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Occupational health priorities for health standards: the current NIOSH approach.

Government agencies responsible for protecting the public from the adverse effects of toxic chemicals must set priorities for research, regulatory action, protocol testing, and monitoring due to the vast number of toxic chemicals and the limited resources available to these agencies. The National Institute for Occupational Safety and Health (NIOSH) must set priorities for research on hazards encountered in the workplace. Priorities are also utilized by NIOSH in preparing criteria for recommended occupational standards which are forwarded to the Occupational Safety and Health Administration (OSHA), U.S. Department of Labor, for possible promulgation. For various reasons, including rapidly changing conditions in the American workplace, NIOSH has instituted a revised priorities program. In the future, NIOSH research and recommended standards activities will focus not only on individual chemicals, but also on industries, occupations, chemical classes, and general industrial processes. NIOSH has also implemented a new program which will allow recommended control procedures for certain chemicals to be forwarded to OSHA in a shorter time period than has been experienced previously.

Humans

[Priority health problems in the Mexico-United States border].

This paper shows a general scope of migration and border health in the US-Mexico border. Project CONSENSO's methodology and the results founded by the local and state health personnel are presented. This activity enabled health personnel from both countries to identify the most relevant health problems at the Northern and Southern US and Mexico border.

Demography

Violence as a public health priority for black Americans.

This study investigated the extent to which black public health and political leaders believe that reducing violence should be a national public health priority for black Americans when compared with other public health problems such as acquired immunodeficiency syndrome, low birthweight, and access to health care. A survey asking whether violence in the black community is amendable to change and who (or what institutions) should be responsible for the reduction of violence was sent to 427 black health leaders, 326 black mayors, and 467 black legislators. Three hundred twenty responses were returned. Virtually all respondents placed violence as one of the top five, if not the highest, public health priority for black Americans. Health and political leaders differed in their beliefs about whether violence and violence-related behaviors can be ameliorated, and who should bear responsibility for the reduction of violence. While this survey had limitations, more than 300 black public health and political leaders indicated that violence among black Americans should be made a national public health priority. Policy implications are discussed, and a proactive role for the National Medical Association is advocated.

Black or African American

[Opinion on health priorities in the community of Valencia].

In this study we have used a qualitative approach partially based on the Delphi technique to establish the ten priorities for health in the Valencian Community for the next five years. Two rounds of mail surveys were made sending questionnaires to 1834 people including Health Councillors of the Town Halls, nurses and doctors of the three valencian provinces. The overall response rate was 28.3%. The priorities which were perceived as most important by the respondents were the development of primary care, improvements in the management of health services and the development of preventive medicine. The fourth and fifth places of the ranking were: improvements of emergency services and increasing the budget devoted to hospital care. The 6th priority was preventive measures in cardiovascular diseases, the 7th actions against drug abuse, the 8th special attention to childhood and ageing populations and the last two priorities were protection of the environment and infectious diseases prevention. We consider this approach as useful to obtain additional valuable information complementary to the information obtained from traditional statistics or health surveys specially in the areas of management, diseases prevention and actions towards special groups of population.

Delphi Technique

Health status and national health priorities.

Various measures of the health status of the population of the United States show there is considerable room for improvement. Compared with other industrialized nations, we are spending more for health care but our health is worse. These data form the basis for setting national priorities. Four selected policy issues are discussed, including access to medical care, maternal and child health care, the acquired immunodeficiency syndrome, and long-term care. Examination of these issues leads to the conclusion that universal and affordable health care is the major national health priority, requiring a commitment by the people of the United States and its leaders to develop a viable solution.

Female

Alternate methods for health priority assessment.

Four methods for assessing priorities of health problems were use in a 15-county Appalachian region. Despite overall similarities the tendency is for providers to focus on categorical disease problems while consumers focus more on organization and financing problems. Only one of the methods described, community diagnosis, uses objective data; thus, the health professional must assume an educational role and help consumers use and interpret data. Prioritization of health problems allows for more appropriate use of limited resources.

Attitude to Health

[Priority health targets in the new Germany from the view point of oral health].

The global pattern of caries prevalence has undergone some changes since the seventies. This has occurred with some remarkable geographic differences. Comparative statistical analysis shows an acceptable situation at the current moment for the population of the new "Bundesländer". The globally given goals of oral health for the various age groups can be reached or have already been accomplished in part. For the youth population the state of good oral health corresponds always to the caries protective availability of fluorides, for the adult population to the remarkable state of a tooth-preservative oriented curative care. For the senior citizen population the high loss of teeth is an indication of past neglect in dental care. Future development of oral health of the population depends largely on all-encompassing preventive and tooth-preservative concepts of dental care.

Adolescent

Hazardous-waste sites: priority health conditions and research strategies--United States.

Uncontrolled disposal sites containing hazardous waste and other contaminants have created national environmental problems (1). Because of potential health problems associated with the more than 33,000 hazardous-waste sites in the United States, the Agency for Toxic Substances and Disease Registry (ATSDR)--as part of its federally legislated mandate--has developed a list of seven priority health conditions (PHCs) to 1) assist in evaluating potential health risks to persons living near these sites and 2) determine program and applied human health research activities involving hazardous substances identified at the sites. This report summarizes the development and intended applications of the seven PHCs.

Environmental Exposure