China
Africa
Explore chapters and articles related to this topic
The philosophical implications of fundamental cause theory
Published in Sridhar Venkatapuram, Alex Broadbent, The Routledge Handbook of Philosophy of Public Health, 2023
Although time and space preclude a deeper analysis of the debate itself and the implications for FCT, the issues involved have significant normative and policy ramifications. Specifically, at what points and at which levels should policymakers intervene? Should proportionally larger efforts be expended on increasing access to healthcare technologies, or on increasing health literacy, or on radical income redistribution? The latter approach would most likely be favored by Wilkinson and colleagues, at least as a means of building the social capital they deem the most powerful cause of unequal health outcomes. Yet, if unequal social conditions cause unequal health outcomes primarily because of unequally distributed access to material resources, relieving such deprivation and “giving people more things” would seem to be the highest priority. But even in the latter case, questions abound. Which things are most significant? Access to pharmaceutical products, like the statins studied in the Chang-Lauderdale study? Or access to early childhood education, as favored by many social epidemiologists?
Personal Health Engagement
Published in Salvatore Volpe, Health Informatics, 2022
In 2016, Meaningful Use Stage 3 transitioned into the MIPS program under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The requirements for patient access were adopted into the MIPS program. While the “one patient” requirement was maintained, the requirement for patients or caregivers to “view, download, and transmit” their health information evolved to include the ability for patients to obtain their data through an Application Programming Interface (API) using an application of their choice. The 2020 rules assign significant weight to patient access.34 CMS stated that the emphasis was appropriate: We believe that the emphasis placed on the Provide Patients Electronic Access to their Health Information measure through the redistribution of points reflects our emphasis on patient engagement in their health care and patient’s electronic access of their health information through the use of APIs. They further state that this redistribution “allows for health IT solutions that encourage adoption and innovation.”35 (See Chapter 6.)
New Public Management in Healthcare
Published in Rui Nunes, Healthcare as a Universal Human Right, 2022
Even so, there are important reasons to consider the necessity of an adequate public sector to deliver high-quality public services and that these services should be financed mainly by taxation and not by charging the consumer directly. In accordance with Davis (1998), “the impossibility of charging for everything,” “the problem of price discrimination,” and even “the failure of private capital markets” justifies this approach. Indeed, and beyond considerations of the ideological and redistributive nature of universal access to certain economic goods, the financing of many activities valued by most people is sometimes more feasible if done through taxes than if implemented using the logic of the user/payer. Eventually, it is carried out according to the criteria of justice since taxes are more than proportional (progressive) in relation to the income of individual citizens. Redistribution through taxes makes access to public services fairer and more equitable.
Bioethics, globalization and pandemics
Published in Global Bioethics, 2022
Globalization has had a huge impact on the redistribution of wealth in the world. Some of this redistribution has been positive and many countries have gained in the process. For instance, some 25 years ago, the average standard of living in high-income countries such as France or Germany was twenty times higher than China, India or other Asian economies. Today this gap has been cut in half and people have much better living conditions (Bourguignon, 2015, p. 2). However, even if inequality among countries has improved in this period, globalization has not necessarily benefited everyone within countries and in many cases has brought about more inequality. Income inequality has become worse: since 1990 income inequality has increased in most high-income countries and in many middle- and low-income countries (LMIC). Today, 71% of the world’s population lives in countries where inequality has grown during this period (UN, 2020). Even in high-income countries, such as the US, income inequality has increased by about 20% from 1980 to 2016 (Horowitz et al., 2020). Around 1980, the top 1% of US income earners received only 12% of the nation’s income; by 2007 the top 1% get in one week 40% more than the bottom fifth receive in a year; the top 0.1 percent received in a day and a half about what the bottom 90% received in a year; and the richest 20% of income earners earn in total after tax more than the bottom 80% combined (Stiglitz, 2012). In different degrees, but this situation has been going on in many countries in the world (Bourguignon, 2015).
“It is very difficult in this business if you want to have a good conscience”: pharmaceutical governance and on-the-ground ethical labour in Ghana
Published in Global Bioethics, 2022
Kate Hampshire, Simon Mariwah, Daniel Amoako-Sakyi, Heather Hamill
However, there are significant risks, both for those working on the “front line” and for wider public health. First, there is the threat of legal penalties. Although rarely imposed, Joseph and Isaac could face heavy fines and the closure of their businesses for acting as they do. Likewise, Mensah could be sanctioned if his superiors found out that he was “turning a blind eye” to certain infringements (although they might well be doing the same). Perhaps more significant, though, is the burden of ethical labour, borne disproportionately by those “on the ground” (cf Kingori, 2013). This is in some ways reminiscent of “task shifting” in healthcare: the redistribution of tasks from more-qualified to less-qualified health workers, advocated by the World Health Organisation as a “pragmatic response to health workforce shortages” (WHO, 2008, p. 3; Zachariah et al., 2009), but criticised by others as unfairly over-burdening poorly-paid community health workers (Smith et al., 2014). The same could be said for the downward shifting of the ethical labour of pharmaceutical governance from highly-paid policy-makers and regulators to those working on the ground, operating on minimal margins, and bearing the moral, professional and legal risks individually.
The relationship of foetal superior mesenteric artery blood flow and the time to first meconium passage in newborns with late-onset foetal growth restriction
Published in Journal of Obstetrics and Gynaecology, 2022
Melih Velipasaoğlu, Ozge Surmeli Onay, Adviye Cakil Saglık, Ozge Aydemir, Huseyin Mete Tanır, Ayşe Neslihan Tekin
It is widely accepted that an optimal foetal growth requires an optimal placental circulation. Foetal growth restriction (FGR) is an important risk factor for perinatal mortality and morbidity. Also, the entity of foetal growth restriction is commonly associated with placental compromise and foetal hemodynamic disturbances such as absent or reversed end-diastolic blood flows (AREDF) in umbilical artery detected by Doppler velocimetry and redistribution of blood flow within the foetal body (Kiserud et al. 2006). The aim of redistribution phenomenon is to supply the oxygen and nutrients to vital organs to the detriment of skeletal muscle, gastrointestinal tract and kidneys. This foetal adaptation is named as ‘brain sparing’ effect because of the most protected target organ is brain (Stampalija et al. 2016).