An analysis of the deep social structure preventing the development of a national policy for children and families in the United States

The United States is one of the few economically developed nations without a national policy supporting children and their families. This paper suggests that the United States has a unique national ideology, based on the “Calvinistic Ethic,” which results in opposition to not only social programs for children and families, but to all government supported welfare programs. Such an ethic is not found in European countries. Finally, since the United States does not have a national family policy, millions of children and their families go without health care, lack social services, and suffer from inadequate economic supports.     

山西省卫Ⅳ项目地区农民因病致贫研究

目的 研究项目地区农民因病致贫严重程度及预防措施。方法 利用扩展线性支出系统界定贫困标准，观察因病致贫率并研究因病致贫人群特点。结果 农民因病致贫率3．44％，因病致贫人群收入低，健康状况差，馒性病患病率高。2周就诊和年住院率高，年家庭医疗费用支出远高于对照人群。结论 通过住院医疗保险和慢性病防治措施缓解农民因病致贫。     

Ageing and comorbidity among low-income psychiatric outpatients

The objective of this study was to determine if non-psychiatric morbidity increases with age in a group of low-income psychiatric outpatients. Data on demographics, presenting complaints, DSM-III diagnoses and use of psychiatric services were collected on all individuals (N = 382) admitted to a psychiatric outpatient clinic serving low-income population. Non-psychiatric morbidity was identified on the basis of medical history, physical examination, and laboratory investigations. Bivariate analyses were done to determine the significance of the associations of comorbidity with other variables. A logistic regression was done using the presence or absence of comorbidity as the dependent variable. Age was the only variable which was significantly predictive of comorbidity. Additional resources should be allocated for the diagnosis and treatment of comorbidity among low-income elderly.     

Making poverty a practice issue

Trends in poverty and changes in service provision are combining to make the promotion of health in poverty a particular challenge to health and welfare practitioners. The evidence suggests that practitioner groups have failed to respond adequately to this challenge. Factors concerned with professional perceptions of poverty, the nature of qualifying and post-qualifying education and the difficulties associated with taking research into practice all appear, in some way, to contribute to practitioners’ failure to incorporate a poverty perspective in their work. A team training approach appears to offer one way forward in the practice-setting. Using a team training approach, the‘Health Promotion in Poverty Project’ has sought to enable the lessons learnt from the broad base of poverty theory and research to be used by practitioners to build responsive and integrated support strategies for low-income families with dependent children.     

Rising Ethnic Inequalities in Acute Rheumatic Fever and Rheumatic Heart Disease,New Zealand, 2000–2018

We describe trends in acute rheumatic fever (ARF), rheumatic heart disease (RHD), and RHD deaths among population groups in New Zealand. We analyzed initial primary ARF and RHD hospitalizations during 2000–2018 and RHD mortality rates during 2000–2016. We found elevated rates of initial ARF hospitalizations for persons of Māori (adjusted rate ratio [aRR] 11.8, 95% CI 10.0–14.0) and Pacific Islander (aRR 23.6, 95% CI 19.9–27.9) ethnicity compared with persons of European/other ethnicity. We also noted higher rates of initial RHD hospitalization for Māori (aRR 3.2, 95% CI 2.9–3.5) and Pacific Islander (aRR 4.6, 95% CI 4.2–5.1) groups and RHD deaths among these groups (Māori aRR 12.3, 95% CI 10.3–14.6, and Pacific Islanders aRR 11.2, 95% CI 9.1–13.8). Rates also were higher in socioeconomically disadvantaged neighborhoods. To curb high rates of ARF and RHD, New Zealand must address increasing social and ethnic inequalities.     

Complexity of Family Life Among the Low‐Income and Working Poor: Introduction to the Special Issue

Like all families, low‐income and working‐poor families need economic stability, safety, good health, and engagement in the larger community. However, the complexity of their lives is greatly impacted by limited economic resources. Three primary themes are explored by the 12 articles in this special issue: competing stressors and tensions, effective parenting, and economic stability and financial decision making. Key findings and program and policy implications identified by each set of authors are discussed. This body of work provides research‐based practice and policy suggestions to guide future efforts in partnering with families to strengthen their families and communities for successful enhancement of child well‐being.     

新型农村合作医疗试点县农民疾病经济风险分析

目的明确农民疾病经济风险的水平和新型农村合作医疗抗风险的重点。方法利用2005年入户调查资料对疾病家庭总体疾病经济风险和特定人群疾病风险进行测量分析。结果医疗费用支付不平衡;贫困人群较易进入“因病致贫,因贫致病”的恶性循环;非劳动年龄人口住院经济风险比劳动年龄人口大。结论在新型农村合作医疗的方案设计中对不同人群设计不同的补偿比,合理配置卫生服务资源。     

中药材产业扶贫现状经验探讨及可持续发展建议

中药材产业扶贫是《中共中央国务院关于打赢脱贫攻坚三年行动的指导意见》中提出的重要扶贫举措。通过梳理各地中药材产业扶贫政策及现状、总结主要扶贫模式,发现政府及相关部门在脱贫攻坚战中起到至关重要的引领作用、产业扶贫成功案例起到示范带动作用、科技支撑为脱贫攻坚保驾护航;同时也应看到,中药材产业扶贫还存在中药材种植规模迅速扩大、风险来源多、脱贫的可持续性有待加强等突出问题;建议在脱贫攻坚的关键时期,要更加注重贫困地区中药材产业的科学规划和全面布局、规范药材种植、提升药材品质、推动产业融合发展、加强科技和人才扶持,增强中药材产业扶贫的可持续性。     

贫困农村地区0~3岁留守儿童心理行为发育影响因素研究

目的 分析农村0~3岁留守儿童心理行为发育异常的影响因素,为促进儿童早期发展提供基础依据。方法 利用2016年原国家卫生计生委“贫困地区农村留守儿童健康教育项目”定量调查数据中3岁以下儿童信息进行分析,调查了全国12个省27个贫困县3 249例0~3岁留守儿童样本。儿童心理行为发育的测量采用“儿童心理行为发育预警征象筛查问卷”,影响因素通过自编的调查问卷获得。结果 农村留守儿童整体可疑心理行为发育异常检出率为9.48%,其中男生(10.94%)显著高于女生(7.75%),0~18个月儿童(12.20%)显著高于19~36个月儿童(8.1%);留守儿童家庭存在看护人年龄偏大、学历普遍偏低的情况,亲子分离情况仍十分严峻;Logistic 回归分析显示,亲子互动良好(OR=0.604,95%CI:0.417~0.876,P=0.008),与兄弟姐妹一起生活(OR=0.664,95%CI:0.473~0.932,P=0.018),较高的家庭经济水平(OR=0.609,95%CI:0.414~0.897,P=0.012)和每日互动时间＞30 min(OR=0.467,95%CI:0.230~0.948,P=0.035)是儿童心理行为发育的保护因素。从未母乳喂养(OR=2.071,95%CI:1.334~3.216,P=0.001)、纯母乳喂养时间＞8个月(OR=1.793,95%CI:1.089~2.952,P=0.022)、存在照顾不周现象(OR=1.833,95%CI:1.047~3.211,P=0.034)是儿童心理行为发育的危险因素。结论 农村0~3岁留守儿童在养育环境上存在劣势,影响心理行为发育因素较多,应针对性加大关注和干预力度