American journal of public health
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We compared differences in mental health needs and provision of mental health services among residents of Santiago, Chile, with private and public health insurance coverage. ⋯ The health reforms that have encouraged the growth of the private health sector in Chile also have increased risk segmentation within the health system, accentuating inequalities in health care provision.
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Historical Article
The World Health Organization and the transition from "international" to "global" public health.
The term "global health" is rapidly replacing the older terminology of "international health." We describe the role of the World Health Organization (WHO) in both international and global health and in the transition from one to the other. We suggest that the term "global health" emerged as part of larger political and historical processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances. Between 1948 and 1998, WHO moved from being the unquestioned leader of international health to being an organization in crisis, facing budget shortfalls and diminished status, especially given the growing influence of new and powerful players. We argue that WHO began to refashion itself as the coordinator, strategic planner, and leader of global health initiatives as a strategy of survival in response to this transformed international political context.
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Comparative Study
Mortality among very low-birthweight infants in hospitals serving minority populations.
We investigated whether the proportion of Black very low-birth-weight (VLBW) infants treated by hospitals is associated with neonatal mortality for Black and White VLBW infants. ⋯ Minority-serving hospitals may provide lower quality of care to VLBW infants compared with other hospitals. Because VLBW Black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States.
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We sought to estimate motor vehicle passenger restraint use among Northwest American Indian children 8 years old or younger and to determine factors associated with using proper (i.e., age and weight appropriate) passenger restraint systems. ⋯ Children in these communities are inadequately restrained. Restraint use was exceedingly low among booster-eligible children and children riding with unrestrained adults. Interventions emphasizing appropriate restraint use and enforcement of passenger safety laws could reduce the risk of injury or death in motor vehicle accidents.
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Randomized Controlled Trial Clinical Trial
Effects of recreational physical activity and back exercises on low back pain and psychological distress: findings from the UCLA Low Back Pain Study.
We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting. ⋯ These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.