Annual review of public health
-
This review describes methods used in comparative effectiveness research (CER). The aim of CER is to improve decisions that affect medical care at the levels of both policy and the individual. The key elements of CER are (a) head-to-head comparisons of active treatments, (b) study populations typical of day-to-day clinical practice, and (c) a focus on evidence to inform care tailored to the characteristics of individual patients. ⋯ Observational studies are especially vulnerable because they use data that directly reflect the decisions made in usual practice. CER will challenge researchers and policy makers to think deeply about how to extract more actionable information from the vast enterprise of the daily practice of medicine. Fortunately, the methods are largely applicable to research in the public health system, which should therefore benefit from the intense interest in CER.
-
U. S. health care spending has increased dramatically in the past several decades, consuming 17.6% percent ($2.6 trillion) of GDP in 2010. Although historical spending drivers do not account for this recent increase, two major changes in population health--the rise in obesity and obesity-related chronic disease--provide a likely explanation. ⋯ We discuss trends in the clinical incidence of obesity and chronic disease as well as timely advancements in disease detection, treatment, and management. Evidence shows that rising obesity rates are influencing spending largely by increasing the treated prevalence of obesity-related chronic disease. Therefore, preventing individuals from becoming treated cases in the first place is one key way that our country can cut health care spending moving forward.
-
Annu Rev Public Health · Jan 2011
ReviewClimate change, noncommunicable diseases, and development: the relationships and common policy opportunities.
The rapid growth in noncommunicable diseases (NCDs), including injury and poor mental health, in low- and middle-income countries and the widening social gradients in NCDs within most countries worldwide pose major challenges to health and social systems and to development more generally. As Earth's surface temperature rises, a consequence of human-induced climate change, incidences of severe heat waves, droughts, storms, and floods will increase and become more severe. ⋯ These two great and urgent contemporary human challenges-to improve global health, especially the control of NCDs, and to protect people from the effects of climate change-would benefit from alignment of their policy agendas, offering synergistic opportunities to improve population and planetary health. Well-designed climate change policy can reduce the incidence of major NCDs in local populations.
-
Annu Rev Public Health · Jan 2011
ReviewAction on the social determinants of health and health inequities goes global.
Marked health inequities exist between regions, between countries, and within countries. Reducing these inequities in health requires attention to the unfair distribution of power, money, and resources and the conditions of everyday life. ⋯ The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) brought together a global evidence base of what could be done to reduce these health inequities, demonstrating that economic and social policy, if done well, can improve health and health equity. A global movement for health equity was reignited by the WHO Commission on Social Determinants of Health when it made a call to action upon delivering its final report.
-
Armed combat (also termed war or armed conflict) has profound direct and indirect impacts on the long-term physical and mental health of both military personnel and noncombatant civilians. Although most research has focused on immediate and short-term health consequences of war, an increasing number of studies have focused on the long-term health consequences for both veterans of military service and noncombatant civilians. ⋯ This article reviews illustrative examples of the existing literature on these long-term health consequences of war, focusing not only on military veterans of several different armed conflicts but also on noncombatant civilian populations, including spouses and children of military veterans as well as refugees and internally displaced persons. Public health professionals can help address these problems.