Anne T. Fidler and Judith Bernstein present a thoughtful and comprehensive review in their article, “Infertility: From a Personal to a Public Health Problem” [Public Health Rep 1999;114:494-511].
The authors point out an important concern—the lack of a consistent definition of infertility. In the insurance debate, infertility is often referenced as a “condition” rather than a “disease.” Resolve has worked to promote a consistent definition of infertility—one that not only focuses on the length of time it takes to conceive but also takes into account physiological factors. Infertility is a disease of the reproductive systems of both men and women that can result in the inability to conceive or to carry a pregnancy to a live birth. With this definition, infertility should be properly addressed as a disease. Read the rest of this entry »
To compare public health today to public health a thouand years ago is to compare apples and bicycles. A thousand years ago, women routinely died in childbirth, most people did not live to see the age of 40, minor injuries often led to disability, and minor illnesses often meant death. The difference between then and now is so great as to be practically unfathomable. It is perhaps easier to think about a hundred years ago. Looking back at the high mortality rates for tuberculosis, diphtheria and croup, diarrhea in children, “diseases of the nervous system,” and “acute respiratory diseases” and the extremely low rates of death from cancer, heart disease, and “diseases of the arteries,” we see the extraordinary strides made in science and the concomitant shift to chronic diseases and diseases of old age. Machines to keep people alive were the stuff of science fiction, and a population of “over-80s” as the fastest-growing age group in America was equally fantastic. Read the rest of this entry »
Coordination and collaboration among public, private, and nonprofit groups is the cornerstone of the Healthy Cities and Communities philosophy. The road to collaboration is fraught with challenges. Turf issues, crossed communications, and conceptual misunderstandings all have the potential to derail rewarding, synergistic efforts. Nonetheless, collaboration has been a key ingredient in much of the Program’s success.
To promote the collaboration, the Project decided to locate its office in the state capital. In Sacramento the Project was well positioned to form significant partnerships with DHS programs and with local government associations, policy groups, health care organizations (and their associations), a food security organization, the state recreation society, and the education and faith sectors. Because each sector reaches a different constituency, these relationships allow for cross-pollination that would not otherwise be possible. Read the rest of this entry »
The Program takes a multi-tiered approach that includes technical assistance, funding, promotion, coordination and collaboration, systems reform, program evaluation, and celebration.
Technical assistance. The goal of the Programs technical assistance services is to help participating cities and communities to develop, implement, and evaluate community-driven programs, policies, and plans for improved quality of life. Site-specific technical assistance is tailored to each community’s characteristics—recognizing its assets and challenges—to facilitate the discovery and sustainability of its collective wisdom and power. In addition, the Program facilitates networking and peer-to-peer exchange among communities in order to share resources and institutionalize best practices.
The Program provides the following forms of technical assistance: consultation, educational programs, literature and information, and a resource clearinghouse.
California Healthy Cities and Communities is the longest running statewide program of its kind in the nation. After providing a brief history, the authors give an overview of the supporting activities and resources the Program provides to Healthy Cities and Communities initiatives throughout California.
During the 1980s, efforts to improve health focused on changing the behavior of individuals. The public was cautioned to quit smoking, eat low fat diets, exercise more, and adopt other lifestyle changes that medical researchers had proven to lower health risks. Unfortunately, a focus on individual behavior change did not translate into appreciable improvement in the health of Americans, especially those with disproportionate risk for disease, disability, and premature death. Read the rest of this entry »