{"title":"The Ethics of Health: Giovanni Berlinguer's Contribution to Building a Fairer Society.","authors":"Fabrizio Rufo","doi":"10.1177/0020731420937933","DOIUrl":"https://doi.org/10.1177/0020731420937933","url":null,"abstract":"<p><p>This article addresses some elements of the work of Giovanni Berlinguer in the field of social medicine, namely the relationship between science and society, on one hand, and bioethics, on the other. Berlinguer's work in these domains centers around the right to health for the popular classes and the concerns of bioethics. My aim is to highlight Berlinguer's effort to connect medical and bioethical issues within his own political vision of a more just society.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420937933","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38154639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gender Equality and Gender Inequalities in Self-Reported Health: A Longitudinal Study of 27 European Countries 2004 to 2016.","authors":"Luis Roxo, Clare Bambra, Julian Perelman","doi":"10.1177/0020731420960344","DOIUrl":"https://doi.org/10.1177/0020731420960344","url":null,"abstract":"<p><p>Significant gender-based health inequalities have been observed across Europe, with women reporting worse health than men. Still, there has been little examination of how the gender-health gap has changed over time, and how it has been shaped by societal gender equality. We used data from the Statistics on Income and Living Conditions Eurostat database (EU-SILC), involving 2,931,081 participants aged 25-64, for 27 European countries. Logistic regressions were performed to model the association between self-reported bad health and gender, in general and over time. Analyses were stratified by employment, education, and clusters of countries according to levels of Gender Equality Index (GEI). Adjusting for age, year, and country, bad health was 17% more likely among women, but this disadvantage ceased after accounting for education and employment. Gender-health inequalities were larger among countries with higher GEI scores and among low-educated groups. The gender-health gap did not reduce significantly between 2004 and 2016, in general and within subgroups. Although societies are becoming more equal, persistent inequalities in employment and income still lead to sustained health differences between men and women.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420960344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38558539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coronavirus, Capitalism in Crisis and the Perversity of Public Health in Bolsonaro's Brazil.","authors":"Leonardo Carnut, Áquilas Mendes, Lucia Guerra","doi":"10.1177/0020731420965137","DOIUrl":"https://doi.org/10.1177/0020731420965137","url":null,"abstract":"<p><p>This article aims to discuss the meaning of the coronavirus crisis as an integral part of the totality of the capitalist crisis and its implication in the health area of Brazilian capitalism, in which the rise of ultraliberal and neofascist policies is witnessed by the Bolsonaro government. To this end, we opted for a historical-dialectical materialist analysis of the situation experienced between the global beginning of the pandemic until the month of May 2020 in Brazil. The article is structured in 2 parts: The first discusses the problem of agrifood systems in the context of capitalism in crisis and its effects on the spread of diseases such as the coronavirus, and the second discusses the neglect of the Bolsonaro government in facing the COVID-19 pandemic and the Brazilian universal health system. Evidence shows that the Bolsonaro government has led to more deaths and more of the barbarism of capitalism. The scenario after the pandemic will be one of a country with a more or less intense capitalist crisis depending on the resistance of workers in the defense of public health and lives.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420965137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38603392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID-19: Need for Equitable and Inclusive Pandemic Response Framework.","authors":"Sabeena Mustafa, Anishia Jayadev, Maya Madhavan","doi":"10.1177/0020731420967630","DOIUrl":"https://doi.org/10.1177/0020731420967630","url":null,"abstract":"<p><p>When a new infectious disease emerges as an epidemic or pandemic, strict and appropriate mitigation strategies are critical. Appropriate steps that facilitate defining of cases, carrying out accurate clinical diagnoses, and forming a powerful health surveillance that addresses public health policies and procedures are necessary. Tracking the number of COVID-19 cases over time and flattening the curve is another important element to establish research settings and identify therapeutic components to expedite and develop effective interventions. Addressing the various sections of the society in a philanthropic way is crucial to acquiring the public cooperation that is essential to controlling a disease like COVID-19. In this study, we discuss various strategies and measures adopted by Kerala, an Indian state, to combat the COVID-19 outbreak. Regular and timely updates by government public relations and health departments were used in many of the adopted strategies. The engagement of health information systems, together with the application of decentralized governance and community engagement, has contributed to effective population health management and surveillance of the pandemic.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420967630","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38506230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabiana Turino, Jonathan Filippon, Francis Sodré, Carlos Eduardo Siqueira
{"title":"Reinventing Privatization: A Political Economic Analysis of the Social Health Organizations in Brazil.","authors":"Fabiana Turino, Jonathan Filippon, Francis Sodré, Carlos Eduardo Siqueira","doi":"10.1177/0020731420961286","DOIUrl":"https://doi.org/10.1177/0020731420961286","url":null,"abstract":"<p><p>The Brazilian state apparatus was reformed throughout the 1990s, influenced by New Public Management (NPM). NPM was embodied in the health care sector by the creation of Social Health Organizations (<i>Organizações Sociais de Saúde</i> or OSS), private non-profit entities to provide welfare services. We performed a systematic review of the literature outlining the origins and role of OSS in Brazil. Our selected articles (peer-reviewed) cover the origins/performance of OSS and their services provision between 1998 and 2018, in English or Portuguese. Databases used were Lilacs, Bireme, Medline, Pubmed, and SciELO. We identified 4,732 articles applying a pre-defined set of descriptors, from which we selected 49 for analysis. The main findings reveal that NPM is the central theme of most articles about OSS in Brazil (n = 26). There is evidence corroborating our hypothesis that transferring management of public health care services to private non-profit organizations is a softer version of privatization as, although financing is kept public, the rationale and ethos of OSS services institutionally and operationally mimic the private sector. The practical consequence is that attainment of health care in Brazil ends up being neither fully commodified (based on ability to pay) nor fulfilled as a citizen's right following its national constitution.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420961286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38464886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Lexchin, Janice Graham, Matthew Herder, Tom Jefferson, Trudo Lemmens
{"title":"Regulators, Pivotal Clinical Trials, and Drug Regulation in the Age of COVID-19.","authors":"Joel Lexchin, Janice Graham, Matthew Herder, Tom Jefferson, Trudo Lemmens","doi":"10.1177/0020731420979824","DOIUrl":"10.1177/0020731420979824","url":null,"abstract":"<p><p>Medicine regulators rely on pivotal clinical trials to make decisions about approving a new drug, but little is known about how they judge whether pivotal trials justify the approval of new drugs. We explore this issue by looking at the positions of 3 major regulators: the European Medicines Agency, Food and Drug Administration, and Health Canada. Here we report their views and the implications of those views for the approval process. On various points, the 3 regulators are ambiguous, consistent, and demonstrate flexibility. The range of views may well reflect different regulatory cultures. Although clinical trial information from pivotal trials is becoming more available, regulators are still reluctant to provide detailed information about how that information is interpreted. As medicines and vaccines come up for approval for treatment of COVID-19, transparency in how pivotal trials are interpreted will be critical in determining how these treatments should be used.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38740006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estimating the COVID-Related Deaths Attributable to President Trump's Early Pronouncements About Masks.","authors":"Robert A Hahn","doi":"10.1177/0020731420960345","DOIUrl":"10.1177/0020731420960345","url":null,"abstract":"<p><p>The goal of this analysis is to estimate the proportion of COVID-19 deaths attributable to President Donald Trump's early pronouncements about voluntary mask use and his intention not to use masks. Data from available research were used to estimate parameters for the calculation of population attributable risk for COVID-19 deaths reported to date. Assuming Trump's pronouncement to have caused 25%, 50%, and 75% of the non-use of masks, estimates of Trump-attributable COVID-19 deaths to date would be, respectively, 4,244, 8,356, or 12,202. The effects of presidential pronouncements on health-related matters may have large public health consequences. Pronouncements of national leaders should be based on the best available science.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38412896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Human Rights: Food for Spreading a Thought \"HR and Empowerment\".","authors":"Claudio Schuftan","doi":"10.1177/0020731420965485","DOIUrl":"https://doi.org/10.1177/0020731420965485","url":null,"abstract":"","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420965485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38477428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"We Must Take Advantage of This Pandemic to Make a Radical Social Change: The Coronavirus as a Global Health, Inequality, and Eco-Social Problem.","authors":"Joan Benach","doi":"10.1177/0020731420946594","DOIUrl":"https://doi.org/10.1177/0020731420946594","url":null,"abstract":"<p><p>COVID-19 not only constitutes a serious public health problem and a global major threat to the poorest and most vulnerable social groups and neighborhoods of the world, creating a potential pandemic of inequality, but also poses an enormous challenge from the perspective of public health, ethics, economy, environment, and politics. However, many of the deep and complex systemic interrelationships created and developed by this pandemic are largely hidden, unknown, or neglected, both by the hegemonic media and by a highly specialized and fragmented academic world. However, when all the available knowledge is critically integrated, the origins and effects underlying this pandemic are likely to be found in the development of neoliberal capitalism and its inherent logic of ceaseless accumulation, economic growth, large inequalities, and ecological devastation. This commentary reflects on these issues, drawing out some of the most important lessons to be learned and challenges to be faced in the COVID-19 pandemic and its aftermath, advocating for a radical social change to deal with these challenges.</p>","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420946594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38223798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alvaro J Idrovo, Edgar F Manrique-Hernández, Julián A Fernández Niño
{"title":"Report From Bolsonaro's Brazil: The Consequences of Ignoring Science.","authors":"Alvaro J Idrovo, Edgar F Manrique-Hernández, Julián A Fernández Niño","doi":"10.1177/0020731420968446","DOIUrl":"10.1177/0020731420968446","url":null,"abstract":"Currently, the fast spread of COVID-19 is the cause of a sanitary emergency in Brazil. This situation is largely due to President Bolsonaro’s denial and the uncoordinated actions between the federal and local governments. In addition, the Brazilian government has reported that it would change its method of sharing information about the pandemic. On June 6, 2020, the presentation of accumulated cases and deaths was stopped, and the Supreme Court of Brazil determined that the federal government should continue to consolidate and disseminate the accumulated figures of cases and deaths. However, doubt about the transparency of the data remained. We used data reported by the government from Situation Reports 38–209 of the World Health Organization to assess the Benford’s law fulfillment as an indicator of data quality. This rapid evaluation of data quality during the ongoing COVID-19 pandemic in Brazil suggests that the Brazilian public health surveillance system had an acceptable performance at the beginning of the epidemic. Since the end of June, the quality of cumulative death data began to decrease and remains in that condition as of August 2020. A similar situation has existed since August, with the data of accumulated new cases.","PeriodicalId":54959,"journal":{"name":"International Journal of Health Services","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0020731420968446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}