Int J Health Serv
-
Since independence in 1971, a large number of health programs run by local and foreign voluntary organizations have been started in Bangladesh. This paper is the result of a survey undertaken on behalf on the Oxford Famine Relief Committee of ten of the most interesting of these projects. ⋯ A basic premise of this analysis is that ill health in particular communities is not simply a result of local conditions; rather, the structural determinants of ill health are frequently national and even international in scope. The effect of these structural determinants of the presence and funding policies of the many voluntary agencies in Bangladesh is assessed by analyzing the performance of the Oxford Famine Relief Committee, one of the more enlightened of these agencies.
-
This study is an historical analysis of food consumption and nutrition in Chile emphasizing the influence of political and economic factors on nutritional standards. It attempts to document and explain the persistence of malnutrition as a widespread social problem in Chile even as the country achieved a relatively advanced state of economic development and boasted an unusually progressive record of social legislation. The major findings of the study were: (a) Chile's pattern of development, social reform efforts notwithstanding, consistently discriminated against low-income groups, and (b) this discrimination perpetuated low standards of nutrition and low levels of food consumption among the country's poor and undermined the effectiveness of specific measures to alleviate malnutrition.
-
Historical Article
The transfer of care: U.S. mental health policy since World War II.
Recent criticism of mental health policy has raised many questions about the so-called "mental health revolution." Following World War II, the federal government and the growing mental health lobby planned the first nationally oriented system of psychiatric treatment, rehabilitation, and prevention. The rapidly expanding National Institute of Mental Health coordinated that policy, particularly through its Community Mental Health Centers program. Custodial state hospitals were depopulated and their patients "dumped" in nursing and boarding homes, which now constitute the largest arena for and most expensive form of psychaitric care. ⋯ They, and many others, are maintained on psychiatric drugs, another source of profit as well as a dangerous technology. Community mental health programs have maintained psychiatry's traditional class, race, and sex biases, and have incurred widespread intrusion into communities. This article shows that such problems are part of an interconnected system in which the driving forces are fiscal crisis, ideological justifications for dumping patients, attempts to pass responsibility from state governments to federal and local bodies, restrictions on government and insurance reimbursements, the free enterprise economics of the nursing home and drug industries, and the professionalist practices of the mental health field.
-
Biography Historical Article
Edwin Chadwick, the market ideology, and sanitary reform: on the nature of the 19th-century public health movement.
This article is an attempt to place the origin of sanitary legislation in England, and its chief proponent, Edwin Chadwick, in the overall dynamics of 19th-century social development. It examines the public health movement in light of the transition of English society into the domination of the market ideology, and the effect that this had on health. ⋯ The main intent of this article is to go beyond the prevailing belief that sanitary reform was a humane contribution of publicly spirited men. It concludes that this state intervention was materially necessitated: it was forced by the contradictions inherent in the market system.