Journal of public health policy
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J Public Health Policy · Jan 1997
Comparative StudyNAFTA and occupational health: a Canadian perspective. North American Free Trade Agreement.
In Canada, health and safety laws are built around three worker rights which are not guaranteed by law in the United States: the right to participate in joint management-worker health and safety committees; the right to know about workplace hazards which requires consultation with the joint committee about the education and training programs; and the right to refuse hazardous work. In the context of NAFTA, health, safety and environmental laws and their enforcement, as well as the workers' compensation system, are all under attack by business leaders who cite the need to deregulate and privatize Canadian institutions in order to harmonize with the United States. The counteroffensive by the trade unions and their allies in the social justice movement is described; the struggle continues.
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J Public Health Policy · Jan 1996
ReviewGeneral practice fundholding in the UK National Health Service: evidence to date.
The published evidence on the effects of General Practitioner Fundholding, a major feature of the 1991 reorganization of the UK National Health Service, is reviewed with regard to the source and character of the evidence, as well as the findings on the outputs (including referrals, prescribing, service shifts, and the attitudes of various actors); the processes (inter- and intra-organizational); and the inputs (costs). An overall assessment based on this evidence is presented; the latest political and organisational developments in NHS primary care are outlined; and the future of GP fundholding is discussed.
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J Public Health Policy · Jan 1996
The economic costs of cardiovascular disease mortality in California, 1991: implications for public health policy.
This study estimates costs of lost productivity in California due to cardiovascular disease (CVD) mortality. Death records were used to calculate mortality losses including the number of deaths due to CVD, Years of Potential Life Lost (YPLL), and the value of productivity losses. ⋯ Racial/ethnic differences in YPLL are pronounced, which likely reflect the long-standing inverse association between CVD mortality and socioeconomic status that has been documented in a variety of populations worldwide. While it is important to effectively retain or develop low risk behaviors in populations, it is equally important to reduce barriers engendered by social, economic, and political patterns that inhibit the compression of CVD morbidity and mortality.
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The health care system of Chile evolved from rather unique historical circumstances to become one of the most progressive in Latin America, offering universal access to all citizens. Since the advent of the Pinochet regime in 1973, Chile has implemented Thatcherite/Reaganite reforms resulting in the privatization of much of the health care system. ⋯ As Chile emerges from the shadow of the Pinochet dictatorship, it faces numerous challenges as it struggles to rebuild its health care system. Other developing nations considering free-market reforms may wish to consider the high costs of the Chilean experiment.
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This study determined differences in U. S. local health department (LHD) expenditures between 1989 and 1993 and examined the factors that were associated with those changes. ⋯ The median change in LHD budgets was 0.2% growth per year. Significant associations were found between the likelihood of a department experiencing a budget increase and several measures describing the LHD's administrative and economic environment.