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PubMed1976

Policies of the Office of Population Censuses and Surveys. Philosophy and constraints.

The Medical Division of the Office of Population Censuses and Surveys (OPCS) organizes and indexes general systems of records for medical research and administration. The main sources of records are the census, registrations of births and of deaths, hospital discharge records, registered cases of cancer and of congenital malformations, surveys by the Social Surveys Division, and samples of records in general practice. Results take the form of regularly published series of statistics and commentaries and of studies in depth, often by scientists in the National Health Service (NHS), and research institutions which are encouraged to use the systems for prospective and retrospective surveys. The surveys are facilitated by the central registry where a note of every death in the country is attached to the relevant record (and the causes of death are available). Recent developments include studies of records of general practitioners; the causes of deaths among immigrants in England and Wales; the fertility, migration, and mortality of a cohort of about 1 percent of the population. The publication policy of OPCS is described.

Confidentiality↗
PubMed2005

Language and country preponderance trends in MEDLINE and its causes.

OBJECTIVE: The authors characterized the output of MEDLINE papers by language and country of publication during a thirty-four-year time period. METHODS: We classified MEDLINE's journal articles by country of publication (Anglos/Non-Anglos) and language (English/Non-English) for the years 1966 and from 1970 to 2000 at five-year intervals. Eight English-speaking countries were considered Anglos. Linear regression analysis of number of papers versus time was performed. RESULTS: The global number of papers increased linearly at a rate of 8,142 papers per year. Anglo and English papers also increased linearly (6,740 and 9,199, respectively). Journals of Non-Anglo countries accounted for 25% of the English language increase (2,438 per year). Only Non-English papers decreased at a rate of 1,056 fewer papers per year. These trends have led to overwhelming shares of English and Anglo papers in MEDLINE. In 2000, 68% of all papers were published in the 8 Anglo countries and 90% were written in English. CONCLUSIONS: The Anglo and English preponderances appear to be a consequence of at least two phenomena: (1) editorial policy changes in MEDLINE and in some journals from Non-Anglo countries and (2) factors affecting Non-Anglo researchers in the third world (publication constraints, migration, and undersupport). These are tentative conclusions that need confirmation.

Bibliography of Medicine↗
PubMed2006

An economic perspective on Malawi's medical "brain drain".

BACKGROUND: The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. DISCUSSION: Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding.Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. SUMMARY: There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence for and against the medical "brain-drain" in Malawi suggests that there are potential gains in managing medical migration to produce outcomes that are beneficial to individuals, households and the country. Finally we present several policy options.

Journal Article↗
PubMed1996

Women and migration: a public health issue.

The need to migrate is usually a function of the complex interaction of economic, social, familial and political factors. Among the most important, however, are the denial of access to education, employment, goods and services and the lack of respect for basic human rights. Because in many societies women are marginalized from these rights, migration to more economically and educationally open societies can often help improve their personal situation and their professional opportunities. On the other hand, because the status of women is usually linked to their role and status within the family and is defined in relationship to their male partners, migration can place women in situations where they experience stress and anxiety due to the loss of their traditional social entourage and environment. Their social integration in new settings may be equally limited by their initial lack of education and occupational experience. The higher vulnerability of women to sexual abuse and violence also places them at risk of STDs, including HIV, and a range of post-traumatic stress disorders associated with sexual violence. Their reproductive health needs often go unnoticed and unprotected even in well organized refugee and migrant situations, and the insensitivity of health staff to the needs of women is often more pronounced in refugee and migrant contexts than it is in general. Health monitoring of women in all migration-related situations has to be given greater priority. Similarly, much more attention at a health policy level is called for if the rights of women refugees and migrants are to be protected, and their contribution to health and social development is to be acknowledged and promoted.

Acculturation↗
PubMed1999

Things ain't what they ought to be: social forces underlying racial disparities in rates of sexually transmitted diseases in a rural North Carolina county.

Social forces shaping a region can also affect behaviors that facilitate the transmission of sexually transmitted diseases (STDs), including HIV. We sought to understand the social forces underlying high rates of infection, particularly among blacks, in a rural county of North Carolina in which 40% of the county is black. In the context of ongoing research on STDs we collected information from archival data on the county since the 1940s and interviewed local residents knowledgeable about the county's history. We present local data in the context of national economic and demographic trends. Successive changes in the national economy and farming policies disproportionately affected black farmers. A rural ghetto formed when poor blacks left their farms to seek work in the central town of the county. Segregationist housing policies and race-based differentials in employment opportunities exacerbated the concentration of poverty. Migration to northern industrial cities, predominantly by skilled black men, decreased the social capital of the community and lowered the ratio of men to women. Poverty, income disparity, social capital and the ratio of men to women can all affect the behaviors that facilitate transmission of STDs. Knowledge of social forces and their effects is critical for designing and evaluating interventions to prevent STDs and to decrease extreme racial disparities in rates of disease.

Adult↗
PubMed1988

Ban on Filipino maids going abroad, 20 January 1988.

On 20 January 1988, the President of the Philippines prohibited Filipino maids from going abroad to work. Later in 1988, the ban was lifted for some countries after the institution of safeguards in agreements with those countries. Among these countries is Saudi Arabia. See Philippine Labor, Vol. 14, No. 10, 1988.

Asia↗
PubMed1991

AIDS knowledge and risk behaviors among culturally diverse women.

This article reports results from a survey of women at risk for HIV infection. The sample (n = 620) included black (50.6%), white (28.7%), Hispanic (13.4%), and Haitian (5.0%) adult women from south Florida. Data concerning their AIDS knowledge, prevalence of risk behaviors, and perceived vulnerability are presented. Results indicate differences in certain knowledge areas and risk behaviors by race/ethnicity and a consistent incidence of unprotected sex with their main partners across all racial/ethnic groups.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Data on the migration of health-care workers: sources, uses, and challenges.

The migration of health workers within and between countries is a growing concern worldwide because of its impact on health systems in developing and developed countries alike. Policy decisions need to be made at the national, regional and international levels to manage more effectively this phenomenon, but those decisions will be effective and correctly implemented and evaluated only if they are based on adequate statistical data. Most statistics on the migration of health-care workers are neither complete nor fully comparable, and they are often underused, limited (because they often give only a broad description of the phenomena) and not as timely as required. There is also a conflict between the wide range of potential sources of data and the poor statistical evidence on the migration of health personnel. There are two major problems facing researchers who wish to provide evidence on this migration: the problems commonly faced when studying migration in general, such as definitional and comparability problems of "worker migrations" and those related to the specific movements of the health workforce. This paper presents information on the uses of statistics and those who use them, the strengths and limitations of the main data sources, and other challenges that need to be met to obtain good evidence on the migration of health workers. This paper also proposes methods to improve the collection, analysis, sharing, and use of statistics on the migration of health workers.

Data Collection↗
PubMed1993

Reproductive health, population growth, economic development and environmental change.

World population will increase by 1000 million, or by 20%, within 10 years. Ninety-five per cent of this increase will occur in the South, in areas that are already economically, environmentally and politically fragile. Morbidity and mortality associated with reproduction will be greater in the current decade than in any period in human history. Annually, 40-60 million pregnancies will be terminated and 5-10 million children will die within one year of birth. AIDS-related infections, e.g. tuberculosis, will undermine health care in Africa (and elsewhere) and in places AIDS-related deaths will decimate the work-force. The growth in population and associated morbidity will inhibit global economic development and spawn new problems. The key issues are migration, the spread of disease, the supply of water and the degradation of land, and fiscal policies with respect to family planning, pharmaceuticals and Third-World debt. Full education, particularly of women, and more effective family planning in the South have the power to unlock the problem. Failure will see the developed countries, with their 800 million population, swamped by the health, economic and environmental problems of the South, with its projected population of 5400 million people for the year 2000.

Demography↗
PubMed1996

Migration of obstetrician-gynecologists into and out of rural areas, 1985-1990.

This study sought to determine if county-level demographic, health care resource, policy, and competitive factors are associated with the movement of obstetrician-gynecologists (ob-gyns) into and out of rural areas. County-level descriptive data from the Area Resource File, the American Medical Association Physician Masterfile, and the American Hospital Association Guide were used for hospital descriptions. This was a correlational study that measured the association of ecologic indicators of nonmetropolitan counties with indicators of gain or loss of ob-gyns. Descriptive statistics characterize the supply and movement of ob-gyns by size and location of the counties. Multinomial logistic regression models describe the net effect of the ecologic indicators on physician movement. During the period 1985 to 1990, a total of 962 patient care ob-gyns moved out of 531 nonmetropolitan counties, and 979 ob-gyns moved into 528 counties. Counties in the southern Atlantic states experienced the greatest net inflow, whereas Illinois, Missouri, and Texas had the greatest net outflow. Counties that retained ob-gyns during this period were in the mid-range of population. Positive correlates of outward migration were adjacency to a metropolitan county and loss of hospital bed supply; negative correlates with outward migration were the supply of hospital beds and total population. Inward migration was positively correlated with retention or gain of county family physicians and with adjacency; negative correlates were overall population and total family physician supply. The movement of ob-gyns in nonmetropolitan counties is influenced by state policies, local resources, and relative location. No clear evidence shows that there are competitive relations between family physician supply and ob-gyn supply.

Adult↗
PubMed1989

[Problems concerning the population geography of China].

The author analyzes recent population trends in China, based primarily on data from the 1982 census. "Starting from the historical population development the present distribution of the population is analyzed, which, owing to the country's nature, shows its highest density in the eastern part. The major part of all working people is still working in agriculture, but they increasingly migrate into other sectors of the economy. In order to reduce the increase in population since 1978...marriage with only one child has been propagandized as [a] strategic aim. Since that time several measures for family planning have been taken. An interesting geographical problem is the relation between urban and rural population, which is discussed in the article in view of the municipal classification of settlements." (SUMMARY IN ENG AND RUS)

Asia↗
PubMed2006

The basic principles of migration health: population mobility and gaps in disease prevalence.

Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented.

Journal Article↗
PubMedDate not supplied

[On the origin and spread of cutaneous and mucosal leishmaniasis, based on pre- and post- colombian historical source].

Drawing from four sixteenth-century sources, the article reports some apparent incidents of American Tegumentary Leishmaniasis within the territory of the Andes. Reinterpretation of these sources affords a look at the longstanding issue of the origin of espundia,or mucosal Leishmaniasis (ML). The study reinforces the hypothesis that ML originated in the western Amazon region, from there climbing into the high forests and later into hot inter-Andean lands via Bolivia's and Peru's borders with Brazil, above al through human migration. dating to archeological times, this process intensified during the Inca period under the social policies of the mitmaq or mitimaes. These events transpired within the historical and social context of the fall of the Inca Empire and the advent of Spanish colonization.

History, Ancient↗
PubMed1996

Providing health care to refugees.

Migration into the United States is currently a hotly debated and highly charged issue. For political reasons changes in U.S. immigration policy are certain to occur in the near future. While America is called a country of immigrants it is much less a country of refugees. The distinction between the two groups is not always clearly understood by clinicians yet is of great importance for both health screening and follow-up care. If all migration into the country were stopped today, health care professionals would still be treating health conditions and observing cultural practices that are unique to those already admitted.

Health Services↗
PubMed1991

Targeted reintegration of expatriate brains into developing countries of origin: the EEC-IOM experience in Central America.

"The present article...reviews the major findings of the end-evaluation of the EEC-IOM project in Central America, the Dominican Republic and Panama, a five-year scheme funded by the Commission of the European Communities (EEC) and implemented by the International Organization for Migration (IOM), to promote a selective and development-oriented return of Latin American professionals to Costa Rica, the Dominican Republic, Honduras, Nicaragua and Panama.... The core objectives of this evaluation, undertaken in September-December 1989, were to assess the project's contribution to local socioeconomic, scientific and technological development through the selective supply of expatriate professionals to developing institutions operating in so-defined priority areas; to identify the returnees' personal reintegration patterns at the professional, socioeconomic and family-related levels; and to measure the project's cost effectiveness." (SUMMARY IN FRE AND SPA)

Americas↗