scholarly journals Viewing Disease as the Synergistic Interaction of Host, Agent, and Environment

1995 ◽  
Vol 16 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Nevin S. Scrimshaw

The agent of disease, whether it is an infectious organism, the deficiency or excess of a nutrient, a toxin, or the expression of a gene, is not sufficient to explain its cause. The impact of the agent depends on host factors and the influence of physical, biological, and social factors in the environment. For nutritional disorders those of the social environment, including the complex of educational, economic, religious, political, and other factors, are likely to be the most important and also the most difficult to understand and modify. If nutritional and other diseases are viewed as problems in human ecology, the primary health-care approach to their prevention follows naturally.

1996 ◽  
Vol 2 (1) ◽  
pp. 130
Author(s):  
Julie Statkus

With a focus on transport and information, and in recognition of the changing structure of neighbourhoods, South Port Day Links has developed and facilitated creative ways of linking people who are frail, are aged, who experience disabilities, or who are carers in their community. Day Links works at the community level and is successful because of the high level of participation by local residents. It has a primary health care approach with an emphasis on increasing and maintaining the social, as well as physical, aspects of people's lives which allows individuals to participate more fully in their community.


2004 ◽  
Vol 10 (3) ◽  
pp. 38 ◽  
Author(s):  
Jenny M Lewis

Partnerships have become a widespread tool for coordinating the disconnected components of primary health care. They are based on network modes of governing which are seen as less susceptible to power disparities and as being more democratic than hierarchies, and more inclusive and egalitarian than markets. This paper examines whether government mandated partnerships, which mix network characteristics with aspects of hierarchies and markets, can contribute to ameliorating the effects of inequities and their impacts on health. Partnerships have benefits but are complicated and time consuming. They have theoretical appeal in addressing health problems which require solutions that reach beyond traditional health boundaries to be more interconnected and inclusive. Evaluations of partnerships in the UK indicate their substantial coordination benefits. But reducing the impact of inequities also requires shifting to a conception of health that emphasises the social and environmental context. This is the case even where partnerships have political support and health inequalities are on the agenda. Partnerships are not a quick fix, but they are a necessary component of tackling the impacts of inequities on health. They create possibilities for reducing the impacts of inequities on health by providing a platform on which additional measures can be built.


Author(s):  
Sanjeev Davey ◽  
Santosh Kumar Raghav ◽  
Jai Vir Singh ◽  
Anuradha Davey ◽  
Nirankar Singh ◽  
...  

Background: Primary health care approach in ENT health care delivery; has shown to be a budding strategy in alleviating the ENT disease burden in the rural of India, as evident from literature. However the impact of Psycho-social needs fulfillment associated with ENT diseases for achieving optimum ENT care has not been studied till now, which was the main issue addressed by this study. Methods: A Prospective study was done on needs of ENT patients in 6 villages (sampled randomly); in a catchment area of a rural health training centre (RHTC) of a Medical College in western Uttar Pradesh (Muzaffarnagar) from 1st January 2015 to 30th June 2016 by way of a Wellness Triangle approach of WHO exploring Physical, Social and Mental needs from ENT Specialist Services. All the needs of patients were studied by a Semi-structured Performa and data was analyzed by appropriate statistical software’s. Results: Among 384 patients, who attended ENT Specialist services at RHTC for 1.6 years- the majority of patients availing ENT care at RHTC were initially dissatisfied with Psycho-social support provided by ENT Specialists(77%,n=296). However when Psycho-social Component of Patients (n=311, 81%) were fulfilled by both ENT & Community Medicine faculties -the ENT Curative treatment % was higher (n=212, 55.2% vs. n=13, 3.3%, OR=9.8, RR=1.5) and this difference was also statistically significant( p<0.00001). Conclusions: Greater psycho-social support is needed by ENT patients; apart from focus on pure curative approach by otorhinolaryngologist. The full-filing of psycho-social needs of ENT patients, needs more attention by both ENT specialists and community physicians for delivering ENT care by primary health care approach.


Author(s):  
Joia S. Mukherjee

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.


2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.


2000 ◽  
Vol 4 (1) ◽  
pp. 3-28 ◽  
Author(s):  
Philip Cotton ◽  
Ian A.M. Fraser ◽  
Wan Ying Hill

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.


Author(s):  
Sabrina T. Wong ◽  
Julia M. Langton ◽  
Alan Katz ◽  
Martin Fortin ◽  
Marshall Godwin ◽  
...  

AbstractAimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources.BackgroundA pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.MethodsA working group representing the 12 teams was established. They undertook an iterative process to consider existing primary care indicators identified from the literature and by stakeholders. Indicators were agreed upon with the intention of addressing three objectives across the 12 teams: (1) describing the impact of improving access to CBPHC; (2) examining the impact of alternative models of chronic disease prevention and management in CBPHC; and (3) describing the structures and context that influence the implementation, delivery, cost, and potential for scale-up of CBPHC innovations.FindingsNineteen common indicators within the core dimensions of primary care were identified: access, comprehensiveness, coordination, effectiveness, and equity. We also agreed to collect data on health care costs and utilization within each team. Data sources include surveys, health administrative data, interviews, focus groups, and case studies. Collaboration across these teams sets the foundation for a unique opportunity for new knowledge generation, over and above any knowledge developed by any one team. Keys to success are each team’s willingness to engage and commitment to working across teams, funding to support this collaboration, and distributed leadership across the working group. Reaching consensus on collection of common indicators is challenging but achievable.


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