Equity,health, and health care

Equity goals, such as equal treatment for equal need or equality of access, commonly take pride of place among the aims of health policy. But do these conceptions, or others derived from more fundamental philosophical systems such as those of the utilitarians or John Rawls, successfully capture the way in which the term equity is generally used? If not, is it possible to find some interpretation that can command a greater consensus? This paper answers no to the first question and yes to the second. It is argued that the standard conceptions of equity ignore the processes by which health states are determined and hence the extent to which they arise from factors beyond individual control. An alternative conception is proposed that directly incorporates these considerations.     

Adjudicated health: incarcerated women and the social construction of health

Women in prison have been identified as one of the most vulnerable groups of women in society. This study examined the social construction of health through weekly interviews with 20 incarcerated women over 15 months. The study was grounded within a critical hermeneutic context using interpretive methods for data analysis. Adjudicated health reflects the social construction of health for women prior to and during imprisonment, and is dually grounded in protection and punishment — a construction in direct apposition to the department of correction's conceptualization of health. Implications for the health of women during imprisonment and post-release are discussed. This revised version was published online in July 2006 with corrections to the Cover Date.     

Mental health parity and newborns' and mothers' health protection--HCFA. Solicitation of comments

This document is a request for comments regarding issues under the Mental Health Parity Act of 1996 (MHPA) and the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). The Department of Labor and the Department of Health and Human Services (collectively, the Departments) have received comments from the public on a number of issues arising under both MHPA and NMHPA. Further comments from the public are welcome.     

Why public opinion changes: the implications for health and health policy

Research on stasis or change in public opinion toward health, health policy, and medical care tends to focus on short-term dynamics and to emphasize the impact of discrete messages communicated by individual speakers in particular situations. This focus on what we term "situational framing," though valuable in some respects, is poorly equipped to assess changes that may occur over the longer term. We focus, instead, on "structural framing" to understand how institutionalized public health and health care policies impact public opinion and behavior over time. Understanding the dynamics of public opinion over time is especially helpful in tracking the political effects of the Patient Protection and Affordable Care Act of 2010 as it moves from the debate over its passage to its implementation and operation.     

National health insurance and the new health occupations: nurse practitioners and physicians' assistants

This article considers a number of issues which might arise in formulating policy for new health occupations. Its particular focus is on nurse practitioners and physicians' assistants and their treatment under potential national health insurance arrangements. The development and expansion of these occupations are described, as is the evidence on their performance with respect to the quality of medical care provided, the impact on the cost of such care, and changes in access to care. We then discuss several issues which might arise in the context of national health insurance legislation, including reimbursement rates and methods, certification and licensure, training subsidies, deployment incentives, and compatibility with an increased supply of physicians.     

Integration and offender mental health

Integrated care can introduce seamless coordinated pathways that are focused around the individual needs of patients, helping to prevent missed opportunities for intervention. Within offender healthcare, sequential funnelling through designated areas where screening can take place, along with co-location of services, lends itself to integrated working, at least in theory. However, within the offender healthcare pathway, service fragmentation and autonomous, disconnected (often referred to as siloed) working, has historically been the norm. If commissioned and designed to ensure and incentivise connections between services, whilst developing high quality service-focused research activities, pathways could enable clinical and social interventions, and outcomes, on a public health scale for these highly morbid populations. As such, offender healthcare offers a real opportunity to model integration for wider introduction across other health and social care areas. Discussed within is the call for integration, its concept, and its role within offender healthcare.     

Human rights and health law

Important statutory and common law developments are changing the landscape of health law in Australia. Human rights considerations are formally included amongst the factors to be applied in the interpretation of statutory provisions and evaluating the lawfulness of actions on the part of government instrumentalities. The Human Rights Act 2004 (ACT) and the Charter of Human Rights and Responsibilities Act 2006 (Vic) create limited bills of rights at State/Territory level in two Australian jurisdictions. Although neither is entrenched, they have the potential to make it more difficult for government to promulgate laws that are inconsistent with human rights, as defined. They will have important repercussions for the evolution of health law in these jurisdictions. The decision of Royal Women's Hospital v Medical Practitioners Board (Vic) [2006] VSCA 85 by the Victorian Court of Appeal has also provided a legitimation for parties to incorporate human rights perspectives in submissions about the interpretation of statutory provisions where health rights are in conflict.     

公共健康和强制许可制度

TRIPS协定将传统的专利保护客体扩大到所有技术领域的任何发明,将医药产品及方法纳入了专利保护的范围,以致受专利保护的药品价格大幅上扬,在一些国家尤其是发展中国家和不发达国家产生健康危机。本文试图在分析《多哈宣言》及其《执行决议》中关于强制许可制度规定的基础上,提出我国可将其作为解决公共健康危机的基本途径。     

Fear of victimization and health

Fear of victimization may have consequences for subjective well-being. I develop and test a model linking fear of victimization to subjective health. I hypothesize that two processes link fear to subjective health-psychological and behavioral. Specifically, I hypothesize that fear of victimization increases psychological distress, and fear decreases outdoor physical activity, especially walking. High levels of psychological distress and low levels of walking, in turn, are associated with poor self-reported health. I find empirical support for the hypothesized processes in a representative national sample of 2031 adults aged 18 to 90 interviewed by telephone in 1990. The negative association between fear and health is explained largely by psychological distress and walking. However, a significant direct effect remains. I conclude with suggestions for future research linking crime and health, focusing on the need for collecting information on community disorganization. Community context is likely the ultimate exogenous variable-the one that sets in motion the destructive cycle of fear, distress, inactivity, and poor health described here.