Income, Poverty, and Health Insurance Coverage in the United States: 2004

Income, Poverty, and Health Insurance Coverage in the United States: 2004

DeNavas-Walt, Carmen, Bernadette D., Proctor, and Cheryl Hill Lee,

U.S. Census Bureau, Current Population Reports

Available online as PDF file [85p.] at:,

http://www.census.gov/prod/2005pubs/p60-229.pdf

“……..This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2005 and earlier Annual Social and Economic Supplements (ASEC) to the Current Population Survey (CPS) conducted by the U.S. Census Bureau.

Real median household income showed no change between 2003 and 2004.1 Both the number of people in poverty and the poverty rate increased between 2003 and 2004. The number of people without health insurance coverage, as well as the number of people with

• News Release
• Current Population Survey (CPS): Income, Poverty and Health Insurance Coverage in theUnited States: 2004 [PDF] Income data Poverty data Health Insurance data
• American Community Survey (ACS): Income, Earnings and Poverty in the United States: 2004 [PDF] Data tables
Presentations
• Dr. Herman Habermann (Guidance on Using CPS/ACS)
• Charles Nelson (CPS)
	Remarks | Slides [PDF-786K] |
• Preston Jay Waite (ACS)
	Remarks | Slides [PDF-834K] |
Webcast and Audio Listen Line
• How to Access the Live Webcast and Audio Listen Line [PDF-226K]
• Webcast Page
• Toll-Free Audio Listen Line: 1-888-882-NEWS (6397)
Background
• Note To Correspondents | (Spanish)
• Media Advisory | (Spanish)
• Differences Between the American Community Survey and Current Population Survey | (Spanish)
• Income and Poverty Estimates: Guidance on When to Use Each Survey | (Spanish)
• ACS:
	ACS News Media Tool Kit
	Web Data Server

Birth Weight Is Inversely Associated With Incident Coronary Heart Disease and Stroke Among Individuals Born in the 1950s. Findings From the Aberdeen C

Birth Weight Is Inversely Associated With Incident Coronary Heart Disease and Stroke Among Individuals Born in the 1950s. Findings From the Aberdeen Children of the 1950s Prospective Cohort Study -- Lawlor et al., 10.1161/CIRCULATIONAHA.104.528356 -- Circulation:
"Birth Weight Is Inversely Associated With Incident Coronary Heart Disease and Stroke Among Individuals Born in the 1950s. Findings From the Aberdeen Children of the 1950s Prospective Cohort Study
Debbie A. Lawlor PhD*, Georgina Ronalds MSc, Heather Clark MSc, George Davey Smith DSc, and David A. Leon PhD

d.a.lawlor@bristol.ac.uk.

Background--
Birth weight is inversely associated with cardiovascular disease risk factors, but few studies have examined the association with disease end points, in particular with stroke risk. Furthermore, previous studies demonstrating an inverse association between birth weight and coronary heart disease (CHD) risk have been conducted on populations born in the early part of the 20th century, when infant mortality rates were high. If the environmental factors associated with improvements in infant mortality rates over the last century explain the inverse association between birth weight and CHD risk, one would expect weaker associations in more contemporary birth cohorts.

Methods and Results--
We have examined the association in a large birth cohort of 10 803 (with an average of 239 000 person-years of follow-up) singleton births that occurred between 1950 and 1956. Our outcomes were hospital admissions for, and fatalities from, CHD (n=296) and stroke (n=107). Birth weight was inversely associated with CHD and stroke. The age-adjusted hazards ratio for a 1-kg increase in birth weight was 0.62 (95% CI 0.50 to 0.78) for CHD and 0.38 (95% CI 0.24 to 0.60) for stroke. Adjustment for gestational age, social class at birth, height and body mass index at school entry, gravidity, maternal age at birth, pregnancy-induced hypertension, antepartum hemorrhage, and maternal height did not alter the association with CHD but attenuated the association with stroke to 0.48 (95% CI 0.30 to 0.76). This attenuation resulted largely from adjustment for gestational age, which was linearly inversely related to stroke risk. Adjusted hazard ratios per sex and gestational age standardized z score of birth weight were 0.85 (95% CI 0.73 to 0.97) for CHD and 0.74 (95% CI 0.71 to 0.88) for stroke.

Conclusions--
Birth weight is inversely associated with CHD and stroke in a population born at a time when environmental circumstances, as indexed by low infant mortality rates, were relatively advantageous for infants.
"

Why Most Published Research Findings Are False

PLoS Medicine: Why Most Published Research Findings Are False: "Why Most Published Research Findings Are False

John P. A. Ioannidis
Summary

There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research."

Imagination

The Lancet: "Imagination

Lars Ole Andersen

Until a few centuries ago, imagination had a far more specific meaning than today's association with flights of fancy and artistic talent. It referred to how the mind and body could impose upon each other, and how disease could be influenced by the mind.

Imagination was the messenger that transferred and translated information from the senses into the mind. It also passed messages in the other direction: translating thoughts into a language amenable to the body through the spirits or passions. For instance, if a person saw a plague victim the imagination could create the same symptoms in the viewer, or if a pregnant woman was frightened by a deformed beggar the “maternal imagination” could cause the same deformity on the sensitive fetus. That which previously had been explained as a punishment from God was, from the 16th century, often explained as caused by the imagination.

From the 18th century, this secular notion of the imagination and disease was gradually replaced by biologically orientated explanations, such as fetal abnormality or genetic defect, while the “influence of the imagination” became part of superstition and folk belief. Even so, a medicalised and gendered version of imagination persisted. During the 19th century, dozens of articles in The Lancet referred to the effects of “maternal imagination” and “maternal impression”. At the same time, however, within the medical profession, the power of “imagination” was increasingly deprecated and circumscribed. Only “dangerous quacks” and fringe practitioners of mesmerism, homoeopathy, and the like were held to exploit patients' imaginations. It was not a power to be associated with qualified gentlemen practitioners. Despite attempts by physicians like John Haygarth (1740–1827) and the alienist Daniel Hack Tuke (1827–95) to reinsert imagination into the therapeutic armamentarium, it was largely consigned to the arts—as the inimitable ingredient for great literature and music.

In the 20th century, the notion of mind over body was thoroughly medicalised, but the name of the object involved was no longer imagination, but rather “suggestion”, “psychosomatics”, and “the placebo effect”. Imagination in medicine is gone, but somatic medicine more than ever is riddled with imagination."

Lancet International Fellowships 2006

The Lancet
Lancet International Fellowships 2006

Astrid James

To promote international collaboration, and to allow individuals to experience and contribute to medical care or research in other settings, The Lancet launched a fellowship scheme in 1998. We now invite applications for two Lancet International Fellowships—L$25 000 each—to start in 2006. The aim of these fellowships is to help doctors to work in a country very different from their own. The differences may lie in a country's delivery of health care, research or health priorities, or educational facilities. To be eligible, you must be a medical graduate but there are no age limits. The fellowship should last at least 6 months. To apply, please send:
• Your curriculum vitae
• A proposal describing where you would like to go, when and for how long, what you plan to do and why, and how you would spend your award
• Letters of support from your head of department and from the person who will be hosting your visit
• The names and addresses (including e-mail addresses and telephone numbers) of three referees.

Please send your applications to Dr Richard Horton, The Lancet, 32 Jamestown Road, London NW1 7BY, UK, in an envelope marked “International Fellowships”. The closing date is Nov 1, 2005.

WHO conference calls for health promotion to be at centre of development -- Parry 331 (7514): 422 -- BMJ

In a bid to put health promotion at the centre of the global development agenda, a new charter urges greater cooperation between medical and non-medical institutions.

The Bangkok charter for health promotion was adopted by participants in last week’s sixth global conference on health promotion, co-hosted by the World Health Organization and Thailand’s Ministry of Public Health.

The charter calls for coherent policy and partnering between governments, international and non-government organisations and the private sector. Other than ensuring that health promotion is central to the development agenda, the charter spells out three other main commitments: that health promotion be a core responsibility of governments, be a part of sound corporate practice, and be a focus of community and social initiatives.

Report on the World Social Situation 2005

Report on the World Social Situation: "he Report on the World Social Situation (RWSS) is prepared on a biennial basis by the Division for Social Policy and Development of the Department of Economic and Social Affairs.

Over the years, the Report has served as a background document for discussion and policy analysis of socio-economic matters at the intergovernmental level, and has aimed at contributing to the identification of emerging social trends of international concern and to the analysis of relationships among major development issues which have both international and national dimensions. In its resolution 56/177 of 15 December 2001, the United Nations General Assembly requested the Secretary-General to change the periodicity of the Reports on the World Social Situation from a four-year cycle to a two-year cycle."

PLoS Medicine: Nuclear Weapons 60 Years On: Still a Global Public Health Threat

PLoS Medicine: Nuclear Weapons 60 Years On: Still a Global Public Health Threat:
"The world is in turmoil: terrorism, or at least the fear of terrorism, seems to have a stranglehold; world governments and the United Nations have an arbitrary way of dealing with “rogue states” (notice, for example, the differences in their treatment of Iraq, the Democratic Republic of Congo, Zimbabwe, and Myanmar); and international treaties can be broken on a whim, such as the recent deal in which the US agreed to share its civilian nuclear knowledge with India. Now is not the time to be gambling with the world's future and that of the human race by holding on to weapons that could destroy the planet thousands of times over. The countries that continue to have such weapons are potential destroyers, not the guardians of democracy, or the defenders of peace, or whatever they choose to call themselves. Democracy should be better than this."

Bangkok Charter on Health Promotion

bangkok_charter2
The Bangkok Charter for Health Promotion, adopted at the recently concluded 6th International Conference on Health Promotion, is an inadequate and timid document that falls far short of what is required to tackle global health problems today.

The Conference was organized by the World Health Organisation and Thailand’s Ministry of Public Health and was attended by 700 leading health promotion experts from more than 100 countries around the world.

The People’s Health Movement (PHM), an international civil society network of health professionals, academics and non-government organizations, is dismayed and disappointed by the Charter and by the failure of WHO to take the opportunity to offer leadership on a progressive agenda to improve the health of the global poor.

“Although we support the aims of the Charter and its call for “political action and sustained advocacy” to promote health, the Charter fails to highlight the current regime of global economic governance as a primary cause of increased poverty, widening income inequalities and poor health” said David McCoy, a researcher associated with PHM.

“It also avoids identifying the political barriers to health for all and consequently offers little in the form of bold or concrete recommendations to advance this agenda” he said.

The failure to provide a robust critique of the causes of global poverty and failing health systems, results in the Charter omitting any reference to the negative social and health impacts of neo-liberal public policy, or the exploitation of natural and human resources by the corporate sector and the wealthy global minority or to the rapidly increasing concentration of wealth.

While the Bangkok Charter echoes previous declarations that health is a human right, it has not grasped the opportunity to call for human and health rights to take precedence over the provisions of economic policy and trade and financial agreements. This Charter does not even call for the routine implementation of equity-focused health impact assessments of trade agreements – an omission that is grave and an issue that WHO must not be allowed to ignore.

There are many concrete strategies that the global public health community should be advocating, but which are neglected in this Charter. These include:

* Ø Further cancellations of unsustainable and unjustified debt
* Ø The end of economic conditionalities on debt cancellation, development assistance or loans/grants from international financial institutions and other development banks
* Ø The democratic reform of the International Monetary Fund and World Bank
* Ø The establishment of a fair international tax regime to eradicate unacceptable transnational tax avoidance
* Ø Promotion of appropriate global redistribution and the public financing for essential services to all citizens
* Ø The renegotiation or even scrapping of multilateral and bilateral trade agreements that have negative impact on public health
* Ø The adoption of an agenda to repair and develop the capacity of public sector health systems in all countries particularly developing nations
* Ø Ratification of the United Nations Convention on Corruption to reduce the negative health effects of bribery and other forms of illegal and unethical practices involving multinational corporations and governments.

Unless the global public health community is serious about identifying, naming and tackling the underlying political barriers and vested interests that lie in the way of health promotion, we run the risk of changing little.

It is vital that WHO, as the lead multi-lateral agency for the promotion of health, takes a more constructive and independent position with respect to the political and economic actors and institutions that retard the promotion of health. It is no longer enough to merely promote well-meaning declarations that lack any meaningful equity-based strategies to improve health.

Detection of Coronary Stenoses at Rest With Myocardial Contrast Echocardiography -- Wei et al. 112 (8): 1154 -- Circulation

Detection of Coronary Stenoses at Rest With Myocardial Contrast Echocardiography -- Wei et al. 112 (8): 1154 -- Circulation: "Methods and Results - Patients with varying degrees of coronary artery stenosis on quantitative angiography underwent high-mechanical-index myocardial contrast echocardiography at 15 Hz to allow measurement of phasic changes in aBV in large intramyocardial vessels using either Definity (group 1; n=22) or Imagent (group 2; n=22). Progressive increases in the background-subtracted systolic/diastolic aBV signal ratio were noted between each level (none, mild [<50%], moderate [50% to 75%], and severe [>75%]) of stenosis severity for both group 1 (0.09+/-0.13, 0.13+/-0.08, 0.58+/-0.22, and 0.77+/-0.40; P<0.001) and group 2 (0.10+/-0.05, 0.27+/-0.18, 0.39+/-0.28, and 0.74+/-0.37; P<0.0001) patients. A systolic/diastolic aBV signal ratio of >0.34 provided a sensitivity and specificity of 80% and 71%, respectively, for the detection of >75% coronary stenosis in group 1 patients, whereas a ratio of >0.43 provided a sensitivity and specificity of 89% and 74%, respectively, for the detection of >75% stenosis in group 2 patients.
Conclusions - Both the presence and severity of a physiologically significant coronary stenosis can be detected at rest by measuring the increase in aBV on myocardial contrast echocardiography that occurs distally to the stenosis without recourse to any form of stress. "

Atenção Primária na Catalunha

Atenção Primária na Catalunha
Apresentação feita pela Dra. Olga Pané sobre Atenção Primária na
Catalunha, semana passada, na ENAP. Arquivo em PDF.
Enviado pela Dra. Rosa Maria Villa-Nova Correa.

How can we achieve and maintain high-quality performance of health workers in low-resource settings?

How can we achieve and maintain high-quality performance of health workers in low-resource settings?
Alexander K Rowe, Don de Savigny, Claudio F Lanata, Cesar G Victora
In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. Health-worker practices are complex behaviours that have many potential influences. Reviews of intervention studies in low and middle income countries suggest that the simple dissemination of written guidelines is often ineffective, that supervision and audit with feedback is generally effective, and that multifaceted interventions might be more effective than single interventions.
Few interventions have been evaluated with rigorous cost-effectiveness trials, and such studies are urgently needed to guide policy. We propose an international collaborative research agenda to generate knowledge about the true determinants of performance and about the effectiveness of strategies to improve performance. Furthermore, we recommend that ministries of health and international organisations should actively help translate research findings into action to improve health-worker performance, and thereby improve health.

8th. Brazilian Congress on Collective Health and 11th. World Congress on Public Health

The World Federation of Public Health Associations (WFPHA) – in a 2004 policy resolution - defined “public health as an art and a science; and also a movement dedicated to the equitable improvement of health and well-being (of communities with their full participation). First and foremost, public health leaders must be catalysts for the public health movement. Individually and collectively around the world, public health leaders must maintain and strengthen their roles and capacities as advocates for public health. The Federation recognizes as “key challenges having a global dimension: the promotion of human rights; the reduction of the burden of disease; the guarantee of appropriate nutrition; the education on all aspects of health promotion; the protection of the environment; and the achievement of worldwide access to essential drugs at reasonable cost” (1).

Although technical and scientific progress provides broad-ranging preventative, and curative resources, and economic and social progress in many developed countries has extended life expectancy and enhanced the quality of life of large segments of the population, yet poverty, hunger, preventable diseases and violence continue to threaten the health and livelihoods of over three quarters of the population of the planet. (2)


There is growing consensus that “to tackle the major global health challenges effectively, the practice of public health will need to change. It is not sufficient to focus only on urgent health priorities, for example, HIV/AIDS, tuberculosis, and malaria in sub-Saharan Africa, or just the Millennium Development Goals. Programs and policies are required that respond to poverty—the basic cause of much of the global burden of disease—prevent the emerging epidemics of non-communicable disease, and address global environmental change, natural, and man-made disasters, and provide for sustainable health development. The justification for action is that health is both an end in itself—a human right—as well as a prerequisite for human development.” (3)

Today’s smaller and faster world -- brought about by advancements in communications and information technology -- has yet to address the daunting task of breaking down the barriers that stand in the way of promoting health and delivering appropriate care to hundreds of millions of human beings. Ethical principles need to be revisited and reinforced. Public health leaders have an enormous challenge to draw attention to these social, economic and political barriers and focus their talents and energy in engaging political and social forces as part of a global and united commitment to actively pulling down these barriers.

The World Federation of Public Health Associations (WFPHA) and the Brazilian Association of Collective Health (ABRASCO) invite the public health leadership from all parts of the world to come to Rio de Janeiro, Brazil, and join the 11th World Congress on Public Health, and the 8th Brazilian Congress on Collective Health in addressing the Congress theme: “Public Health in a Globalized World: Breaking down Political, Social and Economic Barriers”.

Correlates 0f War Home Page

COW Home Page
The Correlates of War Project was founded in 1963 by J. David Singer, a political scientist at the University of Michigan. The original and continuing goal of the project has been the systematic accumulation of scientific knowledge about war. Joined by historian Melvin Small, the project began its work by assembling a more accurate data set on the incidence and extent of inter-state and extra-systemic war in the post-Napoleonic period. To do this scientifically Singer and Small found they needed to operationally resolve a number of difficult issues such as what is a “state” and what precisely is a “war.” Building upon the work of other pioneers such as Pitirim Sorokin, Lewis Frye Richardson, and Quincy Wright, Singer and Small published The Wages of War in 1972, a work that established a standard definition of war that has guided the research of hundreds of scholars since its publication.

Statistics on the Web

SOSIG: Record Details: "Author: Webster West
Description: Webstat is a statistical computing package which runs from a Web browser (written in the form of a Java applet). It is aimed at novice users and offers a range of basic data analysis procedures and graphics capabilities
Keywords: statistical analysis software
Subject Section(s): Statistics
Resource Type: Software
Language: en
URL: http://www.stat.sc.edu/webstat/
"

Prognosis in obesity: Older people should not be misinformed about being overweight -- Visvanathan and Chapman 331 (7514): 452 -- BMJ

Prognosis in obesity: Older people should not be misinformed about being overweight -- Visvanathan and Chapman 331 (7514): 452 -- BMJ: "Prognosis in obesity
Older people should not be misinformed about being overweight

EDITOR—With reference to the editorial by Lean on prognosis in obesity,1 advising apparently overweight older people to lose weight may do more harm than good. Evidence suggests that the risks of being 'overweight' decrease with increasing age. On the basis of mortality, the ideal body mass index (BMI) is higher in older than young adults, with an optimum BMI for people older than 65 in the young adult 'overweight' range of 27-30 kg/m2.2 In a systematic review, Heiat et al concluded that the relation between BMI and mortality in people older than 65 is a flat bottomed, U-shaped curve, with mortality rising only at BMI > 31 kg/m2 and perhaps not at any BMI in people older than 75.2"

Health InterNetwork Access to Research Initiative

WHO | Health InterNetwork Access to Research Initiative: "Health InterNetwork Access to Research Initiative

The HINARI program, set up by WHO together with major publishers, enables developing countries to gain access to one of the world's largest collections of biomedical and health literature. Over 2900 journal titles are now available to health institutions in 113 countries, benefiting many thousands of health workers and researchers, and in turn, contributing to improved world health."

Healthy People 2010 Home Page

Healthy People 2010 Home Page
On behalf of the US Department of Health and Human Services (HHS), the Office of Disease Prevention and Health Promotion (ODPHP) is soliciting the submission of electronic comments for consideration on changes and revisions proposed to the Healthy People 2010 objectives as a result of the Midcourse Review process. The Midcourse Review, conducted at the midpoint of the decade, is the process through which the Healthy People 2010 objectives are reviewed by HHS, the lead agencies for the Healthy People focus areas, and other experts, to assess the data trends during the first half of the decade, consider new science and available data, and make changes that ensure that Healthy People 2010 remains current, accurate, and relevant. The proposed revisions take the form of: establishing baselines and targets for formerly developmental objectives (i.e., objectives that had no baseline data or target when Healthy People 2010 was released in 2000); changes to the language of objectives and subobjectives; deletions of objectives and subobjectives; new subobjectives; and baseline and target revisions.

The public is invited to comment through the Internet Website on: objectives and subobjectives that are moving from developmental to measurable objective status; objectives and subobjectives with revisions to their overall language; the deletion of objectives and subobjectives; the addition of new subobjectives; the establishment of new baselines, targets, and target setting methods; and changes to data sources. Written comments received in response to this notice will be reviewed and considered by the lead agencies for the objectives to which they pertain.

DATES: Written comments must be submitted via the Internet website by the close of business Eastern Standard Time on September 15, 2005.

ADDRESSES: The proposed revisions to Healthy People 2010 objectives can be viewed and commented on at http://www.healthypeople.gov/data/midcourse.

FOR FURTHER INFORMATION CONTACT: Email the Office of Disease Prevention and Health Promotion, Office of Public Health and Science, U.S. Department of Health and Human Services, at hp2010@osophs.dhhs.gov.

BACKGROUND: HHS has led a nationwide process to formulate and monitor national disease prevention and health promotion objectives since 1979. The Healthy People initiative began in 1979 with Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention, which presented general goals for reducing preventable death and injury in different age groups by 1990. These general goals were followed in 1980 by the publication of Promoting Health/Preventing Disease: Objectives for the Nation, which identified five overarching goals supported by a set 226 objectives organized in 15 strategic areas to be achieved by 1990. The five goals targeted mortality and morbidity for five distinct age groups.

In 1990, HHS published Healthy People 2000, which established three overarching goals and contained 319 objectives in 22 priority areas. The Healthy People 2000 goals were 1) increase the span of healthy life, 2) reduce health disparities, and 3) provide access to preventive health services.

Building on the experiences of the first two decades of objectives, public hearings, and a public comment process that generated more than 11,000 public comments, in January 2000, HHS issued Healthy People 2010, the third generation of 10-year disease prevention and health promotion objectives for the Nation. Healthy People 2010 is a comprehensive set of national health objectives, based on science, for the first decade of the 21st century. It identifies two overarching goals (i.e., increase the quality and years of healthy life, and eliminate health disparities) that are supported by 467 objectives in 28 focus areas. For more information about Healthy People 2010 and its history, visit the Healthy People 2010 Internet website at http://www.healthypeople.gov.

Through the Healthy People 2010 Midcourse Review, the lead agencies for the 28 Healthy People 2010 focus areas have proposed revisions to the Healthy People 2010 objectives that are now available for public review and comment. Public comment on the objectives will be considered by the appropriate lead agencies. ODPHP, within the Office of Public Health and Science, serves as the overall coordinator for the dissemination and processing of the public comments.

A new HHS report entitled Healthy People 2010 Midcourse Review, featuring the revisions and a status report on progress from 2000 to 2005 toward achieving the targets for the year 2010, is scheduled for publication in 2006.

Transição Epidemiológica no Brasil

v8n2a08.pdf (application/pdf Object)
A Transição Epidemiológica no Brasil
The Epidemiologic Transition in Brazil
Pedro Reginaldo Prata
PRATA, P. R. The Epidemiologic Transition in Brazil. Cad. Saúde Públ., Rio de Janeiro, 8 (2):
168-175, abr/jun, 1992.
The author critically evaluates the evolution of the Brazilian mortality pattern during the last fifty years under the framework of the epidemiologic transition theory. The author also discusses mortality determination as a result of economic development and preventive measures. He considers that cardiovascular diseases, neoplasms and injuries are related with environmental and socio-cultural factors and therefore cannot be considered chronic degenerative diseases but preventable ones. These groups of disease are also considered to be unevenly distributed and more prevalent in deprived populations. The author also refers to the simultaneous prevalence of two distinct epidemiologic patterns described in the epidemiologic transition theory, due to the remaining infectious diseases prevalence or to the outbreak of previously eradicated infectious diseases in Brazil, leading to an incomplete epidemiologic transition.

Science for Global Sustainability:Toward a New Paradigm

120.pdf (application/pdf Object)
Science for Global Sustainability:Toward a New Paradigm
William C. Clark, Paul J. Crutzen, and Hans J. Schellnhuber
CID Working Paper No. 120
March 2005
Science, Environment and Development Group, CID
(From Ana Ruggiero PAHO)
“……..The authors begin by characterizing the contemporary epoch of Earth history in which humanity has emerged as a major—and uniquely self-reflexive—geological force. They turn next to the extraordinary revolution in our understanding of the Earth system that is now underway, pointing out how it has built on and qualitatively extended the approaches that have served science and society so well since the first Copernican revolution.

The authors then discuss the novel challenges posed by the urgent need to harness science and other forms of knowledge in promoting a worldwide sustainability transition that enhances human prosperity while protecting the Earth’s life-support systems and reducing hunger and poverty ….”

ethical dimension of health inequality

120.pdf (application/pdf Object)
Yukiko Asada
Yukiko.asada@dal.ca

Background: Health inequality has long attracted keen attention in the research and policy arena. While there may be various motivations to study health inequality, what distinguishes it as a topic is moral concern. Despite the importance of this moral interest, a theoretical and analytical framework for measuring health inequality acknowledging moral concerns remains to be established.

Study objective: To propose a framework for measuring the moral or ethical dimension of health inequality—that is, health inequity.

Design: Conceptual discussion.

Conclusions: Measuring health inequity entails three steps: (1) defining when a health distribution becomes inequitable, (2) deciding on measurement strategies to operationalise a chosen concept of equity, and (3) quantifying health inequity information. For step (1) a variety of perspectives on health equity exist under two categories, health equity as equality in health, and health inequality as an indicator of general injustice in society. In step (2), when we are interested in health inequity, the choice of the measurement of health, the unit of time, and the unit of analysis in health inequity analysis should reflect moral considerations. In step (3) we must follow principles rather than convenience and consider six questions that arise when quantifying health inequity information. This proposed framework suggests various ways to conceptualise the moral dimension of health inequality and emphasises the logical consistency from conception to measurement.

WHO | Everyone counts

WHO | Everyone counts: "The Health Metrics Network (HMN) is an innovative global partnership founded on the premise that better health information means better decision making — and that means better health for all. HMN partners are working to improve health and save lives by strengthening and aligning health information systems around the world."

Understanding Genetics: Human Health and the Genome

Understanding Genetics: Human Health and the Genome
Find out how genes work and how they can affect your health and well-being. Learn the basics of genetics, how genes are inherited, genetic testing, ethics, new therapies, and much more.

State of the World 2005 - Press Release

State of the World 2005 - Press Release: Worldwatch Institute News:
"Washington, D.C.—The global war on terror is diverting the world's attention from the central causes of instability, reports the Worldwatch Institute in its annual State of the World 2005. Acts of terror and the dangerous reactions they provoke are symptomatic of underlying sources of global insecurity, including the perilous interplay among poverty, infectious disease, environmental degradation, and rising competition over oil and other resources.

Compounded by the spread of deadly armaments, these 'problems without passports' create the conditions in which political instability, warfare, and extremism thrive. They could lead the world into a dangerous downward spiral in which the basic fabric of nations is called into question, political fault lines deepen, and radicalization grows. Tackling these challenges demands a strategy that emphasizes prevention-focused programs rather than military might, the report concludes.

'Poverty, disease, and environmental decline are the true axis of evil,' says Worldwatch President Christopher Flavin. 'Unless these threats are recognized and responded to, the world runs the risk of being blindsided by the new forces of instability, just as the United States was surprised by the terrorist attacks of September 11.'"

State of the World 2005

State of the World 2005 Table of Contents
Foreword
Mikhail S. Gorbachev, Chairman, Green Cross International

Gorbachev Five years ago, all 191 United Nations member states pledged to meet eight Millennium Development Goals by 2015, including eradicating extreme poverty and hunger and ensuring environmental sustainability. These critical challenges were reaffirmed by health officials from across the globe in October 2004 at the tenth anniversary of the landmark International Conference on Population and Development held in Cairo.

The overarching conclusion from this 2004 meeting was that while considerable, albeit erratic, progress was indeed being made in many areas, any optimism must be tempered with the realization that gains in overall global socioeconomic development, security, and sustainability do not reflect the reality on the ground in many parts of the world. Poverty continues to undermine progress in many areas. Diseases such as HIV/AIDS are on the rise, creating public health time bombs in numerous countries. In the last five years, some 20 million children have died of preventable waterborne diseases, and hundreds of millions of people continue to live with the daily misery and squalor associated with the lack of clean drinking water and adequate sanitation.

We must recognize these shameful global disparities and begin to address them seriously. I am delighted that the 2004 Nobel Peace Prize was awarded to Wangari Maathai, a woman whose personal efforts, leadership, and practical community work in Kenya and Africa inspire us all by demonstrating the real progress that can be made in addressing environmental security and sustainable development challenges where people have the courage to make a difference.
....

Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies

PLoS Medicine: Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies: "
Richard Smith
Recommended by Mario Maranhão
“Journals have devolved into information laundering operations for the pharmaceutical industry”, wrote Richard Horton, editor of the Lancet, in March 2004 [1]. In the same year, Marcia Angell, former editor of the New England Journal of Medicine, lambasted the industry for becoming “primarily a marketing machine” and co-opting “every institution that might stand in its way” [2]. Medical journals were conspicuously absent from her list of co-opted institutions, but she and Horton are not the only editors who have become increasingly queasy about the power and influence of the industry. Jerry Kassirer, another former editor of the New England Journal of Medicine, argues that the industry has deflected the moral compasses of many physicians [3], and the editors of PLoS Medicine have declared that they will not become “part of the cycle of dependency…between journals and the pharmaceutical industry” [4]. Something is clearly up."

Obesity in Latin America: similarity in the inequalities

The Lancet: "Obesity in Latin America: similarity in the inequalities

Patrícia Pelufo Silveira a, André Krumel Portella a and Marcelo Zubaran Goldani
Barbara Fraser (June 11, p 1995)1 reports a partial point of view about obesity in Latin America. She emphasises that poverty and malnutrition, followed by ingestion of junk (and cheap) food, has a pivotal role in the increased rates of obesity seen especially in Latin American children and women.

In Brazil, the largest country of Latin America, social inequalities seem to interact in a complex fashion. People belonging to privileged social strata tend to have adequate access to a well balanced diet and medical care, whereas those from underprivileged social groups tend not to. However, it is intriguing that, in both these social layers, low birthweight and obesity are becoming more frequent."

WHO Bulletin - Information Systems

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This month’s special theme: Health Information Systems (pp. 562–564)

In the first editorial, Sally Stansfield welcomes growing recognition of the need for more investment in health information systems. Such systems may seem expensive for developing countries, but the costs are offset by improved efficiencies. In another editorial, Kimberlyn M. McGrail & Charlyn Black argue that developing countries starting to set up health information systems can learn from the mistakes of wealthier countries. Middle-to-low-income countries should incorporate mechanisms to ensure that health data can be easily accessed by those who need them. Finally, Tony Williams argues that poor countries should shift to policy-making that is based on evidence by developing a health information system that adapts the existing data situation.

Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies

PLoS Medicine: Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies
Richard Smith
“Journals have devolved into information laundering operations for the pharmaceutical industry”, wrote Richard Horton, editor of the Lancet, in March 2004 [1]. In the same year, Marcia Angell, former editor of the New England Journal of Medicine, lambasted the industry for becoming “primarily a marketing machine” and co-opting “every institution that might stand in its way” [2]. Medical journals were conspicuously absent from her list of co-opted institutions, but she and Horton are not the only editors who have become increasingly queasy about the power and influence of the industry. Jerry Kassirer, another former editor of the New England Journal of Medicine, argues that the industry has deflected the moral compasses of many physicians [3], and the editors of PLoS Medicine have declared that they will not become “part of the cycle of dependency…between journals and the pharmaceutical industry” [4]. Something is clearly up.

Using Search Engines to Find Online Medical Information

PLoS Medicine: Using Search Engines to Find Online Medical Information
Mohammad Al-Ubaydli
Brewster Kahle, creator of the Internet Archive (www.archive.org)—a digital library of Internet sites and other cultural artifacts in digital form—has been inspirational in discussing the Internet's potential to become a modern Library of Alexandria. He campaigns for a resource that makes all of humanity's knowledge available to all of humanity.

IDF Diabetes Atlas - Home page

IDF Diabetes Atlas - Home page: "Welcome to the e-Atlas!

The e-atlas is being restructured to enable you to navigate the site more easily and to gain access to the latest data more quickly. Content in the e-atlas is also being updated to include figures from 2003, forecasts of diabetes prevalence for 2025, and the latest information on many new and topical issues.

In this phase, you will already be able to access prevalence estimates of diabetes and impaired glucose tolerance, prevalence rates of diabetic complications, mortality rates of cardiovascular disease, and estimates of the costs of diabetes. New features and topics will be introduced over the next few months, and will include:

* access to insulin and diabetes supplies;
* diabetes education; and
* regional and country profiles"