CONCLUSIONS: Severity of comorbidity was a better predictor of patients' current health rating, rating for angina-free health, and anticipated gain from relief of angina than was severity of angina. Since patient perceptions of a symptom may be distinct from self-reported symptom severity, treatment-outcome studies should assess patient preferences in addition to symptom severity. Comorbidity should also be measured in such studies. Having patients rate current health and symptom-free health may be a useful measure of treatment effectiveness for specific symptoms in clinical trials and patient care, and may help patients and clinicians prioritize multiple health problems.

Activities of Daily Living↗
PubMed2003

[Health-related lifestyle and mental health among inhabitants of a city in Japan].

AIM: Few studies have linked mental health to lifestyle factors in the Japanese general population. The present investigation was conducted to examine whether mental health is associated with a health-related lifestyle and how the strength of the association, if any, differs across sex and age groups, using health survey data for inhabitants of Japan. METHODS: The data used were obtained from a questionnaire survey on lifestyle and health. In 1998, the questionnaires were mailed to 2,288 subjects selected from among the inhabitants of a city in Japan, of whom 1,642 subjects (71.8%) responded. The present study included 1,343 subjects who completed all the items that were used in the analysis. The General Health Questionnaire (GHQ) -12 was used as an indicator of mental health, with 4 points or higher (high score) indicating poor mental health. Information on eight different lifestyle parameters was also obtained. Logistic regression was used to calculate the odds ratio (OR) of having poor mental health for each lifestyle. RESULTS: Subjects in poor mental health had a lower mean score for a healthy lifestyle than those in good mental health. The difference in the mean score increased with age among men, while it decreased with age among women. The OR for having poor mental health among non-exercisers was higher in the older age group among men, while it was higher in the younger age group among women. A strong association between sleep hours and mental health was observed in the older age group among men, while it was seen in the younger age groups among women. Dietary factors in general showed a clearer association with mental health among women than among men, except for the consumption of salty foods, the association of which with mental health was more evident among men. CONCLUSIONS: Mental health was found to be significantly associated with health-related lifestyles in the Japanese population. The strength of the association for each lifestyle varied considerably across sex and age groups.

Adult↗
PubMed1993

[Health promotion. Planning process of health promotion programs for individuals with arthritis].

Based on the health conception viewed from the literature on nursing and by the clients, health is defined as a living experience, or as a perception of wellness in this study. That is, it is the perceived wellness that the individual obtains by wholistically integrating all dimensions of health where ever the individual stands in the health continuum. Thus health exists independently, regardless of illness or disability, because the individual is able to perceive the wellness within limitations imposed to him/her. Also, based on the health conception defined in this study and the literature review on health promotion, health promotion is defined as the process of enhancing the perception of wellness (i.e., living experience), where ever the individual stands in the health continuum. Therefore, health promotive care represents the process of making client help himself to improve health experience/perception of wellness by selecting and/or integrating the individual or social health parameters (determinants) based on his reality. After analyzing the data which is provided from the related literature and the results from the descriptive/exploratory research on this group of clients, and then applying those analysis results to the PRECEDE model, planning process for health promotion program is established. However, as planning process is only based on data from literature in the first stage, it will be modified appropriately according to the assessment feedback from the direct participation of client in the following study. Based on the planning model refined through this assessment process, health promotion program is to be developed, implemented and evaluated. Planning process of health promotion for clients with arthritis is begun from the assessment of health outcome as the first phase. It is analyzed from this study that clients with arthritis indicates lower quality of life/satisfaction than the other groups from the several research findings indicate. In the second phase, according to the analysis results in the first phase, clients' health problems (perceived seriousness about illness, uncertainty in illness, helplessness, difficulty of movement), which affect the low quality of life, are identified and then program objective for each problem is demonstrated. As an objective for the perceived seriousness about illness, relief of the mistrust on the general effects of treatment for illness is determined through appropriate data analysis. And clients' accumulation of accurate knowledge on the nature of illness is determined as an objective, for reducing uncertainty in the illness. Also enhancement of distraction ability and self-efficacy perception is defined as objectives for reducing physical, psychological and social helplessness.(ABSTRACT TRUNCATED AT 400 WORDS)

Arthritis↗
PubMed1998

Risks and benefits of private health care: exploring physicians' views on private health care in Ho Chi Minh City, Vietnam.

As in a number of other low- and middle-income countries, the health sector in Vietnam is transforming with a rapid shift from fully state run and financed health care towards more private financing and delivery of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority of physicians now are practising in private clinics and where the private health care sector is an increasingly popular option for people. While the private sector is an important part of the health care system in Vietnam, few data are available on the characteristics and quality of private health care services. This case study describes some aspects of the re-emerging private health care sector in Ho Chi Minh City, Vietnam, from the view of 27 private and non-private physicians. The paper explores physicians' reasons for going private, physicians' notions of patients' health care preferences, and physicians' views on potential influence of financial incentives on characteristics of private health care. The characteristics of private health care are discussed in relation to a context of private health care characterised by a fully patient-financed fee-for-service payment system, weak regulatory mechanisms, and a public health care system (government-run and-financed health care) that operates under resource constraints. Issues to consider when attempting to steer private health care in Vietnam in a direction where it can optimally contribute to public health, are discussed while considering the interplay between authorised private practitioners, private pharmacies, the informal private sector, and the public health care sector.

Adult↗
PubMed1999

Do risk factors and health behaviours contribute to self-ratings of health?

This study examined the relative importance of five risk factors and health behaviours (namely dietary habits, leisure time exercise, smoking, alcohol consumption and body mass index) on self-ratings of health among the Swedish adult population. The data come from the 1991 Swedish Level of Living Survey, a face-to-face survey interview based on a sample representative of the Swedish population aged between 18 and 75 years (n = 5306). The analyses were carried out using logistic regression analysis. With the exception of the consumption of dietary fat, all the risk factors and health behaviours studied were associated with self-rated health. When they were adjusted for health problems and functional limitations most of the associations weakened or disappeared altogether, but smoking and use of vegetables in the diet were still associated with self-rated health. Self-ratings of young adults (18-34 years) were found to be related to body mass index even when health problems were adjusted for, with both obesity and underweight contributing to less than good self-rated health. The results indicate that risk factors and health behaviours do not, in general, directly contribute to self-ratings of health. Instead, their effect is mediated by more specific health problems and their functional consequences. However, smoking and not consuming vegetables, as well as obesity and underweight among young respondents, were found to have an independent association with self-rated health. This may reflect the effects of health problems not captured by our indicators of ill health, but may also indicate that risk factors and risky behaviours are considered to have an effect on one's perceived health even in the absence of health consequences.

Adult↗
PubMed2005

Patient self-efficacy and health locus of control: relationships with health status and arthritis-related expenditure.

OBJECTIVE: To explore the relationship between measures of self-efficacy, health locus of control, health status and direct medical expenditure among community-dwelling subjects with rheumatoid arthritis (RA) and osteoarthritis (OA). METHODS: This analysis is part of a larger ongoing study of the costs and outcomes of arthritis and its treatments. Community-dwelling RA and OA respondents completed questionnaires concerning arthritis-related expenditure, health status, arthritis related self-efficacy and health locus of control. RESULTS: Data were obtained from 70 RA respondents and 223 OA respondents. The majority of respondents were female with a mean age of 63 yr for RA respondents and 68 yr for OA respondents. Among the RA respondents, those with higher self-efficacy reported better health status and lower overall costs. Health locus of control was not consistently correlated with health status. OA respondents with higher self-efficacy reported better health status and lower costs. Health locus of control had more influence. OA respondents with higher external locus of control reported worse pain and function. A higher belief in chance as a determinant of health was correlated with more visits to general practitioners and a higher cost to both the respondent and the health system. CONCLUSION: Higher self-efficacy, which is amenable to change through education programmes, was associated with better health status and lower costs to the respondent and the health system in this cross-sectional study. Locus of control had less of an influence; however, the tendency was for those with higher external locus of control to have higher costs and worse health status. As the measurement of these constructs is simple and the outcome potentially affects health status, these results have implications for future intervention studies to improve quality of life and reduce the financial impact of arthritis on both the health-care system and patients.

Arthritis, Rheumatoid↗
PubMed2007

Early adolescents perceptions of health and health literacy.

BACKGROUND: Health illiteracy is a societal issue that, if addressed successfully, may help to reduce health disparities. It has been associated with increased rates of hospital admission, health care expenditures, and poor health outcomes. Because of this, much of the research in the United States has focused on adults in the health care system. This study investigated the effect of aspects of health literacy on the motivation to practice health-enhancing behaviors among early adolescents. METHODS: Measures were generally based on 3 National Health Education Standards for grades 5-8. Data were obtained from 1178 9- to 13-year-old students visiting 11 health education centers in 7 states. Students responded via individual electronic keypads. RESULTS: Multivariate logistic regression revealed that, in addition to age, difficulty understanding health information and belief that kids can do little to affect their future health, decreased the likelihood for interest in and desire to follow what they were taught about health. Further, low interest independently decreased motivation to follow what was taught. Girls were more likely to turn to school, parents, and medical personnel for health information. Older students were more likely to turn to school and to the Internet. CONCLUSIONS: Programs and curricula should be designed to increase student interest in health issues and their self-efficacy in controlling their own health destinies. Educators should also teach students to more effectively use nonconventional health information sources such as the Internet, parents, and medical professionals.

Adolescent↗
PubMedDate not supplied

Health promoting effects of friends and family on health outcomes in older adults.

OBJECTIVE: To highlight the significant impact of social relationships on health and illness and suggest implications of these effects for health promotion efforts among older adults. DATA SOURCES: Published studies on social relationships and health (or health behaviors) for the period 1970-1998 were identified through MEDLINE by using the key words social relationships, social support, and health, as well as review of health-related journals such as the American Journal of Epidemiology, Annals of Epidemiology, American Journal of Public Health, Journal of Health and Social Behavior, Social Science and Medicine, and the Journals of Gerontology. STUDY SELECTION: Major published original research was considered. Where published research was too extensive for full discussion of all studies, preference was given to studies focusing on older adults and those using stronger methodology (i.e., representative samples, longitudinal data, or multivariate analyses controlling for potential confounders). DATA EXTRACTION: Reported findings were organized in terms of three major categories: (1) results related to major health outcomes such as mortality, CHD, and depression; (2) findings related to health behaviors; and (3) findings related to potential biological pathways for observed health effects of social relationships. DATA SYNTHESIS: Protective effects of social integration with respect to mortality risk among older adults are the most thoroughly documented, although protective effects have also been documented with respect to risks for mental and physical health outcomes and for better recovery after disease onset. There is also now a growing awareness of the potential for negative health effects from social relationships that are characterized by more negative patterns of critical and/or demanding interactions, including increased risks for depression and angina. Biological pathways are suggested by evidence that more negative social interactions are associated with physiological profiles characterized by elevated stress hormones, increased cardiovascular activity, and depressed immune function, whereas more positive, supportive social interactions are associated with the opposite profile. CONCLUSIONS: Available data clearly indicate that social relationships have the potential for both health promoting and health damaging effects in older adults, and that there are biologically plausible pathways for these effects. Such evidence suggests that aspects of the social environment could play an important role in future health promotion efforts for older adults, although careful consideration of both potentially positive as well as negative social influences is needed.

Aged↗
PubMed1992

The role of public health surveillance: information for effective action in public health.

Public health surveillance can provide the quantitative information needed for setting priorities and establishing rational health policy. Although there are many examples of the effective use of such information, the full potential for surveillance has not yet been realized. To a large degree, failure to achieve this potential has resulted from limited perspectives regarding the role and conduct of surveillance. Both practitioners (those who conduct surveillance) and users (those who apply surveillance data in a real-world setting) have fallen victim to such myopia. Public health surveillance must be advocated as an essential part of the global health agenda if we are to achieve international goals for improving health status. As we improve our appreciation of the variety of uses for public health surveillance data, we need to understand more fully the determinants of the decision-making process. Effective dissemination of information and effective communication are as important as data collection and analysis. No longer do we have--or should we have--the luxury of collecting information for its own sake. The information collected must have a demonstrated utility. Developing and training personnel to have expertise in public health surveillance will necessarily incur opportunity costs. Bridging gaps in data methodology and coverage will force us to weigh alternatives and to compromise. We hope that the International Symposium on Public Health Surveillance will accomplish several goals. First, we wish to foster international understanding of the definition, role, and importance of surveillance in reducing morbidity and mortality, in improving quality of life, and in setting effective health priorities. Second, we hope that this symposium will serve as a springboard for identifying issues and topics that can be addressed in greater depth at future international meetings. Finally, we see the symposium as an essential step in developing a firm commitment on the part of countries, donor agencies, and multilateral organizations to develop the essential capacity for public health surveillance throughout the world. Each country should have the capacity to measure and monitor changes in health status, risk factors, and health-service access and utilization among its people. All countries should have the means to detect emerging health problems and implement measures for their control, to evaluate the impact of health policies and programs, and to communicate health information in a meaningful fashion to policymakers and the public. If we are successful in these endeavors, the long-term effects on the public's health will be well worth the struggle required to achieve them.(ABSTRACT TRUNCATED AT 400 WORDS)

Global Health↗
PubMed2005

[Health resorts and development of the health resort medicine in Lithuania].

Lithuanian health resorts are national resources of this country. Body hardening, health promotion, disease prevention and rehabilitation by means of applying natural factors are linked for centuries with the names of health resorts such as Druskininkai and Birstonas. The effect of natural factors is multiplex and depends on many parameters the study of which in concrete health resorts is indispensable in order to individualize the treatment at the health resorts and avoid undesirable side effects. As the contingent of the patients being referred to the sanatoria is changing--the number of severe patients after acute disorders and traumas is increasing constantly--the need of such studies becomes relevant. However, after renewal of independence of Lithuania in 1990, the policy of health resort development on the national scale has not been carried out yet. Besides, the number of localities that aim for becoming health resorts is increasing, however, such localities often do not meet the required criteria. The article reviews the status of health resorts and their localities together with their regulations in Lithuania, their development, specificity, the effects of the health resort natural factors (climatotherapy, balneotherapy, pelotherapy) on the healthy body and patients. The data are presented on the development of research studies concerning health resorts and main trends of health resort medicine: health promotion, prevention of disorders, early health resort rehabilitation, health resort tourism, treatment and health resort etiology. Possibilities of revival of studies concerning the effects of health resort factors on the rehabilities are discussed.

Balneology↗
PubMedDate not supplied

Peer health advisor program to reduce the health risks of university students.

Health promoters in the United States need to address the challenge of reducing health risks in young adults. The conditions that lead to the largest percentages of early disabilities and deaths are related to lifestyle characteristics. As health care costs continue spiraling upward, many professionals question the use of solely medical solutions to health problems. Health leaders have called for a change in priorities from curing the sick to keeping people well. Reducing health risks will increase longevity, improve quality of life, and reduce health care costs. It is widely believed that during the adolescent and young adult years many important health habits are formed and set. An individual person's health destiny can, in fact, be greatly shaped by the attitudes, behavior, and knowledge adopted during the early years of independence. For these reasons, wellness and self-care programming for college students is vital and worthy of being rigorously explored and evaluated. In this health promotion proposal, peers deliver a Lifestyle Health Planning Program to university students. They can encourage an internal locus of control over health matters and a perception of choice in those they counsel. The peer advisors conduct one-on-one sessions and outreach programs in the subject areas of fitness, nutrition, health-impairing habits, stress management, and sexuality. Promoting self-responsibility during college years can set lifelong positive health habits. A group of trained peer health advisors can be an innovative device to implement a health promotion program in a university setting.

Adult↗