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At least 163 records · Page 9Linked to original sources
PubMed2005

Prisoners with substance abuse and mental health problems: use of health and health services.

Individuals with substance abuse and mental health problems are common in prisons and jails, but relatively little is known about the health or health services utilization of inmates with these types of problems. This study, therefore, focuses on prisoners who self-reported receiving a prior diagnosis from a physician or a psychologist who indicated they had 1) substance abuse problems only, 2) mental health problems only, and 3) substance abuse and mental health problems. A fourth group of prisoners who reported no diagnoses were included as the "no problems" group. Comparisons were made on reports of lifetime health problems, use of preventive health services, and use of medical services. Findings showed the substance abuse and mental health problems group had the most serious health problems profiles. Use of preventive health services was similar across all four groups, but the substance abuse and mental health problems group reported significantly greater use of the emergency room and more hospital stays both for their lifetime and in the year prior to their current incarceration. The policy and practical relevance of the findings are discussed.

Adult↗
PubMed2005

[Differences between Eastern European immigrants of German origin and the rest of the German population in health status, health care use and health behaviour: a comparative study using data from the KORA-Survey 2000].

UNLABELLED: Differences between Eastern European immigrants of German origin and the rest of the German population in health status, health care use and health behaviour: a comparative study using data from the KORA-Survey 2000 OBJECTIVES: To identify differences in health status, health care use and health behaviour between Eastern European immigrants of German origin and the rest of the German population in order to develop new concepts for preventive programs. METHODS: Using data from the KORA-Survey 2000 (Cooperative Health Research in the Region of Augsburg), immigrants of German origin were compared to the rest of the German population with multiple regression models controlling for sex, age, living with partner, years of education and occupation. Tests of trend were performed for the groups classified according to the year of immigration. RESULTS: Compared to other Germans, immigrants of German origin consider their health status more often as poor. They were more likely to be obese (OR = 1.95) and have hyperlipidemia (total-cholesterol/HDL-C > 4: OR = 1.71). They were less likely to use cancer screening (OR = 0.41) or to perform sport activities (OR = 0.47). All these differences decrease with the length of residence in Germany. CONCLUSIONS: Concerning their health status, Eastern European immigrants of German origin were identified as a high risk group. They should be considered for specific preventive programs and health care interventions, especially during the first years of immigration.

Adult↗
PubMed2004

A vision for child health information systems: developing child health information systems to meet medical care and public health needs.

In both the medical care and public health arenas, a variety of information systems have been developed to serve providers and program managers. In general, these systems have not been designed to share information with other information systems and provide comprehensive information about a child's health status to the information user. A number of initiatives are underway to develop integrated information systems. In December 2003, All Kids Count hosted an invitational conference "Developing Child Health Information Systems to Meet Medical Care and Public Health Needs." Through a series of plenary presentations and breakout discussion groups, participants developed a series of recommendations about governance, economic issues, information infrastructure, and uses of information from integrated child health information systems (CHIS). Common threads in the recommendations were: (1) development of a national coalition of stakeholders to promote integration of separate child health information systems within the context of ongoing national initiatives such as the National Health Information Infrastructure and the Public Health Information Network, (2) the need to develop the business and policy cases for integrated CHIS, (3) the need to develop agreement on standards for collecting and transferring information, and (4) the need to get the word out about the importance of integrating separate CHIS to improve health and health services.

Child↗
PubMedDate not supplied

New partnership for health? Business groups on health and health systems agencies.

The experience of the Central Massachusetts Health Systems Agency (CMHSA) and the Central Massachusetts Business Group on Health (CMBGH) demonstrates the feasibility of cooperation between HSAs and BGHs. Objectives and strategies of the two groups in carrying out community health planning and working for health systems change are compared. Nearly two decades of government-sponsored community health planning programs, first through comprehensive health planning agencies and then through HSAs, have had less impact than many had anticipated because neither the technical nor political basis for such planning was sufficiently established. The CMHSA experience is typical, although it is credited with developing a hospital systems plan that is based on sound planning methods and statistical data. It is in the implementation of plans that the CMHSA has made slow progress, reflecting its inadequate community power base. The CMBGH, 1 of more than 90 groups that have developed recently across the country to attack high health care costs, was formed in 1981 by business leaders to address these rising costs. The principal strategy adopted by the CMBGH involves fostering a competitive health care market by creating a critical number of competing health plans. The providers in each plan will then have incentives to provide effective care in an efficient manner to keep the premium competitive and attract enrollees. Cooperation between the CMBGH and CMHSA is based on each organization's emphasizing its strengths. The CMHSA's data base and analyses have been the primary resources used by the CMBGH to identify problems. Each organization has developed its own set of goals and objectives, while keeping in mind those of the other organization. The CMBGH adopted a subset of theCMHSA's goals-those that focus on hospital capacity and utilization. Although the CMHSA's regulatory strategies differ greatly from the CMBGH's competition strategies, they do not necessarily conflict.Actually, each organization is supporting the other's strategies without deemphasizing its own.The CMBGH currently has a decisive advantage over the CMHSA in implementing activities because the business leaders are an integral part of the community power structure. Also, their companies' willingness to offer additional health plans to their employees is the prime incentive to develop such plans.

Commerce↗
PubMed1998

Application of the modified method of "rapid appraisal to assess community health needs" for making rapid city health profiles and city action plans for health.

AIM: To develop a method that Croatian cities could use in the development of the City Health Profile and City Health Plan. The assessment concerned cities that have recently experienced the war and thus the method had to be rapid, cheap, scientifically based, sensitive, participative (involving politicians, experts, and citizens), able to produce immediate action, and to sustain the gained benefits. METHOD: A utilization-focused strategy was selected. Through ongoing interactions with intended information users, research questions were focused and the method of Rapid Appraisal to assess community health needs was selected as appropriate. This method was modified to: 1. assess the health of each city and serve as the basis for creating the City Health Profile; 2. select (Healthy City Project) priority areas; 3. establish the working groups on priority areas; and 4. build on the three previous steps to develop the City Action Plan for Health. RESULTS: During 1996, the Rapid Appraisal was applied in three Croatian cities (Pula, Metkovic, Rijeka). The work resulted in the completion of the City Health Profile, selection of the Project Priority Areas, formation of thematic working groups on priority areas, and acceptance of the agreed City Action Plan for Health. The method provided a scientifically based account of health in each of the three cities and identified targets for the future by using health-related measures and citizens' observations about the community, its problems, and potentials. CONCLUSION: The method proved to be credible and sensitive to the social and cultural differences it encompassed.

Croatia↗
PubMedDate not supplied

Preventive health services use, lifestyle health behavior risks, and self-reported health status of women in Ohio by ethnicity and completed education status.

This study assessed the health status and behavior of college-educated and non-college-educated African American women and European American women in Ohio. Analyses focused on health services utilization, health status, and life style/health behaviors from the 1998 Ohio Family Health Survey. College-educated African American women used more preventive health services and had better health status than non-college-educated African American women. Even so, college-educated African American women still had higher body mass index values, lower health status, and higher percent currently smoking than college-educated European American women. We conclude that college-educated African American women may face unique barriers to implementing all types of health-promoting behaviors available consequent to their higher education. Partnerships with respected community institutions, such as churches, may help these women develop good health practices in their entire community as well as in themselves.

Adult↗
PubMed2003

Evolution of the determinants of health, health policy, and health information systems in Canada.

The history of health determinants in Canada influenced both the direction of data gathering about population health and government policies designed to improve health. Two competing movements marked these changes. The idea of health promotion grew out of the 1974 Lalonde report, which recognized that determinants of health went beyond traditional public health and medical care, and argued for the importance of socioeconomic factors. Research on health inequalities was led by the Canadian Institute for Advanced Research in the 1980s, which produced evidence of health inequalities along socioeconomic lines and argued for policy efforts in early child development. Both movements have shaped current information gathering and the policies that have come to be labeled "population health."

Canada↗
PubMed1993

[Comparative study of the lipid profiles in the health staff versus the non-health staff at a health center].

Levels of cholesterol (CT) and lipoproteins fractions (c-LDL and c-HDL), as well as the atherogenic index (CT/c-HDL), were assessed in 307 workers of a health center. The study population was classified into groups, based on age and sex and whether they were health (physicians, registered nurses, clinical assistants) or non-health staff. The lipidic profile of the health staff groups was similar to the profile of non-health staff groups of the same age and sex. The percentage of subjects with CT above 200 mg/dl. was significantly higher (79.6 vs 60.9%) (p < 0.05) among the male health staff versus the male non-health staff and lower among the female health staff versus the female non-health staff (34.5 vs 55.5%) (p < 0.05). The differences in the lipidic profile depending on age and sex were confirmed grouping the population on the basis of such criteria. We highlight that all groups, with the exception of the female health staff, had CT levels above those recommended by the WHO and we stress the need of making health professionals aware of the importance of a primary prevention plan for the control of the cholesterolemia.

Adult↗
PubMed2007

Progressive segmented health insurance: Colombian health reform and access to health services.

Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal.

Colombia↗
PubMed2003

Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).

OBJECTIVE: To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. METHODS: A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children between 5 and 17 years were identified as chronically ill according to the Questionnaire for Identifying Children with Chronic Conditions (n = 3061). Independent variables included child and family characteristics categorized as predisposing, enabling, and need. Dependent variables included use of 4 medical or 7 health-related services. RESULTS: Most children (88.7%) had seen a physician; 23.9% had an emergency department visit, 11.4% had a mental health outpatient visit, and 6.4% were hospitalized. Health-related service use ranged from <5.0% (transportation and social work) to 65.1% (medical care coordination); 20% to 30% of children used the remaining services (therapeutic, assistive devices, nonmedical care coordination, housing modifications). In fully adjusted logistic models, children with public insurance were significantly more likely than privately insured children to use 2 of the 4 medical services and 5 of the 7 health-related services. Non-Hispanic black children and children from less educated families were significantly less likely to use many of the services examined. CONCLUSIONS: In 1994, factors in addition to need influenced medical and health-related service use by CSHCN. Differences in the scope of benefits covered by public insurance compared with private insurance may influence utilization of medical and especially health-related services. Attention is needed to ensure that CSHCN who are racial/ethnic minorities or are from less educated families have access to needed services. Future studies should determine whether these patterns have changed over time.

Adolescent↗
PubMed2006

[Public health and mental health: methodological tools to evaluate the Brazilian Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System].

This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System (SUS). The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing the importance of reclaiming and guaranteeing the roles of various social actors to shape the assessment process, the need for collecting and standardizing academic studies on the topic, and the importance of promoting a new research field focusing on public health policies to support policymakers, managers, and health teams in reshaping their practices.

Brazil↗
PubMed2006

Serious crisis in the practice of international health by the World Health Organization: the Commission on Social Determinants of Health.

The Commission on Social Determinants of Health (CSDH) is the latest effort by the World Health Organization to improve health and narrow health inequalities through action on social determinants. The CSDH does not note that much work has already been done in this direction, does not make a sufficient attempt to analyze why earlier efforts failed to yield the desired results, and does not seem to have devised approaches to ensure that it will be more successful this time. The CSDH intends to complement the work of the earlier WHO Commission on Macroeconomics and Health, which has not had the desired impact, and it is unclear how the CSDH can complement work that suffers from such serious infirmities. Inadequacies of both commissions reflect a crisis in the practice of international health at the WHO, stemming from a combination of unsatisfactory administrative practices and lack of technical competence to provide insights into the problems afflicting the most needy countries. Often the WHO has ended up distorting the rudimentary health systems of the poor countries, by pressuring them into accepting health policies, plans, and programs that lack sound scientific bases. The WHO no longer seems to take into account historical and political factors when it sets out to improve the health situation in low-income countries--which is supposed to be the focus of the CSDH. An alternative approach is suggested.

Advisory Committees↗
PubMed1996

Health objectives and health system reform in Iowa: complementary approaches to health planning.

Current proposals for health system reform, such as that developed by the Iowa Leadership Consortium on Health care (ILC), call for the creation of agencies responsible for setting rates, monitoring quality and efficiency, and regulating capital investment. These can be described as health planning activities. However, it is planning of a very different nature than that conducted by community groups seeking to achieve the objectives of Healthy People 2000. Yet, despite their apparent differences, modern regulatory planning in the form proposed by the ILC and grass roots planning have at least the following in common: -Both seek to improve the efficiency of the health system in addressing health problems; -Both use population health status data as a basis for planning; -Both derive from a health planning tradition that focuses on restructuring the health care delivery system; -Both assume the legitimacy of the health care reform objectives relating to medical care; -Both may respond to community input regarding the nature of proposed reforms; and -Both may be criticized by radicals for railure to address the root, socioeconomic causes of disease.

Health Care Reform↗
PubMed2004

[Toward strengthening the health politics in Africa: the military health system and its contribution to health policy in Senegal].

Since the following days of independences, the Senegalese army mission has mainly consisted in defending the national territory integrity and in ensuring the protection of the populations and their goods. In the public health system, thanks to the quality of its human resources the army intervenes specifically at every level of the health care structure. The mission assigned to the Senegalese army health unit is therefore multidimensional. In 2001, the operational budget of the army health services is estimated at 177 millions CFA F (265500 euros), its medical consumption at 212 millions CFA F (323 000 Euros) and its health expenditure at 385 millions CFA F (585 000 euros). The army supports the government health policies in different ways: on the one hand, availability of the ministry of health staff, on the other hand, the direct involvement in health care and the implementation of the national and international health programmes.

Budgets↗
PubMed2005

Self-assessed dental health, oral health practices, and general health behaviors in Chinese urban adolescents.

The objectives of this study were: to describe perceived dental health status and oral health-related knowledge, attitudes, and behavior in Chinese urban adolescents; to assess the associations of oral health variables with socio-economic status and school performance; and to analyse the relative effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage cluster sampling and covered three age groups: 11, 13, and 15 years. Data on dental and general health were collected by self-administered questionnaires. Self-assessment of dental health of Chinese adolescents was generally good, only 12% of the students answered that their teeth were "poor" or "very poor", and 9% claimed having "poor" or "very poor" gums. Eleven percent of participants said that other students made fun of their teeth; 24% of the respondents were dissatisfied with the appearance of their teeth, and 41% claimed that they had experienced toothache or symptoms during the previous 12 months. Positive attitudes towards dental care were found in all age groups; 67% of adolescents brushed their teeth at least twice a day and 48% of the students used fluoridated toothpaste. Only 26% of the students visited a dentist during the previous 12 months. In all, 6% of the adolescents had tried cigarette smoking at least once, while 41% reported having tasted alcohol drinks. Multivariate regression analyses showed that perceived dental health status and needs were associated with gender, age, unhealthy lifestyles, poor school performance, and socio-economic status. The establishment of school-based health promotion programs in China is urgently needed, and promotion of oral health lifestyles should be integrated with other general health actions.

Adolescent↗
PubMed1992

From preventive health behavior to health promotion: advancing a positive construct of health.

A concept analysis of preventive health behavior provided the foundation for this review of current health promotion research in nursing. Studies selected for review described or explained behavior for health promotion, illness prevention, or preventive health behavior. The major focus of this critical review is on the conceptualization and measurement of health promotion behaviors being investigated. Despite nursing's claim to an holistic idea of health, the biomedical model continues to influence indicators of health behavior and the context for promotion of healthy life styles. Major issues for future health promotion research relate to the lack of attention to theoretical definitions and multidimensional aspects of health behavior, and the triad of national strategies for health promotion are discussed.

Health↗
PubMed1997

Public health practice linkages between schools of public health and state health agencies: results from a three-year survey.

Several recent examinations of the state of public health have called for enhanced linkages between schools of public health and public health agencies, prompting federal health agencies and schools of public health to develop practice initiatives. Surveys of schools of public health and of state public health agencies were conducted in 1992 to collect baseline data on practice links between the two agencies; follow-up surveys were undertaken in 1993 and 1994. Responses reveal that a substantial amount of interaction between schools and agencies has been occurring for some time, but that until recently much of the interaction has been informal and between individuals or departments rather than institution-wide. Both frequency and formalization of such collaborations have increased, reflecting a growing emphasis on public health practice activities at schools of public health together with public health agencies.

Government Agencies↗
PubMed1999

Final report on public health practice linkages between schools of public health and state health agencies: 1992-1996.

Since 1988 there has been a call for enhanced linkages between schools of public health and public health agencies that has prompted schools of public health to develop public health practice initiatives. The University of Illinois at Chicago School of Public Health conducted surveys of schools of public health and of state public health agencies in 1992 to collect baseline data on practice initiatives undertaken by academe and governmental public health agencies to enhance collaboration; follow-up surveys were undertaken in 1993, 1994 and 1996. This article describes the trends and implications of this survey of practice linkages involving schools of public health and state health agencies.

Cooperative Behavior↗