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- Volume 37, 2016
Annual Review of Public Health - Volume 37, 2016
Volume 37, 2016
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Defining and Assessing Public Health Functions: A Global Analysis
Vol. 37 (2016), pp. 335–355More LessGiven the broad scope and intersectoral nature of public health structures and practices, there are inherent difficulties in defining which services fall under the public health remit and in assessing their capacity and performance. The aim of this study is to analyze how public health functions and practice have been defined and operationalized in different countries and regions around the world, with a specific focus on assessment tools that have been developed to evaluate the performance of essential public health functions, services, and operations. Our review has identified nearly 100 countries that have carried out assessments, using diverse analytical and methodological approaches. The assessment processes have evolved quite differently according to administrative arrangements and resource availability, but some key contextual factors emerge that seem to favor policy-oriented follow-up. These include local ownership of the assessment process, policymakers' commitment to reform, and expert technical advice for implementation.
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Opportunities for Palliative Care in Public Health
Vol. 37 (2016), pp. 357–374More LessIn May 2014, the World Health Assembly, of the World Health Organization (WHO), unanimously adopted a palliative care (PC) resolution, which outlines clear recommendations to the United Nations member states, such as including PC in national health policies and in the undergraduate curricula for health care professionals, and highlights the critical need for countries to ensure that there is an adequate supply of essential PC medicines, especially those needed to alleviate pain. This resolution also carries great challenges: Every year over 20 million patients (of which 6% are children) need PC at the end of life (EOL). However, in 2011, approximately three million patients received PC, and only one in ten people in need is currently receiving it. We describe this public health situation and systems failure, the history and evolution of PC, and the components of the WHO public health model. We propose a role for public health for PC integration in community settings to advance PC and relieve suffering in the world.
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Racial and Ethnic Disparities in the Quality of Health Care
Vol. 37 (2016), pp. 375–394More LessThe annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.
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Rural Health Care Access and Policy in Developing Countries
Vol. 37 (2016), pp. 395–412More LessCompared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status. Nowhere is the worldwide shortage of health professionals more pronounced than in rural areas of developing countries. Sub-Saharan Africa (SSA) includes a disproportionately large number of developing countries; therefore, this article explores SSA in depth as an example. Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from underserviced areas to deliver quality health care in rural community settings.
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The Health Effects of Income Inequality: Averages and Disparities
Vol. 37 (2016), pp. 413–430More LessMuch research has investigated the association of income inequality with average life expectancy, usually finding negative correlations that are not very robust. A smaller body of work has investigated socioeconomic disparities in life expectancy, which have widened in many countries since 1980. These two lines of work should be seen as complementary because changes in average life expectancy are unlikely to affect all socioeconomic groups equally. Although most theories imply long and variable lags between changes in income inequality and changes in health, empirical evidence is confined largely to short-term effects. Rising income inequality can affect individuals in two ways. Direct effects change individuals' own income. Indirect effects change other people's income, which can then change a society's politics, customs, and ideals, altering the behavior even of those whose own income remains unchanged. Indirect effects can thus change both average health and the slope of the relationship between individual income and health.
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Previous Volumes
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Volume 45 (2024)
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Volume 44 (2023)
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Volume 43 (2022)
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Volume 42 (2021)
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Volume 41 (2020)
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Volume 40 (2019)
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Volume 39 (2018)
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Volume 38 (2017)
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Volume 37 (2016)
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Volume 36 (2015)
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Volume 35 (2014)
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Volume 34 (2013)
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Volume 33 (2012)
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Volume 32 (2011)
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Volume 31 (2010)
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Volume 30 (2009)
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Volume 29 (2008)
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Volume 28 (2007)
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Volume 27 (2006)
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Volume 26 (2005)
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Volume 25 (2004)
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Volume 24 (2003)
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Volume 23 (2002)
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Volume 22 (2001)
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Volume 21 (2000)
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Volume 20 (1999)
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Volume 19 (1998)
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Volume 18 (1997)
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Volume 17 (1996)
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Volume 16 (1995)
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Volume 15 (1994)
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Volume 14 (1993)
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Volume 13 (1992)
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Volume 12 (1991)
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Volume 11 (1990)
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Volume 10 (1989)
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Volume 9 (1988)
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Volume 8 (1987)
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Volume 7 (1986)
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Volume 6 (1985)
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Volume 5 (1984)
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Volume 4 (1983)
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Volume 3 (1982)
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Volume 2 (1981)
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Volume 1 (1980)
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Volume 0 (1932)