Monday, 31 October 2011
Tuesday, 18 October 2011
WHO Europe: Inequalities in health system performance and their social determinants in Europe
Interactive Atlases and other resources! Jump here
Inequalities in health system performance and their social determinants in Europe
Inequalities in health are increasing in Europe. They exist between population groups within the same country and between countries across the European region. These inequalities lead to increased vulnerabilities in populations as well as increased differences in health behaviours and outcomes between population groups (whether measured by education, income, or employment). At the same time, there is a trend in a number of countries to devolve more responsibility for health systems to the regional levels.
As a result there is increased demand by policy makers for health information at regional level and for knowledge on the options for addressing socially determined health inequalities. In particular how health system policies and their outcomes in various settings impact on inequalities and what actions can be taken to improve health equity.
As a response, the WHO/Europe undertook the “Inequalities in health system performance and social determinants in Europe – tools for assessment and information sharing” project as a joint action with the European Commission. The focus of this action was on providing policy makers with practical tools and resources for building know-how and capacity for effective action on socially determined health inequalities (SDHI) with a particular focus on health systems actions.
There were two components: the first one was concerned with developing a set of interactive atlases as a tool to improve the evidence base for identifying and analysing social inequalities in health, in particular by recognizing regional patterns suggesting common determinants and focus for cost-effective interventions. The second component was concerned with the development of a range of resources to enable countries to take action to address socially determined health inequalities including: a web-based resource with examples of actions to address socially determined health inequalities.
Here you will find information and access about the project, its process and outcomes, which combine into a unique resource of information and evidence on health inequalities in Europe.
World Conference: Case studies on social determinants of health
World Conference on Social Determinants of Health, Rio Oct 19 -21, 2011
http://www.who.int/sdhconference/en/
http://www.who.int/sdhconference/en/
Case studies on social determinants of health
The following case studies were commissioned by WHO Regional Offices for the World Conference on Social Determinants of Health. The case studies present successful examples of policy action aiming to reduce health inequities, covering a wide range of issues, including conditional cash transfers, gender-based violence, tuberculosis programmes and maternal and child health.
The case studies were written by individual experts and are being circulated as draft background papers to inform discussions at the conference. They represent the views of the authors and do not necessarily represent the views, policies, or decisions of WHO or the governments of the countries where the case studies are set.
- Brazil
pdf, 978kb
The Brazilian experience with conditional cash transfers: a successful way to reduce inequity and to improve health - United States of America
pdf, 1.05Mb
How can we get the 'social determinants of health' message on the public policy and public health agenda? - Solomon Islands
pdf, 836kb
Gender-based violence in Solomon Islands: Translating research into action on the social determinants of health - Republic of Kiribati
pdf, 831kb
Measuring and responding to gender-based violence in the Pacific: Action on gender inequality as a social determinant of health - Viet Nam
pdf, 937kb
Gender-based violence in Viet Nam: Strengthening the response by measuring and acting on social determinants of health - Australia
pdf, 1.23Mb
Health in All Policies: South Australia's country case study on action on the social determinants of health - WHO Western Pacific region
pdf, 891kb
Addressing social determinants of health through tuberculosis control programmes in Western Pacific Region - Malaysia
pdf, 1.47Mb
Health in All Policies: The Primary Health Care Approach in Malaysia. 50 years experience in addressing social determinants of health through Intersectoral Action for Health - India
pdf, 888kb
India's country experience in addressing social exclusion in maternal and child health - India
pdf, 771kb
Effective social determinants of health approach in India through community mobilization - Thailand
pdf, 915kb
Health systems, public health programmes and social determinants of health - Egypt
pdf, 819kb
Social participation in Egypt: Civil society's former experience and new opportunities - Morocco
pdf, 761kb
Social determinants and health equity in Morocco - United States of America
pdf, 764kb
A national partnership for action to end health disparities in the United States of America - Australia
pdf, 732kb
Supporting public policy and action on the social determinants of health by providing evidence through the Social Health Atlases of Australia - Cambodia
pdf, 776kb
Gender as a social determinant of health: Gender analysis of the health sector in Cambodia - WHO Western Pacific region
pdf, 1.11Mb
Gender mainstreaming in emerging disease surveillance and response - Iran
pdf, 845kb
School Pupil Policy Officer (Hamyare Police) - A national initiative based on social participation to improve road safety - Jordan
pdf, 666kb
National commitment to action on social determinants of health in Jordan: Addressing obesity - Namibia
pdf, 2.46Mb
Report on country experience: A multi-sectoral response to combat the polio outbreak in Namibia - Rwanda
pdf, 1.75Mb
Community performance-based financing in health: Incentivizing mothers and community health workers to improve maternal health outcomes in Rwanda - Uganda
pdf, 718kb
Social determinants of health: Food fortification to reduce micronutrient deficiency in Uganda - Strengthening the National Food Fortification Programm - Kenya
pdf, 2.01Mb
The national deworming programme: Kenya's experience - Zimbabwe
pdf, 857kb
Intersectoral actions in response to cholera in Zimbabwe: From emergency response to institution building - Brazil
pdf, 2.01Mb
The Green Area of Morro da Policia: Health practitioners working with communities to tackle the social determinants of health - Chile
pdf, 1.74Mb
Steps towards the health equity agenda in Chile - Pakistan
pdf, 1.03Mb
Heartfile Health Financing: Striving to achieve health equity in Pakistan - Costa Rica
pdf, 766kb
Impact of long term policies based on social determinants of health: The Costa Rican experience
Monday, 17 October 2011
U of Chicago: Gift to Endow New Health Justice Professorship
Gift to Endow New Health Justice Professorship link here
University of Chicago Medical Center Trustee Ellie Block has made a donation to the University of Chicago Medical Center to establish the Ellen H. Block Professorship for Health Justice, the first chair within the Urban Health Initiative (UHI), and to support related work to redress inequities in health and health care.
“I’m thrilled to support the visionary work of a dedicated team of professionals at the Medical Center to eliminate the health care disparities that cause so much suffering in our society,” says Block. “It is compelling to me that, through UHI, people in disenfranchised communities will be afforded the same access to health care as all others. It will level the playing field. From neonatal to geriatrics, UHI will have an impact in the schools, the community, and of course in the relationship people have with their doctor.”
“What I find most exciting,” Block adds, “is that this is an eminently replicable model that can be shared with other disenfranchised communities across the country.”
Assistant Professor of Obstetrics/Gynecology and Medicine-Geriatrics Stacy Lindau, MD, branded the gift, “inspired.”
“It means faculty can invest their energy and talents in addressing inequities in health and health care–especially those we see in the immediate community where many of us live and work.”
CHAIR TO OFFER CREATIVE SOLUTIONS
The holder of the chair will play an integral role in UHI, Lindau says. “This gift will support an individual who, in partnership with the community, can devote his or her scholarship to identifying creative, impactful solutions to health inequities.”
The holder of the chair will play an integral role in UHI, Lindau says. “This gift will support an individual who, in partnership with the community, can devote his or her scholarship to identifying creative, impactful solutions to health inequities.”
Part of Block’s gift will also help support Lindau’s ongoing work on women’s health. As co-principal investigator of the National Social Life, Health, and Aging Project, Lindau helped pioneer the first nationwide study of sexual mores, behaviors, and problems among older Americans. “The theme of health justice underpins my work addressing the issues faced by women with cancer, cardiovascular disease, dementia, and other common, complex conditions, and their ability to return to a normal life,” she says. “This shared passion with Ellie for health justice means we can also improve the effectiveness of care for women around a very important topic that’s largely unaddressed.”
“No one has really addressed this issue before,” says Block. “Stacy’s work ushers in a new day in both women’s health and health justice for all.”
For more information, contact Cathy Deutsch atcdeutsch@mcdmail.uchicago.edu.
Monday, 10 October 2011
African Humanities Fellowships - Nov 1 deadline !
African Humanities Program -American Council of Learned SocietiesLINK HERE
November 1, 2011 Deadline !!
Fellowship Details
For further details on eligibility, submission of applications, and selection criteria, see 2011-12 Competition Announcement (PDF) as well as Instructions and Application materials (at right).
The African Humanities Program (AHP) seeks to revitalize the humanities in Ghana, Nigeria, South Africa, Tanzania, and Uganda through fellowship competitions and meetings associated with them. The AHP is funded by the Carnegie Corporation of New York.
Fellowship awards to promising African scholars are the centerpiece of the African Humanities Program. Approximately 40 such fellowships will be awarded annually. An initiative to publish the best manuscripts produced under the terms of AHP fellowships is now being established. All fellows will be encouraged to submit their completed manuscripts to the African Humanities Series, which will be a cooperative venture between AHP and a major African university press.
The AHP organizes meetings in Africa in cooperation with host institutions to publicize the fellowship program and to discuss new trends in humanities research. In the past three years of the program, meetings were held at universities in Ghana (University of Ghana-Legon), in Nigeria (University of Ibadan, Bayero University Kano, and Ahmadu Bello University in Zaria), in South Africa (University of the Witwatersrand and the University of Johannesburg in Johannesburg, the East London campus of Ft. Hare University, the University of the Western Cape and University of Cape Town in Cape Town), in Tanzania (the University of Dar es Salaam), and in Uganda (Makerere University in Kampala). At the meetings senior African scholars from a variety of disciplines advise on the fine-tuning of the fellowship programs and lead workshops in application preparation. Younger scholars learn about the AHP fellowship program, gain practical advice on the application process, and have the opportunity to discuss new directions in the humanities and standards of quality in humanities research. Through the activities of the African Humanities Program, ACLS promotes local and international cooperation among humanities scholars at all stages of career, with the aim of developing a self-sustaining. continent-wide network of African humanities scholars.
The African Humanities Program is inspired by a commitment to the humanities as a core component of higher education and research in Africa, essential to progress and development. The ACLS defines the humanities as the study of human cultures, languages, and histories through the use of qualitative approaches. Among the disciplines contributing to humanities scholarship are anthropology, archaeology, history, studies of the fine and performing arts, musicology, languages and linguistics, literature studies, religious studies, and philosophy.
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Saturday, 8 October 2011
‘Robin Hood’ doctor prescribes extra govt allowance for food but earned big money
“A doctor is there to be a doctor, not to advocate for the poor, or to be the official opposition in government through taxpayer’s money,” says Toronto City Councillor Robert Ford, a conservative candidate for the city’s top job in the October 2010 municipal elections. “That’s frightening, when I think about it. You can’t have people in the medical field doing that.” (From older article, see below)
Mayoral candidate assails activist doctors (original link & location)
Canadian Medical Association Journal
“The Inquiries, Complaints and Reports committee of the College of Physicians and Surgeons of Ontario has also referred to the Discipline Committee the allegation that Dr. Wong is incompetent as defined by subsection 52(1) of the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, (“the Code”)” the notice says.
3 October 2011
Dr. Roland Wong appeared before the College of Physicians and Surgeons of Ontario on Monday, hand in hand with poverty.
He was dressed in a grey suit and a sharp blue-and-silver striped tie. His poor supporters rolled in with walkers, combat boots and a red banner that declared “Raise Welfare and Disability Rates.”
Dr. Wong is a modern Robin Hood among Toronto’s poor. By his own admission, he filled out more than 14,000 special diet allowance forms in one year alone so that poor people could buy healthy food. Worth up to $250 a month each, they cost the Ontario government — and all of us — around $3 million.
The hearing is investigating whether Dr. Wong followed professional practices and standards in prescribing those allowances or whether, as the college lawyers posit, he acted in a way that was “disgraceful, dishonourable or unprofessional.”
Is he a villain, stealing money to give away to undeserving people? Or is he a hero, stepping forward to feed the hungry when so few others will?
Poverty stood silently beside him, a constant shadow. The college lawyers insist the hearing is about Dr. Wong and Dr. Wong’s actions alone. But we in the spectator seats knew that welfare rates are also on trial here. A single person on welfare in Ontario gets $592 a month. Take out rent and bus tokens, and how is it possible to not end up anemic and diabetic on what’s left over?
“The low levels of welfare are a serious health issue,” said Peter Rosenthal, the lawyer representing Dr. Wong. “This is not about the inadequacies of the social welfare system per se. What it is, is a case about how the medical profession deals with those inadequacies.”
Dr. Wong has dealt with it by filling out more special diet forms than any other physician in the province. According to college lawyer Carolyn Silver, an audit by the Ministry of Community and Social Services revealed Dr. Wong completed 13 per cent of Ontario’s special diet forms in a 3½-year period. Out of the forms that prescribed the greatest amounts of money, Dr. Wong filled out half of them during that period — often with no explanatory notes, evidence of physical exams or requests for lab tests.
In a separate review of 130 special diet forms filled out by Dr. Wong, the ministry discovered that he had diagnosed 98 per cent of the patients with chronic constipation and four food allergies. In one case, Dr. Wong certified that all 10 members of a family had those conditions, which translated to a fat monthly cheque of $2,500.
Did the poor hear about Dr. Wong and flood his dim office in the basement of a Chinatown building, as he claims? Or was he prescribing a political treatment by signing all those forms, combatting the government’s miserly welfare rates in the way only he as a doctor could?
But one disturbing fact that surfaced Monday was that the poor have made Dr. Wong quite rich. The government pays doctors $20 to fill out each special diet allowance form, and up to $40 for an additional assessment. So while he ticked the boxes marked soya allergies (worth $83 a month to the patient), diabetes ($42) and chronic constipation ($10), Dr. Wong was charging the government around $60 a form, the five-member panel heard.
In 2008, he billed $718,000 for the work required to do the special diet allowances — $540,000 more than an average Ontario family health doctor bills overall for a year.
Over four years, he made $1.8 million from the special diet allowance forms alone.
That’s a lot of money, even when you don’t compare it to the $28,416 the average single guy on welfare made during that time.
The College tribunal will judge him on whether his work deserved that money. They could revoke, suspend or limit his licence and fine him.
The court of public opinion will judge him on what he did with that money. Is he truly a Robin Hood or just a sympathetic scammer?
He says, and his lawyer confirmed, the police investigation into his actions turned up no fraud.
“A lot of the money went back in taxes,” the 61-year-old doctor told me out front of the red brick college building. “A lot was used to buy food for people — I gave it to food banks.”
The rest, he says, is going to pay his lawyers.
The hearing continues.
---------------------------------------------Mayoral candidate assails activist doctors (original link & location)
Canadian Medical Association Journal
+Author Affiliations
Doctors should not be advocating for the poor, says a Toronto, Ontario, mayoral candidate who filed a complaint that has a family doctor facing potential loss or suspension of his licence to practice.
“A doctor is there to be a doctor, not to advocate for the poor, or to be the official opposition in government through taxpayer’s money,” says Toronto City Councillor Robert Ford, a conservative candidate for the city’s top job in the October 2010 municipal elections. “That’s frightening, when I think about it. You can’t have people in the medical field doing that.”
Ford asked the College of Physicians and Surgeons of Ontario to investigate Dr. Roland Wong last year for improperly filling out special diet forms that until recently allowed welfare recipients to obtain financial assistance to purchase food needed to allay the effects of such medical conditions as food allergies, celiac disease and diabetes (CMAJ 2010. DOI:10.1503/cmaj.109-3232).
Ford says as many as “three or four” people told him that Wong had filled out forms to allow people on social assistance to access extra money to help them deal with food allergies, even though they were not allergic.
Wong, who specializes in occupation and community medicine, says he has completed as many as 15 000 special diet forms for social assistance recipients in one year.
But Wong insists he has never harmed anyone or acted improperly or illegally in doing so. In addition to signing forms for his own patients, he also signed them for people attending mass clinics arranged by poverty advocates around the province.
Wong now faces a disciplinary hearing at the college, which is investigating whether he failed to meet the standards of the profession or engaged in conduct that “would reasonably be regarded by members as disgraceful, dishonourable or unprofessional,” according to the notice of hearing issued by the college.
The hearing, which has not yet been scheduled, could result in the loss or suspension of Wong’s licence, or in a fine.
Wong says the complaint against him is politically motivated and the province is putting pressure on the college to act.
“It is a form of harassment,” he says. “I don’t think it’s come up too often when a complaint was not made by a patient, but by a politician.”
In its fiscal year 2010/11 budget, Ontario cancelled the diet allowance program, which provided additional benefits of up to $250 per month for 136 250 people on social assistance to buy healthy food because of their medical conditions. The province cited ballooning costs as the rationale for the cut, as the program’s price tag had swelled to $220 million in fiscal 2009/2010, up from $6 million in 2001/02.
Community and Social Services Minister Madeleine Meilleur also cited an auditor general’s report saying the program was being abused. Meilleur noted that doctors and other health care professionals were signing the forms without properly examining clients.
Ford claims he has “no axes to grind” and says people often come to him with complaints, including health-related ones. He says he has never before gone to the college about a doctor and does not know if Wong improperly filled out forms. “Being the son of a [former] MPP [member of the provincial parliament] … and being close friends of the [federal] Finance Minister, Jim Flaherty — I think people know that I know how politics works. I know how to get things done and which departments to complain to,” he says.
Other physicians have spoken out against the cancellation of the diet allowances, arguing that it will cost the province more in the long-term because of the health consequences. They also say Wong cannot be held accountable for $200 million spent under the program.
“He is a very strong advocate for this,” says Dr. Gary Bloch, a family physician at St. Michael’s Hospital in Toronto and a member of Health Providers Against Poverty. “This is clearly an attempt to muzzle him. Luckily, he’s not someone who is easily muzzled. He has not drawn back from talking about this.”
That was evident in an Apr. 6 address that Wong gave at an event organized by the Ontario Public Interest Research Group to protest cuts to the program. “Income level is the best predictor of health,” he told the protesters. “For every rich person with diabetes, about 2.6 people will have diabetes. Large numbers of people die needlessly because of misguided provincial policies. More will die as [Ontario Premier Dalton] McGuinty’s misguided policies continue to suffocate the poor.”
Wong adds that caring for the less fortunate is a Canadian value. “My background is that I’ve seen enough to know the amount of money they [welfare recipients] were getting, around $500 [a month], isn’t going to carry them too far. I suppose I’m different than other people — I’m willing to take some risks. I’m willing to help them,” he says.
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