Demographic characteristics and primary health care utilization patterns of strictly orthodox Jewish and non-Jewish patients.
BACKGROUND: The importance of providing health care services that are acceptable to different cultural groups is widely acknowledged. Strictly orthodox Jewish communities have particular health care needs that reflect their religious teaching and beliefs. OBJECTIVE: To describe the demographic characteristics and health care usage patterns of the strictly orthodox Jewish population of Gateshead. METHODS: Registration and claims data were used in combination with encounter data from computerized and manual practice records. Jewish patients were identified and comparisons made between Jewish and non-Jewish populations registered at the same practices. RESULTS: The orthodox Jewish population was predominantly young (69% aged under 20). The birth rate in orthodox Jewish women aged 20-44 was much higher (294 per 1000) than non-Jewish women. Rates of uptake of cervical screening and childhood immunizations were significantly lower in the orthodox Jewish population. Uptake of breast screening and attendance at diabetic clinics did not differ significantly. The average number of consultations and home visits per annum was higher in Jewish than in non-Jewish patients. CONCLUSIONS: The demographic and health care utilization patterns of orthodox Jewish and non-Jewish patients in Gateshead are different. There are implications for the provision of primary care services, particularly with regard to preventative health care. (+info)
Does reported health promotion activity neglect people with ill-health?
Considering health as an alternative to ill-health ignores the multidimensionality of both concepts and invites neglect of health promotion as a multidimensional activity in persons with known ill-health. Drawing on the Ottawa Charter and Maori perspectives of health, we interpret (ill) health according to people's ability to function in their environment by developing physical, psychological, social and spiritual resources for living. We use this framework to test empirically our hypothesis that although the concept of health promotion has always included people with ill-health, the practice of health promotion has continued to neglect them. Our exploratory review of articles published during 1989-99 and indexed on three electronic databases suggests widespread omission of people with ill-health from research on interventions for health promotion. Of 881 citations, approximately three-quarters included people without ill-health in any dimension. This finding could reflect a failure to include these people in health promotion, to describe activity to improve their health as health promotion, or both. Supporting the latter interpretation is uncertainty over the meaning of health, and the targeting of health promotion at groups at high risk of ill-health and 'all' persons. We need therefore to enable health promotion activity to include ill people explicitly. (+info)
The provision of modern medical services to a nomadic population: a review of medical services to the Bedouins of southern Sinai during Israeli rule 1967-1982.
Southern Sinai, a mountainous desolated arid area, is inhabited by Bedouin nomad tribes composed of Arabic-speaking Moslems. Until the Six Day War between Egypt and Israel in 1967, healthcare services in the region were based on traditional medicine performed by the Darvish, a local healer. Over the course of Israeli rule (1967-1982) an elaborate healthcare service was established and maintained, providing modern, up to date, comprehensive medical services that were available to all free of charge. (+info)
Tribal Self-Governance Amendments of 2000. Final rule.
The Secretary of the Department of Health and Human Services (DHHS) hereby issues this final rule to implement Title V of the Tribal Self-Governance Amendments of 2000 (the Act). The final rule has been negotiated among representatives of Self-Governance and non-Self- Governance Tribes and the DHHS. The final rule includes provisions governing how DHHS/Indian Health Service (IHS) carries out its responsibility to Indian Tribes under the Act and how Indian Tribes carry out their responsibilities under the Act. As required by section 517 (b) of the Act, the Department has developed this final rule with active Tribal participation of Indian Tribes, inter-Tribal consortia, Tribal organizations and individual Tribal members, using the guidance of the Negotiated Rulemaking Act. (+info)
An innovative path to improving cancer care in Indian country.
The Native American Cancer Survivors' Support Network is an innovative public health program designed to improve survival from cancer and the quality of life after a cancer diagnosis for American Indians, Alaska Natives, and Canadian Aboriginal patients and their loved ones. The Network, initiated in 1999, now has more than 300 survivors enrolled as members. This article briefly describes the process that led to its formation and preliminary findings, primarily for breast cancer survivors, of ongoing qualitative and quantitative research. Network data show patterns of cancer care that are partially responsible for poor survivorship outcomes. (+info)
Outreach and improved access to specialist services for indigenous people in remote Australia: the requirements for sustainability.
STUDY OBJECTIVE: To examine the role of specialist outreach in supporting primary health care and overcoming the barriers to health care faced by the indigenous population in remote areas of Australia, and to examine issues affecting its sustainability. DESIGN: A process evaluation of a specialist outreach service, using health service utilisation data and interviews with health professionals and patients. SETTING: The Top End of Australia's Northern Territory, where Darwin is the capital city and the major base for hospital and specialist services. In the rural and remote areas outside Darwin there are many small, predominantly indigenous communities, which are greatly disadvantaged by a severe burden of disease and limited access to medical care. PARTICIPANTS: Seventeen remote health practitioners, five specialists undertaking outreach, five regional health administrators, and three patients from remote communities. MAIN RESULTS: The barriers faced by many remote indigenous people in accessing specialist and hospital care are substantial. Outreach delivery of specialist services has overcome some of the barriers relating to distance, communication, and cultural inappropriateness of services and has enabled an over fourfold increase in the number of consultations with people from remote communities. Key issues affecting sustainability include: an adequate specialist base; an unmet demand from primary care; integration with, accountability to and capacity building for a multidisciplinary framework centred in primary care; good communication; visits that are regular and predictable; funding and coordination that recognises responsibilities to both hospitals and the primary care sector; and regular evaluation. CONCLUSIONS: In a setting where there is a disadvantaged population with inadequate access to medical care, specialist outreach from a regional centre can provide a more equitable means of service delivery than hospital based services alone. A sustainable outreach service that is organised appropriately, responsive to local community needs, and has an adequate regional specialist base can effectively integrate with and support primary health care processes. Poorly planned and conducted outreach, however, can draw resources away and detract from primary health care. (+info)
Improving the health of future generations: the Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health.
In the past and in the present, research studies and media reports have focused on pathology and dysfunction in aboriginal communities and have often failed to present a true and complete picture of the aboriginal experience. The Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health is a national strategic research initiative led by both the aboriginal and research communities. This initiative aims to improve aboriginal health information, develop research capacity, better translate research into practice, and inform public health policy with the goal of improving the health of indigenous peoples. (+info)
Perspectives on American Indian health.
American Indians and Alaska Natives continue to experience significant disparities in health status compared with the US general population and now are facing the new challenges of rising rates of chronic diseases. The Indian health system continues to try to meet the federal trust responsibility to provide health care for American Indians and Alaska Natives despite significant shortfalls in funding, resources, and staff. New approaches to these Indian health challenges, including a greater focus on public health, community-based interventions, and tribal management of health programs, provide hope that the health of Indian communities will improve in the near future. (+info)