Recent iha items

Unpacking the heritability of diabetes: The problem of attempting to quantify the relative contributions of nature and nuture

Wed, 21 Jul 2010 00:00:00 +0000

In this paper I analyze the concept of heritability as used technically in medical research. I use diabetes as a paradigmatic “common disease” whose heritability is computed with a view to disentangling the relative contributions of “nature” and “nurture”. I show what heritability measures and what it does not, and theorize about the scope of application of this measurement for diabetes-relevant medical research, health care practices, and public health policies. I argue that this analysis applies to heritability studies of comparable diseases and complex phenotypes, concerning which heritability estimates shed little if any light on the nature-nurture question, and provide no information relevant to medical practices and public health policies that we do not already have. I conclude that what is interesting about heritability studies in diabetes and similar human contexts is not what they tell us, or fail to tell us, about the relationship between nature and nurture, but what...

A second opinion on U.S. health care reform

Wed, 21 Jul 2010 00:00:00 +0000

A second opinion on U.S. health care reform

The Elephant in the Room: The Invisibility of Poverty in Research on Type 2 Diabetes

Tue, 20 Jul 2010 00:00:00 +0000

Over two hundred years of anecdotal, epidemiological, and experimental evidence indicate that poverty breeds disease. This holds true for type 2 diabetes, which both in the United States and other developed nations disproportionately occurs, cripples, and kills among the poor. In this article we examine rhetorical strategies used in 30 journal articles indexed under type 2 diabetes and poverty. As we show, poverty is rarely highlighted in this literature as a causal factor. Instead, explanations for diabetes among poor people overwhelmingly emphasize features of patients—their biology, behaviors, psychology, culture, or other “risk factors”—while ignoring, reframing or neglecting the links between poverty and disease. By so doing, these discursive strategies naturalize higher rates of diabetes among poor persons, legitimize relations of domination in the larger society, and encourage only research projects, treatment practices and health and social policies that do not challenge...

Medicine and Public Health Partnerships: Predictors of Success

Wed, 14 Mar 2007 00:00:00 +0000

Objective: Empirically examine medicine and public health partnership factors that are associated with partnership success.

Methods: 329 medicine and public health partnership informants were interviewed to assess factors associated with success in achieving partnership goals.

Results: Partnership formation; partner recruitment; barriers to collaboration; and leadership/governance variables were not predictive of partnership success. Partnership duration was significant in predicting success in achieving outcomes.

Conclusions: Factors identified in the literature are not as salient as believed in insuring the success of medicine and public health partnerships. The longer a partnership can remain intact (i.e., minimally longer than one year), irrespective of the particularities of the formation and structure of the partnership, the greater the probability that the partnership will achieve its desired outcomes.

The Unprotected: Characteristics of Older Adults Who Did Not Receive Their Annual Influenza Immunization

Thu, 24 Mar 2005 00:00:00 +0000

The Centers for Disease Control and Prevention (CDC) estimate that influenza causes 36,000 deaths in the United States every year, and results in direct medical care costs of over $4.6 billion annually. Influenza and pneumonia are responsible for 8,800 deaths per year in California alone, making it the sixth leading cause of death among adults in the state, yet the illnesses are largely preventable by immunization.

The California Adult Immunization Coalition (CAIC) is comprised of more than 20 organizations across California who are working together to increase immunization rates for influenza and pneumonia in adults. The CAIC analyzed influenza vaccination rates in California using data from the 2001 California Health Interview Survey (CHIS), and compared the results to the national Healthy People 2010 goals for adult immunization. The national goals specify that 90% of older adults (age 65 and over) should be immunized against influenza annually by the year 2010 (i.e.,...

The State of the Great Central Valley of California-Assessing the Region via Indicators: Public Health and Access to Care

Thu, 24 Mar 2005 00:00:00 +0000

Each year the Great Valley Center produces a report in the five part State of the Great Central Valley series. The data is updated in 5-year increments.

Based on the data, the Great Valley Center recognizes the potential to improve health outcomes throughout the region. Overall, the indicators suggest five strategies:

* Invest in Prevention * Be Strategic With Limited Resources * Model Healthy Lifestyles for Youth * Build Coalitions in Support of a Healthier Environment * Reduce Poverty

Economic implications of increased longevity in the united states

Sun, 13 Mar 2005 00:00:00 +0000

The elderly population in America is growing in size owing to declining death rates, increasing life expectancy, and the aging of the baby boomers. Although the prevalence of chronic illness and disability increases with age, successful aging in the elderly population is widespread, and the elderly are generally healthy. Indeed, the prevalence of disability among the elderly is declining, and expenditures for their care are increasingly concentrated at the end of life rather than during extra years of relatively healthy life. Nevertheless, health care costs will undoubtedly increase during the next 30 years as a result of the baby boomers entering late life. The economic and social impact of future growing health care expenditures for the elderly will be significant. Important policy issues will include the continued viability of the Medicare and Social Security programs, future needs for long-term care, improvement of the health status of the elderly, technological advances,...

The Cost of Alcohol Abuse in California: A Briefing Paper

Fri, 25 Feb 2005 00:00:00 +0000

Alcohol abuse is known to cause illness, disability, and premature death. It is also a contributing factor in many instances to criminal activity, motor vehicle crashes, and other injuries. Substantial costs resulting from alcohol abuse are incurred in the United States and in California, including the cost of providing medical care for people with alcohol-related illness, treatment and prevention costs, costs to the law enforcement system, costs resulting from alcohol-related motor vehicle crashes and other injuries, and the indirect costs associated with disability, diminished capacity, and premature death from alcohol-related causes.

The purpose of this briefing paper is to review the research that has been done in this area, and to present preliminary estimates of the costs of alcohol abuse in California and its impact on the state. These estimates are based on research that has been conducted by experts at the national level over the years coupled with some specific...