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Firearms were found to be a major cause of injury and death among children in the 5- to 18-year-old age group and the leading cause of death in young men in their late teens in South Africa. In the 1990s, the high incidence of firearm deaths and injuries spurred government policy and law reform, culminating in a new Firearms Control Act, which replaced the ineffective and outdated Arms and Ammunition Act. This chapter considers the role research played in this complex process by examining the activities and impact of a research and advocacy project undertaken by an academic policy research organization called the Child Health Policy Institute (CHPI) at the University of Cape Town. The chapter describes the political context within which the project was initiated; outlines the research findings and how they were disseminated and utilized in relation to the law reform process; describes the law reform process and broader advocacy strategy related to it; and reflects on lessons learned.

The comparatively poor contemporary health profiles of Scotland and, in particular, Glasgow have become widely known. Drawing on a body of research compiled by the Glasgow Centre for Population Health, this chapter provides a detailed examination of the health profiles of these populations as they have been shaped over time. The chapter begins by tracing their historical development in their UK and European context, before turning to examine the political, social and economic causal factors and processes which have, over time, contributed to the particularly poor health outcomes experienced in Glasgow. Building on this knowledge, the chapter draws to a close by exploring the potential future health trajectory of the city’s population. Glasgow provides a potent case for other cities and countries as they consider the ways in which politics and policy come to shape health, and health inequalities, across their populations.

This chapter describes how sexual health has become a touchstone in discussions about political belonging in the United States. By linking the management of the individual body to the governance of the social body, proponents of sexual health projects define healthy societies, responsible conduct, and “good” and “bad” sexual citizens. While the uptake of sexual health by federal health agencies suggests movement toward the centralized administration of the concept, other uses of the term escape the control of any central biomedical or state authority. This essay considers how projects of sexual health, some organized by the state and some the efforts of a politically diverse range of activists, circulate within worlds of politics and governance. It concludes that as proponents of sexual health work to establish the proper relations between bodily conduct and social order, they offer a range of templates for modern biocitizenship.

Contemporary U.S. health care is characterized by the under-use of services known to improve patients’ outcomes and the over-use of services beyond what can benefit patients. Large proportions of Americans are not receiving treatment that is in accordance with evidence showing what works best for their conditions. The situation is allowed to continue because of payment policies that reimburse physicians and hospitals for the services they deliver on the basis of volume rather than appropriateness, evidence of effectiveness, or value. Our outlays for health insurance premiums, deductibles, and co-payments are buying us suboptimal medical care. If more and better comparative effectiveness research is to increase the value of the dollars we spend on health care, patients, providers and third party payers must become better students of medical evidence, and payment policies and the organization of health services must be reconfigured to align medical care with evidence.

The chapter begins with an analysis of the ACA for what it is: the realization of an approach to health care reform that traces its origins to the conservative framework for health care reform once advanced by the moderate faction of the GOP and also the Heritage Foundation in its more moderate past. The policy aims, strategies, and specific provisions of the ACA are then critiqued in accordance to the principles of a national health care policy that would be consistent with the realization of democratic citizenship, as explicated in the first two chapters of the book. The chapter then concludes with arguments in support of a perspective of the ACA as a flawed but essential stage in an evolutionary policy progression that propels the nation’s health care system further toward the more radical and fundamental health care reform that is requisite to both the preservation of democratic governance, and the advancement of a more democratic society.

Operationalizing our political economy of health framework, this chapter introduces the role of societal determinants and determination of health (SDOH) in producing health and disease at multiple, co-existing levels: historical, social, economic, and political contexts (including colonialism, the trade and production regime, distribution of wealth, and class, race, and gender-based power and social structures); societal governance and social policies (including democratic processes, welfare state regimes, and conditions related to migration, poverty, education, work, environment, and public health); living conditions (including neighborhood and housing conditions, nutrition, water and sanitation, and transport). Drawing from ecosocial theory, the chapter examines how these synchronous levels and the intersectionality of SDOH over the lifecourse lead to population patterns of health inequities and embodiment of health and illness in individuals. We conclude the chapter with an overview of approaches to addressing SDOH to achieve health equity, turning to global, national, and municipal intersectoral approaches.

The introduction to Understanding Health Inequalities and Justice: New Conversations Across the Disciplines describes the terrain of health justice and inequalities and the multiple disciplinary perspectives that explore it. In the introduction, the editors advance the view that how we approach health inequalities and justice is a matter of great import, and argue for the positive impact multiple disciplinary perspectives may have when engaged in conversations together on these matters. The introduction offers a substantive discussion of normative paradigms informing health justice including egalitarian, libertarian, utilitiarian, rights-based, and principles-based bioethics approaches. In addition to examining each of the three sub-headings of the volume: 1. Interrogating Normative Perspectives on Health Inequality and Justice, 2. Disrupting Assumptions and Expanding Perspectives through Cases, and 3. Rethinking Evidence and the Making of Policy, each chapter is given a detailed introduction and described in relationship to other relevant chapters in the volume.

Throughout the legislative odyssey of federal policy on comparative effectiveness research from 2002 to 2008, the specifics of the policy took many different forms. While opponents to federally-mandated comparative effectiveness research objected to the policy entirely, proponents of the policy were divided as to where the function should be housed (inside the federal government or outside); how it should be financed (congressional appropriations or fees levied on public and private health insurers and health plans), and how it should be governed (how much representation should each stakeholder have on a governing board). Every specification has its advantages and disadvantages. The two federal mandates currently in force for comparative effectiveness research—the 2003 Medicare Modernization Act and the 2010 Affordable Care Act—differ markedly in placement, financing, governance, research priority-setting methods, and processes, illustrating the fact that every alternative is a balance between advantages and disadvantages.

This chapter provides a narrative that explains the politics of access (distribution, utilization, outcomes) as well as the context in which health inequalities are produced in India. While fields such as medical sociology, medical anthropology, health economics, community health, social medicine, epidemiology, and public health, among others, with their own theories, methods, and approaches are able to contribute distinctive dimensions, it becomes essential to engage across the boundaries in a collective manner to understand the complexity of health care that is increasingly shaped by the global market forces and ideologies. This volume thus opens up the possibility of constructing a new paradigm for understanding health sector as well as signalling a new field ‘health care studies’.

This section approaches the political issues that concerned Norwegian shipping as part of the international shipping industry, from four separate angles. The first explores the Norwegian Health Policy as it related to merchant seamen between 1890 and 1940. The second explores the establishment of the Norwegian-American line between 1908 and 1913 and the extent to which the government played a supportive role through intervention, incentives, and nation-building strategies. The third continues to explore government support of maritime activity, by looking at the successes of Norwegian shipping in the Interwar period and the factors which enabled large-scale modernisation such as the re-evaluated tax regime that worked in favour of maritime expansion. The final segment examines the visibility of the small nation of Norway on the international maritime stage - particularly the formation of international organisations and networks, and cooperation between shipowners and government with the end goal of promoting Norwegian shipping to the international community. Overall, it determines that the cohesion between politics and trade helped strengthen Norwegian maritime endeavors during the early-twentieth century.

This chapter examines the changing meanings, popular expectations, health policies and medical views connected to the term “development” in the health care of Tanganyika Territory. The idea that development means improvement or modernization of pre-existing local institutions whereas medicine demands a complete break with and replacement of previous services made health policy a special case. In addition, ideas of what development in health should be, differed largely between “native”, governmental and medical authorities, culminating in open conflict in the 1940s. Bruchhausen takes his point of departure from defining three concepts of causal relations between health and development in development policies after independence: 1. Health as a precondition for economic development 2. Health as a late result of economic development, and 3. Health as an explicit goal of development. The chapter traces the beginnings and earlier expressions of these different conceptual approaches from roughly 1920 to 1960.

In the last few decades, several initiatives have been undertaken by Government of India to increase access to essential health services. A framework for UHC was also developed by a High Level Expert Group (HLEG). The recently developed National Health Policy of India also espouses equity, universality, and affordability among its key principles and commits higher financial resources with emphasis on Primary Health Care. For UHC to be viable, it has to be embedded in a broad based framework of health assurance, based on a conceptual model that extends from financial protection, across a well-functioning health system, to the social determinants of health.

The links between health and development are complex but sufficiently well-established for policy development purposes. The whole idea that health is not a burden on the economy, but is an active partner in fostering economic growth and tackling health inequalities is widely acknowledged. Investments in improving the health of a population as a whole will have positive economic consequences resulting in higher growth; which as a consequence will improve health – a virtuous circle as this chapter illustrates.

Women often approach health facilities to seek treatment for health consequences emerging out of violence. Health facilities are also mandated by several laws in India to play a therapeutic and forensic role in responding to women facing violence. Despite India being a signatory to international treaties, health professionals are unable to respond to violence owing to their own biases and misconceptions related to the issue. The chapter discusses the prevalence of violence against women, the resultant health consequences, and perceptions of health professionals towards this violence. While doing so the chapter raises concerns about the lack of institutionalised health care response and draws attention to the policy gaps that keeps the government from committing itself to ending all forms of violence against women.

This chapter starts with the recognition that policymaking usually precedes evidence of what laws are effective in solving the problem at hand. That does not mean that policymaking cannot be guided by evidence. Policymakers can usually draw on extensive evidence defining the problem and evidence of analogous policy cases. This chapter identifies sources of policy recommendations and direct evidence of policy impact, including systematic reviews, narrative reviews, models, cost-benefit analysis, and individual studies. It reviews strategies for identifying bias and source credibility and tools for “educated guessing” about policy options in matters where evidence is scarce or incomplete, including causal mapping and the Haddon matrix. Finally, it introduces the Health in All Policies approach and the use of health impact assessments as tools to consider broader impact and cross-sectoral cooperation.