CDC on Vaccines and Children's Health: United States 1900–98

During the twentieth century, the health and life expectancy of persons residing in the United States—as in most other countries of the globe—have improved greatly. (For a discussion of some aspects of that improvement, see the article in this issue by Kevin White assessing the effects of changes in cardiovascular and tuberculosis mortality in the United States since 1900.) A considerable share of this change is attributable to advances in public health. To highlight these advances the Morbidity and Mortality Weekly Report (MMWR) of the Centers for Disease Control and Prevention (an agency of the US Department of Health and Human Services) is issuing a series of reports profiling ten great public health achievements in the United States during the present century. The first of these reports discusses vaccination: “Impact of vaccines universally recommended for children—United States, 1900–1998,” MMWR 48 (12), 2 April 1999. It is reproduced below in full. The improvements chronicled in the report are especially great with respect to morbidity. In many developing countries mortality resulting from vaccine-preventable causes is, however, still very high. Recent international initiatives, involving UN agencies, bilateral aid agencies, foundations, and the vaccine industry, aim at accelerating the outreach of immunization in developing countries. A meeting discussing an expanded program of vaccination (Bellagio, March 1999) estimated that global immunization, at a cost of approximately $3 billion per year, could save some 40 million lives over the next ten years.     

WHO on Health and Economic Productivity

The current issue of the World Health Organization's annual flagship publication, titled The World Health Report 1999: Making a Difference, is the first issued under Gro Harlem Brundtland, WHO's Director-General, who assumed the office in 1998. In her preface to the 121-page report Dr. Brundtland identifies four major challenges to be addressed in order to improve the world's health: the need to reduce the burden of excess mortality and morbidity suffered by the poor; the need to counter potential threats to health resulting from economic crises, unhealthy environments, or risky behavior; the need to develop more effective health systems; and finally the need to invest in expanding the knowledge base that made possible the twentieth-century revolution in health. Chapter 1 of the report discusses health and development; subsequent chapters address the problems of emerging epidemics and infectious diseases and of maternal and child disability and mortality; health systems development; and the challenges of rolling back malaria and combating the tobacco epidemic. Chapter 1 consists of two parts: the first documents the twentieth-century revolution in human health, the second discusses the inadequately explored problem of the relationship between health and economic productivity. This second section of Chapter 1 is reproduced below in full, with the permission of WHO. (The endnotes were renumbered.)     

Malaria in Pacific populations: seen but not heard?

Most Pacific Island countries are located in the tropics, where there is an abundance of mosquitoes with the potential to carry debilitating or life-threatening vector-borne diseases. This article examines three Melanesian countries in which malaria is endemic—Papua New Guinea, Solomon Islands and Vanuatu—but the threat posed by the spread of malaria gives the issues a broader significance to the Pacific region. After discussing the spatial distribution and prevalence of malaria in the Pacific, the article examines a number of health interventions through which people have sought to control malaria. Although the disease was nearly eradicated in the Pacific in the 1970s, it is no longer in retreat. The article concludes by examining why there are still grounds for cautious optimism, and the challenges that Pacific Island countries face in reducing the impact of malaria on their populations. There is a need for prompt and concerted action on malaria at the national, regional and international levels if the public health concerns arising from the disease are to be adequately addressed.     

An exploration of China's mortality decline under Mao: A provincial analysis, 1950–80

Between 1950 and 1980, China experienced the most rapid sustained increase in life expectancy of any population in documented global history. We know of no study that has quantitatively assessed the relative importance of the various explanations proposed for this gain in survival. We have created and analysed a new, province-level panel data set spanning the decades between 1950 and 1980 by combining historical information from China's public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that gains in school enrolment and public health campaigns together are associated with 55–70 per cent of China's dramatic reductions in infant and under-5 mortality during our study period. These results underscore the importance of non-medical determinants of population health, and suggest that, in some circumstances, general education of the population may amplify the effectiveness of public health interventions.

Supplementary material for this article (Babiarz et al. 2014, Suppl.) is available at: http://dx.doi.org/10.1080/00324728.2014.972432     

Mediating Healthy Female Citizenship in the HPV Vaccination Campaigns

Analyzing the HPV awareness and Gardasil® vaccine campaigns for the United States (US), we argue that the campaigns reflect “the new public health” model that positions individuals as neoliberal citizens responsible for managing their health and maximizing public health opportunities. The campaigns, directed primarily at girls and young women and their mothers, also mobilized neoliberal discourses of risk, choice, and self-management alongside postfeminist political rhetoric that values empowerment, freedom, choice, and rights. Postfeminist tropes were co-opted by Merck's marketing imperatives in order to produce girls and young women as an agentic, niche market of health consumers. We then foreground a low-budget counter-narrative alternative media campaign produced by young women and disseminated through YouTube. This campaign demonstrates the role of new media in producing alternative perspectives on agentic female citizenship and disrupts Merck's campaign imperatives.     

A Social and Historical Perspective of the San Francisco Gay Men's Chorus

ABSTRACT

This study sought to understand the various roles music played for gay men who were members of the San Francisco Gay Men's Chorus, the world's first gay men's chorus. Specifically, it answers the following questions: What is the demographic profile of the chorus members? How has the chorus shaped or reflected social issues; how has the chorus shaped or reflected political issues; how has the music evolved over time?; How was the chorus impacted by the HIV/AIDS epidemic? Historical information for this study was gathered through eight interviews of original and long-time choral members as well as the current artistic director. Interviews were conducted in San Francisco at the San Francisco Gay Men's Chorus office, and additional data were derived from programs of previous choral concerts, two questionnaires (Internalized Homophobia Scale and Gay Chorus Questionnaire), and observations of choral rehearsals and concerts. As a follow-up to a previous study documenting the formation of the chorus in 1978–1982, this study historically documents the chorus's evolution from 1983 through 2003, emphasizing the chorus's impact on social and political issues, the musicality of the chorus, and the impact of HIV/AIDS on the chorus.     

Between the look (la mirada) and the Escape (la fuga): the imaging of women in Solanas' La hora de los hornos and Tangos/El exilio de Gardel

This paper revisits the issues raised in debates on the politics of recognition from the point of view of media practitioners and their experiences in covering women's issues and perspectives. It explores the concerns regarding the attempts to improve media coverage of women's issues and perspectives by looking into one particular women's programme, BBC Radio 4's Woman's Hour. The analysis is based primarily on interviews with members of the Woman's Hour's team and complemented by basic information on the presence of different subject areas and speakers in a sample of actual programming. The paper explores the criteria employed by journalists in their day-to-day decisions regarding the issues and approaches appropriate for the specialist women's programme. It discusses interviewees' definitions of Woman's Hour items and the three main factors that influence their selection of issues and the ways to approach them. The first factor concerns the identity of the programme: its issues, voices, and their diversity. The second factor is the listeners or, more broadly, the public and the ways it shapes Woman's Hour. The third factor is the professional and institutional context of the programme. The concluding discussion examines the ways in which Woman's Hour combines or oscillates between recognition and deconstruction of women's/gender identities, producers' interests and the perceived interests of their audiences, and feminist politics and journalistic principles.     

Preposterous Histories

This article explores maternal desire, loss, and control by reading Carolee Schneemann's performance Interior Scroll (1975) through Tracey Emin's photographic print I've Got It All (2000). More specifically, I consider Schneemann's work on the energy of female sexuality and maternal desire through Emin's recurrent visualizations of sexuality and maternal loss. The artists' refusal to disengage with the commodified (dis)pleasures of femininity leads me to consider the differently contextualized handling of these issues in each artwork. I explore the mediation of the body of each artist by positioning Emin's work as a “source” for my reading of Schneemann's performance. Invoking the notion of “preposterous history” (Bal 1999), I argue that the concepts of the “live” and the “mediated” are differently intensified by operating outside of the constraints of chronology. Hence the inter-generational dialogue between these particular female artists, whose work has been produced at different historical moments, is itself generative of thoughts and ideas that are irreducible to the individual works.     

Life Satisfaction and Suicide among High School Adolescents

Relationships between perceived life satisfaction, poor mental health, suicide ideation and suicide behaviors were examined in a statewide sample of 13 to 18 year old public high school students (n = 4,758) using the self-report CDC Youth Risk Behavior Survey (YRBS). Adjusted logistic regression analyses and multivariate models constructed separately (via SUDAAN), revealed that poor mental health (past 30 days), poor mental/physical health (past 30 days) serious suicide consideration (past 12 months), planning for suicide (past 12 months), attempted suicide (past 12 months) and suicide attempt requiring medical care (past 12 months) were significantly related to reduced life satisfaction. Also, differences across gender and race were demonstrated. Measures of life satisfaction as a component of comprehensive assessments of adolescent mental health, suicide ideation and suicide behavior in fieldwork, research, and program-evaluation efforts should be considered.     

The United Nations on the Implementation of the Cairo Program of Action

Progress and challenges in implementing strategies on population and development were the focus of a Special Session of the United Nations General Assembly that met at UN headquarters in New York, 30 June-2 July 1999. Participating at the Assembly were representatives of nearly 180 governments, with some 150 of these, and a number of observers and nongovernmental organizations, making statements. The delegates reviewed and appraised the implementation of the Program of Action adopted at the International Conference on Population and Development held at Cairo in 1994. The main topics discussed concerned women's rights, reproductive health issues, and abortion. The Assembly's work culminated in the adoption of a 106-paragraph statement titled Key actions…, formally issued as United Nations Document A/S-21/5. The document is reprinted below in full. It affirms the comprehensive approach to population and development issues articulated at the Cairo conference and identifies needs for further action. Also reproduced below is the address delivered at the Special Session by Kofi Annan, Secretary-General of the United Nations. According to a popular lapidary characterization of the program adopted at the 1994 conference, that program concluded that “population is not about numbers.” Thus the Secretary-General's address is particularly notable for a clear affirmation of the importance of the quantitative dimension of the population issue. “[W]e have to stabilize the population of this planet. Quite simply, there is a limit to the pressures our global environment can stand.”     

BOOK REVIEWS

Research has found negative stereotyping and differential treatment both of women and of the elderly in everyday interactions and in mass media representations. An underresearched cateeorv is middle-aged women. This research included a content L a analysis of 12 issues of a Canadian English-language women's magazine and a comparison of the results with selected characteristics of women 40 to 59 years of age as reported by Statistics Canada. The investigation found that younger middle-aged women (under 50 years) are included, but are underrepresented when compared to the population and to the magazine's readers. Middle-aged women are absent from the covers and the fashion and beauty sections; they are underrepresented in the advertisements, overrepresented in the fiction, portrayed positively but realistically in the editorials, and are shown as winners in a world of challenges in articles on health, family, work, and public life. In general the middle-aged women are white, middle class, heterosexual, well-educated, and employed. Messages about women's aging as portrayed in Chatelaine are interpreted especially in the light on feminist theory.     

Factors that may influence midwives work-related stress and burnout

Research questionTo determine the incidence and level of work-related stress and burnout in midwives and contributing and protective demographic factors that may influence those levels.Participants and methodAll registered midwives (152) working in two public hospital maternity units within the same health service district in NSW completed the Maslach Burnout Inventory Human Services Survey and a demographic survey including care model, shift work, lifestyle data and exercise level.FindingsThere was a response rate of 36.8% with 56 (56/152) midwives completing the surveys. Almost two thirds (60.7%) of midwives in this sample experienced moderate to high levels of emotional exhaustion, a third (30.3%) scoring low personal accomplishment and a third (30.3%) experiencing depersonalization related to burnout. Significant differences were found among groups of midwives according to years in the profession, shifts worked, how many women with multiple psychosocial issues were included in the midwife's workload and the midwife's uptake of physical exercise. Those midwives who had spent longer in the profession and exercised scored low burnout levels.ConclusionThe impact of years in the profession, shifts worked, how many women with multiple psychosocial issues were included in their workload and the midwife's level of exercise significantly affected how these midwives dealt with burnout and provided care for women. As the response rate was low, and the study cannot be generalised to the entire midwifery workforce but provides important insights for further research. Understanding factors related to burnout can benefit health care institutions financially and in terms of human costs, especially in view of consistent international shortages of midwives.     

The President of Russia on Population

Russian president Vladimir Putin's 2005 annual address to the Federal Assembly of the Russian Federation, delivered on 25 April, was widely noted in the world press for the startling statement that “the collapse of the Soviet Union was a major geopolitical disaster of the century.” The address also contained a brief passage discussing the demographic problems of Russia. This passage, touching upon the issues of high mortality and the low birth rate, and commenting on drug abuse and alcoholism and on immigration policy, is reproduced below. The president expressed confidence that by creating conditions to “encourage people to have children, lower the mortality rate and bring order to immigration,” the size of the Russian population will gradually stabilize. (The United Nations medium population projection for Russia, which assumes gradual improvement of fertility and mortality, reaching a TFR of 1.85 and an expectation of life of 72 years by the 2040s, as well as net immigration exceeding 2 million persons, foresees a decline from the current 143 million to 112 million by 2050.) The full English text of the address can be accessed at http://president.kremlin.ru/eng/ .     

Women's perspective of maternity care in Cambodia

BackgroundConsideration of the needs of pregnant women and their ability and willingness to attend maternal services and pay for them is central to the provision of accessible and acceptable maternal care. Women's satisfaction with maternal services is poorly understood in many developing countries, including Cambodia in South East Asia. The objective of this study was to investigate women's perceptions and experiences of private and public skilled birth attendants, including midwives, during childbirth in Cambodia.MethodsA qualitative design using a naturalistic inquiry approach was undertaken to seek sensitive personal issue. Thirty individual in-depth interviews were conducted with women who had recently given birth at private and public health facilities in one province in Cambodia. Data were analysed using a thematic approach.FindingsWomen's choice of health facility was influenced by their perceptions of safety and staff attitudes. Reported barriers to the effective utilisation of public maternity services were costs associated with the birth, staff attitudes and a lack of supportive care during labour and in the postpartum period. Although private health care is more expensive than public health care, some women reported a preference for private birth attendants as they perceived them to provide safer and more supportive care in labour.ConclusionWomen expect, but do not always receive humane, professional, supportive and respectful treatment from public skilled birth attendants. While the removal of unexpected costs and geographical barriers are important to increasing public maternity care and service utilisation, improvements in maternity services should focus on addressing provider attitudes and enhancing communication skills during labour, birth and the immediate postpartum period.     

The Council of Economic Advisers on Work and Retirement Among the Elderly

The 1999 Annual Report of the US council of Economic Advisers (a document of some 450 pages, formally an Annex to the Economic Report of the President Transmitted to the Congress February 1999, Washington, DC: US Government Printing Office) addresses some of the questions an aging population raises for the American economy. (Aspects of this topic were also discussed in earlier Council reports; see the Documents section of the March 1996 and June 1997 issues of PDR.) Chapter 4 of the 1999 report is titled “Work, Retirement, and the Economic Well-Being of the Elderly.” The excerpts from this chapter reproduced below provide a summary of the expected future changes in the age distribution of the US population—a result of improving life expectancy and low fertility—and the concomitant marked changes that will characterize the racial and ethnic composition of the elderly. The report notes recent declines in the rate of disability among persons aged 65 and older and discusses changing patterns of retirement and their causes. Despite long-term improvements in health and longevity, the retirement age has fallen rather than risen during the twentieth century. The report suggests, however, that this trend has now run its course, as influenced by the increasing dominance of physically less demanding service-sector jobs, more flexible work schedules (including availability of part-time employment), and changes in persion arrangements.     

Social indicators in statewide Mental Health planning: Lessons from California

The 1963 Community Mental Health Centers Act stimulated state government interest in assessing local needs for mental health services. In 1973 California began using 22 social indicators to calculate a county-by-county mental health service Need Index used in a formula for distributing incremental mental health funds. California's Need Index is misleading in that 99 percent of its variance across counties is explained by counties' population sizes alone. Stepwise multiple linear regression shows that 99 percent of the residual one percent of the variance in Need Index is explained by a mere five of the 22 social indicators. California's Need Index does not, therefore, represent adequately the factors influencing the need for public mental health funds. Methods for overcoming the defects in Need Index are suggested. Caveats and contextual analyses to guide social-indicator-based allocation of mental health funds are discussed.     

Issue-Relevant Values and Opinions About Gay Rights: Beyond Equality and Morality

Although many studies have examined the role of values in shaping public opinion, the number of values that inform this research is limited. This article employs the concept of issue-relevant values as a means to explore the broader range of values associated with policy issues. After discussing the concept in general terms, the article explores issue-relevant values pertinent to public opinion about gay rights. Using the policy examples of employment nondiscrimination and same-sex couple adoption, the present study identifies, measures, and assesses several values that add to the very short list previously used to explain public opinion about gay rights issues. Content from interest-group Web sites and news media coverage of the two issues aided in identifying the values. Data from an original Internet survey yield valid measures of the values. Multivariate analyses indicate that the values behave in predictable ways: they are strongly influenced by partisanship, and they strongly affect opinions about the two issues. The performance of the values is consistent with findings from previous research on the partisan basis of values and the value-based nature of opinions. The article concludes with suggestions for further empirical and theoretical work that could apply and extend the concept of issue-relevant values.     

我国出生性别比空间特征与影响因素分析

本文利用空间统计学方法对五普和六普出生性别比的时空演变与影响因素进行了分析。结果发现：十年中我国出生性别比的空间集聚特征更加明显;计生政策、公共卫生水平、经济因素对性别偏好的影响显著,城镇化水平的影响不显著,教育、公共服务水平对性别比的影响有待深入研究。     

The elimination of contraceptive acceptor targets and the evolution of population policy in India

In 1996 the government of India announced a new national population policy that eliminated numerical targets for new contraceptive acceptors. This paper examines the history of target setting in India and factors that led to the elimination of targets. The analysis is based on published and unpublished reports on India's population policy and the family planning programme and interviews with senior Indian and foreign officials and population specialists. Five factors are identified as playing a role in the evolution from target setting to a target-free policy: (1) the research of India's academics; (2) the work of women's health advocates; (3) the support of officials in the state bureaucracy who approved the target-free approach; (4) the influence of the donors to India's family planning programme, especially the World Bank; and (5) the International Conference on Population and Development.