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The drinking patterns and the attempt to institute prohibition during 1969-71 on Namoluk Atoll, in the Eastern Caroline Islands, are described. The question of prohibition became a symbol of an intergenerational struggle for political power, which was eventually won by the younger antiprohibitionists.
This article is a reflection about the form of Brazilian nursing professional organization, highlighting the limits of the current model and the challenges for the future. It is based on the authors' analysis of an important social movement of Brazilian Nursing, the "Participation Movement" that took place from 1980 to 1990. This Movement has promoted a reflection about nursing work and organization and about nursing participation in the country's re-democratization, as well as defending the right to health. This article summarizes some gains obtained by the movement, especially in the Brazilian Nursing Association-ABEn, and limits in the discussion about the professional organization. It highlights the need to establish agreements and to include in the "Nursing Political-Professional Project" the importance of building a unifying organization originating from ABEn.
Historicizing the development of the Brazilian Nursing Political-Professional Project (PPPEB), at the Brazilian Nursing Association-Parana Division (ABEn-PR), under the optical overview of the ex-presidents during the years 1980 and 2001, identifying future action perspectives. Data information was collected with interviews and documental research with seven ex-presidents. Concluding that the PPPEB directives, directed the researched management actions. The ex-presidents showed a sense of responsibility, commitment with the Union, with the association and also with the SUS users (Health Unique System). Within the difficulties, pointed low participation of the associated, also the Board Directors; low number of associates, financial instability, and others. Future perspectives suggest an increase of nursery adhesion at the ABEn, stimulated since the college, in order to consolidate the PPPEB.
Authors presents an evolution of the public health's politics in Brasil through a critical review of the historical process. Besides this they call to the importance of this issue in the undergraduate curricular in nursing.
The article examines the conditions in Chile that fostered development of a social medicine doctrine defended by the left. This doctrine influenced the legal, institutional, and technical construction of the Servico Nacional de Saude (SNS) in 1952. Central to the workings of the democratic regime (up until 1973) and to the free and open public discussion of national projects of a socializing nature was a party system that encompassed the entire ideological spectrum. The pioneering creation of Workers Social Security in 1924 is underscored. Likewise of import was the emergence of transformational proposals regarding the health-assistance model that is consolidated. Ensuing conflicts were finally overcome following World War II, under the influence of England's National Health Service. Chilean political culture yielded the consolidation of lasting concepts in social medicine but created barriers to the project to build a universalized sanitary-medical system, intended to provide integral care to all citizens.
This analysis of the 1953 creation of the Ministry of Health identifies the main actors involved, their interests, and the strategies they employed to reach their goals and influence the process of institutional change. Placing the process within the context of the era's specific political characteristics, the article identifies the predominant decision-making arena as well as emergence of this new, autonomous government agency for public health.
Results from three national surveys in Haiti suggest that the prevalence of stunting, underweight, and wasting in children fell considerably between 1978 and 1990. In the following four years, rates of stunting and underweight levelled off, while that of wasting nearly doubled. Child nutrition deteriorated dramatically during a period of intense political crisis and international sanctions that included a strictly enforced trade embargo. Human welfare should be monitored whenever international sanctions are imposed to regulate a country's behavior.
The election of a democratic, nonracial government in South Africa has moved the health needs of the majority of the population to center stage. In the search for precedents, health policymakers have turned to South Africa's pioneering of health centers and social medicine in the 1940s. This paper looks at the intellectual context in which these ideas were first developed; the particular political circumstances and relationships between doctors and the state in the late 1930s, which facilitated the establishment of health centers; the role that the health centers were intended to play in South Africa's wider postwar health plans; and the reasons for the centers' failure. Contrary to conventional wisdom, it argues that the failure of the health centers and the wider health plans predated the advent of the National Party to power in 1948, and resulted mainly from the marginalization of the centers as a low-cost option for the poor, which was itself a consequence of underfunding and the vested interests of local health authorities and private practitioners.
In both African and Asian colonies until the late 19th century, colonial medicine operated pragmatically to meet the medical needs first of colonial officers and troops, immigrant settlers, and laborers responsible for economic development, then of indigenous populations when their ill health threatened the well-being of the expatriate population. Since the turn of the century, however, the consequences of colonial expansion and development for indigenous people's health had become increasingly apparent, and disease control and public health programs were expanded in this light. These programs increased government surveillance of populations at both community and household levels. As a consequence, colonial states extended institutional oversight and induced dependency through public health measures. Drawing on my own work on colonial Malaya, I illustrate developments in public health and their links to the moral logic of colonialism and its complementarity to the political economy.
The issue of environmental tobacco smoke (ETS) and the harms it causes to nonsmoking bystanders has occupied a central place in the rhetoric and strategy of antismoking forces in the United States over the past 3 decades. Beginning in the 1970s, anti-tobacco activists drew on suggestive and incomplete evidence to push for far-reaching prohibitions on smoking in a variety of public settings. Public health professionals and other antismoking activists, although concerned about the potential illness and death that ETS might cause in nonsmokers, also used restrictions on public smoking as a way to erode the social acceptability of cigarettes and thereby reduce smoking prevalence. This strategy was necessitated by the context of American political culture, especially the hostility toward public health interventions that are overtly paternalistic.
In this article, based on a speech to the European Association of Health Policy, the author discusses the political context in which health inequalities research has historically operated in the United States. The discussion focuses on the limitations of research that uses income, consumption, and status as the primary categories of research practice, and demonstrates these limitations by critically analyzing The Health of Nations (by Kawachi and Kennedy). The author concludes that it is essential to use categories of analysis that focus on class relations as well as race and gender relations and their reproduction through the international and national institutions, to study their impact on the health and well-being of populations.
The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long-suffering rural populations to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, either the earlier, somewhat sincere efforts to develop endogenous mechanisms to offer access to health services or the devastating impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, technocentric vertical programs on the people of India. They also ignore some of the basic postulates of public health practice in a country such as India. That they did not substantiate the bases of some of their contentions with scientific data from health systems research reveals that they are not serious about their promise to rural populations. This is yet another instance of what Romesh Thaper called "Baba Log playing government government."
The economic and political development of health care in the Federal Republic of Germany is analyzed within the framework of overall social development. This will be shown describing the main components of the health care system: outpatient care, inpatient care, the dispensing of medicines, and statutory health insurance. The functions of the state and the influence of the pressure groups, i.e. the medical professional associations, are examined. Finally, an assessment of the present situation is made.
Since the mid-1980s international donors have promoted vertical, campaign-based strategies to help improve immunization coverage in poor countries. National immunization days (NIDs) are currently in vogue and are prominent in the worldwide polio eradication efforts. In spite of their widespread use, campaigns that include NIDs have not been well evaluated for their effects on coverage, reduction in vaccine-preventable diseases, or effects on the health system. An assessment of the results of two such campaigns implemented in Ecuador and El Salvador shows limited impact on short-term coverage and questionable effects on long-term coverage and disease incidence. Although NIDs may have substantial short-term political benefits, the vertical approach can undermine provision of routine services by ministries of health and may be counterproductive in the long-term.
After presenting data on how various ethnic/racial and income groups cast their votes in the 2000 presidential election, this article addresses the question of why Al Gore did well enough to beat George W. Bush in the popular vote but not well enough to prevent Bush from achieving a virtual tie. The author challenges some arguments put forward--Gore's being "too much of a populist" and not running on the achievements of the Clinton administration--and, based on poll data, suggests that more important to voters were problems of trust, cultural conservatism, and generic anti-government sentiment. These findings on the 2000 election suggest a number of possibilities about the political future and some ways in which the Democratic Party might develop its program to win back voters.
For the first time ever, a Green party has governed in Germany. From September 1998 to January 2001 the German Green party, Bündnis 90/Die Grünen, held the Federal Ministry of Health. Little has been said so far about Bündnis 90/Die Grünen and its relation to health policy. This article is intended to fill that void. An analysis of the health policy program of the Greens reveals that it centers around moving the health sector toward more comprehensiveness and decentralization, strengthened patients' rights, increased use of preventive and alternative medicine, and a critique of the German cost-containment debate and policy. The current health policy program of the Greens is closest to that of the Party of Democratic Socialism, and to a lesser extent it has affinities to the program of the Social Democratic Party. The health policy program of Bündnis 90/Die Grünen is furthest from those of the Christian Democratic Union and the Free Democratic Party. The health care reforms passed in 1998 and 1999 were not a shift toward a "Green paradigm" of health care policy, because they included no fundamental changes. In addition, cost-containment is still a major political goal in German health care policy.
The research tradition of old age stereotypes has typically been limited to a social psychological perspective of their dysfunctional consequences. This exploratory study examines the possible functions served by such stereotypes from a sociocultural frame of reference, in particular, testing the hypothesis of Richard Kalish and Carroll Estes that problem-oriented conceptions of older persons are part of an emerging political ideology. Using the responses of the Louis-Harris-NOCA "The Myth and Reality of Aging in America" survey, the relation between aging stereotypes and attitudes toward federal support of the aged are reported.
This article reviews the deteriorating health situation of the Palestinian population during the post-Oslo period of the Palestinian Authority and during the current Intifada. It seeks to record findings obtained through primary participants and documents and from personal observations in the field that situate Palestinian health conditions within their political framework. The ongoing crisis highlights longstanding problems in the Palestinian health infrastructure, which make it more vulnerable to Israeli policies, especially the movement restrictions and closures. Efforts by Palestinian professionals and the international health community to provide health services have been constantly thwarted. The Israeli authorities' disregard for Palestinian health care has escalated since 2000 and is directly responsible for a vast number of Palestinian deaths. Israel's indiscriminate obstructions to the coordinated functioning of a health care system in Palestine increase morbidity, degrade health, promote premature deaths, and damage the medical infrastructure. Moreover, the Israeli actions transgress international law and, ultimately, make peace in the region much less likely. This analysis provides further evidence of the social justice violations and the wide-ranging effects on health experienced daily by the Palestinian people as a direct result of the Israeli military occupation.