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1
Annear, Peter Leslie, e mikewood@deakin edu au. "Healthy markets - Heathly people? Reforming health care in Cambodia". Deakin University. School of Health Sciences, 2001. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050825.134836.
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Health care reform has been described as a global epidemic. This thesis deals with nature and experience of health care reform in developing countries. Increasing privatisation, economic transition, and structural adjustment have provided the context for health system changes. Different approaches to reform have been developed by international organisations such as the World Bank, WHO and UNICEF. What has driven national health care reforms? Are such policies really appropriate to developing countries? Has a consensus now emerged in relation to international health policy? Has a new health care model appeared? The study of health care reform in Cambodia is a timely opportunity to investigate the implementation of health care reform under extreme conditions. These conditions include a legacy of genocide, long-term conflict, political isolation, and economic transition. This case study uses both qualitative and quantitative methods and multiple sources of data to analyse the reform program. The study reinforces the conclusion that, under conditions of extreme poverty, market based reforms are likely to have limited positive impact. Rather, understanding the cultural conditions that determine demand, delivering health care of a satisfactory quality, providing appropriate incentives for health practitioners, and supporting services with adequate public funding are the prerequisites for improved service delivery and utilisation. Cambodia's strategy of integrated district health service development and universal population coverage may provide an instructive example of reform. Emerging policy issues identified by this case study include the fundamental role of equity in service provision, the influence of the social determinants of health and illness and interest in the appropriate use of evidence in international health policy-making.
2
Leibe, Mary. "Creating Healthy Urban Environments: Commercial Landscaping, Preference and Public Health". ScholarWorks@UNO, 2016. http://scholarworks.uno.edu/td/2262.
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Landscape development[1] can provide many benefits, including the reduction of stormwater runoff and the creation of habitats for wildlife. It can also provide health benefits. Researchers, such as Roger Ulrich and Rita Berto have demonstrated that views of trees and other vegetation are associated with lower blood pressure and reduced recovery times in hospitals and that environments with more natural elements may lessen mental fatigue (R. Ulrich 1984) and (Berto 2005).
As rebuilding in New Orleans continues 11 years after Hurricane Katrina, landscape development has been limited or lacking, especially in the redevelopment of commercial properties. Two prominent reasons for this deficiency are a lack of funding and, until August of 2015, the absence of a comprehensive landscape ordinance.
The purpose of the research presented here is to determine the degree to which community residents express a preference for healthier commercial environments. As part of my research, I measured community perceptions of four potential redevelopment concepts for a blighted strip shopping center utilizing attention restoration theory (ART), which postulates that certain environmental qualities contribute to reductions in mental fatigue. I found that commercial environments with the most quality landscaping[2] are those that neighborhood residents most prefer and are most conducive to better health.
Keywords: mental fatigue, attention restoration theory, perceived restoration scale, commercial landscape quantity, public health, healthy urban environment
[1] Refer to operational definitions (pages 4-6).
[2] Refer to operational definitions (pages 4-6).
3
Bekker, Marleen Petra Maria. "The politics of healthy policies redesigning health impact assessment to integrate health in public policy /". Delft : Rotterdam : Eburon ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10491.
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Ratima, M. M. (Mihi M. )., e n/a. "Kia uruuru mai a hauora : being healthy, being Maori: conceptualising Maori health promotion". University of Otago. Wellington School of Medicine & Health Sciences, 2001. http://adt.otago.ac.nz./public/adt-NZDU20070508.152546.
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The Decade of Maori Development (1984-1994) stimulated the re-emergence of distinctly Maori approaches to progressing their own advancement. Maori health promotion is one such approach that has a central concern for improving Maori health outcomes. A range of Maori collectives are providing what they claim to be distinctly Maori health promotion initiatives. However, Maori health promotion has a pragmatic orientation, and this has, at least in part, led to conceptual and theoretical under-development. There is an almost complete lack of empirically and theoretically sound work to conceptualise Maori health promotion. This research programme has focused on identifying the defining characteristics of Maori health promotion.
The primary data source for this research programme was three case studies of Maori health promotion interventions.
Tipu Ora - a Maori community-based well-child programme;
the Plunket Kaiawhina Service - a national Maori focussed initiative located within a mainstream service; and,
the Wairarapa Maori Asthma Project - a tribally-based asthma management initiative.
The main source of data in each of the case studies was in-depth open-ended interviews with programme participants and stakeholders. Data was also drawn from document review and archival records.
The findings of this research indicate that Maori health promotion is based on a broad concept of health, which can be expanded as the basis for a more general argument for Maori advancement. Maori health promotion is the process of enabling Maori to increase control over the determinants of health and strengthen their identity as Maori, and thereby improve their health and position in society. Its defining characteristics have been identified in this research programme, and presented in �Kia uruuru mai a hauora�, a framework for Maori health promotion. The Framework has the potential to provide the basis for a more consistent and rigorous approach to Maori health promotion practice, policy, purchasing, and research. Aspects of the Framework may also have wider application to generic health promotion and other indigenous peoples� approaches to health promotion.
This study concludes that Maori health promotion draws primarily on the heritage and new knowledge that arises from Maori and Western experiences. However, it remains grounded in the distinctive concepts and values of Maori worldviews. Maori health promotion is a distinctly Maori process, in step with and indigenous health promotion, but primarily on the determination of Maori to be Maori.
5
Aceves, Martins Magaly. "Health promotion in youth as a global public health challenge: effective strategies to encourage healthy lifestyles". Doctoral thesis, Universitat Rovira i Virgili, 2016. http://hdl.handle.net/10803/396152.
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La combinació de més d'un strategia metodològica (com el màrqueting social, la participació de la joventut, l'educació dirigida per iguals i l'ús dels mitjans de comunicació social) i strategias de cambio de antorn (intervenció basada en l'escola, basada en la intervenció restaurant, basat en la família de la intervenció) pot augmentar l'eficàcia de involucrar els joves en les intervencions de salut destinades a fomentar hàbits i estils de vida saludables. Aquesta tesi té com a objectiu comprendre els factors que intervenen en l'epidèmia de l'obesitat juvenil a tot el món i com influeixen en l'obesitat. En resposta a aquest desafiament global, aquest treball proporciona estratègies basades en proves científiques innovadores, eficaces i de qualitat per millorar els estils de vida saludables entre els joves. Aquestes estratègies podrien donar lloc a un enfocament d'investigació més fort que podrien beneficiar tant a la comunitat científica i el coneixement general de les parts interessades i els responsables polítics, fomentant així un enfocament multidisciplinari participatiu i inclusiu per obtenir resultats duradors i eficaçosLa combinación de más de una estrategía metodológica (como el marketing social, la participación de la juventud, la educación dirigida por pares y el uso de los medios de comunicación social) y/o de una estrategia de cambio de entorno (intervención basada en la escuela, basada en la intervención restaurante, basado en la familia de la intervención) puede aumentar la eficacia de involucrar a los jóvenes en las intervenciones de salud destinadas a fomentar hábitos y estilos de vida saludables. Esta tesis tiene como objetivo comprender los factores que intervienen en la epidemia de la obesidad juvenil en todo el mundo. En respuesta a este desafío global, este trabajo proporciona estrategias basadas en pruebas científicas innovadoras, eficaces y de calidad para mejorar los estilos de vida saludables entre los jóvenes. Estas estrategias podrían dar lugar a un enfoque de investigaciónque podrían beneficiar tanto a la comunidad científica y el conocimiento general de las partes interesadas en prevenir este problema así como a responsables políticos, fomentando así un enfoque multidisciplinario participativo e inclusivo para obtener resultados duraderos y eficaces.
The combination of more than one methodological (such as social marketing, youth involvement, peer-led education and social media usage) and environmental (school-based intervention, restaurant-based intervention, family-based-intervention) strategy may increase the effectiveness of engaging young people in health interventions aimed at encouraging healthy habits and lifestyles. This thesis aims to understand the factors involved in the worldwide youth obesity epidemic and how they influence obesity. In response to this global challenge, this work provides innovative, effective and quality scientific evidence-based strategies for improving healthy lifestyles among young people. These strategies could lead to a stronger research approach that could benefit both the scientific community and the general knowledge of relevant stakeholders and policy makers, thus fostering a participatory and inclusive multidisciplinary approach for long-lasting and effective results.
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Holmes, Catherine Ann. "Healthy marketplaces : insights into policy, practice and potential for health promotion /". View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031031.160623/index.html.
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Harvey, Alison. "Risky genes, healthy choices : public health as government of the somatic self". Thesis, University of East Anglia, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443179.
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Bührer, Sabine. "Public Health im Wandel : eine vergleichende Bestandsaufnahme dreier Schools of Public Health /". Konstanz, 2004. http://www.public-health-edu.ch/new/Abstracts/BS_07.03.05.pdf.
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Santiago, Denise L. "Assessment of public health infrastructure to determine public health preparedness". Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2006. http://library.nps.navy.mil/uhtbin/hyperion/06Mar%5FSantiago.pdf.
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Thesis (M.A. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, March 2006.Thesis Advisor(s): Anke Richter. "March 2006." Includes bibliographical references (p. 75-81). Also available online.
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Emmelin, Maria. "Self-rated health in public health evaluation". Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-226.
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Faust, Linda A. "AIDS Public health implications /". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1991. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1991.Source: Masters Abstracts International, Volume: 45-06, page: 2940. Abstract precedes thesis as [2] preliminary leaves. Typescript. Includes bibliographical references (leaves 94-100).
12
Heimburg, Dina von. "Public health and health promotion: a salutogenic approach". Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-12094.
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Shah, Rebecca Sonul. "Global health inequality : Justice and public health ethics". Thesis, Keele University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.535801.
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This thesis is motivated by the intuition that current extremes of global health inequality and deprivation constitute moral problems of the utmost importance. It aims to advance our understanding of how we should think about and be morally guided in our responses to global health inequality by engaging critically with literature and arguments at the intersection of global health, public health and social justice. Part I addresses the more conceptual question of how we should think about global health inequality. I suggest that we reject international empirical, operational and normative accounts of global health inequality in favour of genuinely global approaches. I suggest five core features of public health practice and ask whether they are meaningful at the global level. I find no argument for why the features of public health may not relate to the global sphere convincing and therefore tentatively conclude that we might think of global health inequality as a matter of public health. Part II addresses the more normative question of how we should be morally guided in our responses to global health inequality. Through engagement with the public health ethics literature I propose two roles for justice as a core public health value. First, justice may be an ethical principle guiding how public health is practiced, and second justice may provide the normative justification for why public health is practiced. I identify existing accounts of public health ethics and theories of justice reflecting these twin justice roles and evaluate how well they can morally guide our responses to global health inequality. I conclude by suggesting that public health may be a social institution governed by the principles ofjustice at the global level and that public health may be a human right which should be globally fulfilled as requirement of justice.
14
Bunten, A. "The application of health psychology to public health". Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/20309/.
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Background: There is strong evidence linking obesity to health issues and long term conditions such as high blood pressure, type II diabetes, heart disease and some cancers (NICE, 2006). Despite this growing evidence base, the prevalence of obesity continues to rise and rates have more than doubled in England in the last 25 years (Public Health England, 2014). Currently 26% of adults are obese (Health Survey for England, 2014), and the proportion of women that are classified as overweight and obese has risen to 57% (Health Survey for England, 2014). Weight loss can reduce the risk of an individual developing these conditions and can increase their healthy life expectancy. It is estimated that approximately one in every two adults in England are actively trying to lose weight, the majority of which are over-weight or obese women (Piernas, Aveyard and Jebb, 2016). This indicates that over-weight and obese women are motivated to lose weight but are struggling to achieve or maintain a healthy weight. To-date potentially effective weight management interventions have been identified as long term multi-component interventions including diet and exercise components along with behavioural strategies. However, weight changes have been small and weight regain has been found to be very common (Loveman, Frampton, Shepherd, Picot, Cooper et al, 2011; Dombrowski, Knittle, Avenell, Araújo-Soare & Sniehotta, 2014). Despite the primary focus on weight loss being to improve health, research suggest that people’s prime motivation to lose weight is unrelated to health (Piernas, Aveyard and Jebb, 2016). Aim: This study aims to improve the understanding of the challenge of achieving and maintaining a healthy weight in overweight and obese young women. In particular, it aims to i) better understand the barriers and facilitators to achieving and maintaining a healthy weight as experienced by these young women, ii) further understand the relationships and influences of these factors, to iii) inform and develop a new theoretical framework in which to capture this social phenomena and societal challenge. Recruitment: This study recruited 14 female participants aged 18- 35 years, with a BMI over 30 (or 28 with co-morbidity), actively seeking support to lose weight. Participants were recruited through purposive sampling in two primary care practices in East London as part of the ‘Peer Support Weight Action Programme’ (SWAP). This was a Randomised Controlled Trial run by Barts Health NHS Trust and Queen Mary’s School of Medicine and Dentistry, funded by the National Institute for Health Research, Health Technology Assessment fund. Design: The research is qualitative in design utilising in-depth semi-structured interviews. Interviews took place with women recruited to take part in a weight loss programme before commencing the intervention, and follow up interviews took place approximately six months after completion of the weight management programme. Grounded Theory Analysis was used to analyse the data. Results and Findings: An overarching theoretical framework is presented from the findings of the data analysis of the pre and post weight loss attempt interviews. A new ‘Emotion and Mindset’ model is presented to explain the challenge of achieving and maintaining a healthier weight in young women. It includes the core categories of sense of self, emotion and mindset, self-efficacy, and stress and conflicting priorities and has been theoretically framed around the concept of Finding the Health Enhancing Equilibrium - maintaining a positive sense of self whilst generating action to achieve and maintain a healthy weight. It describes the balancing act required between these key contributing elements to engage in positive health behaviour which contributes to achieving and maintaining a healthy weight. Recommendations: Based on the findings from this study, and supported by previous findings (Cochrane, 2008), weight management interventions targeting young women need to build in coping strategies to support individuals cognitively, behaviourally and emotionally. These should include building self-efficacy (NOO, 2011; Ashford, Edmunds, French, 2010), sense of self and re-aligning identity (West & Brown, 2013). Individuals need to be taught how to identify, address and re-orient dysfunctional thoughts, to identify potential stressors such as triggers and environmental cues to prevent relapse. Consideration needs to be given to weight loss maintenance and ongoing tailored support. Further research is needed to identify what type and method of support is most effective and for whom.
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Borruso, Laura. "Organizational Aspects of a Public Health Initiative: Inter-Organizational Interactions in the Healthy Ontario Initiative". Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/scripps_theses/1154.
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This qualitative study focuses on the intersection of Organizational Studies and Public Health. Through the use of cross-sector work, the Public Health field coordinates work across multiple organizations to diagnose and prevent health issues. Interviewing several administrators from organizations who partake in the Healthy Ontario Initiative allowed me to examine how organizations of different types and sectors interact and connect around this project. This study will predominantly focus on the challenges they face, how they overcome them, and how they are evaluated. Highlighting the intersection of Public Health and Organizational Studies and the way a current Public Health initiative organizes and delivers services may impact the way in which the field evolves in the future.
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Schwaller, Denise E. "Stürzen und Public Health : Evaluation des PatientInnenklientels der Sturzklinik Basel /". Oberkulm, 2007. http://www.public-health-edu.ch/new/Abstracts/SD_09.01.08.pdf.
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Nguyen, Quynh. "The views and expectations of young healthy adults about using an online personal health record". Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104516.
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BACKGROUND: Personal health records (PHRs) are tools that allow individuals to access, share and manage their health information online. PHRs have received considerable interest and investment in recent years, because they are thought to have the potential to promote patient self-management and greater involvement in their own care. Despite apparent public interest and a proliferation of available options, adoption rates remain low. There is a gap in our understanding as to why people are choosing to use or not use PHRs, and what different populations of users might want from such a tool. In particular, young adults could be a potential group to target with preventative strategies using a PHR, since technology is much more integrated in their everyday life.OBJECTIVE: This qualitative descriptive study therefore aimed to explore the views and expectations of young healthy adults about using an online personal health record. METHODS: Four focus groups were conducted with a total of 29 participants (18-34 years old) from a community setting in Montreal, Canada. Interviews were transcribed and analyzed with inductive thematic analysis. RESULTS: With respect to how young adults viewed PHRs, three broad themes were identified: perceived advantages to using a PHR; future PHR users; and concerns about PHRs. In terms of what they themselves expected from using a PHR, different themes were elaborated: characteristics of an “ideal” PHR; using the PHR for preventative health; taking more control over their health; and making the PHR worthwhile. A conceptual framework of factors influencing expectations of PHR use in this population is proposed.CONCLUSION: The findings suggest that what young adults perceive as benefits of a PHR may not be the same things that motivate them to actually use a PHR. The results emphasize the fact that more research is needed to understand the expectations and anticipated use of different populations in designing a patient-centered tool. The proposed framework can be used as a basis and tested in future research on PHR adoption.CONTEXTE: Les dossiers de santé personnels (DSP) sont des outils qui permettent aux individus d'accéder, de partager et de gérer l'information sur leur santé en ligne. Ils ont obtenu beaucoup d'intérêt et des investissements considérables ces dernières années puisqu'on considère que les DSP ont le potentiel de promouvoir une plus grande implication des patients dans la gestion de leurs propres soins. Malgré l'intérêt public apparent et une prolifération des options, les taux d'adoption des DSP restent faibles. Notre compréhension des raisons pour lesquelles les gens choisissent d'utiliser ou non les DSP et de ce que les différentes populations d'utilisateurs pourraient vouloir d'un tel outil est limitée. En particulier, les jeunes adultes pourraient être un bon groupe à cibler en ce qui concerne les possibilités de prévention avec un DSP puisque la technologie est beaucoup plus intégrée dans leur vie quotidienne.OBJECTIF: Cette étude qualitative descriptive vise donc à explorer les points de vue et les attentes des jeunes adultes en bonne santé à propos de l'utilisation d'un dossier de santé personnel. METHODES: Quatre tables rondes ont été menées avec un total de 29 participants (18-34 ans) dans un milieu communautaire de Montréal, au Canada. Les entrevues ont été transcrites et ensuite analysées avec la méthode d'analyse thématique inductive. RÉSULTATS: En ce qui concerne ce que les jeunes adultes pensent à propos des DSP, trois grands thèmes ont été identifiés: les avantages perçus, les futurs utilisateurs et les préoccupations au sujet des DSP. En terme de ce qu'eux-mêmes attendaient d'un DSP, différents thèmes ont été élaborés: les caractéristiques d'un DSP «idéal»; la contribution des DSP à la santé préventive en prenant plus de contrôle sur leur santé, et l'aspect pratique des DSP. Un cadre conceptuel des facteurs ayant une influence sur les attentes des participants à propos des DSP est proposé. CONCLUSION: Les résultats suggèrent que ce que les jeunes adultes perçoivent comme avantages d'un DSP ne sont pas les mêmes choses qui les motivent à se servir d'une PHR. Cela souligne l'importance de comprendre l'utilisation prévue et les attentes des populations d'utilisateurs spécifiques dans la conception d'un outil centré sur le patient. Le cadre proposé peut constituer une base pour de plus amples recherches sur l'adoption des DSP.
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Sofia, Gustina, e n/a. "Information needs of health researchers at the National Institute of Health Research and Development, Ministry of Health, Indonesia". University of Canberra. Information, Language & Culture, 1992. http://erl.canberra.edu.au./public/adt-AUC20061109.083237.
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The present study attempted to investigate the information needs/information seeking
behaviour of health researchers at the National Institute of Health Research and
Development, Ministry of Health, Indonesia. Its objective was to identify the
relationship between information needs/information seeking behaviour and the
characteristics of those health professionals. Those characteristics include institution
to which health professionals belonged, institution geographic location, level of
appointment, level of education, and work experience.
Research was carried out through survey by using a questionnaire. This survey
obtained a response rate of 92 percent from a sample of 131 health professionals.
Their information needs/information seeking behaviour were correlated with their
characteristics to determine relationships, and the Statistical Package for the Social
Sciences (SPSS) was used to analyse the data. Frequency distribution, chi-square
analysis, and descriptive analysis were used to obtain the results.
The study found that the health information available did not match the health
professionals' needs and that there was strong demand by these personnel for automated
information services. It also found that total hours reading per week was significantly
related to level of appointment, level of education, and work experience at other
institutions. The perceived usefulness of journals as information sources was
significantly related to institution, geographic location, level of appointment, level of
education and work experience at other institutions. Government publications and
statistical data as a source of information were found to be related significantly to
institution and geographic location. There was also a relationship between the
perceived value of reference books and work experience at the current institution. The
usefulness of library catalogues as a guide to information was found to be related
significantly to institution and geographic location, as was the usefulness of abstracting
and indexing services to level of education. Frequency of visiting libraries was
significantly related to institution, geographic location and level of appointment. The
membership of professional organizations and obtaining useful information from
friends, colleagues or personal contact were found to be significantly related to level of
education.
The study concludes with recommendations and suggestions for further research.
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Wallace, Maria. "Public Health Nurses’ Perceptions of High School Dropout Rates as a Public Health Issue". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7766.
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Education is one of the strongest predictors of health, and well-being. Early termination of education can lead to poorer health, shorter lifespans, and increased stress on the healthcare system. Improving overall high school graduation rates has been debated and discussed by the Toronto District School Board (TDSB) and the Ministry of Education, however, there is a paucity of research on increased graduation rates as they relate to public health in the Canadian context. The purpose of this phenomenological qualitative study was to explore the perceptions of liaison public health nurses (PHNs) who worked directly with the TDSB regarding their roles in terms of influencing students in Toronto, Ontario to complete high school. Bronfenbrenner’s ecological model was the underlying conceptual framework for the study.Purposive sampling was used to select 10 PHNs who were interviewed regarding their role and involvement in high schools. The data was subjected to triangulation and analyzed to identify commonalities, trends and patterns. Findings from this study indicated that liaison PHNs believe that high school dropout rates are a public health issue and collaboration between the Ministry of Education and Public Health is needed to take action. Recommendations include more Canadian research that explores connections between health and school achievements and the expanded role of PHNs in Canadian high schools. Social change implications for this research include highlighting high school dropout rates as a public health concern in Canadian schools, particularly in communities of lower socioeconomic status. With increased research and resources, the Toronto public health system may work toward making improving graduation rates among their core mandate.
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Wang, Xiaochuan (Sherry). "Three essays on population health and public health policy". Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/29270.
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Empowered patient or empowered physician. An analysis of the importance of the gatekeeper in the health delivery system. This paper examines the important role of the gatekeeper in the health delivery system. A simple theoretical model is developed which compares the resource allocation when physicians act as gatekeepers with the decisions taken when patients are empowered. It is shown that even when there is no asymmetry of information---and so patients and doctors are equally able to identify the appropriate therapy---that the institutional arrangement matters. Patients demand more time with physicians when they are empowered whereas physicians want to spend more time developing their expertise when they are empowered. The reaction of physicians and patients to changes in policy instruments also differs across institutional arrangements. The analysis also draws attention to the design of the compensation scheme for physicians, and investigates the benefits of using a non-linear scheme.
Wealth, health, and the pursuit of happiness. This paper provides a theoretical framework to illustrate the relationship between income, utility maximization, and healthy choices. The analysis indicates that the choices of individuals who maximize utility are not the same as those arising were the individual to maximize wellness. In fact, rational individuals will over-eat and under-exercise relative to health maximizing levels. Yet as individuals get wealthier, they have better health. The paper also compares different strategies for health promotion. Income redistribution may lead to a net increase in population health and in social welfare. By contrast, policies that specifically target lifestyle choices may succeed in persuading citizens to choose a health-maximizing lifestyle, but result in a net welfare loss to society.
An empirical investigation of household income and income polices on obesity in Canada. Using the master files of the Canadian Community Health Survey (CCHS), this paper examines the effect of income on obesity and individuals' body-mass index. An instrumental variable technique is employed to derive consistent estimates of this effect and to take account of the possible endogeneity between income and body weight. It is found that higher income will lead to lower body weight for women, while its effect on the body-weight outcome of men is unclear. This chapter uses the estimates of the relationship between income and body weight to simulate the impact of government income policies---like social assistance and child support---on obesity. It is shown that incomes policies may not only decrease income inequality but may also contribute to a lower incidence of obesity amongst the poorer population thus decreasing overall health care costs.
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Minarcine, Scott. "Health Security Intelligence : Assessing the Nascent Public Health Capability". Thesis, Monterey, California. Naval Postgraduate School, 2012. http://hdl.handle.net/10945/6836.
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Approved for public release; distribution is unlimitedThis thesis explores the current state of public healths (HS) intelligence capability across State, Local, Tribal and Territorial (SLTT) jurisdictions through qualitative analysis of current public health jurisdiction plans for the collection, analysis, product creation, dissemination and programmatic oversight related to public health inputs into the homeland security intelligence apparatus. An assessment was conducted using an online Plan Assessment Tool, or PLAT, that allowed jurisdictional public health leadership to provide de-identified responses. This assessment of 25 of the 62 federally funded SLTT public health preparedness programs indicates one impediment to the continued maturation of this new intelligence capability is the lack of codified plans. The results also suggest that while public health programs at the SLTT level do indeed have much room for improvement, there is a burgeoning intelligence capability within public health. However, to sustain and improve this emergent capability will require a national effort to create mission focus and centralized guidance.
22
Boyle, Melissa Ann. "Health and utilization effects of expanding public health insurance". Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/32410.
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Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Economics, 2005.Includes bibliographical references.
This thesis exploits a major overhaul in the U.S. Department of Veterans Affairs health care system to answer various questions about publicly-provided health care. The VA restructuring involved the adoption of a capitated payment system and treatment methods based on the managed care model. This reorganization was accompanied by a major expansion in the population eligible to receive VA care. Chapter one analyzes both the efficiency of providing public health care in a managed care setting and the effectiveness of expanding coverage to healthier and wealthier populations. I estimate that between 35 and 70 percent of new take-up of VA care was the result of individuals dropping private health insurance. While utilization of services increased, estimates indicate that the policy change did not result in net health improvements. Regions providing more care to healthier, newly-eligible veterans experienced bigger reductions in hospital care and larger increases in outpatient services for previously-eligible veterans. This shift away from specialty care may help to explain the aggregate health declines. Chapter two examines the impact of the introduction of a VA-sponsored drug benefit on Medicare-eligible veterans. Results suggest that a drug benefit does not result in changes in the quantity of drugs consumed, but does lead to an increase in spending and a shift in who pays for the prescriptions. The benefit appears to have a larger effect on lower-income individuals. Results also show suggestive evidence of positive health effects as a result of the drug benefit, an outcome which could be cost-saving in the long run.
(cont.) Chapter three utilizes the change in government health care coverage for veterans to test whether employer-provided insurance leads to inefficiencies in the labor market, and the degree to which such inefficiencies might be alleviated by expanding public health insurance programs. We examine the impact of health care coverage on labor force participation and retirement by comparing veterans and non-veterans before and after the VA expansion. Results indicate that workers are significantly more likely to cease working as a result of becoming eligible for public insurance, and are also more likely to move to part-time work.
by Melissa Ann Boyle.
Ph.D.
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Bosworth, Ryan Cole. "Demand for public health policies /". view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?index=0&did=1192186841&SrchMode=1&sid=1&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1176749188&clientId=11238.
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Thesis (Ph. D.)--University of Oregon, 2006.Typescript. Includes vita and abstract. Includes bibliographical references (leaves 127-130). Also available for download via the World Wide Web; free to University of Oregon users.
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Polyakova, Maria A. (Maria Alexandrovna). "Regulation of public health insurance". Thesis, Massachusetts Institute of Technology, 2014. http://hdl.handle.net/1721.1/90128.
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Thesis: Ph. D., Massachusetts Institute of Technology, Department of Economics, 2014.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 147-150).
The first chapter takes advantage of the evolution of the regulatory and pricing environment in the first years of a large federal prescription drug insurance program for seniors - Medicare Part D - to explore interactions among adverse selection, switching costs, and regulation. I document evidence of both adverse selection of beneficiaries across contracts and switching costs for beneficiaries in changing contracts within Medicare Part D. Using an empirical model of contract choice and contract pricing, I show that in the present environment, on net, switching costs help sustain an adversely-selected equilibrium with large differences in risks between more and less generous contracts. I then simulate how switching costs may alter the impact of "filling" the Part D donut hole as implemented under the Affordable Care Act. I find that absent any switching costs, this regulation would have eliminated the differences in risks across contracts; however, in the presence of the switching costs that I estimate, the effect of the policy is largely muted. The second chapter (co-authored with Francesco Decarolis and Stephen Ryan) explores federal subsidy policies in Medicare Part D. We estimate an econometric model of supply and demand that incorporates the regulatory pricing distortions in the insurers' objective functions. Using the model, we conduct counterfactual analyses of what the premiums and allocations would be in this market under different ways of providing the subsidies to consumers. We show that some of the supply-side regulatory mechanisms, such as the tying of premiums and subsidies to the realization of average "bids" by insurers in a region, prove to be welfare-decreasing empirically. The third chapter studies two competing systems that comprise the German health insurance landscape. The two systems differ in the ability of insurers to underwrite individual-specific risk. In contrast to the community rating of the statutory insurance system, enrollees of the private plans face full underwriting and may be rejected by the insurers. I empirically assess to what extent the selection of "good risks" dominates the interaction between the two systems, using a regression discontinuity design based on statutory insurance enrollment mandates. I do not find compelling evidence of cream-skimming by private insurers from the statutory system. Motivated by this finding, I quantify the change in consumer welfare that would result if the government relaxed the statutory insurance mandate to lower income levels.
by Maria A. Polyakova.
Ph. D.
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Petersen, J. "Social marketing and public health". Thesis, University College London (University of London), 2009. http://discovery.ucl.ac.uk/18925/.
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The public health field exists to safeguard the general public from health risks by controlling risk factors, classically through immunization programmes that prevent or control epidemics, or through actions such as monitoring the quality of drinking water. In our post-industrialised society, risk factors other than the environment, such as diet, exercise, tobacco and alcohol use, have grown in importance. The policy response to the growing demand upon healthcare services arising from chronic diseases caused by changing lifestyle factors has taking different forms, and these include targeting vulnerable groups using health promoting campaigns. This thesis addresses some of the challenges and opportunities in public health campaigns and healthcare planning that arise from the growing repositories of data that can be made available for targeting at the individual and small area level in a public health setting. The first part sets the scene by describing the concepts of health, public health and social marketing. The intention is to pave the way for broader discussions – in the progress of the thesis – about healthcare planning, population health, and social processes in the light of targeted public health interventions. Part two addresses the problems and possible solutions to a number issues in healthcare planning, starting with studies at the individual, then moving to organisations and ending with area classifications. The thesis draws on a number of case studies for targeting in a public health context including frequent accident and emergency users, teenage users of abortion services, women’s breast screening uptake, GP registration, and the neighbourhood characteristics of chronic disease patients. Finally, part three provides a synopsis of both context (part one), results (part two) and future perspectives on how routinely collected healthcare data can be used to create evidence for the planning of new cost-effective interventions.
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Wettstein, Gal. "Essays on Public Health Insurance". Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493442.
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Over the last ten years there have been dramatic changes in the health insurance environment in the United States, spurred on by broad reforms in the public health insurance sector. In 2006 the Medicare Prescription Drug, Improvement and Modernization Act went into effect, providing broad access to prescription drug insurance for millions of elderly Americans. In 2014 the main provisions of the Patient Protection and Affordable Care Act began to be felt, dramatically changing health insurance markets, particularly for those seeking non-group coverage. These legislative changes both raise questions regarding how well the policy changes meet their goals, as well as offering new variation with the potential to answer questions of fundamental economic significance.
This dissertation addresses such important questions surrounding the effectiveness of public health insurance in meeting policymakers’ goals, and the implications of public health insurance for private markets. In the three chapters of this dissertation I utilize the policy changes of Medicare Part D and the Affordable Care Act to provide quasi-experimental estimates of retirement lock, of the correlation of risk aversion and crowd-out of private insurance, and of the effectiveness of the individual health insurance mandate in expanding coverage.
The first part studies the implications of public drug insurance for labor markets. This part examines whether the lack of an individual market for prescription drug insurance causes individuals to delay retirement. I exploit the quasi-experiment of the introduction of Medicare Part D, which provided subsidized prescription drug insurance to all Americans over age 65 beginning in 2006. Using a differences-in-differences design, I compare the labor outcomes of individuals turning 65 just after 2006 to those turning 65 just before 2006 in order to estimate the causal effect of eligibility for Part D on labor supply. I find that individuals at age 65 who would have otherwise lost their employer-sponsored drug insurance upon retirement decreased their rate of full-time work by 8.4 percentage points due to Part D, in contrast to individuals with retiree drug insurance even after age 65 for whom no significant change was observed. This reduction was composed of an increase of 5.9 percentage points in part-time work and 2.5 percentage points in complete retirement. I use these estimates to quantify the extent of the distortion due to drug insurance being tied to employment, and the welfare gains from the subsidy correcting that distortion. The results suggest that individuals value $1 of drug insurance subsidy as much as $3 of Social Security wealth.
The second part of this dissertation considers the effect of public drug insurance on private drug coverage, with a focus on the correlation of crowd-out and risk aversion. I utilize Health and Retirement Survey data around the time of introduction of the Medicare Part D prescription drug insurance for the elderly in order to estimate crowd-out of private prescription drug insurance. I use individuals between the ages of 55 and 64, who are not eligible for the program, as a control group relative to individuals aged 65 to 75, who are eligible. I take a differences-in-differences approach to estimation by comparing outcomes before and after 2006, when Medicare Part D went into effect. I construct measures of risk aversion by exploiting unique questions eliciting risk preferences in the Health and Retirement Survey, as well as information on whether individuals have other kinds of insurance, or engage in risky behaviors. I find substantial differential crowd-out by risk aversion: every standard deviation increase in risk aversion was associated with about 5 percentage points less crowd-out, over a base crowd-out rate of 50%-60%. More risk averse individuals also saw greater reductions in out-of-pocket spending on prescription drugs due to Part D, particularly at high levels of spending: at the 85th percentile of spending an individual one standard deviation more risk averse than the average experienced a decline of $110/year due to Part D eligibility, above and beyond the gains for an averagely risk averse individual of $382/year.
The third part of the dissertation estimates the effectiveness of the individual mandate in the Patient Protection and Affordable Care Act in expanding health insurance coverage. This paper studies the impact of the individual health insurance mandate in the Patient Protection and Affordable Care Act (PPACA) on health insurance coverage. This mandate went into effect in 2014, alongside various other elements of the PPACA. I focus on individuals ages 26-64 who are ineligible for the subsidies or Medicaid expansions included in the PPACA to isolate the effect of the mandate from these other components. To account for changes unrelated to the PPACA that occur over time and affect insurance coverage I utilize a control group of residents of Massachusetts who were already subject to mandated insurance following the 2006 health care reform in their state. Employing a differences-in-differences design applied to data from the American Community Survey, I find that the mandate caused an increase of 0.85 percentage points in health insurance coverage, or a 17% decline in the uninsurance rate. This increase was concentrated in coverage purchased directly by individuals, rather than acquired through an employer, and predominantly affected younger individuals. Both these observations are consistent with the mandate ameliorating adverse selection in the individual health insurance market.Economics
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Lee, Karen. "Scaling up public health interventions". Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/27829.
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The scale-up of effective or efficacious public health interventions to prevent chronic disease is important if population wide impacts are to be achieved. However, scale-up is complex and doesn’t happen as often as it should. This is despite growing interest in the area of research translation and scale-up by researchers and policy makers and a plethora of conceptual frameworks developed to guide the scale-up of efficacious interventions.
The objectives of this thesis are to understand how scale-up may be facilitated within a research translation framework as well as in the real-world by understanding the key factors that contribute to facilitating scale-up. A key finding from this thesis is that scale-up in the real-world does not occur in a linear fashion and is often influenced by a range of factors including the political and/or strategic context, values of key actors as well as community needs and the availability of funding. Furthermore, decisions to scale-up are not only determined by the level of evidence available, but also through the convergence of the abovementioned factors into an opportunity for scale-up, ‘the scale-up window’.
The opportunities to facilitate scale-up in this thesis include: cementing ‘scale-up’ as the end goal within a research translation framework which places the emphasis on scale-up equally alongside the other research translation activities; conducting research that promotes greater understanding of implementation and scale-up (through replication and scale-up studies) while reducing the traditional focus of smaller efficacy trials that are not conducive for scale-up; encouraging the uptake of pragmatic tools that provide guidance to those considering scale-up, through assessing the potential scalability of interventions considered for scale-up to expedite more informed decision making; and by comprehensively reflecting on and documenting scale-up experiences which contribute to capturing lessons for researchers and policy makers.
Finally, the field of scale-up may benefit from greater clarity around the ‘roles’ within research and policy settings on scale-up, which would increase the accountability for scaling up interventions as well as greater delineation between the growing field of implementation science and scale-up.
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Lazzarato, Fulvio. "Dynamic Models for Public Health". Doctoral thesis, Università del Piemonte Orientale, 2018. https://hdl.handle.net/11579/148543.
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Dynamic models are important tools for public health purposes; they allow esimaing the impact of diferent approaches and can be used for a populaion health improvement planning or to organize a response to an emerging public health issue. The aims of my thesis are to design, build, test, parameterized, and illustrated two dynamic models. One is a populaion-based model of Human Papilloma Virus (HPV) infecion natural history and vaccinaion; the other is an individual based model of tobacco control. Both models have been adapted to account for public health measure of prevenion and control. Also, both models can incorporate enough demographic data to adapt their outputs to speciic populaion, in which realisic intervenions are simulated. The model of HPV transmission and control has been adapted and parameterized to represent diferent populaions from both high- and low-middle-income countries, i.e. Sweden, Italy, US, and India, and diferent HPV types, i.e. 16,18, and 45. By contrast, the model of tobacco control has been designed to reproduce smoking behaviors and demography of the Italian populaion between year 2000 and 2013 and used to evaluate the efect of public health policy, e.g. smoking prevalence on the Italian populaion in year 2030. Both models are coded in C compuing language, according to high-performance programming standards, eicient data structures and algorithms, and opimizaion techniques to maximize the compuing eiciency. In my thesis, I have used the two models to predict the expected impact of selected public health intervenions both for HPV and cervical cancer control and for tobacco control. The outputs of each set of simulations have been analysed using advanced staisical methods/libraries, e.g. GNU Scieniic Library and sotware such as R (CRAN) and STATA. These predicions illustrate the potenial of using mathemaical model for assessing the efeciveness of selected prevenion and control measures.
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Fowler, Lesley, e n/a. "Meditation and mental health". University of Canberra. Education, 1986. http://erl.canberra.edu.au./public/adt-AUC20060710.130437.
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The claims of the traditional texts and teachers of Buddhist meditation include the enhancement of mental health.
Twenty five meditators sitting a ten day retreat in Vipassana and Metta meditation were measured on a compassion scale and an androgyny index. The androgyny index was used to measure mental health.
Compassion scores for all meditators increased slightly after the
retreat. Experienced meditators had significantly higher scores than
inexperienced meditators.
Regardless of previous experience, meditators with high
compassion scores significantly increased in androgyny after the
retreat. The traditional claims for the enhancement of mental health
are therefore supported by these results.
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Sarkar, Chinmoy. "The science of healthy cities : deciphering the associations between urban morphometrics and health outcomes". Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/47613/.
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Over the past decade there has been mounting evidence of the significant role played by the myriad attributes of our city's built environments in shaping our health and well-being. This thesis hypothesizes that the constituent components of the built environment, especially the configuration and design of land uses and street networks governs the distribution of resources and services, configures the neighbourhood activity space, and thereby influences individual physical activity behaviours, social interactions, weight outcomes as well as mental health and well being. Enhanced accessibility to health-promoting community resources improves local opportunities for physical activity, thereby enhancing mobility, social interactions and independence as well as reducing isolation. The first section of this thesis conceptualizes the urban health niche as a novel holistic and spatially-explicit paradigm in public health and proposes a health niche model of healthy city. Based on the proposed paradigm and gathered research evidence, multilevel data sets pertaining to health, socio-economic, built and natural environment have been produced and integrated together to constitute the high resolution database, spatial Design Network Analysis for Urban Health (sDNA-UH). sDNA-UH has been developed for the assembly constituency of Caerphilly, South Wales enabling operationalization of the spatial elements of the proposed urban health niche. State-of-the-art spatial and network analysis techniques have been employed upon the UK Ordnance Survey Mastermap data layers to quantify the various facets of urban built environment in the form of built environment morphological metrics (morphometrics) with the potential to influence individual's health. Based on the developed sDNA-UH, a series of three empirical studies comprising multilevel cross-sectional and longitudinal models have been presented which examine the association between specific attributes of a built environment and health outcomes. Firstly, a two-part multi-level regression model was employed to examine the impact of built environment configuration upon psychological distress. Land use mix, density of amenities, local street-network general accessibility (‘betweenness’) and slope variability were identified as significant predictors. Secondly, the first long-term longitudinal evidence relating the built environment to change in obesity in older people identified land use mix, density of amenities street network accessibility and slope variability as significant predictors. The third study examined the health effects of differential accessibility of an individual's dwelling with respect to multiple service and facility catchments at multiple spatial scales. Dwelling level density, dwelling type, density of community services, street network movement potential expressed in terms of betweenness index as well as neighbourhood-level deprivation were identified as the significant parameters. The study reported significant differences in point estimates and level of significance when comparing the two spatial scales of 0.5 and 1.0 mile street network catchments. The empirical evidence thus generated lends support to the thesis’ principal hypothesis that the built environment influences individual health behaviour and eventually health. The research concludes that optimized design and planning of urban built environments act as effective public health intervention in our goal of health-sustaining communities and a healthy city.
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Pankaj, Vibha. "Mobilising knowledge in public health : analysis of the functioning of the Scottish Public Health Network". Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9440.
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The extent to which the knowledge mobilisation potential of public health networks is actually achieved in their functioning has not been previously studied. There are prescriptions from policy documents and from research literature as to the form networks in health should take and the way they should operate. However, there has been little research connecting the nature of the networks and the manner in which they function to their knowledge mobilising ability. Constituted in 2006, the Scottish Public Health Network (ScotPHN), which is the primary vehicle in Scotland for mobilising public health knowledge and informing policy and practice, constitutes the location for this study investigating this knowledge mobilisation and how networks function in public health. Feedback from the consultation conducted prior to the formation of ScotPHN was obtained. Interviews were conducted with the members of the ScotPHN steering group, a project group and the stakeholder group. Two ScotPHN steering group meetings were also attended by the author as an observer. The consultation feedback, transcripts of the interviews and those of steering group meetings were analysed using the constructivist version of the grounded theory approach. The process involved coding and abstracting codes to categories and themes. The emerging themes were reviewed in the light of existing literature on networks and knowledge mobilisation. These themes were then used to develop a model to understand how the network operates and consequently mobilises knowledge. The study shows that prior to its formation ScotPHN was expected to address the fragmentation of the public health workforce; significantly enhance links amongst existing public health networks; support ground level knowledge exchange amongst practitioners and significantly enhance multisectorial working. None of these expectations appear to have been met. ScotPHN has, however, managed to fill the gap left by the demise of the Scottish Needs Assessment Programme (SNAP). ScotPHN’s structure and the manner in which it is controlled lead to it being akin to a policy community rather than an issue network. The generic public health concerns of the steering group and the selective nature of the project group prevent it from functioning as an issue network. The dominance of people from the medical profession also causes a social closedness in the ScotPHN steering group. The limited multisectorial participation in its activities results in: a lack of constructionist learning; limited inclusion of the social context of knowledge; and a deficit of Mode 2 knowledge mobilisation. In the context of knowledge conversion there is some evidence of externalisation but no socialisation. ScotPHN is not a network that can be classed as a community of practice. This study highlights how health policies, which have advocated the establishment of networks, could derive considerable guidance from research into how networks actually function. With respect to the knowledge mobilisation activity of these networks the study finds that top-down and prescribed structures are unable to capture the transdisciplinarity and diverse intellectual frameworks that contribute to public health knowledge. It is seen that the hierarchical network structures can undermine the engagement of actors from the less represented sectors. Additionally the study finds that the established patterns of professional power and control further hinder multisectorial engagement.
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French, Martin Andrew. "Picturing public health surveillance : tracing the material dimensions of information in Ontario's public health system". Kingston, Ont. : [s.n.], 2009. http://hdl.handle.net/1974/1689.
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Weichelt-Picard, Manuela. "Public Health und individuelle Krankenkassenprämienverbilligung im Kanton Graubünden : Kriterien für die Vergabe der Durchführung /". Zug, 2002. http://www.public-health-edu.ch/new/Abstracts/WPM_23.09.02.pdf.
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Kato, Ryuta. "Three essays in health economics : uncertainty and public health policy". Thesis, University of Essex, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310085.
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Johnson, S., M. Belcher, M. Moody e Megan Quinn. "Collaboration Between Local Health Department and College of Public Health". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6794.
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Hanna, Elizabeth Gayle (Liz), e lizhanna@netc net au. "Environmental health and primary health care: towards a new workforce model". La Trobe University. School of Public Health, 2005. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20061110.152550.
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Public health was once synonymous with environmental health. However, as living conditions improved the two fields diverged. Environmental factors are again re-emerging as hazards human health. Increasing global reliance on agricultural and veterinary chemicals (AgVets) over recent decades has is now a serious public health concern. Evidence of their toxicity has prompted international efforts to minimize, monitor and manage exposure risks. Direct involvement of the primary health care workforce is seen as critical to this process, yet little data exists on the health burden on Australian rural communities imposed by these chemicals.
The study presented here attempts to explore the impact of these chemicals on two rural communities in Victoria, and ascertain the how the existing primary heath care system responds to AgVet exposure issues. Health determinants are complex, and inter-related, and the client �provider interface is not an entity acting in isolation from other frameworks. The provider-client service relationship has evolved against a background of legislation and provider training. Many external factors also impinge, such as the structure and focus of the health sector, and Australia�s systematic approach to environmental and chemical management. Examination of this underlying infrastructure in Australia provided the background against which the issue of exposure to agricultural and veterinary chemicals was explored. A brief summary of international developments in this area served to provide insight as to what interventions may be introduced to address the issue of chemical exposure.
A CATI (Computer Assisted Telephone Interview) survey of 1050 households sought the perspectives from two Victorian agricultural communities to gather self-reported AgVet exposure patterns and health data, and whether respondents perceived their health problems were linked to exposure. Respondents were also asked to comment on the primary health care service experiences from local providers, and which services they preferred to seek for health advice. Perspectives were then sought from all primary health care providers servicing these communities. Information was sought on their level of expertise in diagnosing, and managing exposure related illness, via face-to-face interviews, focus groups and paper surveys.
The study revealed rural communities have a long history of hazardous exposure to toxic AgVets. Awareness of toxicity risks is growing, yet further scope exists to improve safe handling of chemicals. High levels of illnesses known be associated with AgVet exposure exist among rural populations. Many believe their own ill-health is linked to exposure, and express strong dissatisfaction with the apparent lack of environmental health expertise especially among their GPs. Health providers demonstrated limited understanding of the health impacts of AgVet exposure.
The lack of environmental health expertise among the existing primary health care workforce means that health conditions associated with exposure to AgVets are not being identified, and the absence of health intelligence hampers health planning. In Australia, the health, environment and primary industries sectors function in effect, as distinct silos, with little cross-fertilisation. The United States has combined its agricultural chemical legislative authority to develop a focus on human health, establish direct links, and biomonitoring programs to protect human heath. The U.S. has also developed environmental health expertise at the primary health care level to address community needs as they arise. Strategies are required in Australia to connect the environment, chemical management and health portfolios, with respect to the emerging environmental issues of chemical exposure. There is a need also in Australia to inject environmental health capacity into the primary health care practice.
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Yang, Hui, e h. yang@latrobe edu au. "Priorities and Strategies for Health Information System Development in China - How Provincial Health Inforamtion Systems Support Regional Health Planning". La Trobe University. Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050818.135812.
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China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care.
Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management.
The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted.
The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care.
To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.
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Lalonde, Lyne. "Health-related quality of life measures in coronary heart disease prevention and treatment". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0006/NQ44484.pdf.
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Peeso, Jennifer. "The Effects of Personal Health Assessments on Health Knowledge and Health Behavior Among Students Enrolled in an Undergraduate Personal Health Course". TopSCHOLAR®, 1996. http://digitalcommons.wku.edu/theses/796.
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The purpose of this research was to determine whether personal health assessments would increase Personal Health 100 students' health knowledge and healthy behaviors. This research is important because of the objectives set by Healthy People 2000 to promote health and because of the need for comprehensive school health education programs. By focusing on health promotion in the school setting, more effective preventive programs can be devised. The factors investigated included health knowledge and the following health behaviors: exercise, alcohol consumption, use of tobacco, sleep, breakfast, sexual activity, and seatbelt use. These factors were chosen based on a longevity theory. Data were collected for this study in the spring semester 1996 at Western Kentucky University. The responses from 244 undergraduate students were collected using the HKI (Health Knowledge Inventory) and a behavioral assessment. The data were analyzed using an analysis of covariance and a chi- square analysis. None of the factors^ were found to be significantly affected by the personal health assessments. The results revealed that the methods to increase health knowledge and healthy behaviors had no short-term effects on the undergraduate students.
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Koopu, Pauline Irihaere, e n/a. "Kia pakari mai nga niho : oral health outcomes, self-report oral health measures and oral health service utilisation among Maori and non-Maori". University of Otago. School of Dentistry, 2005. http://adt.otago.ac.nz./public/adt-NZDU20070502.152634.
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Health is determined by the past as well as the present; the health status of indigenous peoples has been strongly influnced by the experience of colonisation and their subsequent efforts to participate as minorities in contemporary society while retaining their own ethnic and cultural identities. Colonial journays may have led to innovation and adaptation for Maori, but they have also created pain and suffering from which full recovery has yet to be felt (Durie, 2001).
The oral health area can be described as having considerable and unacceptable disparities between Maori and non-Maori (Broughton 1995; Thomson, Ayers and Broughton 2003). Few reports have been conducted concerning Maori and patterns of oral health service utilisation, however a lower service utilisation among Maori than non-Maori has been noted (TPK 1996; Broughton and Koopu 1996). Overall, Maori oral health is largely unknown due to a paucity of appropriate research.
This research aims to provide new information by describing Maori oral health outcomes over the life course, within a Kaupapa Maori Research (KMR) methodology. In general, the basic tenets presented for KMR are: (1) to prioritise Maori - from the margin to the centre; (2) to be Maori controlled - by Maori, for Maori; (3) to reject �victim-blame� theories; and (4) to be a step towards action and change in order to improve Maori oral health outcomes.
The aims of this research are to:
1. Describe the occurrence of caris at ages 5, 15, 18 and 26 and periodontal disease at age 26 years for Maori.
2. Describe self-reported oral health, self-reported dental aesthetics and oral health service utilisation among Maori at ages 5, 15, 18 and 26.
3. Compare the above oral health characteristics between Maori and non-Maori .
4. Investigate the determinants of any differences in oral health outcomes between Māori and non-Maori using a KMR methodology.
The investigation involves a secondary analysis of data from the Dunedin multidisciplinary Health and Development study (DMHDS). The existing data-set was statistically analysed using SPSS (SPSS Inc, Chicago, USA). Descriptive statistics were generated. The levels of statistical significance were set at P< 0.05. Chi-square tests were used to compare proportions and independent sample t-tests or ANOVA were used for comparing means.
A summary of the Maori/non-Maori analysis shows that, for a cohort of New Zealanders followed over their life-course, the oral health features of caries prevalence, caries severity, and periodonal disease prevalence are higher among Maori compared to non-Maori. In particular, it appears that while Maori females did not always have the highest prevalence of dental caries, this group most often had a higher dmfs/DMFS for dental caries, compared to non-Maori. As adolescents and adults, self-reported results of oral health and dental appearance indicate that Maori males were more likely to report below average oral health and below average dental appearance, when compared to non-Maori. However, at age 26, non-Maori males made up the highest proportion of episodic users of oral health services.
This study has a number of health implications: these relate specifically to the management of dental caries, the access to oral health services, and Maori oral health and the elimination of disparities. These are multi-levelled and have implications for health services across the continuum of care from child to adult services; they also have public health implications that involve preventive measures and the broader determinants of health; and involve KMR principles than can be applied to oral health interventions and dental health research in general.
Dental diseases and oral health outcomes, such as dental anxiety and episodic use of services, are a common problem in a cohort of New Zealanders with results demonstrating ethnic disparities between Maori and on-Maori. As an area of dentistry that has had very little research in New Zealand, the findings of this study provide important information with which to help plan for population needs.
The KMR approach prioritises Maori and specifically seeks to address Maori oral health needs and the elimination of disparities in oral health outcomes. While the issues that are raised may be seen as the more difficult to address, they are also more likely to achieve oral health gains for Maori and contribute to the elimination of disparities.
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Vaidyanathan, Ambarish. "Environmental and health impacts of extreme heat events". Diss., Georgia Institute of Technology, 2014. http://hdl.handle.net/1853/54021.
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In the United States (U.S.), extreme temperature-related deaths account for far more deaths than hurricanes, lightning, tornadoes, floods, and earthquakes combined. An extreme heat event (EHE) or a heat wave is a sustained period of substantially hotter and/or more humid weather. EHEs cause a wide range of health problems such as rashes, cramps, heat exhaustion, heat stroke, and, in some instances, death. Further, meteorology plays a dominant role in the formation of air pollutants. In particular, extremely high temperatures are conducive to the formation of certain air pollutants. In order to understand the adverse health impacts of extreme heat and air pollution levels prevailing during EHEs, it is necessary to define what constitutes a heat episode; however, there is a lack of scientific consensus on definitions and procedures to accurately identify EHEs. This work employs a hierarchical clustering technique to group 92 different EHE definitions into homogeneous sets and uses negative binomial rate regression approach to identify those definitions that are most strongly associated with mortality. Our findings suggest that definitions with thresholds that are either too extreme or too moderate are poorly associated with heat-related mortality for most climate regions. Additionally, the association between air pollution and health, especially mortality, is well understood. However, the role of air pollutants in modifying the relationship between EHEs and mortality is not well characterized in the U.S., yet is critical to generating accurate estimates of health burden. Our results indicate that air pollution confounds the relationship between EHE and mortality, and the extent of confounding varies with climate regions. Further, through this work, the sensitivities associated with selecting an EHE definition is taken into consideration when providing region-specific health and economic burden associated with EHEs. Ideally, the excess deaths and costs presented in this work could be useful to study and quantify the public health risk associated with EHEs, either in a prospective or a retrospective setting.
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Wright, Trudy, e n/a. "Primary health care : the health care system and nurse education in Australia, 1985-1990". University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061110.171759.
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Primary health care as a model for the provision of health services was
introduced by the World Health Organization In the mid 1970s. Initially
viewed as a means of health promotion and advancement of wellness in
developing countries., it was soon to be adopted by industrialised countries to
assist in relieving the demand on acute care services. This was to be achieved
through education of the community towards good health practices and the
preparation of nurses to practice in the community, outside of the acute care
environment Australian nurses were slow to respond to this philosophy of
health care and this study has sought to examine why this is so. It has been
found that there are a multitude of reasons for the lack of action In the decade
or more following the Declaration of Alma Ata and the major Issues have been
identified and elaborated.
Some of the major reports of the time that were associated with and had some
Influence on health care and nurse education have been examined to identify
recommendations and how much they support the ethos of primary health
care. These include the Sax committee report of 1978 and a submission by
the Department of Employment and Industrial Relations In 1987.
As part of the investigation, nursing curricula from around Australia in the
mid 1980s have been examined to determine the degree of the primary health
care content according to guidelines recommended by the World Health
Organization. It was found that generally at that time, there was a deficit In
the preparation of undergraduate students of nursing for practice In the area
of primary health care when the world, including industrialised nations, was
making moves towards this model of health care delivery.
Factors Influencing the slow response of nursing have been examined and
finally recommendations for further studies have been put forward.
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Ardalan, Christine. "Forging Professional Public Health Nursing in a Southern State: Florida's Public Health Nurses, 1889 to 1934". FIU Digital Commons, 2012. http://digitalcommons.fiu.edu/etd/663.
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From 1889 to 1934, Florida’s nurses belonging to a new group of professional women ushered in a pioneering phase of public health nursing in Florida. During this era, the nurses’ ability to confront health and professional issues varied a great deal but in quiet and forceful ways they tackled cultural and environmental problems to assist people who were ill or help prevent people from becoming ill. This dissertation places the development of professional public health nursing in its social context by uncovering the relationships public health nurses formed with clubwomen, the medical profession, city leaders, midwives, and others.
In 1888, there were few graduate nurses in the state, no state board of health and no organized nursing service to respond to Jacksonville’s great yellow fever epidemic. By 1934, national and state leaders of public health nursing had built up the profession to become an essential part of the State Board of Health’s service to the community. Between these milestones, in the era of white supremacy and Jim Crow, public health nurses combined their professional training with a pioneer spirit of innovation and risk-taking. In the predominately rural state, the public health nurses’ resolve to overcome environmental hazards and cultural obstacles stands out as they attempted to reach those who were unserved or underserved by modern medicine.
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Carter, Nakia, e Rick Wallace. "Collaborating with Public Libraries, Public Health Departments, and Rural Hospitals to Provide Consumer Health Information Services". Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etsu-works/8682.
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East Tennessee State University Quillen College of Medicine Library (ETSUQCOML) developed a training program to enable public libraries, public health workers, and rural hospital staff to be consumer health information providers. Four NN/LM-developed classes were taught to public libraries. Regional public library directors were invaluable in obtaining the concurrence of their boards for release time for class attendance. Classes were also developed for the public health workforce and rural hospital staff. Five-hundred thirty-three students attended the classes. Fifty-two public library workers will receive the MLA's Consumer Health Information Specialist certification. Thirty-one public libraries have joined NN/LM. All ordered MedlinePlus marketing materials for their libraries from InformationRx.org.
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Yrjälä, Ann. "Public health and Rockefeller wealth : alliances strategies in the early formation of Finnish public health nursing /". Åbo : Åbo Akademi University Press, 2005. http://catalogue.bnf.fr/ark:/12148/cb40236478x.
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46
Gleeson, J. A. "Using policy analysis to explore the reciprocal impact of health policy on public health nursing and public health nursing on policy". Thesis, Bournemouth University, 2013. http://eprints.bournemouth.ac.uk/21387/.
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The overall aim of this study was to explore the reciprocal impact of health policy on public health nursing and public health nursing on policy. This study uses a new approach to considering public health nurses’ engagement in policy: one which puts public health nurses, as actors in the policy process, at the centre of the investigation. The overall philosophical lens through which the research was conducted was critical social theory and the methodology was a grounded theory influenced research design. The study adopted a three stage data collection and analysis process: primary data (questionnaires and interviews), detailed policy analyses of two specific White Papers and secondary data (extant documents). The data were collected and analysed through a grounded theory approach in order to answer four research questions: 1. What do public health nurses know about policy, specifically in relation to two English Department of Health White Papers: Creating A Patient-Led NHS (DOH 2005) and Our Health, Our Care, Our Say (DOH 2006)? 2. How do they engage in the policy process? 3. What affects their implementation of policy? 4. Is there a policy-practice gap? A triangulated approach to data collection and analysis was used. Primary data were collected through questionnaires and follow up telephone interviews with public health nurses (health visitors and school nurses) in four PCTs and one social enterprise in five different geographical areas of England. Further data from detailed policy analyses using frameworks by Popple and Leighninger (2008) and Walt and Gilson (1994) were also considered. Finally, secondary data from extant documents including newspapers, websites and organisational documents were reviewed. At the end of the research process, it was possible to answer the four research questions. In addition to this, new knowledge and theory emerged around three main themes: i) A proposal for a new combined framework for policy analysis which leads to a comprehensive and analytical account of policy content and context combined with a detailed consideration of the role of public health nurses as actors in the policy process. ii) Theories as to why and how public health nurses lack influence in the policy process. iii) Analysis of the effect of lack of resources on inhibiting practice innovation in response to policy agendas. Consideration of these theories led to several recommendations for practice. Throughout the research process, there was continued interaction between the three phases of data collection, analysis and theory development.
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Bolmgren, Margareta, e Alexandra Westin. "Healthy Cities - What makes the difference at a local level? : an analysis on factors for success in creating healthy public policy". Thesis, University West, Department of Nursing, Health and Culture, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-1655.
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The World Health Organization (WHO) states that working intersectorally and internationally with health issues is crucial in creating a change towards healthy public policy at a local level. Healthy Cities is one of the programmes where WHO uses a health governance approach (governing through networks) to try to reach this objective. The aim of this bachelor thesis is to identify the factors that make member cities of the WHO European Healthy Cities Network successful in reorienting local public policy towards healthy public policy. An analysis of nine documents corresponding to the selection criteria set up by the authors was conducted. These documents consisted of reports published by WHO on the Healthy Cities programme, but also of independent research articles and one thesis published on other networks similar to Healthy Cities. Also, further data was collected through telephone interviews with contact persons in four member cities. The interviews were transcribed word by word. Both data (documents and interviews) were analysed using a qualitative content analysis.
The results show that the four key “elements for action” (political commitment, leadership, readiness for institutional change and intersectoral collaboration) crystallized by WHO for creating healthy public policy were mainly confirmed in this research study. Therefore, the authors draw the conclusion that WHO has succeeded in making the member cities commit to the Healthy Cities philosophy and in spreading the idea of health governance in Europe. However, additional factors were found both in the document analysis and in the interviews. When looking at the top four frequently occurring factors in the documents, community participation and status were highlighted. The two additional factors found in the interview data was holistic thinking and systematic, goal-oriented work. Also, the importance of political commitment was questioned by a minority of the respondents. This might indicate that the four key “elements for action” crystallized by WHO might not have as big of an effect in creating change at a local level as has been made out by WHO. Furthermore, respondents stated that difficulties existed in translating theory into practice at a local level. This might indicate that potential changes made in the member cities after joining the Healthy Cities programme are mainly ideological. Despite this, the attitudes among the respondents towards membership in the WHO European Healthy Cities Network were overall positive, and even though difficulties still exist, the respondents maintained that Healthy Cities enables them in taking the next step towards healthy public policy at a local level.
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Loinder, Arvidsson Lova. "A Healthy Performance in Times of a Pandemic : A review of the World Health Organization's policy performance in times of global public health crises". Thesis, Stockholms universitet, Institutionen för ekonomisk historia och internationella relationer, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-190550.
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This paper explores WHO’s response during the COVID-19 pandemic and compares it to its response during the SARS epidemic in 2003. This is done by examining the organization’s performance through a policy output approach and theoretical perspectives of effectiveness and performance theories. The policy output approach offers an operational model that suggests studying five variables of output applied to the policy documents published by the organization. The results show that WHO has increased its performance and productivity since SARS 2003 which might indicate that the effectiveness of the organization could have increased along with it. However, in order to ultimately establish effectiveness, external factors such as compliance of member states and domestic politics needs to be considered in future studies. This study contributes to the understanding of WHO’s performance in times of crisis and can be used as background for further research on effectiveness.
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Wagner, Steven M. "Public Sponsored Health Insurance to Improve Health Outcomes with Implications for Government Health Policy, Design, and Decision Making". ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1002.
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This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this population. This study used an unobtrusive, longitudinal, one group pretest-posttest design. Research questions were designed to measure the strength of the relationship between PSHI and patient health outcomes using physical examination data, laboratory results, and diagnosis of 712 diabetic patients with 5,300 medical visits over 3 years before and after enrolling for PSHI. Logistic regression was used to analyze data related to age, gender, time enrolled in PSHI, and service location relative to health outcomes. Findings support the theories that accessibility increases with the provision of health insurance but also show that health outcomes do not improve after enrollment in a PSHI. This study contributes to the body of knowledge in public health policy and administration by quantifying the strength and significance of the relationship between health insurance and health outcomes and effects positive social change by measuring the effectiveness of legislation providing the uninsured with health insurance in order to improve health outcomes.
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Danis, Ajau. "Health communication and health literacy : participants perspectives on the PROSTAR Health Promotion Programme". Thesis, Liverpool John Moores University, 2006. http://researchonline.ljmu.ac.uk/5800/.
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