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Health in humanitarian emergencies : principles and practice for public health and healthcare practitioners
\"The fields of Global Health and Global Emergency Medicine have attracted increased interest and study. There has been tremendous growth in the educational opportunities around humanitarian emergencies, however educational resources have not yet followed the same growth. This book corrects this trend, offering a comprehensive single resource dedicated to health in humanitarian emergencies. Providing an introduction to the public health principles of response to humanitarian emergencies, the text also emphasizes the need to coordinate the public health and emergency clinical response within the architecture of the greater response effort. With contributing authors among some of the world's leading health experts and policy influencers in the field, the content is based on best practices, peer reviewed evidence and expert consensus. The text acts as a resource to clinical and public health practitioners, graduate level students, and individuals working in response to humanitarian emergencies for government agencies, international agencies, and NGOs\"--Provided by publisher.
Book
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.
eBook
Health economics
This book introduces students to the growing research field of health economics. Rather than offer details about health systems without providing a theoretical context, Health Economics combines economic concepts with empirical evidence to enhance readers' economic understanding of how health care institutions and markets function. The theoretical and empirical approaches draw heavily on the general field of applied microeconomics, but the text moves from the individual and firm level to the market level to a macroeconomic view of the role of health and health care within the economy as a whole. The book takes a global perspective, with description and analysis of institutional features of health sectors in countries around the world. This second edition has been updated to include material on the U.S. Patient Protection and Affordable Care Act, material on the expansion of health insurance in Massachusetts, and an evaluation of Oregon's Medicaid expansion via lottery. The discussion of health care and health insurance in China has been substantially revised to reflect widespread changes there. Tables and figures have been updated with newly available data. Also new to this edition is a discussion of the health economics literature published between 2010 and 2015. The text includes readings, extensive references, review and discussion questions, and exercises. A student solutions manual offers solutions to selected exercises. Downloadable supplementary material is available for instructors. -- Provided by publisher.
Book
Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: a qualitative study
Background
People experiencing homelessness have unique health needs and barriers to medical and behavioral health care (mental health, substance use disorder, and overall well-being) compared to housed people. It remains unclear why many people experiencing homelessness do not access care when community-based homeless health care resources are available at low or no cost. This qualitative study examined perspectives of people experiencing homelessness and staff members at community-based homeless health and service organizations in San Francisco’s Mission District on unmet medical and behavioral health needs and barriers to accessing care.
Methods
We conducted 34 interviews between September and November 2020: 23 with people experiencing homelessness and 11 with staff at community-based homeless health and service organizations in the Mission District. Qualitative interviews were transcribed, coded, and analyzed using the Framework Method on NVivo Qualitative Data Analysis Software.
Results
Both staff and homeless participants reported unmet and common health needs of mental illness, physical injury and disability, food and nutrition insecurity, and substance use disorder. Barriers to care included negative prior health care experiences, competing priorities, and provider turnover. Recommendations for improving services included building more trust with people experiencing homelessness by training clinic staff to treat patients with respect and patience and expanding clinical outreach and health education programs.
Conclusions
People experiencing homelessness face many different health needs and barriers to care, some of which community-based organizations have the ability to address. These findings can help inform future strategies for homeless health care programs to identify and target the specific unmet health needs and barriers to care of people experiencing homelessness in their communities.
Journal Article
Exploring why global health needs are unmet by research efforts: the potential influences of geography, industry and publication incentives
Background
It has been well established that research is not addressing health needs in a balanced way — much more research is conducted on diseases with more burden in high-income countries than on those with more burden in lower-income countries. In this study, we explore whether these imbalances persist and inquire about the possible influence of three factors, namely geography, industry and publication incentives.
Methods
We use WHO data on the Global Burden of Disease as a proxy measure of health needs and bibliometric information as a proxy for research efforts. Scientific publications on diseases were collected from MEDLINE using MeSH terms to identify relevant publications. We used Web of Science to collect author affiliations and citation data. We developed a correspondence table between WHO ICD-10 and MeSH descriptors to compare global health needs and research efforts. This correspondence table is available as supplementary material.
Results
Research output is heavily concentrated in high-income countries and is mainly focused on their health needs, resulting in a relative lack of attention to diseases in lower income countries. A new finding is that diseases with a similar burden in high- and middle-income countries are also under-researched, both globally and in relation to disease burden in high- and middle-income countries. Global industrial R&D is found to be very similar to the focus of public research. Diseases more prevalent in high-income countries generate ten-fold more research attention than those in low-income countries. We find no discernible preference towards diseases of high-income countries versus those of low-income countries in the top 25% most prestigious journals. However, in middle-income countries, citation rates are substantially lower for diseases most prevalent in low- and middle-income countries.
Conclusions
From a global perspective, the imbalance between research needs and research efforts persists as most of the research effort concentrates on diseases affecting high-income countries. Both pharmaceutical companies and the public sector also tend to focus on diseases with more burden in high-income countries. Our findings indicate that researchers in middle-income countries receive more citations when researching diseases more prevalent in high-income countries, and this may divert the attention of researchers in these countries from diseases more prevalent in their contexts.
Journal Article
Accelerating progress in obesity prevention
One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress.
Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention.
The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention.
eBook
Underserved and socially disadvantaged groups and linkages with health and health care differentials
The contributors to this latest volume of Research in the Sociology of Health Care investigate macro-level system issues and micro-level issues involving the socially disadvantaged and underserved. Looking specifically at the factors impacting on health and health care differentials, this book is an examination of the health and health care issues of both patients and providers of care in the United States and around the globe. Chapters focus on linkages to policy, population concerns and patients and providers of care as ways to meet health care needs. -- Provided by publisher.
Book
Barriers to improvement of mental health services in low-income and middle-income countries
Despite the publication of high-profile reports and promising activities in several countries, progress in mental health service development has been slow in most low-income and middle-income countries. We reviewed barriers to mental health service development through a qualitative survey of international mental health experts and leaders. Barriers include the prevailing public-health priority agenda and its effect on funding; the complexity of and resistance to decentralisation of mental health services; challenges to implementation of mental health care in primary-care settings; the low numbers and few types of workers who are trained and supervised in mental health care; and the frequent scarcity of public-health perspectives in mental health leadership. Many of the barriers to progress in improvement of mental health services can be overcome by generation of political will for the organisation of accessible and humane mental health care. Advocates for people with mental disorders will need to clarify and collaborate on their messages. Resistance to decentralisation of resources must be overcome, especially in many mental health professionals and hospital workers. Mental health investments in primary care are important but are unlikely to be sustained unless they are preceded or accompanied by the development of community mental health services, to allow for training, supervision, and continuous support for primary care workers. Mobilisation and recognition of non-formal resources in the community must be stepped up. Community members without formal professional training and people who have mental disorders and their family members, need to partake in advocacy and service delivery. Population-wide progress in access to humane mental health care will depend on substantially more attention to politics, leadership, planning, advocacy, and participation.
Journal Article