WHO | Access and Services

WHO | Access and Services: "

Surgeon General's Report.

Company/Source Collection: R.J. Reynolds

Document Date: 26 Feb 1982
Length: 1 page
Bates No. 506062870

URL of this Posting (w/ images): http://tobaccodocuments.org/...
Document Images: http://legacy.library.ucsf.edu/...

In this memo, R.J. Reynolds' Vice President of Government Relations, Gene Ainsworth, describes how the company could deal with the damage being done to the cigarette industry by the annual U.S. Surgeon General's reports on the health consequences of smoking: eliminate the reports entirely by sneaking an amendment to do just that into an omnibus legislative bill.

An undated memo written by Horace Kornegay of the Tobacco Institute (http://legacy.library.ucsf.edu/...) shows that the industry thought it was a valuable idea. Kornegay wrote up the rationale for eliminating the requirement that the U.S. Surgeon General issue annual reports on the health consequences of smoking:

"There are no public benefits from annual reports that essentially duplicate previous reports. To the contrary, repetitive statements based on previously reported information tend to mislead the public about the state of knowledge concerning smoking and health issues... Antismoking advocates have come increasingly in recent years to seize on the annual report of the Surgeon General for propaganda purposes, which obscures the purpose of the reports --which is to provide in a scientifically accurate and dispassionate manner information with regard to smoking and health. As a result, public confidence in the reliability of government health information programs has been undermined, the Office of the Surgeon General has been diverted from its mission of health promotion and disease prevention, and tax revenues have been wasted."

Tobacco industry attacks on the Office of the Surgeon General continued in later years. A 2-page report describes a 1997 legislative attempt by industry political ally Rep. Henry Bonilla (R-TX, defeated in the Nov. 7, 2006 election) to de-fund the Surgeon General's Office completely : (http://legacy.library.ucsf.edu/...) A transcript from a February 11, 1997 meeting of the Department of Health and Human Services (DHHS) Congressional Subcommittee on Appropriations shows Rep. Bonilla pressing for the complete termination of the Office of the Surgeon General. Bonilla told the head of DHHS that "The Office of the Surgeon General is unnecessary. Moneys used to fund it could otherwise be used for CDC health treatment efforts...Why not eliminate it, like the private sector would?" (http://legacy.library.ucsf.edu/...)

Quotes

In your February 23 memorandum to Ed Horrigan on the 1982 Surgeon General's Report you listed two possible actions the industry might wish to pursue. I would like to add a third item to this list for your consideration:

-- Amend the relevant provision of the Federal Cigarette Labeling and Advertising Act to eliminate the annual reporting obligation of the Secretary of HHS with respect to "the health consequences of smoking." This is certainly not a new item for consideration -- it was contained in the May 1, 1981 TI submission to the Presidential Task Force on Regulatory Relief -- however the problems created by annual Surgeon General's Reports are so serious, in my opinion, as to warrant an immediate and thorough review of possible actions to eliminate this reporting requirement. I hold no naive thoughts that such action could be successful standing alone as an independent legislative proposal. However, if it were to be woven into an omnibus regulatory and legislative relief proposal by the Administration it might have a chance of passage. Without change in the annual reporting requirement we can, unfortunately, expect future reports by Dr. Koop to be increasingly damaging to the industry.

-------------------------

Company

R.J. Reynolds

Author

Ainsworth, W. Eugene (RJR VP, Government Relations)

W. Eugene "Gene" Ainsworth Jr. served as the Vice President of Government Relations for R. J. Reynolds Tobacco USA in 1984 and 1987 and as Senior Vice President of Government Relations for RJR Tobacco USA in 1988 & 1989. (Source: R. J. Reynolds Summary - RJR Liability Notebook).

Recipient

Tucker, Charles A. (Director, RJR Tobacco Co. 1983)

Also on TI Communications Committee, 1983

."

BBC NEWS | Health | Housework cuts breast cancer risk

BBC NEWS | Health | Housework cuts breast cancer risk: "The research on more than 200,000 women from nine European countries found doing household chores was far more cancer protective than playing sport.

Dusting, mopping and vacuuming was also better than having a physical job.

The women in the Cancer Research UK-funded study spent an average of 16 to 17 hours a week cooking, cleaning and doing the washing."

Sinais dos Tempos?

Aloyzio Achutti. Membro da Academia Sul-Rio-Grandense de Medicina

(Artigo publicado na ZH de hoje)

É lugar comum ao bater o relógio do tempo, quando um ciclo se fecha para dar lugar a outro, olhar para trás na busca de alguma característica marcante, preparando-se para a próxima rodada.

Não causaria surpresa se a escolha apontasse para a agressividade como o que de mais chocante marcou este ano. Pelo mundo afora e também por aqui.

Uma guerra que vai para cinco anos, na qual já foram imolados mais soldados do lado que se sentiu agredido, do que o número daqueles que pretendiam vingar. E têm sido jovens, selecionados e treinados, usando altas e riquíssimas técnicas e logística para matar. Sem falar da enorme instabilidade local provocada pela intervenção intempestiva, exacerbação de ódios, extermínio massificado e risco de generalização.

A agressão não é a primeira resposta adequada, nem remédio para outra agressão, pois termina gerando um efeito cascata com conseqüências imprevisíveis tanto no terreno biológico, como no psicológico e no social. É comum esta atitude criar um clima que compromete mesmo quem não está diretamente envolvido na disputa, fomentando a multiplicação de focos de violência.

Si se acredita em sanções econômicas capazes de frear essa escalada, esta seria uma boa oportunidade para se suspender a remessa de dinheiro - pretensamente devido para pagar uma dívida externa - mas que está sendo pessimamente e de forma hedionda empregado.

As agressões têm sido também morais, enquanto violam, a pretexto de direitos de uns, valores humanos, a autonomia e o direito internacional. Cria-se um clima de insegurança e de desespero. O vale tudo termina refletindo também em casa, dando chance a aproveitadores na corrupção política e na proliferação da criminalidade.

As agressões ao meio ambiente, com destruição e toda sorte de lixo acumulado há muito tempo mostram suas conseqüências cada vez mais ostensivas. Banalizam-se a falta de respeito com os outros e consigo mesmo: com exagero na intensidade do som, no tráfego, na propaganda, na violação da privacidade, na mentira, na omissão de responsabilidade, na exposição a riscos desnecessários e às chamadas atividades radicais, em atitudes suicidas, no excesso alimentar e nas drogas, desesperadamente, como se o mundo estivesse por acabar.

A agressividade é a virtude da arrogância e da insensatez. Nesses tempos tem se tornado modelo de desempenho e estratégia de competição no comércio, na indústria, na pesquisa científica, no esporte e até no estilo de vida. A agressividade consome e destrói e só encontra limite na autodestruição. O mundo não se estimula nem se move mais por amor e nem por cooperação.

É uma lástima ter que terminar mais um ano com esta sensação amarga, sem perspectiva da tão almejada e prometida paz aos homens de boa vontade...

JAMA -- Theme Issue on Poverty and Human Development: Call for Papers on Interventions to Improve Health Among the Poor, December 27, 2006, Flanagin a

JAMA -- Theme Issue on Poverty and Human Development: Call for Papers on Interventions to Improve Health Among the Poor, December 27, 2006, Flanagin and Winker 296 (24): 2970: "

Call for Papers on Interventions to Improve Health Among the Poor

Annette Flanagin, RN, MA; Margaret A. Winker, MD

JAMA. 2006;296:2970-2971.

Poverty is an inveterate consequence and cause of ill health.¹ Without financial resources, people cannot pay for basic human needs: food, water, sanitation, housing, and health care services. In addition, poor people often live in poor countries that have limited or deteriorating health care systems and not enough physicians, nurses, and other trained health care workers. Others live in countries with governments that ignore or are too ineffectual to address the health care needs of the poor. Individuals who are poor also lack adequate education to make appropriate decisions about health and prevention of disease and often lack equity and empowerment to attain education, employment, and skills needed to escape the cycle of poverty.

The first of the United Nation's 8 Millennium Development Goals, determined by 189 countries in 2000, is to eradicate extreme poverty and hunger.² This specific goal is to halve the proportion of people living on less than $1 a day (the World Bank's definition of extreme poverty) and those who suffer from hunger by the year 2015.^2-3 This goal cannot be achieved without improving the level of human development—the opportunity to escape poverty through "the choices that come with a sufficient income, an education, good health, and living in a country that is not governed by tyranny"—among the poor.⁴ Such development requires careful evaluation and study of interventions aimed to address the needs of poor individuals within their unique local conditions and socioeconomic context, with sufficient follow-up to determine whether effects are sustainable.

In 1990, more than 28% of the developing world's population (1.2 billion people) lived in extreme poverty.^2-3 By 2002, this proportion had decreased to 19% but still represented more than 1 billion people.^2-3 While substantial declines in extreme poverty have been reported for Eastern and Southern Asia between 1990 and 2002 (from a rate of 33% to 14% in Eastern Asia and from 39% to 31% in Southern Asia), progress in other regions has been mixed or marginal at best. Limited reductions in poverty rates have been seen in Latin America and the Caribbean (from 11% to 9%), but this region now still has more than 47 million people living in poverty. Rates of poverty in Western Asia and Northern Africa have remained almost unchanged since 1990 (approximately 2%) and have increased in the transition economies of Southeastern Europe and many of the countries of the former Soviet Union (from 0.4% in both regions to 1.8% and 2.5%, respectively). In sub-Saharan Africa, which has the largest regional proportion of extreme poverty in the world, the poverty rate declined only marginally from 1990 to 2002 (from 44.6% to 44.0%), and the number of people living in extreme poverty has increased to 303 million.^2-3

Among all regions of the world other measures demonstrate some progress toward achieving the Millennium Development Goals, including declines in the proportion of people with insufficient food and sanitation, increased enrollments in education, increased proportion of women employed, decreases in child mortality rates, increases in measles vaccination rates, and increased proportion of births attended by skilled health care workers.² Each of these successes will contribute to reducing poverty and promoting human development, but some of this progress has been only marginal and much additional work, aid, funding, and research are needed.^2-3,5

Despite huge increases in wealth and prosperity throughout the world in the last several decades, the gap between the wealthy and the poor has widened, with more than 1 billion people still living in extreme poverty.^{3, 5} The United Nations Human Development Index is a composite of 3 dimensions of human development: living a long and healthy life (measured by life expectancy), being educated (measured by adult literacy and enrollment in primary, secondary, and tertiary schools), and having a decent standard of living (measured by purchasing power parity and income).⁴ According to the most recent report, Norway has the highest level of human development, and Niger the lowest.⁴ Individuals in Norway are nearly 50 times wealthier and live almost twice as long as those in Niger and have nearly universal enrollment in education, compared with 21% in Niger. People in the 31 countries with the lowest levels of human development, which represent 9% of the world's population, have an average life expectancy of 46 years, 32 years less than in countries with high levels of human development. This discrepancy illustrates the connection between income and poverty and human development: poverty prevents people from attaining education and employment, achieving and maintaining health, managing illness or disability, and thus, escaping poverty.⁴

Substantial efforts have been directed at reducing poverty, addressing health needs, and ultimately improving human development during the last few decades.^3-5 However, much of the early work begun in the 1960s and 1970s lost support in the mid-1980s following severe economic downturns in many poor countries, the demise of previously state-run approaches to development and the provision of health care, and overall pessimism about the ability to actually reduce poverty and provide health care for all.⁶ In addition, acts of violence, conflicts, and mass disasters have led to social upheaval and long-term displacement, rendering the most basic health care impossible to deliver. Signs of renewed concern and attention began in the late 1990s with recognition by agencies such as the World Bank of the connection between health, poverty reduction, equity, and economic success as well as increased governmental and private aid and funding of research into poverty and health.⁶ However, most aid still falls far short of promises and what is needed.⁵

A vast literature discusses poverty and its associations and effects. A recent search of MEDLINE using the key term "poverty" resulted in more than 22 000 citations, while results in Google Scholar included about 1.3 million articles. However, the MEDLINE citations represent less than 0.002% of the database's 14 million total citations.⁷ Furthermore, despite the large number of articles, the effectiveness of many interventions to improve health in poor countries remains untested and unproven.⁸ In fact, compared with costly interventions and therapies that are mostly available to those who can pay for them, relatively few health interventions targeted to serve the poor are evidence-based.⁸ A systematic review of 286 randomized controlled trials (RCTs) on topics relevant to 35 leading causes of global burden of disease published in 6 leading general medical journals in 1999 found that 124 (43%) of these trials addressed 1 of the 35 leading causes of global burden of disease. Of these, ischemic heart disease, HIV/AIDS, and cerebrovascular disease were the most commonly studied.⁹ One third of these trials studied 1 of 10 top causes of global burden of disease, but 7 (20%) of the leading causes of global burden of disease were not addressed by any trial.

However, progress is being made in efforts to conduct reliable research on the health needs of the poor and to provide evidence-based solutions. Since 1971, 404 reports of RCTs on interventions related to poverty have been included in MEDLINE, with 57% of these published in the last 6 years. Recent studies have examined a range of interventions, some successful and some not, including strategies to reduce inequalities in access to care; microcredit programs; sustainable health care financing alternatives for the poor; strategies to provide access to essential drugs, vaccines, and therapies; strategies to reduce infant and maternal mortality rates; nutritional interventions; behavioral interventions to improve health and adherence with therapeutic regimens and to prevent disease; educational programs; family planning services; interventions to increase access to clean water and sanitation; and primary care treatments for preventable diseases, chronic diseases, and mental health disorders. The success of microcredit was recognized with this year's award of the Nobel Peace Prize to Muhammad Yunus and Grameen Bank for their "efforts to create economic and social development from below."¹⁰

To help disseminate research into interventions that specifically address the needs of the poor, JAMA will publish a theme issue on poverty and human development in October 2007. JAMA is 1 of more than 140 scientific journals participating in plans to simultaneously publish papers on this topic under the coordination of the Council of Science Editors.¹¹ For this theme issue, JAMA will consider manuscripts that report original research of interventions targeted to address poverty, hunger, access to care, and prevention of disease that are based on careful consideration and analysis of local context, evidence, and environments and that are directly targeted to serve the poor. We are also interested in assessments of interventions that are both scalable and sustainable. We are primarily interested in receiving reports of randomized or cluster controlled trials, but we will also consider cohort studies, case-control studies, and other observational studies as well as systematic reviews, meta-analyses, and commentaries. Manuscripts received by May 1, 2007, will have the best chance of consideration for the issue. Please see JAMA's Instructions for Authors for information on preparing and submitting manuscripts.¹²

AUTHOR INFORMATION

Financial Disclosures: None reported.

Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.

Author Affiliations: Ms Flanagin (annette.flanagin@jama-archives.org) is Deputy Managing Editor and Dr Winker is Deputy Editor, JAMA.

REFERENCES
1. Health, nutrition and population. In: Klugamn J, ed. A Sourcebook for Poverty Reduction Strategies. Washington, DC: World Bank; 2002. 2. United Nations. The Millennium Development Goals Report. 2006. http://unstats.un.org/unsd/mdg/Resources/Static/Products/Progress2006/MDGReport2006.pdf. Accessed November 25, 2006.3. Chuhan P. Poverty and inequality. In: Global Issues for Global Citizens: An Introduction to Key Development Challenges. http://siteresources.worldbank.org/EXTABOUTUS/Resources/Chapter2.pdf. Accessed November 28, 2006.4. United Nations Development Programme. Human Development Report 2006. Beyond scarcity: power, poverty and the global water crisis. 2006. http://hdr.undp.org/hdr2006. Accessed November 15, 2006.5. Sachs JD. The End of Poverty: Economic Possibilities for Our Time. New York, NY: Penguin Press; 2005.6. Gwatkin DR. Health inequalities and the health of the poor: what do we know? what can we do? Bull World Health Organ. 2000;78:3-17. ISI | PUBMED 7. PubMed Overview. http://www.ncbi.nlm.nih.gov/entrez/query/static/overview.html#Introduction. Updated November 14, 2006. Accessed November 26, 2006.8. Buekens P, Keusch G, Belizan J, Bhutta ZA. Evidence-based global health. JAMA. 2004;291:2639-2641. FREE FULL TEXT 9. Rochon PA, Mashari A, Cohen A, et al. Relation between randomized controlled trials published in leading general medical journals and the global burden of disease. CMAJ. 2004;170:1673-1677. FREE FULL TEXT 10. The Nobel Peace Prize for 2006. http://nobelprize.org/nobel_prizes/peace/laureates/2006/press.html. Accessed November 28, 2006.11. Global theme issue. Council of Science Editors Web site. http://www.councilscienceeditors.org/globalthemeissue.cfm. Accessed November 25, 2006.12. JAMA Instructions for Authors. http://jama.ama-assn.org/misc/ifora.dtl. Accessed November 26, 2006."

A quantas andamos aonde chegamos

VEJA on-line: "

Edição 1988 . 27 de dezembro de 2006

Millôr

A infância não, a infância dura pouco. A juventude não, a juventude é passageira. A velhice sim. Quando um cara fica velho é pro resto da vida. E cada dia fica mais velho.

A QUANTAS ANDAMOS
AONDE CHEGAMOS

Neste momento em que, afinal, aparecem algumas mulheres defendendo a preservação das rugas, e repudiam botoquicis e cirurgias deformantes, repito a minha posição desde os 20 anos de idade, quando comecei a envelhecer. Defendi isso, entre outros lugares, no belo livro do fotógrafo gaúcho Robinson ACHUTTI e no roteiro Últimos Diálogos, que escrevi para Walter SALLES.

Prefácio para FOTOGRAFIA, de Robinson Achutti

Mas olho, com ternura e profunda identificação, essa cara. E ela me olha, essa cara, não com a cara que tem quando anda pelas ruas, mas com a cara que a sensibilidade – do dedo, do olho, do psíquico? – do fotógrafo fixou. Com um pouco da crueldade de /.../

CADEIA IMPRODUTIVA

CADEIA IMPRODUTIVA (artigo enviado para ZH mas não publicado)

Aloyzio Achutti. Membro da Academia Sul-Rio-Grandense de Medicina.

Causam perplexidade as múltiplas e diversas atitudes anti-sociais, corrupção, formação de quadrilhas, e crime organizado que a mídia tem nos revelado, eficientemente contribuindo para o controle social, frequentemente abafado pelas estruturas de poder do estado. Fica-se mais chocado ainda frente à dificuldade em identificar culpados e controlar as atividades criminosas, aliadas e sacramentadas pela impunidade oficializada.

Parte significativa da explicação para o fenômeno pode-se encontrar na teoria das redes que se aplica na cadeia produtiva do lado bom, e na cadeia epidemiológica no campo das doenças.

Não se existe, nem se subsiste no isolamento. O ser humano está naturalmente comprometido com seus circunstantes e circunstâncias, numa abrangência, cada vez maior. Também no crime e nas atitudes anti-sociais.

Tudo que acontece pode ser analisado dentro de uma seqüência encadeada que determina o evento ou produto final, mas que também torna difícil definir responsabilidades e terminar com o processo.

Da mesma forma como para se ter um automóvel é necessário uma enorme cadeia para fabricá-lo, da mesma forma quando se considera um doente aparentemente isolado, ou vítimas de uma epidemia, inúmeros elementos inter-relacionados, encontrando-se em determinadas circunstâncias para que o problema ocorra.

Esta cadeia, como no exemplo (desde a concepção e planejamento do carro, construção das peças, montagem, comercialização, comprador, combustível, estradas...) é tão extensa que aqui não cabe detalhar. Da mesma forma, a rede epidemiológica pode ser analisada e montada desde conjuntos biológicos, comumente relacionados no setor saúde, até determinantes extra-setoriais, relacionados com indústria, comércio, política, cultura, etc...

Quando um carro é roubado, não basta encontrar e prender o ladrão. Hoje, em geral os roubos atendem encomendas. Mesmo que desmanchado, há quem o faça e comercialize as peças, existem os receptadores, há agentes de segurança ativa ou passivamente comprometidos, agentes de seguro que se beneficiam com o aumento dos prêmios, o comércio e a indústria movimentados na reposição e, quem sabe, até o próprio proprietário (roubado), ao renovar o seu veículo...

Se não houvesse interessados na aquisição não haveria produtos falsificados ou contrabandeados. Se não existissem usuários de drogas, deixaria de existir o tráfico e outras redes paralelas que terminam infernizando a sociedade e promovendo ou facilitando outras contravenções.

“Mensalão”, “sangue-sugas”, “dossiers”, e tantas outras estórias; conchavos, compra de votos, caixas dois, ilusão populista, privilégios corporativos, omissão culposa, inocentes úteis, tudo se encadeia numa rede inextricável na qual todos são culpados ou agiram irresponsavelmente. Este submundo formado por enorme e articulada quadrilha, com tanta capacidade de organização e eficiência, em vez de seqüestro social, poderia estar a serviço da produção, o que certamente reduziria a entropia e poderia contribuir para a riqueza nacional e o tão cobiçado crescimento econômico e social. e promovendo ou facilitando outras contraven falsificados ou contrabandeados deixariam de existir

História Ciências Saúde - Manguinhos

História Ciências Saúde - Manguinhos: "gora você já pode acessar gratuitamente
os textos completos de toda a coleção de História, Ciências, Saúde – Manguinhos na Scielo, biblioteca virtual de periódicos científicos. Nosso título foi incluído recentemente no PubMed/Medline, complexo de bases de dados mais utilizado em todo o mundo por profissionais das áreas de saúde
e medicina.

Este ano a revista publicada pela Casa de Oswaldo Cruz/Fiocruz., que circulava a cada quatro meses, passou a ser trimestral. Uma outra novidade é que, já neste número,
daqui a alguns dias vários dos artigos publicados apenas em português ou
espanhol na versão impressa da revista, começam a ser apresentados também em inglês na edição eletrônica

Visite a História, Ciências Saúde - Manguinhos em www.scielo.br/hcsm"

Flu 'could wipe out 62 million'

BBC NEWS | Health | Flu 'could wipe out 62 million': "The 1918 pandemic claimed 50 million lives, and experts in The Lancet predict the toll today would be higher than this, despite medical advances.

The world's poorest nations would be hardest hit, fuelled by factors such as HIV and malaria infections, the Harvard University researchers believe.

Yet developing countries can least afford to prepare for a pandemic, which needs to be addressed, they say."

Nanak Kakwani

Revista Desafios do Desenvolvimento: "O economista indiano Nanak Kakwani desenvolveu uma nova metodologia para medir a pobreza, usando como parâmetro não apenas a renda, mas também outras necessidades de consumo. Após três anos no Brasil, durante os quais criou o Centro Internacional de Pobreza, ele está voltando para a Austrália e conta, nesta entrevista, como foi sua experiência e como vê o crescimento do país"

WHO Health Promotion Glossary: new terms -- Smith et al. 21 (4): 340 -- Health Promotion International

WHO Health Promotion Glossary: new terms -- Smith et al. 21 (4): 340 -- Health Promotion International: "The WHO Health Promotion Glossary was written to facilitate understanding, communication and cooperation among those engaged in health promotion at the local, regional, national and global levels. Two editions of the Glossary have been released, the first in 1986 and the second in 1998, and continued revision of the document is necessary to promote consensus regarding meanings and to take account of developments in thinking and practice. In this update 10 new terms that are to be included in the Glossary are presented. Criteria for the inclusion of terms in the Glossary are that they differentiate health promotion from other health concepts, or have a specific application or meaning when used in relation to health promotion. The terms defined here are: burden of disease; capacity building; evidence-based health promotion; global health; health impact assessment; needs assessment; self-efficacy; social marketing; sustainable health promotion strategies, and; wellness. WHO will continue to periodically update the Health Promotion Glossary to ensure its relevance to the international health promotion community."

Heightened Height Loss Increases Mortality in Men - CME Teaching Brief® - MedPage Today

Heightened Height Loss Increases Mortality in Men - CME Teaching Brief® - MedPage Today: "LONDON, Dec. 11 -- Excess shrinking as men age accelerates the risk of an earlier death, found investigators here.
Action Points

* Explain to interested patients that loss of height commonly occurs as people age, but note that this study suggests excessive loss of height has health consequences, including an increased risk of death.

* Point out that it's not understood what causes the effect.

A longitudinal study carried out here showed that men who lose three centimeters or more of height (about 1.18 inches) as they age are at an increased risk of death, compared to men who lose less than a centimeter, according to S. Goya Wannamethee, Ph.D., of the Royal Free and University College Medical School here.

The excess mortality was largely attributable to cardiovascular and respiratory conditions and other causes, but not to cancer, Dr. Wannamethee and colleagues reported in the Dec. 11 issue of Archives of Internal Medicine."

Empowerment -

Empowerment - Wikipedia, the free encyclopedia: "mpowerment refers to increasing the spiritual, political, social or economic strength of individuals and communities. It often involves the empowered developing confidence in their own capacities."

Health in an unequal world

HARVEIAN ORATION - Professor Sir Michael Marmot
Wednesday 18 October 2006 Royal College of Physicians London

Video: http://rcplondon.emea.acrobat.com/p40258774

Website: http://www.rcplondon.ac.uk/event/details.aspx?e=312

-----Original Message-----

From: David McDaid LSE Health and Social Care

Sent: Friday, December 08, 2006
FYI - from the latest issue of the Lancet - lecture by Michael Marmot

Health in an unequal world

Michael Marmot

The Lancet December 9, 2006; 368:2081-2094.

This lecture was presented at the Royal College of Physicians, London, UK, on Oct 18, 2006
Published simultaneously in Clin Med 2006; 6: 559-72.

DOI:10.1016/S0140-6736(06)69746-8 Lecture, Harveian Oration

Website: http://www.thelancet.com/journals/lancet/full?volume=368&issue=9552
Subscription required

........In poor countries, tragically, people die unnecessarily. In rich countries, too, the higher death rate of those in less fortunate social positions is unnecessary. Can there be a link between these two phenomena: inequalities in health between countries and inequalities within? Surely, we could argue, the depredations of grinding poverty-inadequate food, shelter, clean water, and basic medical care or public health-that ravage the lives of the poor in developing countries are different in kind from the way that social disadvantage leads to poor health in modern Britain, for example. The diseases of the slums of Nairobi are, to be sure, different in kind from the diseases that affect disadvantaged people in east London in the UK, or Harlem in the USA, and have different proximate causes. There is, however, a link. The unnecessary disease and suffering of disadvantaged people, whether in poor countries or rich, is a result of the way we organise our affairs in society. I shall argue, in this oration, that failing to meet the fundamental human needs of autonomy, empowerment, and human freedom is a potent cause of ill health. In making this case, I shall bring together two rather disparate streams of work. The first is a report of my own research endeavour. I have sought explanations for the social gradient in health, as observed in the Whitehall studies, pointing to the fundamental importance of the circumstances in which people live and work. I emphasise control and the opportunities for full social engagement.1 The second draws on the work of development economists Amartya Sen and Nicholas Stern

Improved Diagnostic Technologies for the Developing World: Collections : Supplements : Nature

Improved Diagnostic Technologies for the Developing World: Collections : Supplements : Nature: "

NPG and the Bill & Melinda Gates Foundation are proud to present this custom publication which presents findings of the Global Health Diagnostics Forum, in partnership with the RAND Corporation, to determine global health diagnostics needs.

• Improved Diagnostic Technologies for the Developing World - Foreword
• Improved Diagnostic Technologies for the Developing World - Papers

"

Scans 'can predict schizophrenia'

BBC NEWS Health Scans 'can predict schizophrenia'
Magnetic resonance imaging (MRI) scans have revealed key changes in the brain's grey matter in a small group before they developed symptoms.
The finding suggests tracking these changes over time, combined with traditional assessments, could help doctors to predict illness.
The research, published in BioMed Central Medicine, was carried out by the University of Edinburgh.

Arranha-céus diminuíram o fluxo do vento em Hong Kong

De: João Paulo Fagundes [mailto:j.paulo@via-rs.net]
Enviada em: quarta-feira, 6 de dezembro de 2006 19:55
Para: Undisclosed-Recipient:;
Assunto: Arranha-céus diminuíram o fluxo do vento em Hong Kong

Arranha-céus diminuíram o fluxo do vento em Hong Kong

Pior ventilação da cidade elevou a poluição e aumentou as temperaturas

EFE

PEQUIM - A velocidade do vento em Hong Kong se reduziu à metade nos últimos 40 anos devido à altura cada vez maior dos arranha-céus construídos na metrópole, segundo um estudo governamental publicado neste domingo pelo jornal "South China Morning Post".

A pior ventilação da cidade elevou a poluição, agravada pela acumulação de partículas no ar, e aumentou as temperaturas na antiga colônia, de clima subtropical.

As autoridades mediram a força do vento durante os últimos 40 anos em King´s Park, um parque central da metrópole, onde registraram que entre 1968 e 1995 a velocidade do vento caiu em 0,6 metro por segundo a cada década.

Apesar de levar a estação meteorológica a outra parte do parque, menos resguardada em 1996, os cientistas registraram que o vento também perdeu força à razão de 0,57 metros por segundo nos últimos dez anos.

Lam Chiu-ying, diretor do Observatório de Hong Kong, assinalou que a velocidade do vento na ilha de Waglan, ao sul da ex-colônia, não tinha mostrado nenhuma mudança significativa, o que apontou que a altura dos edifícios está intimamente ligada à perda do vento.

Além disso, as temperaturas nas zonas centrais da metrópole aumentaram, desde 1989, 0,37 graus por década, enquanto nos arredores da cidade isso ocorreu em um ritmo entre 0,08 e 0,25 graus.

A altura dos arranha-céus na ex-colônia, que alguns chama de a cidade vertical, subiu de uma média de 30 andares, nas construções dos anos 80, a 50 atualmente, segundo o Instituto de Arquitetos de Hong Kong.

The World Distribution of Household Wealth

De: Equity, Health & Human Development [mailto:EQUIDAD@LISTSERV.PAHO.ORG]
Em nome de Ruggiero, Mrs. Ana Lucia (WDC)
Enviada em: quarta-feira, 6 de dezembro de 2006 12:18
Assunto: [EQ] The World Distribution of Household Wealth

The World Distribution of Household Wealth

Authors: The Director of UNU-WIDER Anthony Shorrocks, James Davies, Susanna Sandström, and Edward Wolff

World Institute for Development Economics Research of the United Nations University (UNU-WIDER)

5 December 2006:

Download the full study: WIDER WDHW (PDF 1,167KB), Powerpoint presentation (PPT 7,003KB)

Pioneering Study Shows Richest Two Percent Own Half World Wealth

The richest 2% of adults in the world own more than half of global household wealth according to a path-breaking study released today by the Helsinki-based World Institute for Development Economics Research of the United Nations University (UNU-WIDER).

Much of the wealth is concentrated in North America, Europe and rich Asia-Pacific nations such as Japan, Australia and the Republic of Korea, despite their comparatively small population when measured against Africa and countries such as China and India.

The UNU’s World Institute for Development Economics Research (UNU-WIDER), which conducted the study, called it the first of its kind to cover all countries and all major components of household wealth, including financial assets, debts and tangible property such as land and buildings.

PRESS RELEASE in English (PDF 254 KB), French (PDF 260 KB) and Spanish (PDF 160KB)
Links to high resolution figures are at the end of this press release.

Violência

Artigo - Violência:
(Mais um artigo meu publicado pelo jornal ZH no dia de ontem)

"Vive-se um clima generalizado e crescente de violência. Está por toda parte: nos jornais, no rádio, na televisão, nas revistas, está no cotidiano, bem à vista...

Assume também várias formas: no trânsito, nos assaltos e seqüestros, contra a mulher, a criança e o velho, no esporte, no comércio, na política, na academia, entre países, etnias e vizinhos, contra animais e contra a natureza, na própria natureza provocada, entre religiões, na propaganda, na intensidade do som, entre aqueles que lutam por justiça e eqüidade social, no terrorismo e no desrespeito a si mesmo. Parece não haver mais outra forma de manifestação e de relacionamento.

Discute-se muito sobre a explicação do fenômeno: drogas, aumento populacional, paraefeito da comunicação, desigualdade social, falta de religião...
Alguns dizem que é da natureza humana e que sempre foi assim.

Entretanto, existe uma forma de violência que não tem sido suficientemente explorada: a violência (ou assédio) moral.

Violência moral acontece quando o governo, menosprezando a inteligência da população, expropria parte significativa do produto interno (quase a metade) através de impostos maquiados, sem declarar claramente o quanto e, muito menos, onde vai gastar; quando privilegia quem ocupa estruturas de poder e desvaloriza e avilta aqueles que prestam serviço na construção da cidadania através da educação, e aqueles que cuidam da saúde das pessoas. Quando ignora a identidade do cidadão (indivíduo), mesmo quando alardeia o coletivo na busca do poder.

O mesmo acontece quando são jogados uns contra outros, alienando e abafando a capacidade de controle social. Também é vilipêndio a corrupção impune e encoberta, transmudada e legitimada como negociação política necessária. Estão na mesma linha a distorção dos fatos e a propaganda política enganosa, que terminam legitimando comportamento semelhante nas ofertas enganosas do comércio e na ilusão do financiamento.

Cada leitor deve ter exemplos semelhantes para acrescentar a esta lista, mas o importante é que a violência moral institucionalizada termina por justificar e fomentar o comportamento de cada indivíduo, desenvolvendo uma nova cultura e desagregando o tecido social. Os fundamentos estão em desvalores da competição selvagem, da intolerância, da discriminação e da esperteza covarde, gerando descrédito, infelicidade e desespero generalizados.

De nada adiantam promessas de que o crescimento virá, se a casa estiver dividida, a entropia fomentada, se a confiança se desfez e se os fundamentos são imorais.

Essas considerações não se referem exclusivamente a nosso país, aplicam-se para quase todo o mundo. Servem também para a academia, para muitas empresas, para muitas ONGs, cooperativas e outras instituições. Não há mais para onde fugir, é necessário tentar arrumar globalmente nossa casa, começando peça por peça.
"

Brasil o menos competitivo do BRIC (países emergentes)

Jornal do Comércio: "Acostumado a freqüentar as últimas posições dos rankings internacionais em que aparece, o Brasil surge negativamente em outro estudo. Desta vez, o País, ao lado do México são considerados os países menos competitivos do bloco dos emergentes, conhecido como Bric (Brasil, Rússia, Índia e China). O México corre por fora para integrar o bloco, motivo pelo qual, no estudo, a sigla virou Bric-M.
A China aparece em primeiro lugar, seguida de Índia e Rússia. Os cinco países (Bric-M) são considerados os principais emergentes, com potencial para impulsionar a economia mundial nas próximas décadas e ultrapassar o G-6 (Estados Unidos, Japão, Reino Unido, Alemanha, França e Itália) até 2050.
O levantamento foi realizado pela Câmara Americana de Comércio (Amcham) e o Movimento Brasil Competitivo (MBC). O estudo é composto por 24 variáveis distribuídas em três subgrupos: custo e disponibilidade de capital, custo fiscal e institucional, além de custo operacional.
Dados do levantamento avaliam que dos 24 indicadores, o Brasil possui dez ruins, nove intermediários e cinco em nível superior, mesmo desempenho do México. Já a China, primeira colocada no estudo, apresenta 13 indicadores bons, cinco intermediários e cinco ruins - um dos indicadores não"

Cost benefit analysis of health impact assessment - final report

De: Social Determinants of Health [mailto:SDOH@YORKU.CA] Em nome de Adam P. Coutts
Enviada em: terça-feira, 5 de dezembro de 2006 16:45
Para: SDOH@YORKU.CA
Assunto: Cost benefit of HIA

http://www.dh.gov.uk/assetRoot/04/14/08/39/04140839.pdf

Cost benefit analysis of health impact assessment - final report

The report sets out the findings of the cost benefit evaluation of Health Impact Assessment (HIA). York Health Economics Consortium followed 16 HIAs looking at the process, impact, outcomes and costs and benefits of HIA. The findings show the benefits outweigh the costs, although it was a small sample. The report will be subject to further consideration and comments are welcome. _____________________________________________

Adam P. Coutts
Magdalene College,
University of Cambridge,
CB3 0AG.

tel: +44 (0)7818 216 559
http://www.esrcsocietytoday.ac.uk/ESRCInfoCentre/Minisite/adamcoutts/index.html

Obese should exercise not 'diet'

BBC NEWS | Health | Obese should exercise not 'diet': "Women who are clinically obese don't need to diet to improve their health, say UK researchers.

A programme which encouraged women not to diet but to take part in exercise classes found significant improvements in health and mental well-being.

The women in the study were also taught about good eating habits, such as how to cook, and received social support.

After a year, the women had only lost a little weight but were significantly fitter and happier with themselves.

The team from Leeds Metropolitan University and the University of Hull who are presenting the results at the UK Society of Behavioural Medicine Scientific Meeting in Cambridge said a healthy lifestyle could improve health risks regardless of weight."

Violência Moral no trabalho

: "Nos últimos dez anos, empurrados por um sensível aumento do número de diplomados com curso superior e pela “feminização”, os executivos passaram a vivenciar uma situação inusitada: o “escândalo” do desemprego


Paul Bouffartigue
Do desemprego, de que não são isentos, ao aumento de pressões no trabalho, passando por carreiras mais incertas, os executivos passaram por várias linhas de fratura ao longo das duas décadas anteriores. E a retomada desses últimos anos não foi suficiente para apagá-las. As mudanças tecnológicas e industriais e o avanço neoliberal abalaram a figura social tradicional do executivo.
Tudo começou no início da década de 90, quando o número dos executivos em busca de emprego passou de 90 mil, em 1990, para 180 mil, em 1994: duplicou em quatro anos. Aqueles que, até ontem, as diretorias das empresas se contentavam em pôr de lado provisoriamente, agora estão nas listas dos demitidos por razões econômicas. Um trauma.
O trauma do “solicitante de emprego”
A antinomia dos termos “executivo” e “desempregado” está tão arraigada, que eles preferem definir-se sob o eufemismo de “solicitante de emprego”
Trata-se de uma época em que o desemprego dos colarinhos brancos escandaliza. A antinomia dos termos “executivo” e “desempregado” está, aliás, tão profundamente arraigada, que os próprios interessados, na maioria das vezes, se recusam a definir-se dessa forma, inclusive sob o eufemismo “solicitante de emprego1”. Uma testemunha disso é Christiane, gerente comercial numa pequena empresa e diplomada numa escola d"

Health Indicators in the Americas. 2006

“…….Timely, valid and reliable data at the country and local levels are essential in the formulation and monitoring of policies to improve the health of the peoples of the Americas. Since 1995, the Pan American Health Organization/World Health Organization (PAHO/WHO), has been disseminating health data through the Regional Core Health Data Initiative (RCHDI) to provide Member States with valid and reliable basic health indicators. In addition, some countries are producing and disseminating national basic indicators, with disaggregated data at the sub-national level. National health authorities can use this information to evaluate population health needs, plan and monitor programs, and tailor the health response to the specific needs of the population.

Global and Regional new initiatives are being implemented to guarantee the availability, quality, reliability, and consistency of health data. These initiatives include the Health Metrics Networks; PAHO/MEASURE Evaluation project, financed by USAID; and the PAHO/WHO Program for Strengthening Vital and Health Statistics of the Americas, among others.

In this edition, we have included selected indicators from the Millennium Development Goals (MDG). Tuberculosis control is MDG 6, Target 8; its objective is “to have halted and begun to reverse the incidence of TB by 20015.” This target was also endorsed by the WHO-led “Stop Tuberculosis” global plan whose specific objective is “to reduce the tuberculosis prevalence and deaths by 50% relative to 1990.” As such, a graph depicting the estimated tuberculosis incidence from 1990 to 2004 is presented in this brochure. MDG 6, Target 8 also includes the objective “to have halted and begun to reverse the incidence of malaria by 2015.” Also included in the brochure is a map showing the geographical distribution of the Annual Parasite Index which is a measure used to show the number of confirmed cases per 1000 people living in malaria transmission risk areas.

The material presented in this brochure has been compiled, prepared, and reviewed by PAHO/WHO. More information on country health profiles, the complete basic indicators set, including definitions, as well as time series for the years of 1995 to the present, can be accessed through PAHO’s website at: www.paho.org/english/dd/ais/coredata.htm . .....” Mirta Roses Periago, Director

Google is a good diagnostician -- 333 (7579): 0 -- BMJ

Google is a good diagnostician -- 333 (7579): 0 -- BMJ: "Using signs and symptoms as search terms on Google finds the correct diagnosis 57.7% of the time (95% confidence interval 38.3% to 77.1%) say Tang and Ng (doi: 10.1136/bmj.39003.640567.AE). The authors identified 26 case reports published in a single journal and selected three to five specific symptoms and signs from each to be used as Google search terms. They compared Google results with the original diagnoses. Google searching is less helpful in identifying complex diseases with non-specific symptoms than in diagnosing illnesses with unique symptoms.

Related Article
Googling for a diagnosis—use of Google as a diagnostic aid: internet based study
Hangwi Tang and Jennifer Hwee Kwoon NgBMJ 2006 333: 1143-1145. [Abstract] [Full Text] "

Red wine health locations found

BBC NEWS Health Red wine health locations found: "UK researchers discovered chemicals called procyanidins were responsible for red wine's well-documented heart-protecting effect.
And they found traditionally made wines from these areas had more procyanidins than wines in other parts of the world.
The research is published in the journal Nature. "