Ted Tulchinsky

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Josiah Heyman

University of Texas at El Paso (UTEP)

Andrés Díaz

Concordia University (Canada)

Krzysztof Wasielewski

Nicolaus Copernicus University

Pathik B. Variya

Dharmsinh Desai University

Timothy Pychyl

Carleton University

Ignacio Perez Pulido

Universidad de Guadalajara

Tim Pychyl

Carleton University

Celestine O Ani

Enugu State University of Science and Technology

Maria Kontaridis

Harvard Medical School

J. Gascho

Pennsylvania State University

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Papers by Ted Tulchinsky

Reviews IAnalyses Poliomyelitis control in Israel, the West Bank

Israel has faced the challenge presented by epidemic poliomyelitis by using different immunizatio... more Israel has faced the challenge presented by epidemic poliomyelitis by using different immunization strat-egies. In the 1950s, inactivated poliovirus vaccine (IPV) helped to reduce the total burden of the dis-ease, but cases continued to occur. Introduction of oral poliovirus vaccine (OPV) in mid-1961 had a dramatic effect in controlling an extensive epidemic of poliomyelitis; however, poliovirus activity and cases continued during the 1970s, and at a low level in the 1980s. A localized outbreak of 15 cases of poliomyelitis in 1988 occurred in an area using enhanced potency IPV (eIPV) only. This led to a revi-sion of poliomyelitis immunization policy. The successful poliomyelitis control in the West Bank and the

The Association of Schools of Public Health in the European Region Statement on the Erosion of Public Health Systems

Public Health Reviews, 2021

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Are Schools of Public Health Needed to Address Public Health Workforce Development in Canada for the 21st Century?

Canadian Journal of Public Health, 2006

In addition to establishing Canadian federal institutions for public health to work in cooperatio... more In addition to establishing Canadian federal institutions for public health to work in cooperation with provincial and local health authorities, the infrastructure of public health for the future depends on a multidisciplinary and well-prepared workforce. Traditionally, Canada trained its public health workforce in schools of public health (or hygiene), but in recent decades this has been carried out in departments and centres primarily within medical faculties. Recent public health crises in Canada have led to some new federal institutions and reorganization of public health activities as well as other reforms. This commentary proposes re-examination of the context of public health workforce training and especially for schools of public health as independent faculties within universities as in the United States or, as developed more recently in Europe, semi-independent schools within medical faculties. The multidisciplinary nature of public health professionals and the complex challenges of the "New Public Health" call for a new debate on this vital issue of public health workforce development. Public health needs a new image and higher profile of training, research and service to meet provincial and national needs, based on international standards of accreditation and recognition.

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A successful preventive-oriented village health workers program in Hebron, the West Bank, 1985-1996J Public health mangement and practice, 1997;3 (4):57-67 Tulchinsky TH, Al Zeer AM, Mounshar JA, Subeih T, Schoenbaum M, Roth M, Gamulka B, Abueneze M, Acker C

Our contribution to international public health workforce development: Training at the Braun School of Public Health and Community Medicine in Jerusalem

The School of Public Health & Community Medicine at Hebrew University- Hadassah, Jerusalem, Israe... more The School of Public Health & Community Medicine at Hebrew University- Hadassah, Jerusalem, Israel, has nearly 40 years of experience in international public health training. Since 1971, some 700 health professionals from 85 countries in Africa, Asia, Latin America, Eastern and Western Europe, the Middle East, and North America have graduated our International Master of Public Health (IMPH) program. An even larger number of Israelis (Jews and Arabs) completed the local MPH course. The urgent international need for trained public health personnel identified by the School founders in the early-1970s, remains as pertinent for the twenty-first century as it was then. The School's academic philosophy dictated the development of an integrated training in research methodology (e.g., epidemiology, biostatistics, social and behavioral sciences) with the study of major public health issues, and their application in public health practice in the community. Training in Community-Oriented Pr...

Comparing Israeli and Palestinian polio vaccination policies and the challenges of silent entry of wild poliovirus in 2013-14: a 'natural experiment

International journal of public health, Jan 4, 2015

This commentary is part of the special issue ''Driving the Best Science to Meet Global Health Cha... more

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Technology, Quality, Law, and Ethics

The New Public Health, 2000

Technology, quality, the law, and ethics are closely interrelated in public health. Well-informed... more Technology, quality, the law, and ethics are closely interrelated in public health. Well-informed and sensitive analysis of all aspects of their development is a part of the New Public Health. The balance between individual and community rights is very sensitive and must be under continuous surveillance. The New Public Health is replete with technological and ethical questions, especially in a time of cost restraint, increasing technologic potential, the public expectation of universal access to health care, and the assumption that everyone will live a healthy and long life. Health status has always been linked with socioeconomic status, and, despite enormous gains, that remains true even in the most egalitarian countries. Expansions of market mechanisms, such as control of supply of hospital beds, and providers, access to referrals, competition, and incentives/disincentives in payment systems for hospital and managed care systems, contribute to a need for dynamic health management capacity. The New Public Health assumes a social responsibility for health for all, using community and personal care modalities as effectively as possible to achieve that overall goal.

Malignant Mesothelioma in Israel, 1961–1992

International Journal of Occupational and Environmental Health, 1999

The authors monitored time trends in the incidences and distributions of malignant mesotheliomas ... more The authors monitored time trends in the incidences and distributions of malignant mesotheliomas during 1961-92 in 223 Israeli persons, including 21 men from a cohort of 3,057 asbestos-cement workers (83,122 person-years). The annual incidence rates of malignant mesotheliomas in Jewish men ranged between 2.5 per million in 1961-82 and 4.6 per million in 1985-92. The male-to-female incidence ratio rose from 1.2 in the 1960s to 2.9 during 1985-92, as a result of increases in risk among Israeli-born males. Females accounted for 37.6% of all cases, after exclusion of the cohort of asbestos workers. Of the 223 cases, 202 (91%) had no indication of direct occupational exposure to asbestos. In Jewish females, the incidence of malignant mesotheliomas did not increase after 1961. The mean age at diagnosis in all cases was lowest in the Israeli-born (53.0 years). High levels of asbestos exposure in the 1970s and the relatively early age of onset of the disease indicate that exposure began at a younger age in Israel than in European countries. Asbestos manufacture and use peaked in Israel during the mid-1970s, so the maximum impact of these trends has yet to be seen.

Addition of essential micronutrients to foods--implication for public health policy in Israel

The Israel Medical Association journal : IMAJ, 2003

Micronutrient deficiencies have reoccupied the center stage of public health policy with the real... more Micronutrient deficiencies have reoccupied the center stage of public health policy with the realization that folic acid deficiency results in neural tube defects and possibly other birth defects as well as ischemic heart disease. These, in turn, have raised an older debate on food fortification policy for the elimination of iodine, iron and vitamin D deficiencies. Data from the First Israeli National Health and Nutrition Survey (MABAT 2000) provided an impetus to develop an active national nutrition policy aimed to improve the nutritional status of iodine, iron, vitamins A and D and B-vitamins, including folate. In this paper we examine some of the micronutrient deficiency issues in Israel and their implications for public health, and suggest options for the formulation of policy.

Drug and alcohol-related emergency department visits: results of a pilot survey in two hospitals in Israel

The Israel journal of psychiatry and related sciences, 2002

There is no system for reporting drug and alcohol-related emergency department (ED) visits in Isr... more There is no system for reporting drug and alcohol-related emergency department (ED) visits in Israel. This pilot survey was aimed at examining the feasibility of establishing an ED surveillance system in a general hospital and a psychiatric hospital. We describe the design and preliminary results of a pilot-survey conducted in the emergency departments of two hospitals in Northern Israel. Active and passive case identification was conducted in Rambam Hospital and Tirat Carmel Psychiatric Hospital, from August, 1999-January, 2000. A total of 160 ED patients were identified, 64% as drug-related, with heroin being the most common drug. The majority of cases were identified through self-reports. Overdose and IVDU complications accounted for 20% of drug cases identified at Rambam Hospital, and injury and motor vehicle accidents accounted for 12% of all visits at this hospital. We did not attempt to estimate the proportion of all ED visits that are associated with drugs and/or alcohol. Un...

Successful control of poliomyelitis by a combined OPV/IPV polio vaccine program in the West Bank and Gaza, 1978-93

Israel journal of medical sciences

In the 1970s the incidence of poliomyelitis in Gaza and the West Bank was high, even among childr... more In the 1970s the incidence of poliomyelitis in Gaza and the West Bank was high, even among children immunized with as many as four doses of oral polio vaccine (OPV). This was thought to be due to interference in uptake from other enteroviruses in the environment. A combined program of OPV and inactivated polio vaccine (IPV) was instituted in these areas in 1978, and the incidence of polio declined dramatically. Wild poliovirus findings in sewage in 1990-91 coupled with two outbreaks of polio, one in Israel in 1988 and another in Jordan in 1992, were reminders that the area should still be considered endemic. The potential of fresh entry of wild poliovirus may occur via persons who may have personal protection but may still shed the virus due to inadequate enteric immunity. In addition, the combined program protects against vaccine-associated poliomyelitis. A similar modified combined OPV/IPV program has been adopted in Israel. The combination of OPV and IPV provides an important alt...

Organization of local health services: a case study

Israel journal of medical sciences

Health services in Israel are provided by various organizations. In most areas, curative, prevent... more Health services in Israel are provided by various organizations. In most areas, curative, preventive and welfare services are under the administration of separate agencies. Even in small towns, health and social services are provided by many agencies. EAch health care agency is responsible for its own service and there is a lack of joint functioning on the administrative and service levels. To illustrate this, a locality of 11,500 people is described in relation to the characteristics of the population, health care services and other agencies, manpower and use of services. A model is suggested for the organization of comprehensive primary health care at the local level, with integrated curative, preventive and social services. Development of neighborhood health centers with comprehensive services may provide more effective and efficient care for the individual and family and may serve as a suitable framework for the development of community health care programs. The importance of su...

Anemia as a public health problem in Israel

Public health reviews, 1988

Regional differences in cancer incidence and mortality in Israel: possible leads to occupational causes

Israel journal of medical sciences

Occupational causes of cancer are difficult to establish because of the long latency period and d... more Occupational causes of cancer are difficult to establish because of the long latency period and difficulty in identifying occupational linkages. This study provides a regional analysis of cancer incidence and mortality as a method of identifying localizing factors in cancer that can be followed by more specific epidemiologic investigation. In this study we analyze the regional standardized mortality ratios (SMRs) for site-specific cancers, by age, sex and continent of birth for the years 1983-86, for the Jewish population of Israel. Elevated total malignant and benign neoplasm SMRs were found in Acre (SMR 109, P < 0.05), Haifa (104, P < 0.05) and Tel Aviv (107, P < 0.001). The only other statistically significantly elevated SMRs were found in Acre for lung cancer (133, P < 0.05) and leukemia (171, P < 0.05). Age and sex-standardized incidence ratios (SIRs) by regions are also presented for the years 1980-81 for the Jewish population. Haifa had elevated SIRs for colore...

Occupational health in Israel: research and prevention approaches for the 1990s

Israel journal of medical sciences

Polio bullwho Goldblum, Gerichter THT 1994

Cost-benefit analysis of a national thalassaemia prevention programme in Israel

Journal of Medical Screening, 1998

Objective In Israel (population 5.7 million) there are around 200 known living subjects with thal... more Objective In Israel (population 5.7 million) there are around 200 known living subjects with thalassaemia major, of whom around 80% are from the northern district. This study aims at examining the costs and benefits of a national screening programme to prevent thalassaemia in Israel. Measurements and main resultsThe lifetime healthcare costs of caring for a person born with thalassaemia major are &dollar;284 154. The costs of the home infusion service (33.1&percnt;) actually exceed the costs of the chelating agent itself (22.1&percnt;). The remaining 44.8&percnt; of costs are due to stay in hospital, operations, outpatient visits, laboratory tests, therapists, etc. Lost earnings and premature mortality costs account for a further &dollar;51 843 and &dollar;141 944 respectively for each case. A national screening programme would cost &dollar;900 197 and prevent around 13.4 homozygotes being born, at a cost of &dollar;67 369 for each birth prevented. The benefit-cost ratio of the prog...

Epidemic suppression packages in disasters: A public health viewpoint

Public Health, 1979

Communicable disease outbreaks may emerge several days after a sudden large disaster in which the... more Communicable disease outbreaks may emerge several days after a sudden large disaster in which there has been disruption and contamination of water and food supply, breaking of sewer lines, garbage accumulation, loss and destruction of housing and breakdown of personal sanitation. Water-borne diseases (typhoid, cholera, hepatitis) and "'Dirt" diseases (impetigo, shigella) are targets of public health strategies .of suppression. Restoration of the water supply for drinking and for washing is probably the most important step in aborting spread of communicable disease. For diarrhoea and enteritis, case detection and immediate antibiotic treatment of affected cases and close contacts are sensible temporary measures for suppressing morbidity and spread. Post-disaster mass immunization campaigns are tile "'golden calf" of disaster medicine. Pre-disaster education of tile public should emphasize this point. Measures to restore the sanitary infrastructure (water supply, garbage disposal, sewage disposal, vector and rodent control} remain basic to infectious disease control in the post-disaster recovery period. Anticipating the need for those measures remains basic to pre-disaster planning.

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The Ashkelon Hypertension Detection and Control Program (AHDC Program): a community approach to reducing cardiovascular mortality☆

Preventive Medicine, 2003

Background. Blood pressure (BP) reduction is crucial in reducing cardiovascular (CV) morbidity an... more Background. Blood pressure (BP) reduction is crucial in reducing cardiovascular (CV) morbidity and mortality in the community. Subjects aged 20-65 seldom visit the primary care clinics, so they are unlikely to be detected without an active outreach screening program. The aim of the project was to prepare a professional doctor-nurse screening team, who will instruct those found to be at high risk in control of their risk factors, in order to reduce CV morbidity and mortality. Methods. During a 10-year period (1980-1990), teams examined 12,202 subjects, (mean age 51 Ϯ 7 years, range 20-65 years) accounting for 23.4% of the total regional population. High risk subjects underwent an intensive CV risk factor control program. Results. Subjects (3,506 or 28.6%) were found to have one or more CV risk factors (hypertension, obesity, smoking, hypercholesterolemia). During an average of 2 years, follow-up BP, weight reduction, and smoking cessation remained statistically significant. Total cholesterol was unchanged. Over this period, the standardized mortality ratio (SMR) in the area for acute MI fell from 100 to 76 (P Ͻ 0.01), for CV disease from 129 to 107 (P Ͻ 0.0001), and for hypertension from 121 to 87 (P Ͻ 0.1 NS). The project saved many life-years at no additional net cost to society, and cost effectiveness analysis showed positive results. Conclusions. A community approach with mainly nonpharmacological treatment is feasible and cost effective in reducing CV morbidity and mortality.

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Asbestos-exposed populations: Prevention, care, and compensation

Preventive Medicine, 1984

In Israel, the prevention and care of asbestos-associated diseases with latency periods of one to... more In Israel, the prevention and care of asbestos-associated diseases with latency periods of one to four decades (asbestosis, mesothelioma, increased frequency of cancer of the lung and other sites) are not satisfactory, and new national policies are required. Such policies have three major goals: (a) elimination or reduction of exposure to asbestos dust; (b) measures to promote cessation or drastic reduction of cigarette smoking among those currently or formerly exposed; and (c) equitable compensation for the consequences of past exposures. The practical elements of a program to achieve these three goals include (a) exposure standards and control technology; (b) identification of sources, routes, and levels of exposure and groups at risk; (c) compensation and job security; (d) medical monitoring and follow-up; (e) smoking cessation; (f) selective substitution of other substances for asbestos; and (g) establishment of a panel for policy supervision and the overseeing of compensation programs. Delay in implementation risks higher death rates for asbestosis and cancer among previously exposed workers, greater exposure among current workers, loss of experienced workers from the work force, and unnecessary hardship for families not adequately compensated.

Reviews IAnalyses Poliomyelitis control in Israel, the West Bank

The Association of Schools of Public Health in the European Region Statement on the Erosion of Public Health Systems

Public Health Reviews, 2021

Download

Are Schools of Public Health Needed to Address Public Health Workforce Development in Canada for the 21st Century?

Canadian Journal of Public Health, 2006

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Our contribution to international public health workforce development: Training at the Braun School of Public Health and Community Medicine in Jerusalem