RESUMO
This essay studies the images, perceptions, and values of the professional medical journals, as well as popular sources such as magazine and films, to show that the country doctor was a contested figure in the late nineteenth and early twentieth centuries. The country doctor's image embodied competing ideals of a racialized professional and masculine identity that included both place as well as visions of science. Medical professionals pressed an image in their journals and professional advice books that mapped a celebration of science and its predictive value onto urban places that were enshrined in hospitals and laboratory facilities. The public, while embracing this image, also embraced a second one shown in popular media that glorified the self-sacrificing rural solo practitioner. This practitioner's wisdom came from long contact with patients, he was dedicated to seeing patients in their homes, and his identity was based in the larger needs of the entire community.
Assuntos
Clínicos Gerais/história , Opinião Pública/história , Clínicos Gerais/psicologia , História do Século XIX , História do Século XX , Saúde da População Rural/história , Serviços de Saúde Rural/história , Estados UnidosRESUMO
The US public health community has demonstrated increasing awareness of rural health disparities in the past several years. Although current interest is high, the topic is not new, and some of the earliest public health literature includes reports on infectious disease and sanitation in rural places. Continuing through the first third of the 20th century, dozens of articles documented rural disparities in infant and maternal mortality, sanitation and water safety, health care access, and among Black, Indigenous, and People of Color communities. Current rural research reveals similar challenges, and strategies suggested for addressing rural-urban health disparities 100 years ago resonate today. This article examines rural public health literature from a century ago and its connections to contemporary rural health disparities. We describe parallels between current and historical rural public health challenges and discuss how strategies proposed in the early 20th century may inform current policy and practice. As we explore the new frontier of rural public health, it is critical to consider enduring rural challenges and how to ensure that proposed solutions translate into actual health improvements. (Am J Public Health. 2020;110:1678-1686. https://doi.org/10.2105/AJPH.2020.305868).
Assuntos
Saúde Pública/história , Saúde da População Rural/história , Saúde da Criança/história , Doenças Transmissíveis/epidemiologia , Participação da Comunidade/história , Participação da Comunidade/métodos , Planejamento em Saúde/história , Planejamento em Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/história , Acessibilidade aos Serviços de Saúde/organização & administração , Disparidades nos Níveis de Saúde , História do Século XX , Humanos , Saúde Materna/história , Enfermeiros de Saúde Pública/história , Enfermeiros de Saúde Pública/organização & administração , Política , Grupos RaciaisRESUMO
The Italian research group of the Seven Countries Study of Cardiovascular Diseases (SCS), through the independent use of the national cohorts and data, had the lucky opportunity, starting in the early 1960, to launch the Italian research in epidemiology of cardiovascular diseases (CVD). In this way, the Italian Section of that international study became the first investigation with baseline measurements in various cohorts, subsequent re-examinations, systematic search for morbid events, and follow-up for mortality up to 50 years. A large number of scientific aspects has been tackled including estimates of morbidity and mortality rates, the association of risk factors with cardiovascular events and total mortality, the role of risk factor changes, the use of multivariable models, the role of lifestyle behavior, the determinants of all-cause mortality including risk factors rarely measured in other studies, the identification of characteristics of a condition called Heart Disease of Uncertain Etiology (HDUE), the production of predictive tools for practical use and several other issues. All this has been enhanced by the availability of extremely long follow-up data rarely found in other studies. Field work organization, measurement techniques, diagnostic criteria, data handling and computing had the limitations and difficulties typical of those times, the mid of last century, when CVD epidemiology was at its beginning. All this represented anyhow the start of CVD epidemiology research in the country and was the stimulus to the start of other studies and a valuable collaboration with some of them.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/história , Projetos de Pesquisa Epidemiológica , Monitoramento Epidemiológico , Estudos Multicêntricos como Assunto/história , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Feminino , Estilo de Vida Saudável , História do Século XX , História do Século XXI , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional/história , Prevalência , Prognóstico , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Saúde da População Rural/história , Fatores de Tempo , Saúde da População Urbana/históriaRESUMO
As new government health policy was created and implemented in the late 1910s and the late 1960s, women patients and health practitioners recognized gaps in the new health services and worked together to create better programs. This article brings the histories of the district nursing program (1919-43) and local birth control centres (1970-79) together to recognize women's health provision (as trained nurses or lay practitioners) as community-based and collaborative endeavours in the province of Alberta. The district nursing and birth control centre programs operated under different health policies, were influenced by different feminisms, and were situated in different Indigenous-settler relations. But the two programs, occurring half a century apart, provided space for health workers and their patients to implement change at a community level. Health practitioners in the early and late twentieth century took women's experiential knowledge seriously, and, therefore, these communities formed a new field of women's health expertise.
Assuntos
Instituições de Assistência Ambulatorial/história , Enfermagem em Saúde Comunitária/história , Anticoncepção/história , Pessoal de Saúde/história , Serviços de Saúde do Indígena/história , Saúde da Mulher/história , Alberta , Feminino , Feminismo/história , Política de Saúde/história , História do Século XX , Humanos , Saúde da População Rural/históriaRESUMO
From the late 19th century, some of the physicians settled in Algeria and teachers at the School of Medicine of Algiers sought to map the extent of malaria in order to propose prophylactic measures against a disease that was widespread in the countryside of the colony. When the fight against malaria was organized in Algeria at the beginning of the 20th century, under the joint direction of the General Government and the Pasteur Institute, the Institute researchers needed to gather various types of data for determining epidemic indexes and preparing action programmes. The so-called «colonization physicians¼, responsible for delivering healthcare to colonials and natives in rural districts since the 1850s, appeared to be appropriate collaborators with the administration in the campaigns. The organizers of these campaigns also worked with agents quininisateurs (quinine distributors) and those involved in anti-larval measures, as well as with agencies responsible for roads and bridges and for water services, among others. However, there were soon repeated calls for them to be trained in the new bacteriology techniques. Advanced courses were also proposed to allow these practitioners to act as true and effective agents of the anti-malarial service, such as the 34-day course organized in 1932 by the Pasteur Institute of Algeria.
Assuntos
Academias e Institutos/história , Malária/história , Médicos/história , Saúde da População Rural/história , Argélia , Colonialismo , França , História do Século XIX , História do Século XX , Malária/prevenção & controleRESUMO
The Korean government introduced CHPs (Community Health Practitioners) as front-line primary health care providers to address the health disparity between urban and rural areas. Through their dedicated contribution over last 30 years, the CHPs have improved Korea's public health through the successful control of high birth rates, a lowered maternal and infant mortality rate in the 1980s, eradication of parasitic infection, and containing many communicable diseases including hepatitis B. However, rapid changes in the health care environment and demands for health care among rural residents have required changes in the roles and functions of the CHPs. They are challenged by fundamental changes in the public health system addressing various health issues due to a rapidly aging society, pandemic of chronic disease, new infectious disease, and climate changes. CHPs should continuously transform their roles and functions to establish a lifelong health management system. This article presents a historical overview of the CHP system and their tasks and activities. Also, recent challenges that CHPs are facing and strategies to overcome those challenges will be discussed. This historical overview will be informative for other developing countries in resolving their own public health problems.
Assuntos
Enfermagem em Saúde Comunitária/história , Profissionais de Enfermagem/história , Atenção Primária à Saúde/história , História do Século XX , Humanos , Papel do Profissional de Enfermagem/história , Atenção Primária à Saúde/organização & administração , Saúde Pública/história , República da Coreia , Saúde da População Rural/históriaRESUMO
Based on household food security surveys conducted in Ethiopia, this study seeks to understand the roles and limitations of income transfer projects as determinants of households' food security. By covering the Food-For-Work Programs (FFWPs) and the Productive Safety Net Programs (PSNPs), the study shows that these programs served as temporary safety nets for food availability, but they were limited in boosting the dietary diversity of households and their coping strategies. Households which participated in the programs increased their supply of food as a temporary buffer to seasonal asset depletion. However, participation in the programs was marred by inclusion error (food-secure households were included) and exclusion error (food-insecure households were excluded). Income transfer projects alone were not robust determinants of household food security. Rather, socio-demographic variables of education and family size as well as agricultural input of land size were found to be significant in accounting for changes in households' food security. The programs in the research sites were funded through foreign aid, and the findings of the study imply the need to reexamine the approaches adopted by bilateral donors in allocating aid to Ethiopia. At the same time the study underscores the need to improve domestic policy framework in terms of engendering rural local institutional participation in project management.
Assuntos
Abastecimento de Alimentos , Programas Governamentais , Saúde da População Rural , Problemas Sociais , Fatores Socioeconômicos , Etiópia/etnologia , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , Abastecimento de Alimentos/legislação & jurisprudência , Programas Governamentais/economia , Programas Governamentais/educação , Programas Governamentais/história , Programas Governamentais/legislação & jurisprudência , História do Século XX , História do Século XXI , Cooperação Internacional/história , Cooperação Internacional/legislação & jurisprudência , Assistência Pública/economia , Assistência Pública/história , Assistência Pública/legislação & jurisprudência , Saúde da População Rural/educação , Saúde da População Rural/etnologia , Saúde da População Rural/história , População Rural/história , Problemas Sociais/economia , Problemas Sociais/etnologia , Problemas Sociais/história , Problemas Sociais/legislação & jurisprudência , Problemas Sociais/psicologia , Responsabilidade Social , Fatores Socioeconômicos/históriaRESUMO
Medical assistance to the Saharian populations (1900-1976) is viewed through its organization. The management of the Health Service in the Southern Territories, doctors, nursing staff, medical districts, centred on infirmary-hospitals and rural first-aid posts. We insist on the everrising free consultations and the care to sick and wounded patients in infirmaries; the fight against epidemics and social scourges. Then on French medical mission from 1963 to 1976, and on the humanitarian work by the Health Service throughout the five continents.
Assuntos
Altruísmo , Doenças Transmissíveis/história , Atenção à Saúde/história , Primeiros Socorros/história , Hospitais Militares/história , Medicina Militar/história , Saúde Pública/história , Serviços de Saúde Rural/história , África do Norte , Argélia , Instituições de Assistência Ambulatorial/história , França , História do Século XX , Hospitais/história , Humanos , Agências Internacionais/história , Vacinação em Massa/história , Saúde da População Rural/história , Infecções Sexualmente Transmissíveis/história , Varíola/história , Tifo Epidêmico Transmitido por Piolhos/históriaRESUMO
The accommodation of livestock husbandry with crop agriculture is crucial for the future of the West African Sahel. Present trends are leading to greater restrictions on livestock husbandry and a growing convergence of livelihood practices among groups whose identities are tied to herding and farming. Using the cases of four rural communities in Niger, this study adopts an 'access to resources' framework to analyse the causal connections among: rural peoples' livelihood strategies, everyday social relations of production, perceptions of social groups' identities, and the potential for farmer-herder conflict. While the convergence of livelihoods arguably increases the frequency of conflict triggers, it has also, through the expansion of shared common interests and cross-group, production-related relationships, improved the ability of communities to effectively manage these incipient conflicts.
Assuntos
Criação de Animais Domésticos , Produtos Agrícolas , Características de Residência , Saúde da População Rural , Mudança Social , Fatores Socioeconômicos , África Ocidental/etnologia , Criação de Animais Domésticos/economia , Criação de Animais Domésticos/história , Produtos Agrícolas/economia , Produtos Agrícolas/história , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , História do Século XIX , História do Século XX , História do Século XXI , Gado , Características de Residência/história , Saúde da População Rural/história , População Rural/história , Mudança Social/história , Identificação Social , Fatores Socioeconômicos/históriaRESUMO
This article analyses the role of social networks as facilitators of information flows and banana output increase. Based on a village census, full information is available on the socio-economic characteristics and banana production of farmers' kinship group members, neighbours and informal insurance group members. The census data enable us to use individual specific reference groups and include exogenous group controls to tackle standard difficulties related to identification and omitted variables bias when analysing social effects. For the survey village of Nyakatoke in Tanzania the results suggest that information flows exist within all types of groups analysed but output externalities are limited to kinship groups. Using networks may offer scope for effective information flows on agricultural techniques, but our evidence suggests that not just any local network will have a social externality impact, requiring a clear understanding of local social networks for maximum impact.
Assuntos
Produtos Agrícolas , Abastecimento de Alimentos , Musa , Características de Residência , Saúde da População Rural , Apoio Social , Agricultura/economia , Agricultura/educação , Agricultura/história , Produtos Agrícolas/economia , Produtos Agrícolas/história , Indústria Alimentícia/economia , Indústria Alimentícia/educação , Indústria Alimentícia/história , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , Amigos/etnologia , Amigos/psicologia , História do Século XX , História do Século XXI , Características de Residência/história , Saúde da População Rural/história , População Rural/história , Fatores Socioeconômicos/história , Tanzânia/etnologiaRESUMO
This paper explores the implications of using two methodological approaches to study poverty dynamics in rural Bangladesh. Using data from a unique longitudinal study, we show how different methods lead to very different assessments of socio-economic mobility. We suggest five ways of reconciling these differences: considering assets in addition to expenditures, proximity to the poverty line, other aspects of well-being, household division, and qualitative recall errors. Considering assets and proximity to the poverty line along with expenditures resolves three-fifths of the qualitative and quantitative differences. Use of such integrated mixed-methods can therefore improve the reliability of poverty dynamics research.
Assuntos
Pobreza , Assistência Pública , Saúde da População Rural , População Rural , Fatores Socioeconômicos , Bangladesh/etnologia , Serviços de Saúde Comunitária/economia , Serviços de Saúde Comunitária/história , Serviços de Saúde Comunitária/legislação & jurisprudência , História do Século XX , História do Século XXI , Pobreza/economia , Pobreza/etnologia , Pobreza/história , Pobreza/legislação & jurisprudência , Pobreza/psicologia , Áreas de Pobreza , Assistência Pública/economia , Assistência Pública/história , Assistência Pública/legislação & jurisprudência , Saúde da População Rural/história , População Rural/história , Classe Social/história , Fatores Socioeconômicos/históriaRESUMO
Bt cotton is accused of being responsible for an increase of farmer suicides in India. In this article, we provide a comprehensive review of evidence on Bt cotton and farmer suicides. Available data show no evidence of a 'resurgence' of farmer suicides. Moreover, Bt cotton technology has been very effective overall in India. Nevertheless, in specific districts and years, Bt cotton may have indirectly contributed to farmer indebtedness, leading to suicides, but its failure was mainly the result of the context or environment in which it was planted.
Assuntos
Agricultura , Poluentes Ambientais , Gossypium , Saúde da População Rural , Suicídio , Indústria Têxtil , Agricultura/economia , Agricultura/educação , Agricultura/história , Produtos Agrícolas/economia , Produtos Agrícolas/história , Meio Ambiente , Poluentes Ambientais/economia , Poluentes Ambientais/história , Prática Clínica Baseada em Evidências/economia , Prática Clínica Baseada em Evidências/educação , Prática Clínica Baseada em Evidências/história , História do Século XIX , História do Século XX , História do Século XXI , Índia/etnologia , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Saúde Pública/legislação & jurisprudência , Saúde da População Rural/história , População Rural/história , Suicídio/economia , Suicídio/etnologia , Suicídio/história , Suicídio/legislação & jurisprudência , Suicídio/psicologia , Indústria Têxtil/economia , Indústria Têxtil/educação , Indústria Têxtil/históriaRESUMO
This article explores the implications of women's work in agriculture in Telangana, a region in the state of Andhra Pradesh, India. I suggest that higher capital costs for cultivators' post-liberalisation increased the pressure to contain wage costs in a region where women form the majority of the agricultural wage labour force. Under such conditions, when women perform both own-cultivation as well as agricultural wage work in the fields of others, they face pressure to restrict bargaining for higher wages, contributing to a widening gender wage gap. To the extent that wages shape intra-household bargaining power, the empowering effect of workforce participation for such women would thus be blunted. From available NSS data I provide some preliminary evidence in support of this argument.
Assuntos
Agricultura , Poder Psicológico , Fatores Socioeconômicos , Saúde da Mulher , Direitos da Mulher , Mulheres , Agricultura/economia , Agricultura/educação , Agricultura/história , Emprego/economia , Emprego/história , Emprego/psicologia , Família/etnologia , Família/história , Família/psicologia , História do Século XX , História do Século XXI , Índia/etnologia , Saúde da População Rural/história , População Rural/história , Condições Sociais/economia , Condições Sociais/história , Condições Sociais/legislação & jurisprudência , Fatores Socioeconômicos/história , Mulheres/educação , Mulheres/história , Mulheres/psicologia , Saúde da Mulher/etnologia , Saúde da Mulher/história , Direitos da Mulher/economia , Direitos da Mulher/educação , Direitos da Mulher/história , Direitos da Mulher/legislação & jurisprudênciaRESUMO
This paper analyses vulnerability to poverty of rural small-scale fishing communities using cross-section data from 295 households in Cameroon and 267 in Nigeria. We propose a vulnerability measure that incorporates the idea of asset poverty into the concept of expected poverty, which allows decomposing expected poverty into expected structural-chronic, structural-transient, and stochastic-transient poverty. The findings show that most households in our study areas are expected to be structurally-chronic and structurally-transient poor. This underlines the importance of asset formation for long-term poverty reduction strategies. Further refinements are possible with longitudinal data and information about future states of nature.
Assuntos
Pesqueiros , Abastecimento de Alimentos , Pobreza , Saúde da População Rural , Fatores Socioeconômicos , Populações Vulneráveis , Camarões/etnologia , Emprego/economia , Emprego/história , Emprego/psicologia , Prática Clínica Baseada em Evidências/economia , Prática Clínica Baseada em Evidências/educação , Prática Clínica Baseada em Evidências/história , Pesqueiros/economia , Pesqueiros/história , Indústria Alimentícia/economia , Indústria Alimentícia/educação , Indústria Alimentícia/história , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , História do Século XX , História do Século XXI , Nigéria/etnologia , Pobreza/economia , Pobreza/etnologia , Pobreza/história , Pobreza/legislação & jurisprudência , Pobreza/psicologia , Saúde da População Rural/história , População Rural/história , Classe Social/história , Fatores Socioeconômicos/história , Populações Vulneráveis/etnologia , Populações Vulneráveis/legislação & jurisprudência , Populações Vulneráveis/psicologiaRESUMO
Favored by neoliberal agrarian policies, the production of fresh crops for international markets has become a common strategy for economic development in Mexico and other Latin American countries. But as some scholars have argued, the global fresh produce industry in developing countries in which fresh crops are produced for consumer markets in affluent nations implies "virtual water flows," the transfer of high volumes of water embedded in these crops across international borders. This article examines the local effects of the production of fresh produce in the San Quintín Valley in northwestern Mexico for markets in the United States. Although export agriculture has fostered economic growth and employment opportunities for indigenous farm laborers, it has also led to the overexploitation of underground finite water resources, and an alarming decline of the quantity and quality of water available for residents' domestic use. I discuss how neoliberal water policies have further contributed to water inequalities along class and ethnic lines, the hardships settlers endure to secure access to water for their basic needs, and the political protests and social tensions water scarcity has triggered in the region. Although the production of fresh crops for international markets is promoted by organizations such as the World Bank and Inter-American Development Bank as a model for economic development, I argue that it often produces water insecurity for the poorest, threatening the UN goal of ensuring access to clean water as a universal human right.
Assuntos
Irrigação Agrícola , Abastecimento de Alimentos , Política , Saúde da População Rural , Abastecimento de Água , Irrigação Agrícola/economia , Irrigação Agrícola/educação , Irrigação Agrícola/história , Irrigação Agrícola/legislação & jurisprudência , Agricultura/economia , Agricultura/educação , Agricultura/história , California/etnologia , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , Abastecimento de Alimentos/legislação & jurisprudência , História do Século XX , História do Século XXI , México/etnologia , Saúde da População Rural/etnologia , Saúde da População Rural/história , População Rural/história , Abastecimento de Água/economia , Abastecimento de Água/história , Abastecimento de Água/legislação & jurisprudênciaRESUMO
The future of Chinese agriculture lies not with large mechanized farms but with small capital-labor dual intensifying family farms for livestock-poultry-fish raising and vegetable-fruit cultivation. Chinese food consumption patterns have been changing from the old 8:1:1 pattern of 8 parts grain, 1 part meat, and 1 part vegetables to a 4:3:3 pattern, with a corresponding transformation in agricultural structure. Small family-farming is better suited for the new-age agriculture, including organic farming, than large-scale mechanized farming, because of the intensive, incremental, and variegated hand labor involved, not readily open to economies of scale, though compatible with economies of scope. It is also better suited to the realities of severe population pressure on land. But it requires vertical integration from cultivation to processing to marketing, albeit without horizontal integration for farming. It is against such a background that co-ops have arisen spontaneously for integrating small farms with processing and marketing. The Chinese government, however, has been supporting aggressively capitalistic agribusinesses as the preferred mode of vertical integration. At present, Chinese agriculture is poised at a crossroads, with the future organizational mode for vertical integration as yet uncertain.
Assuntos
Agricultura , Abastecimento de Alimentos , Agricultura Orgânica , Saúde da População Rural , População Rural , Mudança Social , Agricultura/economia , Agricultura/educação , Agricultura/história , Povo Asiático/educação , Povo Asiático/etnologia , Povo Asiático/história , Povo Asiático/legislação & jurisprudência , Povo Asiático/psicologia , China/etnologia , Comércio/economia , Comércio/educação , Comércio/história , Indústria Alimentícia/economia , Indústria Alimentícia/educação , Indústria Alimentícia/história , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/história , Tecnologia de Alimentos/economia , Tecnologia de Alimentos/educação , Tecnologia de Alimentos/história , História do Século XX , História do Século XXI , Humanos , Agricultura Orgânica/economia , Agricultura Orgânica/educação , Agricultura Orgânica/história , Saúde da População Rural/história , População Rural/história , Mudança Social/históriaRESUMO
This article explores, through the lenses of text, practice, and life narrative, how Chinese peasant women as daughters manage patrilocality and carry outor fail to carry outfilial piety toward their parents. Based on field research in a locale in southern China conducted since 1992, this article focuses on four women's life histories and juxtaposes how these women articulated filial piety as daughter-brides in wedding lamentations and how they practiced it after marriage. This research illuminates how peasant women perceive daughterly filial piety as a complex entailing not only emotional attachment but also peace of mind, tolerance, and material support. For these women, concerns about filial piety emerge as a focus of their maneuvering and negotiating among the strategic possibilities in their livestheir social responsibilities, personal conditions, the broader socialpolitical milieu, and above all, the male support that is often ignored but indispensable in these women's stories.