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PubMed2006

Political and welfare state determinants of infant and child health indicators: an analysis of wealthy countries.

Economic indicators such as income inequality are gaining attention as putative determinants of population health. On the other hand, we are just beginning to explore the health impact on population health of political and welfare state variables such as political orientation of government or type of medical care coverage. To determine the socially structured impact of political and welfare state variables on low birth weight rate, infant mortality rate, and under-five mortality rate, we conducted an ecological study with unbalanced time-series data from 19 wealthy OECD countries for the years from 1960 to 1994. Among the political/welfare state variables, total public medical coverage was the most significant predictor of the mortality outcomes. The low birth weight rate was more sensitive to political predictors such as percentage of vote obtained by social democratic or labor parties. Overall, political and welfare state variables (including indicators of health policies) are associated with infant and child health indicators. While a strong medical care system seems crucial to some population health outcomes (e.g., the infant mortality rate), other population health outcomes might be impacted by social policies enacted by parties supporting strong welfare states (the low birth weight rate). Our investigation suggests that strong political will that advocates for more egalitarian welfare policies, including public medical services, is important in maintaining and improving the nation's health.

Child Mortality↗
PubMedDate not supplied

[Health reform and its political component: a feasibility analysis].

The political dimension of the health reform is a fundamental aspect that not only influences the project's feasibility, but also its form and content. Therefore the study of the political aspects involved in the health reform process is essential to determine the political feasibility of the reform. Based on the case studies of Colombia and Mexico, this study concentrates on the State's capability to promote health reform projects successfully. It specifically focuses on those elements that seek to improve the political feasibility of formulating, legislating and implementing reform proposals. The relevant variables under study are: the institutional context in which the reform initiatives develop; the political dynamic of the reform process; and the characteristics and strategies of the teams in charge of leading the reforms (change teams). The similarities in the political strategies used by the teams in charge of the health reform, and those of similar technocratic teams in charge of economic reform, stand out as one the study's main findings. It is argued that, although these strategies were effective in bringing about the creation of new actors in the health sector such as private organizations for the financing and provision of health services, they did not have the same impact on the transformation of the old actors the health ministries and the social security institutes, therefore considerably limiting the scope of the reforms.

Colombia↗
PubMed1995

The 'political correctness' debate and caring in psychiatric nursing.

In recent years the controversy over so-called 'political correctness' has figured prominently in discourses of higher education. In terms of nursing, the issue of 'political correctness' cannot be confined to intellectual word-games, but is of key significance in the debate around the nature of professional caring. This paper is a discussion of the relevance of the controversy around 'political correctness' to the practice of psychiatric nursing. It placed the 'political correctness' debate in the context of the current debate within nursing about definitions of 'caring', and discusses the connections between both these debates and the theoretical imperatives of person-centered psychology. After discussing the particular problems which arise when the three issues of 'political correctness', 'caring' and humanistic psychology are brought together in this way; it proposes a politically focused strategy for the future development of psychiatric nursing. Although it is written from the perspective of psychiatric nursing in Britain and is very much concerned with the use of a particular language; the arguments put forward are equally appropriate to other English-speaking countries, and perhaps also to non-English speaking countries.

Empathy↗
PubMed1998

Perceptions of politics: does measuring different foci matter?

Recent research on perceptions of politics in organizations and other organizational phenomena (e.g., commitment) has suggested the use of a multiple-foci approach to understand important politics-outcome relationships. This study confirms separate measures of perceptions of politics at the organizational and work-group levels and demonstrates differential effects in the prediction of various outcomes. After controlling for the effects of the relationship with one's supervisor (leader-member exchange), perceptions of politics existing at the organizational level predicted turnover intentions, whereas citizenship behavior was predicted by perceptions of politics at the group level. Both foci of politics significantly predicted organizational commitment.

Adult↗
PubMed2002

Agonizing care: care ethics, agonistic feminism and a political theory of care.

'Care' is central to nursing theory and practice, and has been described in a variety of ways. Intense conversations about care have been developing in other fields of study as well, from the social sciences to the humanities. Care ethics has grown out of intellectual exchange between feminist thought, moral theory and the critique of traditional western political philosophy. However, care ethics is not without its critics, as these accounts of care have also sparked vigorous challenges. This paper traces the construct of care through nursing theory, care ethics, feminist critiques of moral and political theory and agonistic feminism to outline a set of problematics that a political theory of care should engage. It discusses how care is conventionally posited in more or less essentialist, universalizing and naturalizing terms. It introduces the ideas of feminist theorists who resist dichotomizing care and the political, and situate care in the context of power and politics. The tensions between care feminism and agonistic feminism are highlighted in order to explore the potential of theorizing both care and nursing in political terms.

Empathy↗
PubMed1998

HIV-related politics in long-term perspective.

Some long-term, large-scale socio-economic changes may affect the politics of HIV and other emerging viruses such as hepatitis C. It is useful to ask why the potential peace dividend of the early 1990s failed to provide adequate resources for HIV-related social and medical service delivery in developed or developing nations. This failure can be understood by looking at long-term global economic trends and the pressures they put on governments and corporations. They have produced a period in which fundamental issues of political and economic structure are at stake and, often, the response is a divide-and-rule politics to promote stability. National politics differ in terms of the extent to which such a 'politics of scapegoating' is institutionalized and in terms of which groups are scapegoated. Groups such as drug injectors, gay and bisexual men and sex traders are particularly likely to be targeted both by the scapegoaters and by HIV. Given this framework, how should public health professionals and activists engaged in HIV-related issues respond? Under what circumstances should we orient efforts upwards towards corporate, political or bureaucratic leaders? Under what circumstances, and how, should we orient towards popular forces? Relatedly, we need to consider an issue we often ignore: What do we have to offer potential allies? That is, in terms of their goals, philosophies and needs, why should they ally with us?

Attitude to Health↗
PubMed1999

Political analysis of health reform in the Dominican Republic.

This article examines the major political challenges associated with the adoption of health reform proposals, through the experience of one country, the Dominican Republic. The article briefly presents the problems of the health sector in the Dominican Republic, and the health reform efforts that were initiated in 1995. The PolicyMaker method of applied political analysis is described, and the results of its application in the Dominican Republic are presented, including analysis of the policy content of the health reform, and assessment of five key groups of players (public sector, private sector, unions, political parties, and other non-governmental organizations). The PolicyMaker exercise was conducted in collaboration with the national Office of Technical Coordination (OCT) for health reform, and produced a set of 11 political strategies to promote the health reform effort in the Dominican Republic. These strategies were partially implemented by the OCT, but were insufficient to overcome political obstacles to the reform by late 1997. The conclusion presents six factors that affect the pace and political feasibility of health reform proposals, with examples from the case of the Dominican Republic.

Developing Countries↗
PubMed1998

Adverse political events and psychological adjustment: two cross-cultural studies.

OBJECTIVE: The life events model was extended to the political arena to enable the comparison of children's adjustment reactions to political stress. The cross-cultural impact of adverse political events on psychological adjustment was examined for two closely matched research samples, Arab and Jewish children and Palestinian and Israeli children. METHOD: All children completed the Political Life Events scale and the Brief Symptom Inventory in their home languages. RESULTS: The hypothesis of a linear relation between adverse events and psychological distress was not confirmed in both studies. In study 1, a direct relation emerged for both Jewish and Arab Israeli children. However, in study 2, when separated by nationality, results revealed opposite trends for each nation. For Israelis there was a linear relation, but for Palestinians there was a consistent inverse relation between increased severity of political life events exposure and distress, both for the global index and for specific symptomatology. CONCLUSION: It is proposed that these cross-cultural results stem from differential mediating coping mechanisms, specifically passive versus active strategies, which intervene between the stressor-adjustment link. The need to address short- and long-term consequences of political stress on children's mental health is discussed.

Adaptation, Psychological↗
PubMed2005

Mad tales from Bollywood: the impact of social, political, and economic climate on the portrayal of mental illness in Hindi films.

OBJECTIVE: To study the portrayal of mental illness (especially psychosis) in Hindi films since 1950 and to study the influence of prevalent social, political and economic factors on each portrayal. METHOD: Using two encyclopedias and one source book, films that had mental illness affecting one of the protagonists were identified. The social, economic and political factors were identified using history texts. RESULTS: In the 1960s after India became a Republic, the political climate was one of idealism and as a result the portrayal of mental illness was gentle, more international in its outlook, and used psychoanalytic techniques. In the 1970s and 1980s, as a result of increased political and bureaucratic corruption and an unstable political climate, the portrayals became harder and psychopaths were portrayed more often. In the 1980s, the trend continued with female psychopaths, and avenging women emerged as a major force because the political and judicial systems were seen as impotent in delivering justice. In the 1990s, following economic liberalization, the women were seen and used as possessions in society and the cinema, and portrayals of stalking and morbid jealousy increased. CONCLUSION: Hindi films since the 1950s appear to have been influenced by changing cultural norms which in turn affected the way mental illness is portrayed.

Adult↗
PubMed2006

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia.

BACKGROUND: The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. METHODS: In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. RESULTS: SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. CONCLUSION: Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option.

Air Pollution, Indoor↗
PubMed2005

Obesity, courts, and the new politics of public health.

Health care politics are changing. They increasingly focus not on avowedly public projects (such as building the health care infrastructure) but on regulating private behavior. Examples include tobacco, obesity, abortion, drug abuse, the right to die, and even a patient's relationship with his or her managed care organization. Regulating private behavior introduces a distinctive policy process; it alters the way we introduce (or frame) political issues and shifts many important decisions from the legislatures to the courts. In this article, we illustrate the politics of private regulation by following a dramatic case, obesity, through the political process. We describe how obesity evolved from a private matter to a political issue. We then assess how different political institutions have responded and conclude that courts will continue to take the leading role.

Humans↗
PubMed2001

Pensioners' political parties in Israel.

Involvement and participation of older persons in politics and political systems reflect the extent to which they are integrated into their society. During the last two decades, political parties of pensioners have emerged in a number of countries, including Israel, and have run candidates in national elections. If only 10% of those aged 65 and older had voted for pensioners' parties in Israel, they would have qualified for two "pensioners" seats in the Knesset (Israel's parliament). However, they suffered complete defeat, as has been the case in most other countries. This article first describes the phenomenon of pensioners' political parties in Israel, examines the circumstances around their emergence, and presents their goals. Second, it identifies and analyzes the causes for their political defeat. Third, it discusses alternatives to political parties to promote the interests of the older population. Finally, implications for further research are raised.

Aged↗
PubMed1999

The pattern of sexual politics: feminism, homosexuality and pedophilia.

Until recently sex and gender issues were thought to be biological or natural rather than political. The feminist movement largely changed perceptions of gender, and the gay and lesbian movements significantly altered conceptions of sex, so that what were once seen as permanent moral standards are now viewed as historical and political constructions. As views of these groups have moved towards social constructionism, perceptions of child sexuality have become more absolutist. Current attitudes towards child sexuality and representations of it resemble historical attitudes towards women and homosexuals. This article argues that there is a two-phase pattern of sexual politics. The first is a battle to prevent the battle, to keep the issue from being seen as political and negotiable. Psychological and moral categories are used to justify ridicule and preclude any discussions of the issue, and standard Constitutional guarantees are seen as irrelevant. The second phase more closely resembles traditional politics as different groups argue over rights and privileges. Feminist and gay/lesbian politics have recently entered the second phase, while pedophilia is in the first.

Adolescent↗
PubMed2004

Identity construction and British Muslims' political activity: beyond rational actor theory.

Political activity is often addressed in terms of rational actor theory (RAT). We review RAT's psychological assumptions and highlight the neglect of collective identity. In turn, we view the perception of 'interest' as contingent upon constructions of identity and explore how different characterizations of collective identity are organized strategically so as to shape people's understandings of their interests and how they should act to realize them. Using examples taken from a study of British Muslims' political activity we emphasize the contested and strategic dimension to identity construction and analyse how activists addressing the same constituency construe Muslim identity in different ways so as to promote different conceptions of collective interest. Specifically, we explore the contested invocations of Prophetic example in the definition of Muslim identity. The broader thrust behind this work is a critique of the sharp dichotomization of Muslim and non-Muslim political activity. We maintain that essentially similar processes of identity construction underlie all attempts to organize collective sentiment and political action (including that comprising so-called 'conventional' electoralist politics in the West), and that conceiving of identity as a site of political struggle underscores the inadequacy of Orientalist characterizations of Muslim identity in terms of a singular, transhistorical essence.

Communication↗
PubMed1979

Comparative social policy and political conflict in advanced welfare states: Denmark and Sweden.

There has developed an abundant literature on the social and political determinants of social policies, but few have addressed the question of how state policies, once implemented, affect the system of stratification in civil society. This article examines the political consequences of social policy in Denmark and Sweden, countries in which a social democratic labor movement has predominated for decades. Superficially, these two highly developed welfare states appear very similar. Yet the political and social contexts in which their social policies have evolved differ substantially. I shall demonstrate the argument that the traditional welfare state approach may be conducive to a new and powerful political conflict, which directly questions the legitimacy of the welfare state itself, unless government is successful in subordinating private capitalist growth to effective public regulation. In Denmark, where social democratic governments have failed to match welfare state growth with more control of private capital, social policy has tended to undermine the political unity of the working class. Consequently, the Social Democratic Party has been weakened. Social welfare programs, in effect, have helped create new forms of stratification within the working class. In Sweden, social democratic governments have been quite successful in shifting a decisive degree of power over the private market to the state. This has helped avert a crisis of the welfare state, and has also been an important condition for continued social democratic hegemony and working-class unity. I conclude that social reform politics tend to be problematic from the point of view of the future power of social democratic movements.

Conflict, Psychological↗
PubMed1976

Medical politics, health policy. Party health platforms, promise and performance.

Health policy in the United States is a product of medical politics. "Medical politics" includes not only traditional patterns of interest group pressures but traditional political party philosophies and patient expectations as well. Characteristic Republican politics reflects narrower governmental spending and greater emphasis on support of entrepreneurial effort. Desired effects will "trickle down" to the needy. Democratic politics tend to follow a more generous spending line, not neglecting the entrepreneurs, but spreading some of the funds around to the needy themselves. In addition, Republicans tend to distrust salaried officials, placing governmental power (through government funds) into the hands of private agencies or companies. Democrats hesitate less to build bureaucratic structures. On the record, both parties follow roughly similar lines in spite of these philosophic differences, which turn out to be differences in style. Both parties have practiced restraint in financing of medical services, only recently undertaking payment for these, and only recently undertaking to pay for medical education. Research has been a favored federal focus. Rapid and seemingly uncontrollable inflation has forced both parties to take a harder line. Political platforms are not necessarily clear signals of eventual party action. Nevertheless, they underline what the parties consider to be the problems as the voters see them and they express what the parties see as the appropriate response to these problems. This paper suggests what the party platforms will look like for the presidential election this year and also what the parties will probably do thereafter.

Aged↗
PubMed1995

On politics and health: an epidemic of neurologic disease in Cuba.

Political decisions may cause disease. During 1992 and 1993, an epidemic of neuropathy in Cuba--largely overlooked by U.S. physicians--affected more than 50,000 persons and caused optic neuropathy, deafness, myelopathy, and sensory neuropathy. Patients with the neurologic disease responded to B group vitamins, and oral vitamin supplementation of the population curbed the epidemic. Dietary restrictions and excessive carbohydrate intake were the immediated cause of the epidemic; however, the primary cause might have been political. Political changes in eastern Europe had major repercussions on Cuba's economy and food supply. In turn, these changes compounded the effects of internal political decisions in the island, leading toward isolationism and economic dependence on the former Soviet Union. Also, for more than 30 years, the United States has maintained an economic embargo against Cuba. In 1992, the U.S. embargo was tightened by the Torricelli amendment (or the Cuba Democracy Act), which prohibited third-country subsidiaries of U.S. companies from trading with Cuba and prevented food and medicines from reaching the island; this amendment produced a virtual economic blockade. Penuries resulting from all these political events resulted in the largest epidemic of neurologic disease in this century. Physicians may need to use their influence to modify political decisions when these decisions result in adverse health consequences. The American Academy of Neurology has issued a plea to encourage physicians and other health personnel to support efforts leading to lifting of the U.S. embargo against Cuba for humanitarian reasons.

Cuba↗
PubMed1999

Political participation in Hong Kong: a study.

AIMS: The aim of this study was to investigate nurses' level of political participation and their perception of political efficacy. METHODOLOGY: This is a descriptive study. A self-completed questionnaire survey was conducted. Some items in the adopted questionnaire were modified to suit the Hong Kong situation. SAMPLES: A convenience sample was used. Three hundred and fifty registered nurses that were studying nursing degree programmes in the three universities in Hong Kong were invited to participate in the study. FINDINGS: Three hundred and eleven registered nurses completed the questionnaire. The findings showed that there were some positive signs of both political awareness and participation in nurses. However, political activities were mainly confined to voting in general elections. Attempts to influence politicians were not evident. Subjects generally have low political efficacy, and they did not feel that nurses had the power to influence the government's policy. The results of this study are discussed in terms of the barriers to nurses' political participation and the recommendations for nursing professional development.

Attitude of Health Personnel↗