The objective of this study was to assess the effect of a housing provision package on treatment ... more The objective of this study was to assess the effect of a housing provision package on treatment outcomes among homeless South Korean tuberculosis (TB) patients. We conducted a prospective, single-arm, community-based study with historical controls as follows: community-based intervention group (COM), who were provided housing, nutrition, and case management, and received directly observed therapy services; a first historical control that was treated as usual (TAU); and a second historical control that comprised homeless TB patients residing in long-term TB-care facility (FAC). A multivariable logistic regression model was constructed to identify predictors associated with treatment success among homeless TB patients. Treatment was successful in 86.0%, 58.3%, and 96.1% of patients in the COM, TAU, and FAC groups, respectively. Interventions, including those found in the COM and FAC groups, were the only predictors of treatment success. Therefore, we determined that housing provision...
International Journal of Environmental Health Research, 2019
The objective of this study was to identify the association between social deprivation, outdoor a... more The objective of this study was to identify the association between social deprivation, outdoor air pollution, and tuberculosis (TB) incidence rate or mortality rate. The study sample comprised 25 districts in Seoul, Korea. We used two public data derived from the Community Health Survey and Seoul Statistics. The geographic information system analysis and random effects Poisson regression were applied to explore the association of social deprivation and air pollution with TB incidence and mortality. An 1 ppb increase in sulfur dioxide (SO 2) concentration was significantly associated with the risk of TB incidence (risk ratio [RR] = 1.046, 95% confidence interval [CI]: 1.028, 1.065). An 1 unit increase in the deprivation index was significantly related to a6% increase in the mortality of TB (RR = 1.063, 95% CI: 1.031, 1.097). : Our results imply that social deprivation and air pollution may affect the different TB outcomes. Effective policy-making for TB control should reflect the differing outcomes between TB incidence and mortality.
Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health, Jan 28, 2015
The aim of this study is to identify the social determinants of prescription drug use among adult... more The aim of this study is to identify the social determinants of prescription drug use among adults with chronic diseases by examining the associations between socioeconomic position and prescription medicine use and perceived burden for pharmaceutical expenditure, using a sample of the Korean population from the 2008 Korea Health Panel, with 4 analytic models. Controlled with health status and the type of health insurance, the probability of using prescription drugs and overall spending on drugs significantly increased with rising income level, while perceived burden for out-of-pocket payment significantly decreased. These results imply that the poor are likely to underuse prescription drugs compared with their wealthier counterparts with the same need for health care, probably due to economic barriers.
Fair and efficient government policies on labour and welfare can reduce health inequalities that ... more Fair and efficient government policies on labour and welfare can reduce health inequalities that accompany poor employment conditions and unemployment, explain Joan Benach and colleagues.
The authors develop a macro-social theoretical framework to explain how employment and working co... more The authors develop a macro-social theoretical framework to explain how employment and working conditions affect health inequalities. The theo-retical framework represents the social origins and health consequences of various forms of employment conditions. The emphasis is thus on deter-minants and consequences of employment conditions, not on social deter-minants of health in general. The framework tries to make sense of the complex link between macro-social power relations among employers, government, and workers ’ organizations, labor market and social policies, employment and working conditions, and the health of workers. It also suggests further testing of hypothetical causal pathways not covered in the literature. This macro-social theoretical framework might help identify the main “entry points ” through which to implement policies and inter-ventions to reduce employment-related health inequalities. The theoretical framework should be approached from a historical perspective. The Employment Conditions Knowledge Network (EMCONET) has constructed a theoretical framework to explain how employment and working conditions affect health inequalities. Given the social complexity of employment conditions, the use of theoretical frameworks helps us summarize, organize, and explain large quantities of research (1). Our framework tries to make sense of the complex link between macro-social power relations, employment conditions, and the health of workers, and suggests further testing of hypothetical causal pathways not covered in the literature. Theoretical frameworks also help identify the main
Since the nineteen seventies, high-and low-income countries have undergone a pattern of transnati... more Since the nineteen seventies, high-and low-income countries have undergone a pattern of transnational economic and cultural integration known as globalization. The weight of the available evidence suggests that the effects of globalization on labor markets have increased economic inequality and various forms of economic insecurity that negatively affect workers' health. Research on the relation between labor markets and health is hampered by the social invisibility of many of these health inequalities. Empirical evidence of the impact of employment relations on health inequalities is scarce for low-income countries, small firms, rural settings, and sectors of the economy in which ''informality'' is widespread. Information is also scarce on the effectiveness of labor market interventions in reducing health inequalities. This pattern is likely to continue in the future unless governments adopt active labor market policies. Such policies include creating jobs through state intervention, regulating the labor market to protect employment, supporting unions, and ensuring occupational safety and health standards.
Korean Journal of Health Policy and Administration, 2012
The purpose of the study is to examine the use of medication among adults by comparing the patter... more The purpose of the study is to examine the use of medication among adults by comparing the pattern of outpatient prescription drug use with the pattern of long term taking lifestyle drug use. Furthermore, the study investigates factors associated with the use of medication, particularity focusing on socioeconomic factors.
Richard Wilkinson and Kate Pickett's latest book, The Spirit Level: Why Equality is Best for ... more Richard Wilkinson and Kate Pickett's latest book, The Spirit Level: Why Equality is Best for Everyone, has caught the attention of academics and policymakers and stimulated debate across the left-right political spectrum. Interest in income inequality has remained unabated since the publication of Wilkinson's previous volume, Unhealthy Societies: The Afflictions of Inequality. While both books detail the negative health effects of income inequality, The Spirit Level expands the scope of its argument to also include social issues. The book, however, deals extensively with the explanation of how income inequality affects individual health. Little attention is given to political and economic explanations on how income inequality is generated in the first place. The volume ends with political solutions that carefully avoid state interventions such as limiting the private sector's role in the production of goods and services (e.g., non-profit sector, employee-ownership scheme...
The authors develop a macro-social theoretical framework to explain how employment and working co... more The authors develop a macro-social theoretical framework to explain how employment and working conditions affect health inequalities. The theoretical framework represents the social origins and health consequences of various forms of employment conditions. The emphasis is thus on determinants and consequences of employment conditions, not on social determinants of health in general. The framework tries to make sense of the complex link between macro-social power relations among employers, government, and workers' organizations, labor market and social policies, employment and working conditions, and the health of workers. It also suggests further testing of hypothetical causal pathways not covered in the literature. This macro-social theoretical framework might help identify the main “entry points” through which to implement policies and interventions to reduce employment-related health inequalities. The theoretical framework should be approached from a historical perspective.
In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement ... more In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement as part of a political project known as the Bolivarian Revolution. Inspired by the democratic ideologies of Simón Bolívar, this movement was committed to reducing intractable inequalities that defined Venezuela's Fourth Republic (1958–1998). Given the ambitious scope of these reforms, Venezuela serves as an instructive example to understand the political context of social inequalities and population health. In this article, we provide a brief overview of the impact of egalitarian policies in Venezuela, stressing: ( a) the socialist reforms and social class changes initiated by the Bolivarian Movement; ( b) the impact of these reforms and changes on poverty and social determinants of health; ( c) the sustainability of economic growth to continue pro-poor policies; and ( d) the implications of egalitarian policies for other Latin American countries. The significance and implications of...
This article presents an update on the characteristics and performance of Venezuela's Bolivar... more This article presents an update on the characteristics and performance of Venezuela's Bolivarian health care system, Barrio Adentro (Inside the Neighborhood). During its first five years of existence, Barrio Adentro has improved access and utilization of health services by reaching approximately 17 million impoverished and middle-class citizens all over Venezuela. This was achieved in approximately two years and provides an example of an immense “South-South” cooperation and participatory democracy in health care. Popular participation was achieved with the Comités de Salud (health committees) and more recently with the Consejos Comunales (community councils), while mostly Cuban physicians provided medical care. Examination of a few epidemiological indicators for the years 2004 and 2005 of Barrio Adentro reveals the positive impact of this health care program, in particular its primary care component, Barrio Adentro I. Continued political commitment and realistic evaluations are...
The association between certain increasingly pervasive employment conditions and serious health i... more The association between certain increasingly pervasive employment conditions and serious health inequalities presents a significant policy challenge. A critical starting point is the recognition that these problems have not arisen in a policy vacuum. Rather, policy frameworks implemented by governments over the past 35 years, in conjunction with corporate globalization (itself facilitated by neoliberal policies), have undermined preexisting social protection policies and encouraged the growth of health-damaging forms of work organization. After a brief description of the context in which recent developments should be viewed, this article describes how policies can be reconfigured to address health-damaging employment conditions. A number of key policy objectives and entry points are identified, with a summary of policies for each entry point, relating to particular employment conditions relevant to rich and poor countries. Rather than trying to elaborate these policy interventions in detail, the authors point to several critical issues in relation to these interventions, linking these to illustrative examples.
Welfare states have long been 'in transition'since the 1970s (Johnson 1987, Esping-Ande... more Welfare states have long been 'in transition'since the 1970s (Johnson 1987, Esping-Andersen 1996). In line with globalization and post-industrialization, new types of 'risks' and 'insecurity'have ceaselessly emerged and welfare states have had to transform themselves to cope with them. In particular, rapid ageing, family transformations, and flexible labor markets have become critical factors affecting the effectiveness of welfare states in modern crisis-ridden economies. In this context, many seriously question the sustainability of ...
Click on the pictures to access each section directly Labour and Social Cohesion Section 1 Develo... more Click on the pictures to access each section directly Labour and Social Cohesion Section 1 Developmen t and Trade Section 2 Markets and the Financia l Crisis Section 3 Climate Change and the Environment Section 4 Democracy Section 5 Acknowledgments We are very grateful to all the authors who thoughtfully and generously contributed to this collection of essays. The authors brought to this project the synthesis and progressive forethought that we had hoped for. We also want to thank the staff in the secretariat of the Socialist Group in the European Parliament who tirelessly ...
Results: The authors analyze changes in health policies in Venezuela that occurred within a frame... more Results: The authors analyze changes in health policies in Venezuela that occurred within a framework of events linked to the implementation of the neoliberal model in this country: 1) the external debt and declining oil revenues which together contributed to the economic crisis in 1989. 2) The succinct implementation of neoliberal measures. 3) The promotion of the decentralization of government health services in 1993. 4) The increase in private investment in medical care in the face of the deterioration of public services. 5) The governmental implementation of ...
Objetivos: Describir las reformas aplicadas en el 2003 a la atención primaria de la salud en Vene... more Objetivos: Describir las reformas aplicadas en el 2003 a la atención primaria de la salud en Venezuela en el marco de la Misión" Barrio Adentro" y analizar indicadores del impacto de sus operaciones, así como de los retos que enfrenta esta misión.
Objetivos: Descrever as reformas aplicadas em 2003 em relaà § ã o ao atendimento primá rio da s... more Objetivos: Descrever as reformas aplicadas em 2003 em relaà § ã o ao atendimento primá rio da saúde na Venezuela no marco da Missã o †œBairro Adentro†e analisar os indicadores de impacto de suas operaà § ões, assim como dos desafios enfrentados por esta missã o.
The objective of this study was to assess the effect of a housing provision package on treatment ... more The objective of this study was to assess the effect of a housing provision package on treatment outcomes among homeless South Korean tuberculosis (TB) patients. We conducted a prospective, single-arm, community-based study with historical controls as follows: community-based intervention group (COM), who were provided housing, nutrition, and case management, and received directly observed therapy services; a first historical control that was treated as usual (TAU); and a second historical control that comprised homeless TB patients residing in long-term TB-care facility (FAC). A multivariable logistic regression model was constructed to identify predictors associated with treatment success among homeless TB patients. Treatment was successful in 86.0%, 58.3%, and 96.1% of patients in the COM, TAU, and FAC groups, respectively. Interventions, including those found in the COM and FAC groups, were the only predictors of treatment success. Therefore, we determined that housing provision...
International Journal of Environmental Health Research, 2019
The objective of this study was to identify the association between social deprivation, outdoor a... more The objective of this study was to identify the association between social deprivation, outdoor air pollution, and tuberculosis (TB) incidence rate or mortality rate. The study sample comprised 25 districts in Seoul, Korea. We used two public data derived from the Community Health Survey and Seoul Statistics. The geographic information system analysis and random effects Poisson regression were applied to explore the association of social deprivation and air pollution with TB incidence and mortality. An 1 ppb increase in sulfur dioxide (SO 2) concentration was significantly associated with the risk of TB incidence (risk ratio [RR] = 1.046, 95% confidence interval [CI]: 1.028, 1.065). An 1 unit increase in the deprivation index was significantly related to a6% increase in the mortality of TB (RR = 1.063, 95% CI: 1.031, 1.097). : Our results imply that social deprivation and air pollution may affect the different TB outcomes. Effective policy-making for TB control should reflect the differing outcomes between TB incidence and mortality.
Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health, Jan 28, 2015
The aim of this study is to identify the social determinants of prescription drug use among adult... more The aim of this study is to identify the social determinants of prescription drug use among adults with chronic diseases by examining the associations between socioeconomic position and prescription medicine use and perceived burden for pharmaceutical expenditure, using a sample of the Korean population from the 2008 Korea Health Panel, with 4 analytic models. Controlled with health status and the type of health insurance, the probability of using prescription drugs and overall spending on drugs significantly increased with rising income level, while perceived burden for out-of-pocket payment significantly decreased. These results imply that the poor are likely to underuse prescription drugs compared with their wealthier counterparts with the same need for health care, probably due to economic barriers.
Fair and efficient government policies on labour and welfare can reduce health inequalities that ... more Fair and efficient government policies on labour and welfare can reduce health inequalities that accompany poor employment conditions and unemployment, explain Joan Benach and colleagues.
The authors develop a macro-social theoretical framework to explain how employment and working co... more The authors develop a macro-social theoretical framework to explain how employment and working conditions affect health inequalities. The theo-retical framework represents the social origins and health consequences of various forms of employment conditions. The emphasis is thus on deter-minants and consequences of employment conditions, not on social deter-minants of health in general. The framework tries to make sense of the complex link between macro-social power relations among employers, government, and workers ’ organizations, labor market and social policies, employment and working conditions, and the health of workers. It also suggests further testing of hypothetical causal pathways not covered in the literature. This macro-social theoretical framework might help identify the main “entry points ” through which to implement policies and inter-ventions to reduce employment-related health inequalities. The theoretical framework should be approached from a historical perspective. The Employment Conditions Knowledge Network (EMCONET) has constructed a theoretical framework to explain how employment and working conditions affect health inequalities. Given the social complexity of employment conditions, the use of theoretical frameworks helps us summarize, organize, and explain large quantities of research (1). Our framework tries to make sense of the complex link between macro-social power relations, employment conditions, and the health of workers, and suggests further testing of hypothetical causal pathways not covered in the literature. Theoretical frameworks also help identify the main
Since the nineteen seventies, high-and low-income countries have undergone a pattern of transnati... more Since the nineteen seventies, high-and low-income countries have undergone a pattern of transnational economic and cultural integration known as globalization. The weight of the available evidence suggests that the effects of globalization on labor markets have increased economic inequality and various forms of economic insecurity that negatively affect workers' health. Research on the relation between labor markets and health is hampered by the social invisibility of many of these health inequalities. Empirical evidence of the impact of employment relations on health inequalities is scarce for low-income countries, small firms, rural settings, and sectors of the economy in which ''informality'' is widespread. Information is also scarce on the effectiveness of labor market interventions in reducing health inequalities. This pattern is likely to continue in the future unless governments adopt active labor market policies. Such policies include creating jobs through state intervention, regulating the labor market to protect employment, supporting unions, and ensuring occupational safety and health standards.
Korean Journal of Health Policy and Administration, 2012
The purpose of the study is to examine the use of medication among adults by comparing the patter... more The purpose of the study is to examine the use of medication among adults by comparing the pattern of outpatient prescription drug use with the pattern of long term taking lifestyle drug use. Furthermore, the study investigates factors associated with the use of medication, particularity focusing on socioeconomic factors.
Richard Wilkinson and Kate Pickett's latest book, The Spirit Level: Why Equality is Best for ... more Richard Wilkinson and Kate Pickett's latest book, The Spirit Level: Why Equality is Best for Everyone, has caught the attention of academics and policymakers and stimulated debate across the left-right political spectrum. Interest in income inequality has remained unabated since the publication of Wilkinson's previous volume, Unhealthy Societies: The Afflictions of Inequality. While both books detail the negative health effects of income inequality, The Spirit Level expands the scope of its argument to also include social issues. The book, however, deals extensively with the explanation of how income inequality affects individual health. Little attention is given to political and economic explanations on how income inequality is generated in the first place. The volume ends with political solutions that carefully avoid state interventions such as limiting the private sector's role in the production of goods and services (e.g., non-profit sector, employee-ownership scheme...
The authors develop a macro-social theoretical framework to explain how employment and working co... more The authors develop a macro-social theoretical framework to explain how employment and working conditions affect health inequalities. The theoretical framework represents the social origins and health consequences of various forms of employment conditions. The emphasis is thus on determinants and consequences of employment conditions, not on social determinants of health in general. The framework tries to make sense of the complex link between macro-social power relations among employers, government, and workers' organizations, labor market and social policies, employment and working conditions, and the health of workers. It also suggests further testing of hypothetical causal pathways not covered in the literature. This macro-social theoretical framework might help identify the main “entry points” through which to implement policies and interventions to reduce employment-related health inequalities. The theoretical framework should be approached from a historical perspective.
In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement ... more In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement as part of a political project known as the Bolivarian Revolution. Inspired by the democratic ideologies of Simón Bolívar, this movement was committed to reducing intractable inequalities that defined Venezuela's Fourth Republic (1958–1998). Given the ambitious scope of these reforms, Venezuela serves as an instructive example to understand the political context of social inequalities and population health. In this article, we provide a brief overview of the impact of egalitarian policies in Venezuela, stressing: ( a) the socialist reforms and social class changes initiated by the Bolivarian Movement; ( b) the impact of these reforms and changes on poverty and social determinants of health; ( c) the sustainability of economic growth to continue pro-poor policies; and ( d) the implications of egalitarian policies for other Latin American countries. The significance and implications of...
This article presents an update on the characteristics and performance of Venezuela's Bolivar... more This article presents an update on the characteristics and performance of Venezuela's Bolivarian health care system, Barrio Adentro (Inside the Neighborhood). During its first five years of existence, Barrio Adentro has improved access and utilization of health services by reaching approximately 17 million impoverished and middle-class citizens all over Venezuela. This was achieved in approximately two years and provides an example of an immense “South-South” cooperation and participatory democracy in health care. Popular participation was achieved with the Comités de Salud (health committees) and more recently with the Consejos Comunales (community councils), while mostly Cuban physicians provided medical care. Examination of a few epidemiological indicators for the years 2004 and 2005 of Barrio Adentro reveals the positive impact of this health care program, in particular its primary care component, Barrio Adentro I. Continued political commitment and realistic evaluations are...
The association between certain increasingly pervasive employment conditions and serious health i... more The association between certain increasingly pervasive employment conditions and serious health inequalities presents a significant policy challenge. A critical starting point is the recognition that these problems have not arisen in a policy vacuum. Rather, policy frameworks implemented by governments over the past 35 years, in conjunction with corporate globalization (itself facilitated by neoliberal policies), have undermined preexisting social protection policies and encouraged the growth of health-damaging forms of work organization. After a brief description of the context in which recent developments should be viewed, this article describes how policies can be reconfigured to address health-damaging employment conditions. A number of key policy objectives and entry points are identified, with a summary of policies for each entry point, relating to particular employment conditions relevant to rich and poor countries. Rather than trying to elaborate these policy interventions in detail, the authors point to several critical issues in relation to these interventions, linking these to illustrative examples.
Welfare states have long been 'in transition'since the 1970s (Johnson 1987, Esping-Ande... more Welfare states have long been 'in transition'since the 1970s (Johnson 1987, Esping-Andersen 1996). In line with globalization and post-industrialization, new types of 'risks' and 'insecurity'have ceaselessly emerged and welfare states have had to transform themselves to cope with them. In particular, rapid ageing, family transformations, and flexible labor markets have become critical factors affecting the effectiveness of welfare states in modern crisis-ridden economies. In this context, many seriously question the sustainability of ...
Click on the pictures to access each section directly Labour and Social Cohesion Section 1 Develo... more Click on the pictures to access each section directly Labour and Social Cohesion Section 1 Developmen t and Trade Section 2 Markets and the Financia l Crisis Section 3 Climate Change and the Environment Section 4 Democracy Section 5 Acknowledgments We are very grateful to all the authors who thoughtfully and generously contributed to this collection of essays. The authors brought to this project the synthesis and progressive forethought that we had hoped for. We also want to thank the staff in the secretariat of the Socialist Group in the European Parliament who tirelessly ...
Results: The authors analyze changes in health policies in Venezuela that occurred within a frame... more Results: The authors analyze changes in health policies in Venezuela that occurred within a framework of events linked to the implementation of the neoliberal model in this country: 1) the external debt and declining oil revenues which together contributed to the economic crisis in 1989. 2) The succinct implementation of neoliberal measures. 3) The promotion of the decentralization of government health services in 1993. 4) The increase in private investment in medical care in the face of the deterioration of public services. 5) The governmental implementation of ...
Objetivos: Describir las reformas aplicadas en el 2003 a la atención primaria de la salud en Vene... more Objetivos: Describir las reformas aplicadas en el 2003 a la atención primaria de la salud en Venezuela en el marco de la Misión" Barrio Adentro" y analizar indicadores del impacto de sus operaciones, así como de los retos que enfrenta esta misión.
Objetivos: Descrever as reformas aplicadas em 2003 em relaà § ã o ao atendimento primá rio da s... more Objetivos: Descrever as reformas aplicadas em 2003 em relaà § ã o ao atendimento primá rio da saúde na Venezuela no marco da Missã o †œBairro Adentro†e analisar os indicadores de impacto de suas operaà § ões, assim como dos desafios enfrentados por esta missã o.
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