Improving breast health education for Hispanic women

Hispanic women are less likely to receive screening mammograms than are white or African American women, even though breast cancer is the leading cause of cancer-related deaths in the population. Between 1990 and 2000, the Hispanic population of Indianapolis, Indiana (Marion County) grew by approximately 300%: from 8450 to 33 290. The present project was undertaken to provide educational outreach in Spanish to the new Hispanic residents of Indianapolis. A bilingual outreach coordinator visited community centers, churches, and health clinics and presented information to Hispanic women and men about a variety of cancers for which Hispanic women are at particularly high risk, including breast and cervical cancer. The number of Hispanic women obtaining mammograms rose by more than 200% during the first 6 months of the program. The authors conclude that culturally appropriate educational outreach presented by a Spanish-speaking woman using a Spanish-language videotape about mammography can improve breast cancer screening in Latinas.     

Women's health: time for a redefinition.

Traditionally, women's health has been defined in mainly biologic terms. The various contexts within which women's health can be considered have been ignored, and many people have been unable to recognize the need for such a clinical entity as "women's health" in the first place. It is time for a change in attitudes and approaches. We need a more inclusive definition of women's health, one that takes into account social, cultural, spiritual, emotional and physical aspects of well-being. Case histories that have recently received media attention and statistics on the impact of poverty and violence on women also show how urgently a redefinition of "women's health" is needed. Regardless of whether "women's health" will always have to be viewed as a separate discipline or whether it can be brought within mainstream medical practice, it is clear that, by altering their perception of women's health and of the problems unique to women, physicians can improve both health care and medical education to the benefit of all members of our society.     

Australian mental health reform: time for real outcomes

After 12 years of national mental health reform, major service gaps and poor experiences of care are common. The mental health community reports little progress in implementing its key priorities, such as expanded early-intervention programs, comanagement of people with mental health problems and related alcohol or substance misuse, and widening of the spectrum of acute care settings. We propose new national targets for reducing the social and economic costs of poor mental health; these include increased access to effective care, reduced suicide rates and improved rates of return to full social and economic participation. We detail specific service reforms designed to maximise the chance of achieving these targets, and prioritise youth health and integrated primary care programs. New independent and national reporting systems on the progress of mental health reform are urgently required.     

Setting goals for health in a time of prosperity:

Millennium development goals for the world's poorest nations need to be matched by health priority goals for prosperous nations, to relieve the burden of wealth-related disease.