5 results on '"Vallgårda, Signild"'
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2. Ethics, equality and evidence in health promotion Danish guidelines for municipalities.
- Author
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Vallgårda, Signild
- Subjects
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PUBLIC health ethics , *HEALTH policy , *HEALTH promotion , *HEALTH services accessibility , *MEDICAL protocols , *SOCIAL justice , *SOCIAL stigma , *HEALTH equity - Abstract
Aim: The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages. The aim of this article is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. Methods: An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence-informed disease prevention and health promotion. Results: Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages. When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions are recommended, where there is no evidence to support them, notwithstanding the ambition of interventions being evidence-informed. Ethical considerations are scanty, scattered and unsystematically integrated. Further, although some packages mention the importance of avoiding stigmatization, there is little indicating how this could be done. Conclusions: Including reduction of health inequalities and evidence-informed and ethically defendable interventions in health promotion is a challenge, which is not yet fully met by the National Board of Health. When judged from liberal ethical principles, only few of the suggested interventions are acceptable, i.e., those concerning information, but from a paternalistic view, all interventions that may actually benefit the citizens are justified. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
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3. Why did the stillbirth rate decline in Denmark after 1940?
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Vallgårda, Signild
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STILLBIRTH , *PERINATAL death , *OBSTETRICS , *COHORT analysis , *MEDICAL care , *MEDICAL records - Abstract
Stillbirth rates began declining in several industrialized countries simultaneously at the beginning of the 1940s. The reasons for this sudden decline have been discussed ever since. Changes in obstetric care, in risk factors, and in the composition of the population at risk have been suggested. One hypothesis is that it reflects a cohort effect of improved reproductive health status among women born during the first decades of the twentieth century arising from the decline in fertility. Other hypotheses point towards improved antenatal and obstetric care and changes in the prevalence of different risk factors. In this study, all death certificates for the stillborn in Denmark during 1938, 1941, 1945, and 1949 were used to investigate the different hypotheses. As possible contributing factors, the results suggest improvements in relation to the course of the delivery, changed parity distribution, and a cohort effect. [ABSTRACT FROM AUTHOR]
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- 2010
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4. Health inequalities: Political problematizations in Denmark and Sweden.
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Vallgårda, Signild
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PUBLIC health , *HEALTH policy , *EQUALITY , *MEDICAL care - Abstract
Problematisation is a crucial step in any political process. By defining the nature of a problem, pointing to reasons for dealing with it and identifying its causes as well as its possible solutions, problematisation frames an issue as relevant and accessible to political action. Through a study of political documents in the field of public health policies from Denmark and Sweden published during the previous decades, this article analyses the problematisation of social inequalities in health. The article concludes that, in spite of similarities between Denmark and Sweden, in several social and political issues, politicians in the two countries problematised social inequalities in health differently. There were differences in all aspects of the problematisation: timing, reason for dealing with the issue, descriptions, explanations and suggested solutions. While in Denmark social inequalities in health were predominantly defined as poor health of the disadvantaged caused by their own inappropriate behaviour, in Sweden they were defined as a gradient along income or educational achievements caused by both behaviour and living conditions. In Swedish problematisation, the welfare state played a central role and the citizen was seen as part of the community, dependent on the way society was organised. The Danish approach, on the other hand, implied a more individualistic interpretation of people's conditions and health plights and the state were accorded a less prominent place. The policies chosen to address social inequalities in health follow the same pattern as the general public health policies in the two countries. [ABSTRACT FROM AUTHOR]
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- 2007
- Full Text
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5. Why was the perinatal mortality rate higher in Denmark than in Sweden? The development in the 1970s and 1980s.
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Vallgårda, Signild
- Abstract
The purpose of this article is to identify factors explaining why the perinatal mortality rate ceased to fall in Denmark during the 1980s, while it continued to do so in Sweden, and to study the ability of known risk factors to predict this development. My analysis is based on routinely collected published data on all births, where I have studied the levels and changes in known risk factors for perinatal deaths in the two countries. The results of the study are: The proportion of low birth weight infants and the mothers' age and parity did not differ or change in a way that explains the higher perinatal mortality rate in Denmark during the 1980s. The weight specific perinatal mortality rate was the same in the two countries, with the exception of very low birth weight babies, i.e. below 1,500 grammes, where the perinatal mortality rate was higher in Denmark; this difference increased during the 1980s. The proportion of very low birth weight infants increased in Denmark from the 1970s to the 1980s while it remained stable in Sweden. The Danish increase in the proportion of low birth weight infants can be due to changed registration practices with more very small infants being registered in the 1980s. Among the factors studied registration practices, smoking and neonatal care seemed to be able to explain part of the differences between the two countries. The relative risk of perinatal death associated with the mothers' age and parity varied depending on the size of the groups at risk: the more women in high age and parity groups the lower the relative risk, which indicates that a selection as well as a causal effect was present. A conclusion is that the changes in relative risk over time associated with age and parity should lead to a closer investigation of the characteristics actually associated with an increased risk in order not to treat all old and multiparous women as patients at risk. [ABSTRACT FROM PUBLISHER]
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- 1997
- Full Text
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