Documents morbidity 64 results

"Lives in Peril demonstrates how and why seafarers are a vulnerable group of workers. It argues they are made so by the organisation and structure of their employment; the prioritisation of profit over safety by the actors that engage and control their labour; the limits of enforcement of the regulatory framework that is in place to protect them; and by their weakness as collective actors in relation to capital. The consequences of this vulnerability are seen in data on their occupationally-related morbidity and mortality - evidence that probably only represents a partial picture of the actual extent of the physical, mental and emotional harm resulting from work at sea. This volume's central argument is that this situation is likely to remain broadly unchanged as long as global maritime governance and regulation remains in thrall to the neo-liberal economic and political arguments that drive globalisation, and fails to enforce regulatory standards more robustly."

"In a cohort of some 11,000 men born 1891-1920 and employed in the Quebec chrysotile production industry, including a small asbestos products factory, of 9780 men who survived into 1936, 8009 are known to have died before 1993, 38 probably from mesothelioma--33 in miners and millers and five in factory workers. Among the 5041 miners and millers at Thetford Mines, there had been 4125 deaths from all causes, including 25 (0.61%) from mesothelioma, a rate of 33.7 per 100,000 subject-years; the corresponding figures for the 4031 men at Asbestos were eight out of 3331 (0.24%, or 13.2 per 100,000 subject-years). At the factory in Asbestos, where all 708 employees were potentially exposed to crocidolite and/or amosite, there were 553 deaths, of which five (0.90%) were due to mesothelioma; the rate of 46.2 per 100,000 subject-years was 3.5 times higher than among the local miners and millers. Six of the 33 cases in miners and millers were in men employed from 2 to 5 years and who might have been exposed to asbestos elsewhere; otherwise, the 22 cases at Thetford were in men employed 20 years or more and the five at Asbestos for at least 30 years. The cases at Thetford were more common in miners than in millers, whereas those at. Asbestos were all in millers. Within Thetford Mines, case-referent analyses showed a substantially increased risk associated with years of employment in a circumscribed group of five mines (Area A), but not in a peripherally distributed group of ten mines (Area B); nor was the risk related to years employed at Asbestos, either at the mine and mill or at the factory. There was no indication that risks were affected by the level of dust exposure. A similar pattern in the prevalence of pleural calcification had been observed at Thetford Mines in the 1970s. These geographical differences, both within the Thetford region and between it and Asbestos, suggest that the explanation is mineralogical. Lung tissue analyses showed that the concentration of tremolite fibres was much higher in Area A than in Area B, a finding compatible with geological knowledge of the region. These findings, probably related to the far greater biopersistence of amphibole fibres than chrysotile, have important implications in the control of asbestos related disease and for wider aspects of fibre toxicology."

"Contrairement à une idée répandue, nous ne sommes pas tous égaux face à la mort. Et nous ne le sommes pas davantage face aux maladies et aux risques sanitaires. Il ne s'agit pas seulement d'une ligne de partage entre les plus pauvres et les autres, mais d'inégalités qui traversent l'ensemble de la société. Il ne s'agit pas non plus avant tout d'accès aux soins. Les inégalités de santé trouvent leur origine dans des domaines extrêmement variés, comme le quartier d'habitation, l'emploi, les conditions de travail, les ressources. Paradoxalement, les "progrès de la médecine" et le développement des démarches de prévention créent également des inégalités.
Les connaissances ont beaucoup progressé dans ces domaines, ce qui permet de dresser pour la France un état des lieux fondé sur des données récentes. Synthétisant les résultats de nombreuses enquêtes, cet ouvrage aborde les multiples facettes du problème. Il montre notamment que les "causes" de ces inégalités sont de mieux en mieux cernées et que cela devrait inciter les responsables politiques et, au delà, l'ensemble de la société à agir en conséquence pour les réduire. En effet, dans de nombreux pays, particulièrement en Europe, une mobilisation importante existe autour de cet enjeu. Le but de cet ouvrage est de le rendre davantage présent dans les débats et les décisions, non seulement dans le secteur de la santé, mais bien au delà, dans tous les secteurs de la société. "

"This excellent policy paper prepared for the Global Commission on Womens Health is an important resource for trade unionists and all those interested in improving working conditions for women and men. It provides comprehensive and reliable information on the workplace hazards experienced by women in all sectors. A number of authors provide papers, including Understanding Occupational Disease in Women Workers, Migration, Workforce and Health, Reproductive Health and Occupational Hazards among Women Workers. "

"Social inequalities in health rarely feature in general books for the lay public. But they are something that vitally affects us all, from cradle to grave. To its great credit, this collective book makes a valuable contribution to a debate that too seldom makes it onto the agenda. In fewer than 300 pages, the authors look at health inequalities in France from three angles. They show them at work throughout life from infancy to old age, painting a compelling picture of their pervasiveness from early deaths from cancer through cardiovascular disease to AIDS, not forgetting mental health. They single out the lack of systematic preventive activity, picking up on the importance of working and employment conditions, often the Cinderellas of public health policies seemingly uncertain of their own legitimacy to intervene in business management.
Looking at the part played by working and employment conditions, the authors refrain from putting the whole emphasis on psychosocial conditions, and instead stress how they interact with the physical factors of production, arguing that the key to a prevention policy lies in work organization. A look at the unequal distribution of domestic duties between men and women, and how they interact with paid work, would have been welcome here.
Three of the many points made by this book are worth picking up on.
Health inequalities are not on the way out in our societies. Access to care alone is not enough without a prevention policy on the collective determinants of health. Throughout the 20th century, the trade union movement rightly fought for social security systems that would provide access to health care. This remains a key aim, but it is not enough. As the introduction states, “social inequalities in health are found as much in the case of illnesses where the healthcare system is effective, as those where it is less so”. Progress in diagnosis or treatment is sometimes seen to do no more than shuffle the inequalities around. Middle-class women have benefited greatly from advances in the early diagnosis of breast cancer, for example, closing the gap with the comparatively lower mortality of working class women for this disease.
Social inequalities in health are not confined to there being a chronically deprived section of the population. Public policies too frequently focus on social exclusion and its health impact. This results in emergency measures to address what are described as exceptional situations. Every winter, emergency services for the homeless are brought into play, when the housing problem demands completely different answers. In reality, health inequalities are present in the population as a whole. Looking from top to bottom of each level in the social hierarchy, a gradual deterioration of most health indicators can be seen. As the authors say, “the health of poorest is only the tip of the iceberg”.
Tackling social inequalities in health is not just a public health concern. The authors emphasise the importance of a critical assessment of policies in a wide range of spheres, be it education, housing or agricultural policy.
The authors show how France has built up data on social inequalities in health across a wide range of areas over the past decade. The knowledge gap with other countries – Britain and the Scandinavian countries in particular, which had a longer tradition of data collection and analysis – has largely been narrowed. Sadly, increased knowledge is no guarantee of a more effective policy. In the final analysis, health inequality always comes down to inequality straight and simple, and the policy responses that are made to it. — Laurent Vogel"

"Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course.Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs.Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31?298/100?000 population in the most affluent fifth of areas to 43?385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was

"Der Versorgungs-Report 2012 setzt sich schwerpunktmäßig mit der Gesundheit im Alter auseinander. Er beleuchtet das Thema aus verschiedenen Perspektiven unter der Leitfrage, welche Schritte bei der Weiterentwicklung einer bedarfsgerechten medizinisch-pflegerischen und präventiven Versorgung gegangen werden sollten. Die Autoren analysieren Versorgungsrealitäten und zeigen auf, wie Reformansätze zu stabilisieren und zu stärken sind. Die medizinischen und ökonomischen Auswirkungen der demografischen Entwicklung werden ebenso diskutiert wie die damit verbundenen Herausforderungen für die Versorgungsstrukturen. Letzteres geschieht sowohl auf der Systemebene als auch anhand konkreter Projekte."