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The PHA - an informed, collaborative and strong advocate for public health.

 

From the journals

Strategy for reducing health inequalities in the UK

In 2009 the World Health Organization adopted the report of their Commission on the Social Determinants of Health and called on countries to take action to reduce health inequalities.

Now, in the UK, a report has been produced for the English Secretary of State for Health to propose the most effective evidence-based strategies for reducing health inequalities in England from 2010. The strategy will include policies and interventions that address the social determinants of health inequalities.

This rewiew and report was chaired by Prof Sir Michael Marmot, who previously chaired the WHO Commission on the Social Determinants.

www.ucl.ac.uk/gheg/marmotreview/FairSocietyHealthyLives


Understanding Health Inequalities
Professor Hilary Graham, Department of Health Sciences, University of York – 2009

US Publisher: www.mcgraw-hill.co.uk/openupusa/html/0335234593.html

Chapter 1 available at: www.mcgraw-hill.co.uk/openup/chapters/9780335234592.pdf

UK Publisher : http://www.mcgraw-hill.co.uk/html/0335234593.html

"...Thoroughly updated and revised, this new edition of Understanding Health Inequalities, edited by Hilary Graham, remains a welcome and timely contribution. Replete with thoughtful essays on health inequities analyzed in relation to societal structure, social position and geography . the volume provides important insights into how class, racial/ethnic, gender, and spatial health inequities are produced – and how they can be rectified.

The world economic crisis launched by the implosion of unregulated financial markets in the fall of 2008 only serves to underscore the volume's central conclusion: that government regulation and intervention, premised on a commitment to equity, is essential for tackling health inequalities. Health professionals, students, and any and all working for healthy and sustainable ways of living will benefit from this collection..." Nancy Krieger, Harvard School of Public Health, USA.

Hilary Graham and her contributors outline the enduring link between people’s socioeconomic circumstances and their health and tackle questions at the forefront of research and policy on health inequalities. These include:

  • How health is influenced by circumstances across people's lives and by the areas in which they live
  • How health is simultaneously shaped by inequalities of gender, ethnicity and socioeconomic position
  • How policies can impact on health inequalities.

Contributors: Karl Atkin, Mel Bartley, G. David Batty, David Blane, Bo Burstrom, Danny Dorling, Anne Ellaway, Hilary Graham, Barbara Hanratty, Kate Hunt, Saffron Karlsen, Catherine Law, Sally Macintyre, James Nazroo, Naomi Rudoe, Bethan Thomas, Rachel Thomson, Margaret Whitehead.

ISBN: 9780335234592
Division: Open University Press Pub Date: AUG-09


World Development Report 2010: Development and Climate Change
Published September 15, 2010

Website: http://go.worldbank.org/FTD88BBDV0

"...Poverty reduction and sustainable development remain core global priorities. A quarter of the population of developing countries still lives on less than $1.25 a day. One billion people lack clean drinking water; 1.6 billion, electricity; and 3 billion, adequate sanitation. A quarter of all developing country children are malnourished. Addressing these needs must remain the priorities both of developing countries and of development aid—recognizing that development will get harder, not easier, with climate change.

Yet climate change must urgently be addressed. Climate change threatens all countries, with developing countries the most vulnerable. Estimates are that they would bear some 75 to 80 percent of the costs of damages caused by the changing climate. Even 2°C warming above preindustrial temperatures—the minimum the world is likely to experience—could result in permanent reductions in GDP of 4 to 5 percent for Africa and South Asia. Most developing countries lack sufficient financial and technical capacities to manage increasing climate risk. They also depend more directly on climate-sensitive natural resources for income and well-being. And most are in tropical and subtropical regions already subject to highly variable climate.

Economic growth alone is unlikely to be fast or equitable enough to counter threats from climate change, particularly if it remains carbon intensive and accelerates global warming. So climate policy cannot be framed as a choice between growth and climate change. In fact, climate-smart policies are those that enhance development, reduce vulnerability, and finance the transition to low-carbon growth paths.

A climate-smart world is within our reach if we act now, act together, and act differently than we have in the past:

  • Acting now is essential or else options disappear and costs increase as the world commits itself to high-carbon pathways and largely irreversible warming trajectories.
  • Acting together is key to keeping the costs down and effectively tackling both adaptation and mitigation.
  • Acting differently is required to enable a sustainable future in a changing world. In the next few decades, the world’s energy systems must be transformed so that global emissions drop 50 to 80 percent..."

Violence prevention: the evidence

World Health Organization (WHO) and Liverpool John Moores University have launched Violence prevention: the evidence, an eight-part series of briefings on the evidence for interventions to prevent.

Website: http://www.preventviolence.info/

By spotlighting evidence for the effectiveness of interventions, Violence prevention: the evidence provides clear directions for how violence prevention funders, policy makers and programme implementers can boost the impact of their violence prevention efforts.


The most recent edition of Preventing Chronic Disease, www.cdc.gov/pcd,  looks at comprehensive cancer control.

There is also an article that is close to the theme of our recent Dunedin PHA conference – Epidemiology, Public Health, and Public Policy.

There are two articles on making diabetes services relevant to indigenous people


The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis
The Lancet, Early Online Publication, 8 July 2009

Background http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61124-7/fulltext

There is widespread concern that the present economic crisis, particularly its effect on unemployment, will adversely affect population health. We investigated how economic changes have affected mortality rates over the past three decades and identified how governments might reduce adverse effects.

Methods

We used multivariate regression, correcting for population ageing, past mortality and employment trends, and country-specific differences in health-care infrastructure, to examine associations between changes in employment and mortality, and how associations were modified by different types of government expenditure for 26 European Union (EU) countries between 1970 and 2007.

Findings

We noted that every 1% increase in unemployment was associated with a 0.79% rise in suicides at ages younger than 65 years (95% CI 0.16—1.42; 60—550 potential excess deaths [mean 310] EU-wide), although the effect size was non-significant at all ages (0.49%, −0.04 to 1.02), and with a 0.79% rise in homicides (95% CI 0.06—1.52; 3—80 potential excess deaths [mean 40] EU-wide).

By contrast, road-traffic deaths decreased by 1.39% (0.64—2.14; 290—980 potential fewer deaths [mean 630] EU-wide). A more than 3% increase in unemployment had a greater effect on suicides at ages younger than 65 years (4.45%, 95% CI 0.65—8.24; 250—3220 potential excess deaths [mean 1740] EU-wide) and deaths from alcohol abuse (28.0%, 12.30—43.70; 1550—5490 potential excess deaths [mean 3500] EU-wide).

We noted no consistent evidence across the EU that all-cause mortality rates increased when unemployment rose, although populations varied substantially in how sensitive mortality was to economic crises, depending partly on differences in social protection. Every US$10 per person increased investment in active labour market programmes reduced the effect of unemployment on suicides by 0.038% (95% CI −0.004 to −0.071).

Interpretation

Rises in unemployment are associated with significant short-term increases in premature deaths from intentional violence, while reducing traffic fatalities. Active labour market programmes that keep and reintegrate workers in jobs could mitigate some adverse health effects of economic downturns.


Managing the Health effects of Climate Change

London, UK, May, 2009

A collaboration between The Lancet and University College London, UK

"...setting out how climate change over the coming decades could have a disastrous effect on health across the globe. The report examines practical measures that can be taken now and in the short and medium term to control its effects..."

Website: http://www.thelancet.com/climate-change

"...Climate change could be the biggest global health threat of the 21st century. Effects on health of climate change will be felt by most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, the earth’s average surface temperature rises are likely to exceed the safe threshold of 2°C above pre-industrial average temperature.

"This report outlines the major threats—both direct and indirect—to global health from climate change through changing patterns of disease, water and food insecurity, vulnerable shelter and human settlements, extreme climatic events, and population migration. Although vector-borne diseases will expand their reach and death tolls, the indirect effects of climate change on water, food security, and extreme climatic events are likely to have the biggest effect on global health.

"A new advocacy and public health movement is needed urgently to bring together governments, international agencies, non-governmental organisations, communities, and academics from all disciplines to adapt to the effects of climate change on health."

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