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The Prevention of Global Chronic Disease: Academic Public Health's New Frontier
No full textA confluence of stimuli is propelling academic public health to embrace the prevention of chronic disease in developing countries as its new frontier. These stimuli are a growing recognition of the epidemic, academia's call to reestablish public health as a mover of societal tectonics rather than a handmaiden to medicine's focus on the individual, and the turmoil in the US health system that makes change permissible. To enable graduating professionals to participate in the assault on chronic diseases, schools of public health must allocate budgets and other resources to this effort. The barriers to chronic disease prevention and risk factor modulation are cultural and political; confronting them will require public health to work with a wide variety of disciplines. Chronic disease will likely become the dominant global public health issue soon. In addressing this issue, academia needs to lead, not follow. (Am J Public Health. Published online ahead of print June 16, 2011: e1-e5. doi:10.2105/AJPH.2011.300147)
Comparative Effectiveness Research and Patients with Multiple Chronic Conditions.
No full textThe aim of comparative effectiveness research (CER) is to improve the quality, effectiveness, and efficiency of health care and to help patients, health care professionals, and purchasers make informed decisions. CER is moving forward, with recently defined priorities and a newly funded Patient-Centered Outcomes Research Institute, which we hope will survive congressional cost cutting. To achieve its goals, CER must address the population that consumes the most health care: patients with multiple chronic conditions, especially those with combinations of behavioral and physical conditions such as dementia, mental illness, end-stage renal disease, and heart failure. Such patients account for more than . .
Dialogical Action: Moving From Community-Based to Community-Driven Participatory Research
No full textProponents of community-based research advocate for the active involvement and engagement of community members, citing improved construct validity, intervention efficacy, and accountability. However, to create the conditions in which expertise is mutually constructed and in which no one is the object of research, a reconsideration of the fundamental ethos of community involvement and engagement is required. In this article, we seek to accomplish two goals: (a) to briefly assess the definitions of community health, focus groups, and dissemination that are often used in community-based research; and (b) to introduce an application of dialogical action that goes beyond traditional focus group methodology to promote the creation of an evolving and dynamic dialogue among campus and community stakeholders. An urban case study is presented
Race, Ethnicity, and NIH Research Awards
No full textWe investigated the association between a U.S. National Institutes of Health (NIH) R01 applicant’s self-identified race or ethnicity and the probability of receiving an award by using data from the NIH IMPAC II grant database, the Thomson Reuters Web of Science, and other sources. Although proposals with strong priority scores were equally likely to be funded regardless of race, we find that Asians are 4 percentage points and black or African-American applicants are 13 percentage points less likely to receive NIH investigator-initiated research funding compared with whites. After controlling for the applicant’s educational background, country of origin, training, previous research awards, publication record, and employer characteristics, we find that black applicants remain 10 percentage points less likely than whites to be awarded NIH research funding. Our results suggest some leverage points for policy intervention
State of Health Equity Movement, 2011 Update Part C: Compendium of Recommendations DRA Project Report No. 11-03
Get PDFState of Health Equity Movement, 2011 Update
Part C: Compendium of Recommendations
DRA Project Report No. 11-0
Secondhand Smoke Exposure Among Hispanics/Latinos Living in Multiunit Housing: Exploring Barriers to New Policies
No full textPurpose. Despite a high prevalence of voluntary home smoking bans and laws protecting Californians from exposure to secondhand smoke (SHS) in the workplace, many Hispanic/Latino (H/L) residents of multiunit housing (MUH) are potentially exposed to SHS from neighboring apartments. An advocacy/policy intervention was implemented to reduce tobacco-related health disparities by encouraging H/L living in MUH to implement voluntary policies that reduce exposure to SHS. This article presents findings from qualitative and quantitative data collected during development of the intervention, as well as preliminary results of the intervention.
Design, Setting, and Subjects. MUH residents in Southern California participated in focus groups (n = 48), door-to-door surveys (n = 142), and a telephone survey (n = 409).
Measures. Exposure to SHS, attitudes toward SHS, and attitudes toward policies restricting SHS in MUH were assessed.
Results. H/L MUH residents reported high levels of exposure to SHS and little ability to protect themselves and their families from SHS. Respondents expressed positive attitudes toward adopting antismoking policies in MUH, but they also feared retaliation by smokers. The cultural values of familismo, respeto, simpatía, and personalismo influenced their motivation to protect their families from SHS as well as their reluctance to ask their neighbors to refrain from smoking. Nonsmokers were more likely to favor complete indoor and outdoor smoking bans in MUH, whereas smokers were more likely to favor separate smoking areas. The Regale Salud advocacy/policy intervention, implemented to reduce SHS exposure, prompted the passage of seven voluntary policies in apartment complexes in Southern California to prevent smoking in MUH.
Conclusions. H/L in California support voluntary policies, local ordinances, and state laws that prevent exposure to SHS in MUH, especially those that are consistent with H/L cultural values and norms for interpersonal communication
Using the Tax System to Promote Physical Activity: Critical Analysis of Canadian Initiatives
No full textIn Canada, tax incentives have been recently introduced to promote physical activity and reduce rates of obesity. The most prominent of these is the federal government's Children's Fitness Tax Credit, which came into effect in 2007. We critically assess the potential benefits and limitations of using tax measures to promote physical activity. Careful design could make these measures more effective, but any tax-based measures have inherent limitations, and the costs of such programs are substantial. Therefore, it is important to consider whether public funds are better spent on other strategies that could instead provide direct public funding to address environmental and systemic factors. (Am J Public Health. Published online ahead of print June 16, 2011:e1-e7. doi:10.2105/AJPH.2011.300201)
Integration of Social Epidemiology and Community-Engaged Interventions to Improve Health Equity
No full textThe past quarter century has seen an explosion of concern about widening health inequities in the United States and worldwide. These inequities are central to the research mission in 2 arenas of public health: social epidemiology and community-engaged interventions. Yet only modest success has been achieved in eliminating health inequities. We advocate dialogue and reciprocal learning between researchers with these 2 perspectives to enhance emerging transdisciplinary language, support new approaches to identifying research questions, and apply integrated theories and methods. We recommend ways to promote transdisciplinary training, practice, and research through creative academic opportunities as well as new funding and structural mechanisms
Maryland group to tackle health disparities
No full textThe state has assembled a work group of top health professionals to come up with ways to reduce health disparities among racial and ethnic groups, Lt. Gov. Anthony G. Brown announced Thursday.
The seven-member panel, to be headed by Dr. E. Albert Reece, dean of the University of Maryland School of Medicine, will identify new legislation and financial incentives that can be used to bring equality to healthcare.
While studies have shown the overall life expectancy in the United States has improved, there are still large differences between the health of minorities and that of whites
Social and Cultural Factors Influence African American Men's Medical Help Seeking
No full textObjective: To examine the factors that influenced African American men’s medical help seeking. Method: Thematic analysis of 14 focus groups with 105 older, urban African American men. Results: African American men described normative expectations that they did not go to the doctor and that they were afraid to go, with little explanation. When they did go, men reported that they were particularly uncomfortable with the tone physicians used when talking to them. Providers often made recommendations but offered the men little useful information on how to make lifestyle and behavior changes. Following receipt of care, spouses, medical test results, and men’s desire to fulfill social roles were key motivating and instrumental factors in following medical advice. Conclusions: African American men’s medical help seeking seemed to be negatively influenced by social norms and patient-provider interactions but positively influenced by spouses and the desire to fulfill social roles