Public Health and Epidemiology

Health care systems in developed countries must respond to diverse populations especially given increasing population movements. These groups make different claims upon the state and may have different health care needs and expectations. But policy-makers and professionals often seem blind to this diversity. To ensure the wellbeing of its whole population, a state must respond to subgroups in terms of their health status and access to health services. The chapters in this book discuss countries and population groups that illustrate different responses to claimant groups and different ways of delivering health services. The chapters consider inherent population diversity (age, sex), citizenship issues (e.g. migrants, asylum seekers), and ethnic and indigenous groups (Roma in Europe, New Zealand Maori, Australian Aborigines). Are there barriers to people receiving equitable health care? Should mainstream health services be more responsive to the needs of different people, or should alternative health services be set up? The book provides a breadth of perspectives from which to draw conclusions on how to meet the needs of societies characterized by diversity.

Alcohol has always been an issue in public health but it is currently assuming increasing importance as a cause of disease and premature death worldwide. This book provides an interdisciplinary source of information that links together the usually separate fields of science, policy, and public health. This volume highlights the importance of bringing scientific knowledge to bear in order to strengthen and develop alcohol public policy. The book looks at the historical evolution of alcohol consumption in society, key early studies of alcohol and disease, and the cultural and social aspects of alcohol consumption. It then goes on to cover the chemistry and biology of alcohol, patterns of consumption, gender and age-related issues, alcohol and injury, alcohol and cancer and non-malignant disease, and various current therapeutic aspects. The book concludes with a section on alcohol policy, looking at issues of poverty, the availability of alcohol and alcohol control measures.

Alcohol: No Ordinary Commodity - Research and Public Policy Second Edition is a collaborative effort by an international group of addiction scientists to improve the linkages between addiction science and alcohol policy. It presents the accumulated scientific knowledge on alcohol research that has a direct relevance to the development of alcohol policy on local, national, and international levels. It provides an objective analytical basis on which to build relevant policies globally, and informs policy makers who have direct responsibility for public health and social welfare. By locating alcohol policy primarily within the realm of public health, this book draws attention to the growing tendency for governments, both national and local, to consider alcohol misuse as a major determinant of ill health, and to organize societal responses accordingly. The scope of the book is comprehensive and international. The authors describe the conceptual basis for a rational alcohol policy and present new epidemiological data on the global dimensions of alcohol misuse. The core of the book is a critical review of the cumulative scientific evidence in seven general areas of alcohol policy: pricing and taxation; regulating the physical availability of alcohol; modifying the environment in which drinking occurs; drink-driving countermeasures; marketing restrictions; primary prevention programs in schools and other settings; and treatment and early intervention services. The final chapters discuss the current state of alcohol policy in different parts of the world and describe the need for a new approach to alcohol policy that is evidence-based, realistic, and coordinated.

The options in antenatal and neonatal care are legion. Preferences still tend to be subjective. In spite of much publicity that has raised public expectation, an up-to-date thorough evaluation of antenatal and neonatal screening has been lacking. This book sets out the principles and theory of screening using single and multiple markers. It emphasizes the need to examine screening approaches in a quantitative manner and aims to help enable choices to be based on objective evidence of efficacy safety, and cost — essential in determining public health policy. Technical advances have sometimes been introduced uncritically and without adequate assessment. It has been assumed, perhaps naively, that the early detection of abnormality will invariably be a good thing. In this book, there is no such assumption that new tests or technical procedures are useful. They are only considered as a legitimate medical option if they can and have been shown to lead to improvements in outcome. Each disorder is defined and the screening procedure which is designed to identify the disorder critically evaluated. Priority is given to the screening of disorders which lend themselves to effective intervention and practical guidance is provided on how screening should be conducted. Most chapters include a discussion of problem areas and research needs. There are twenty-three chapters from leading experts from Europe and North America. The book bridges different disciplines concerned with screening, and aims to improve the understanding of the subject and delivery of preventive medical services.

This book examines the critical role of anthropology in four crucial public health domains: (1) anthropological understandings of public health problems such as malaria, HIV/AIDS, and diabetes; (2) the anthropological design of public health interventions in areas such as tobacco control and elder care; (3) anthropological evaluations of public health initiatives such as Safe Motherhood and polio eradication; and (4) anthropological critiques of public health policies, including neoliberal health care reforms. Anthropologists provide crucial understandings of public health problems from the perspectives of the populations in which the problems occur. On the basis of such understandings, anthropologists may develop and implement interventions to address particular public health problems, often working in collaboration with local participants. Anthropologists also work as evaluators, examining the activities of public health institutions and the successes and failures of public health programs. Anthropological critiques may focus on major international public health agencies and their workings, as well as public health responses to the threats of infectious disease and other disasters. Through twenty-four case studies from around the world, the book provides an argument for the imperative of anthropological perspectives, methods, information, and collaboration in the understanding and practice of public health.

This book focuses on areas of public health practice in which the systematic application of epidemiologic methods can have a large and positive impact. It describes how best to apply traditional epidemiologic methods for determining disease etiology to “real-life” problems in public health and health services research. This book bridges the gap between theoretical epidemiology and public health practice, and covers a number of topics not addressed elsewhere. This edition contains a new chapter on the development and use of systematic reviews and one on epidemiology and the law. Each chapter includes one or more case studies intended to illustrate major points from the chapter and to provide a basis for teaching exercises. All of the chapters are authored by leading experts in the fields of epidemiology and public health, and all are fully revised and updated.

Change is constant in everyday life. Infants crawl and then walk, children learn to read and write, teenagers mature in myriad ways, and the elderly become frail and forgetful. Beyond these natural processes and events, external forces and interventions instigate and disrupt change: test scores may rise after a coaching course, drug abusers may remain abstinent after residential treatment. By charting changes over time and investigating whether and when events occur, researchers reveal the temporal rhythms of our lives. This book is concerned with behavioral, social, and biomedical sciences. It offers a presentation of two of today's most popular statistical methods: multilevel models for individual change and hazard/survival models for event occurrence (in both discrete- and continuous-time). Using data sets from published studies, the book takes you step by step through complete analyses, from simple exploratory displays that reveal underlying patterns through sophisticated specifications of complex statistical models.

Although asbestos was once considered a miracle mineral, today even the word itself has ominous implications for all strata of our society. Incorporated in the past into over 3,000 different industrial and consumer products, as well as in building materials and military equipment, opportunities for exposure continue to be ever present in our environment. Thousands of workers and servicemen in a wide variety of trades have been disabled or have died consequent to the health effects of asbestos, and many more can be expected to be affected in years to come. Litigation continues, and financial awards have bankrupted many Fortune 500 companies and numerous smaller companies. While one might implicate our forefathers in this widespread, relentless medical catastrophe, only in recent decades has science appreciated the complexities of the problem and the long disease latencies. The characteristics and discovery of the unique fibrous minerals known as asbestos are considered in this book. A discussion of the major uses of these materials in the past follows. The epidemiology of the diseases asbestos cause and the risk associated with exposure are then discussed. Individual asbestos-associated diseases are considered in detail from clinical, pathologic, and pathogenic perspectives in the context of approaches to diagnosis and treatment. The authors also explore the history of regulatory efforts based on governmental actions, and the complex story of litigation related to asbestos-associated diseases. Finally, projections for the future worldwide occurrence of asbestos-related diseases are calculated.

This book draws from the social sciences, the natural sciences, and the health sciences to introduce the principles and methods applied in environmental health. It presents an overview of the basic sciences needed to understand environmental health hazards, including toxicology, microbiology, health physics, injury analysis, and relevant psychosocial concepts. It also presents a basic approach to risk assessment and risk management. The first part of the book concentrates on broad issues, providing frameworks for the investigation and management of environmental health problems. The middle section deepens the discussion of routes of exposure (air quality, water and sanitation, food and agricultural issues). The final section addresses environmental health from sustainable development themes (settlements and urbanization, energy, industry, and global concerns). The final chapter focuses on ethical issues and action planning.

Environmental chemical hazards are a highly contentious topic in modern life. Nearly every nation on earth has faced its own environmental crises, and also shares perspectives on the possibility of global catastrophes. Of the many global concerns we face, the environmental issue is unique in many ways. The greatest of these is the fundamental scientific nature of the issue, and the extent to which our opinions are formed based on high-level scientific inquiry and assessment. The two key fields of study on this issue, environmental epidemiology and exposure assessment, are still given separate names because of their separate historical roots and scientific traditions, but are seen increasingly as inseparable aspects of the same basic investigation. In this book, the authors assert that important advances in the quantification of environmental risks can only come through a true synthesis of the two fields. They have built a common biologic model of exposure, physiologic response and disease, a synthesis of the various existing models which serves to both simplify and improve the application of environmental epidemiology and exposure assessment to current and future environmental chemical risks. When exposure assessor and epidemiologist agree from the start on the model for their study, the conceptual framework for the study they design and the analyses they carry out are much more likely to yield useful exposure-risk information. An explicit biologic model of the apparent processes linking exposure to disease should form the basis for any study seeking to quantify risk from environmental chemicals.