Background: The health status of a population is directly associated with the social conditions of the place where they live. Likewise, oral health is also linked to social determinants, especially the individual and family income, access to health services and social interaction. Methods: It is a cross-sectional population-based survey whose target population comprises adults above 18 years, of both sexes, users of the Brazilian Public Health System (BPHS). It aims to evaluate the impact of the Family Health Strategy (FHS) and Bolsa Familia (BF) in oral health of this population, carried in Porto Alegre, in units of the Family Health and Traditional ones. Participants answered a structured interview and had their mouth examined for investigation of oral health. The association between variables was calculated using negative binomial, using the statistical package R 3.0.1.t. Results: A sample of 187 adults was studied, which comprised 127 (68, 2%) women and 59 men (31, 7%). The mean DMFT (decayed, missed and filled teeth) increase according with age, being 1.6 for the age 18-19 years and 23.5 for older than 74 years. DMFT was equal to zero in only 12 participants (6,4%). The number of missed teeth increase with age and brushing frequency and decrease with income and flossing. The number of decayed teeth decrease with age (RR=0.98; 95% CI 0.97-0.98) and in subjects that receive the cash transfer BF (RR=0.89; 95% CI 0.79-0.98). The presence of filled teeth decreased in subjects who live in áreas covered by FHS (rr=0.74; 95% CI 0.52-0.95) area and increase according with age (RR=1.02; 95% CI 1.01-1.03) and in people with frequency of flossing less than once a day (RR=1.47, 95% CI 1.09-1.99). The presence of sound teeth decrease with age (RR 0.98, 95% CI 0.97-0.98) and in areas with FHS (RR=0.89, 95% CI 0.80-0.98). Conclusions: The oral health measured by the DMFT index and its components is associated with both, type of primary healthcare model and income (family income and Bolsa Familia access). In general, the oral health of the studied sample is better than the nationwide mean, translated in the higher number of sound teeth. / Introdução: O estado de saúde de uma população é diretamente associado as condições sociais do local onde ela vive. Da mesma forma, a saúde bucal também é associada a determinantes sociais, especialmente a renda familiar e individual, acesso aos serviços de saúde e convívio social. Métodos: Trata-se de um estudo transversal, de base populacional cuja população alvo compreende adultos acima de 18 anos, de ambos os sexos, usuários do Sistema Único de Saúde (SUS). Tem como objetivo geral avaliar o impacto dos Programas Saúde da Família e Bolsa Família na Saúde Bucal dessa população e foi realizado no município de Porto Alegre, em Unidades de Saúde da Família e em Unidades Básicas de Saúde. Os participantes responderam a uma entrevista estruturada e tiveram sua boca examinada, após serem informados sobre a natureza do estudo e assinarem um termo de consentimento livre e esclarecido. A associação entre as variáveis foi calculada através de binomial negativa, usando o pacote estatístico R 3.0.1. Resultados: O estudo foi realizado com uma amostra de 187 adultos, que compreendeu 127 (68, 2%) mulheres e 59 homens (31,7%). O CPOD aumentou na amostra de acordo com a idade, sendo 1,6 para a idade 18-19 anos e 23,5 para maiores de 74 anos. O CPOD foi igual a zero para apenas 12 participantes (6,4%). Dentes perdidos estão associados positivamente com a idade e freqüência de escovação e inversamente associados com renda e fio dental. O número de dentes cariados deminuiu com a idade (RR = 0,98, IC,97-,98 95%) e em indivíduos que pertencem ao Bolsa Família (RR = 0,89, IC 95% 0,79-0,98). A presença de dentes obturados é menor em pessoas que pertencem as áreas de ESF (RR = 0,74, IC 95% 0,52-0,95) e aumenta de acordo com a idade (RR = 1,02, IC 95% 1,01-1,03) e em pessoas que usam de fio dental menos de uma vez por dia (RR = 1,47, 95% CI 1,09-1,99). O número de dentes hígidos diminui com a idade (RR de 0,98, IC de 95% 0,97-0,98) e é menor em moradores de áreas adscritas a ESF (RR = 0,89, IC de 95% 0,80-0,98). Conclusão: A saúde bucal medida pelo índice CPO-D e seus componentes está associada tanto ao tipo de modelo de cuidados de saúde primários quanto renda (renda familiar eo Bolsa Família acesso). Em geral, a saúde bucal da amostra estudada é melhor do que a média nacional, demonstrado pelo maior número de dentes hígidos.

The aim of this thesis is to find out how the future teachers adopt a stance on health and if they are ready to pass the information on health issues of their pupils. Currently reveals how faculty of education prepares future teachers in terms of health issues and his support. The theoretical part devote to teacher's personality, general health issue, but also specifically teacher's health, the determinants of health, the issue of health literacy and burnout. The practical part is focused on research of personal attitudes of future teachers towards health and their awareness in this direction. The outcome of this work is to propose an elective subject, whose inclusion in the program of study at faculties of education can give students the opportunity to obtain the necessary information relating to health in relation to the development of health literacy among students in their future teaching profession.

Gender inequality is the root cause of the differences in mental disorders prevalence between men and women. The aim of this thesis was to examine social inequalities in mental health, focusing on gender as a critical determinant of mental health and mental illness. In the first chapter, the ways mental health is shaped by gender and other social determinants are discussed. Gender-based discrimination, traditional gender roles, unequal distribution of power and lack of control over life events are the most common risk factors for higher prevalence of mental disorders in women. In the empirical part of this thesis the European countries were grouped based on indicators related to women's mental health. The typology was developed using factor and cluster analyses. Subsequently, logistic regression analysis investigated associations between prevalence of depression and various social determinants of mental health in respondents of the Survey of Health, Ageing and Retirement in Europe (SHARE). The results suggest that risk factors for common mental disorders are gender specific.

Osteoarthritis (OA) is the leading cause of disability in North American and has major economic consequences for society. People with knee OA experience the worst quality of life, among musculoskeletal conditions, with function and mobility being influenced by symptoms such as pain and stiffness. However, the impact of OA symptoms varies due to intrinsic and extrinsic factors, leading many researchers to employ biopsychosocial and other population health frameworks to study the disease. These population health approaches have not been adopted when studying knee OA outcomes in bioarchaeology, where a limited biological lens prevails due to the sole reliance on skeletal remains. The purpose of this research was to explore methods for identifying the impairment potential of knee OA in archaeological populations using a clinical sample and population health approaches. Clinical studies have the advantage of assessing not only the biological implications of knee OA but also the functional outcomes. By creating a knee OA grading system applicable for both MRI and dry bone femora samples (Clinical Archaeological Osteoarthritis Score) a link between clinical and archaeological populations was proposed. Using this link to infer functional deficits onto archaeological populations using population health frameworks, a theoretical analysis was performed with two populations; the 17th century Huron and the 19th century Inuit from the Igloolik region of Nunavut. The results demonstrated the increased impairment potential of knee OA in the Inuit population versus the Huron population, produced by contrasting factors captured by the determinants of health, including social and physical environments.

The objective of this thesis was to defend an alternative approach by health policy makers for improving health outcomes through investing on social factors of peoples' lives, rather than by increasing health expenditures. In order to defend this theory, this master thesis addresses two research questions: Which are the social determinants of health with largest impact on health status of individuals? And what is the statistical correlation between those social determinants of health and self-reported health status, and psychological health, for Germany, Denmark, Spain and Ireland? The first question was answered by developing a comprehensive research among the mostrelevant literature in the field of social determinants of health and the second through the construction of a statistical multiple regression model. According this study the social determinants with largest impact on the health status of individuals are: physical activity, education level, the welfare state, emotional support, socio-economic status, living conditions, working conditions, and life balance. Regarding the results of multiple regression models all variables followed the expected trend and it was possible to proof significant statistical correlation in 7 of the 8 determinants chosen, especially in the cases of working conditions and life balance, where those having problems managing these aspects of life experienced 50% or in some cases 30% of the health status of individuals with positive experiences in these life dimensions.

Esta tese tem o propósito de desenvolver uma argumentação normativa sobre justiça distributiva e saúde. São duas as questões que pautam a pesquisa: o que devemos uns aos outros, enquanto cidadãos de uma sociedade democrática, na promoção e proteção da saúde de nossos concidadãos? Quais obrigações e deveres de justiça que um Estado democrático possui perante a saúde de seus cidadãos? Para respondermos essas questões, inicialmente, buscamos apresentar um entendimento objetivo e publicamente acessível de necessidades de saúde. Essas necessidades estão relacionadas ao funcionamento normal das espécies e impactam o leque de oportunidades disponíveis ao longo de nossas vidas. Dialogando com a teoria da justiça como equidade, de Rawls, e com a extensão dessa teoria proposta por Daniels, defendemos que o conjunto das instituições, dos serviços, dos bens e dos recursos necessários à manutenção, ao reestabelecimento e à provisão de equivalentes funcionais ao funcionamento normal dos cidadãos devem ser distribuído de modo a respeitar o princípio de igualdade equitativa de oportunidades. Em sequência, desenvolvemos uma argumentação sobre o debate contemporâneo dedicado à definição e à defesa do princípio fundamental que deve balizar a justa distribuição dos mais variados distribuenda. Argumentamos que embora a justiça exija uma noção de igualdade (como a de igualdade democrática que defendemos) e não um patamar de suficiência ou um princípio de prioridade, esses critérios normativos podem auxiliar na formulação e na avaliação de políticas públicas e recomendações institucionais. Questionamos os ataques direcionados às teorias igualitárias, defendendo que essas teorias não podem ser reduzidas, nem obrigatoriamente exigem, a aplicação de princípios distributivos igualitários simples. Por fim, nos dedicamos a desenvolver uma argumentação sobre justiça e saúde centrada nas questões dos determinantes sociais da saúde e do gradiente social em saúde. Defenderemos, em diálogo com a literatura empírica sobre a questão, que políticas públicas de saúde devem ser baseadas em um ideal de igualdade democrática e devem assumir como uma pauta central a eliminação de iniquidades de saúde existentes entre grupos sociais, assim como combater injustiças estruturais presentes nas sociedades contemporâneas. / This thesis aims to develop a normative argument about distributive justice and health. Two questions underpin the study: what do we owe each other, as citizens of a democratic society, in the promotion and protection of the health of our fellow citizens? What justice obligations and duties does a democratic State have vis-à-vis the health of its citizens? Firstly, to answer these questions, we seek to present an objective and publicly accessible understanding of health needs. These needs are related to the normal functioning of species and impact the range of opportunities available throughout our lives. Drawing on Rawls\'s theory of justice as fairness, and on the extension to this theory, proposed by Daniels, we argue that the set of institutions, services, goods and resources necessary for the maintenance, reestablishment, and provision of functional equivalents to normal functioning, should be distributed in a way that respects the principle of fair equality of opportunity. Secondly, we develop an argument about the contemporary debate dedicated to the definition and defense of the fundamental principle that should mark the fair allocation of the most varied distribuenda. We argue that although justice requires a notion of equality (such as that the democratic equality we defend) rather than a threshold of sufficiency or a principle of priority, these normative criteria can aid in the formulation and evaluation of public policies and institutional recommendations. We question the attacks directed at egalitarian theories, arguing that these theories can not be reduced, nor do they necessarily require, the application of simple egalitarian distributive principles. Finally, we are dedicated to developing an argument about justice and health centred on the issues of social determinants of health and the social gradient in health. We shall argue, drawing on the empirical literature on the issue, that public health policies should be based on an ideal of democratic equality and should take the elimination of existing health inequities between social groups as a central guideline, as well as combatting present structural injustices in contemporary societies.

Background: Ballad Health participates in the Centers for Medicare and Medicaid Services’ (CMS) Accountable Health Communities (AHC) model. The AHC model is evaluating if universal screening, referral, and navigation services for health-related social needs (HRSN) can improve outcomes and reduce unnecessary utilization and costs of health care services. To ensure the evaluation of the model has sufficient statistical power, navigation services are expected to be provided to a minimum number of individuals. The purpose of this study is to analyze the characteristics of Ballad Health’s AHC navigation services that could be modified to improve opt-in rates. Methods: The primary outcome measure was identified as whether a beneficiary contacted via telephone opted-in or –out of the navigation program. Andersen’s Behavioral Model for Health Service Use was used as the conceptual framework for selecting covariates of interest. Enabling factors were of primary interest because alternate interventions may be designed around them. Data was pulled for the time period of November 17, 2018 through February 14, 2019. Where possible, covariates were associated with data from CMS’ AHC Data Template v3.1 to accommodate replication for all AHC bridge organizations, though additional internally-collected data, which may not be available for all bridge organizations, were needed for some variables. Chi-squared tests were performed for each covariate. Results: No statistical differences were found for the primary covariates of interest. Opt-in rates by Navigator were lowest for Navigator 5 and highest for Navigator 4 (67.53% and 88.24%). Opt-in rates by weekday of decision were lowest on Thursdays and highest on Wednesdays (64.91% and 77.42%). Opt-in rates based on time of day were lowest between 8:00am and 9:59am, and highest between 12:00pm and 1:59pm (62.50% and 100%). Opt-in rates were lowest when the decision was made six days after the screening and highest when made the same day (53.57% and 83.33%). Opt-in rates were lowest when there were five weekdays between screening and navigation decision, and highest when there were three weekdays between the screening and decision (60% and 90%). Other non-process covariates of interest that were statistically significant for opt-in rates were the presence of either food, safety, or utility needs. Conclusions: Several groups had higher opt-in rates that were not statistically significant; small sample sizes may have impacted the significance of these differences. For example, opt-in rates were higher when made the same day as the screening than when made one day after (83.33% and 74.79%). However, only 18 beneficiary decisions were made on the same day, while 119 were made one day after. Increasing the number of same-day phone call attempts may be a method to improve opt-in rates. Importantly, date and time data for contact attempts before a beneficiary decides to opt-in or opt-out were unavailable as of the time of the analysis. These data are captured and will be added to the analysis when available, which could provide more insight into whether a beneficiary is more likely to opt-in or opt-out.

The main objective of diploma thesis "Suburbanization in Central Bohemia Region and its impact on health" is research of non-coordinated suburbanization in Central Bohemia Region and its relation to health of inhabitants. There is used an appropriate combination of research methods according to the research objectives and questions (mental maps, actor analysis, public policy analysis, comparation, interviews). It enables understanding of all aspects of thesuburbanization process. Many theoretical concepts are used, eg. determinants of health, urbanism, sustainable development, quality of life or social transformation. The first part of diploma thesis presents health problems caused by urban sprawl. These problems are related to air quality, physical activity, traffic, water quantity and quality, mental health, social capital and health of special populations. Inguiry identifies roles, interests and behaviour of relevant actors. It proves that current suburbanization of Central Bohemia Region, similar to urban sprawl, may influence health and quality of life of its inhabitants, and brings many negative externalities. Incrementakl knowledge development and pressure of the European Union leads to changes in public policy and legislation, which was influenced with social transformation and impact on...

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