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The article reports on the announcement of Vision Care Section of the American Public Health Association in the U.S. of its awards program for 1987. The association solicits nominations in the three categories of awards including distinguished achievement, outstanding student and outstanding paper or project. The distinguished achievement award is the highest honor bestowed by the Vision Care Section, designed to recognize the leaders in vision care and public health. The outstanding student award provides recognition to a student who has demonstrated the ability in the promotion of vision care in the public health field. The paper or project award is designed to recognize an individual, institution, or group that have significantly contributed to the advancement of vision care.

Health planning in this paper is considered as a developmental process in which different types of planning appear at different times. These types are discussed and the place in the complex health care system developing in the United States is assessed. [ABSTRACT FROM AUTHOR]

Predictions that measles would be eradicated through vaccination have not been fulfilled. The reasons for this failure are analyzed in this paper, and the possibilities for successful action against measles are outlined. [ABSTRACT FROM AUTHOR]

The following six papers examine a broad range of disease processes and relevant social conditions, such as urban living, social disorganization, poverty, socioeconomic status, and emotional conflict and instability, and show that much illness and death is caused, directly and indirectly, by social and personality factors. [ABSTRACT FROM AUTHOR]

This paper examines the uses of some health status indices in measuring equity of access to medical care. Empirical examples are provided using data from national surveys of the U.S. population conducted from 1964 through 1976. A simple indicator, mean number of physician visits, suggests that between 1963 and 1976 the poor improved their position relative to the rest of the population and, indeed, currently enjoy the highest level of access. However, a second measure, the use-disability ratio indicates that the poor may still receive less care relative to their need. A third measure, the symptoms-response ratio suggests how norms of appropriate behavior might be incorporated into an access measure. [ABSTRACT FROM AUTHOR]

The article focuses on the cases of infant mortality and morbidity in England in 1909 until the present. In 1909, there are bout 120 of the 1,000 infants born alive died before reaching their first birthday not only in England but also to countries which were now considered developed or industrialized. However, infant mortality today in most rich countries had been cut down to about 10 percent than what it was 70 years ago which is primarily because of better social welfare and public health services. One reason for the adequate decline in infant mortality during the twentieth century is the improvement in nutrition which plays a very important role in infant mortality. In the decline in the U.S. infant mortality is the spread of various family planning methods.

The threshold of the new millennium offers an opportunity to celebrate remarkable past achievements and to reflect on promising new directions for the field of public health. Despite historic achievements, much will always remain to be done (this is the intrinsic nature of public health). While every epoch has its own distinct health challenges, those confronting us today are unlike those plaguing public health a century ago. The perspectives and methods developed during the infectious and chronic disease eras have limited utility in the face of newly emerging challenges to public health. In this paper, we take stock of the state of public health in the United States by (1) describing limitations of conventional US public health, (2) identifying different social philosophies and conceptions of health that produce divergent approaches to public health, (3) discussing institutional resistance to change and the subordination of public health to the authority of medicine, (4) urging a move from risk factorology to multilevel explanations that offer different types of intervention, (5) noting the rise of the new "right state" with its laissez-faire attitude and antipathy toward public interventions, (6) arguing for a more ecumenical approach to research methods, and (7) challenging the myth of a value-free public health. (Am J Public Health. 201)0;90:25-33) [ABSTRACT FROM AUTHOR]

This paper traces the development of the US federal government's program to provide personal and public health services to American Indians and Alaska Natives since the 1940s. Minimal services had been provided since the mid 19th century through the Bureau of Indian Affairs of the Department of the Interior. As a result of attempts by western congressmen to weaken and destroy the bureau during the 1940s, responsibility for health services was placed with the US Public Health Service. The transfer thus created the only US national health program for civilians. providing virtually the full range of personal and public health services to a defined population at relatively low cost. Policy changes since the 1970s have led to an emphasis on self-determination that did not exist during the 1950s and 1960s. Programs administered by tribal governments tend to be more expensive than those provided by the Indian Health Service, but appropriations have not risen to meet the rising costs, nor are the appropriated funds distributed equitably among Indian Health Service regions. The result is likely to be an unequal deterioration in accessibility and quality of care. [ABSTRACT FROM AUTHOR]

Objectives. This paper analyzes the impact of seven chronic conditions (three nonfatal: arthritis, visual impairment, hearing impairment; four fatal: ischemic heart disease, chronic obstructive pulmonary disease, diabetes mellitus, malignant neoplasms) on US adults aged 18 and older. Impact refers to how readily a condition prompts activity limitations, physician visits, and hospital stays. Methods. Data come from three national health surveys and vital statistics. For comparability, a single disease classification scheme was applied, and new rates were estimated. Frequency, impact, and prominence of the target conditions are studied via rates, ratios of rates, and ranks, respectively. Results. In young adulthood, the nonfatal conditions prompt limitations less readily than do the fatal ones, but by older ages, arthritis and visual impairment have a limiting impact equivalent to that of fatal conditions. Despite high prevalence and limitations, nonfatal conditions stand well below fatal conditions for health services use. Conclusions. Although statistics on frequency, impact, and prominence all indicate conditions' "importance," they give only weak clues about specific service needs of affected persons. The persistent finding that nonfatal conditions do not receive health services care commensurate with their prevalence and impact reflects long-standing imbalanced attention on fatal conditions in research and medical care. [ABSTRACT FROM AUTHOR]

Abstract: One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per ¢ of adults 18-65 years of age to be participating regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure lime physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per ¢ expended more than 1600 kcals/week in leisure time physical activity, and 10 per ¢ met the DHHS physical activity requirements. (Am J Public Health 1987:77:455-460.) [ABSTRACT FROM AUTHOR]

Abstract: This paper concerns care of refugees from Southeast Asia who speak little English and are relatively unfamiliar with the formal health care system in the United States. It aims to demystify the behaviors of refugee patients and to support health practitioners who are attempting to care for them. Western medicine is discussed in terms of the expectations that refugees tend to hold of it, and of the conflicts with Southeast Asian beliefs and practices which it presents. Despite language differences, health care agents can increase the effectiveness of their communication with persons from Southeast Asia, primarily by allowing for their viewpoints. Topics discussed are: the first encounter with a refugee patient: use of interpreters; obtaining informed consent: "the passive obedient" patient: the "non-compliant" patient: body image: sources of social support for healing; use of medications; traditional self-care practices; and death and depression. (Am J Public Health 1983: 73:431-438.) [ABSTRACT FROM AUTHOR]

This paper describes changes in the population for which General Motors provides health benefits using data from domestic personnel records. Total population size grew from 2.01 million in 1983 to 2.14 million in 1987, twice as fast as the US populations. Dependents, particularly spouses, fueled the population growth. Trends suggest that nonworker eligibility for employer-provided health benefits may receive more attention in health care cost containment efforts. [ABSTRACT FROM AUTHOR]

What changes in public health nursing service in the home have taken place as result of crisis situations in various American cities? This paper based on mail questionnaire responses presents some tentative answers. [ABSTRACT FROM AUTHOR]

This paper presents a case study of the satisfactory results that can be obtained when local health departments communicate and cooperate with each other. [ABSTRACT FROM AUTHOR]

The public health community has made important, original contributions to the debate over universal access to health services in the United States. Well before the decision of the American Public Health Association in 1944 to endorse a health plan encompassing virtually the entire populace, prominent public health practitioners and scholars embraced universality as an essential principle of health policy. Influenced by Arthur Newsholme, C.-E.A. Winslow began to promote this principle in the 1920s. Many others came to justify universal medical care as a corollary of the traditional ideal of all-inclusive public health services. By the 1940s, most leaders in the field saw national health insurance as the best way to attain universal access. For the past 30 years, advocates of universalism have asserted a social right to health services. [ABSTRACT FROM AUTHOR]

The article comments on the public health promotion policy in the U.S. proposed by J. B. Richmond and M. Kotelchuck in their paper titled "Coordination and Development of Strategies and Policy for Public Health Promotion in the United States," that was published in the book "Oxford Textbook of Public Health." According to the authors, the health policy model devised by Richmond and Kotelchuck posits that there are three necessary ingredients that make preventive action happen, namely, the knowledge base; the political will to support change; and a social strategy to accomplish change.

The article discusses the issues concerning the training and deployment of social work manpower in the U.S. Manpower problems involved in providing health and medical care services to the total population of the country has, for the first, been recognized by health professionals, the consumers of services and policy-makers. Another concern in the country's health system is the significant changes in the organization and structure of the health and mental health services, which will have great impact on the ultimate delivery of service.

The article offers information on the challenges faced by the American Public Health Association on the development of the association's Medical Care Section in the U.S. On November 10, 1948, the American Public Health Association's Governing Council voted to approve the petition requesting the establishment of a Medical Care Section. In 1972, the association expanded their health services because of the changes on their needs and demands. In 1920, the association created a committee to study the municipal health departments and determine the extent of variation on the health services and procedures offered in a specific community.

The article focuses on the development of neighborhood health center approach to health care delivery in the U.S. The neighborhood health centers have proliferated under a variety of federal grant-in-aid programs and private sources of support. It was mentioned that neighborhood health center approach demands an increasing emphasis on cost-effective management of neighborhood health centers and increased revenue generation activities. In addition, changes in federal health service funding policies have necessitated a reevaluation of sources of future support for neighborhood health centers.

Presents several letters to the editor. Comment on the two "planning" articles "The Application of a Model for Health Care Service in a Rural Setting," by Rhesa L. Penn and "Changing State Laws Regulating Health Manpower," by Steven Mosow, published in the January 1973 issue of the "American Journal of Public Health"; Discussion of an article related to the lactose intolerance in the nonwhite population, published in the November 1972 issue of the "American Journal of Public Health"; Focus on the association between abnormal lactose tolerance tests and milk rejection in Negroes.

The article presents a position paper from the American Public Health Association relative to the improvement of health care in prisons, jails, and youth detention centers in the U.S. The association backs the recommendation for a federal strategy to help improve health care these centers as structured by the report of General Accounting Office to U.S. Congress. It also supports the Health Services Administration's Prison Health Initiative aimed to assign National Health Service Corps staff to prisons and jails. In addition, the group urges the development of periodic and independent medical audit reviews to check that standards are being met and quality care provided. Other significant decisions of the group are presented.

The Pennsylvania Cancer Registry was used to contact breast cancer patients and, through them, their adult sisters and daughters. The sisters and daughters were counseled concerning their higher than average risks for breast cancer and their need for mammography and breast self-examination. Results showed a 9 percent increase in mammography and a 10 percent increase in breast self-examination rates for the counseled over control group. Costs were $49 per counseled sister or daughter indicating a need to increase cost effectiveness before implementation is practical. [ABSTRACT FROM AUTHOR]

Forty-eight of the 50 state dental directors, program managers, or state health officials were interviewed by telephone about the nature of current oral health programs for the elderly and factors that aided or hindered the development of such programs. Oral health programs for the elderly were reported in 30 states (63 percent of respondents). A majority of respondents indicated that a perceived or documented need for oral health programs for the elderly and lobbying by local advocacy groups were instrumental in implementing or planning such programs. [ABSTRACT FROM AUTHOR]

Abstract: A study was conducted at Neighborhood Health Centers to evaluate procedures to improve compliance with referrals of patient at risk for cancer. Intervention consisted of a standardized communication from the exit nurse, a patient form to be returned after compliance, and one written and one telephone reminder as needed. Compliance was 68.2 percent in a control group and 89.0 percent among patients who received the experimental intervention, a significant increase of 20.8 percent (95% CI: 12.5, 29.1). (Am J Public Health 1990; 80:85-87.) [ABSTRACT FROM AUTHOR]

Abstract: A survey of state developmental disability agencies was undertaken in October 1987 regarding AIDS policy development, education, and training and service provision. Of 44 states responding to the 27-item questionnaire, only 21 had formal AIDS policies. Policies varied considerably from state to state. Twenty-five of the responding states include information on AIDS in their staff training curriculum, with such training more likely to be provided to institutional staff than to community-based staff. Only 10 states reported AIDS prevention to be part of their client training programs, with training more likely to be found in institutional settings. Eleven states reported HIV positive cases, with such cases found more often in institutions than in community settings. Several states reported some type of segregation of HIV positive individuals. Policies, educational programming, and services to meet the special needs of persons with developmental disabilities are called for. (Am J Public Health 1990; 80:54-56.) [ABSTRACT FROM AUTHOR]

The author reflects on the 1978 coal strike in the U.S., concerning health protection and health care issues. It is stated that the United Mine Workers in the U.S. had one of the most comprehensive health benefit plans among the trade unions of the country from 1946 to 1977. The author discusses the federal government's involvement of the issue in specific periods.

The article reports on the American Public Health Association's announcement of the schedule for the annual process of considering proposed policy statements for 1990. These public policy statements form the basis of the association's position on legislative, regulatory, legal and health matters of interest to the public health community. They also provide a record of the association's stand on a variety of health issues, reflecting the diverse interest of its membership. Deadline for receipt of proposed resolutions is on February 26, 1990.

Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health,community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy. [ABSTRACT FROM AUTHOR]

The author addresses the core public health functions of ensuring that people learn their HIV status, reduce their risky behaviors, and have access to new treatments that might prolong life. According to the data from the U.S. Centers for Disease Control & Prevention, in 25 states with HIV reporting, 41% of people infected with the disease learned their status long after infection. He discusses the importance of being tested. He examines how to make HIV risk assessment, HIV testing, and HIV prevention an integral part of the health care delivery system.

The article reports on the cooperative agreement between the Mautner Project for Lesbians with Cancer and the U.S. Centers for Disease Control and Prevention that aims to pursue the goals of improving the skills of individual practitioners in providing health care to lesbians. The project is called Removing the Barriers. Training programs have been conducted, and feedback has resulted in curriculum modifications. The training curriculum features participant learning aids and modules on subjects such as culturally competent health care, common language and lesbian health issues.

The article reports that the American Public Health Association offers new educational opportunities. The organization aims to excel in providing continuing professional education to public health workforce for re licensure and recertification and to empower or strengthen the public health workforce to provide health education to the public. Through independent and collaborative activities with other associations, organizations, state public health affiliates and the private sector, the association will exert effort to enrich the knowledge, skills and abilities of health professionals and the public health workforce.

As the 100th anniversary of the 1915 Welch-Rose report approaches, the Association of Schools and Programs of Public Health (ASPPH) has been pursuing two initiatives to spark innovation in academic partnerships for enhancing population health: (1) Framing the Future: The Second 100 Years of Education for Public Health and (2) Reconnecting Public Health and Care Delivery to Improve the Health of Populations. We describe how ASPPH member schools and programs accredited by the Council on Education for Public Health, along with their extraordinarily diverse array of partners, are working to improve education that better prepares health professionals to meet 21st-century population health needs. [ABSTRACT FROM AUTHOR]

Abstract: As domestic gas was detoxified in the United States, the rate of suicide by domestic gas decreased. During this time period (1950-60), there was a parallel increase in the per capita ownership of cars and an accompanying increase in the rate of suicide by motor vehicle exhaust. However, displacement of suicide method from domestic gas to car exhaust occurred only for males and not for females. (Am J Public Health 1990; 80:80-81.) [ABSTRACT FROM AUTHOR]

The author comments on the strategies to improve coverage by mass immunization campaigns, where there is a political and technical infrastructure supporting such campaigns in the U.S. He argues that it makes mobile medical units more expensive than stationary clinics. He suggests that the solution is to implement vertical programs until the infrastructure required to apply the ideals of primary health care is available.

The authors comment on the use of le Système International d' Unités conversion factors which are used by the American Journal of Public Health (AJPH) and other medical institutions in the U.S. in medical measurements. Clinical hematology and chemistry values are used in the AJPH than in medical journals. The authors have suggested using this unit of measurement.

The article reflects on the divisive issue in abortion in the U.S. The extremists would play on the Quebec program to justify abortion under any circumstances, ignoring the moral implications, ignoring the moral implications of a such a stance. The contributors to the Hastings Center book who are chosen to represent the pro-life view are not representative of those on this side of the abortion issue.

Abstract: This study describes exposure-related hypothermia deaths in the United States from 1970 to 1979. Mortality risk from hypothermia increases with age: at all ages. non-White men are at highest risk and White women at lowest risk. Counts of deaths from hypothermia based on information from death certificate data may be understated. Effective social intervention to prevent hypothermia mortality and morbidity requires better public health surveillance and intensive case-finding. [ABSTRACT FROM AUTHOR]

Abstract: Temporal trends in US cigarette smoking prevalence rates 1920 to 1978 were related to temporal trends in US pancreatic cancer mortality rules in both sexes. In males, the rise and fall in smoking prevalence was followed by a rise and recent fall in cancer rates. In females, the later rise in smoking prevalence has been accompanied by a rise in cancer rate, and a recent slight decline in smoking rate has been associated with a slowing of the rise in cancer rate. [ABSTRACT FROM AUTHOR]

The article discusses the population-based spot maps as one common tool of epidemiologists in the U.S. The maps can be made for any entity whose population at risk is known, including census tracts, blocks, floors of a building, states, counties, cities, nations, or combinations of any. In addition, the spots or dots may represent any condition since the map represents the population at risk for that health condition. The author concludes that such maps are more effective than any other methods in presenting prevalence rates and have the advantage of being updated immediately without any calculations of rates.

The article presents a model for personnel planning as well as the establishment in a family planning service in the U.S. It has been focused on the capability of the planning service in dealing the patients. It gives explanation as to the use of this service in the required personnel. It has been observed that various personnel in a family planning clinic are not interchangeable. This shows that the nurse cannot execute the duties of the doctor. It also indicates that a clinic where doctors are fully occupied, an increase in the number of nurses would not contribute anything to the output.

The author reflects on the activities of the American Public Health Associations (APHA) that were intended to advance the cause of community health services in the U.S. It cites some of APHA's documented activities such as the Committee on Administrative Practices, the Health Bulletin Service, and the APHA Newsletter. According to the author, the documentation of the organization's activities will provide the basic material for a story of its past services.

The author reflects on LGBT equality and public health in the United States. He comments on his editorial "Why LGBT public health" published in the journal in 2001 and on health disparities related to gender minority and sexual orientation status and research on how stigma, prejudice, and the role of the social environment has on adverse health outcomes for LGBT individuals. He talks about how LGBT issues have changed in recent years but that social equality isn't the same as legal equality.

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns. [Am J Public Health. 2010;100: 205-211. doi:10.2105/AJPH. 2008.156588) [ABSTRACT FROM AUTHOR]

Objectives. We sought to quantify the extent of health selection (i.e., the degree to which potential immigrants migrate, or fail to migrate, on the basis of their health status) among contemporary US immigrant groups and evaluate the degree that selection explains variation in self-rated health among US legal permanent residents. Methods. Data came from the New Immigrant Survey 2003 cohort. We estimated the extent of positive and negative health selection through a unique series of questions asking immigrants in the United States to evaluate their health and compare it to that of citizens in their country of origin. Results. The extent of positive health selection differed significantly across immigrant groups and was related to compositional differences in the socioeconomic profiles of immigrant streams. Conclusions. The salience of socioeconomic status and English-language ability in explaining health differentials across immigrant groups reinforces the importance of further research on the role of these factors in contributing to the health of immigrants above and beyond the need for additional attention to the health selection process. (Am J Public Health. 2008;98:2058-2064. doi:10.2105/AJPH.2006.100974) [ABSTRACT FROM AUTHOR]

Health services at the community level are organized and financed in such a way that men need access but encounter barriers to care such as poor service design, lack of insurance, and the absence of health literacy. Community health delivery systems may not be appropriate, effective, fit, or able to meet the needs they are charged to fill. Community-based health services, including health departments, are underfunded, understaffed, and unable to carry out their mission in a way that protects the health of the community. The current design for funding and delivering health care services excludes poor men, particularly men of color. Improving the health of men requires modifications in the way health care is financed, delivered, and managed. {Am J Public Health. 2003;93:749-752) [ABSTRACT FROM AUTHOR]

Single-payer national health insurance could cover the uninsured and upgrade coverage for most Americans without increasing costs; savings on insurance overhead and other bureaucracy would fully offset the costs of improved care. In contrast, proposed incremental reforms are projected to cover a fraction of the uninsured, at great cost. Moreover, even these projections are suspect; reforms of the past quarter century have not stemmed the erosion of coverage. Despite incrementalists' claims of pragmatism, they have proven unable to shepherd meaningful reform through the political system. While national health insurance is often dismissed as ultra left by the policy community, it is dead center in public opinion. Polls have consistently shown that at least 40%, and perhaps 60%, of Americans favor such reform. (Am J Public Health. 2003;93: 102-105) [ABSTRACT FROM AUTHOR]

Because of the importance of grassroots social movements, or "change from below," in the history of US reform, the relationship between social movements and demands for universal health care is a critical one. National health reform campaigns in the 20th century were initiated and run by elites more concerned with defending against attacks from interest groups than with popular mobilization, and grassroots reformers in the labor, civil rights, feminist, and AIDS activist movements have concentrated more on immediate and incremental changes than on transforming the health care system itself. However, grassroots health care demands have also contained the seeds of a wider critique of the American health care system, leading some movements to adopt calls for universal coverage. [ABSTRACT FROM AUTHOR]

This article provides an overview of the magnitude of and trends in racial/ethnic disparities in health for women in the United States. It emphasizes the importance of attending to diversity in the health profiles and populations of minority women. Socioeconomic status is a central determinant of racial/ethnic disparities in health, but several other factors, including medical care, geographic location, migration and acculturation, racism, and exposure to stress and resources also play a role. There is a need for renewed attention to monitoring, understanding, and actively seeking to eliminate racial/ethnic disparities in health. (Am J Public Health. 2002;92:588-597) [ABSTRACT FROM AUTHOR]

Caregiving has only recently been acknowledged by the nation as an important topic for millions of Americans. A psychological or sociological approach to caregiving services has been most often applied, with little attention to the population-based public health outcomes of caregivers. We conceptualize caregiving as an emerging public health issue involving complex and fluctuating roles. We contend that caregiving must be considered in the context of life span needs that vary according to the ages, developmental levels, mental health needs, and physical health demands of both caregivers and care recipients. (Am J Public Health. 2007;97:224228.) [ABSTRACT FROM AUTHOR]

The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues--particularly within the oral health field--and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation's public health. [ABSTRACT FROM AUTHOR]