46 results
Search Results
2. The prevention green paper: blink and you'll miss it.
- Author
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Briggs, Adam and Elwell-Sutton, Tim
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FOOD labeling ,HEALTH services accessibility ,HEALTH status indicators ,LIFE expectancy ,MARKETING ,HEALTH policy ,CHILDHOOD obesity ,PREVENTIVE health services ,PUBLIC health ,DECISION making in clinical medicine ,HEALTH & social status - Published
- 2019
- Full Text
- View/download PDF
3. OBESITY: Weight management services' waiting lists close as demand soars.
- Author
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Mahase, Elisabeth
- Subjects
PREVENTION of obesity ,HEALTH services administration ,HEALTH services accessibility ,NATIONAL health services ,GLUCAGON-like peptide-1 agonists ,WEIGHT loss ,REGULATION of body weight ,MEDICAL care ,GENERAL practitioners ,HEALTH policy ,INJECTIONS ,MEDICAL needs assessment ,INTEGRATED health care delivery ,MEDICAL referrals ,PSYCHOSOCIAL factors - Published
- 2024
4. NHS and the whole of society must act on social determinants of health for a healthier future.
- Author
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Hiam, Lucinda, Klaber, Bob, Sowemimo, Annabel, and Marmot, Michael
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NATIONAL health services ,HEALTH services accessibility ,SOCIAL determinants of health ,INFANT mortality ,LIFE expectancy ,HEALTH policy ,CHILD mortality ,HEALTH planning ,HEALTH equity ,PRACTICAL politics ,POVERTY - Published
- 2024
- Full Text
- View/download PDF
5. Can current interlinked crises stimulate the structural and policy choices required for healthy societies?
- Author
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Rasanathan, Kumanan
- Subjects
HEALTH services accessibility ,SOCIAL security ,HEALTH policy ,SOCIOECONOMIC factors ,POPULATION health ,EQUALITY ,COMMUNITIES ,SUSTAINABILITY ,WORLD health ,SUSTAINABLE development ,PUBLIC health ,HEALTH care industry ,PUBLIC administration ,MEDICAL care costs ,ECONOMIC aspects of diseases - Published
- 2024
6. Socioeconomic inequalities in smoking cessation in 11 European countries from 1987 to 2012.
- Author
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Bosdriesz, Jizzo R., Willemsen, Marc C., Stronks, Karien, and Kunst, Anton E.
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CONFIDENCE intervals ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,RESEARCH funding ,SMOKING cessation ,SOCIOECONOMIC factors ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background During the 1990s, inequalities in smoking prevalence by socioeconomic status (SES) have widened in Europe. Since then, many tobacco control policies have been implemented. Yet, European overviews of recent trends in smoking inequalities are lacking. This paper aims to provide an overview of longterm trends of socioeconomic inequalities in smoking cessation in Europe. Methods We used data for 11 countries taken from Eurobarometer surveys from 1987 to 1995 and 2002- 2012, with a total study sample of 63 737 respondents. We performed multilevel logistic regression to model associations of the quit ratio (proportion former smokers of ever smokers) with SES, measured by education and occupation separately, with adjustments for age, sex and time. Results We found a significant, positive association for education and occupation with the quit ratio. The strength of the association decreased slightly from 1987 to 1995 and increased again from 2002 to 2012. Inequalities increased between the two periods in most countries and decreased in only one country. While in 1987-1995, the quit ratio increased among all SES groups and most strongly among the low SES group, in 2002-2012 it increased only among the high-education group (OR=1.38, 95% CI 1.02 to 1.87), and nonmanual occupation group (OR=1.59, 95% CI 1.19 to 2.12). Conclusions Socioeconomic inequalities in smoking cessation rates have strongly increased since the 1990s and during the 2000s. This suggests that the tobacco control policies implemented during the 2000s have not been able to counter the trend in increasing inequalities. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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7. Is tobacco a driver of footfall among small retailers? A geographical analysis of tobacco purchasing using electronic point of sale data.
- Author
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Tunstall, Helena, Shortt, Niamh K., Kong, Amanda Y., and Pearce, Jamie
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HEALTH policy ,HEALTH services accessibility ,ACQUISITION of property ,BEHAVIOR ,BAR codes ,INDUSTRIES ,MARKETING ,COMPARATIVE studies ,SHOPPING ,BUSINESS ,SOCIAL classes ,DESCRIPTIVE statistics ,RESEARCH funding ,TOBACCO products ,SMOKING ,NEIGHBORHOOD characteristics - Published
- 2023
- Full Text
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8. The NHS founding principles are still appropriate today and provide a strong foundation for the future.
- Author
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Crisp, Nigel, Bamrah, J. S., Morley, Jessica, Augst, Charlotte, and Patel, Kiran
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WELL-being ,MEDICAL quality control ,RACISM ,HEALTH policy ,HEALTH services accessibility ,MEDICAL care ,MEDICAL technology ,UNIVERSAL healthcare ,NATIONAL health services ,HEALTH care reform ,QUALITY assurance ,HEALTH equity - Published
- 2024
9. Can we reduce health inequalities? An analysis of the English strategy (1997-2010).
- Author
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Mackenbach, Johan P.
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INFANT mortality ,CLINICAL medicine ,GOAL (Psychology) ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,HEALTH outcome assessment ,SOCIAL classes ,SAMPLE size (Statistics) ,SOCIOECONOMIC factors ,KEY performance indicators (Management) ,HUMAN services programs ,PREVENTION - Abstract
England was the first European country to pursue a systematic policy to reduce socio-economic inequalities in health. This paper assesses whether this strategy has worked, and what lessons can be learnt. A review of documents was conducted, as well as an analysis of entry-points chosen, specific policies chosen, implementation of these policies, changes in intermediate outcomes, and changes in final health outcomes. Despite some partial successes, the strategy failed to reach its own targets, that is, a 10% reduction in inequalities in life expectancy and infant mortality. This is due to the fact that it did not address the most relevant entry-points, did not use effective policies and was not delivered at a large enough scale for achieving population-wide impacts. Health inequalities can only be reduced substantially if governments have a democratic mandate to make the necessary policy changes, if demonstrably effective policies can be developed, and if these policies are implemented on the scale needed to reach the overall targets. [ABSTRACT FROM AUTHOR]
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- 2011
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10. A labour of Sisyphus? Public policy and health inequalities research from the Black and Acheson Reports to the Marmot Review.
- Author
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Bambra, C., Smith, K. E., Garthwaite, K., Joyce, K. E., and Hunter, D. J.
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PREVENTION of obesity ,EDUCATION ,EMPLOYMENT ,EXERCISE ,FOOD ,GREENHOUSE effect ,HEALTH behavior ,HEALTH services accessibility ,HOUSING ,MATHEMATICAL models ,HEALTH policy ,MEDICAL research ,NATIONAL health services ,PRACTICAL politics ,TRANSPORTATION ,WORK environment ,THEORY ,GOVERNMENT policy ,LIFESTYLES - Abstract
Objectives To explore similarities and differences in policy content and the political context of the three main English government reports on health inequalities: the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010). Methods Thematic policy and context analysis of the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010) in terms of: (i) underpinningtheoretical principles; (ii) policy recommendations; (iii) the political contexts in which each was released; and (iv) their actual or potential influence on research and policy. Results There were great similarities and very few differences in terms of both the theoretical principles guiding the recommendations of these reports and the focus of the recommendations themselves. However, there were clear differences in terms of the political contexts of each report, as well as their subsequent impacts on research and policy. Conclusion The paper calls into question the progress of health inequalities research, the use of evidence and of the links between research, politics and policy. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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11. SEVEN DAYS IN MEDICINE.
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MORTALITY risk factors ,HEALTH policy ,STATINS (Cardiovascular agents) ,COVID-19 ,DRUG tolerance ,HEALTH services accessibility ,AWARDS ,PREVENTION of communicable diseases ,FAMILY medicine ,COVID-19 vaccines ,PUBLIC health ,MEDICAL consultants ,ESTROGEN ,EARLY detection of cancer ,RISK assessment ,NATIONAL health services ,PROFESSIONAL competence ,OVERDIAGNOSIS ,EXCELLENCE ,TUMORS ,INTEGRATED health care delivery ,PROCHLORPERAZINE ,CERVIX uteri tumors ,WOMEN'S health ,COVID-19 pandemic ,MEDICAL research - Published
- 2022
12. Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury.
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A Mytton, Julie, Towner, Elizabeth M L, Powell, Jane, Pilkington, Paul A, and Gray, Selena
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WOUND & injury classification ,CINAHL database ,CAUSES of death ,ETHNIC groups ,HEALTH services accessibility ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,HEALTH policy ,MEDLINE ,SEX distribution ,WOUNDS & injuries ,SYSTEMATIC reviews ,CHILDREN - Abstract
ABSTRACT: Objective The relative significance of child injury as a cause of preventable death has increased as mortality from infectious diseases has declined. Unintentional child juries are now a major cause of death and disability across the world with the greatest burden falling on those who are most disadvantaged. A review of longterm data on child injury mortality was conducted to explore trends and inequalities and consider how data were used to inform policy, practice and research.Methods: The authors systematically collated and quality appraised data from publications and documents reporting unintentional child injury mortality over periods of 20 years or more. A critical narrative synthesis explored trends by country income group, injury type, age, gender, ethnicity and socioeconomic group. Findings 31 studies meeting the inclusion criteria were identified of which 30 were included in the synthesis. Only six were from middle income countries and none were from low income countries. An overall trend in falling child injury mortality masked rising road traffic injury deaths, evidence of increasing vulnerability of adolescents and widening disparities within countries when analysed by ethnic group and socioeconomic status. Conclusions Child injury mortality trend data from high and middle income countries has illustrated inequalities within generally falling trends. There is scope for greater use of existing trend data to inform policy and practice. Similar evidence from low income countries where the burden of injury is greatest is needed. [ABSTRACT FROM AUTHOR]
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- 2012
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13. Counting 15 million more poor in India, thanks to tobacco.
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John, Rijo M., Sung, Hai-Yen, Max, Wendy B., and Ross, Hana
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FAMILIES & economics ,SMOKING laws ,POVERTY ,HEALTH services accessibility ,MEDICAL care costs ,HEALTH policy ,RURAL population ,SMOKING ,SURVEYS ,TAXATION ,TOBACCO ,CITY dwellers ,RELATIVE medical risk ,ECONOMICS - Abstract
Objective To quantify the impact of tobacco use and the related medical expenditure on poverty in India. Methods Tobacco expenditure and associated medical expenditure attributable to tobacco use were subtracted from the household monthly consumption expenditure in order to derive an appropriate measure of household disposable income. The 2004 National Sample Survey, a nationally representative survey of Indian households, was used to estimate the true level of poverty. Results Our estimates indicate that accounting for direct expenditure on tobacco would increase the rural and the urban poverty rates by 1.5% (affecting 11.8 million people) and 0.72% (affecting 2.3 million people), respectively. Similarly, the out-of-pocket costs of tobacco-attributable medical care result in 0.09% higher poverty rates in rural areas (affecting 0.7 million people) and in 0.07% higher poverty rates in urban locations (affecting 0.23 million people). Conclusions Tobacco consumption impoverishes roughly 15 million people in India. Hence tobacco control measures would not only improve public health, but would also reduce poverty in India. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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14. Tackling population health challenges as we build back from the pandemic.
- Author
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McCartney, Gerry, Douglas, Margaret, Taulbut, Martin, Katikireddi, S. Vittal, and McKee, Martin
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POPULATION health management ,HEALTH policy ,HEALTH services accessibility ,COVID-19 ,STRATEGIC planning ,PREVENTION of communicable diseases ,COVID-19 vaccines ,PUBLIC health ,SOCIAL justice ,HOLISTIC medicine ,NATIONAL health services ,TUMORS ,GOVERNMENT aid ,COVID-19 pandemic ,CLIMATE change - Published
- 2021
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15. Scaling COVID-19 against inequalities: should the policy response consistently match the mortality challenge?
- Author
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McCartney, Gerry, Leyland, Alastair, Walsh, David, and Ruth, Dundas
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MORTALITY prevention ,CAUSES of death ,HEALTH policy ,SUICIDE ,COVID-19 ,HEALTH services accessibility ,COMMUNICABLE diseases ,LIFE expectancy ,MATHEMATICAL models ,AGE distribution ,SOCIOECONOMIC factors ,THEORY ,DESCRIPTIVE statistics ,HEALTH & social status ,HEALTH equity ,STATISTICAL correlation ,POLICY sciences ,DRUG toxicity - Published
- 2021
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16. Universal interventions for suicide prevention in high-income Organisation for Economic Co-operation and Development (OECD) member countries: a systematic review.
- Author
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Ishimo, Marie-Claire, Sampasa-Kanyinga, Hugues, Olibris, Brieanne, Chawla, Mitulika, Berfeld, Noami, Prince, Stephanie A., Kaplan, Mark S., Orpana, Heather, and Lang, Justin J.
- Subjects
SUICIDE -- Law & legislation ,SUICIDE prevention ,SUICIDE ,PSYCHOLOGY information storage & retrieval systems ,HEALTH policy ,DEVELOPED countries ,INTERNATIONAL relations ,EVALUATION of human services programs ,MEDICAL information storage & retrieval systems ,HEALTH services accessibility ,SYSTEMATIC reviews ,MENTAL health ,HEALTH care reform ,COMMUNICATION ,MEDLINE - Published
- 2021
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17. Mitigating ethnic disparities in covid-19 and beyond.
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Razai, Mohammad S., Kankam, Hadyn K. N., Majeed, Azeem, Esmail, Aneez, and Williams, David R.
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CULTURE ,ETHNIC groups ,HEALTH services accessibility ,HEALTH status indicators ,EVALUATION of medical care ,HEALTH policy ,MINORITIES ,RACISM ,SOCIOECONOMIC factors ,HEALTH equity ,HEALTH & social status ,COVID-19 - Published
- 2021
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18. Policies to tackle inequalities in child health: why haven't they worked (better)?
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Law, Catherine, Parkin, Chloe, and Lewis, Hannah
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HEALTH policy ,CHILDREN'S health ,BRITISH politics & government, 2007- ,LIFE chances ,HEALTH services accessibility - Abstract
The article discusses the uncompromising issue related to health policies that aim to tackle the inequalities in child health in Great Britain. It states that the Labour Government, which came into power in 1997, has championed the policies that will promote the well-being of children and their life chances. It reveals that while the condition of the children improved, the access to health care were not fairly distributed.
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- 2012
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19. Older LGBT+ health inequalities in the UK: setting a research agenda.
- Author
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Westwood, Sue, Willis, Paul, Fish, Julie, Hafford-Letchfield, Trish, Semlyen, Joanna, King, Andrew, Beach, Brian, Almack, Kathryn, Kneale, Dylan, Toze, Michael, and Becares, Laia
- Subjects
CANCER patient medical care ,ALCOHOL drinking ,HEALTH promotion ,HEALTH services accessibility ,HEALTH status indicators ,LONELINESS ,MATHEMATICAL models ,MEDICAL needs assessment ,HEALTH policy ,MENTAL health services ,PALLIATIVE treatment ,PATIENT education ,PRIORITY (Philosophy) ,RESEARCH evaluation ,RISK-taking behavior ,SMOKING ,SOCIAL isolation ,SOCIAL justice ,THEORY ,LGBTQ+ people ,SOCIOECONOMIC factors ,SEXUAL minorities ,HEALTH equity ,CONTENT mining - Published
- 2020
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20. The impact of New Labour's English health inequalities strategy on geographical inequalities in infant mortality: a time-trend analysis.
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Robinson, Tomos, Brown, Heather, Norman, Paul D., Fraser, Lorna K., Barr, Ben, and Bambra, Clare
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CONFIDENCE intervals ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,INFANT mortality ,POPULATION geography ,REGRESSION analysis ,PREVENTION - Published
- 2019
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21. Scope-of-practice laws and expanded health services: the case of underserved women and advanced cervical cancer diagnoses.
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Smith-Gagen, Julie, White, Larissa L., Santos, Amanda, Hasty, Shaun M., Wei-Chen Tung, and Minggen Lu
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CERVIX uteri tumors ,CANCER patients ,CONFIDENCE intervals ,COST effectiveness ,HEALTH services accessibility ,HEALTH status indicators ,LONGITUDINAL method ,MEDICAL personnel ,HEALTH policy ,NURSE practitioners ,NURSE supply & demand ,NURSING practice ,PUBLIC health surveillance ,TUMOR classification ,ODDS ratio ,DIAGNOSIS - Published
- 2019
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22. Effect of copayment policies on initial medication non-adherence according to income: a population-based study.
- Author
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Aznar-Lou, Ignacio, Pottegård, Anton, Fernández, Ana, Peñarrubia-María, María Teresa, Serrano-Blanco, Antoni, Sabés-Figuera, Ramón, Gil-Girbau, Montserrat, Fajó-Pascual, Marta, Moreno-Peral, Patricia, and Rubio-Valera, Maria
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DRUGS & economics ,ANALGESICS ,CONFIDENCE intervals ,DRUGS ,HEALTH services accessibility ,INCOME ,PENICILLIN ,MEDICAL care costs ,HEALTH policy ,PATIENT compliance ,PRIMARY health care ,RESEARCH funding ,MATHEMATICAL variables ,LOGISTIC regression analysis ,HEALTH insurance reimbursement ,SOCIOECONOMIC factors ,DATA analysis software ,INDEPENDENT variables ,ODDS ratio - Abstract
Objective Copayment policies aim to reduce the burden of medication expenditure but may affect adherence and generate inequities in access to healthcare. The objective was to evaluate the impact of two copayment measures on initial medication non-adherence (IMNA) in several medication groups and by income level. Design A population-based study was conducted using real-world evidence. Setting Primary care in Catalonia (Spain) where two separate copayment measures (fixed copayment and coinsurance) were introduced between 2011 and 2013. Participant Every patient with a new prescription issued between 2011 and 2014 (3 million patients and 10 million prescriptions). Outcomes IMNA was estimated throughout dispensing and invoicing information. Changes in IMNA prevalence after the introduction of copayment policies (immediate level change and trend changes) were estimated through segmented logistic regression. The regression models were stratified by economic status and medication groups. Results Before changes to copayment policies, IMNA prevalence remained stable. The introduction of a fixed copayment was followed by a statistically significant increase in IMNA in poor population, low/middleincome pensioners and low-income non-pensioners (OR from 1.047 to 1.370). In high-income populations, there was a large statistically non-significant increase. IMNA decreased in the low-income population after suspension of the fixed copayment and the introduction of a coinsurance policy that granted this population free access to medications (OR=0.676). Penicillins were least affected while analgesics were affected to the greatest extent. IMNA to medications for chronic conditions increased in low/middle-income pensioners. Conclusion Even nominal charge fixed copayment may generate inequities in access to health services. An anticipation effect and expenses associated with IMNA may have generated short-term costs. A reduction in copayment can protect from non-adherence and have positive, long-term effects. Copayment scenarios could have considerable long-term consequences for health and costs due to increased IMNA in medication for chronic physical conditions. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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23. Socioeconomic inequalities in health and the use of healthcare services in Catalonia: analysis of the individual data of 7.5 million residents.
- Author
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García-Altés, Anna, Ruiz-Muñoz, Dolores, Colls, Cristina, Mias, Montse, and Bassols, Nicolau Martín
- Subjects
PUBLIC health ,AGE distribution ,DISEASES ,DRUGS ,EMPLOYMENT ,HEALTH services accessibility ,HEALTH status indicators ,HOSPITAL care ,MEDICAL care costs ,HEALTH policy ,MENTAL health services ,SEX distribution ,SOCIAL security ,SOCIOECONOMIC factors ,EDUCATIONAL attainment ,CROSS-sectional method - Published
- 2018
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24. Socioeconomic inequalities in child vaccination in low/middle-income countries: what accounts for the differences?
- Author
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Hajizadeh, Mohammad
- Subjects
BACTERIAL vaccines ,BCG vaccines ,CONFIDENCE intervals ,DIPHTHERIA vaccines ,HEALTH services accessibility ,HEALTH status indicators ,IMMUNIZATION ,MEASLES vaccines ,MEDICAL appointments ,HEALTH policy ,WHOOPING cough vaccines ,POLIOMYELITIS vaccines ,PRENATAL care ,REGRESSION analysis ,SURVEYS ,TETANUS ,WORLD health ,SOCIOECONOMIC factors ,DESCRIPTIVE statistics ,MIDDLE-income countries ,LOW-income countries ,CHILDREN - Published
- 2018
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25. Increasing socioeconomic gap between the young and old: temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity, 2004-2015.
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Kontopantelis, Evangelos, Mamas, Mamas A., van Marwijk, Harm, Buchan, Iain, Ryan, Andrew M., and Doran, Tim
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AGE distribution ,ETHNIC groups ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,RECESSIONS ,RESEARCH funding ,RURAL conditions ,SEX distribution ,SOCIOECONOMIC factors ,HEALTH equity ,CROSS-sectional method - Published
- 2018
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26. Coffey's plan will make "no tangible difference" to patients, say GP leaders.
- Author
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Mahase, Elisabeth
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HEALTH policy ,HEALTH services accessibility ,PHYSICIANS' attitudes ,NATIONAL health services ,TREATMENT delay (Medicine) ,PENSIONS ,MEDICAL appointments ,SOCIAL services ,DENTISTRY ,GOVERNMENT aid ,HEALTH planning - Published
- 2022
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27. Income-based equity weights in healthcare planning and policy.
- Author
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Herlitz, Anders
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HEALTH & social status ,LIFE expectancy ,SOCIOECONOMIC factors ,EQUALITY ,WELL-being ,PSYCHOLOGICAL adaptation ,HEALTH planning ,HEALTH services accessibility ,HEALTH status indicators ,INCOME ,HEALTH policy ,POVERTY ,PSYCHOLOGICAL tests ,SOCIAL classes ,SOCIAL justice ,HEALTH equity - Abstract
Recent research indicates that there is a gap in life expectancy between the rich and the poor. This raises the question: should we on egalitarian grounds use income-based equity weights when we assess benefits of alternative benevolent interventions, so that health benefits to the poor count for more? This article provides three egalitarian arguments for using income-based equity weights under certain circumstances. If income inequality correlates with inequality in health, we have reason to use income-based equity weights on the ground that health inequality is bad. If income inequality correlates with inequality in opportunity for health, we have reason to use such weights on the ground that inequality in opportunity for health is bad. If income inequality correlates with inequality in well-being, income-based equity weights should be used to mitigate inequality in well-being. Three different ways in which to construe income-based equity weights are introduced and discussed. They can be based on relative income inequality, on income rankings and on capped absolute income. The article does not defend any of these types of weighting schemes, but argues that in order to settle which of these types of weighting scheme to choose, more empirical research is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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28. The global burden of diagnostic errors in primary care.
- Author
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Singh, Hardeep, Schiff, Gordon D., Graber, Mark L., Onakpoya, Igho, and Thompson, Matthew J.
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COMMUNICATION ,CONCEPTUAL structures ,CORPORATE culture ,DECISION making ,DIAGNOSIS ,DIAGNOSTIC errors ,HEALTH services accessibility ,MEDICAL informatics ,HEALTH policy ,MEDICAL practice ,GENERAL practitioners ,PRIMARY health care ,QUALITY assurance ,RISK management in business ,PATIENT participation ,PREVENTION - Published
- 2017
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29. Public investment in the development of vaccines: providing equitable access around the world.
- Author
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Barnes-Weise, Julia, Hoemeke, Laura, and Telford, Bridie
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INVESTMENTS ,HEALTH policy ,IMMUNIZATION ,HEALTH services accessibility ,COVID-19 vaccines ,WORLD health ,PUBLIC health ,PUBLIC administration ,MESSENGER RNA ,HEALTH equity ,ECONOMICS - Published
- 2023
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30. Covid-19: Is the government dismantling pandemic systems too hastily?
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Limb, Matthew
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HEALTH policy ,HEALTH services accessibility ,PREVENTION of communicable diseases ,RULES ,HEALTH status indicators ,NATIONAL health services ,INFORMATION resources ,COVID-19 testing ,CONTACT tracing ,COVID-19 pandemic ,LEGISLATION ,LAW - Published
- 2022
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31. Challenges with participant reimbursement: experiences from a post-trial access study.
- Author
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Mngadi, Kathryn Therese, Frohlich, Janet, Montague, Carl, Singh, Jerome, Nkomonde, Nelisiwe, Mvandaba, Nomzamo, Ntombeka, Fanelesibonge, Luthuli, Londiwe, Abdool Karim, Quarraisha, and Mansoor, Leila
- Subjects
CLINICAL trials ,HIV prevention ,MEDICAL care ,HEALTH policy ,MEDICAL ethics ,EXPERIMENTAL design ,HEALTH services accessibility ,HEALTH insurance reimbursement ,PILOT projects ,HUMAN research subjects ,FAMILY planning - Abstract
Reimbursement of trial participants remains a frequently debated issue, with specific guidance lacking. Trials combining post-trial access and implementation science may necessitate new strategies and models. CAPRISA 008, a post-trial access study testing the feasibility of using family planning services to rollout a prelicensure HIV prevention intervention, tried to balance the real-life scenario of no reimbursement for attendance at public sector clinics with that of a trial including some visits that focused on research procedures and others that focused on standard of care procedures. A reduced reimbursement was offered for 'standard of care' visits, meant primarily to cover transport costs to and from the clinic only. This impacted negatively on accrual, retention and participant morale, primarily due to the protracted delay in regulatory approval, during which time, the costs of living, including travel costs had increased. Relevant guidelines were reviewed and institutional policy was updated to incorporate the South African National Health Research Ethics Committee guidelines on reimbursement (taking into account participant time, travel and inconvenience). The reimbursement amount for 'standard of care' visits was increased accordingly. The question remains whether a trial that combines post-trial access with implementation science, with clear benefits for the participants and the provision of above standard medical care, should have reimbursement rates that approach those of a proof-of-concept trial, for 'standard of care' visits. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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32. Priorities for the new health secretary.
- Author
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Alderwick, Hugh
- Subjects
HEALTH policy ,INVESTMENTS ,HEALTH services accessibility ,EXECUTIVES ,PUBLIC health ,HEALTH status indicators ,NATIONAL health services ,LABOR supply ,WAGES ,AT-risk people ,SOCIAL services ,MEDICAL needs assessment ,COVID-19 pandemic - Published
- 2021
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33. Resourcing specialist palliative care.
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Gardiner, Clare
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HEALTH policy ,HEALTH services accessibility ,MEDICAL care costs ,MEDICAL care use ,PALLIATIVE treatment - Published
- 2022
34. Relevant evidence, reasonable policy and the right to emigrate.
- Author
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Brock, Gillian
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IMMIGRATION policy ,MEDICAL personnel ,SKILLED labor ,TAXATION ,MEDICAL care ,IMMIGRATION law ,HEALTH services accessibility ,INTELLECT ,LIBERTY ,MEDICAL laws ,HEALTH policy ,SOCIAL justice - Abstract
In this article I respond to commentaries by Javier Hidalgo and Phillip Cole. Javier Hidalgo believes that we would be justified in restricting the liberties of health personnel if we had compelling evidence that this would bring about beneficial consequences. He is sceptical that this evidence exists or would ever be forthcoming. Hidalgo therefore supports my position, at least in theory, that where there is good evidence concerning relevant beneficial consequences for remedying important losses associated with high skill migration, we may permissibly restrict health personnel's freedom to migrate through introduction of carefully crafted compulsory service and taxation programmes. So one important issue is whether such evidence is or could ever become available in a form useful to members of government. By contrast, Phillip Cole expresses significant reservations about the policies I argue are permissible under certain conditions. He believes that health workers should never be required to comply with the sorts of taxation and compulsory services programmes I recommend. I show that the programmes for which I argue are not as onerous as Cole imagines and therefore that they can be justified. I also show that relevant evidence exists to address Hidalgo's concerns. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
35. Alcohol related deaths are on the rise, but we remain a nation in denial.
- Author
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Hamilton, Ian
- Subjects
ALCOHOLISM ,PSYCHOLOGY of alcoholism ,DEATH ,ETHANOL ,HEALTH services accessibility ,HOUSING ,HEALTH policy ,PRACTICAL politics ,REPORT writing ,SALES personnel ,SOCIAL security ,UNEMPLOYMENT ,COVID-19 pandemic - Published
- 2021
36. Are health inequalities really not the smallest in the Nordic welfare states? A comparison of mortality inequality in 37 countries.
- Author
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Popham, Frank, Dibben, Chris, and Bambra, Clare
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MORTALITY ,AGE distribution ,DATABASES ,HEALTH services accessibility ,LIFE expectancy ,HEALTH policy ,PUBLIC welfare ,SEX distribution ,WORLD health ,SOCIOECONOMIC factors ,DATA analysis software ,STATISTICAL models ,DESCRIPTIVE statistics - Abstract
Background Research comparing mortality by socioeconomic status has found that inequalities are not the smallest in the Nordic countries. This is in contrast to expectations given these countries’ policy focus on equity. An alternative way of studying inequality has been little used to compare inequalities across welfare states and may yield a different conclusion. Methods We used average life expectancy lost per death as a measure of total inequality in mortality derived from death rates from the Human Mortality Database for 37 countries in 2006 that we grouped by welfare state type. We constructed a theoretical ‘lowest mortality comparator country’ to study, by age, why countries were not achieving the smallest inequality and the highest life expectancy. We also studied life expectancy as there is an important correlation between it and inequality. Results On average, Nordic countries had the highest life expectancy and smallest inequalities for men but not women. For both men and women, Nordic countries had particularly low younger age mortality contributing to smaller inequality and higher life expectancy. Although older age mortality in the Nordic countries is not the smallest. There was variation within Nordic countries with Sweden, Iceland and Norway having higher life expectancy and smaller inequalities than Denmark and Finland (for men). Conclusions Our analysis suggests that the Nordic countries do have the smallest inequalities in mortality for men and for younger age groups. However, this is not the case for women. Reducing premature mortality among older age groups would increase life expectancy and reduce inequality further in Nordic countries. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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37. Quantitative health impact assessment: taking stock and moving forward.
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Fehr, Rainer, Hurley, Fintan, Mekel, Odile Cecile, and Mackenbach, Johan P.
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HEALTH policy ,HEALTH services accessibility ,HEALTH status indicators ,MATHEMATICAL models ,RESEARCH methodology ,THEORY - Abstract
Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents. INSETS: Box 1 The DYNAMO-HIA tool;Box 2 HEIMTSA/INTARESE toolbox. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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38. Geographical variation in cancer survival in England, 1991--2006: an analysis by Cancer Network.
- Author
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Walters, Sarah, Quaresma, Manuela, Coleman, Michel P., Gordon, Emma, Forman, David, and Rachet, Bernard
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AGE distribution ,ANALYSIS of variance ,BREAST tumors ,CANCER patients ,CERVICAL cancer ,COMMUNITY health services ,COMPARATIVE studies ,STATISTICAL correlation ,REPORTING of diseases ,HEALTH services accessibility ,INFORMATION services ,LIFE expectancy ,LONGITUDINAL method ,MAPS ,HEALTH policy ,POPULATION geography ,RESEARCH funding ,SEX distribution ,STATISTICS ,SOCIOECONOMIC factors - Abstract
Background Reducing geographical inequalities in cancer survival in England was a key aim of the Calman-Hine Report (1995) and the NHS Cancer Plan (2000). This study assesses whether geographical inequalities changed following these policy developments by analysing the trend in 1-year relative survival in the 28 cancer networks of England. Methods Population-based age-standardised relative survival at 1 year is estimated for 1.4 million patients diagnosed with cancer of the oesophagus, stomach, colon, lung, breast (women) or cervix in England during 1991-2006 and followed up to 2007. Regional and deprivation-specific life tables are built to adjust survival estimates for differences in background mortality. Analysis is divided into three calendar periods: 1991-5, 1996-2000 and 2001-6. Funnel plots are used to assess geographical variation in survival over time. Results One-year relative survival improved for all cancers except cervical cancer. There was a wide geographical variation in survival with generally lower estimates in northern England. This north-south divide became less marked over time, although the overall number of cancer networks that were lower outliers compared with the England value remained stable. Breast cancer was the only cancer for which there was a marked reduction in geographical inequality in survival over time. Conclusion Policy changes over the past two decades coincided with improved relative survival, without an increase in geographical variation. The north-south divide in relative survival became less pronounced over time but geographical inequalities persist. The reduction in geographical inequality in breast cancer survival may be followed by a similar trend for other cancers, provided government recommendations are implemented similarly. [ABSTRACT FROM AUTHOR]
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- 2011
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39. Equity and the child health Millennium Development Goal: the role of pro-poor health policies.
- Author
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Kruk, Margaret E, Prescott, Marta R, de Pinho, Helen, and Galea, Sandro
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CHILD welfare ,DEVELOPING countries ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,MULTIVARIATE analysis ,REGRESSION analysis ,RESEARCH funding ,SOCIAL classes ,SURVEYS ,MATHEMATICAL variables ,ORGANIZATIONAL goals ,CROSS-sectional method ,DESCRIPTIVE statistics - Abstract
Background There are substantial disparities in mortality between rich and poor children in developing countries. As a result, there is a call for explicitly pro-poor health programming in efforts to reach the child health Millennium Development Goals. Aim To estimate the contribution made by pro-poor health policy to reduction in wealth disparities in under-5 mortality. Methods An ecological, cross-sectional analysis was performed using Demographic and Health Survey data from 47 developing countries. Multivariate analysis was used to estimate the association between government health expenditure, the wealth distribution of two essential child health services (concentration indices of immunisation and treatment for acute respiratory infection) and aggregate under-5 mortality, as well as two measures of poor–rich equity in mortality outcomes—the quintile ratio and the concentration index of under-5 mortality—while confounders were controlled for. Results Lower concentration (more pro-poor) indices for immunisation and treatment for acute respiratory infection were found to be associated with a reduction in inequity in under-5 mortality to the benefit of the poor. Government health expenditures were associated with lower overall national mortality reductions but had no effect on equity of mortality outcomes. Conclusions Redistributive health policies that promote pro-poor distribution of health services may reduce the gap in under-5 mortality between rich and poor in low-income and middle-income countries. To ensure that the poor gain from the current efforts to reach the Millennium Development Goals, essential child health services should explicitly target the poor. Failing that, the gains from these services will tend to accrue to the wealthier children in countries, magnifying inequalities in mortality. [ABSTRACT FROM PUBLISHER]
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- 2011
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40. National HIV treatment guidelines in Tanzania and Ethiopia: are they legitimate rationing tools?
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Johansson, K. A., Jerene, D., and Norheim, O. F.
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HEALTH services accessibility ,HIV infections ,HEALTH policy ,MEDICAL ethics - Abstract
Objective: To provide an ethical analysis of whether the Ethiopian and Tanzanian national HIV/AIDS treatment guidelines can be considered legitimate and fair rationing tools. Method: Qualitative study and ethical analysis involving guideline documents and interviews with nine key members involved in the development of the guidelines. The analysis followed an editing organising style. The theoretical framework was a guideline-specific framework based on theories of just resource allocation in healthcare and conditions that ensure fair processes in guideline development. According to this framework, legitimate rationing requires reasons for patient selection to be explicit, public and relevant, and decisions must be open to question and revision. Results: The only explicit rationing criteria that both guidelines recommended were clinical antiretroviral treatment indications. Explicit non-clinical rationing criteria were expressed in a separate Ethiopian implementation guideline. Neither of the guideline development processes fully satisfies minimal requirements of procedural fairness. There is a lack of transparency. The reasons for decisions are rarely given and are not publicly available. This reduces the opportunity for public questioning, debate and revisions. The guidelines were based on expert opinion and consensus. Recommendations from the WHO were copied without much discussion, disagreement or adjustment. Conclusions: The two national HIV treatment guidelines discussed are de facto mechanisms for rationing but were developed using methods that do not fully satisfy the requirements of fair processes. [ABSTRACT FROM AUTHOR]
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- 2008
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41. Covid-19: UK government response was overcentralised and poorly communicated, say peers.
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Dyer, Clare
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FEDERAL government ,HEALTH services accessibility ,HEALTH policy ,SOCIAL case work ,GOVERNMENT aid ,COVID-19 - Published
- 2020
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42. On emergencies and emigration: how (not) to justify compulsory medical service.
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Blake, Michael
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IMMIGRATION law ,MEDICAL personnel ,LOW-income countries ,MEDICAL care ,SOCIAL history ,DEVELOPING countries ,ETHICS ,HEALTH services accessibility ,HUMAN rights ,LIBERTY ,MEDICAL emergencies ,MEDICAL laws ,HEALTH policy ,PRACTICAL politics ,POVERTY ,SOCIAL justice ,GOVERNMENT regulation - Abstract
I have argued that the best way to understand the supposed right to restrict emigration is with reference to the concept of an emergency; restrictions on emigration are permitted, if at all, only as responses to an emergency situation, and must be judged with reference to the ethics of responding to such an emergency. Eszter Kollar argues, against this, that the concept of 'emergency' fails to describe the actual situation in low/middle-income countries, in which shortages of medical personnel are long-standing problems; she also argues that there is no need to invoke the concept of an emergency, when we might simply discuss these restrictions with reference to the relative importance of the human goods and interests involved. I argue, against Kollar, that we have no reason to think that an emergency must involve novelty; if the moral stakes are significant enough, we have reason to think of a situation as an emergency, regardless of when that situation began. I argue, too, that we have reason to differentiate between restrictions of liberties undertaken as part of the process of specifying liberal freedoms and emergency restrictions of those liberties defended by liberalism itself. The latter, I suggest, ought to be recognised and defended as a distinct moral category, if only to recognise the continuing moral remainder when a liberal right is temporarily suspended under emergency circumstances. I conclude that a permission to restrict emigration is, if at all, only justifiable as an emergency response to unfavourable circumstances, and ought not to be analysed in the more conventional liberal terms Kollar deploys. [ABSTRACT FROM AUTHOR]
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- 2017
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43. Taking health into account in all policies: raising and keeping health equity high on the political agenda.
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Kokkinen, Lauri, Shankardass, Ketan, O'Campo, Patricia, and Muntaner, Carles
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CELEBRITIES ,HEALTH services accessibility ,HEALTH status indicators ,HEALTH policy ,PRACTICAL politics ,PUBLIC health ,HEALTH & social status - Published
- 2017
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44. Challenges for health in the Anthropocene epoch.
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Haines, Andy, Scheelbeek, Pauline, and Abbasi, Kamran
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PREVENTION of communicable diseases ,NON-communicable diseases ,ENVIRONMENTAL health ,FOOD quality ,HEALTH promotion ,HEALTH services accessibility ,LIFE expectancy ,HEALTH policy ,WASTE management ,SOCIOECONOMIC factors ,POPULATION health ,PREVENTION - Published
- 2019
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45. Unanswered questions about the seven day NHS.
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Rimmer, Abi
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WORKING hours laws ,EMERGENCY medical services ,WORKING hours ,HEALTH policy ,CELEBRITIES ,CONTRACTS ,HEALTH care reform ,HEALTH services accessibility ,EVALUATION of medical care ,SHIFT systems ,LEGAL status of hospital medical staff ,ECONOMICS ,STANDARDS - Abstract
The article discusses how seven day healthcare services are likely to be implemented in Great Britain. Topics covered include the role of the National Health Service (NHS) England in providing seven day services, the estimated cost of such services, and the finding of a study that implementing seven day services would exceed the quality adjust life year (QALY) threshold used by the National Institute for Health and Care Excellence (NICE) for determining the cost effectiveness of treatments.
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- 2016
46. P62 Improving health equity via the social determinants of health in the EU.
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Lavin, T and Metcalfe, O
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HEALTH services accessibility ,HEALTH policy ,SOCIOECONOMIC factors - Abstract
Objective Health inequalities between different socioeconomic groups persist throughout Europe. DETERMINE is a 3-year project supported by the European Commission which brings together a high level Consortium from 26 countries. Its objective is to support and enable policy makers and practitioners in all policy sectors to place a higher priority on health and health inequalities when developing policy. A frequent criticism of policy or action to address health inequalities and one that is particularly relevant in a worsening macroeconomic climate is that there has been insufficient economic analysis or inadequate adoption of an economic perspective in these areas. The DETERMINE project sought to address this deficit in a discrete work package strand coordinated by the Institute of Public Health in Ireland. Design Using a specifically designed data collection instrument, examples of economic evaluations conducted on relevant policies and actions were identified and the benefits and barriers to using economic arguments in this area were explored. Setting Data were collected by partners representing Belgium, Czech Republic, England, Estonia, Finland, Iceland, Netherlands, Northern Ireland, Norway, Poland, Republic of Ireland, Scotland, Slovenia, Spain and Wales. In addition, one partner collected data at the EU level (EuroHealthNet). Main Outcome Measures The rationale is that where such work has been undertaken, results should be disseminated to influence decision-making in favour of addressing health inequalities. If such work has not been undertaken it is important to understand why this is the case. Results Findings show that much work is occurring and there are examples of good practice. Barriers and opportunities to progressing work were identified and described by project partners. Conclusions Economic arguments are a useful approach to tackling health inequalities when used in conjunction with a range of mechanisms. Our research showed diversity across Europe regarding the desire to use such an approach as well as availability of data and tools. [ABSTRACT FROM PUBLISHER]
- Published
- 2010
- Full Text
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