This project assesses the effects certain variables have on African American adults that suffer from diabetes. These include behaviors of African Americans that contribute to diabetes such as; diet behavior and physical activity. Thus, the focus of this study is to examine the effects of these health behaviors on the likelihood of having diabetes among African Americans. This assessment will be used to provide insights as they pertain to African Americans and diabetes.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

In the early 1900s, African Americans died at higher rates, got sick more often, and had worse health outcomes for almost all diseases when compared to whites. This disparity was due to a combination of racism, discrimination, and segregation. Most blacks could only afford to live in unhealthy conditions and had little or no access to medical professionals. Problematically, poor black health led many whites to think of blacks as being inherently diseased, promoting the segregation and discrimination that contributed to black ill health in the first place. This project examines Negro Health Week (NNHW), which became National Negro Health Week (NNHW), a public health campaign designed by African Americans as a systematic effort to improve their health that lasted between 1915 and 1950. The dissertation reveals the strategies African Americans used to empower themselves to combat ill health and the ways medical ideas became accessible to blacks. The racism of the white medical establishment limited the ability of African Americans to enter the medical profession. The small number of black doctors and nurses meant that NHW had to rely on non-medical professionals to teach health practices. Originally begun as a local campaign in Savannah, Booker T. Washington adopted Negro Health Week as a program to teach formerly enslaved blacks in Tuskegee, Alabama how to live. Working as sharecroppers and living in the small cabins they had inhabited as enslaved people, the majority of blacks lived in squalor. Margaret Murray Washington, who co-founded the National Association of Colored Women in 1896, laid the groundwork for NHW at Tuskegee. During her tenure as Lady Principal of Tuskegee, she created the Tuskegee Woman’s Club and brought together local organizations and women’s clubs to work with women in improving their homes by providing advice on basic hygiene and sanitation that they could implement with little cost. Booker T. Washington coopted the TWC program and brought Monroe Work from Savannah to Tuskegee to head up a more ambitious program which he envisioned expanding throughout the rural South. In 1900 Washington founded the National Negro Business League (NNBL) which included key black business men from throughout the nation, especially the South. The NNBL was instrumental in helping Washington to expand and publicize Negro Health Week. Under the leadership of Booker T. Washington and his successor, Robert Moton, NHW continued to focus on providing advice on basic hygiene and sanitation in one’s home and neighborhood. The emphasis on low-cost individual health practices, such as basic privy sanitation or proper whitewash technique, gave African Americans the ability to take ownership of their health. The Week explained how blacks could improve their health and that of the community even without medical professionals. After Booker T. Washington’s death in 1915, Moton succeeded in getting the support of the national Public Health Service (PHS) and National Negro Health Week came into existence in 1921. The Service’s vast network of health professionals and connections with state and local health departments allowed the campaign to expand out of the South. However, with the involvement of the PHS, the Week began to change. As hygiene practices became more accepted, the Service reframed NNHW to focus on vaccinations and regular physician and dentist visits. As medical professionals became NNHW leaders, the campaign’s message transformed from emphasizing how individuals could improve health on their own to describing how much people needed physicians to obtain good health. Under the PHS, lay people could do little to improve their health. Instead, they had to rely on the medical profession. The PHS used NNHW to reposition the medical establishment as the ultimate arbiter of African American health. Today, there is still a wide racial disparity in participation in, and access to, public health, and indeed in health outcomes in the United States. Understanding the Week can better position scholars and public health officials to understand how race and health intersect and the ramifications of health policies on race relations. / History

No description available.

Reduction in the price of oil in the mid-eighties forced the Saudi government to adopt new health policies in order to finance health services. On August 11, 1999, the Saudi government approved a new Mandatory Cooperative Health Insurance Program (MCHIP). This new health policy was enacted to replace the current policy of providing free health care. MCHIP is intended to reduce the financial burden on government by sharing the costs of health care with the public. This study had a dual purpose: to analyze the components of MCHIP program by comparing it with the American health system, and to investigate the perceptions of Saudi students attending American universities towards MCHIP program, based on the students' experiences with the American health care system.A multiple methods approach was used to conduct the study. A descriptive approach was employed to compare components of the MCHIP program with similar components of the American health care system. A survey method was used to investigate the perceptions of Saudi students attending American universities toward the new MCHIP program. Scales were constructed to measure the students' expectations of the MCHIP program with respect to cost, quality, and access of health care. Additional scales were used to measure the students' knowledge of the MCHIP program, knowledge of the American health system, and total health insurance knowledge. An electronic survey was posted on the VCU SERL Web page, and a link was e-mailed to 2210 Saudi students using a list provided by the Saudi Arabian Cultural Mission (SACM). The survey response rate was 40.6 percent.During the first phase of the research, the comparison to American health care identified areas in which the United States of America experience could be useful in promoting effective implementation of the MCHIP program in Saudi Arabia. In sum, the comparison indicated that the American health insurance model may not be an ideal approach for the Saudi health system. During the second phase of the study, survey results indicated that students expected MCHIP implementation to increase total health costs, improve quality of health care, and increase access to health care in Saudi Arabia. The students' total knowledge of health insurance had a significant effect on students' perceptions of cost and a non-significant effect on their perceptions of quality and access to health care. In order for the MCHIP program to be effectively implemented, study results point to the need for regulation of the Saudi insurance market and for health insurance-related systems (such as for coding, billing, and maintaining effective medical records) to be established. American health insurance system models are not ideal for the Saudi health system, although certain aspects may be useful. To promote success, the MCHIP program should be structured to meet the goal of providing affordable and accessible quality health care to the population, based on Islamic principles.

No description available.

This thesis is about the prospect of change in the Peruvian mental health services system as seen through the lens of public psychiatry. It is based on the depiction of the work of psychiatrists in two of Lima's mental hospitals -Hospital Valdizán and Instituto Noguchi- and the projects of mental health services reform that I found in both of these institutions and an advocacy group sponsored by the Pan American Health Organisation. Ethnographic fieldwork was conducted from April 2012 to July 2013. I portray the current paradigm of care that dominates the public psychiatric sphere by describing the practice of specialists in outpatient consultations and hospitalisation wards. What I call the empirical model of psychiatry is an objectivistic, pharmaceuticalized, and top-down practice that finds its most augmented version in the wards. It loses sight of such therapeutic mandates as cultivating rapport, giving voice, and providing social support, elements that can be encountered in alternative paradigms of care that hold a marginal position in today's mental health system, such as the community mental health model that was developed in the 1980s at Instituto Noguchi and has progressively faded into near oblivion. The multiple inadequacies of treatment reviewed in this thesis, which are fuelled by a historical relegation of mental health policy in the country, speak of a psychiatry that is far from effectively improving the lives of service users. This was the greatest blind spot revealed by the mental health reform agenda; the need to improve psychiatry as a therapeutic practice was largely absent from reform discourse. Another important issue encountered was the failure of initiatives focused on training primary healthcare professionals in detecting and treating mental health problems (task-sharing). I argue that sustainable task-sharing strategies, added to comprehensive and locally-sensitive models of mental health services, should be explored. Finally, there is a paradox to be solved in relation to mental health governance in Peru. Psychiatry has hegemony; it owns the national institute of mental health and presides over the national mental health direction at the Ministry of Health. However, as a profession it has remained alienated from public health matters, absorbed in the daily practice of public hospitals and private practices. Mental health governance, then, needs to be balanced with the contribution of other professions and this is where the social route of the mental health system gains significance: anthropology has great potential to help develop a richer understanding of people's mental health and craft effective services in socially unequal and multicultural societies.

Made available in DSpace on 2013-01-07T15:55:00Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 11.pdf: 1003659 bytes, checksum: 93e4dc64d449d41d8154423cc7c5366b (MD5) Previous issue date: 2005 / A dissertação examina a gênese e os primeiros anos de funcionamento da Biblioteca Regional de Medicina - Bireme, da Organização Pan-Americana de Saúde - Opas, hoje Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde. Discute os antecedentes, a sua instalação em 1967 e as gestões dos seus dois primeiros diretores, Amador Neghme e Abraham Sonis, no período compreendido entre 1969 e 1982. Ao fazê-lo, caracteriza a Bireme, simultaneamente, como aparato e como arena de negociação, inscrita nos processos mais gerais do desenvolvimento, da informação em C&T, da cooperação internacional e das políticas de saúde no contexto latino-americano, assim como expressão das posições presentes no movimento de expansão e reforma do ensino médico na região. Este percurso histórico tem como marco inicial a concepção de uma biblioteca regional de medicina para a América Latina, segundo um modelo que foi simultaneamente proposto, pela biblioteconomia médica norte-americana, para a constituição de um sistema de bibliotecas nos Estados Unidos, sob a liderança National Library of Medicine - NLM.

The Catholic Church is one of the largest providers of medical care in the US, with 1 in 6 acute-care beds residing in a Catholic hospital. One third of these hospitals are in rural or underserved areas in the US, and advocacy for the vulnerable is a central platform of the Catholic Healthcare Association. Despite this, the Church has been under attack for allegedly putting women at risk of injury or death due to the care restrictions concerning reproductive health stipulated in the Ethical and Religious Directives (ERDs). Additionally, scholars are questioning the distinctiveness of the Catholic healthcare mission in practice, pointing to the increased homogenization of Catholic and non-Catholic hospitals. For these reasons, it is necessary to assess if and how women are being harmed in Catholic hospitals and, if there is harm being done, if there is a way to prevent these harms while preserving the Catholic Social Tradition in medicine. In carrying out this assessment, I read the current literature closely to explore both the origins and the practical consequences of these ethical conflicts. Subsequently, I use Chris Durante's "pragmatic perspectivism" to formulate a proposal that considers both Catholic medical ethics and secular medical ethics on the same plane. The proposal suggests the adoption of an alternative and complementary lens for Catholic health care. Using this framework would allow the Church to pursue its health care mission in a fuller sense, unencumbered by the inertia of the medical industry towards homogenization due to legal and economic pressures. It also provides the potential for Catholics to more easily receive Catholic care in all hospitals, not just those under Catholic sponsorship. Importantly, it would also prevent any American woman from being practically forced to receive Catholic care, circumventing many of the ethical conflicts present in the current system.