Precarity in the Time of COVID-19: Aging Housing and Aging Population in Cuba

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Nancy J. Burke
Keyword(s):  
Family Support ◽  
Housing Stock ◽  
Economic Reforms ◽  
Universal Health Care ◽  
Multiple Forms ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
Cuban Government ◽  
Vulnerable Elderly ◽  
Universal Health

In January 2020 the Cuban government launched a rapid and comprehensive multisectoral response to the threat posed by SARS-CoV-2. This response built upon the strengths of the nation’s public health infrastructure, including an expansive health professional workforce experienced with prior epidemics (e.g., dengue, HIV, and Ebola). It also revealed the challenges posed by the vulnerabilities of aging and weak municipal infrastructures. Deteriorating housing, poor airflow, and sweltering heat undermined adherence to lockdown measures, putting those over age sixty—an increasingly large proportion of Cuba’s population—at particular risk. I discuss challenges posed by a rapidly graying population, vulnerabilities and increasing inequality stemming from Raul Castro’s 2009 economic reforms, and the island’s struggle to address its precarious housing stock to highlight the severe difficulties sheltering in place posed for the most vulnerable: elderly Cubans living without family support. The COVID-19 pandemic crisis has underscored the multiple forms infrastructure—including pipes, energy grids, and social networks—takes on the island, and the implications infrastructural strain and weakness have for maintenance of the socialist state and its continued provision of universal health care, housing, and nutrition.

The costs of a public health infrastructure for delivering parenting and family support

2008 ◽  
Vol 30 (5) ◽  
pp. 493-501 ◽  
Author(s):  
E. Michael Foster ◽  
Ronald J. Prinz ◽  
Matthew R. Sanders ◽  
Cheri J. Shapiro
Keyword(s):  
Public Health ◽  
Family Support ◽  
Public Health Infrastructure ◽  
Health Infrastructure

Indian Muslim(s) After Liberalization

2019 ◽  
Author(s):  
Maidul Islam
Keyword(s):  
Economic Development ◽  
Free Market ◽  
Political Leadership ◽  
Economic Reforms ◽  
Turn Of The Century ◽  
The Political ◽  
Economic Policies ◽  
Multiple Forms ◽  
Muslim Identity ◽  
Economic Changes

Close to the turn of the century and almost 45 years after Independence, India opened its doors to free-market liberalization. Although meant as the promise to a better economic tomorrow, three decades later, many feel betrayed by the economic changes ushered in by this new financial era. Here is a book that probes whether India’s economic reforms have aided the development of Indian Muslims who have historically been denied the fruits of economic development. Maidul Islam points out that in current political discourse, the ‘Muslim question’ in India is not articulated in terms of demands for equity. Instead, the political leadership camouflages real issues of backwardness, prejudice, and social exclusion with the rhetoric of identity and security. Historically informed, empirically grounded, and with robust analytical rigour, the book tries to explore connections between multiple forms of Muslim marginalization, the socio-economic realities facing the community, and the formation of modern Muslim identity in the country. At a time when post-liberalization economic policies have created economic inequality and joblessness for significant sections of the population including Muslims, the book proposes working towards a radical democratic deepening in India.

scholarly journals Creating universal health care in Ireland: A legal context

Health Policy ◽  
2021 ◽  
Author(s):  
Manfred Lau ◽  
Charles Larkin ◽  
Michael Harty ◽  
Shaen Corbet
Keyword(s):  
Health Care ◽  
Universal Health Care ◽  
Legal Context ◽  
Universal Health

scholarly journals Actionable lessons for the US COVID vaccine program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gary L. Freed
Keyword(s):  
Public Health ◽  
Local Health ◽  
National Strategy ◽  
Individual State ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
The Us ◽  
Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

scholarly journals P1490MONTHLY TREND AND SEASONALITY IN ACUTE AND CHRONIC HEMODIALYSIS; RESULT FROM NATIONWIDE DATABASE OF MEDICAL BILLS OF UNIVERSAL HEALTH CARE INSURANCE SYSTEM IN JAPAN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ryoya Tsunoda ◽  
Hirayasu Kai ◽  
Masahide Kondo ◽  
Naohiro Mitsutake ◽  
Kunihiro Yamagata
Keyword(s):  
Health Care ◽  
Seasonal Variation ◽  
Chronic Hemodialysis ◽  
Universal Health Care ◽  
Health Care Insurance ◽  
Individual Data ◽  
Insurance System ◽  
Number Of Patients ◽  
Medical Bills ◽  
Universal Health

Abstract Background and Aims Although knowing the accurate number of patients of hemodialysis important, data collection is a hard task. Establishing a simplified and prompt method of data collection for perspective hemodialysis is strongly needed. In Japan, there is a universal health care insurance system that covers almost all population. This study aimed to know a seasonal variation of hemodialysis patients using the big database of medical bills in Japan. Method Japanese Ministry of Health, Labour and Welfare established a big database named National Database (NDB), that consists of medical bills data in Japan. All bills data were sent to the data server from The Examination and Payment Agency, the organization that receives all medical bills from each medical institution and judge validity for payment. Each record of the database consists of bill data of one patient of a month for each medical institution. All data were anonymized before saved in the server and gave virtual patient identification number (VPID) that is unique for each patient. VPID is a hash value calculated by patient’s individual data such as name, date of birth, so that the value cannot be duplicate. Calculation of VPID is executed by an irreversible way to make it difficult to decrypt VPID into patient’s individual data. This database includes all information about medical care of whole population in Japan except for patients not under the insurance system (patients under public assistance system, victims of the war, or any other specified people under the public medical expense). Using this database, we investigated monthly number of patients who were recorded to be undergone hemodialysis (HD, includes hemodiafiltration). We searched chronic HD patients who have undergone HD on the month and continued it for 3 months, and acute HD patients who have discontinued HD within 3 months. Results In NDB, the number of chronic HD patients under public insurance system who confirmed to have undergone HD in December 2014 was 284 433. In contrast, the number of HD patients identified from the year-end survey by Japanese Society of Dialysis Therapy in the same year was of 311 193, but this number includes patients not under insurance system. Incidence rate of acute HD in Japan was persisted at 30-39 per million per month. There is a reproducible seasonal variation in number of acute HD patients, that increases in every winter and decreasing in every summer. The significantly highest frequency was observed in February(38.5/million/month) compared with September(30.6/million/month), the lowest month of the year (p<0.01). Conclusion We could show the trend in number of HD patients using nationwide bills data. Seasonality in some clinical factors in patients under chronic hemodialysis such as blood pressure, intradialytic body weight gain, morbidity of congestive heart failure, and, mortality, has been reported in many observational studies. Also, there are a few former reports about seasonality in AKI. However, a report about acute RRT is few. From our knowledge, this is the first report that revealed monthly dynamics of HD in a whole nation and rising risk of acute HD in winter. The true mechanism of this seasonality remains unclear. We have to establish a method to collect clinical data such as prevalence of CKD, causative diseases of AKI, kinds of precedent operations, and medications in connection with billing data.

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