Wednesday, May 26, 2010

[EQ] The role of urban municipal governments in reducing health inequities

The role of urban municipal governments in reducing health inequities:
A meta-narrative mapping analysis


Patricia A. Collins1, Michael V. Hayes1,2

1 Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada

2Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada


International Journal for Equity in Health 2010, 9:13 (25 May 2010)

Available online PDF [57p.] at: http://bit.ly/aX33DI

Abstract

“….The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a `health inequities knowledge base`, the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities.

Methods:

Using meta-narrative mapping, four bodies of scholarly literature – ‘health promotion’, ‘Healthy Cities’, ‘population health’ and ‘urban health’ – that have made substantial contributions to the health inequities knowledge base were analyzed over the 1986-2006 timeframe. Article abstracts were retrieved from the four literature bodies using three electronic databases (PubMed, Sociological Abstracts, Web of Science), and coded for bibliographic characteristics, article themes and determinants of health profiles, and prescriptions for municipal government interventions on health inequities.

Results:

1004 journal abstracts pertaining to health inequities were analyzed. The overall quantity of abstracts increased considerably over the 20 year timeframe, and emerged primarily from the ‘health promotion’ and ‘population health’ literatures. ‘Healthy lifestyles’ and ‘healthcare’ were the most commonly emphasized themes in the abstracts. Only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. Such interventions included public health campaigns, partnering with other governments and nongovernmental organizations for health interventions, and delivering effectively on existing responsibilities to improve health outcomes and reduce inequities. Abstracts originating from Europe, and from the ‘Healthy Cities’ and ‘urban health’ literatures, were most vocal regarding potential avenues for municipal government involvement on health inequities.

Conclusions:

This study has demonstrated a pervasiveness of ‘behavioural’ and ‘biomedical’ perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the ‘health inequities knowledge base’ inadequately reflects the complex aetiology of, and solutions to, population health inequities…..”

 


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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
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[EQ] Social Protection in Latin America Achievements and Limitations

Social Protection in Latin America Achievements and Limitations

Francisco H.G. Ferreira

David Robalino

Policy Research Working Paper 5305 - May 2010

The World Bank - Latin America and the Caribbean Region

Office of the Chief Economist & Human Development Network

Social Protection and Labor Unit

Available online PDF [41p.] at http://bit.ly/a1r7To

“…..Social protection systems in Latin America have been transformed in the past two decades. Until the 1980s, those who were not covered by the social security arrangements available primarily in the urban formal sector received little public assistance beyond universal subsidies for some food or fuel purchases.

 

Since the 1990s, the introduction of non-contributory social insurance programs (including “social pensions”) and conditional cash transfers has substantially extended the coverage and improved the incidence of social assistance.

 

However, the organic growth of subsidized social assistance in parallel to the older social insurance system, financed largely out of taxes on formal sector employment, has led to a dual system that is neither properly equitable nor efficient.

 

The twin challenges that now face social protection in Latin America are to better integrate those two halves of the system, and to develop programs that promote sustainable self-reliance, by moving from “safety nets” to “opportunity ropes.”….”

 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
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IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
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any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.