International Journal of Health Services
ISSN / EISSN : 0020-7314 / 1541-4469
Published by: SAGE Publications (10.1177)
Total articles ≅ 2,425
Latest articles in this journal
International Journal of Health Services; https://doi.org/10.1177/00207314221125057
Every year, 8 million small arms and 15 billion rounds of ammunition are manufactured in the world. Every day, 700 people worldwide (more than 2.5 million in a decade) die from firearms such as pistols, shotguns, assault rifles, or machine guns. Between 1968 and 2011, there were 1.4 million gun-related deaths in the United States (including suicides, homicides, and accidents) compared with 1.2 million North American deaths in all wars. This article looks at the historic and cultural context that has generated and shaped the U.S.'s “gun culture” and prevailing mentality regarding the right to bear arms, critiquing the vision that such a pro-arms mentality is an intrinsic and unchangeable element of U.S. culture. It exposes the neoliberal roots of the current U.S. gun violence epidemic, asking the question of “why?” in order to move toward an alternative conventional wisdom and overcome this urgent public health crisis in the U.S. and elsewhere.
International Journal of Health Services; https://doi.org/10.1177/00207314221126283
Area regeneration of deprived neighborhoods is being used to reduce health inequality, socioeconomic deprivation and ethnic segregation. This quasi-experimental study examines if long-term graded exposure to urban regeneration is associated with primary healthcare-seeking behavior among residents. We compared general practitioner (GP) contacts from 2015-2020 in two adjacent, deprived social housing areas, one exposed to area regeneration. Populations were into Western and non-Western males and females aged 15 years and older (N = 3,960). Mean annual GP contact frequency for each group were estimated and a difference-in-difference (DiD) analysis was conducted with adjustments for propensity scores based on baseline characteristics. GP contact frequency increased for all groups across time with a systematically higher level and faster increase in the control groups. In particular, the mean difference between the exposed and control area for non-Western women more than doubled from −0.61 to −1.47 annual contacts across the period. The mean differences in contact frequency increased for all groups but results of the DiD analyses were insignificant. In conclusion, an emerging gap in GP contact frequency, with the highest levels in the control area, was observed for all comparisons across time. More long-term research is needed to understand how the emerging gaps evolve.
International Journal of Health Services; https://doi.org/10.1177/00207314221125151
Existing frameworks seek to elucidate the social, political, and commercial determinants of health in order to inform practice, policy, and research that can improve health and reduce health inequities. Each approach has widened the scope of public health practice and research and identified new partners and targets for intervention. But as the public health crises of the past decade have shown, these frameworks have not yet yielded insights that have enabled the public health profession and movement to prevent or overcome dominant threats to global health and health equity. This report explores the value of an integrated framework that combines insights from previous scholarship and practice using the social, political, and commercial determinants of health. It proposes the questions such an integration would need to answer and suggests processes and tasks that could lead to the creation of a blended framework.
International Journal of Health Services; https://doi.org/10.1177/00207314221126110
This study examines the effect of democracy on public health by using panel data of 188 countries over the period 1972–2019. We use various regression methods, such as pooled ordinary least squares, fixed effects, dynamic generalized method of moments (GMM), a split-sample method, and a quadratic model to address econometric issues. The pooled regression supports the positive effect on health, but it does not exist in low-income countries, which can be explained by the threshold effect. The fixed effects regression confirms the positive impact on infant mortality but not on life expectancy, which illustrates the historical and cumulative effect of democracy on life expectancy. The non-linear regression finds a U-shaped relationship between democracy and infant mortality, which is consistent with the fixed effects regression result of the positive effect on mortality in the low-income group. The dynamic GMM regression shows the expected strong relationship between previous health and current health status. Overall, the regression analysis supports the positive effect of democracy on public health.
International Journal of Health Services, Volume 52, pp 442-454; https://doi.org/10.1177/00207314221122658
COVID-19 outbreak quickly spread to all corners of the globe. In Brazil, the outbreak was particularly frightening because it worsened existing health, political, economic, and social problems. The results already observed show the contagion ripple-spreading process across the country, causing the death of thousands of people each day and counting, added to a very serious wave of unemployment, scientific denial, and social precariousness. Based on this, this study reviews recent research that looked at the role of the government, the Brazilian health system, and the main economic and social impacts fostered by the pandemic. We perform a scoping review according to the PRISMA-ScR to structure the qualitative synthesis of the 67 associated documents. The results reinforce the negative effects of the country's mismanagement and its consequent impacts on the Brazilian economy and society. The battleground against COVID-19 has fueled political tensions, shaken the health system, and unleashed social despair tinged with thousands of deaths. Finally, in the present scoping review, we discuss concerns about the impacts of the COVID-19 outbreak in Brazil and what the world hopes the country has learned from the current crisis.
International Journal of Health Services; https://doi.org/10.1177/00207314221122657
The concept of the social determinants of health has become increasingly accepted and mainstream in anglophone public health over the past three decades. Moreover, it has been widely adopted into diverse geographic, sociocultural, and linguistic contexts. By recognizing the role of social conditions in influencing health inequalities, the concept challenges narrow behavioral and reductive biological understandings of health. Despite this, scholars and activists have critiqued the concept of the social determinants of health for being incomplete and even misrepresenting the true nature of health inequities. Arguably, these critiques have been most thoroughly developed among those working in the Latin American social medicine and collective health traditions who formulated the “social determination of health” paradigm and the concept of interculturality decades prior to the advent of the social determinants of health. We draw on Jaime Breilh's main works, with a focus on the recently published book, Critical Epidemiology and the People's Health, to (1) provide a broad overview of the social determination of health paradigm and its approach to interculturality and (2) clarify how these ideas and the broader collective health movement challenge assumptions within the social determinants of health concept.
International Journal of Health Services; https://doi.org/10.1177/00207314221114543
The Vira Vida program promotes the health of adolescents and young adults, ages 16 to 24, who have been sexually exploited. It has served more than 3000 individuals in 18 Brazilian states. The objective of this research was to estimate the costs of Vira Vida and compare them with the costs of detention policies for juveniles under 18. This program cost study considers two periods: 2008 to 2012 (Cycle 1) and 2013 to 2014 (Cycle 2). The System S perspective and time horizon for one year were adopted. Direct costs incurred by the National Council of Industry Social Services, which coordinates Vira Vida, and by the Regional Departments (RD), responsible for the direct execution of Vira Vida, were analyzed. The cost of detention measures for adolescents and youngsters under the age of 18 was obtained from the literature. The annual cost per student enrolled in Vira Vida varied between US$ 3754.93 and US$27,244.48, depending on the cycle and the state. Most of the costs of the program were lower than those reported for detention measures for adolescents in Brazilian states. Evidence indicates that health promotion interventions targeting sexually exploited children and adolescents can help their recovery; on the other hand, studies indicate that detention measures do not help adolescents recover.
International Journal of Health Services; https://doi.org/10.1177/00207314221119425
Academic interest in the social determinants of health has grown substantially in the past quarter century. In the past decade this academic engagement has been followed by greater public engagement with the conditions where we live, work, and play and how they affect our health. This moment of greater engagement with social determinants presents an opportunity for us to think about the determination of health more broadly, to look to a future beyond the social determinants. This would mean recognizing the full set of determinants of health across the lifecourse, spanning levels of influence, and including medical determinants to cure disease as much as we include the social forces that can prevent, or can cause that disease to begin with. Such a conception would have us see the determination of health as our central concern, and within that to recognize that health is produced throughout the lifecourse, by forces proximal and distal. The scholarship and practice of health can then usefully array itself around a conceptual framing that encompasses the full range of determinants of health.
International Journal of Health Services; https://doi.org/10.1177/00207314221115945
England’s National Health Service (NHS) is in the process of major reform as old institutional structures based around an internal “market” are being replaced with integrated care systems. The changes represent a significant shift in ethos away from commercialisation to collaboration between health providers. But the way that these policies unfold will depend on the context within which they are implemented, and three decades of neoliberal reforms have left their mark on the structure of the health system. This paper shows how a powerful, politically-connected financialised private sector has evolved alongside a weakened public system, depleted further by the pandemic. While the share of overall public health spending reaching the private sector has not increased greatly over the past decade, private financial investors are strongly embedded in some segments of health delivery, particularly mental health services where shareholder returns are boosted by financial engineering. The boundaries between private and public are increasingly blurred with the NHS treating private patients and self-payment for health services is increasingly normalised. Rather than traditional privatisation, the health system is facing a more subtle and pernicious erosion of public services across different dimensions which seems likely to continue despite the new reforms.
International Journal of Health Services; https://doi.org/10.1177/00207314221114533
This article examines the distribution patterns of primary health care centers (PHCC) in the 30 Local Government Areas (LGAs) of Osun State, Nigeria, using secondary data. The study focused on the problem of inequality and inadequacy in the distribution pattern of PHCCs among the population. The provision of PHCCs in the state was analyzed using three criteria: among the three senatorial districts; among the 30 LGAs; and on the basis of population per PHCC. Findings revealed that although PHCCs were almost equally distributed among senatorial districts, disparities exist in distribution patterns among the LGAs and within each senatorial district and in terms of population ratio per PHCC in the state. Sixty percent (60%) of the LGAs had fewer than 26 PHCCs, which is the expected average number of PHCCs in the state. The inequalities observed in the study favored rural areas against urban areas. The study further revealed inadequacies in the provision of PHCCs in terms of the population ratio per PHCCs. The study concluded that to achieve the Sustainable Development Goals (SDGs) by 2030—and to contain the COVID-19 pandemic—there is a need for government intervention in the provision of PHCCs in Osun State for equal and adequate distribution.