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

Relating health policy to women's health outcomes.

Individuals' social and economic circumstances, including socioeconomic status and medical care availability, are central to health outcomes, particularly for women. These factors are often mediated by governmental policies. This exploratory study found associations between women's health outcomes and state-level policies related to women's health. Outcomes were mortality rates for four leading causes of death for women in the US (heart disease, stroke, lung cancer, and breast cancer), infant mortality, and a mental health outcome variable. State policies on key women's health issues were evaluated on the degree to which they adequately protected women's health. Our regression models accounted for significant variance in mortality rates and substantial variance in the mental health outcome. Policies affecting access to care (Medicaid eligibility and efforts to expand Medicaid) and community (environmental health tracking and violence against women) were significantly associated with mortality outcomes. State health policies should be examined further for their relationship to health outcomes.

Chronic Disease↗
PubMedDate not supplied

The shape of public health policy: the Australian experience.

Public health policy is shaped by many factors. A brief historical reflection is given on policy development in Australia to illustrate the various influences on health policy. Medical technology; ethical trade-offs; environmental, social, and political imperatives; popular movements; and changing patterns of disease; as well as market forces have helped to shape Australian contemporary public health policy. These multiple and often competing forces, however, can work against individual consumer choice in health care decisions. This article demonstrates through the eyes of history the factors that shape public health policy. As Australia has a short history compared to most industrialized democratic societies and can be viewed as a microcosm, it is used as the exemplar.

Australia↗
PubMedDate not supplied

Towards an integrated adolescent health policy in Israel.

The principle health issues of Israeli adolescents are largely related to health risk behaviors, and are therefore preventable. Deciding which public health interventions are of highest priority ought to be determined according to the relative importance of these issues among Israeli youth. Violence in the schools and dieting to lose weight are highly prevalent in this population, with unintentional accidents, smoking and other substance abuse, and reproductive health being other important issues. Special health planning considerations that take into account Israel's unique population mix are necessary. Israel does not yet have a comprehensive, integrated health policy for youth. Nevertheless, legislation has been enacted that provides universal national health insurance, as well as preventive school health services to all school children from the 1st to 9th grade under the Ministry of Health's responsibility, setting the foundations for such a comprehensive youth health policy. In addition, policy makers and health care providers have recently recognized the need for a pro-active approach regarding health service development for adolescents. In this article, we give an overview of current Israeli health policies that impact upon the adolescent population, and propose seven priority areas that should be addressed in order to advance the health of youth in this country.

Adolescent↗
PubMed2005

Tensions in public health policy: patient engagement, evidence-based public health and health inequalities.

This paper examines the proposition that there are considerable tensions between key strategies in health policy--namely, evidence-based approaches to population health improvement, reduction of health inequalities, and public and patient engagement--using (1) a critical analysis of the intersection of evidence-based public health, patient and public engagement, and health inequalities policies from a social constructionist perspective and (2) mathematical modelling of paternalistic and shared decision making in the management of hypertension in a random age and sex stratified community sample of residents of south east Northumberland, UK. It is concluded that there may be unintended effects on population health of incongruities in major components of public health policy. Greater public and patient engagement may militate against the disease prevention goals of evidence-based policy, and may better engage sections of the population who already benefit from greater access and better health associated with social status and opportunity, serving to increase inequalities by further marginalising those already suffering from relative exclusion.

Adult↗
PubMed1994

Information, market government, and health policy: a study of health data organizations in the states.

Information is essential to the success of market-oriented policies. Information on health care costs and quality is collected and distributed by state governments through health data organizations (HDOs) to enhance competition and lower costs in the medical industry and to improve consumer choice among medical alternatives. This article examines the information collected, produced, and distributed by state health data organizations in Colorado and Pennsylvania. Findings reveal that information was not the objective determinant of choice and competition as market-oriented policy designers had hoped. Nor did market-oriented bureaucracies produce and distribute data readily accessible for public choice. Instead, information produced and distributed by these HDOs was the result of political and bureaucratic exercises that conform much more to classic interest group policymaking and captured bureaucracies than to contemporary market-oriented government ideals. The findings underscore the extraordinary difficulties facing federal-level policy designers as they contemplate introducing market-oriented health care policies on the national level.

Colorado↗
PubMed1992

Teaching health policy and politics in U.S. schools of public health.

Because most public health endeavors in the United States are funded by the public sector, public health practitioners need to be adept at working within the political system. However, the 1988 Institute of Medicine report, The Future of Public Health, found that many public health professionals are ignorant or disdainful of political processes and will not participate in activities that they perceive to be political. Our study examined the health policy and politics curricula of the 24 accredited schools of public health in the U.S., finding that most public health students are not exposed to these areas during their graduate coursework. Moreover, those students who do take health policy and politics courses study these areas within the context of health care delivery; the politics of public health and prevention are ignored by most schools of public health. Recommendations for improving public health curricula in health policy and politics are presented, including linkages with prevention activities.

Curriculum↗
PubMed1994

Health policy reform initiatives to improve the health of black Americans.

Black Americans comprise 12.4 percent of the United States (U.S.) population and is one of the fastest growing minority groups (U.S. Bureau of the Census, 1992). Recent health statistics indicate, however, that the life expectancy for Black Americans has lagged dramatically behind other minorities and White Americans throughout the century (DHHS, 1990). Economic, legislative and social factors hinder access to care and the provision of services within the current structure of health care in the U.S. Under health care reform, these three factors must be redefined to promote access to comprehensive health care services for Black Americans. Nursing is being challenged to provide the vision and leadership that will influence the key players to support a reform in health policy.

Black or African American↗
PubMed2004

Evidence for public health policy on inequalities: 2: assembling the evidence jigsaw.

STUDY OBJECTIVE: To garner research leaders' perceptions and experiences of the types of evidence that influence policy on health inequalities, and their reflections on how the flow of such research evidence could be increased. DESIGN, SETTING, AND PARTICIPANTS: Qualitative two day residential workshop with senior research leaders, most of whom were currently involved in evaluations of the health effects of major policies. In four in depth sessions, facilitated by the authors in turn, focused questions were presented to participants to reveal their views and experiences concerning evidence synthesis for policy on inequalities. These were analysed thematically. MAIN RESULTS: Five types of evidence for policy on health inequalities were felt to be particularly persuasive with policymakers: observational evidence showing the existing of a problem; narrative accounts of the impacts of policies from the household perspective; controlled evaluations; natural policy experiments; and historical evidence. Methods of improving the availability and use of these sources of information were put forward. CONCLUSIONS: This paper and its companion have considered the current evidence base for policies to reduce health inequalities, and how this could be improved. There is striking congruence between the views of the researchers in this study and policy advisers in paper 1, suggesting that a common understanding may be emerging. The findings suggest significant potential for rapid progress to be made in developing both evidence based policy, and policy relevant evidence to tackle inequalities in health.

Epidemiologic Methods↗
PubMed2002

Policy mapping for establishing a national emergency health policy for Nigeria.

BACKGROUND: The number of potential life years lost due to accidents and injuries though poorly studied has resulted in tremendous economic and social loss to Nigeria. Numerous socio-cultural, economic and political factors including the current epidemic of ethnic and religious conflicts act in concert in predisposing to and enabling the ongoing catastrophe of accident and injuries in Nigeria. METHODS: Using the "policymaker", Microsoft-WindowscircledR; based software, the information generated on accidents and injuries and emergency health care in Nigeria from literature review, content analysis of relevant documents, expert interviewing and consensus opinion, a model National Emergency Health Policy was designed and analyzed. A major point of analysis for the policy is the current political feasibility of the policy including its opportunities and obstacles in the country. RESULTS: A model National Emergency Health Policy with policy goals, objectives, programs and evaluation benchmarks was generated. Critical analyses of potential policy problems, associated multiple players, diverging interests and implementation guidelines were developed. CONCLUSIONS: "Political health modeling" a term proposed here would be invaluable to policy makers and scholars in developing countries in assessing the political feasibility of policy managing. Political modeling applied to the development of a NEHP in Nigeria would empower policy makers and the policy making process and would ensure a sustainable emergency health policy in Nigeria.

Journal Article↗
PubMed1990

Conceptions of space and community in British health policy.

Several recent United Kingdom health policy initiatives include ideas implicitly or even explicitly involving geographical space as a central theoretical construct. Neighbourhood nursing is perhaps the best known recent example. These initiatives are not without common features, and the paper commences with a typology of the roles which geographical space plays in health policy. A second section gives specific consideration to neighbourhood nursing. Thirdly the paper outlines the social theoretic debates surrounding geographic inputs to health policy: ideas such as community and locality. It is suggested that spatial conceptions in health policy reflect a complex amalgam of sociological assumptions which might fruitfully be considered in the light of Giddens' concept of locale.

Community Health Centers↗
PubMed2003

Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy.

Decision makers in health care are increasingly interested in using high-quality scientific evidence to support clinical and health policy choices; however, the quality of available scientific evidence is often found to be inadequate. Reliable evidence is essential to improve health care quality and to support efficient use of limited resources. The widespread gaps in evidence-based knowledge suggest that systematic flaws exist in the production of scientific evidence, in part because there is no consistent effort to conduct clinical trials designed to meet the needs of decision makers. Clinical trials for which the hypothesis and study design are developed specifically to answer the questions faced by decision makers are called pragmatic or practical clinical trials (PCTs). The characteristic features of PCTs are that they (1) select clinically relevant alternative interventions to compare, (2) include a diverse population of study participants, (3) recruit participants from heterogeneous practice settings, and (4) collect data on a broad range of health outcomes. The supply of PCTs is limited primarily because the major funders of clinical research, the National Institutes of Health and the medical products industry, do not focus on supporting such trials. Increasing the supply of PCTs will depend on the development of a mechanism to establish priorities for these studies, significant expansion of an infrastructure to conduct clinical research within the health care delivery system, more reliance on high-quality evidence by health care decision makers, and a substantial increase in public and private funding for these studies. For these changes to occur, clinical and health policy decision makers will need to become more involved in all aspects of clinical research, including priority setting, infrastructure development, and funding.

Clinical Trials as Topic↗
PubMedDate not supplied

Ethical issues in public health policy.

Ethics in public health policy is given the least importance and rarely discussed. Resolving ethical issues in public health is often an arduous task as these are complicated and require careful handling. Using four case studies, we discuss issues pertaining to pertussis and brain damage, water fluoridation and dental caries, infection with the human immunodeficiency virus and the right to marriage, and the debate surrounding universal salt iodization. The core issue in all these examples pertains to the relevance of ethics in public health policy.

Decision Making↗
PubMed1992

U.S. mental health policy. Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, U.S. health policy in the 20th century has been inherently flawed. The short-term general hospital--the "doctors' workshop"--emphasizing acute care and surgery, has been the cornerstone of U.S. health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure.

Community Mental Health Centers↗
PubMedDate not supplied

Creating a state minority health policy report card.

A state minority health policy report card may provide an important tool for evaluating and promoting state policies to reduce health disparities. This study develops criteria that can form the basis of such a state report card and assesses the performance of all fifty states on these measures. The results indicate wide variation among states, with geographic region being a significant predictor of performance on all four measures. Future research should be conducted on other predictors of state variation in minority health policy and connections between state policy and health outcomes for minorities.

Cultural Diversity↗
PubMedDate not supplied

[Analysis of health policies, a new field?].

Health policies are discussed within the framework of State Programs, reviewing its origins as a field of study in the United States, Latin America and Europe. The efforts to develop research and teaching in this area in Mexico are analyzed. A definition of health policies is proposed, as "the set of decisions, actions, and omissions that reflect, in a given time and place, the State's position on the health problems of the population". The difference between "policies" and "politics" is discussed, and the development of public policies is briefly reviewed. The reasons for including this area of study in the Master's degree in a public health curriculum are given.

Health Policy↗
PubMedDate not supplied

Social surveys and health policy implications for national health insurance.

The authors explore the utility of applying social survey data (a) to evaluate the impact of existing health programs and (b) to rank-order priorities concerning future health care policies. Based on national survey data from 1963, 1970, and 1976, they concluded that although Medicare and Medicaid have enabled more people to see a physician than ever before, a large proportion of the population still registers dissatisfaction with the health care they received--particularly with respect to their out-of-pocket costs for obtaining it. However, national health insurance options favored by the majority of the population--particularly those who can best afford the cost of care--suggest preferences for programs that incorporate some mix of existing modes of financing rather than those that provide for substantial restructuring of the current system.

Attitude to Health↗