Focus: Preventive Medicine: Race,Racism, and the Policy of 21st Century Medicine

This perspective describes three new policies passed at the November 2020 Special Meeting of the American Medical Association House of Delegates. These policies (1) denounce racism as a public health threat; (2) call for the elimination of race as a proxy for ancestry, genetics, and biology in medical education, research, and clinical practice; and (3) decry racial essentialism in medicine. We also explore the social and institutional context leading to the passage of these policies, which speak directly to the harmful legacy of racism in America, and its insidious impact on the healthcare system.     

Invisible Fences: Egalitarianism, Nationalism and Racism

With its specific combination of a bureaucratic welfare state and an open, globalized capitalist economy, Norway, along with the other Nordic countries, provides a particularly interesting context for the examination of the relationship between egalitarianism, nationalism, and racism in Europe. A racialization of difference takes place, as immigration emerges as a site for racial and racist discourse, and as a site of conjuncture between the welfare state and its citizens. By presenting an analysis of the contemporary debate on immigration in Norway, this article demonstrates how equality conceived as sameness ('imagined sameness') underpins a growing ethnification of national identity. Widely different utterances and points of view refer to metaphors of home and family life, a close link between territory and generalized kinship, and the renewed importance of Lutheran Christianity in contrast to Islam. A model of group identity and relationship is therefore suggested, in which organizational boundaries and cultural substance inflect one another, rather than being the bases of different or even opposed approaches. It is also argued that anthropologists need to take a more serious interest in the European majority populations.     

Conservation with a Gun: Understanding Landowner Attitudes to Deer Hunting in the Scottish Highlands

Conservation conflicts are often difficult to resolve due to a combination of poorly defined property rights, inadequate funding, high transaction costs, and contrasting value systems among stakeholders. This paper explores these barriers to collaboration in the context of the emerging deer crisis in the Scottish Highlands, where deer numbers are now higher than at any time in recorded history. In particular we explore the potential role of recreational hunting in the government’s strategy to contain rising deer numbers from the landowners’ perspective. Using both qualitative and quantitative analysis we find that hunting traditions and personal preferences, reinforced by antipathy to conservationists and their perceptions of land stewardship, are the major barriers to shooting more deer for conservation objectives. We conclude that an expansion of commercial hunting opportunities is the best practical approach to resolving the current conflict over deer, but conservationists and landowners must work together to create a more positive context for hunter-conservation initiatives and activities.

Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global,Multivariable Analysis

Background

Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance).

Methods and Findings

Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18–0.76), or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33–0.75). For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00–1.04). Global recommendations and local studies were not associated with time to decision.

Conclusions

This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors. Please see later in the article for the Editors'' Summary     

2016 年5 月美国、欧盟和日本新批准药物概述

2016 年5 月,美国、欧盟和日本共批准32 个新药,包括新分子实体、新有效成分、新生物制品、新增适应证及新剂型药物。 对全球首次获得批准的新分子实体、新有效成分、新生物制品进行分析,重点介绍这些药物的临床研究结果和研发历史进程。     

Strategic Grassland Bird Conservation throughout the Annual Cycle: Linking Policy Alternatives,Landowner Decisions,and Biological Population Outcomes

Grassland bird habitat has declined substantially in the United States. Remaining grasslands are increasingly fragmented, mostly privately owned, and vary greatly in terms of habitat quality and protection status. A coordinated strategic response for grassland bird conservation is difficult, largely due to the scope and complexity of the problem, further compounded by biological, sociological, and economic uncertainties. We describe the results from a collaborative Structured Decision Making (SDM) workshop focused on linking social and economic drivers of landscape change to grassland bird population outcomes. We identified and evaluated alternative strategies for grassland bird conservation using a series of rapid prototype models. We modeled change in grassland and agriculture cover in hypothetical landscapes resulting from different landowner decisions in response to alternative socio-economic conservation policy decisions. Resulting changes in land cover at all three stages of the annual cycle (breeding, wintering, and migration) were used to estimate changes in grassland bird populations. Our results suggest that successful grassland bird conservation may depend upon linkages with ecosystem services on working agricultural lands and grassland-based marketing campaigns to engage the public. With further development, spatial models that link landowner decisions with biological outcomes can be essential tools for making conservation policy decisions. A coordinated non-traditional partnership will likely be necessary to clearly understand and systematically respond to the many conservation challenges facing grassland birds.     

Racism,disadvantage and multiculturalism: towards effective anti-racist praxis

Measuring ethnicity in any society is a challenge. Given world immigration patterns, many countries face a growing dilemma in determining the cultural antecedents of their populations. A further complication is the reality that such determination occurs within the political and nationalistic settings where ethnic‐cultural groups may be potent forces in their own right. As societies mature and evolve, there is an increasing tendency for populations, especially those with many generations of residence in the country, to see themselves as ‘indigenous’ to the society in which they live. Canada is not alone in having to deal with the fluidity of the concept, ‘Canadian’, ‘American’, ‘Australian’, ‘Yugoslav’, and ‘Soviet’ are parallel concepts in other countries of multiple ethnic composition. Using 1991 National Census Test results, the article explores some of the parameters of the indigenous category ‘Canadian’. In particular, the location in Canada and mother tongue of respondents reporting ‘Canadian’ as the ethnic origin of their parents and grandparents or as their own ethnic identity are important indicators for this emerging ethnic category.     

Corporate Philanthropy,Political Influence,and Health Policy

Background

The Framework Convention of Tobacco Control (FCTC) provides a basis for nation states to limit the political effects of tobacco industry philanthropy, yet progress in this area is limited. This paper aims to integrate the findings of previous studies on tobacco industry philanthropy with a new analysis of British American Tobacco''s (BAT) record of charitable giving to develop a general model of corporate political philanthropy that can be used to facilitate implementation of the FCTC.

Method

Analysis of previously confidential industry documents, BAT social and stakeholder dialogue reports, and existing tobacco industry document studies on philanthropy.

Results

The analysis identified six broad ways in which tobacco companies have used philanthropy politically: developing constituencies to build support for policy positions and generate third party advocacy; weakening opposing political constituencies; facilitating access and building relationships with policymakers; creating direct leverage with policymakers by providing financial subsidies to specific projects; enhancing the donor''s status as a source of credible information; and shaping the tobacco control agenda by shifting thinking on the importance of regulating the market environment for tobacco and the relative risks of smoking for population health. Contemporary BAT social and stakeholder reports contain numerous examples of charitable donations that are likely to be designed to shape the tobacco control agenda, secure access and build constituencies.

Conclusions and Recommendations

Tobacco companies'' political use of charitable donations underlines the need for tobacco industry philanthropy to be restricted via full implementation of Articles 5.3 and 13 of the FCTC. The model of tobacco industry philanthropy developed in this study can be used by public health advocates to press for implementation of the FCTC and provides a basis for analysing the political effects of charitable giving in other industry sectors which have an impact on public health such as alcohol and food.     

Racism,fascism, and the state in recent British politics: A review essay

Christopher T. Husbands, RACIAL EXCLUSIONISM AND THE CITY: THE URBAN SUPPORT OF THE NATIONAL FRONT, London, George Allen & Unwin, 1983, pp. 191, £18. Harris Joshua and Tina Wallace with the assistance of Heather Booth, TO RIDE THE STORM: THE 1980 BRISTOL ‘RIOT’ AND THE STATE, London, Heinemann, 1983, pp. 221, £6.95.     

Heterogeneous Nature and Distribution of Interruptions in Dinucleotides May Indicate the Existence of Biased Substitutions Underlying Microsatellite Evolution

Some aspects of microsatellite evolution, such as the role of base substitutions, are far from being fully understood. To examine the significance of base substitutions underlying the evolution of microsatellites we explored the nature and the distribution of interruptions in dinucleotide repeats from the human genome. The frequencies that we inferred in the repetitive sequences were statistically different from the frequencies observed in other noncoding sequences. Additionally, we detected that the interruptions tended to be towards the ends of the microsatellites and 5'-3' asymmetry. In all the estimates nucleotides forming the same repetitive motif seem to be affected by different base substitution rates in AC and AG. This tendency itself could generate patterning and similarity in flanking sequences and reconcile these phenomena with the high mutation rate found in flanking sequences without invoking convergent evolution. Nevertheless, our data suggest that there is a regional bias in the substitution pattern of microsatellites. The accumulation of random substitutions alone cannot explain the heterogeneity and the asymmetry of interruptions found in this study or the relative frequency of different compound microsatellites in the human genome. Therefore, we cannot rule out the possibility of a mutational bias leading to convergent or parallel evolution in flanking sequences.     

Ethnicity and Educational Performance in the United Kingdom: Racism, Ethnicity, and Variability in Achievement

This article examines recent research on the variability of educational performance in Britain. The composition of Britain's minority population is reviewed, followed by a discussion of differences in attainment. The bulk of the article explores some of the social processes that lie behind the statistics, especially concerning teacher racism and student adaptations. The possibilities for improvement at the school level are considered briefly within the context of national reforms that prioritize market principles and marginalize equality concerns.     

Belonging: Australians, Place and Aboriginal Ownership

Belonging: Australians, Place and Aboriginal Ownership. Peter Read. Cambridge: Cambridge University Press, 2000. 248 pp.