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PubMed2003

Social differentials in the decline of infant mortality in Sweden in the twentieth century: the impact of politics and policy.

This article describes some of the policies behind the decline of infant mortality in Sweden during the 20th century, from very high levels and large social differentials at the turn of the 19th century to one of the lowest levels in the world by 1950. Political commitment to reducing infant mortality and disparities between groups, a more equitable distribution of economic resources, and a successful combination of universal social and health policies most benefiting the least advantaged families and their children contributed to this favorable development.

Health Policy↗
PubMed1991

Political action committees: how much influence will $7.7 million buy?

The influence of health-related political action committees (PACs) continued to grow during the 1990 election campaign. During the first 18 months of the election cycle, contributions from medical and health care PACs to congressional candidates reached a total of $7.7 million. Among the leading PACs were the American Medical Association, American Dental Association, and American Hospital Association, which contributed a total of $3.3 million to congressional races through September 1990. For its study, HealthWeek monitored the contributions and Federal Election Commission reports of 52 leading health care PACs, including professional and trade associations, drug companies, insurers, and other groups. Trade groups made up about two-thirds of all PAC dollars spent, and several of these groups increased their spending significantly in the 1990 election cycle. Key lawmakers on health-related congressional committees received nearly $1.5 million from health care PACs, the study found. In all, 16 senators and representatives received more than $30,000 each from health care PACs. Senator John D. Rockefeller IV (Democrat, West Virginia) and Representative Thomas Tauke (Republican, Iowa) led the Senate and House, respectively, in total PAC receipts.

American Dental Association↗
PubMed1999

The politics of "natural" disaster: who made Mitch so bad?

The devastation in Central America following the 1998 hurricane (Hurricane Mitch) resulted more from economic and political policies than from "natural" disaster. Over the last 30 or 40 years, huge numbers of poor people in these countries have been forced off good, stable agricultural land onto degraded hillsides and into shanty towns constructed on floodplains--areas known to pose serious hazards of flooding and mudslides. This, together with the failure of impoverished countries to anticipate disaster through mass evacuations or to respond effectively to the hurricane's widespread damage--ensured the loss of thousands of lives.

Central America↗
PubMed1990

The politics of Alzheimer's disease: a case study in apocalyptic demography.

Catastrophic projections of the burden to society of an increasing aging population abound. The prevailing belief is that an increasing dependent aging population means increasing demands on the resources of society, including health care resources, in the face of competing interests and diminishing, or at best finite, resources. But how justified is this "apocalyptic demography"? This article presents one challenge to the apocalyptic scenario by considering the politics surrounding the most publicized, although not the most prevalent, disease of elders: Alzheimer's disease. The recent emergence of Alzheimer's disease as the "fourth or fifth leading cause of adult deaths" is critically examined, and the evidence for the social construction of Alzheimer's disease in terms of the "biomedicalization of aging" discussed. The author considers that it is, in part, the response of the health care system (as it is currently constituted) to changes in demography and disease distribution--and not, as is commonly asserted, the numbers of elders or their increasing "morbidity"--that drives up health care costs.

Aged↗
PubMed1978

The political economy of controlling transnationals: the pharmaceutical industry in Sri Lanka, 1972-1976.

This paper describes the experience of Sri Lanka in reforming the structure of production, importation, and distribution of pharmaceuticals in the period 1972-1976. It highlights the actions and reactions of transnational pharmaceutical corporations to these reforms, and traces the achievements and problems of the State Pharmaceuticals Corporation which was set up to implement the reforms. The roles of political leadership in regulating the power of drug transnationals, and of the medical profession in resisting reform, seem to be of crucial significance. Developing countries wishing to lower the present high cost of drug delivery must proceed with great care and immense caution, since complex problems of quality control, bioequivalence, medical acceptance, and consumer reeducation are involved.

Drug Industry↗
PubMed1984

The politics of stress: the case of air traffic control.

Analysis of the 1981 Professional Air Traffic Controllers Organization strike suggests that workers who employ the concept of stress to describe undesirable job conditions risk unexpected negative consequences. In deciding not to make subjective claims that can only be addressed in political terms, workers necessarily appeal to outside experts to provide scientific, objective descriptions of job conditions. Unfortunately, different experts define stress in strikingly different ways, allowing for a kind of shell game in which the very existence of stress can become problematical. In addition, the stress experts have been unable to offer more than weak data to support the theories that link difficult working conditions to pathological outcomes. Thus workers are likely to lose labor disputes that depend on the stress discourse. A major reason for such an outcome is that job conditions, as part of the social world, lend themselves poorly to a form of inquiry designed to investigate the physical world.

Aviation↗
PubMed1993

The politics of reform: public health insurance in Canada.

The centerpiece of Canadian health policy is a system of public health insurance covering the cost of hospital and medical services for all Canadians. The author analyzes the historical development of this policy and critically assesses its structure and dynamics. He argues that health insurance was won by Canadian workers through protracted industrial and political struggle. At the same time, health insurance was accommodated to the existing structure of power and privilege within the health care delivery system, which precluded a significant shift in the distribution of health care consumption and perpetuated the "irrationality" of a system that treats health as a problem located in the sphere of personal consumption.

Canada↗
PubMed1989

The politics of welfare privatization: the British experience.

The 1980s Conservative government in Britain is committed to policies of welfare privatization for practical and ideological reasons--to facilitate tax cuts and to roll back the state. One problem this policy faces is that the most expensive and interventionist services are highly popular with voters from all parties. In this article, the author examines the extent to which recent privatization policies in welfare are influenced by conflict between the goals of achieving tax cuts and of maintaining electoral support, so that the outcome is a change in the form of state interventionism, rather than a rolling back of the welfare state. It also considers the impact of new policies designed to undermine the consensus across social groups and political parties of support for big-spending state services, which may facilitate reductions in the overall scope of welfare provision in future years.

Aged↗
PubMed1980

Starting from year one: the politics of health in Nicaragua.

The triumphant Sandinista revolution inherited a health situation characterized by high mortality, low life expectancy, widespread malnutrition, and a medical system limited in scope. The extent of these problems can only be estimated as a result of the somocista government's failure to develop an accurate system of vital statistics. While there are many options available for rapidly decreasing the high levels of mortality and morbidity in Nicaragua, the revolutionary government has chosen a strategy which fuses public health and politics. A health network based on popular participation and control is being formed which should not only decrease the high rates of malnutrition and infectious diseases in a cost-efficient manner, but should increase the strength of the revolution as well.

Community Health Services↗
PubMed1987

Tobacco or health in the Third World: a political economy perspective with emphasis on Mexico.

In response to declining cigarette sales in the United States and Europe, transnational tobacco conglomerates have turned to the underdeveloped world to promote their unhealthy products for consumers who are at best only vaguely aware of the health risks associated with cigarette smoking. While cigarette sales in the Third World are growing "healthily," the consumers of these cigarettes generally are not. Along with the already difficult problems of malnutrition and communicable diseases, underdeveloped countries are facing the probability of a smoking epidemic, which is directly related to the penetration of capitalist tobacco interests into new markets. While the tobacco companies are quick to suggest that these people who can least afford cigarettes (both financially and in terms of health risks) are exercising their "free choice" as consumers in an "open marketplace," the author suggests that political and economic factors are central. Aided by two months of fieldwork in Mexico in 1986, the author examines smoking behavior and perceptions of associated health consequences. In addition, the influence of the tobacco companies and the Mexican government on tobacco production and consumption is analyzed.

Advertising↗
PubMed1991

Politics and equity in policy-making for the medically uninsured.

A sizable number of Americans (many of low income) lack health insurance, and their ranks grew over the 1980s. One might expect to find vigorous political efforts to redress this inequity. In fact, conflicting normative and practical images of equity have blunted the sense of urgency of the problem, inhibited agreement on the proper division of labor between the market and government, and blocked consensus on strategic models for public policy for the uninsured.

Health Policy↗
PubMed1975

The political context of health service regulation.

Can regulation work in health services, given the present political context? General issues in the regulatory process are discussed, followed by a consideration of the relevance of these issues to the health care field. Regulatory processes are reviewed for the United States in four areas: credentialling of people, surveillance of delivery systems, quality of materials and technology, and rate-setting or cost control. It is concluded that the process cannot work. Four alternatives are presented and briefly evaluated: tinkering, centralized regulation, national health service, and general nationalization of most major economic sectors.

Accreditation↗
PubMedDate not supplied

Age and social composition factors as explanations for cleavages in socio-political values.

While age group differences on social and political values have been frequently documented in survey data, it is often claimed that these differences are due to social composition factors rather than to age itself. In this analysis we test for the effects of age vs. social composition in explaining variation in four attitudinal dependent variables. Using a sample especially drawn to study generational differences, and employing a multivariate statistical model, it was found that age differences were only modestly reduced by social composition variables. It is concluded that nonartifactual age group differences do exist on the dependent variables.

Adolescent↗
PubMed2003

Religiosity and conservatism revisited: relating a new religiosity measure to the two main conservative political ideologies.

The relation between the two religiosity dimensions which Wulff (1997) described (Exclusion vs Inclusion of Transcendence and Literal vs Symbolic) and two conservative political ideologies (Cultural and Economic Conservatism) was investigated in a sample of 714 students, a heterogeneous sample of 262 adults, and a sample of 301 religiously affiliated adults gathered in Flanders (Belgium). Both Exclusion vs Inclusion of Transcendence and Literal vs Symbolic were expected to relate only to Cultural Conservatism. Analysis supported these hypotheses, providing further evidence for the close association between religiosity and Cultural Conservatism and the validity of the Post-Critical Belief scale as a measure of Wulff's dimensions of religiosity.

Adolescent↗
PubMed1983

Politics of mental health: circles or spirals.

A brief reference to history suggests that there is a recurrent alternation of providing service to the indigent disturbed through asylum, general hospital and community. Despite modern knowledge about mental health, public attitudes remain seriously prejudiced against this group of mentally ill, and political decisions reflect these attitudes. Many developments for the emotionally disturbed deny the needs of the most disturbed. This paper considers the alienation of the severely mentally ill, the fear about the mentally ill, the guilt about their care, community education about the mentally ill, the development of advocacy on their own behalf by the mentally ill, and therapeutic advances in their care. The paper, although pessimistic about the future, concludes with the hope that the combination of modern humanism, modern communication technology and therapeutic advances may lead to an improvement in the lives of 'hard core' chronically ill psychiatric patients.

Attitude↗
PubMed1983

The political structure of the brain: cerebral localization in Bismarckian Germany.

Eduard Hitzig and Gustav Fritsch's experimental "demonstration" of cerebral localization in 1870 was a major event in the history of attempts to relate behavior to the central nervous system. Their work transformed the vague speculations that began with Franz Josef Gall into professionally responsible activity. In Germany the work of Hitzig and his followers led to violent controversies concerning both the observations and interpretations of cerebral localization. This paper considers why German scientists, who had universally opposed the work of British and French localizers up to 1870, suddenly became interested in the subject at this time, and also why the issue of cerebral localization evoked such passion within the German scientific community. Adequate answers to these questions must involve consideration of the professional relations between physiologists and the developing field of psychiatry. They must also include discussion of the reactions of scientific intellectuals to the most important political development of the time, namely, the unification of Germany.

Brain Mapping↗
PubMed1993

The political process and its relationship to the psychotherapy of substance misusers: an historical perspective.

There are massive changes underway in the allocation of funds for health care in the United States which will impact upon services provided for users and misusers of intoxicating substances. Recent findings suggest that conditions in the marketplace and the development of professions have effected standards of care rather than a reasoned analysis of need and outcome. Psychologists question to what extent they will be involved in public policy issues including what is clinically and socially relevant. The goal of this paper was to determine if an historical perspective upon federal regulation of intoxicating substances (tobacco/alcohol/drugs) would enlighten the psychotherapy scientist in the pursuit of standards for service. The methodology included a review of the economic and social structure of colonial America which included tobacco plantations, breweries, and distilleries as well as a review of the formation of the federal government and political system in which men, women, and slaves were each assigned different performance standards/roles and economic rewards within the community. The implication is that potential for self-regulation and psychological development is based upon the legacy of our forefathers.

Alcohol Drinking↗
PubMed1995

The Medical Profession in Upper Canada reconsidered: politics, medical reform, and law in a colonial Society.

This study explores some of the important questions raised but not answered in William Canniff's standard century-old study, The Medical Profession in Upper Canada, 1783-1850. Primarily based on the original medical licenses issued between 1819 and 1841, an array of manuscript material belonging to the Civil Secretary of Upper Canada and the Colonial Office, and documents pertaining to the Medical Board of Upper Canada, this article argues that the disallowance of legislation for the establishment of a colonial College of Physicians and Surgeons in 1839 can only be fully understood in the context of demographic, political, and medical developments which included factors such as ethnicity, tensions between the colony and mother country, and rivalry between medical schools. It explains why the issues of the 1830s continued into the 1840s and undermined any possibility by the profession of forming a single, self-regulating, and unified medical body for licensing and educating practitioners.

Canada↗