Prevention in France, 2004: first elements for reflection

Prevention has been underdeveloped in the public health arena, at least in France. It is a complex discipline, relying both on strong scientific methodology as well as social and economical considerations, which may be sometimes a source of conflicts.     

浙江省新型冠状病毒疫情空间扩散特征及影响因子探究

2020年新型冠状病毒肺炎(COVID-19)在全球200多个国家蔓延,对世界公共卫生环境、民众生命健康安全与社会经济带来了巨大影响。为了解病毒传播的时空特征及驱动因子对新型冠状病毒(SARS-CoV-2)防控的重要意义,本研究基于2020年1月21日~2020年3月10日浙江省各县、市(区)的COVID-19疫情数据,按照病例数的变化情况将疫情时期分为迅速增长期、高位回落期、控制减少期和稳定期,发现省外输入病例主要确诊于迅速增长期和高位回落期,省内扩散病例主要确诊于控制减少期和稳定期。利用ArcGIS软件进行数据可视化,总结了两种病例类型在浙江省各县、市(区)分布的时空变化特征,发现浙江省新冠肺炎疫情在温州最为严重,其次是杭州、宁波和台州;并利用地理探测器方法探究了各因子的作用,发现社会经济因子和城市建设因子影响较大,自然环境因子影响较小。     

Risk Perception and Chronic Exposure to Organochlorine Pesticides in Maya Communities of Mexico

In order to analyze risk perception related to the use and handling of organochlorine pesticides (OCP) in agricultural and livestock activities among Maya communities of Yucatan, Mexico, and to study their impact on public health and the environment, we conducted an analytical study applying 274 semi-structured interviews in 11 municipalities in the zone called “Ring of Cenotes.” The harmful effects of agrochemicals on water supplies, soils, air, and human health were considered, including the indoor use of pesticides to preserve harvest products. Recent studies showed high levels of OCP in groundwater. A generalized low risk perception related to human health and the environment due to pesticide use was found. Likewise, social parameters were analyzed, including the educational level, as well as risk factors related to groundwater karst vulnerability. Pesticides that have been banned by international conventions are still in use. The occurrence of some diseases such as cervical cancer, with a very high prevalence at the national level, and the practice of obtaining drinking water from polluted wells and sinkholes, may be associated with this low risk perception and with poor social conditions. Establishing programs on health education, agro-ecological production alternatives, and water chemical quality monitoring is recommended.     

The role of the social sciences and economics in understanding and informing tree biosecurity policy and planning: a global summary and synthesis

Increased global biosecurity threats to trees, woods and forests have been strongly linked to the upsurge in worldwide trade and the expansion of tourism. A whole range of social, economic and political actors are implicated and affected by the movement of pests and diseases along these international pathways. A number of factors affect the actions of stakeholders, and wider public, including their values and motivations, how risks are perceived and acted upon, their ability to act, as well as the existing regulatory and economic environment. Understanding these factors is key to any future attempts to improve biosecurity policy and practice, and we present available evidence on six key dimension: (1) the role of different stakeholders and the broader public within tree health; (2) levels of knowledge and awareness of tree pests and diseases amongst the variety of end-user ‘stakeholder’ groups, and influences on their attitudes and practices; (3) social acceptability of management approaches; (4) the impact of formal and informal governance arrangements; (5) risk communication; (6) economic analyses on the impact of tree pests. We conclude by identifying evidence gaps and emphasising the need for better integration within the social sciences and between the social and natural sciences to promote effective interdisciplinary and policy-relevant contributions to tree health.     

Public Health Ethics and a Status for Pets as Person-Things

Within the field of medical ethics, discussions related to public health have mainly concentrated on issues that are closely tied to research and practice involving technologies and professional services, including vaccination, screening, and insurance coverage. Broader determinants of population health have received less attention, although this situation is rapidly changing. Against this backdrop, our specific contribution to the literature on ethics and law vis-à-vis promoting population health is to open up the ubiquitous presence of pets within cities and towns for further discussion. An expanding body of research suggests that pet animals are deeply relevant to people’s health (negatively and positively). Pet bylaws adopted by town and city councils have largely escaped notice, yet they are meaningful to consider in relation to everyday practices, social norms, and cultural values, and thus in relation to population health. Nevertheless, not least because they pivot on defining pets as private property belonging to individual people, pet bylaws raise emotionally charged ethical issues that have yet to be tackled in any of the health research on pet ownership. The literature in moral philosophy on animals is vast, and we do not claim to advance this field here. Rather, we pragmatically seek to reconcile philosophical objections to pet ownership with both animal welfare and public health. In doing so, we foreground theorizations of personhood and property from sociocultural anthropology.     

城-镇-乡人口教育差距的演变及影响机制

在城乡一体化的过程中,以平均受教育水平测量的城乡人口教育差距,并没有出现库兹涅茨倒U型发展,乡村、县镇与城市之间的差距都在不断扩大。对近20年间差距演变的过程进行分析表明,乡村和县镇人口平均受教育水平的增长速度始终低于城市,尤其是县镇区域几乎没有增长。通过对主要影响因素及作用机制的理论分析和实证检验,研究发现,经济发展水平的提高并没有促使已经存在的差距自然消弥,城乡两个被分割的群体通过显性渠道与隐性渠道不断地文化教育再生产是差距存在和扩大的社会基础;高中阶段教育投入的增加更多是促进了城镇人口受教育水平的提高,初中阶段教育投入城乡差距的扩大直接导致人口受教育程度差距的扩大,而小学阶段教育投入城乡差距没有显示出统计上显著的影响;非户籍人口流动造成城乡人口结构的异质化,并进而扩大城乡常住人口受教育程度的差距;户籍人口迁入对城市和县镇人口受教育程度都有提升作用,迁出在抵消迁入的提升作用后,仍然导致城市与县镇之间教育差距的扩大。     

Psychosocial Mechanisms Linking the Social Environment to Mental Health in African Americans

Resource-poor social environments predict poor health, but the mechanisms and processes linking the social environment to psychological health and well-being remain unclear. This study explored psychosocial mediators of the association between the social environment and mental health in African American adults. African American men and women (n = 1467) completed questionnaires on the social environment, psychosocial factors (stress, depressive symptoms, and racial discrimination), and mental health. Multiple-mediator models were used to assess direct and indirect effects of the social environment on mental health. Low social status in the community (p < .001) and U.S. (p < .001) and low social support (p < .001) were associated with poor mental health. Psychosocial factors significantly jointly mediated the relationship between the social environment and mental health in multiple-mediator models. Low social status and social support were associated with greater perceived stress, depressive symptoms, and perceived racial discrimination, which were associated with poor mental health. Results suggest the relationship between the social environment and mental health is mediated by psychosocial factors and revealed potential mechanisms through which social status and social support influence the mental health of African American men and women. Findings from this study provide insight into the differential effects of stress, depression and discrimination on mental health. Ecological approaches that aim to improve the social environment and psychosocial mediators may enhance health-related quality of life and reduce health disparities in African Americans.     

我国人口与健康状况简析

随着经济全球化格局的逐步形成,环境、生态、资源等与人类社会自身发展密切相关的因素已成为超越国界的共性课题。进入新世纪后,我国医药卫生事业面临着人口结构和疾病谱系迅速改变、公共卫生和医疗保健需求剧增、环境污染和食品安全保障等巨大挑战。在计划生育及生殖健康领域,在公共卫生与医疗网络领域,在医学研究与健康促进领域,以及在高新技术与健康产业领域,坚持科学的发展观,以最先进的科学技术研究成果为主导,推动关键技术的相互渗透及综合集成,提倡合理的生活方式已成为我国经济发展和社会进步的重要历史任务。     

An ethnomedicine study among women in Uremia (North-West Iran)

During the recent years, ethomedicine has attracted a great deal of attention among the investigators throughout the world. Although ethnomedicine seeks, in the first place, to compensate for a biological need through providing cures for disorders, it, however, is of a cultural nature, too, in that it investigates people's behaviors and reactions toward health and the issues related to it. Consequently, traditional health must be counted as a component of a society's culture. Investigations of people's views toward traditional medicine are capable of throwing light on acquaintance with their conducts, customs, traditions and behaviors, as well as the social-economic conditions prevailing in their environment. In addition, such investigations of public medicine bring about familiarities with gradual developments in traditional medical methodologies as introduced by culture, economic, or social factors, first into the society, then medicine. Familiarizations with cultural diversities in relation to medicine are the end results. The present paper comprise an anthropological approach toward investigation of ethnomedical practiced by women of Uremia (North-West, Iran).     

Estimating the Effects of September 11th and Other Forms of Violence on the Mental Health and Social Development of New York City's Youth: A Matter of Context

This longitudinal study examines the effects of exposure to the terrorist attack of September 11th as well as exposure to other forms of community violence on change in the mental health and social attitudes of youths in New York City. Three quarters of the youths reported some form of direct exposure to the events of September 11th, and 80% reported a lot of exposure to at least 1 form of media coverage of September 11th; these rates were comparable with the citywide survey of public school students in New York City conducted by the New York City Department of Education. Results of a structural equation model that included controls for previous levels of mental health and social attitudes, as well as a range of demographic factors, indicated that direct exposure and family exposure to the event did not predict change in any mental health outcomes, but did predict change in levels of social mistrust; media exposure did predict posttraumatic stress disorder symptoms. In contrast, victimization by other forms of violence was strongly associated with change in or current levels of all of the examined mental health symptoms, whereas witnessing other forms of violence was associated with change in or levels of 3 of 4 mental health symptoms and with increased hostile attribution bias and levels of social mistrust. Implications of the results for applied developmental and public mental health strategies in response to traumatic events are discussed.     

Public health and carrageenan regulation: a review and analysis

The status of carrageenan in the regulatory sphere influences how and where it may be used, with implications for seaweed farmers, carrageenan manufacturers and consumers. Over the period 1935 to the present the status of carrageenan has been effected by changes in the regulatory environment that reflect new understandings about carrageenan, health and health risks as well as broader trade, social and political changes. This paper reviews regulatory progress from the 1930s to the present. It reflects, in particular, the shifting priorities in public health and their effects on the regulatory status of carrageenan. Four case studies of public controversies about carrageenan safety are discussed in relation to regulatory responses and their public health significance. It is concluded that current assessments of risk associated with carrageenan have, in some contexts, failed to take into account the full spectrum of safety assessments that have been carried out and the maturing of food additive regulations thereby allowing a myth of risk to continue.     

Beyond Disciplinary Boundaries: Leptospirosis as a Model of Incorporating Transdisciplinary Approaches to Understand Infectious Disease Emergence

Leptospirosis is a zoonotic infectious disease of global significance. Political, economic, demographic, ecologic, and other anthropogenically driven environmental changes have fueled the reemergence of this disease in industrialized and developing countries, and in both urban and rural settings. We argue that conventional disciplinary, even interdisciplinary, research methods are not sufficient to elucidate the complex mechanisms and causal relationships among the myriad factors responsible for infectious disease emergence. To address the significant gaps in the field of leptospirosis, an integrated research agenda is needed to guide successful public health remediation of the disease. Based on both working group analysis of literature and newly obtained information, we describe cross-disciplinary collaborative approaches that allow a novel approach to understand leptospirosis emergence with regard to mountain-to-sea ecosystems in Hawai‘i and other region-specific ecosystems. Leptospirosis research is a model for how complementary disciplines in the social, cultural, ecological, and biomedical sciences can optimally interact towards a higher understanding of emerging infectious diseases.     

Habits of the Home: Spatial Hegemony and the Structuration of House and Society in Brazil

This article examines the relation between spatial structure and social practice in a Brazilian fishing town. The sociospatial division of the Brazilian house into rooms with distinct social functions and role relationships helps to define the domestic practices of the family members and socializes them into a conception of social interaction that influences their economic and public practices outside the home. However, the hegemony of this domestic sociospatial structure is not autonomous, but rather stands in dynamic interaction with the public and economic dimensions of the household's reproduction in society. A comparison between canoe fishermen and boat fishermen demonstrates that their different involvement in the economic and public domains of the town affects their interpretation of the architectural structure of the house and differentiates their domestic practices.     

A Role for Biology in the Cultural Ecology of Ladakh

Human ecology research in the high-altitude region of Ladakh (northern India) has tended to focus on the adaptive significance of Ladakhi social institutions given a natural environment characterized by numerous challenges. This research appears to lead to the conclusion that traditionally-living Ladakhis are in a state of well-being and harmonious balance with their environment, as social institutions such as polyandry constrain fertility to keep the population size in check relative to constrained resources. There has been little research on biological adaptation in Ladakh, and the view from biology presents a very different picture of the relationship between Ladakhis and their environment. Data presented here show that the health of reproductive women and infants is compromised by both natural and social factors. Since reproductive health is crucial to the production of future generations, it is argued that mortality plays a major role in constraining population growth in Ladakh, and may be due to the limited biological history that Ladakhis have in this high-altitude region. This may also help us understand Ladakhi patterns in relation to those observed in the Andes.     

Major Concerns in Developing Countries: Applications of the Precautionary Principle in Ecuador

Ecuador is a Latin American country with one of the biggest biodiversities. At the same time, social and environmental problems are also big. Poverty, political and social problems as well as questions like old transport systems, imported hazards from industrialized countries and lack of information and weak health care systems are the framework of this situation. The most common problems are the use of heavy metals in many activities without safety and health protection, a low technological oil production during two decades, intensive use of pesticides in agriculture, and some other chemical risks. A limited capacity to develop prevention strategies, reduced technical and scientific skills, and the absence of a reliable information and control system, lead to a weak response mechanism. The Precautionary Principle could help to stimulate prevention, protection and to have a new tool to improve the interest in environment and health problems. Reinforcing the presence of international organizations like WHO and ILO, establishing bridges among scientific organizations from developed and developing countries and introducing the Precautionary Principle in the legislation and daily practices of industry and agriculture could lead to an improvement in our environment and health.     

Letter from Chile: Re-establishing health care in Chile

Chile''s long term social policy has produced very impressive outcomes in general health indicators, with a national health service established as early as 1952. During the years of the Pinochet dictatorship (1973-89) public health institutions were greatly affected, with sharp diminution in financing which affected investment and salaries. The democratic government initiated in 1990 faced a difficult situation, with underpaid staff and decrepit hospitals. The ministry took immediate action to improve salaries and start an ambitious health sector reform including investment in infrastructure, technology, and modern management. Decentralisation and autonomy, changes in payment for service mechanisms, and a public-private mix are the main objectives of this reform, keeping the public role as predominant in the proposed structure. This process has been affected by union unrest and public opinion dissatisfaction, which tend to present obstacles to progress in this complicated issue.     

Social determinants of health--a comparative study of Bosnian adolescents in different cultural contexts

This study investigated the effects of sociocultural contexts on health and the psychological well-being of immigrant adolescents, aged 15 to 18 years, originally from Bosnia and Herzegovina and now living as displaced persons either in Bosnia, or immigrants in Croatia and Austria. The study addresses the social determinants of health with a specific focus on five factors in the social environment that might have an influence on health status: gender, socio-economic status (SES), perceived discrimination and exposure to violence, social support and religious commitment. Dependent variables included self-rated health, a count of self-reported objective health problems and a range of indices of psychological well-being (somatic stress, anxiety, depression and self-esteem). The purpose of the study was to examine whether social risk factors have an effect on health, which factors mediate these effects on self-rated health and to assess whether these effects differ by gender Results indicate that perceived discrimination and violence are related to poor health through psychological stress as a major mechanism with stronger effects for girls in the study. Differences across the three socio-cultural contexts reveal the complexity and specificity of the relationships between analyzed factors as the association between discrimination and health was attenuated for some groups due to the protective resources of immigrants.     

Trends in drug abuse in the mid-1980s

This paper summarizes some of the causes of, and some of the health and social concerns from, the growing illicit drug problem in the 1980s. It suggests that two recent developments, the decentralization of much drug production and modification to chemical laboratories in homes, and the application of increasingly innovative marketing techniques, have brought us to a new and more hazardous era of drug abuse. The new designer drugs and the new developments in cocaine abuse reveal these to be of major concern to the medical and public health professions, as well as a major worry to the public. In the absence of effective elimination of illegal drugs from the environment, attention must focus on alternative ways to reduce drug abuse. Education regarding the nature of the hazards of these drugs must increase, but there are no simple methods for reducing drug use. We must be prepared to fight growing drug abuse for some time to come.