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At least 163 records · Page 9Linked to original sources
PubMed2003

Health priorities in Wisconsin: a case for tracking childhood mortality.

OBJECTIVE: To assess trends in mortality among children ages 1-14 in Wisconsin over the last 2 decades and prompt policymakers to include annual monitoring of childhood mortality in the state Health Plan for 2010. METHODS: Data for all-cause and cause-specific (intentional-, unintentional-, non-injury related) mortality for 1980-1999 were obtained from WONDER, the Centers for Disease Control and Prevention's mortality database, and stratified by black/white race and gender. Trends were assessed using the 5-year moving average method and projected to 2010 to estimate future mortality. RESULTS: Childhood mortality rates in Wisconsin decreased 26% from 1980-1999 to 23.7/100,000 population, representing 87 lives saved annually. Throughout this period, Wisconsin's mortality rate was lower than the national average; however, disparities have increased. Boys and blacks experienced the highest death rates and the greatest increases in rates from homicide and suicide. If trends continue, Wisconsin is predicted to have the same overall rate as the United States in 2010. CONCLUSIONS: Wisconsin has experienced slower rates of decline in childhood mortality than the United States over the past 20 years, due, in part, to increasing disparities by race and gender. To halt this phenomenon, policymakers should include annual monitoring of childhood mortality rates in the state health plan and support appropriate interventions for children at risk.

Adolescent↗
PubMed2006

Adverse health effects of fluoro-edenitic fibers: epidemiological evidence and public health priorities.

Subsequent to the detection of a cluster of mesothelioma cases in the Sicilian town of Biancavilla, located at the slopes of Etna volcano, ad hoc epidemiological studies and environmental monitoring suggested an etiological role of an asbestiform fiber present in a stone quarry. The fiber was shown to constitute a new mineral species named fluoro-edenite. Fluoro-edenitic fibers were found in the materials extracted from the quarry and used in the local building industry, as well as in soils. Besides the risk of mesothelioma, residents in Biancavilla showed a significantly increased mortality from chronic obstructive pulmonary disease, which was particularly evident among women. In the light of these findings, Biancavilla was defined a site of national interest for environmental reclamation. The first preventive action involved termination of quarrying activity, covering with asphalt of roads previously paved with local soil materials, and removal of sources of dust in the urban area. Concurrent to the implementation of environmental cleanup, some specific "second generation" studies are now being designed and performed, namely morbidity surveys based on hospital discharge cards, monitoring of fibers in sputum and health surveillance in selected population groups. In this frame, special emphasis is given to the issue of communication, both to the general public and to target groups like family doctors, teachers, and media professionals. This experience could represent a useful basis for the elaboration of a strategy to approach similar environmental issues.

Asbestos↗
PubMed1995

Smokers who fail to identify smoking cessation as a health priority.

BACKGROUND: Smokers who identified smoking cessation as the primary activity they could undertake to improve their health were compared with smokers who did not identify smoking cessation. Examined factors included personal characteristics, health status, smoking attitudes and behaviors, and social factors. METHODS: Subjects were 225 smokers who participated in a telephone survey of 853 randomly selected adults. RESULTS: Fifty-six percent of smokers did not identify smoking cessation as a priority. Nonidentifiers were more likely than identifiers to have minimal personal income, no paid employment, poor or fair health, dissatisfaction with their overall physical condition, less energy than others, little perceived control over their health, smoked fewer cigarettes per day, and reported no previous quit attempts. They were less likely to agree that they lacked the willpower to quit or that smoking helped them deal with stress. CONCLUSIONS: Smokers who fail to identify smoking cessation as a priority strategy for health improvement are unlikely to be exposed to workplace and social censures and should be targeted by health professionals.

Adult↗
PubMedDate not supplied

[Mental disorders in Latin America and the Caribbean: a public health priority].

OBJECTIVE: The growing burden of mental disorders in Latin America and the Caribbean has become too large to ignore. There is a need to know more about the prevalence of mental disorders and the gap between the number of individuals with psychiatric disorders and the number of those persons who remain untreated even though effective treatments exist. Having that knowledge would make it possible to improve advocacy, adopt better policies, formulate innovative intervention programs, and apportion resources commensurate with needs. METHODS: Data were extracted from community-based psychiatric epidemiological studies published in Latin America and the Caribbean from 1980 through 2004 that used structured diagnostic instruments and provided prevalence rates. Estimates of the crude rates in Latin America and the Caribbean for the various disorders were determined by calculating the mean and median rates across the studies, by gender. In addition, data on service utilization were reviewed in order to calculate the treatment gap for specific disorders. RESULTS: Nonaffective psychosis (including schizophrenia) had an estimated mean one-year prevalence rate of 1.0%; major depression, 4.9%; and alcohol use abuse or dependence, 5.7%. Over one-third of individuals with nonaffective psychosis, over half of those with an anxiety disorder, and some three-fourths of those with alcohol use abuse or dependence did not receive mental health care from either specialized or general health services. CONCLUSIONS: The current treatment gap in mental health care in Latin America and the Caribbean remains wide. Further, current data likely greatly underestimate the number of untreated individuals. The epidemiological transition and changes in the population structure will further widen the treatment gap in Latin America and the Caribbean unless mental health policies are formulated or updated and programs and services are expanded.

Adolescent↗
PubMed1996

Choosing between competing health priorities. A government payer perspective.

Policy makers in developed countries are increasingly having to look at how they are to control the cost of healthcare in the face of the pressures of an aging population, the introduction (and cost) of new technologies and the increasing expectations of patients. To some extent, costs can be contained by concentrating on those technologies with proven clinical effectiveness. However, if priorities have to be set, some method of appraisal of the relative values of different interventions is required. Increasingly, economic analyses are being used to justify policies and the use of resources, by introducing measures of cost and quality as well as effectiveness. Those economic evaluations most commonly used, and their shortcomings, are described. Priority setting cannot, however, be reduced to a purely technical exercise. Decisions on what should and should not be funded from the public purse will be influenced by the overall framework of national aims and objectives and by professional opinion and public values; they will be more firmly based and defensible if they are subject to wide public discussion and debate.

Cost-Benefit Analysis↗
PubMed1994

Reaching toward and beyond the year 2000 goals for cigarette smoking. Research and public health priorities.

The 1980s witnessed decreases in adult smoking prevalence in the face of increasing morbidity and mortality from past and current tobacco use. To facilitate even greater cessation activity, innovative research continues to be conducted on methods of improving intensive, individual approaches to smoking cessation, particularly through pharmacologic intervention. However, the major thrust in this country today is toward broad, systemic, public health campaigns, targeting selected high risk groups and the general public. Vulnerable populations continue to include various ethnic groups, especially those with unusually low or high prevalence, women, persons with smoking-related diseases, and heavy smokers. Self-help methods, physician advice, work site and community based interventions, and antismoking coalitions have been in the forefront. Methodologic and intervention studies are needed, concurrent with ongoing large scale public health efforts. What efforts in research and in the public arena are requisite to reach the year 2000 goals for tobacco use? Prevention remains the number one priority. Bringing about a substantial decline in teenage smoking will require the combination of school based programs, environmental and advertising restrictions, and societal revision of norms toward the relative dangers of smoking and drug use in adolescence. Research is needed to define the optimal combinations of such interventions with booster components to sustain effects. Public health efforts, symbolized by the Community Intervention Trial for Smoking Cessation (COMMIT) and the American Stop Smoking Intervention Study (ASSIST) programs, must be combined with stronger advocacy, taxation, antismoking policy formation and implementation to realize a smoke free society.

Adolescent↗
PubMed1998

Meeting information needs in health policy and public health: priorities for the National Library of Medicine and The National Network of Libraries of Medicine.

Those seeking information in health policy and public health are not as well served as those seeking clinical information. Problems inhibiting access to health policy and public health information include the heterogeneity of professionals seeking the information, the distribution of relevant information across disciplines and information sources, scarcity of synthesized information useful to practitioners, lack of awareness of available services or training in their use, and lack of access to information technology or to knowledgeable librarians and information specialists. Since 1990, the National Library of Medicine and the National Network of Libraries of Medicine have been working to enhance information services in health policy and public health through expanding the coverage of the NLM collection, building new databases, and engaging in targeted outreach and training initiatives directed toward segments of the health policy and public health communities. Progress has been made, but more remains to be done. Recommendations arising from the meeting, Accessing Useful Information: Challenges in Health Policy and Public Health, will help NLM and the National Network of Libraries of Medicine to establish priorities and action plans for the next several years.

Health Policy↗
PubMed2005

Counties selecting public health priorities--a "bottom-up" approach (Croatian experience).

The subject of this paper is how to incorporate a multi-disciplinary and inter-sectored approach into development of public health policy and plans at the local (county) level in Croatia by educational program. Method used was the public health capacity building program "Health--Plan for it", which was developed with the aim to assist the counties to overcome recognized weaknesses and introduce more effective and efficient local public health practices. Two main instruments were used: Local Public Health Practice Performance Measures Instrument, and Basic Priority Rating System. This program has helped counties to asses population health needs in a participatory manner, to plan for health and, ultimately, assure provision of the right kind and quality of services (better tailored to population health needs). This program's benefits are going beyond and above the county level. It provides support for the Healthy Cities project locally, and facilitates changes in national policymaking body's mindset that a "one-size-fits-all" approach is sufficient.

Croatia↗