The demand for return in investment (ROI) analyses in public health is on the rise as a ‘business case’ needs to be presented before a public health programme can be funded. This book explains the science behind ROI analyses and shows how policy makers can learn the art of understanding and using it in the context of public health. Using examples drawn from the NICE ROI Tools, business cases for various alternative policy options around smoking cessation, improving physical activity and reducing alcohol use are presented. In addition, several examples of real-world decision problems facing public health investors are discussed to address the usefulness of ROI evidence in public health policy making.

In Obama, Doctors, and Health Reform, Richard Reece, MD explains what patient-centered care, physician demoralization, the entrepreneurial U.S. culture, and our system's complexities portend for reform. Reform and its handmaiden, transformation, hinge on how America's individualistic, entrepreneurial, and innovative culture responds to demands for higher quality, lower costs, and greater access.

When 78 million baby boomers turn 65 in 2011, they will expect the best medical care and a personal physician to care for them, as will the rest of the population. Will the doctors be there? And what will the care be like? Whatever the answers, it will require more personal involvement and personal responsibility on your part.

You may be asked: What plan do you want, a government alternative to a private plan? An HMO, PPO, basic plan, or a high deductible plan linked to a tax-deductible health savings account (HSA)? You may choose to receive your care at a retail clinic at a drug store or in a discount store. You may carry with you a personal hard disk loaded with your medical history.

If present trends continue, you also may have a hard time finding a personal doctor to care for you. What will you do then?

This book assesses harmful effects of plastics on the environment and public health. Risk assessment of plastics is required to evaluate currently available treatment technologies and identify the significance of plastic pollution. This book covers background information concerning plastic pollution in the environment, sources and pathways of plastics, characterization and analysis of plastics in the environment, environmental risks of plastics, public health risk of plastics, life cycle approaches in assessing plastic pollution, preventive measures of plastic pollution, fate and transport of plastics, and summary and outlook. The content of the book focuses on assessment of risks of plastics (including nano- and micro-plastics) released into the environment, and it is designed to educate fundamental aspects of plastic materials, including potential risks to the public health and environment, approaches to assessing their harmful effects, prevention of plastic pollution, and environmentally sound technologies for recycling plastics and/or converting them into renewable energy sources. Readers, particularly those in the field of toxicology, materials, environmental policy, public health, and water treatment, benefit from this book's content and educational features, in perspectives of providing knowledge in the environmental field, namely the current status and technology developments for avoiding or minimizing plastic contamination, case studies used to assess environmental and public health risks of micro- and nano-plastics, and educational recommendations in resolving issues with global plastic pollution.

Advancing the Human Right to Health offers a prospective on the global response to one of the greatest moral, legal, and public health challenges of the 21st century - achieving the human right to health as enshrined in the Universal Declaration of Human Rights (UDHR) and other legal instruments. Featuring writings by global thought-leaders in the world of health human rights, the book brings clarity to many of the complex clinical, ethical, economic, legal, and socio-cultural questions raised by injury, disease, and deeper determinants of health, such as poverty. Much more than a primer on the right to health, this book features an examination of profound inequalities in health, which have resulted in millions of people condemned to unnecessary suffering and hastened deaths. In so doing, it provides a thoughtful account of the right to health's parameters, strategies on ways in which to achieve it, and discussion of why it is so essential in a 21st century context. Country-specific case studies provide context for analysing the right to health and assessing whether, and to what extent, this right has influenced critical decision-making that makes a difference in people's lives. Thematic chapters also look at the specific challenges involved in translating the right to health into action. Advancing the Human Right to Health highlights the urgency to build upon the progress made in securing the right to health for all, offering a timely reminder that all stakeholders must redouble their efforts to advance the human right to health.

This book critically analyses the influence of international policies and guidelines on the performance of interventions aimed at reducing health inequities in Latin America, with special emphasis on health promotion and health in all policies strategies. While the implementation of these interventions plays a key role in strengthening these countries' capacity to respond to current and future challenges, the urgency and pressures of cooperation and funding agencies to show results consistent with their own agendas not only hampers this goal, but also makes the territory invisible, hiding the real problems faced by most Latin American countries, diminishing the richness of local knowledge production, and hindering the development of relevant proposals that consider the territory's conditions and cultural identity. Departing from this general analysis, the authors search for answers to the following questions: Why, despite the importance of the theoretical advances r egarding actions to address social and health inequities, haven't Latin American countries been able to produce the expected results? Why do successful initiatives only take place within the framework of pilot projects? Why does the ideology of health promotion and health in all policies mainly permeate structures of the health sector, but not other sectors? Why are intersectoral actions conjunctural initiatives, which often fail to evolve into permanent practices? Based on an extensive literature review, case studies, personal experiences, and interviews with key informants in the region, Globalization and Health Inequities in Latin America presents a strategy that uses monitoring and evaluation practices for enhancing the capacity of Latin American and other low and middle-income countries to implement sustainable processes to foster inclusiveness, equity, social justice and human rights. <

For fifty years, Medicare and Medicaid have stood at the center of a contentious debate surrounding American government, citizenship, and health care entitlement. In Medicare and Medicaid at 50, leading scholars in politics, government, economics, health policy, and history offer a comprehensive assessment of the evolution of these programs and their impact on society - from their origins in the Great Society era to the current battles over the Affordable Care Act ("Obamacare"). These highly accessible essays examine Medicare and Medicaid from their origins as programs for the elderly and poor to their later role as a safety net for the middle class. Along the way, they have served as touchstones for heated debates about economics, social welfare, and the role of government. Medicare and Medicaid at 50 addresses key questions for understanding the past and future of health policy in America, including: DT What were the origins for these initiatives, and how were they transformed over time? DT What marks have Medicare and Medicaid left on society? DT In what ways have these programs produced innovation, even in eras of retrenchment? DT How did Medicaid, once regarded as a poor person's program, expand its benefits and coverage over the decades to become the platform for the ACA's future expansion? The volume's contributors go on to examine the powerful role of courts in these transformations, along with the shifting roles of Congress, public opinion, and state governors in the programs' ongoing evolution. From Lyndon Johnson to Barack Obama on the left, and from Ronald Reagan to George W. Bush on the right, American political leaders have tied their political fortunes to the fate of America's entitlement programs; Medicare and Medicaid at 50 helps explain why, and how those ongoing debates are likely to shape the future of the Affordable Care Act.

Every year, the average American spends about $7,300 on medical expenses. The typical Canadian pays $2,700, the Briton only $2,000. And yet, according to the World Health Organization, our healthcare system, in terms of total quality, ranks thirty-eighth in the world, right between Costa Rica and Slovenia. Not only do 40 million Americans lack health insurance, but more than 200,000 die each year because of medical mistakes. Our average life expectancy is lower than Cuba's.
In Next Medicine, Dr. Walter Bortz zeroes in on why the American medicine is spiraling toward disaster. A physician with fifty years of experience and a leading authority on aging, Bortz argues that the financial interests of biotech and drug companies have distorted the healthcare system. Thanks to them, medicine today is economically motivated to treat disease rather than to prevent it. Heart disease, for example, is widely treated with drug interventions and invasive surgery--both of which are extravagantly profitable for pharmaceutical giants and hospitals. Daily exercise and a healthy diet, on the other hand, can prevent heart disease, and can be obtained by patients essentially for free--but there's no money in that. The medical-industrial complex has a vested interest in keeping us sick, and until that changes medicine will fail to effectively address the leading cause of disability and mortality today: chronic diseases like diabetes that are largely preventable. Bortz proposes a medical system that emphasizes personal responsibility and provides incentives for healthy lifestyle choices, along with new training for medical professionals.
Through a lively narrative full of personal anecdotes and jarring statistics, Bortz makes a powerful case for a radically new medical system--one that is based on rigorous science and loosens the strangle hold of corporate interests on American health.

This book provides a unique and succinct account of the history of health and fitness, responding to the growing recognition of physicians, policy makers and the general public that exercise is the most potent form of medicine available to humankind. Individual chapters present information extending from the earliest reaches of human history to the present day, arranged in the form of 30 thematic essays covering topics from the supposed idyll of the hunter-gatherer lifestyle and its posited health benefits to the evolution of health professionals and the possible contribution of the Olympic movement to health and fitness in our current society. Learning objectives are set for each topic, and although technical language is avoided as far as possible, a thorough glossary explains any specialized terms that are introduced in each chapter. The critical thinking of the reader is stimulated by a range of questions arising from the text context, and each chapter concludes with a brief discussion of some of the more important implications for public policies on health and fitness today and into the future. The material will be of particular interest to graduate and undergraduate students in public health, health promotion, health policy, kinesiology, physical education, but will be of interest also to many studying medicine, history and sociology.

Few topics in the field of eating disorders engender as much emotional debate as that of prevention. Too often, preventative plans against eating disorders are highly praised, but not carried out in practical actions. It is often easier and more immediately fulfilling to focus on treatment and not to wait for the long-term effects of prevention, despite the fact that treatment alone does nothing to reduce the incidence of eating disorders.

The Prevention of Eating Disorders offers a survey of modern approaches to eating disorder prevention, arguing that models of prevention as opposed to treatment are conceptually flawed.

The first half of the volume addresses general approaches and dilemmas, including feminist and participatory approaches to the problem and the role played by fashion magazines and television in promoting risk factors such as thin ideal body images and dieting. The second half provides examples of concrete strategies and projects aimed at prevention, including school based programs, approaches to early identification and prevention by general practitioners, and the principles of screening programs.

Equitable Access to High-Cost Pharmaceuticals seeks to aid the development and implementation of equitable public health policies by pharmaco-economics professionals, health economists, and policymakers. With detailed country-by country analysis of policy and regulation, the Work compares and contrasts national healthcare systems to support researchers and practitioners identify optimal healthcare policy solutions. The Work incorporates chapters on global regulatory changes, health technology assessment guidelines, and competitive effectiveness research recommendations from international bodies such as the OECD or the EU. Novel policies such as horizon scanning, managed-entry agreement and post-launch monitoring are considered in detail. The Work also thoroughly reviews novel pharmaceuticals with particular research interest, including cancer drugs, orphan medicines, Hep C, and personalized medicines.

This issue of Primary Care: Clinics in Office Practice, Guest Edited by Dr. Mark B. Stephens, is devoted to Cardiovascular Disease. Articles in this issue include: State of the Heart: Overview of disease burden of cardiovascular disease from an epidemiologic perspective; Heavy Heart: Economic burden of heart disease with projections/implications for impact on the health care system; Prevention of Heart Disease; Coronary Artery Disease; Congestive Heart Failure; Valvular Heart Disease; Peripheral Vascular Disease; The Athlete's Heart and Sudden Death; Metabolic Syndrome: systems thinking in heart disease; Women and Heart Disease; Heart Disease in Children; and Cardiac Imaging.

This important new study explores how American health care evolved in the 1990s, as well as the changes in public support and policy. Birenbaum examines where the interests of consumers and professionals have dovetailed and where they differ. He considers the health care systeM's future and suggested ways the system must be adjusted to provide better and wider coverage at reasonable costs. This volume is essential reading for scholars, students, and professionals in the medical field, as well as general readers concerned with health care issues.

The 90s saw the country moving toward a realization that health care had become unaffordable--or an enormous financial burden for people with otherwise adequate incomes. Health care providers and consumers alike worried that the problem was becoming uncontrollable. Doctors saw their autonomy and control eroded, employers saw their costs rising significantly, the costs began shifting to employees, and alternative approaches to cost containment were explored.

Millions of men suffer from diseases such as diabetes, hypertension, heart disease, cancer, obesity, and other ailments."Men's Health and Wellness for the New Millennium" explains why these diseases occur, how to evaluate them, and how to treat them.

Geared toward the medical professional but written in such a way that a layperson can understand its language and concepts, Dr. Valiere Alcena explains the best way to take a person's blood pressure, how hypertension affects different areas of the brain, the proper ways to treat various diseases in men, and much more. Dr. Alcena also delves into the risk factors for different age groups and races, explains the variations between assorted types of strokes, and offers suggestions to men and their doctors on how to reduce susceptibility to various illnesses.

If you are a doctor trying to diagnose or treat an illness or if you are simply looking for recommendations on how to cope with or avoid an illness, "Men's Health and Wellness for the New Millennium" has the answers you seek.

This edited volume builds on existing alternative food initiatives and food movements research to explore how a systems approach can bring about health and well-being through enhanced collaboration. Chapters describe the myriad ways community-driven actors work to foster food systems that are socially just, embed food in local economies, regenerate the environment and actively engage citizens. Drawing on case studies, interviews and Participatory Action Research projects, the editors share the stories behind community-driven efforts to develop sustainable food systems, and present a critical assessment of both the tensions and the achievements of these initiatives. The volume is unique in its focus on approaches and methodologies that both support and recognize the value of community-based practices. Throughout the book the editors identify success stories, challenges and opportunities that link practitioner experience to critical debates in food studies, practice and policy. By making current practices visible to scholars, the volume speaks to people engaged in the co-creation of knowledge, and documents a crucial point in the evolution of a rapidly expanding and dynamic sustainable food systems movement. Entrenched food insecurity, climate change induced crop failures, rural-urban migration, escalating rates of malnutrition related diseases, and aging farm populations are increasingly common obstacles for communities around the world. Merging private, public and civil society spheres, the book gives voice to actors from across the sustainable food system movement including small businesses, not-for-profits, eaters, farmers and government. Insights into the potential for market restructuring, knowledge sharing, planning and bridging civic-political divides come from across Canada, the United States and Mexico, making this a key resource for policy-makers, students, citizens, and practitioners.

After Haiti's 2010 earthquake, over half of U.S. households donated to thousands of nongovernmental organizations (NGOs) in that country. Yet we continue to hear stories of misery from Haiti. Why have NGOs failed at their mission?
Set in Haiti during the 2004 coup and aftermath and enhanced by research conducted after the 2010 earthquake, "Killing with Kindness" analyzes the impact of official development aid on recipient NGOs and their relationships with local communities. Written like a detective story, the book offers rich enthnographic comparisons of two Haitian women's NGOs working in HIV/AIDS prevention, one with public funding (including USAID), the other with private European NGO partners. Mark Schuller looks at participation and autonomy, analyzing donor policies that inhibit these goals. He focuses on NGOs' roles as intermediaries in "gluing" the contemporary world system together and shows how power works within the aid system as these intermediaries impose interpretations of unclear mandates down the chain--a process Schuller calls "trickle-down imperialism."

This book presents new insights into the consequences of the impending growth in and impact of the older segment of Latino aging adults across distinctive regions of the Americas. It uses a comparative research framework to further understanding of current issues in health and aging in the transnational context of the health and migratory experiences of the U.S.- Mexican population. It provides an important contribution to the interdisciplinary investigation of chronic diseases and functional impairments, social care and medical services, care-giving and intervention development, and neighborhood factors supporting optimal aging, using new conceptual and methodological approaches (inter-group comparisons). Specifically, the chapters employ different methodologies that investigate trends in aging health and services related to immigration processes, family and household structure, macroeconomic changes in the quality of community life, and focus on the new realities of aging in Latino families in local communities. The book focuses on measurement, data-quality issues, new conceptual modeling techniques, and longitudinal survey capabilities, and suggests needed areas of new research. As such it is of interest to researchers and policy makers in a wide range of disciplines from social and behavioral sciences to economics, gerontology, geriatrics, and public health.

Over the past 200 years, a health reform movement has emerged about every 80 years. These clean living cycles surged with, or were tangential to, a religious awakening. Simultaneously with these awakenings, out groups such as immigrants and/or youth were seen to exhibit behaviors that undermined society. Middle class fear of these dangerous classes and a desire to eliminate disease, crime, and other perceived health or social problems led to crusades in each of the three reform eras against alcohol, tobacco, drugs, certain foods, and sexual behaviors. A backlash began to emerge from some segments of the population against reform efforts. After the dissipation of the activism phase, laws made during the reform era often became ignored or repealed. With a few exceptions, during the 30 to 40 year ebb of the cycle, the memory of the movement disappeared from public awareness.

The desire for improved health and social conditions also led to campaigns in favor of exercise, semi-vegetarian diets, women's rights, chastity, and eugenics. Engs describes the interweaving of temperance, women's rights, or religion with most health issues. Factions of established faiths emerged to fight perceived immorality, while alternative religions formed and adopted health reform as dogma. In the reform phase of each cycle, a new infectious disease threatened the population. Some alternative medical practices became popular that later were incorporated into orthodox medicine and public health. Ironically, over each succeeding movement, reformers became more likely to represent grass roots beliefs, or even to be state or federal officials, rather than independent activists.

This book addresses public safety and security from a holistic and visionary perspective. For the first time, safety and security organizations, as well as their administration, are brought together into an integrated work.
The protection of persons and property involves many public agencies and priivate organizations. Entities from the criminal jutics system (law enforcement, courts, corrections) as well as the fire service, private security and hazardous materials all contribute to public safety and security. This book addresses these entities, as well as safety and security issues, from a holistic and visionary perspective. It addresses criminal and non-criminal safety and security concerns, provides an overview of each entity (component) of the system of public safety and security, presents an overview of the administration process involved in planning, organizing, managing and evaluating public safety and security organizations and describes collateral functions of investigations, documentation and report writing.
Public safety and security organizations should not work in isolation. Rather, they should collaborate to protect persons and property. This book represents the first time all the public safety and security entities have been addressed in one text.

Focuses on the theories, concepts, practices and problems related to the present and future of public safety and security
Examines different strategies for problem solving which personnel working in the field may utilize
Synthesizes college-level lectures prepared, presented, and updated by the author over the past twenty years

Paradigms Lost challenges key paradigms currently held about the prevention or reduction of stigma attached to mental illness using evidence and the experience the authors gathered during the many years of their work in this field. Each chapter examines one currently held paradigm and presents reasons why it should be replaced with a new perspective. The book argues for enlightened opportunism (using every opportunity to fight stigma), rather than more time consuming planning, and emphasizes that the best way to approach anti-stigma work is to select targets jointly with those who are most concerned. The most radical change of paradigms concerns the evaluation of outcome for anti-stigma activities. Previously, changes in stigmatizing attitudes were used as the best indicator of success. Paradigms Lost and its authors argue that it is now necessary to measure changes in behaviors (both from the perspective of those stigmatized and those who stigmatize) to obtain a more valid measure of a program's success. Other myths to be challenged: providing knowledge about mental illness will reduce stigma; community care will de-stigmatize mental illness and psychiatry; people with a mental illness are less discriminated against in developing countries.
Paradigms Lost concludes by describing key elements in successful anti stigma work including the recommended duration of anti-stigma programmes, the involvement of those with mental illness in designing programmes, and the definition of programmes in accordance with local circumstances. A summary of weaknesses of currently held paradigms and corresponding lists of best practice principles to guide future anti-stigma action and research bring this insightful volume to an apt conclusion.

This book, written decades into the HIV epidemic, reflects critically on the idea that the socially excluded populations often focused on in HIV research are in fact difficult to access and reach. The author broadly applies the concept 'hard to reach' to characterize populations that researchers find difficult to engage with. Social factors that produce marginalization and ultimately result in people choosing not to engage in research are not captured by the concept of 'hard to reach'. Limited attention has focused on how researchers can address the social factors that result in decisions to not engage in research. Disrupting the ways in which people are conceptualized as 'hard to reach' so as to refocus on transforming social systems and personal values, beliefs and approaches is understudied. This book uses case examples based on HIV research with Indigenous youth, internally displaced women, LGBTQ communities in the Global North and Global South, and persons at the intersection of these identities, to identify successful approaches to working with marginalized and often vulnerable communities and groups. The chapters signal the need for attention to five key social factors when developing successful approaches: context and storytelling; cultural humility; critical hope; imagination and possibility; and love, intimate inquiry, and the beloved community, if nations, individuals and communities are to address the epidemic in a sustainable and impactful way.

This issue of Clinics in Geriatric Medicine, Guest Edtied by Drs. Danelle Cayea and Samuel C. Durso, is devoted to Screening and Prevention in Geriatric Medicine. Articles in this issue include: The Medicare Annual Wellness Visit; Individualized Cancer Screening; Frailty; Medication Appropriateness; Geriatric Syndromes; Mental Health; Cardiovascular Screening; Preoperative Screening; Safety; Substance Use Disorders; Sexuality; Vaccines; and Excercise.

The world is faced with an epidemic of metabolic diseases such as obesity and type 2 diabetes. This is due to changes in dietary habits and the decrease in physical activity. Exercise is usually part of the prescription, the first line of defense, to prevent or treat metabolic disorders. However, we are still learning how and why exercise provides metabolic benefits in human health. This open access volume focuses on the cellular and molecular pathways that link exercise, muscle biology, hormones and metabolism. This will include novel "myokines" that might act as new therapeutic agents in the future.

Most studies of geriatric patients have focused on nursing homes. In fact, most people are placed in these institutions only after being evaluated by medical and social service staff. This ethnography details the day-to-day experiences of a geriatric and assessment unit by examining the staff, families, and patients themselves. It looks at the activities that take place in the unit as well as the less obvious cultural patterns of the process. Using the Ethnography of Speaking method, it explores the human side of this most difficult of life's decisions.