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PubMed2004

(In/Out)side AIDS activism: searching for a critically engaged politics.

Experience has always been a hallmark of activist work; my work in AIDS activism began with my family's role as caretakers for two children whose parents died of HIV-related complications. Previously, my scholarly work critiqued political and medical establishments and their policies surrounding HIV/AIDS. At the NEH institute, I interacted with the medical world, shadowing nurses and doctors. Through this experience, I discovered the importance of interactivity as a crucial element of the critically engaged AIDS activist experience, creating a more thorough understanding of the medical establishment and a more humanized portrait of hospitals and their staff.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Comparing the incommensurable: where science and politics collide.

Arguments about the possibility that cognitive variables may play a causal role in human behavior are unlikely to be resolved in favor of one side or the other, because they set against each other two incommensurable views of human agency. Contemporary cognitive models of psychology are based on an implicitly dualist view of human behavior, assuming the existence of a nonmaterial mental realm which has the capacity to act on the material world. Critics, by comparison, frequently argue from an epiphenomenalist position. While there may be sound scientific reasons for rejecting self-efficacy theory, and particularly for rejecting the utility of the concept that behavior is caused by efficacy expectations, this paper argues that epistemic criteria are frequently less important than a sense that a theory is compatible with a particular world view. I argue that cognitive theories are accepted by the psychological mainstream because their dualist basis accords with deeply held cultureal beliefs about the relationship between the person and the world. However, the social and political consequences of such models are rarely articulated, and there is a need for psychologists to develop a more explicit understanding of the relationship between psychological theories and their broader implications.

Cognition↗
PubMed1991

The Pariacaca or Tullujuto story: political realism?

The first documented description of acute altitude sickness was published by Father Acosta in 1590. Acosta described this sickness when he traveled through a pass across the Andean divide in central Peru near the mountain Pariacaca. Almost all the maps of modern Peru do not name this mountain. We present evidence that mountaineers who have climbed this mountain know it as Tullujuto. This change in name is the reason why physiologists have found it difficult to locate Acosta's route; consequently the altitude where Acosta experienced this sickness could not be determined until recently. Further, we speculate that political pressures in the late 18th century caused the place name of Pariacaca either to be obliterated or else to be changed to Tullujuto.

Altitude Sickness↗
PubMed1991

Hospital management of voluntary total fasting among political prisoners.

In 1989 20 political detainees, held without trial for up to 32 months, were admitted, on hunger strike, to the Johannesburg Hospital, South Africa. Most were held under the regulations of the State of Emergency (since revoked) and 5 were held incommunicado under section 29 of the Internal Security Act (still in force). Guidelines for ethical management were based on the Declaration of Tokyo, which included the understanding that such detentions constituted mental torture. Conditions of detention in hospital were complicated by police interference in medical and nursing care, and by the chaining of some prisoners to their beds. Doctors are in a unique position to protest against inhuman treatment of prisoners, and should use this authority.

Adolescent↗
PubMed1996

The politics of nutrition in North America.

In the 100-odd years since the rise of modern nutritional science, North American' ideas about food and health have been influenced by much more than the scientists' findings. They have invariably been affected by political considerations. War, fear of revolution, leftist ideology, and the enormous financial stakes of giant food producers have all played important roles in shaping ideas about nutrition.

Humans↗
PubMed1991

Political change and course of affective psychoses: Berlin 1989-90.

In this study, the political change associated with the fall of the Berlin Wall in November 1989 was examined as a shared life event for the population of West Berlin. Its influence on the course of affective psychoses was studied in 67 patients in long-term treatment. Recurrences from November 1989 to March 1990 were compared with the same period 1 year before. While patients with bipolar affective psychosis did not show a difference in recurrences between the two periods, patients with unipolar depression had a significantly better and those with schizoaffective psychosis a significantly worse course of illness after November 1989 than in the year before.

Affective Disorders, Psychotic↗
PubMed1989

Political decision-making in health care: the Dutch case.

In many western countries health care is a subject of increasing importance on the political agenda. Issues such as aging, development of medical technologies, equity and efficiency of care, increasing costs, market elements, etc. are leading to a review of existing health care systems. In The Netherlands the government has proposed fundamental changes in the structure and financing of care, based on a report by the so-called Dekker Committee. The final result of a step-wise process of change should be the introduction of a new insurance scheme and the strengthening of market elements. After a short description of the government proposals, this article gives an analysis of the process of decision-making for a restructuring of health care in the Netherlands. The analysis is based on a bureaupolitical model, as originally described by Allison.

Decision Making↗
PubMed1989

Local housing scheme and political preference as conditions for the results of a health centre-stimulating policy in The Netherlands.

About two decades ago, changes in the demand for primary care in the Netherlands resulted in a need for more interprofessional collaboration. Health centres developed as a new supply of integrated care. The government was aware of the importance of this phenomenon in its policy to strengthen primary care. The encouragement of health centres was a crucial part of it. The development of this policy and the resulting growth in the number of health centres will be reviewed here. In general, this growth is lagging behind initial policy expectations, partly because of a lack of instruments to implement PHC policy. Examination of geographical distribution of health centres, however, shows a variation suggesting that local factors also affect the development of health centres. Empirical findings show that the number of newly built houses in an area and the political 'colour' of the alderman for public health play a role in the development of health centres and thus co-determine the results of a central promotion policy to a certain extent.

Analysis of Variance↗
PubMed1985

Legal and political aspects of the regulation of chemicals: Swiss environmental protection law.

The premises for regulations in the field of ecology demonstrate clear scientific deficiency regarding basic relations in technical and scientific aspects but also a deep political disagreement on how to cope with them. These characteristics result in a new kind of law whose prime notion is to satisfy a social concern. The Swiss ecology regulation may be qualified as a so-called "tentative legislation." The structure of this kind of legislation is shown in the use of unclear notions, goal-oriented rules, and deviation to governmental and administrative regulation and may even lead to a more or less symbolic use of legislation.

Environmental Pollution↗
PubMed1982

Politics and medicine: the case of Israeli National Health Insurance.

The paper focuses on the attempts to introduce a national health insurance system in Israel. So far all these attempts advanced through six public committees and various legislative initiatives have been futile. The major actors involved in the process of NHI formulation are (a) the sick funds, the largest of which (KH) nearly monopolizes the health services; (b) political parties which are affiliated with the sick funds; (c) the Israeli medical association. The labor oriented parties and sick funds aimed for the introduction of an NHI system which would strengthen KH and preserve its autonomy. The right wing parties and sick fund advocated nationalization of the NHI. The IMA took a mid-way position not identifying with either of the parties. By allying with a small coalition party it was effective in impeding the legislative process that was initiated by the Labor Party. The vigorous opposition of KH has hindered the adoption of the Likud's version of the NHI. Hence, the issue, torn between conflicting parties, reached a stalemate which is not likely to be resolved in the near future.

Insurance, Health↗
PubMed1982

Social, spatial and political determinants of U.S. abortion rates.

Abortion rates in the United States have risen annually since the 1973 Supreme Court decision. The regions with the greatest rate increases are the Southern and Plains states; the lowest rate increases were in regions which had high abortion rates soon after abortion was legalized. While spatial contiguity appears to influence abortion rates, that is, states with high rates of abortion are clustered spatially, social and political influence are also evident. Ratification of the equal rights amendment, the seeking of abortion outside the state of residence, and the degree of urbanization within a state are variables which influenced U.S. abortion rates between 1973 and 1977.

Abortion, Legal↗
PubMed1982

The political economy of sexism in industrial health.

In the last several years, increasing numbers of American women have lost their industrial jobs or have been refused jobs because they are of child-bearing age. Industrial physicians and management in manufacturing plants using various chemicals have decided that the risk their women workers take of having deformed children as a result of workplace hazards is such that the women must be 'protected'. An alternative 'choice' given to many of these women is proof of sterilization in order to maintain or attain jobs. In choosing to approach the growing problem of workplace contamination in this fashion, management and industrial physicians ignore the effects of chemical toxins on male employees' reproductive systems, and obscure the larger problem of hazards to all employees' total body systems. This paper explores the political economy of the interactions between Society, the Medical System and Women in a Capitalist State, in order to uncover the flow of forces operating in this conflict. Using an historical perspective, a feminist analysis is made of the social order, and a model is presented which demonstrates the articulations between the domains mentioned above, particularly the historical control by the medical system as an agent of the state.

Capitalism↗
PubMed1985

Health services and the political culture of Saudi Arabia.

Health services occupy a high priority in the development agenda of Saudi Arabia, Saudi culture--devotion to Islam, extended-family values, the segregated status of females and the Al Saud monarchic hegemony--is being formulated in an increasingly deliberate fashion, constituting a new 'political culture' which acts as a screen to insure that technological and human progress remain within acceptable bounds. There is a general disposition on the part of the Saudi populace to use modern health services as these become available, largely under governmental auspice. The role of the government in providing health care for pilgrims during the hajj to Mecca is of particular culture importance. Cultural sensitivities concerning male physicians and female patients will be minimized by the training of a substantial number of Saudi female physicians, whose efforts will be directed toward female patients. At present, most health care in the Kingdom is delivered by male expatriate physicians, as part of the general massive reliance upon expatriate workers: although the expatriates will eventually be replaced by Saudi physicians, this dependency, which is felt to threaten Saudi culture, will continue for a decade or more. Private medicine is rapidly increasing though not on the same scale as government medicine. The provision of government health services is a source of legitimation for the Al Saud regime. In general, health services appear to constitute a form of modernization which meets the test of cultural compatibility.

Attitude to Health↗
PubMed1986

Politics and policies of food self-sufficiency in Tanzania.

Since independence, Tanzania has stated her food production goals in many national declarations and indicated how the policies were to be met. Implementation of policies has not produced more food because the political ends were not consistent with economic directions. This paper discusses both.

Adult↗
PubMed1986

Curative medicine, preventive medicine and health status: the influence of politics on health status in a rural Mexican village.

This paper examines a recent program which purports to address the health concerns of millions of poor rural Mexicans whose constitutional guarantees of health have been largely ignored. This new program asserts the importance of preventive medicine, but makes little effort to implement preventive measures. The curative medicine it does emphasize in practice may alleviate pain and suffering for a time, but ignores critical factors that contribute to the persistence of disease. This paper examines why underdeveloped countries are more likely to implement curative than preventive services for poor people, even while proclaiming the importance of preventive measures. In dependent capitalist economies, the rural penetration of state-directed health services perpetuates the privileged position of the political and economic elite. Based on research conducted in a highland Chinantec village in Oaxaca, this paper concludes that the recent health services program addresses symptoms rather than causes of disease and is not likely to significantly improve the health status of the people who are most in need of such assistance.

Delivery of Health Care↗
PubMed1988

The political economy of health care: colonial Namibia 1915-1961.

The political economy of health care services in colonial Namibia during 1915-1961 closely reflected the extreme racial and class imbalance of power in a conquest state. The colonial power allocated to the indigent nine-tenths, the poorest nine-tenths of the people, an average 43% of the health care budget between 1922 and 1954. The League of Nations mandate proved toothless in pressuring the Mandatory power to rectify this or other inequalities.

Black or African American↗
PubMed1989

The political economy of workers' health and safety.

The paucity of social science research on workers' health and safety (WHS) is noted and a framework based on class struggle within the capitalist political economic world-system is suggested. It is hypothesized that the historical and current strengths of workers' movements within nation states will largely determine the adequacy of provisions for WHS. This hypothesis was generally confirmed through field studies in Sweden, Finland, the German Democratic Republic, the Federal Republic of Germany, the U.K. and the U.S.A. However, one key aspect, the linkages between the general health services, especially at points of first entry (sometimes inappropriately referred to as primary health care, PHC) and WHS are highly problematic in all systems. Workers and their representatives, as well as concerned WHS and public health workers should develop greater awareness, concern and understanding of this PHC-WHS problem as well as other aspects of WHS.

Europe↗
PubMed1989

The politics of immunization in public health.

The role of socio-political and psychological factors in the decision to immunize is explored using data collected in a county health department in the United States. Decisions regarding the administration of post-exposure immunizations for hepatitis A and rabies are described, and a tendency toward unnecessary use noted. At times these interventions function more to reduce the anxiety of a patient or clinician than they do to prevent an infection. These findings may have implications for analyses of clinical decision making that involve other types of interventions.

Decision Making, Organizational↗