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Throughout history, knowledge and practices on the health of populations have had different names: medical police, public health, social medicine, community health, and preventive medicine. To what extent is the Brazilian collective health, established in the 1970s, identified with and differentiated from these diverse movements that preceded it? The analysis of the socio-genesis of a social field allows us to identify the historical conditions that made possible both theoretical formulations and the achievement of technical and social practices. Collective health, a product of transformations within the medical field, constituted a rupture in relation to preventive medicine and public health and hygiene, being part of a social medicine movement in Latin America that, in turn, had identification with European social medicine in the 19th century. Focused on the development of a social theory of health that would support the process of sanitary reform, collective health has been built as a space involving several fields: scientific, bureaucratic, and political. Thus, it brought together health professionals and social scientists from universities, health care services, and social movements. Its scientific subfield has developed, and the sanitary reform project has had several successes related to the organization of a unified health system, which has ensured universal coverage for the population in Brazil. It has incorporated into and dialogued with several reformist movements in international public health, such as health promotion and the pursuit of health equity. Its small relative autonomy stems from subordination to other dominant fields and its dependence on the state and governments. However, its consolidation corresponded to the strengthening of a pole focused on the collective and universal interest, where health is not understood as a commodity, but as a right of citizenship.

The prevention of communicable diseases, the containment of epidemic disorders, and the design of programs and the implementation of public health policies went through important transformations in Mexico, as in other Latin American nations, between the final decades of the 19th century and first half of the 20th century. During that period not only did the advances in medical science make possible the identification and containment of numerous contagious diseases; it was also a time when the consolidation of formal medical institutions and their interaction with both national and international actors contributed to shape the definitions and solutions of public health problems. Disease prevention strategies were influenced by medical, scientific, and technical innovations and by the political values and commitments of the period, and Mexico experienced profound and far-reaching political, economic, and social transformations: the apogee, crisis, and downfall of the long Porfirio Díaz regime (1876–1910), the armed phase of the Mexican Revolution (1910–1920), and the period of national reconstruction (1920–1940). Thus, during the period under consideration, and alongside the consolidation of an official medical apparatus as an integral part of public power, the promotion of public health became a crucial element to reinforce the political unification and the social and economic strength of the country.

Starting in the 1920s, the first initiatives to organize the control of cancer in Argentina soon revealed the presence of different actors and interests, a specialized cancer institute, a women’s voluntary organization, state authorities, university departments, cancerologists, and gynecologists. Initially concentrated around the activities of the Institute of Experimental Medicine for the Study and Treatment of Cancer in Buenos Aires, cancer interventions expanded in the following decades through university departments and gynecology services, which outlined a decentralized approach for reining in the centralized efforts from the institute. While a therapeutic-based approach with substantial funding for research institutes characterized industrialized countries’ initiatives until the end of World War II, in Argentina it was within the field of cancer diagnosis where specialists sought to create the foundational structures of cancer organization. Early detection of tumors, it was argued, favored a good prognosis with surgical treatment, placing the burden of cancer control on public education, the availability of diagnostic services, and doctors’ knowledge of cancer identification. From the 1920s to the early 1980s, three distinct periods can be identified: first, an institutional approach, where the first cancer institute attempted to concentrate all the activities related to the control of cancer, that is, lay education, scientific research, diagnosis and treatment, patients’ support, and cancer statistics; second, a state approach, inaugurated by the arrival of Juan Domingo Perón to government, where the centralization of cancer initiatives became a state affair; and third, a long period characterized by the retirement of the state—marked by political unrest and a succession of military governments until the return of democracy in 1983—informed by decentralizing policies, the prominent role of civil society actors, such as voluntary organizations and medical societies, and the relative sway of the Pan American Health Organization. Throughout these three periods, all these actors played a role, and their ambivalent relationship and, often poor, interaction shaped the country’s efforts to control and prevent a disease that, since the 1940s, has steadily occupied the second cause of death. As the early detection strategy prevailed, responsibility for cancer control and prevention was constantly redistributed among the public, doctors, educators, and those who financed cancer services. The national state emerged as a feeble agent in cancer governance and, as discussed in the final section, this legacy is still felt today.

Public health social work is a substantive area within the discipline of social work that applies social work and public health theories, frameworks, research, and collaborative practices to address contemporary health issues through a transdisciplinary lens. It is epidemiologically informed and characterized by prevention, health promotion, and other integrative practices. With its strong focus on health impact and population health, public health social work is central to the profession’s viability and success for tackling pervasive 21st-century challenges, such as health inequity, behavioral health integration, chronic disease, health reform implementation, and global health.

Empowerment features prominently in public health and health promotion policy and practice aimed at improving the social determinants of health that impact communities and groups that are experiencing disadvantage and discrimination. This raises two important questions. How should empowerment be understood from the perspective of health and health equity and how can public health practitioners support empowerment for greater health equity? Many contemporary definitions link empowerment to improvements in individual self-care and/or the adoption of “healthier” lifestyles. In contrast, from a health equity perspective community empowerment is understood as sociopolitical processes that engage with power dynamics and result in people bearing the brunt of social injustice exercising greater collective control over decisions and actions that impact their lives and health. There is growing evidence that increased collective control at the population level is associated with improved social determinants of health and population health outcomes. But alongside this, there is also evidence that many contemporary community interventions are not “empowering” for the people targeted and may actually be having negative impacts. To achieve more positive outcomes, existing frameworks need to be used to recenter power in the design, implementation, and evaluation of local community initiatives in the health field. In addition, health professionals and agencies must act to remove barriers to the empowerment of disadvantaged communities and groups. They can do this by taking experiential knowledge more seriously, by challenging processes that stigmatize disadvantaged groups, and by developing sustainable spaces for the authentic participation of lay communities of interest and place in decisions that have an impact on their lives.

Patterns of health and disease have been relevant to international studies for as long as human populations have migrated across large territorial spaces. After World War II, international health cooperation was accepted as a key function of the newly established United Nations system, with the creation of the World Health Organization (WHO) as the UN specialized agency for health alongside other UN bodies. However, social science scholarship paid little attention to the perceived technical field of health, and thus international health organizations, until the 1970s. The limited scholarship produced during the postwar period was largely by those engaged with international health organizations and was primarily descriptive of technical and legal issues. It was not until debates emerged about the role and effectiveness of WHO, beginning in the 1980s, that scholars began considering the politics of international health cooperation. The adoption of the Declaration of Alma Ata, List of Essential Drugs, and International Code of Marketing of Breast-Milk Substitutes spurred debates about the “politicization” of WHO’s technical mandate. Public health practitioners and social historians contributed reflections on how structural inequalities shape health outcomes, and international organization scholarship introduced critical theoretical approaches to the study of health institutions. Scholars began to locate patterns of health and disease within the broader international political economy. The subsequent proliferation of new institutional arrangements for collective action on health issues, involving both state and non-state actors, generated studies of the distribution of power and responsibilities in an increasingly complex institutional landscape. This led to the concept of global health governance (GHG), with health becoming located within globalization processes, encouraging scholarly links across international relations, social policy, law, and anthropology. A wider range of international organizations, with health-related impacts, were incorporated into GHG scholarship. Concurrently, new theoretical approaches to understanding collective action for global health emerge, notably realist notions of global health security and critical approaches to the construction of GHG. The study of international organization and health since the mid-2000s has focused intense attention on the reform or creation of new institutional arrangements amid major global health crises, acute health inequities, and shared risks. This increasingly rich literature has been informed by diverse normative perspectives.

The second half of the 20th century saw the development of social thought in health in Latin America and the Caribbean in which the social sciences had a central role. Such an innovative development was based on the understanding that health and disease are social processes that require the understanding of different health contexts. The origins of this development dates back to the renewal of medical teaching in Latin America, which had important support from the Pan-American Health Organization. The so-called field of social sciences in health then took shape, especially beginning in the 1970s and 1980s. The social sciences became part of teaching and assistance activities in social medicine and public health in many countries and contributed to consolidating postgraduate programs and networks of professors, researchers, professionals, and government agents who were active in public health actions and policies. Regarding Latin American realities, the issues of inequality in incidences of sickness and death and in the healthcare delivered to populations became relevant during this time. In close dialogue with relevant social groups, these actors have been significant in constructing responses to health problems in the region. Given the profound political, social, economic, environmental, and sanitary changes that took place in the transition from the 20th to the 21st century, social thought has attempted to meet the new empirical as well as theoretical and conceptual challenges to social sciences as applied to health. The analysis of the trajectory of this regional development, its details, advancements, and limits, is an important endeavor that should help to encourage suggestions toward bettering public health as well as fairness in these times of uncertainties and of new risks for humanity, as evidenced in an unprecedented way in the handling of the Covid-19 pandemic.

Homelessness is a public health challenge for modern governments. Homelessness emerged as a formal policy problem for rich nations in the mid- to late 20th century as nations developed stable economies and democracies, including housing and job markets, and social welfare mechanisms to protect citizens from disenfranchisement. In early 21st-century Organisation for Economic Co-operation and Development (OECD) nations, homelessness arises most often among at-risk or vulnerable populations, such as historically marginalized groups and/or persons with constrained access to welfare state mechanisms, such as immigrants or refugees. Thus, homelessness in OECD nations is very different from informal housing or mass poverty in poor nations and/or non-democratic regimes. Homelessness affects individual and population health, requiring complex policy solutions across multiple domains of health, as well as intergovernmental coordination. Policy responses to homelessness vary across OECD nations in their approach and efficacy. There are four key factors influencing how OECD nations respond to homelessness: (a) the strength and inclusivity of the welfare state; (b) degrees of decentralization in homeless policy governance; (c) the strength, capacity, and inclusivity of the health and behavioral healthcare systems; and (d) the role of federated structures in health and welfare state policy. Overall, nations with weaker welfare states and health/behavioral healthcare systems face greater risks of homelessness. The inclusivity of these systems also shapes who may be eligible for protection or experience homelessness. Local governments, especially those in large metropolitan areas, are the frontline providers of homelessness services. Yet local governments are constrained at both ends: Policies designed, delivered, and funded at larger units of government—such as welfare state provisions—influence many of the determinants of homelessness, such as housing, and the resources available to subnational actors to combat homelessness. Local actors are also constrained by the degree of decentralization. Devolution of homelessness policy to smaller units of government or even solely to nongovernmental actors, through federated mechanisms or decentralization, may create barriers to locally tailored solutions by perpetuating disparities across jurisdictions and/or constraining authority and resources necessary to design or deliver homeless policy.

Effective public communication and engagement have played important roles in ameliorating and managing a wide range of public health problems including tobacco and substance use, cardiovascular disease, HIV/AIDS, vaccine preventable diseases, sudden infant death syndrome, and automobile injuries and fatalities. The public health community must harness what has been learned about effective public communication to alert and engage the public and policy makers about the health threats of climate change. This need is driven by three main factors. First, people’s health is already being harmed by climate change, and the magnitude of this harm is almost certain to get much worse if effective actions are not soon taken to limit climate change and to help communities successfully adapt to unavoidable changes in their climate. Therefore, public health organizations and professionals have a responsibility to inform communities about these risks and how they can be averted. Second, historically, climate change public engagement efforts have focused primarily on the environmental dimensions of the threat. These efforts have mobilized an important but still relatively narrow range of the public and policy makers. In contrast, the public health community holds the potential to engage a broader range of people, thereby enhancing climate change understanding and decision-making capacity among members of the public, the business community, and government officials. Third, many of the actions that slow or prevent climate change, and that protect human health from the harms associated with climate change, also benefit health and well-being in ways unrelated to climate change. These “cobenefits” to societal action on climate change include reduced air and water pollution, increased physical activity and decreased obesity, reduced motor-vehicle–related injuries and death, increased social capital in and connections across communities, and reduced levels of depression. Therefore, from a public health perspective, actions taken to address climate change are a “win-win” in that in addition to responsibly addressing climate change, they can help improve public health and well-being in other ways as well. Over the past half decade, U.S.-based researchers have been investigating the factors that shape public views about the health risks associated with climate change, the communication strategies that motivate support for actions to reduce these risks, and the practical implications for public health organizations and professionals who seek to effectively engage individuals and their communities. This research serves as a model for similar work that can be conducted across country settings and international publics. Until only recently, the voices of public health experts have been largely absent from the public dialogue on climate change, a dialogue that is often erroneously framed as an “economy versus the environment” debate. Introducing the public health voice into the public dialogue can help communities see the issue in a new light, motivating and promoting more thoughtful decision making.

The People’s Health Movement (PHM) is a vibrant global network bringing together grass-roots health activists, public interest civil society organizations, issue-based networks, academic institutions, and individuals from around the world, particularly the Global South. Since its inception in 2000, the PHM has played a significant role in revitalizing Health for All (HFA) initiatives, as well as addressing the underlying social and political determinants of health with a social justice perspective, at global, national, and local levels. The PHM is part of a global social movement—the movement for health. For more than a century, people across the world have been expressing doubts about a narrowly medical vision of health care, and calling for focus on the links between poor health and social injustice, oppression, exploitation, and domination. The PHM grew out of engagement with the World Health Organization by a number of existing civil society networks and associations. Having recognized the need for a larger coalition, representatives of eight networks and institutions formed an international organizing committee to facilitate the first global People’s Health Assembly in Savar, Bangladesh, in the year 2000. The eight groups were the International People’s Health Council, Consumer International, Health Action International, the Third World Network, the Asian Community Health Action Network, the Women’s Global Network for Reproductive Rights, the Dag Hammarskjold Foundation and Gonoshasthaya Kendra. All these groups consistently raised and opposed the selectivization and verticalization of Primary Health Care (PHC) that followed Alma Ata leading to what was called Selective PHC (i.e., not the original comprehensive PHC). These groups came together to organize the committee for the first People’s Health Assembly and then to form the Charter Committee that led to the People’s Health Charter, which finally led to the actual PHM. Within PHM, members engage critically and constructively in health initiatives, health policy critique, and formulation, thus advancing people’s demands. The PHM builds capacities of community activists to participate in monitoring health-related policies, the governance of health systems, and keeping comprehensive PHC as a central strategy in world debate. The PHM ensures that people’s voices become part of decision-making processes. The PHM has an evolving presence in over 80 countries worldwide, consisting of groups of individuals and/or well-established PHM circles with their own governance and information-sharing mechanisms. It additionally operates through issue-based circles across countries.

Religion, in both its personal and institutional forms, is a significant force influencing the health of populations across the life course. Decades of research have documented that expressions of faith and the practice of spiritual pursuits exhibit significantly protective effects for physical and mental health, psychological well-being, and population rates of morbidity, mortality, and disability. This finding has been observed across sociodemographic categories, across nations and cultures, across specific disease outcomes, and regardless of one’s religious affiliation. A salutary religious effect on health and well-being is especially apparent among older adults, but is also observed across generations and age cohorts. Moreover, this association has been persistently found for various religious indicators, including attendance at worship services, prayer and other private practices, subjective feelings of religiosity, and numerous measures of religious behaviors, attitudes, beliefs, and experiences. Finally, a protective or primary preventive effect of religion has been observed in clinical, epidemiologic, social, and behavioral studies, regardless of research design or methodology. Faith-based organizations also have contributed to the health of populations, in partnerships or alliances with medical institutions and public health agencies, many of these dating back many decades. Examples include congregational health promotion and disease prevention programs and community-wide interventions, especially targeting the health and well-being of older congregants and those in less well-resourced communities, as well as faith–health partnerships in healthcare delivery, public health policymaking, and legislative advocacy for healthcare reform. Religious denominations and institutions also play a substantial role in global health development throughout the world, individually and in partnership with national health ministries, transnational medical mission organizations, and established nongovernmental agencies. These efforts focus on a wide range of goals and objectives, including building public health infrastructure, addressing ongoing environmental health needs, and responding to acute public health challenges and crises, such as infectious disease outbreaks. Constituencies include at-risk populations and cohorts throughout the life course, and programming ranges from perinatal care to maternal and child healthcare to geriatric medicine.

Since 1976, incarcerated individuals in the United States have an established right to healthcare. This has created a national system charged with addressing the unique challenges of healthcare delivery in jails and prisons. As incarcerated populations are often excluded from large research studies, evidence-based practices must often be extrapolated from community data. There is a wide variation in care delivery across institutions nationwide. Challenges in correctional settings include a “dual loyalty” to patients’ health and facility security and the toxic effects of disciplinary practices including solitary confinement, violence, communicable disease control, an aging population, discharge planning for community reentry, and a high prevalence of substance use disorder and mental health disease. Although incarceration may offer a unique opportunity to address chronic health issues of a difficult-to-reach population, the net health effects in the United States seem to be mostly negative. Mass incarceration in the United States has led to significant health consequences at the individual, family, and community levels and has exacerbated health, socioeconomic, and racial disparities. As most incarcerated individuals return to the community, healthcare delivery during incarceration plays a substantial role in the health of communities at all levels.

Julian Samora (1920–1996) was a researcher and scholar in sociology and Mexican American studies and the first Mexican American in the fields of sociology and anthropology. He was professor of sociology at the University of Notre Dame.

An important function of public health is to prevent injuries or to lessen their impact when they occur. An estimated 251,000 people worldwide die each year from a firearm-related death and many more suffer nonfatal injuries with consequences that can last a lifetime. Firearm injuries, which include those that are intentionally self-inflicted, unintentional, or from an act of interpersonal violence, are heavily concentrated in the Americas, driven largely by firearm homicides. Firearm-related deaths and injuries disproportionately impact males and younger populations and are associated with factors such as access, substance use, adverse childhood experiences, involvement in high-risk social networks, drug trafficking, density of alcohol outlets, and neighborhood and social disadvantage. While progress is being made to understand firearm injuries and how to effectively prevent them, much more needs to be done to improve the availability and timeliness of data; apply the knowledge that is generated to effectively reduce firearm-related injuries, deaths, and costs; strengthen the scientific infrastructure; and move countries closer to achieving the violence-related targets in the 2030 Sustainable Development Goals.

The COVID-19 crisis—the most catastrophic international public health emergency since the Spanish influenza 100 years ago—provides impetus to review the significance of public and global health in the context of Sustainable Development Goal (SDG) achievement. When countries unanimously adopted the 17 SDGs in September 2015, stakeholders had mixed views on global health goal SDG 3 (Good Health and Well-Being). Concern arose over the feasibility of achieving SDG 3 by 2030 when countries pursued its nine targets and four means of implementation with sixteen other ambitious global goals. Nonetheless, health surely cuts across the SDG framework: for instance, the underlying health determinants are expressed in many goals as is urban and planetary health. Although health (and its different constructions) is central to overall SDG achievement, SDG success depends on a paradigm shift toward whole-of-government policy and planning. Indeed, the 2030 Agenda echoes calls for a Health in All Policies (HiAP) approach to public health programming. This depends on another paradigm shift in public health tertiary education, practitioner training, and policy skills development within and beyond ministries of health. Added to this are the underlying problematics around SDG health financing, human resources for health, health target and indicator localization for equitable country responses that leave no one behind, strengthening civil registration and vital statistics systems for inclusive and accountable health implementation, and the sidelining of human rights from SDG metrics. While COVID-19 has derailed SDG efforts, it could also be the ultimate game changer for intergenerational human and environmental health transformation. Yet strong global health governance and rights-based approaches remain key.

Dolores Gonzalez Molina de la Caro (1910–1979) was a pioneer in mental health training, public welfare, public health, school health, and university counseling in Puerto Rico. She was director of the Bureau of Medical Social Work and Mental Health Program.

Suicide in later life is a significant public health problem around the world—a problem that will increase in magnitude in the coming years with the impact of population aging. Adults age 70 and older have higher suicide rates than younger groups worldwide in both lower-income and higher-income countries. While suicide rates tend to increase with age, suicide in later life is not an expected or normative response to stressors that accompany the aging process. Instead, a constellation of risk factors places an older adult at elevated risk for suicide. These factors can be remembered as the Five D’s: psychiatric illness (primarily depression); functional impairment (also called disability, often associated with dependency on others); physical illness (particularly multiple comorbid diseases); social disconnectedness (including social isolation, loneliness, family conflict, and feeling like a burden); and access to lethal (deadly) means. The greatest risk occurs when multiple domains of risk converge in a given individual. Approaches to prevention can address the Five D’s. Given that older adults are reluctant to seek out mental healthcare and that standard primary care practice cannot easily provide it, models of primary care-based integrated care management for mental disorders, including in older adulthood, have been developed, rigorously tested, and widely disseminated. These models play an important role in suicide prevention by integrating treatment for physical and mental illness. Upstream, selective prevention strategies that target disconnectedness—such as engaging older adults as volunteers—may serve to reduce disconnectedness and thereby reduce suicide risk. Universal prevention strategies that involve growing the geriatric workforce may address disability by increasing older adults’ access to medical and social service providers with expertise in improving physical, cognitive, and social functioning, as well as improving quality of life. Addressing ageism and building age-friendly communities that use strategies to integrate older adults into society and promote social participation hold promise as universal prevention strategies. Ultimately, effective suicide prevention strategies for older adults must focus on improving quality of life as well as preventing suicide: strategies such as psychotherapy and medication for psychiatric disorders must be supplemented by prevention strategies for older adults give at all ages in addition to treating psychiatric disorders and suicidal thoughts is needed to address the problem of suicide in later life.

In the United States, gender and health in adolescence are sites of contestation and conflict marked by both hyperrepresentations and absences. Youth who are multiply marginalized by interlocking systems of racism, sexism, classism, heterosexism, cissexism, ableism, and so on are overrepresented in cultural and policy domains as “at risk” for negative health outcomes. At the same time, absences surrounding young people’s complex health needs and experiences abound in schools, healthcare settings, families, and the media. For instance, debates around sex education and teen pregnancy prevention have dominated the policy landscape for decades, with no signs of receding any time soon. Missing from these debates has been an analysis of how the intersections of race, class, gender, and sexuality structure the health outcomes and educational experiences of diverse youth. Likewise, queer, transgender, and gender-expansive youth are overrepresented in discussions about bullying to the detriment of the social structural factors that produce poor mental health outcomes. Understanding how gender and health play out in the lives of adolescents, as well as at the level of social institutions and structures, is central to teasing out the dynamics of gender, health, and social inequalities.