BACKGROUND:Over the past two decades, international health policies focusing on the fight against the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), malaria, and those diseases that address maternal and child health problems, among others, have skewed disease control priorities in China and other Asian countries. Although these are important health problems, an epidemic of chronic, non-communicable diseases (NCDs) in China has accounted for a much greater burden of disease due to the ongoing rapid socioeconomic and demographic transition.DISCUSSION:Although NCDs currently account for more than 80% of the overall disease burden in China, they remain very low on the nation's disease control priorities, attracting marginal investment from central and local governments. This leaves the majority of patients with chronic conditions without effective treatment. International organizations and national governments have recognized the devastating social and economic consequences caused by NCDs in low- and middle-income countries, including China. Yet, few donor-funded projects that address NCDs have been implemented in these countries over the past decade. Due to a lack of strong support from international organizations and national governments for fighting against NCDs, affected persons in China, especially the poor and those who live in rural and less developed regions, continue to have limited access to the needed care. Costs associated with frequent health facility visits and regular treatment have become a major factor in medical impoverishment in China. This article argues that although China's ongoing health system reform would provide a unique opportunity to tackle current public health problems, it may not be sufficient to address the emerging threat of NCDs unless targeted steps are taken to assure that adequate financial and human resources are mapped for effective control and management of NCDs in the country.SUMMARY:The Chinese government needs to develop a domestically-driven and evidence-based disease control policy and funding priorities that respond appropriately to the country's current epidemiological transition, and rapid sociodemographic and lifestyle changes.

In lifetime risk for Human Immunodeficiency Virus (HIV), Black men who have sex with men (BMSM) are at the greatest risk of all demographic groups. Creative modes of engagement have been established to reach this group in prevention efforts, including prevention programming in community-based organizations such as churches. Church-based HIV prevention is an emerging area of research and existing studies fall into one of three categories: BMSM’s perspectives on church and church-based HIV prevention, church leaders’ and members’ perspectives on HIV prevention in their congregations, and reported outcomes of HIV prevention interventions that have been conducted in church settings. Given the paucity of research in this area, a scoping analysis was conducted to survey the existing studies in order to identify overarching themes and gaps for future research efforts. In a review of the research, facilitators and barriers to successful implementation of HIV programming in churches emerged. Prominent barriers were stigmatizing sermons given in church and pastoral denial that HIV is a relevant issue to the Black community. Facilitators reported commonly were BMSM’s comfort found in faith and a pastor’s blessing of HIV prevention efforts in churches. Interventions primarily reported lessons learned in implementation of church-based HIV programs. A frequently reported lesson learned was the importance of close collaboration with participant churches to develop program curricula that were effectively couched within church doctrine, and that would be received well by church members. Some interventions also measured intervention efficacy outcomes, one of which showed a statistically significant decrease in HIV stigma post-intervention. This research has important implications for the effective development, implementation, and reporting of outcomes for future, church-based HIV interventions. As research in HIV prevention in the church continues to develop, it may be able to serve as a template for other community-based HIV prevention efforts and open doors for inclusion of other high risk groups such as injection drug users and sex workers.

Obesity is currently viewed as one of the most important health concerns in the United States. Researchers have minimally investigated perspectives surrounding obesity within the African-American female population. This lack of research presented a gap in knowledge concerning the perceived social, environmental, and cultural influences of obesity within this population. The research questions asked African-American females about their views toward these influences. This research was guided by tenets of the social cognitive theory and the transtheoretical model for behavioral change. Thirteen African-American females participated in the interviews. The data collected were reviewed and coded using word frequencies and themes. Findings included recurring themes of cultural influences, social disparities, and the lack of access to healthy food sources and health providers. Positive social change could result from this research to help enlighten public health professionals and community planners to understand the perspectives of African-American women's belief systems surrounding obesity. The information delivered by this research could possibly empower the participants to address the issues within their communities with civic leaders and policy makers to create and sustain needed change.

This ethnographic study was conducted among the riverine people, also known as Ribeirinhos, in the state of Amazonas, Brazil, during four months of field research. The study focused on learning from Ribeirinhos’ experiences and practices of malaria. In this thesis, I argue that paying attention to Ribeirinhos’ experiences and diagnostic, treatment, and control practices of malaria can provide useful insights into blind spots in the current interventions to control the disease in Brazil. As this is a thesis by publications, the findings are presented in three manuscripts. The first manuscript focuses on how malaria is experienced by Ribeirinhos. It explores the embodiment of malaria, empirical strategies to distinguish it from other febrile sicknesses, misalignment between bodies and current biomedical diagnosis methods, “becomings” of bodies and experiences, and the vicissitudes of having the disease. The second manuscript examines experiences and treatment practices for vivax malaria highlighting the uses of pharmaceuticals, side effects of antimalarial drugs, and traditional treatments for malaria. The third manuscript describes Ribeirinhos’ perceptions of malaria-carrying mosquitoes, their everyday practices to manage these beings, and their experiences with control interventions, such as time monitoring recommendations (TMR), indoor residual spraying (IRS), and insecticide-treated nets (ITN). The three manuscripts clearly show that Ribeirinhos' lives are thoroughly entangled with Amazonian rivers and forests; malaria also takes part in these entanglements. Learning from their experiences and practices of malaria has provided information about the nuances, improvisations, and continuous negotiations required to coexist with the parasite and disease vectors.