Suchergebnisse

Economic indicators such as income inequality are gaining attention as putative determinants of population health. On the other hand, we are just beginning to explore the health impact on population health of political and welfare state variables such as political orientation of government or type of medical care coverage. To determine the socially structured impact of political and welfare state variables on low birth weight rate, infant mortality rate, and under-five mortality rate, we conducted an ecological study with un balanced time-series data from 19 wealthy OECD countries for the years from 1960 to 1994. Among the political/welfare state variables, total public medical coverage was the most significant predictor of the mortality outcomes. The low birth weight rate was more sensitive to political predictors such as percentage of vote obtained by social democratic or labor parties. Overall, political and welfare state variables (including indicators of health policies) are associated with infant and child health indicators. While a strong medical care system seems crucial to some population health outcomes (e.g., the infant mortality rate), other population health outcomes might be impacted by social policies enacted by parties supporting strong welfare states (the low birth weight rate). Our investigation suggests that strong political will that advocates for more egalitarian welfare policies, including public medical services, is important in maintaining and improving the nation's health. © 2006 Elsevier Ltd. All rights reserved.

Background: Nursing professionalization has substantial benefits for patients, health care systems, and the nursing workforce. Currently, however, there is limited understanding of the macro-level factors, such as policies and other country-level determinants, influencing both the professionalization process and the supply of nursing human resources. Objectives: Given the significance of gender to the development of nursing, a majority-female occupation, the purpose of this analysis was to investigate the relationship between gender regimes and gender equality policies, as macro-level determinants, and nursing professionalization indicators, in this case the regulated nurse and nurse graduate ratios. Design: This cross-sectional, time-series analysis covered 16 years, from 2000 to 2015, and included 22 high-income countries, members of the Organisation for Economic Co-operation and Development. We divided countries into three clusters, using the gender policy model developed by Korpi, as proxy for gender regimes. The countries were grouped as follows: (a) Traditional family ¿ Austria, Belgium, France, Germany, Greece, Italy, Netherlands, Portugal, and Spain; (b) Market-oriented ¿ Australia, Canada, Ireland, Japan, New Zealand, South Korea, Switzerland, United Kingdom, and the United States; and (c) Earner-carer ¿ Denmark, Finland, Norway, and Sweden. Methods: We used fixed-effects linear regression models and ran Prais-Winsten regressions with panel-corrected standard errors, including a first-order autocorrelation correction to examine the effect of gender equality policies on nursing professionalization indicators. Given the existence of missing observations, we devised and implemented a multiple imputation strategy, with the help of the Amelia II program. We gathered our data from open access secondary sources. Results: Both the regulated nurse and nurse graduate ratios had averages that differed across gender regimes, being the highest in Earner-carer regimes and the lowest in Traditional family ones, with the exception of the nurse graduate ratio, which was the highest in Market-oriented countries. In addition, we identified a number of indicators of gender equality policy in education, the labour market, and politics that are predictive of the regulated nurse and nurse graduate ratios. Conclusion: This study's findings could add to existing upstream advocacy efforts to strengthen nursing and the nursing workforce through healthy public policy. Given that the study consists of an international comparative analysis of nursing, it should be relevant to both national and global nursing communities.

Preface In the 1990s Latin American countries, with the exception of Cuba, undertook reforms in their health systems. In general, they followed a pattern similar to that adopted in other parts of the world by pursuing a neoliberal agenda that included the promotion of changes designed to achieve greater participation of the private sector in the funding and delivery of health services. Despite the different modes of reform, all strengthened the view of health as a consumer commodity and favored abandonment of the concept of health care as a right guaranteed by the state. Most of the changes implemented corresponded to the policies of structural adjustment, in accordance with the neoliberal paradigm recommended by international financial institutions with the aim of guaranteeing payments of the external debt (1-4). After several years of application, the negative impact of neoliberal health policies has been demonstrated by its inability to improve coverage or access to health services. These consequences coincide with the general failure of neoliberalism to improve quality of life; thus, Latin America remains the region of the world with the greatest inequalities between social classes. These persistent inequalities have motivated a variety of political responses in Latin America, including proposals advocated by liberal left-wing sectors in various countries of the region that are contrary to neoliberalism and include the promotion of policies to reverse privatization of health care while asserting it as a right guaranteed by the state. The amendments to the Venezuelan health system are one of the earliest examples of this type of reform. From 1999 onward, after a decade of implementing neoliberal policies, a marked adjustment in the health system was initiated to establish health as a fundamental right guaranteed by the state in a context of broad participation of organized communities and international ("South-South") cooperation. This article describes the primary health care reforms in Venezuela, formalized as "Misión Barrio Adentro" (Inside the Neighborhood) from 2003 onwards. We begin with an analysis of the neoliberal model that existed in Venezuela at the time changes in health policy were initiated. This is followed by an explication of Barrio Adentro in its historical, political and social context, pointing to the central role played by popular resistance to neoliberalism. We continue with a description of its operation, consolidation, analysis of the first indicators of the program's impact on health, and the discussion of the main challenges to a guarantee of sustainability. We conclude by suggesting that Barrio Adentro not only provides a model for health care reform in other countries of the region, but that it also offers important lessons for countries throughout the world, including those with the most powerful economies.

Using the 2002 World Health Survey, we examine the association between welfare state regimes, gender and mental health among 26 countries classified into seven distinct regimes: Conservative, Southeast Asian, Eastern European, Latin American, Liberal, Southern/Ex-dictatorship, and Social Democratic. A two-level hierarchical model found that the odds of experiencing a brief depressive episode in the last 12 months was significantly higher for Southern/Ex- dictatorship countries than for Southeast Asian (odds ratio (OR) = 0.12, 95% confidence interval (CI) 0.05–0.27) and Eastern European (OR = 0.36, 95% CI 0.22–0.58) regimes after controlling for gender, age, education, marital status, and economic development. In adjusted interaction models, compared to Southern/Ex-dictatorship males (reference category), the odds ratios of depression were significantly lower among Southeast Asian males (OR = 0.16, 95% CI 0.08–0.34) and females (OR = 0.23, 95% CI 0.10–0.53) and Eastern European males (OR = 0.41, 95% CI 0.26–0.63) and significantly higher among females in Liberal (OR = 2.00, 95% CI 1.14–3.49) and Southern (OR = 2.42, 95% CI 1.86–3.15) regimes. Our results highlight the importance of incorporating middle-income countries into comparative welfare regime research and testing for interactions between welfare regimes and gender on mental health.

Using the 2002 World Health Survey, we examine the association between welfare state regimes, gender and mental health among 26 countries classified into seven distinct regimes: Conservative, Southeast Asian, Eastern European, Latin American, Liberal, Southern/Ex-dictatorship, and Social Democratic. A two-level hierarchical model found that the odds of experiencing a brief depressive episode in the last 12 months was significantly higher for Southern/Ex- dictatorship countries than for Southeast Asian (odds ratio (OR) = 0.12, 95% confidence interval (CI) 0.05-0.27) and Eastern European (OR = 0.36, 95% CI 0.22-0.58) regimes after controlling for gender, age, education, marital status, and economic development. In adjusted interaction models, compared to Southern/Ex-dictatorship males (reference category), the odds ratios of depression were significantly lower among Southeast Asian males (OR = 0.16, 95% CI 0.08-0.34) and females (OR = 0.23, 95% CI 0.10-0.53) and Eastern European males (OR = 0.41, 95% CI 0.26-0.63) and significantly higher among females in Liberal (OR = 2.00, 95% CI 1.14-3.49) and Southern (OR = 2.42, 95% CI 1.86-3.15) regimes. Our results highlight the importance of incorporating middle-income countries into comparative welfare regime research and testing for interactions between welfare regimes and gender on mental health.

The current economic recession has caused striking levels of unemployment, underemployment, and job insecurity globally. The International Labour Organization (ILO) estimated that the number of unemployed people was 212 million in 2009, and it projects the global unemployment rate in 2010 to be 6.5%, with a confidence interval ranging from 6.1% to 7%. In rich countries in the Organization for Economic Co-operation and Development more than 57 million people, or 10%, are unemployed in 2010, the current unemployment rate in Spain is 20%, and in the United States the rate is around 10% using conservative estimates. The ILO has predicted that the impact of the economic crisis on vulnerable employment is likely to have increased the number of working poor—those living on $1.25 (£0.80; €0.90) a day—by 215 million workers between 2008 and 2009, and that in 2009 there were between 1.48 and 1.59 billion vulnerable workers worldwide. These developments will increase global health inequalities, and inequalities between social classes within countries, because unemployment and underemployment cluster among lower income countries and workers. In this article we explore the relation between unemployment, poor working conditions, and health, and argue that governments and public health agencies should recognise that fair employment conditions should be regarded as a human right.

The current economic recession has caused striking levels of unemployment, underemployment, and job insecurity globally. The International Labour Organization (ILO) estimated that the number of unemployed people was 212 million in 2009, and it projects the global unemployment rate in 2010 to be 6.5%, with a confidence interval ranging from 6.1% to 7%. In rich countries in the Organization for Economic Co-operation and Development more than 57 million people, or 10%, are unemployed in 2010, the current unemployment rate in Spain is 20%, and in the United States the rate is around 10% using conservative estimates. The ILO has predicted that the impact of the economic crisis on vulnerable employment is likely to have increased the number of working poor—those living on $1.25 (£0.80; €0.90) a day—by 215 million workers between 2008 and 2009, and that in 2009 there were between 1.48 and 1.59 billion vulnerable workers worldwide. These developments will increase global health inequalities, and inequalities between social classes within countries, because unemployment and underemployment cluster among lower income countries and workers. In this article we explore the relation between unemployment, poor working conditions, and health, and argue that governments and public health agencies should recognise that fair employment conditions should be regarded as a human right.