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1.
Bull World Health Organ ; 98(6): 394-405, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514213

RESUMO

Objective: To investigate whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions. Methods: We analysed survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions, in which at least two surveys had been conducted since 1995. We calculated the composite coverage index, a function of essential maternal and child health intervention parameters. We adopted the wealth index, divided into quintiles from poorest to wealthiest, to investigate wealth-related inequalities in coverage. We quantified trends with time by calculating average annual change in index using a least-squares weighted regression. We calculated population attributable risk to measure the contribution of wealth to the coverage index. Findings: We noted large differences between the four regions, with a median composite coverage index ranging from 50.8% for West Africa to 75.3% for Southern Africa. Wealth-related inequalities were prevalent in all subregions, and were highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as we observed a higher coverage in Southern (around 70%) compared with Central and West (around 40%) subregions for the same income. Wealth-related inequalities in coverage were reduced by the greatest amount in Southern Africa, and we found no evidence of inequality reduction in Central Africa. Conclusion: Our data show that most countries in sub-Saharan Africa have succeeded in reducing wealth-related inequalities in the coverage of essential health services, even in the presence of conflict, economic hardship or political instability.


Assuntos
Disparidades em Assistência à Saúde/economia , Serviços de Saúde Materno-Infantil/organização & administração , África , África ao Sul do Saara , Conflitos Armados , Humanos , Serviços de Saúde Materno-Infantil/economia , Política , Pobreza , Fatores de Tempo
6.
J Environ Manage ; 268: 110601, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32510424

RESUMO

During the second half of the twentieth century, northwestern New Mexico served as the primary production site for one of the world's largest nuclear arsenals. From 1948 to 1970 the "Grants uranium district" provided almost half of the total uranium ore accumulated by the United States federal government for the production of nuclear weapons, in addition to becoming a national source for commercial nuclear energy from the late 1960s to the early 1990s. By the twenty-first century, after a prolonged period of economic decline that began in the late 1970s, all uranium mining and milling in New Mexico had ceased, leaving a legacy of environmental health impacts. What was once referred to as "The Uranium Capital of the World" now encompasses over a thousand abandoned uranium mines and seven massive uranium mill tailings piles, which are associated with airborne and soil contamination as well as groundwater plumes of uranium and other contaminants of concern, in a landscape that has been fractured by underground mine workings and punctured by thousands of exploratory boreholes. This article presents an ethnographic study of the diverse forms of expertise involved in monitoring and managing the mine waste and mill tailings. Drawing from over two years of ethnographic research, I describe the relationship between different stakeholders from local communities, government agencies, and transnational mining corporations as they deliberate about the possibility of cleaning up the former mining district. My thesis is that the possibility of cleaning up the Grants district hinges on the "politics of baselining"-a term I introduce to describe the relationship between stakeholders and their competing environmental models and hydrogeological theories; each accounts for a different geological past prior to mining that can be deemed "natural," as the background against which to measure the anthropogenic impacts from mining.


Assuntos
Urânio , Mineração , New Mexico , Política
9.
Rev Esp Salud Publica ; 942020 Jun 24.
Artigo em Espanhol | MEDLINE | ID: mdl-32576811

RESUMO

OBJECTIVE: In Europe there is a great variability in mortality by Covid-19 among different countries. While some countries, such as Greece, Belarus or Ukraine, have a mortality rate of less than 5 cases/100,000 inhabitants, other countries such as Belgium, Spain or the United Kingdom have a mortality rate of well over 50 cases/100,000 inhabitants. It is generally considered that the reason for this variability is multifactorial (including political reasons), but there are few studies that associate factors related to this variability. The objective of this work was to analyse political risk factors/markers that could explain the variability in mortality due to Covid-19 among different European countries. METHODS: This is a retrospective, multinational, ecological study based on the exploitation of the database provided by the European Centre for Disease Prevention and Control which collects daily information worldwide on new cases and deaths. The accumulated mortality of Covid-19 in European countries (with more than 100 deaths on 01/05/2020) was calculated up to 29/05/2020. Political variables were compiled from different sources in the countries included in the study. The variables analysed were: the democracy index and the different factors included in it, the country's political system and the country's corruption index. On the other hand, specific political measures implemented in the different countries were collected, such as the number of days elapsed from the notification of the first infected person to 100 infected persons, to lockdown, to the closure of schools or the cancelation of meetings. The number of people infected up to the date of lockdown was also registered. For the statistical analysis of the association between the dependent variable (mortality) and the factors studied, correlation index were calculated, and the association was studied through univariate and multivariate linear regression models. RESULTS: At May 1 2020, 27 European countries had at least 100 deaths. The mean mortality was 19.83 cases/100,000 inhabitants (SD 22.4) and a median of 7.95. Mortality varied from a minimum of 1.49 cases/100,000 population in Ukraine to 82.19 cases/100,000 population in Belgium. About factors analyzed both the democracy index (as well as the factors included in it), the political system (full democracy vs. no) and the corruption index were statistically associated with mortality. Also, the time until the implementation of the political measures was associated with mortality. CONCLUSIONS: In Europe, there is a west to east (from highest to lowest) gradient in the mortality of Covid-19. Some of the observed mortality variability can be explained by political factors.


Assuntos
Infecções por Coronavirus/mortalidade , Democracia , Pneumonia Viral/mortalidade , Política , Betacoronavirus , Europa (Continente)/epidemiologia , Humanos , Cooperação Internacional , Pandemias , Quarentena , Estudos Retrospectivos
11.
BMJ ; 369: m1914, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414756
14.
Cad Saude Publica ; 36(4): e00088120, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32401907

RESUMO

This essay discusses the proliferation of discourses about the COVID-19 pandemic, presenting the challenges both to science and public policies that such an information overload present, having Collins' sociology of expertise as a theoretical framework.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Política , Ciência , Mídias Sociais , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-32397199

RESUMO

Since the first known case of a COVID-19 infected patient in Wuhan, China on 8 December 2019, COVID-19 has spread to more than 200 countries, causing a worldwide public health crisis. The existing literature fails to examine what caused this sudden outbreak from a crisis management perspective. This article attempts to fill this research gap through analysis of big data, officially released information and other social media sources to understand the root cause of the crisis as it relates to China's current management system and public health policy. The article draws the following conclusions: firstly, strict government control over information was the main reason for the early silencing of media announcements, which directly caused most people to be unprepared and unaware of COVID-19. Secondly, a choice between addressing a virus with an unknown magnitude and nature, and mitigating known public panic during a politically and culturally sensitive time, lead to falsehood and concealment. Thirdly, the weak autonomous management power of local public health management departments is not conducive for providing a timely response to the crisis. Finally, the privatization of many state-owned hospitals led to the unavailability of public health medical resources to serve affected patients in the Wuhan and Hubei Province. This article suggests that China should adopt a Singaporean-style public health crisis information management system to ensure information disclosure and information symmetry and should use it to monitor public health crises in real time. In addition, the central government should adopt the territorial administration model of a public health crisis and increase investment in public health in China.


Assuntos
Infecções por Coronavirus/epidemiologia , Gestão da Informação em Saúde/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Política , Administração em Saúde Pública , Betacoronavirus , China/epidemiologia , Surtos de Doenças , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Saúde Pública , Política Pública , Mídias Sociais
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