We trace the development of the concept of the corporate determinants of health. We argue that these determinants are predicated on the un- checked power of corporations and that the means by which corporations exert power is increasingly unseen.
We identify four of the ways corporations influence health: defining the dominant narra- tive; setting the rules by which society, especially trade, oper- ates; commodifying knowledge; and undermining political, so- cial, and economic rights.
We identify how public health professionals can respond to these manifestations of power. (Am J Public Health. 2018;108: 1167–1170. doi:10.2105/AJPH. 2018.304510)
CHAPTER 7The policy processEileen T. O’GradyThere are tJinElias52
CHAPTER 7
The policy process
Eileen T. O’Grady
“There are three critical ingredients to democratic renewal and progressive change in America: good public policy, grassroots organizing and electoral politics.”
Paul Wellstone
Nurses can more strategically and effectively influence policy if they have a clear understanding of the policymaking process. Conceptual models can help to organize and interpret information by depicting complex ideas in a simplified form; to this end, political scientists have developed a number of conceptual models to explain the highly dynamic process of policymaking. This chapter reviews two of these conceptual models.
Health policy and politics
Health policy encompasses the political, economic, social, cultural, and social determinants of individuals and populations and attempts to address the broader issues in health and health care (see Box 7.1 for policy definitions). A clear understanding of the points of influence to shape policy is essential and includes framing the problem itself. For example, if nurses working in a nurse-managed clinic are troubled by staff shortages or long patient waits, they may be inclined to see themselves as the solution by working longer hours and seeing more patients. Defining and framing the problem is the first step in the policy process and involves assessing its history, patterns of impact, resource allocation, and community needs. Broadening and framing the problem to influence or educate stakeholders at the local, state, or federal level could include advocating for better access or funding for nursing workforce development (see Box 7.1).
BOX 7.1
Policy Definitions
Policy is authoritative decision making related to choices about goals and priorities of the policymaking body. In general, policies are constructed as a set of regulations (public policy), practice standards (workplace), governance mandates (organizations), ethical behavior (research), and ordinances (communities) that direct individuals, groups, organizations, and systems toward the desired behaviors and goals.
Health policy is the authoritative decisions made in the legislative, judicial, and executive branches of government that are intended to direct or influence the actions, behaviors, and decisions of others (Longest, 2016).
Policy analysis is the investigation of an issue including the background, purpose, content, and effects of various options within a policy context and their relevant social, economic, and political factors (Dye, 2016).
The next step is to bring the problem to the attention of those who have the power to implement a solution. Other key factors to consider include generating public interest, the availability of viable policy solutions, the likelihood that the policy will serve most of the people at risk in a fair and equitable fashion, and consideration of the organizational, community, societal, and political viability of the policy solution.
Public interest is a fascinating dynamic ...
A Career in Public Health Essay examples
Public Health Principles
Public Health Assessment Essay
Public Vs. Public Health Essay
Public Health Research Paper
Master In Public Health
Public Health Entrance Paper
The Ethics Of Public Health Essay
Global Public Health Essay
Public Health Nursing Essay
Legal PrinciplesNon- Malfeasance- Do n.docxsmile790243
Legal Principles
Non- Malfeasance- Do no harm
The legal principles are rules of human behavior that used to be considered as just, before the law started being written.
The ethical category of Non-Malfeasance represents the doctor’s try to avoid any act or treatment plan that would hurt the patient or violate the patient’s trust, and has been popularized in the phrase “first, do no harm.” Non-Malfeasance is supported through discretion and avoidance. It is critically important that the specialist provider of highly persistent treatments uphold Non-Malfeasance.
(Rodak, 2012)
Beneficence- Promote the welfare of others
Beneficent actions and motives have usually occupied a middle place in morality. Ordinary examples today are found in social welfare programs, policies to improve the welfare of animals etc.
Distributive Justice- All involved should have equal entitlements
The economic structure that each society has its laws, institutions, policies, etc. results in different distributions of economic benefits and burdens across members of the society. These economic frameworks are the result of human political processes and they continually change both across societies and within societies over time.
Autonomy- non influenced decisions for both patients and physicians
The term “autonomy” has appeared more and more often in the medical literature. According to this interpretation of autonomy, the goal for an autonomous person is to decide on his or her own, without undue manipulation by others.
One of the first empirical papers in medical decision making on patient autonomy thus linked autonomy to the question of whether patients wanted to make decisions themselves. In the descriptive medical decision making literature, this meaning has become the default.
The patient described in the informative model from the well known paper of Emanuel and Emanuel corresponds with an autonomous patient in this sense.
Healthcare Rights
Non- Discrimination- race, religion, sexual orientation
In human social affairs, discrimination is treatment or consideration of, or making a difference in favor of or against, a person or thing based on the group, class, or category to which that person or thing is apparent to belong to rather than on individual merit. This includes treatment of an individual or group, based on their real or perceived membership in a certain group or social group.
(Lamont, 2016)
Credentialing/ Scope of Practice
When you go for health care, identity matters a lot. You need to verify certain proofs. Following are the things that you need:
Verification of identity
(NAMSS, n.d.)
Legal Employment Qualifications
The Immigration Reform and Control Act of 1986 (IRCA) required employers to verify that all newly hired workers present "facially valid" documentation verifying the employee's identity and legal authorization to accept employment in the United States. The I-9 form or more properly ...
Five Questions” You will write responses to five (5.docxRAJU852744
“
Five Questions
”
:
You will write responses to five (5) questions provided by the instructor, each response
approximately 350-500 words long.
These questions will help you identify and evaluate:
theroleofthegoverningbodythatyouaretargetingwithyourproposal;
thetwoopposingpolicypositionsandtheirclaimsmakers(i.e.thosewhoaresupporting
each position and their investment in that stance); and,
your integration of conceptual material from weekly readings and class discussions
through midterm, including:
types of moral perspectives;
political alliances and relative political power of policy proposals;
impact of social factors/social conditions on issue and proposed solutions;
current and projected disparities in healthcare use and outcomes.
It is expected that you will be building on these writings as you proceed through the term.
list of the topic
Sources must include course readings as well as research from peer-reviewed academic
journals.
Final write-up of the paper is due at 7 p.m. on Wednesday of Finals Week and emailed to the instructor
.
Choose one of the following for your policy analysis paper.
Public Health and Rights to Privacy:
Should medical providers be bound by Public Health policies? Recently, a nurse who was exposed to the Ebola virus refused quarantine rules imposed by the legislature and health department of New Jersey. What were the arguments on both sides? What roles did science, cultural values and norms, and political posturing play in policymaking? What other factors were involved? What are implications for other issues in which private and public health sectors must collaborate?
Is unregulated economic growth good for our health?
Scientists argue that diminishing biodiversity in our ecosystems world-wide, much of it due to unrestricted development and other human activity, will affect our health in the future. Are there ways we can grow an economy and maintain diversity in the environment?
Health care digitization and other new technologies in your docto
r’s
office:
Physicians and their staffs are facing increased pressures to digitize medical records, and recruit and maintain a remote client base through telemedicine practices, i.e., incorporate new technologies into their practices. Are these new practices changing the doctor-patient relationship? What do both doctors and patients think about the changes? And, what roles are medical industries, healthcare corporations, and governments playing in effecting certain changes?
Making the rules regarding wom
en’s
contraceptive choices:
One of most controversial (and litigated) provision of the PPACA is the obligation of employer plans to cover contraceptive services under prevention. Businesses that oppose coverage have challenged the law and won concessions. What are the origins of this debate, both in the construction of the law and in the history of women
’s
contraceptive choices in America? What implications doe ...
Programs for public health practitioners in the field, due to the profession is so dispersed in its work—from employment in private managed care organizations and clinics. The main purpose of this study is to analysis the relationship between law and ethics with public healthcare performance. The present study used a quantitative research design, specifically the descriptive survey design. This is because such design accurately and objectively describes the characteristics of a situation or phenomenon being investigated in a given study. It provides a description of the variables in a particular situation and, sometimes, the relationship among these variables rather than focusing on the cause-and effect relationships. Thus, this study used a questionnaire which was developed from previous research in order to measure the relationships among the investigated variables. This study was carried out in different healthcare centers located in Erbil, the total of 81 participants participated in this study. The researcher developed research hypothesis as follow; there is a positive and significant relationship between law and healthcare performance in Erbil. The finding of this study showed that the value of beta for law and ethics factor is .749 with the P-value .000 this means that the law and ethics will have positive and significant influence on healthcare performance; accordingly the main research hypothesis is supported.
Chapter 15Health Professional LeadershipNormal is getting narrEstelaJeffery653
Chapter 15
Health Professional Leadership
Normal is getting narrower and narrower.
—Personal observation by an experienced nurse practitioner
Health professionals can be important participants in health policy processes. They bring their experiences, their knowledge of both science and art, their ability to distinguish between the two, and their commitment to the patient. Typically, they also bring a commitment to lifelong learning. The power of the professions, especially physicians, has been waning of late, but that has a lot to do with the height of their dominance in the past. In an open, market-driven, information-rich society, the old monopoly power described by Starr (1982) is not sustainable. Health professionals now need to undertake new leadership roles or else their status will be further undermined by those actively seeking a greater share of the pie. Those new roles will have to focus more on collaboration and coordination of care.
15.1 DISINTERESTEDNESS
Much of the diminished respect for health professionals stems from the public’s perception of reduced disinterestedness. Current fashion in economics seems to deny the concept of disinterestedness—the concept of lack of bias and freedom from special interests, the ability to set aside one’s own interests and to seek the best possible outcome for others. The opposite is the oft-repeated phrase, “All they care about is money.” Money is harder to come by in most parts of the health care system because of utilization controls and deep discounts to health care plans, and thus the increased concern is understandable; however, that is not reassuring to the public. Much of the literature on the rising costs of care blames the current fee-for-service system for making it in the providers’ interest to promote overutilization. Schlesinger (2002) argued that this loss of faith seemed to intensify with the advent of Medicare and Medicaid, and that that has led to a loss of political power as well. One parameter of successful professional leadership will be the ability to engender faith that the professional and the profession have the interests of other constituencies in mind.
15.2 INFORMATIONAL CREDIBILITY
Disintermediation in general and direct-to-consumer advertising in particular have affected the informational monopoly of the health professions. This is not a one-way street. The claims and counterclaims of the various interested parties can be hard to sort out. One leadership role for the health professional is to guide the general public through that welter of information. This is not just a physician’s task. It involves all health professionals. An article in BusinessWeek asked, “How Good Is Your Online Nurse?” and compared the online patient portals of the three largest health insurers: WellPoint, United Health Group, and Aetna (Weintraub, 2006). The trends reported in the article included greater integration with patient records, more add-on purchased counseling, and more person ...
Wiley and Springer are collaborating with JSTOR to digitize,.docxjoyjonna282
Wiley and Springer are collaborating with JSTOR to digitize, preserve and extend access to Sociological Forum.
http://www.jstor.org
Not Just a Matter of Criminal Justice: States, Institutions, and North American Drug Policy
Author(s): Ellen Benoit
Source: Sociological Forum, Vol. 18, No. 2 (Jun., 2003), pp. 269-294
Published by: Springer
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is mainly concerned with policy effects rather than origins. Yet, like other
social policies, drug policy is a product of the legislative process, and its
variations, too, are shaped by the ways in which political institutions me-
diate the fortunes of policy agendas. Drug policy is also, like welfare poli-
cies, a way in which the state manages the socioeconomic risks faced by its
constituents.
This article presents a rationale for an analytical approach to drug pol-
icy grounded in politics and institutions. I propose a polity-centered analysis
that emphasizes the role of the state-its configuration and capacities, its
relationships with other institutional sectors and with its citizens-and the
legacies of previous policies, not only in drug control but in other, related pol-
icy areas as well. Such a perspective provides a more complete explanation
of drug-policy variations cross-nationally and over time than do approaches
that conceive of drug policy narrowly as a matter of criminal justice. Exam-
ining the evolution of drug-control strategies in this way also demonstrates
the potential for a new theoretical argument regarding policy development
more broadly: that institutional interests can cross policy domains, creating
potential administrative capacity for new policies and fostering linkages by
which one policy influences another.
Drug policy everywhere must manage the tension between the state's
interests in protec ...
Discussion1 ( 200 words)You have just developed a GPS unit tha.docxelinoraudley582231
Discussion1 ( 200 words)
You have just developed a GPS unit that can be worn on a necklace, wristband or belt. The unit is designed to aid in locating missing children, individuals with dementia, or those who are developmentally disabled. Who your target audience(s) are and what approach will you use with them.
Discussion2 ( 200 words)
Duluth Trading Company Ads
COLLAPSE
Top of Form
The Duluth Trading Company began in 1989 with the creation of a work belt for carpenters and "handy" men (and now women). It has since expanded into clothing and a focus on underwear and work clothes. A new series of attention grabbing ads has been released this year bringing more visibility to the company.
Watch the ads - both those aimed at men and at women - featured on the page linked below (copy and paste into your browser).
Discuss how effective this advertising campaign is to today's audience.
What segment of the market is Duluth targeting?
Do you think this ad campaign will be effective for that segment?
Would this same ad campaign work in another country such as Saudi Arabia, Korea or China? Why or why not?
https://www.youtube.com/user/DuluthTrading
Case 5.1(answer following questions, 300 words)
Case 6.1(answer following questions, 300 words)
Bottom of Form
Malpractice Reform in Illinois
COLLAPSE
Top of Form
Client:
The client is the Illinois Health and Hospital Association (IHA). They seek to “To advocate for and support hospitals and health systems as they serve their patients and communities” (Illinois Health and Hospital Association, 2016). The IHA has a strong interest in malpractice reform. They maintain a page on their website for medical liability (Illinois Health and Hospital Association, 2016).
Problem Statement:
What can be done to reduce malpractice premium costs in the State of Illinois?
Kingdon Analysis:
Problem stream:
The problem is real - Malpractice issues in Illinois are particularly problematic. Illinois is ranked as having the fourth highest tort costs in the country and the fifth most draconian tort laws according to The Pacific Research Institute (Luke, Illinois, NY among Usual Tort Suspects in PRI Study, 2008). Illinois is also in the top five states in terms of malpractice insurance costs (Kiernan, 2016’s Best & Worst States for Doctors, 2016).
Politics Stream
Stakeholders:
1) Patients - the consumers of health care - Individuals who are scheduled for or are receiving healthcare services. There are a variety of associations and organizations that advocate for patients. For example, Propublica is committed to “expose abuses of power and betrayals of the public trust by government, business, and other institutions, using the moral force of investigative journalism to spur reform through the sustained spotlighting of wrongdoing” (Propublica, 2016). Their journalistic interest extends to healthcare including medical malpractice. They are particularly interested in changes in the malpractice environment that will de.
July 2002, Vol 92, No. 7 American Journal of Public Health E.docxcroysierkathey
July 2002, Vol 92, No. 7 | American Journal of Public Health Editorial | 1057
⏐ EDITORIAL
A Code of
Ethics for
Public Health
The mandate to ensure and pro-
tect the health of the public is an
inherently moral one. It carries
with it an obligation to care for
the well-being of communities,
and it implies the possession of an
element of power to carry out
that mandate. The need to exer-
cise power to ensure the health of
populations and, at the same time,
to avoid abuses of such power are
at the crux of public health ethics.
Until recently, the ethical na-
ture of public health has been im-
plicitly assumed rather than ex-
plicitly stated. Increasingly,
however, society is demanding ex-
plicit attention to ethics. This de-
mand arises from technological
advances that create new possibil-
ities and, with them, new ethical
dilemmas; new challenges to
health, such as the advent of HIV;
and abuses of power, such as the
Tuskegee study of syphilis.
Medical institutions have been
more explicit about the ethical
elements of their practice than
have public health institutions.
However, the concerns of public
health are not fully consonant
with those of medicine. Thus, we
cannot simply translate the princi-
ples of medical ethics to public
health. In contrast to medicine,
public health is concerned more
with populations than with indi-
viduals, and more with prevention
than with cure. The need to artic-
ulate a distinct ethic for public
health has been noted by a num-
ber of public health professionals
and ethicists.1–5
A code of ethics for public
health can clarify the distinctive
elements of public health and the
ethical principles that follow from
or respond to those elements. It
can make clear to populations and
communities the ideals of the pub-
lic health institutions that serve
them, ideals for which the institu-
tions can be held accountable.
THE PROCESS OF
WRITING THE CODE
The backgrounds and perspec-
tives of people who identify
themselves as public health pro-
fessionals are as diverse as the
multitude of factors affecting the
health of populations. Articulating
a common ethic for this diverse
group is a formidable challenge.
In the spring of 2000, the gradu-
ating class of the Public Health
Leadership Institute chose writing
a code of ethics for public health
as a group project. The institute
provides advanced leadership
training to people who are al-
ready in leadership roles in pub-
lic health. Because the fellows
bring a wealth of experience from
a wide variety of public health in-
stitutions, they are uniquely able
to represent diverse perspectives
and identify ethical issues com-
mon in public health.
At the 2000 meeting of the Na-
tional Association of City and
County Health Officers, the group
added a non-institute member
( J. C. Thomas) and charted a plan
for working toward a code. The
plan included receiving a formal
charge as the code of ethics work-
ing group at the annual meeting of
the American Public Health Asso-
c ...
July 2002, Vol 92, No. 7 American Journal of Public Health E.docxdonnajames55
July 2002, Vol 92, No. 7 | American Journal of Public Health Editorial | 1057
⏐ EDITORIAL
A Code of
Ethics for
Public Health
The mandate to ensure and pro-
tect the health of the public is an
inherently moral one. It carries
with it an obligation to care for
the well-being of communities,
and it implies the possession of an
element of power to carry out
that mandate. The need to exer-
cise power to ensure the health of
populations and, at the same time,
to avoid abuses of such power are
at the crux of public health ethics.
Until recently, the ethical na-
ture of public health has been im-
plicitly assumed rather than ex-
plicitly stated. Increasingly,
however, society is demanding ex-
plicit attention to ethics. This de-
mand arises from technological
advances that create new possibil-
ities and, with them, new ethical
dilemmas; new challenges to
health, such as the advent of HIV;
and abuses of power, such as the
Tuskegee study of syphilis.
Medical institutions have been
more explicit about the ethical
elements of their practice than
have public health institutions.
However, the concerns of public
health are not fully consonant
with those of medicine. Thus, we
cannot simply translate the princi-
ples of medical ethics to public
health. In contrast to medicine,
public health is concerned more
with populations than with indi-
viduals, and more with prevention
than with cure. The need to artic-
ulate a distinct ethic for public
health has been noted by a num-
ber of public health professionals
and ethicists.1–5
A code of ethics for public
health can clarify the distinctive
elements of public health and the
ethical principles that follow from
or respond to those elements. It
can make clear to populations and
communities the ideals of the pub-
lic health institutions that serve
them, ideals for which the institu-
tions can be held accountable.
THE PROCESS OF
WRITING THE CODE
The backgrounds and perspec-
tives of people who identify
themselves as public health pro-
fessionals are as diverse as the
multitude of factors affecting the
health of populations. Articulating
a common ethic for this diverse
group is a formidable challenge.
In the spring of 2000, the gradu-
ating class of the Public Health
Leadership Institute chose writing
a code of ethics for public health
as a group project. The institute
provides advanced leadership
training to people who are al-
ready in leadership roles in pub-
lic health. Because the fellows
bring a wealth of experience from
a wide variety of public health in-
stitutions, they are uniquely able
to represent diverse perspectives
and identify ethical issues com-
mon in public health.
At the 2000 meeting of the Na-
tional Association of City and
County Health Officers, the group
added a non-institute member
( J. C. Thomas) and charted a plan
for working toward a code. The
plan included receiving a formal
charge as the code of ethics work-
ing group at the annual meeting of
the American Public Health Asso-
c.
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.
Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...Jim Bloyd, DrPH, MPH
Links to Recommended Readings from June 4, 2020 presentation “Work With Organizers to Build People Power for Health Equity” by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health (IL) jbloyd@cookcountyhhs.org Presented as part of “Covid-19 and Health Equity: A Policy Platform and Voices from Health Departments” by Human Impact Partners, co-sponsored by APHA, ASTHO, Big Cities Health Coalition, HealthBegins, and NACCHO. (Links current as of June 12, 2020 prepared by Jim)
More Related Content
Similar to Revisiting the Corporate and Commercial Determinants of Health
CHAPTER 7The policy processEileen T. O’GradyThere are tJinElias52
CHAPTER 7
The policy process
Eileen T. O’Grady
“There are three critical ingredients to democratic renewal and progressive change in America: good public policy, grassroots organizing and electoral politics.”
Paul Wellstone
Nurses can more strategically and effectively influence policy if they have a clear understanding of the policymaking process. Conceptual models can help to organize and interpret information by depicting complex ideas in a simplified form; to this end, political scientists have developed a number of conceptual models to explain the highly dynamic process of policymaking. This chapter reviews two of these conceptual models.
Health policy and politics
Health policy encompasses the political, economic, social, cultural, and social determinants of individuals and populations and attempts to address the broader issues in health and health care (see Box 7.1 for policy definitions). A clear understanding of the points of influence to shape policy is essential and includes framing the problem itself. For example, if nurses working in a nurse-managed clinic are troubled by staff shortages or long patient waits, they may be inclined to see themselves as the solution by working longer hours and seeing more patients. Defining and framing the problem is the first step in the policy process and involves assessing its history, patterns of impact, resource allocation, and community needs. Broadening and framing the problem to influence or educate stakeholders at the local, state, or federal level could include advocating for better access or funding for nursing workforce development (see Box 7.1).
BOX 7.1
Policy Definitions
Policy is authoritative decision making related to choices about goals and priorities of the policymaking body. In general, policies are constructed as a set of regulations (public policy), practice standards (workplace), governance mandates (organizations), ethical behavior (research), and ordinances (communities) that direct individuals, groups, organizations, and systems toward the desired behaviors and goals.
Health policy is the authoritative decisions made in the legislative, judicial, and executive branches of government that are intended to direct or influence the actions, behaviors, and decisions of others (Longest, 2016).
Policy analysis is the investigation of an issue including the background, purpose, content, and effects of various options within a policy context and their relevant social, economic, and political factors (Dye, 2016).
The next step is to bring the problem to the attention of those who have the power to implement a solution. Other key factors to consider include generating public interest, the availability of viable policy solutions, the likelihood that the policy will serve most of the people at risk in a fair and equitable fashion, and consideration of the organizational, community, societal, and political viability of the policy solution.
Public interest is a fascinating dynamic ...
A Career in Public Health Essay examples
Public Health Principles
Public Health Assessment Essay
Public Vs. Public Health Essay
Public Health Research Paper
Master In Public Health
Public Health Entrance Paper
The Ethics Of Public Health Essay
Global Public Health Essay
Public Health Nursing Essay
Legal PrinciplesNon- Malfeasance- Do n.docxsmile790243
Legal Principles
Non- Malfeasance- Do no harm
The legal principles are rules of human behavior that used to be considered as just, before the law started being written.
The ethical category of Non-Malfeasance represents the doctor’s try to avoid any act or treatment plan that would hurt the patient or violate the patient’s trust, and has been popularized in the phrase “first, do no harm.” Non-Malfeasance is supported through discretion and avoidance. It is critically important that the specialist provider of highly persistent treatments uphold Non-Malfeasance.
(Rodak, 2012)
Beneficence- Promote the welfare of others
Beneficent actions and motives have usually occupied a middle place in morality. Ordinary examples today are found in social welfare programs, policies to improve the welfare of animals etc.
Distributive Justice- All involved should have equal entitlements
The economic structure that each society has its laws, institutions, policies, etc. results in different distributions of economic benefits and burdens across members of the society. These economic frameworks are the result of human political processes and they continually change both across societies and within societies over time.
Autonomy- non influenced decisions for both patients and physicians
The term “autonomy” has appeared more and more often in the medical literature. According to this interpretation of autonomy, the goal for an autonomous person is to decide on his or her own, without undue manipulation by others.
One of the first empirical papers in medical decision making on patient autonomy thus linked autonomy to the question of whether patients wanted to make decisions themselves. In the descriptive medical decision making literature, this meaning has become the default.
The patient described in the informative model from the well known paper of Emanuel and Emanuel corresponds with an autonomous patient in this sense.
Healthcare Rights
Non- Discrimination- race, religion, sexual orientation
In human social affairs, discrimination is treatment or consideration of, or making a difference in favor of or against, a person or thing based on the group, class, or category to which that person or thing is apparent to belong to rather than on individual merit. This includes treatment of an individual or group, based on their real or perceived membership in a certain group or social group.
(Lamont, 2016)
Credentialing/ Scope of Practice
When you go for health care, identity matters a lot. You need to verify certain proofs. Following are the things that you need:
Verification of identity
(NAMSS, n.d.)
Legal Employment Qualifications
The Immigration Reform and Control Act of 1986 (IRCA) required employers to verify that all newly hired workers present "facially valid" documentation verifying the employee's identity and legal authorization to accept employment in the United States. The I-9 form or more properly ...
Five Questions” You will write responses to five (5.docxRAJU852744
“
Five Questions
”
:
You will write responses to five (5) questions provided by the instructor, each response
approximately 350-500 words long.
These questions will help you identify and evaluate:
theroleofthegoverningbodythatyouaretargetingwithyourproposal;
thetwoopposingpolicypositionsandtheirclaimsmakers(i.e.thosewhoaresupporting
each position and their investment in that stance); and,
your integration of conceptual material from weekly readings and class discussions
through midterm, including:
types of moral perspectives;
political alliances and relative political power of policy proposals;
impact of social factors/social conditions on issue and proposed solutions;
current and projected disparities in healthcare use and outcomes.
It is expected that you will be building on these writings as you proceed through the term.
list of the topic
Sources must include course readings as well as research from peer-reviewed academic
journals.
Final write-up of the paper is due at 7 p.m. on Wednesday of Finals Week and emailed to the instructor
.
Choose one of the following for your policy analysis paper.
Public Health and Rights to Privacy:
Should medical providers be bound by Public Health policies? Recently, a nurse who was exposed to the Ebola virus refused quarantine rules imposed by the legislature and health department of New Jersey. What were the arguments on both sides? What roles did science, cultural values and norms, and political posturing play in policymaking? What other factors were involved? What are implications for other issues in which private and public health sectors must collaborate?
Is unregulated economic growth good for our health?
Scientists argue that diminishing biodiversity in our ecosystems world-wide, much of it due to unrestricted development and other human activity, will affect our health in the future. Are there ways we can grow an economy and maintain diversity in the environment?
Health care digitization and other new technologies in your docto
r’s
office:
Physicians and their staffs are facing increased pressures to digitize medical records, and recruit and maintain a remote client base through telemedicine practices, i.e., incorporate new technologies into their practices. Are these new practices changing the doctor-patient relationship? What do both doctors and patients think about the changes? And, what roles are medical industries, healthcare corporations, and governments playing in effecting certain changes?
Making the rules regarding wom
en’s
contraceptive choices:
One of most controversial (and litigated) provision of the PPACA is the obligation of employer plans to cover contraceptive services under prevention. Businesses that oppose coverage have challenged the law and won concessions. What are the origins of this debate, both in the construction of the law and in the history of women
’s
contraceptive choices in America? What implications doe ...
Programs for public health practitioners in the field, due to the profession is so dispersed in its work—from employment in private managed care organizations and clinics. The main purpose of this study is to analysis the relationship between law and ethics with public healthcare performance. The present study used a quantitative research design, specifically the descriptive survey design. This is because such design accurately and objectively describes the characteristics of a situation or phenomenon being investigated in a given study. It provides a description of the variables in a particular situation and, sometimes, the relationship among these variables rather than focusing on the cause-and effect relationships. Thus, this study used a questionnaire which was developed from previous research in order to measure the relationships among the investigated variables. This study was carried out in different healthcare centers located in Erbil, the total of 81 participants participated in this study. The researcher developed research hypothesis as follow; there is a positive and significant relationship between law and healthcare performance in Erbil. The finding of this study showed that the value of beta for law and ethics factor is .749 with the P-value .000 this means that the law and ethics will have positive and significant influence on healthcare performance; accordingly the main research hypothesis is supported.
Chapter 15Health Professional LeadershipNormal is getting narrEstelaJeffery653
Chapter 15
Health Professional Leadership
Normal is getting narrower and narrower.
—Personal observation by an experienced nurse practitioner
Health professionals can be important participants in health policy processes. They bring their experiences, their knowledge of both science and art, their ability to distinguish between the two, and their commitment to the patient. Typically, they also bring a commitment to lifelong learning. The power of the professions, especially physicians, has been waning of late, but that has a lot to do with the height of their dominance in the past. In an open, market-driven, information-rich society, the old monopoly power described by Starr (1982) is not sustainable. Health professionals now need to undertake new leadership roles or else their status will be further undermined by those actively seeking a greater share of the pie. Those new roles will have to focus more on collaboration and coordination of care.
15.1 DISINTERESTEDNESS
Much of the diminished respect for health professionals stems from the public’s perception of reduced disinterestedness. Current fashion in economics seems to deny the concept of disinterestedness—the concept of lack of bias and freedom from special interests, the ability to set aside one’s own interests and to seek the best possible outcome for others. The opposite is the oft-repeated phrase, “All they care about is money.” Money is harder to come by in most parts of the health care system because of utilization controls and deep discounts to health care plans, and thus the increased concern is understandable; however, that is not reassuring to the public. Much of the literature on the rising costs of care blames the current fee-for-service system for making it in the providers’ interest to promote overutilization. Schlesinger (2002) argued that this loss of faith seemed to intensify with the advent of Medicare and Medicaid, and that that has led to a loss of political power as well. One parameter of successful professional leadership will be the ability to engender faith that the professional and the profession have the interests of other constituencies in mind.
15.2 INFORMATIONAL CREDIBILITY
Disintermediation in general and direct-to-consumer advertising in particular have affected the informational monopoly of the health professions. This is not a one-way street. The claims and counterclaims of the various interested parties can be hard to sort out. One leadership role for the health professional is to guide the general public through that welter of information. This is not just a physician’s task. It involves all health professionals. An article in BusinessWeek asked, “How Good Is Your Online Nurse?” and compared the online patient portals of the three largest health insurers: WellPoint, United Health Group, and Aetna (Weintraub, 2006). The trends reported in the article included greater integration with patient records, more add-on purchased counseling, and more person ...
Wiley and Springer are collaborating with JSTOR to digitize,.docxjoyjonna282
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Not Just a Matter of Criminal Justice: States, Institutions, and North American Drug Policy
Author(s): Ellen Benoit
Source: Sociological Forum, Vol. 18, No. 2 (Jun., 2003), pp. 269-294
Published by: Springer
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is mainly concerned with policy effects rather than origins. Yet, like other
social policies, drug policy is a product of the legislative process, and its
variations, too, are shaped by the ways in which political institutions me-
diate the fortunes of policy agendas. Drug policy is also, like welfare poli-
cies, a way in which the state manages the socioeconomic risks faced by its
constituents.
This article presents a rationale for an analytical approach to drug pol-
icy grounded in politics and institutions. I propose a polity-centered analysis
that emphasizes the role of the state-its configuration and capacities, its
relationships with other institutional sectors and with its citizens-and the
legacies of previous policies, not only in drug control but in other, related pol-
icy areas as well. Such a perspective provides a more complete explanation
of drug-policy variations cross-nationally and over time than do approaches
that conceive of drug policy narrowly as a matter of criminal justice. Exam-
ining the evolution of drug-control strategies in this way also demonstrates
the potential for a new theoretical argument regarding policy development
more broadly: that institutional interests can cross policy domains, creating
potential administrative capacity for new policies and fostering linkages by
which one policy influences another.
Drug policy everywhere must manage the tension between the state's
interests in protec ...
Discussion1 ( 200 words)You have just developed a GPS unit tha.docxelinoraudley582231
Discussion1 ( 200 words)
You have just developed a GPS unit that can be worn on a necklace, wristband or belt. The unit is designed to aid in locating missing children, individuals with dementia, or those who are developmentally disabled. Who your target audience(s) are and what approach will you use with them.
Discussion2 ( 200 words)
Duluth Trading Company Ads
COLLAPSE
Top of Form
The Duluth Trading Company began in 1989 with the creation of a work belt for carpenters and "handy" men (and now women). It has since expanded into clothing and a focus on underwear and work clothes. A new series of attention grabbing ads has been released this year bringing more visibility to the company.
Watch the ads - both those aimed at men and at women - featured on the page linked below (copy and paste into your browser).
Discuss how effective this advertising campaign is to today's audience.
What segment of the market is Duluth targeting?
Do you think this ad campaign will be effective for that segment?
Would this same ad campaign work in another country such as Saudi Arabia, Korea or China? Why or why not?
https://www.youtube.com/user/DuluthTrading
Case 5.1(answer following questions, 300 words)
Case 6.1(answer following questions, 300 words)
Bottom of Form
Malpractice Reform in Illinois
COLLAPSE
Top of Form
Client:
The client is the Illinois Health and Hospital Association (IHA). They seek to “To advocate for and support hospitals and health systems as they serve their patients and communities” (Illinois Health and Hospital Association, 2016). The IHA has a strong interest in malpractice reform. They maintain a page on their website for medical liability (Illinois Health and Hospital Association, 2016).
Problem Statement:
What can be done to reduce malpractice premium costs in the State of Illinois?
Kingdon Analysis:
Problem stream:
The problem is real - Malpractice issues in Illinois are particularly problematic. Illinois is ranked as having the fourth highest tort costs in the country and the fifth most draconian tort laws according to The Pacific Research Institute (Luke, Illinois, NY among Usual Tort Suspects in PRI Study, 2008). Illinois is also in the top five states in terms of malpractice insurance costs (Kiernan, 2016’s Best & Worst States for Doctors, 2016).
Politics Stream
Stakeholders:
1) Patients - the consumers of health care - Individuals who are scheduled for or are receiving healthcare services. There are a variety of associations and organizations that advocate for patients. For example, Propublica is committed to “expose abuses of power and betrayals of the public trust by government, business, and other institutions, using the moral force of investigative journalism to spur reform through the sustained spotlighting of wrongdoing” (Propublica, 2016). Their journalistic interest extends to healthcare including medical malpractice. They are particularly interested in changes in the malpractice environment that will de.
July 2002, Vol 92, No. 7 American Journal of Public Health E.docxcroysierkathey
July 2002, Vol 92, No. 7 | American Journal of Public Health Editorial | 1057
⏐ EDITORIAL
A Code of
Ethics for
Public Health
The mandate to ensure and pro-
tect the health of the public is an
inherently moral one. It carries
with it an obligation to care for
the well-being of communities,
and it implies the possession of an
element of power to carry out
that mandate. The need to exer-
cise power to ensure the health of
populations and, at the same time,
to avoid abuses of such power are
at the crux of public health ethics.
Until recently, the ethical na-
ture of public health has been im-
plicitly assumed rather than ex-
plicitly stated. Increasingly,
however, society is demanding ex-
plicit attention to ethics. This de-
mand arises from technological
advances that create new possibil-
ities and, with them, new ethical
dilemmas; new challenges to
health, such as the advent of HIV;
and abuses of power, such as the
Tuskegee study of syphilis.
Medical institutions have been
more explicit about the ethical
elements of their practice than
have public health institutions.
However, the concerns of public
health are not fully consonant
with those of medicine. Thus, we
cannot simply translate the princi-
ples of medical ethics to public
health. In contrast to medicine,
public health is concerned more
with populations than with indi-
viduals, and more with prevention
than with cure. The need to artic-
ulate a distinct ethic for public
health has been noted by a num-
ber of public health professionals
and ethicists.1–5
A code of ethics for public
health can clarify the distinctive
elements of public health and the
ethical principles that follow from
or respond to those elements. It
can make clear to populations and
communities the ideals of the pub-
lic health institutions that serve
them, ideals for which the institu-
tions can be held accountable.
THE PROCESS OF
WRITING THE CODE
The backgrounds and perspec-
tives of people who identify
themselves as public health pro-
fessionals are as diverse as the
multitude of factors affecting the
health of populations. Articulating
a common ethic for this diverse
group is a formidable challenge.
In the spring of 2000, the gradu-
ating class of the Public Health
Leadership Institute chose writing
a code of ethics for public health
as a group project. The institute
provides advanced leadership
training to people who are al-
ready in leadership roles in pub-
lic health. Because the fellows
bring a wealth of experience from
a wide variety of public health in-
stitutions, they are uniquely able
to represent diverse perspectives
and identify ethical issues com-
mon in public health.
At the 2000 meeting of the Na-
tional Association of City and
County Health Officers, the group
added a non-institute member
( J. C. Thomas) and charted a plan
for working toward a code. The
plan included receiving a formal
charge as the code of ethics work-
ing group at the annual meeting of
the American Public Health Asso-
c ...
July 2002, Vol 92, No. 7 American Journal of Public Health E.docxdonnajames55
July 2002, Vol 92, No. 7 | American Journal of Public Health Editorial | 1057
⏐ EDITORIAL
A Code of
Ethics for
Public Health
The mandate to ensure and pro-
tect the health of the public is an
inherently moral one. It carries
with it an obligation to care for
the well-being of communities,
and it implies the possession of an
element of power to carry out
that mandate. The need to exer-
cise power to ensure the health of
populations and, at the same time,
to avoid abuses of such power are
at the crux of public health ethics.
Until recently, the ethical na-
ture of public health has been im-
plicitly assumed rather than ex-
plicitly stated. Increasingly,
however, society is demanding ex-
plicit attention to ethics. This de-
mand arises from technological
advances that create new possibil-
ities and, with them, new ethical
dilemmas; new challenges to
health, such as the advent of HIV;
and abuses of power, such as the
Tuskegee study of syphilis.
Medical institutions have been
more explicit about the ethical
elements of their practice than
have public health institutions.
However, the concerns of public
health are not fully consonant
with those of medicine. Thus, we
cannot simply translate the princi-
ples of medical ethics to public
health. In contrast to medicine,
public health is concerned more
with populations than with indi-
viduals, and more with prevention
than with cure. The need to artic-
ulate a distinct ethic for public
health has been noted by a num-
ber of public health professionals
and ethicists.1–5
A code of ethics for public
health can clarify the distinctive
elements of public health and the
ethical principles that follow from
or respond to those elements. It
can make clear to populations and
communities the ideals of the pub-
lic health institutions that serve
them, ideals for which the institu-
tions can be held accountable.
THE PROCESS OF
WRITING THE CODE
The backgrounds and perspec-
tives of people who identify
themselves as public health pro-
fessionals are as diverse as the
multitude of factors affecting the
health of populations. Articulating
a common ethic for this diverse
group is a formidable challenge.
In the spring of 2000, the gradu-
ating class of the Public Health
Leadership Institute chose writing
a code of ethics for public health
as a group project. The institute
provides advanced leadership
training to people who are al-
ready in leadership roles in pub-
lic health. Because the fellows
bring a wealth of experience from
a wide variety of public health in-
stitutions, they are uniquely able
to represent diverse perspectives
and identify ethical issues com-
mon in public health.
At the 2000 meeting of the Na-
tional Association of City and
County Health Officers, the group
added a non-institute member
( J. C. Thomas) and charted a plan
for working toward a code. The
plan included receiving a formal
charge as the code of ethics work-
ing group at the annual meeting of
the American Public Health Asso-
c.
Towards a Critical Health Equity Research Stance: Why Epistemology and Method...Jim Bloyd, DrPH, MPH
Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography— that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.
Links to Recommended Readings from June 4, 2020 presentation “Work With Organ...Jim Bloyd, DrPH, MPH
Links to Recommended Readings from June 4, 2020 presentation “Work With Organizers to Build People Power for Health Equity” by Jim Bloyd, MPH, Regional Health Officer, Cook County Department of Public Health (IL) jbloyd@cookcountyhhs.org Presented as part of “Covid-19 and Health Equity: A Policy Platform and Voices from Health Departments” by Human Impact Partners, co-sponsored by APHA, ASTHO, Big Cities Health Coalition, HealthBegins, and NACCHO. (Links current as of June 12, 2020 prepared by Jim)
Senators call for investigation into Pulaski County jail amid COVID-19 outbreakJim Bloyd, DrPH, MPH
News article published May 30, 2020 "The senators’ letter follows the efforts of several health-justice advocates to implore the Illinois Department of Public Health to take a more active role in managing the outbreak in Pulaski County. Those individuals, which include representatives from the Collaborative for Health Equity Cook County and the Health & Medicine Policy Research Group, Chicago-based health justice organizations, DePaul University and the University of Illinois Chicago School of Public Health, are circulating a petition that demands IDPH make site visits to ICE detention sites across Illinois, and specifically the facility in Pulaski County, to ensure compliance with care plans and infectious disease control."
A 5-Year Retrospective Analysis of Legal Intervention Injuries and Mortality ...Jim Bloyd, DrPH, MPH
There has been a public outcry for the accountability of law enforcement agents who kill and injure citizens. Epidemiological surveillance can underscore the magnitude of morbidity and mortality of citizens at the hands of law enforcement. We used hospital outpatient and inpatient databases to conduct a retrospective analysis of legal interventions in Illinois between 2010 and 2015. We calculated injury and mortality rates based on demographics, spatial distribution, and cause of injury. During the study period, 8,384 patients were treated for injuries caused during contact with law enforcement personnel. Most were male, the mean age was 32.7, and those injured were disproportionately black. Nearly all patients were treated as outpatients, and those who were admitted to the hospital had a mean of length of stay of 6 days. Most patients were discharged home or to an acute or long-term care facility (83.7%). It is unclear if those discharged home or to a different medical facility were arrested, accidentally injured, injured when no crime was committed, or injured when a crime was committed. Surveillance of law enforcement-related injuries and deaths should be implemented, and injuries caused during legal interventions should be recognized as a public health issue rather than a criminal justice issue.
Life Expectancy and Mortality Rates in the United States, 1959-2017Jim Bloyd, DrPH, MPH
Importance: US life expectancy has not kept pace with that of other wealthy countries and is now decreasing.
Objective: To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends.
Evidence: Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined.
Findings: Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.
Conclusions and Relevance: US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014. A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups, with an onset as early as the 1990s and with the largest relative increases occurring in the Ohio Valley and New England. The implications for public health and the economy are substantial, making it vital to understand the underlying causes.
Public Health, Politics, and the Creation of Meaning: A Public Health of Cons...Jim Bloyd, DrPH, MPH
"The creation of meaning may be an unfamiliar role for public health, but one whose import comes into sharp relief when we recognize the inevitability of the political at the heart of what we do."
Cook County Department of Public Health staff who are presenters, moderators, and secondary authors at the annual meeting of the American Public Health Association are pictured. Their presentations are listed by Session number. The meeting attracts over 12,000 participants and is health in Philadelphia, PA from November 2nd to November 6th, 2019. #APHA2019 @PublicHealth @APHAAnnualMtg
This transcript is useful for a small group exercise when participants are listening to Dr. Linda Rae Murry discuss her critique of the Ten Essential Services as a frame popular in the USA for describing what public health is and should do. It was used along with a worksheet to successfully generate small group discussion on September 12, 2019. Available at RootsofHealthInequity.org
Exercise Linda Murray Voices of Public Health questions worksheet Used Septem...Jim Bloyd, DrPH, MPH
This was one of two 20-minute exercises used by Jim Bloyd and Rachel Rubin with a 30-minute slide presentation. The exercises generated discussion among groups of 2-3 people. The group also listened to the audio of Dr. Murray's 6-minute statement, and followed along reading a transcript of the statement. Both the audio and the transcript are available at RootsofHealthInequity.org of NACCHO.
Roots of Health Inequity Dialogues: Designing Staff Development to Strengthen...Jim Bloyd, DrPH, MPH
Presentation and 3 20-minute exercises prepared for the annual conference of the Illinois Public Health Association, September 12, 2019 in Springfield, Illinois, USA. Abstract: The Cook County Department of Public Health (CCDPH) used the National Association of County and City Health Officials' online course for the public health workforce Roots of Health Inequity, to accomplish three goals: change the way staff think about public health; change the way staff practice public health; and apply health equity principles to the daily work. Chief Operating Officer Terry Mason, MD, required all staff to participate in the training.
Increasing the integration of a health equity approach by first training staff on health equity and how it is relevant to their work was a priority of the agency strategic plan, as well as a QI and Workforce Development priority for CCDPH.
Components of the CCDPH Roots of Health Inequity Dialogues include the creation of 1small groups for in-person discussion; a leadership committee; training staff as facilitators; evaluation; a commitment to dialogue. The small group-approach accomplished two things: dialogue and discussion were maximized, while disruption of regular duties and health department functions was minimized.
Reliance on staff to facilitate dialogues strengthened leadership for health equity within the health department, and eliminated the need for external facilitation. In addition, the “insider” knowledge of the Facilitators—most of whom have years of experience working at CCDPH---ensured that dialogue leaders understood the institutional culture, and increased the likelihood that the dialogues will be able to examine real barriers as well as opportunities to practice transformation.
Chicago Panels Details COOKED documentary Film July 12-25, 2019Jim Bloyd, DrPH, MPH
This is a list of the panels and panelists for the July 12-25 2019 screenings of COOKED in Chicago, Illinois at the Gene Siskel Film Center, 164 N. State St., Chicago, Illinois. USA
New approaches for moving upstream how state and local health departments can...Jim Bloyd, DrPH, MPH
Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are “upstream” drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on “downstream” behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators’ role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.
Editorial: Evidence based policy or policy based evidence? by Michael MarmotJim Bloyd, DrPH, MPH
A simple prescription would be to review the scientific evidence of what would make a difference, formulate policies, and implement them—evidence based policy making. Unfor- tunately this simple prescription, applied to real life, is simplistic. The relation between science and policy is more complicated. Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be.
Can health equity survive epidemiology? Standards of proof and social determi...Jim Bloyd, DrPH, MPH
Objective. This article examines how epidemiological evidence is and should be used in the context of increasing concern for health equity and for social determinants of health.
Method. A research literature on use of scientific evidence of “environmental risks” is outlined, and key issues compared with those that arise with respect to social determinants of health.
Results. The issue sets are very similar. Both involve the choice of a standard of proof, and the corollary need to make value judgments about how to address uncertainty in the context of “the inevitability of being wrong,” at least some of the time, and to consider evidence from multiple kinds of research design. The nature of such value judgments and the need for methodological pluralism are incompletely understood.
Conclusion. Responsible policy analysis and interpretation of scientific evidence require explicit consideration of the ethical issues involved in choosing a standard of proof. Because of the stakes involved, such choices often become contested political terrain. Comparative research on how those choices are made will be valuable.
The importance of public policy as a determinant of health is routinely acknowledged, but there remains a continuing absence of mainstream debate about the ways in which the politics, power and ideology, which underpin public policy influence people's health. This paper explores the possible reasons behind the absence of a politics of health and demonstrates how explicit acknowledgement of the political nature of health will lead to more effective health promotion strategy and policy, and to more realistic and evidence-based public health and health promotion practice
REDSACOL ALAMES ante la intromision imperial [REDSACOL ALAMES facing imperial...Jim Bloyd, DrPH, MPH
Statement from the Red de Salud Colectiva of the Asociacion Latinoamericana de Medicina Social y Salud Colective (Latin American Association of Social Medicine and Collective Health) distributed February 1, 2019 on the ALAMES list serve by Oscar Feo Isturiz, physician, specialist in public health and occupational health, and retired professor at the University of Carabobo, Venezuela. He advises the Ministries of Health of El Salvador and Bolivia. He is on the Consultative Committee of ALAMES.
A Chicago case example of public health professionals allying with community ...Jim Bloyd, DrPH, MPH
Inspired by the Guide to Public Health Actions for Immigrant Rights, a coalition of health workers and community allies in Chicago have been organizing to pressure the Cook County Health and Hospitals System (CCHHS) to meet six demands to Protect Immigrant Health Now! Two promotoras de salud-Community Health Workers-from Enlace Chicago provided testimony at the September 1, 2017 meeting of the CCHHS Board,
marking a milestone in this campaign. Four additional leaders of the Public Health Woke coalition will join the two promotoras on the panel. They will describe the coalition’s collection of new data, use of the Thunderclap social media tool, relationship-building, analysis of local power structures, and the ethical duties of public health professionals in the context of mass deportation. The Co-Founder and Executive Director of Arab- American Family Services will describe her experience as an ally, and the importance of centering immigrant voices in the fight for sanctuary health care for immigrants and all marginalized people; The role of Cook County Commissioner Jesús ‘Chuy’ García’s 7th District Health Task Force will be
described; A Past-President of APHA (faculty at UIC School of Public Health and National Collaborative for Health Equity Board Member) will discuss the historical commitment of Cook County, Illinois, to provide health care to all people; and a leader with the Collaborative for Health Equity Cook County will moderate and guide one participatory activity. This session will emphasize audience participation & dialogue.
More info go to CHECookCounty.org Follow @CHECookCounty
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Revisiting the Corporate and Commercial Determinants of Health
1. Revisiting the Corporate and Commercial
Determinants of Health
We trace the development of
the concept of the corporate
determinants of health. We
argue that these determinants
are predicated on the un-
checked power of corporations
and that the means by which
corporations exert power is
increasingly unseen.
We identify four of the ways
corporations influence health:
defining the dominant narra-
tive; setting the rules by which
society, especially trade, oper-
ates; commodifyingknowledge;
and undermining political, so-
cial, and economic rights.
We identify how public health
professionals can respond to
these manifestations of power.
(Am J Public Health. 2018;108:
1167–1170. doi:10.2105/AJPH.
2018.304510)
Martin McKee, MD, and David Stuckler, PhD
In 2013, Millar coined the
term “corporate determinants
of health.”1
He described how
some companies acted in ways
that promoted health, embracing
a “triple bottom line” that
encompassed “people, planet,
and profits.” They paid living
wages and their fair share of taxes,
empowered their workers, and
mitigated their effects on the
environment. Others, many
employing the language of
corporate social responsibility,
pursued profit above all else,
marketing unhealthy products,
exploiting workers and sup-
pliers, and giving nothing
back to society.
Research on corporations,
and the power they exert, draws
on several strands of scholarship.
It recognizes that they may be
a force for good or bad. Many
corporations make positive con-
tributions: through their primary
activities, such as the discovery
and development of medicines;
indirectly, through philanthropic
activities; or in a growing number
of health-related public–private
partnerships.2
Historians have
adopted more critical perspec-
tives as they chronicle the impacts
of early transnational corpora-
tions, such as the Dutch East India
Trading Company, “the original
corporate raiders,” and the Royal
Africa Company, which was ac-
tive in the Atlantic slave trade.
Development economists de-
scribe contemporary examples
of exploitation—although the
property involved is often in-
tellectual rather than physical,
such as indigenous knowledge,
and slavery has given way to
the exploitation of illegal mi-
grants. Public health researchers
studying diverse topics such as
tobacco,3
alcohol,4
pharmaceu-
ticals, and injuries attributable
to motor vehicles5
or firearms6
have realized the importance of
corporations as vectors of their
spread.
There is an emerging con-
versation on why it is necessary
to respond to corporate de-
terminants of health, reflecting
in part a growing appreciation
of their enormous power. For
example, Walmart and Exxon-
Mobil would rank as the world’s
25th and 30th biggest countries,
respectively, by their revenues.7
In 2005, Freudenberg called
on public health advocates to
challenge corporate practices.8,9
In a 2008 article with Galea, he
reviewed three egregious ex-
amples: trans fats, sports utility
vehicles, and the drug Vioxx.9
Freudenberg and Galea noted
that some measures, including
legislation and litigation, had
achieved some degree of success
but viewed these as piecemeal
responses. They proposed
a multifaceted response that
included enhancing rights to
information; restricting mar-
keting, especially to children;
constraining lobbying; and
sanctioning deliberate scientific
distortions.
In 2016, Kickbusch took
these ideas further. Drawing on
growing evidence of the adverse
health consequences of trans-
national corporations’ activities,
she explored the “commercial
determinants of health,” 10
a term
she had introduced earlier.11
She
identified four channels through
which influence was exerted:
marketing, lobbying, corporate
social responsibility strategies to
“whitewash tarnished reputa-
tions,” and extended supply
chains. Kickbusch also decried
the piecemeal response and called
for us to “systematise our efforts.”
We have studied the actions of
global corporations and their
consequences using the internal
documents of the tobacco, al-
cohol, and food industries12,13
and by applying natural experi-
ments in trade and fiscal policy.14
We conclude that at the heart of
an extremely complex subject lies
the nature of power. An effective
response to the corporate and
commercial determinants of
health must address the power
imbalance between global cor-
porations, which are account-
able only to their owners and
shareholders, and governments,
ABOUT THE AUTHORS
Martin McKee is with the London School of Hygiene & Tropical Medicine, London, UK.
David Stuckler is with the Department of Policy Analysis and Public Management and
Dondena Research Centre, University of Bocconi, Milan, Italy.
Correspondence should be sent to Martin McKee, Centre for Global Chronic Conditions,
London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH,
United Kingdom (e-mail: martin.mckee@lshtm.ac.uk). Reprints can be ordered at http://www.
ajph.org by clicking the “Reprints” link.
This article was accepted April 25, 2018.
doi: 10.2105/AJPH.2018.304510
September 2018, Vol 108, No. 9 AJPH McKee and Stuckler Peer Reviewed Commentary 1167
AJPH PERSPECTIVES
2. which are accountable to their
citizens.
We examine four ways cor-
porations exert power and sug-
gest how the balance might be
restored to align corporate be-
havior more closely with the
public good. We do not pretend
that this list is exhaustive, but we
believe that it offers a basis for
action.
THE CHANGING
NATURE OF
CORPORATE POWER
The power of the 16th-
century trading corporations was
obvious when heavily armed ships
sailed into view, consistent with
Dahl’s definition of power as the
ability of “A to get B to do
something that B would not
otherwise do.”15(p204)
Modern
corporate power is more subtle
and includes A’s creation or re-
inforcement of social and political
values and practices that permit
consideration of only issues that
are innocuous to A.16
Later the-
oristsaddedtheabilitytoshapethe
preferences of others so that A can
influence B to share A’s desires,
even when contrary to the in-
terests of B17
; this is sometimes
referred to as “false conscious-
ness.” These concepts can be
thought of as visible, hidden, and
invisible facets of power, re-
spectively. Thus, visible power
takes the form of laws and regu-
lations that are often backed up by
legal or economic sanctions.
Hidden power, which often un-
derlies visible power, takes the
form of access to key decision-
makers or rules of procedure that
include or exclude certain groups.
Invisible power legitimizes or
delegitimizes certain discourses,
especially those that threaten the
interests of the powerful. Conse-
quently, in seeking to understand
the commercial determinants of
health, we must go well beyond
what happens in public, such as
deliberations in legislatures and
public consultations, to un-
derstand the hidden and invisible
influences on public policy.18
Our four manifestations of
corporate power fall primarily
within the second and third
definitions of power. They are
the ability to define the dominant
narrative; set the rules and
procedures by which society is
governed; determine the rights,
living, and working conditions
of ordinary people; and take
ownership of knowledge and
ideas. We now look at each
of these in turn.
DEFINING THE
NARRATIVE
Corporations are able to frame
dominant narratives on the de-
terminants of health, thereby
exerting invisible power. One
pathway is through their owner-
shipofmassmedia—suchasNews
Corporation, a US multinational
mass media corporation—which
can determine whether obesity,
diabetes, heart disease, and other
health threats are framed as issues
of individual or societal choices
and responsibilities.19
They create
doubt about issues when, in re-
ality, there is scientific consensus,
for example, on the health effects
of smoking and the causes of
climate change. Oreskes and
Conway show how the same
scientists often appear in different
subject areas but always support-
ing the corporate agenda.20
Corporations can also directly
influence these determinants
through their marketing activities
(which may include influencing
which issues are covered in pro-
grams or networks they advertise
on), determining what is available
in stores and at what price and
therefore what people con-
sume,21
as well as how people
work,live,andseekpleasure(such
as whether tobacco or alcohol use
areacceptablesocialnorms). They
influence people’s beliefs, cogni-
tions, and perceptions on how
society should deal with its most
pressing health threats, using dis-
course that stresses the failure of
public services, condemns any
measure that can be portrayed as
restricting the right of the indi-
vidual to be “free to be foolish,”22
elevates the primacy of individual
choices over social solidarity,
decries “welfare cheats,” and di-
vides the poor into “deserving”
and “undeserving” or “self” and
“other.”
Corporations can influence
the boundaries of what political
scientists have called the “Over-
ton window” or the “window of
discourse.”23
Policies falling in-
side this window are considered
acceptable, or even desirable,
whereas those falling outside it
are deemed unacceptable, un-
worthy of even being discussed.
However, the window can
move, so that something once
considered the norm, such as
slavery, becomes unacceptable,
whereas policies once considered
unacceptable, such as women’s
suffrage, become the norm.
Crucially, the window can move
in both directions and can be
influenced by those with power
over the media. Thus, in the
United States, the rollout of
Fox News on cable in different
cities and at different times in
the late 1990s created a natural
experiment that, when evalu-
ated, showed a significant shift
to support for the Republican
Party.24
Similarly, when the
Sun newspaper in the United
Kingdom—which, like Fox
News, is owned by Rupert
Murdoch—shifted its political
allegiance in 1997, there was
a demonstrable effect on the
voting behavior of its readers.25
Thus, it is unsurprising that
Glenn Beck—a conservative
commentator and former Fox
News host—chose The Overton
Window as the title for his novel
about a man coming to accept
views that he first considered
ludicrous.26
The growth of social media
creates many opportunities for
those with resources to influence
norms and values and mine in-
dividuals’ online profiles to target
messages to them that address
their concerns and reinforce their
beliefs27
; this was seen in 2016,
in the US presidential election
and the UK vote to leave the
European Union.28
SETTING THE RULES
There is a paradox at the heart
of the relationship between
corporations and governments.
Although corporations often rail
against government actions, in
particular increases in taxes and
regulatory burdens, they also
depend on them to, for example,
uphold protection of their in-
tellectual property and enforce
contracts. Thus, the historian
Gabriel Kolko proposed that
governments and large corpora-
tions worked together to develop
regulations designed to reduce
the power of small companies.29
As the regulatory reach of
governments has increased, cor-
porations have found new ways
to influence how and where
decisions are made and to create
mechanisms that ensure that they
will survive and prosper, many
with implications for health.
They deploy their technical
and research expertise to define
global standards, as exemplified
by the way that the tobacco
industry set the standards for
measuring cigarette tar content
AJPH PERSPECTIVES
1168 Commentary Peer Reviewed McKee and Stuckler AJPH September 2018, Vol 108, No. 9
3. and the machines used for this
purpose30
and the predominance
of corporate scientists represent-
ing agri-food industries at Codex
Alimentarius meetings. Corpo-
rations influence regulatory
bodies by placing their advisors
on committees or by creating
revolving doors that enable
officials to move into lucrative
consultancies once they have
retired. They capture elected
officials, who vote for the in-
terests of their elite funders.31
They determine where disputes
will be resolved, advocating al-
ternatives to courts that rule in
public on the basis of law.32
They
prefer secret tribunals to hear
investor state dispute resolution
cases and promote trade liber-
alization that will enable their
products to dominate emerging
markets (e.g., the Trans-Pacific
Partnership Agreement).33
Fi-
nally, they seek to capture the
means by which the public health
community might hold them to
account, such as health impact
assessments, promoting their
concepts of “good epidemiol-
ogy” and “sound science.”34,35
COMMODIFYING
KNOWLEDGE
Corporations have affected
health through their growing
commodification, and thus con-
trol, of knowledge needed to
improve health. They have done
this by extending the concept of
intellectual property. One ex-
ample is their commodification
of “insurgent knowledges,”36
which create dependence among
indigenous farmers by promoting
patented genetically modified
foods.37
Another example is ex-
ploitation of their power over
medicine discovery and devel-
opment by failing to invest in
those for which they see no
market, typically those for treat-
ing diseases of the poor, while
lobbying for ever greater in-
tellectual property protection
that impedes market entry of
those who could make those
medicines affordable.38
How-
ever, despite arguing for shrink-
ing the role of the state in areas
such as welfare provision, they
advocate mechanisms by which
they receive state subsidies to
generate their intellectual prop-
erty, such as research funding
and access to basic science re-
search undertaken in govern-
ment facilities as well as state
mechanisms to enforce these
property rights.
POLITICAL,
ECONOMIC, AND
SOCIAL RIGHTS
Although multinational cor-
porations’ foreign direct invest-
ment can, in some circumstances,
improve wages and working
conditions, for example by im-
proving health care for their
employees and their families, it
can also worsen them.39
Much
depends on the context in the
country concerned. There are
several ways corporations have
been able to undermine political,
economic, and social rights. Large
multinational corporations often
determine the working condi-
tions of workers by either shifting
jobs to countries with weaker
labor protections or simply
threatening to, thereby reducing
the effects of collective bar-
gaining and legislation on
health and safety and mini-
mum wages. They can slow,
or even reverse, the expan-
sion of universal health coverage,
promoting international trade
deals that challenge national
policies through investor–
statedisputeresolutionprocedures.
Multinational corporations
have exploited the global finan-
cial crisis, recasting it as excessive
spending on welfare rather than
a failure of regulation of the fi-
nancial sector, thereby justifying
austerity measures that dispro-
portionately hit the most vul-
nerable. They also use their
political power, which is sup-
ported by media campaigns and
reports from think tanks, to shape
health systems to minimize their
redistributive elements and to
become vehicles for private
capital accumulation.
Finally, they use the complex
web of deregulated global fi-
nance. For example, they in-
stitute large transfer payments
and internal loans that shift their
reported profits to low tax ju-
risdictions to minimize what they
contribute to the creation of
public goods (domestically) and
global public goods (in-
ternationally). This defies the
advice of the US jurist Oliver
Wendell Holmes, who said,
“Taxes are what we pay for
civilized society.”40(p275)
WHAT CAN BE DONE?
As these examples, and many
others, illustrate, it is impossible
to take a comprehensive view of
global health and health policy
without considering the distri-
bution of power at a global level
and within countries. We agree
with Hastings, who, in 2012,
argued that tackling corporate
power should be a public health
priority.41
However, we are not
so na¨ıve as to believe that public
health professionals can put right
all of the problems we have de-
scribed, especially as the global
political situation in 2018 is
hardly propitious for concerted
international action. But neither
do we believe that they are as
impotent as they often appear.
We envisage several actions
that the public health community
can undertake. First, they can
challenge dominant narratives.
For example, those focusing on
social determinants of health can
show where and how people’s
choices are structured by forces
outside their immediate control.
More can be done to reveal how
corporate actors have shaped
these narratives, as when the to-
bacco industry manufactured the
belief that smokers had heart
disease because of the stress that
caused them to smoke and not
the tobacco42
and exaggerated
the role of illicit trade to argue
against tax increases.43
Second, they can shape norms
for healthy policymaking, sup-
porting measures that impose
checks and balances on corporate
power. One example is Article
5.3 of the Framework Conven-
tion on Tobacco Control, which
excludes the tobacco industry
from health policymaking; even
here there is no room for com-
placency: the new Philip Morris
Foundation risks circumventing
it.44
They can ask whether it is
acceptable that alcohol and fast
food industries still retain a seat
at health policy tables. To in-
form this debate, researchers can
systematically document corpo-
rate behaviors that affect health.45
Third, they can support
communities that have stood up
to powerful corporations and
won, such as local administra-
tions adopting soda taxes46,47
and indigenous communities
opposing threats to their envi-
ronments and working condi-
tions.48
They can evaluate and
communicate these successes
using innovative ways to reach
the population, including social
media. They can also take ad-
vantage of transnational systems
of information exchange, such
as the Peoples’ Health Move-
ment and Globalink.
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4. Finally, echoing Wiist’s 2006
plea, they can align with other
social movements committed to
challenging the concentration of
power in the hands of these
corporations,49
as is beginning
to happen as the environmental
and health movements identify
cobenefits to health from
“greening” the economy.
In these ways, it is possible to
empower a new generation of
health professionals who can work
closely with civil society organi-
zations and the public to begin the
process of holding powerful global
corporations to account for their
impacts on health.
CONTRIBUTORS
Both authors contributed equally to this
commentary.
ACKNOWLEDGMENTS
We are grateful to Daniel Fox for en-
couraging us to put these thoughts on
paper.
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