Scholars agree that global climate change is a major threat to the physical environment, affecting all aspects of life on the planet. However, the general public do not feel that climate change is a major risk or threat, especially to humans. It is important to understand the public’s perception and opinions of climate change as it affects and influences the creation and passing of climate change adaptation and mitigation policies. Specifically, little is known about public perceptions in regards to the greater health risk imposed by global climate change. This study examines the public's perception of health risks related to climate change in Broward County, Florida by using mixed methods. An online survey was conducted along with in-person interviews with the general public and a physician. The study found majority of respondents to believe climate change affects health, but lacked an understanding of how it is harmful to their health. It also found that gender affects their perceptions and political ideology appears to have an effect, but the effect of socioeconomic status on their perceptions were unable to be determined at this time. Broward is just developing policies to adapt and mitigate the health effects of climate change. / Includes bibliography. / Thesis (M.A.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

Made available in DSpace on 2016-04-29T14:17:57Z (GMT). No. of bitstreams: 1 Rosangela Marques dos Santos.pdf: 1374667 bytes, checksum: dc9f858e12ea2dca198bf8619fb6da14 (MD5) Previous issue date: 2009-10-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research presents an analysis of the struggles and strategic actions developed by the Movement Popular for Health in Sergipe Mops/SE in the period 1989/2008. The object of study highlighted the participation and social control aiming at the realization of rights to health. It appeared in Aracaju in the 1980 Mops/SE in the figure since then socio-political scenario with the work of building and strengthening of actions for the development of a social policy of public health and quality. To do so, acts in connection with the Popular Education and invests in training its militant policy of bringing articulate scientific knowledge and popular knowledge in order to recover and popular cultural practices. The theoretical frameworks used for the analysis of interviews and testimony were based on Gramscian and the privileged categories in the study were social movements, participation and social control. Qualitative research took place from bibliographical an documentary research, enriched with empirical observations during the course of events. She has produced a video documentary entitled Mops/SE 20 Years Expanding Achievements , this feature can be used with educational purposes, in addition to being an instrument to contribute to the historical memory of the movement. The study about the struggles and strategic actions of Mops/SE it highlighted the defense of a political project in a wider perspective of health and its contribution to expand the political space for the exercise of participation and social control and the struggles to build democratic processes participation and confrontation of social contradictions are given in the struggles between different political forces in which collective interests are not always included as a priority in government agendas / Esta pesquisa realiza uma análise das lutas e ações estratégicas desenvolvidas pelo Movimento Popular de Saúde de Sergipe - Mops/SE no período 1989/2008. O objeto de estudo destacou a participação e o controle social com vistas à efetivação dos direitos à saúde. Surgido em Aracaju na década de 1980 o Mops/SE desde então figura no cenário político com um trabalho de construção e fortalecimento das ações voltadas para a construção de uma política social de saúde pública e com qualidade. Para tanto, atua na perspectiva da Educação Popular e investe na formação política de seu militante intentando articular saber científico e saber popular com o objetivo de resgatar e valorizar as práticas culturais populares. Os referenciais teóricos utilizados para a análise das entrevistas e depoimentos foram de base gramsciana e as categorias privilegiadas no estudo foram movimentos sociais, participação e controle social. A pesquisa qualitativa se deu a partir de pesquisa documental e bibliográfica, enriquecida com as observações empíricas durante a realização dos eventos. Foi produzido um Vídeo-Documentário intitulado Mops/Se - 20 Anos Ampliando Conquistas , esse recurso pode ser utilizado com finalidades educativas, além de se constituir num instrumento para garantir a memória histórica do movimento. O estudo sobre as lutas e ações estratégicas do Mops/SE evidenciou a defesa de um projeto político numa perspectiva ampliada de saúde e a sua contribuição na ampliação dos espaços políticos para o exercício da participação e do controle social; as lutas para a construção de processos democráticos de participação e enfrentamento das contradições sociais se dão nos embates entre distintas forças políticas no qual os interesses coletivos nem sempre figuravam como prioridades nas agendas governamentais

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Having a chronic illness may feel alienating, yet examination of the literature shows limited research on social connectedness and health. In order to contribute to the understanding of this impact of illness, I examined perceived levels of social connectedness in persons with chronic diseases (CD), functional somatic syndromes (FSS) and medically unexplained symptoms (MUS). A major focus of this study was to investigate the association of social connectedness with depression, anxiety, and general health in patients with ongoing symptoms of illness. Data collection was obtained through the use of four online surveys collectively known as VOICE (Verification of Coping, Illness and Experience). For the purposes of this study, five measures were used: the Social Connectedness Scale, Short Form Health Survey (SF-36), Patient Health Questionnaire depression scale (PHQ-8), Hopkins Symptoms Checklist (HSCL) and the Social Impact Scale. Participants were recruited through announcements via online message boards and support groups, as well as through the distribution of brochures in local medical practices. A total of 148 participants (80% female) completed all four surveys. Results indicated that the chronic illness groups did not significantly differ in social connectedness, although there was some indication that the FSS group felt more social isolation. Regression analyses indicated that, while accounting for socio-cultural and health factors, social connectedness was the strongest predictor of depression (β = - .43, p < .001), anxiety (β = -.48, p < .001) and general health (β = .34, p < .001) in chronically ill persons. The independent and robust relationship of social connectedness with psychological and physical health in individuals with chronic illness suggests that this is an important factor deserving of future research with important clinical applications.

Bakgrund: Samhälls-och hälsoorienteringen till nyanlända är en av de hälsofrämjande insatserna som bedrivs över hela landet och är även lagstadgad. Trots det etableras det inte på samma sätt eller nivå i varje län och forskning visar för att de nyanlända ska kunna finna möjligheterna att etablera sig bör det finnas ett arbete som förhåller sig till den nivån av behov som krävs. Syfte: Syftet med studien är att undersöka hur aktörer arbetar och upplever samhälls-och hälsoinformation för nyanlända och personer med utomnordiskt påbrå samt vilka förutsättningar finns för att genomföra samhälls-och hälsoinformation på modersmål. Metod: En kvalitativ metod användes för att besvara studiens syfte och frågeställning. Kvalitativa semi-strukturerade intervjuer var studiedesignen som valdes för att smala in data. Urvalet bestod av tio intervjupersoner och alla intervjupersoner är aktörer med olika yrken, som är kopplade till integration och nyanlända. Resultat: Studiens resultat påvisade att befintliga samhälls-och hälsoorienteringen upplevs ge både möjligheter och svårigheter när det gäller aktörerna som arbetar med det och deras upplevelse av nyanlända som deltar. En ständig utveckling, ökade resurser och behovsanpassade insatser krävs för en lyckad samhälls-och hälsoorientering som hjälper till att främja hälsan. Slutsats: Resultatet redogjorde att den befintliga samhälls-och hälsoorienterings insatsen har två olika upplevda perspektiv. Det studerade perspektivet som var aktörerna och det andra var mottagarna av insatsen vilket är de nyanlända. Aktörerna upplevdes ha olika behov, upplevelser och uppfattningar av samhälls-och hälsoorienterings insatsen. Studiens fynd redovisade att samhälls-och hälsoorientering på modersmål kommer att gynna och påverka samhället på ett främjande sätt lika mycket som individen själv, samt att förutsättningarna är positiva trots de olika nivåerna av utmaningar som kan påträffa insatsen. / Background: Community and health orientation to immigrants is one of the health promotion efforts conducted across the country and is also statutory. Despite this, they do not hold the same quality in each county, which is required to give immigrants the same opportunities to integrate themselves in the new contest. Aim: The purpose of the study is to examine how sectors experience social and health information for immigrants and people with non-Nordic ancestry and the conditions for implementation of social and health information in the native language. Method: A qualitative method was used to answer the questions of the study. Qualitative semi-structured interviews were used. The sample consisted of ten interviewees and all respondents are sectors with different professions, that work with immigrant integration. Results: The results of the study show that existing social and health orientation is perceived to provide both opportunities and difficulties in terms of both perspectives, the actors working with it and immigrants participating. Continuous development, increased resources and needs-based efforts are needed for a successful community and health orientation that helps to promote health. Conclusion: The existing social and health orientation has two different perceived perspectives. The studied perspective was the sectors working with the orientation. Each perspective has different needs, experiences, and perceptions of the orientation. The study's findings showed that orientation in the native language will benefit and influence society as much as the individual, and that the conditions are positive despite the different levels of challenges that may be encountered.

This dissertation focuses on the long term (2006 - 2015) unsolved problems with the critical nature of healthcare payments in residential social services (PZSS) in the Czech Republic. The aim is a critical reflection of the legitimacy and the causes of this condition, including past efforts to identify and solutions. The used research methods are institutional analysis in combination with critical discourse analysis. The work is conceived as a critically-oriented research on social and health policies in the field of health care financing in PZSS in the period 1998 - 2015. Main findings of the cause of this problem are the failure to use the tool health- insurance plans and their unjustifiable replacement tool called. Reimbursement regulations, the use of which in combination with by power unilateral approach in the contractual relationship between health insurance and PZSS not only leads to problems, but especially to the general alienation public health insurance from the objectives and functions of the health system itself, which provides in this case health care in PZSS.

The diploma thesis focuses on the optimization of the income payment the partner (shareholder), who is also the executive heads of a trading company with limited liability. An analysis of the incomes paid according to their amount and type is fundamental for the choice of the optimum variants in the particular trading company. The result achieved is a reduction of the costs associated with the payment of the company´s and the partner´s financial resources. The thesis will help founders of companies to save costs related to expenditure incurred in the disbursement of financial resources for their personal use.

More than 16 years post-apartheid, South Africa is still regarded as the most unequal society in the world. The government is facing various obstacles and challenges in improving the standard of living and quality of life for all its citizens, for example in facilitating the access to clean drinking water and sanitation, building houses and providing basic education. In addition, the country is facing the world’s largest HIV/AIDS epidemic with a national prevalence rate of 18.1 %, equalling approximately 5.7 million people who are currently infected. (Pressly, 2009; UNAIDS, 2008c) Against this background, the aim of this thesis was to study the Madwaleni community, situated in a deeply rural area of the former apartheid homeland Transkei. Applying the Community Oriented Primary Care approach, a strategy of ‘community assessment and diagnosis’ was used to obtain a holistic community profile and to determine the perceptions of its community members regarding their health and social problems and needs, intending to make recommendations to health care providers working at Madwaleni Hospital regarding future health education and disease prevention programmes. (Brown and Fee, 2002) This research used a cross-sectional design. In a preliminary survey, qualitative data was collected in short interviews with health care providers working at Madwaleni Hospital (N=46). The information served as a basis to develop and design parts of the Madwaleni community survey questionnaire. The questionnaire consisted of 36 questions, complying with the aim and objectives of this thesis. It was used for the structured interviews with the main study population, all of whom were members of the Madwaleni community (N=200), whereas half of the main study population were men and half were women, then again, half were unaware of their HIV status and half were HIV+ and had joined the Madwaleni HIV/AIDS programme. Key findings 1) Madwaleni community profile and characteristics Thoughtful sexual behaviour: Particularly interesting in light of the HIV/AIDS epidemic, more than 90 % of the sexually active community members were monogamous at the time of the survey. While only 36.4 % of the men and women unaware of their HIV status used condoms, 76.5 % of the HIV+ community members claimed to do so, indicating that the Madwaleni HIV wellness programme and especially its counselling and health education components are adequate and valuable in serving their purpose. High rates of illiteracy and insufficient education: Only 56.5 % of the interviewed community members were ‘functionally literate’ at the time of the survey. Of those, only 8 % had received a matriculation and not one of the community members had received any higher degree. In addition, 19.5 % of the sampled men and women were not able to read at all. High rates of unemployment, poverty and dependency on welfare grants: Only 20 % of the Madwaleni community members were employed at the time of the survey. Taking the daily income per capita as a reference, one third of the community members suffered from ‘moderate poverty’, defined as an income of 1 to 2 US $ per day, while the other two thirds suffered from ‘extreme poverty’, defined as an income of less than 1 US $ per day, although more than 90 % of the corresponding households received at least one type of welfare grant already. Large household sizes and predominance of traditional dwellings: In the Madwaleni community, an average of eight people lived together per household at the time of the survey, whereas 95 % of the community members lived in traditional dwellings, constructed from freely occurring natural resources. In need of safe drinking water, sanitary systems and access to electricity: More than 80 % of the Madwaleni community members obtained their drinking water from rivers or stagnant dams, while only 6.5 % used rain water and 9.5 % had access to piped water. In addition, almost 70 % of the community members had no access to any sanitary systems, using nearby bushes instead. Furthermore, more than 90 % had no access to electricity. The majority used paraffin for cooking, candles for lighting and wood for heating their homes. Small-scale cultivation to provide an extra source of food: In the Madwaleni area, 90 % of the families owned a small garden patch attached to their houses, used for small-scale cultivation. In addition, almost 90 % owned livestock, mainly poultry, cattle and goats. Crops and animals were used to provide an extra source of food; however, not one of the households could solely live on subsistence farming. Difficulties in accessing health care facilities: On average, each of the community members needed three-quarters of an hour to access their closest clinic and almost one and a half hours to reach Madwaleni Hospital, with 40 % and 60 % respectively depending on public taxi transport to get there. No substantial improvement of the living circumstances since apartheid: Comparing the Madwaleni community characteristics with corresponding data from apartheid-times, no substantial improvement of the living circumstances and conditions could be noticed, proving that governmental and non-governmental actions, programmes and services have not yet reached all remote communities. Similar community characteristics in the neighbouring communities: Comparing these characteristics with corresponding features of communities in the immediate or surrounding areas, namely Cwebe, Ntubeni, Mboya, Shixini and Zithulele, various similarities could be detected, indicating that the living circumstances and conditions might be generalisable to a certain degree, at least to deeply rural communities in the former Transkei area. More disadvantaged than the general South African population: The Madwaleni community differed significantly from the general South African population in 75 % of the compared characteristics. For example, amongst the community members the illiteracy rate (21.7 % vs. 13.6 %, p = 0.002) and unemployment rate (80.5 % vs. 25.5 %, p < 0.001) were significantly higher. In addition, the ‘poverty headcount ratio of 2 US $ per day’ showed that significantly more people were suffering from poverty in the Madwaleni area (92.2 % vs. 34 %, p < 0.001). The Madwaleni community members were less likely to have access to clean drinking water, along with significantly higher proportions of them using river water as their main source of drinking water (75.5 % vs. 5.1 %, p < 0.001). Also, they were less likely to have access to any sanitation or toilet facilities (31.3 % vs. 91.8 %, p < 0.001) or to electricity (8.5 % vs. 80.2 %, p < 0.001). 2) Weightiest health and social problems as experienced by the Madwaleni community In the Madwaleni area, the three health problems with the highest impact on the community were TB, HIV/AIDS and hypertension. On the basis of the applied 3-to-0-point rating matrix, they were rated by more than 95 % of the community members as being relevant problems, with mean values of 2.33, 2.30 and 2.14 respectively. Interestingly, women rated HIV/AIDS higher than men. Musculoskeletal problems and headache were additional health problems with relevant impact on the Madwaleni community, rated by more than 90 %, with mean values above 1.80. While pain and discomfort experienced by PLWHA have been recognised and researched before, there are no corresponding studies on rural communities and further research is necessary to identify the contributing factors. Additional relevant health problems: Interestingly, six health problems were rated higher by HIV untested than by HIV+ community members, namely bilharzia/ schistosomiasis, epilepsy, Herpes Zoster, HIV/AIDS, lung infections and stroke. Since the HIV+ men and women were educated about and screened for all of those diseases within the Madwaleni HIV/AIDS programme, this might explain the deviating rating patterns between the different sub-samples. Moreover, these results demonstrate that health education and disease prevention programmes are able to reduce the perceived burden of health problems and might therefore serve as a substantial argument in their favour. Interestingly, for the Madwaleni community, social matters had a higher impact on their lives than health problems, whereas the three social problems with the highest impact on the community were alcohol abuse, dependency on social grants and smoking. They were rated by more than 98 % of the community members as being relevant problems, with mean values of 2.75, 2.73 and 2.72 respectively. In accordance with these findings, employment & lack of work opportunities, education & illiteracy, food supply and poverty were additional social problems with relevant impact in the Madwaleni area, rated by more than 90 %, with mean values above 2.00. 3) Recommendations for future health education and disease prevention programmes At the time of the survey, the three most relevant health education and disease prevention topics for the Madwaleni community were HIV/AIDS, TB and healthy nutrition. They were rated by more than 95 % of the community members as being relevant health education problems, with mean values of 2.65, 2.51 and 2.36 respectively. In addition, STIs, alcohol & drug-related problems, water & sanitation and body & muscle pain were rated as the subsequent issues of relevance, with mean values above 2.00, supporting the identified community characteristics as well as the listing of the weightiest health and social problems. In addition, valuable new insight could be gained. For instance, HIV untested men rated the topic HIV/AIDS lower than all other community members, which is particularly interesting since men only constitute a minority of 20 % of the people testing for HIV in the Madwaleni area. Besides, topics not previously considered, such as injury prevention and basic first aid, were in-fact relevant for more than 85 % of the community members and require further attention. Furthermore, deviating rating patterns between men and women and the corresponding need for gender-specific educational workshops became evident, for example, for men about prostate & testicular cancer check-up or erectile dysfunction and for women about breast & cervical cancer check-up & papsmears or nutrition & growth. In addition, HIV+ community members rated depression & stress and psychiatric diseases higher than HIV untested men and women, with further studies required to identify the underlying reasons for these deviating rating patterns. Taking all findings from this Madwaleni community survey into consideration, health care providers working at the hospital and its peripheral clinics should first and foremost concentrate their efforts on maintaining the existing programmes, particularly, the Madwaleni HIV/ARV programme and the workshops on hypertension and diabetes mellitus. In addition, if qualified and motivated personnel can be recruited and the necessary funding can be raised, future health education and disease prevention programmes should focus on TB, alcohol & substance abuse-related problems as well as water & sanitation.