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Societal Influences (societal + influence)
Selected AbstractsIntellectual Disabilities and Socioeconomic Inequalities in Health: An Overview of ResearchJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2005Hilary Graham Background, There is an enduring association between socioeconomic position and health, both over time and across major causes of death. Children and adults with intellectual disabilities are disproportionately represented among the poorer and less healthy sections of the population. But research on health inequalities, and on the broader societal influences on health, has yet to be integrated into perspectives and policy for people with intellectual disabilities. Methods, The paper reviews evidence on the patterns and causes of socioeconomic inequalities in health. Results, It points to evidence that socioeconomic position is the fundamental determinant of health, drawing on longitudinal studies to highlight how it exerts its influence on health from before birth and across the lifecourse. The factors shaping an individual's socioeconomic position are also discussed. Conclusions, The paper concludes by identifying research and policy challenges. [source] Media coverage of ,decades of disparity' in ethnic mortality in AotearoaJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2004Darrin Hodgetts Abstract For some time we have known that factors such as economic prosperity, community cohesion, and social justice bear on health. These societal influences are particularly pertinent to the health of indigenous groups, such as Maori, who are still responding to processes of colonization. In July 2003 the New Zealand Ministry of Health published a report entitled ,Decades of Disparity', which proposed (among other things) that neoliberal policies of the last two decades impacted negatively on mortality rates for Maori and Pacific peoples, when compared with Pakeha. In this article we explore media coverage of this report through analyses of media releases, radio, television and newspaper items. It is argued that as the story evolved media increasingly challenged the importance of societal determinants of health, preferring individual level explanations. As a result coverage failed to give due emphasis to structural health concerns for Maori, which necessitate social change. Copyright © 2004 John Wiley & Sons, Ltd. [source] Evolving patterns of tobacco use in northern SwedenJOURNAL OF INTERNAL MEDICINE, Issue 6 2003B. Rodu Abstract., Rodu B, Stegmayr B, Nasic S, Cole P, Asplund K (University of Alabama at Birmingham, Birmingham, AL, USA; Umeå Hospital, Umeå, Sweden). Evolving patterns of tobacco use in northern Sweden. J Intern Med 2003; 253: 660,665. Background and objectives., Cross-sectional data from northern Sweden suggest that the increased use of Swedish moist snuff (snus) may have contributed to a decline in the prevalence of smoking, especially amongst men. This study describes the evolving patterns of tobacco use in this population over the period 1986,1999. Design., This is a prospective follow-up study of 1651 men and 1756 women, aged 25,64 years, who were enrolled in the northern Sweden MONICA project (entry in 1986, 1990, 1994) and who were followed-up in 1999. Information on tobacco use at entry and at follow-up was used to describe the stability of tobacco use over a period of 5,13 years ending in 1999. Results., Snus was the most stable form of tobacco use amongst men (75%); only 2% of users switched to cigarettes and 20% quit tobacco altogether. Smoking was less stable (54%); 27% of smokers were tobacco-free and 12% used snus at follow-up. Combined use (smoking and snus) was the least stable (39%), as 43% switched to snus and 6% switched to cigarettes. Former users of both products were much less stable than former users of either cigarettes or snus. The stability of smoking amongst women was 69%, which was higher than that amongst men (P < 0.05). Conclusions., The use of snus played a major role in the decline of smoking rates amongst men in northern Sweden. The evolution from smoking to snus use occurred in the absence of a specific public health policy encouraging such a transition and probably resulted from historical and societal influences. [source] Tobacco Screening Multicomponent Quality Improvement Network Program: Beyond EducationACADEMIC EMERGENCY MEDICINE, Issue 11 2009Sharon Kimmel PhD Abstract Objectives:, Due to the addictive nature of the disease and interrelated societal influences on the behavior of tobacco use, repeated interventions are often required before people successfully stop using tobacco. Our objective was to implement a multicomponent clinical intervention initiative enabling health care providers to effectively screen for tobacco use. We also sought to describe changes in emergency medicine providers' documentation of cessation advice to tobacco users. Methods:, The intervention was conducted at three emergency departments (EDs) and four clinics at a community-based teaching hospital and health network. Health care providers with the opportunity to identify and counsel tobacco-using patients in ambulatory health care settings were the study population. The authors initiated a quality improvement initiative for tobacco screening that employed a multicomponent strategy to facilitate systemic changes that support 100% tobacco use identification, documentation, and counseling. Baseline, posteducation, and post,wrap-around documented screening rates were compared within each site across the intervention. Cumulative ED baseline, posteducation, and post,wrap-around rates of provider advice to tobacco users were compared across the intervention. Percentage of possible available gain was calculated in consideration of a 100% ceiling effect. Statistical analysis was performed using SPSS and MetStat. Descriptive statistics and Pearson's chi-square cell frequency were used to analyze and compare sites. Fisher's exact test was used to compare those tests with a chi-square cell frequency of five or less. The statistical tests used for pre-/postintervention percentage comparisons by site had power between 80% and 90%, detecting differences of 10% and 20% or more at a 0.05 level of significance. Results:, Significant increases in posteducation screening rates for all ED sites complemented significant increases in ED post,wrap-around intervention screening rates. Significant increases in ED provider documented cessation advice were also noted. Conclusions:, This initiative successfully changed tobacco screening behavior of health care providers at all sites. It was particularly successful in the ED, typically an environment less likely to be conducive to preventive health interventions. [source] | ||||||||||