- Email: [email protected]
End of year report – could do better, much better
Public Health (2008) 122, 1293e1294
www.elsevierhealth.com/journals/pubh
Editorial
End of year report e could do better, much better As we write at the end of an incredibly eventful year, we have to ask: how has it been for public health? Well, the credit crunch and the deepening economic recession have undoubtedly hit many individuals and families very hard. Apart from introducing us all to some names from the US including Freddie Mac and Fanny Mae, the media have focussed on the fall from grace of what they viewed as extravagantly paid bankers, hedge fund managers and derivatives investors; the plight of secretarial staff, kitchen labourers and couriers has received much less attention. Yet it is these low paid workers who are likely to be worst hit by the job losses hitting many commercial and financial sectors. In terms of health inequalities, some levelling down in average family income might help to narrow the overall ‘gap’, but the proportionately greater impact which will affect low income families will have the opposite effect. Mergers and acquisitions amongst massive organisations in the financial sector may save some highly specialised jobs, but these are unlikely to help the ‘little’ man or woman losing his or her manual or semi-skilled job. Nor will it help the nanny, gardener or driver who is e however regretfully e let go as no longer affordable to the young banker’s family. As you read this editorial, you will know the identity of the new US president and his team. However, as we had to write it a few weeks before the election, we have been circumspect and refrained from speculation. That said, we have wondered whether or not we shall have the opportunity to experience the impact of a creationist and champion of gun-ownership as a matter of right, as vice-president. As purveyors of evidence into the determinants of population health, we find this difficult to contemplate or comprehend in the twenty first century. Of course, other
areas of the world have experienced significant political change this year: a new president for Pakistan; tightening of the reins in Russia; changes of leadership in South Africa and Israel. In all of these lands, in amongst what to the rest of the world may appear to be potentially insurmountable political and social challenges, inequalities in health loom large: we hope these leaders heed advice from experts to tackle them. Much of the relevant advice is now accessible to any government following publication in August this year of the report of the WHO Commission on the Social Determinants of Health, chaired by Sir Michael Marmot.1 We welcome the Report and look forward to more progress being made to tackle inequalities in health around the globe. In this issue of Public Health alone e though admittedly this is a particularly bumper issue on which to end the year e there are no less than thirteen papers directly addressing topics concerned with identifying and/or addressing inequalities in health. They include papers on: social factors influencing children to smoke,2 factors influencing acceptance of HPV vaccine3 and hepatitis vaccine,4 trends in TB,5 impact of physical inactivity,6 child nutrition,7 burns,8 diet in pregnancy9 and attendance for maternity care,10 racial health inequities,11 influence of price on smoking behaviour,12 impact of life circumstances on wellbeing,13 and road traffic injuries.14 Having recognised the scale of the challenge and the emerging picture of the potential solutions, we hope our readers will utilise the evidence published here to energise their own public health system to rise to the challenge of tackling inequalities in health. And if anyone remains unconvinced by the ‘rightness’ of tackling health inequalities, we invite them to look no further than a book on evidence based approaches for health and human rights, which is reviewed at the end of this issue.15
0033-3506/$ - see front matter ª 2008 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health. doi:10.1016/j.puhe.2008.10.001
1294
Editorial
Recently, the world witnessed the switching on of the world’s biggest man-made scientific experiment: the Large Hadron Collider (LHC). We wonder when we shall be reading peer-reviewed papers about the beginning of the material universe and the extent to which the findings are compatible with denial of evolutionary theory. At the launch, the contagious excitement of scientists from so many countries was fascinating to observe. One can only hope that their optimism is well-founded and that this project will deliver as much valuable new information about our world as they have anticipated. At the time of writing, the LHC was grounded as a result of a failure in one section of the ring of magnets that direct and accelerate the beam of protons that are deliberately collided to study the physics of sub-atomic particles. It would seem that a small electrical connection failed allowing a major leak of the super-cooled helium that allows the magnets of LHC to operate at levels of very high efficiency. The European Organisation for Nuclear Research (CERN) have suggested that the failure is likely to mean that further work with the LHC will now have to wait until the spring of 2009 after the usual period of planned down-time over winter. However, they are adamant that this is not an insurmountable problem.16 Is it too much to hope that such a can-do attitude spills over into the financial sector and into those responsible for setting policies that address the health consequences of social factors?
4.
5.
6.
7.
8.
9. 10.
11. 12. 13.
14. 15. 16.
References 1. WHO Commission on Social Determinants of health, chair M.Marmot. Geneva: WHO; 2008. 2. Pust S, Mohnen SM, Schneider S. Individual and social environment influences on smoking in children and adolescents. Public Health 2008;122:1324e30. 3. Lenselink CH, Schmeink CE, Melchers WJG, Massuger LFAG, Hendriks JCM, van Hamont D, Bekkers RLM. Young adults
and acceptance of the human papillomavirus vaccine. Public Health 2008;122:1295e301. Sadoh AE, Eregie CO. Age at presentation for infant immunization in Nigeria: Implications for hepatitis B immunization. Public Health 2008;122:1318e20. Crofts JP, Gelb D, Andrews N, Delpech V, Watson JM, Abubakar I. Investigating tuberculosis trends in England. Public Health 2008;122:1302e10. Liu J, Wade T, Faught BE, Hay J. Physical inactivity in Canada: Results from the Canadian Community Health Survey Cycle 2.2 (2004-2005). Public Health 2008;122:1384e6. He Q-Q, Wong TW, Du L, Lin G-Z, Gao Y, Jiang Z-Q, Yu TI, Wu J-G, Lin L, Lin R. Nutrition and children’s respiratory health in Guangzhou, China. Public Health 2008;122: 1425e32. Mashreky SR, Rahman A, Chowdhury SM, Giashuddin S, Svanstro ¨m L, Khan TF, Cox R, Rahman F. Burn injury: economic and social impact on a family. Public Health 2008; 122:1418e24. Elsheikha HM. Safer food for pregnant women: Practices and risks. Public Health 2008;122:1407e9. Rowe RE, Magee H, Quigley MA, Heron P, Askham J, Brocklehurst P. Social and ethnic differences in attendance for antenatal care in England. Public Health 2008;122: 1363e72. Oliver MN. Racial health inequalities in the USA: The role of social class. Public Health 2008;122:1440e2. Franz GA. Price effects on the smoking behaviour of adult age groups. Public Health 2008;122:1343e8. Hansson A, Forsell Y, Hochwalder J, Hillera ˚s P. Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period. Public Health 2008;122:1392e8. Sharma BR. Road traffic injuries: A major global public health crisis. Public Health 2008;122:1399e406. O’Keefe E. Book Review: Public Health & Human Rights: Evidence-Based Approaches. Public Health 2008;122:1456e7. CERN. LHC re-start scheduled for 2009. PR10.08. Available from, http://press.web.cern.ch/press/PressReleases/Releases2008/PR10.08E.html [accessed 24.09.2008].
F. Sim P. Mackie The Royal Society for Public Health, 28 Portland Place, London W1B 1DE, UK E-mail address: [email protected] (F. Sim)
In this issue Readers will notice that this final issue of 2008 is a bigger issue than is usual, with papers from all parts of the world on a wide range of subjects. Papers on communicable disease control include topics from transmission of Salmonella, Clostridium and hepatitis B, to acceptability of the new HPV vaccine. Several papers look at health determinants and inequalities, with a focus on the so-called ‘lifestyle factors’, including child nutrition, physical (in)activity, obesity, and racial inequalities. A paper which at first glance is lighthearted, but has a serious message for those of us in the serious business of communicating about health, looks at the vast amount of jargon used in public health conference presentations. There is certainly scope for reducing the amount of jargon we use: essential if we are serious about sharing the public health agenda with the many partners who are unfamiliar with our technical language.
www.elsevierhealth.com/journals/pubh
Editorial
End of year report e could do better, much better As we write at the end of an incredibly eventful year, we have to ask: how has it been for public health? Well, the credit crunch and the deepening economic recession have undoubtedly hit many individuals and families very hard. Apart from introducing us all to some names from the US including Freddie Mac and Fanny Mae, the media have focussed on the fall from grace of what they viewed as extravagantly paid bankers, hedge fund managers and derivatives investors; the plight of secretarial staff, kitchen labourers and couriers has received much less attention. Yet it is these low paid workers who are likely to be worst hit by the job losses hitting many commercial and financial sectors. In terms of health inequalities, some levelling down in average family income might help to narrow the overall ‘gap’, but the proportionately greater impact which will affect low income families will have the opposite effect. Mergers and acquisitions amongst massive organisations in the financial sector may save some highly specialised jobs, but these are unlikely to help the ‘little’ man or woman losing his or her manual or semi-skilled job. Nor will it help the nanny, gardener or driver who is e however regretfully e let go as no longer affordable to the young banker’s family. As you read this editorial, you will know the identity of the new US president and his team. However, as we had to write it a few weeks before the election, we have been circumspect and refrained from speculation. That said, we have wondered whether or not we shall have the opportunity to experience the impact of a creationist and champion of gun-ownership as a matter of right, as vice-president. As purveyors of evidence into the determinants of population health, we find this difficult to contemplate or comprehend in the twenty first century. Of course, other
areas of the world have experienced significant political change this year: a new president for Pakistan; tightening of the reins in Russia; changes of leadership in South Africa and Israel. In all of these lands, in amongst what to the rest of the world may appear to be potentially insurmountable political and social challenges, inequalities in health loom large: we hope these leaders heed advice from experts to tackle them. Much of the relevant advice is now accessible to any government following publication in August this year of the report of the WHO Commission on the Social Determinants of Health, chaired by Sir Michael Marmot.1 We welcome the Report and look forward to more progress being made to tackle inequalities in health around the globe. In this issue of Public Health alone e though admittedly this is a particularly bumper issue on which to end the year e there are no less than thirteen papers directly addressing topics concerned with identifying and/or addressing inequalities in health. They include papers on: social factors influencing children to smoke,2 factors influencing acceptance of HPV vaccine3 and hepatitis vaccine,4 trends in TB,5 impact of physical inactivity,6 child nutrition,7 burns,8 diet in pregnancy9 and attendance for maternity care,10 racial health inequities,11 influence of price on smoking behaviour,12 impact of life circumstances on wellbeing,13 and road traffic injuries.14 Having recognised the scale of the challenge and the emerging picture of the potential solutions, we hope our readers will utilise the evidence published here to energise their own public health system to rise to the challenge of tackling inequalities in health. And if anyone remains unconvinced by the ‘rightness’ of tackling health inequalities, we invite them to look no further than a book on evidence based approaches for health and human rights, which is reviewed at the end of this issue.15
0033-3506/$ - see front matter ª 2008 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health. doi:10.1016/j.puhe.2008.10.001
1294
Editorial
Recently, the world witnessed the switching on of the world’s biggest man-made scientific experiment: the Large Hadron Collider (LHC). We wonder when we shall be reading peer-reviewed papers about the beginning of the material universe and the extent to which the findings are compatible with denial of evolutionary theory. At the launch, the contagious excitement of scientists from so many countries was fascinating to observe. One can only hope that their optimism is well-founded and that this project will deliver as much valuable new information about our world as they have anticipated. At the time of writing, the LHC was grounded as a result of a failure in one section of the ring of magnets that direct and accelerate the beam of protons that are deliberately collided to study the physics of sub-atomic particles. It would seem that a small electrical connection failed allowing a major leak of the super-cooled helium that allows the magnets of LHC to operate at levels of very high efficiency. The European Organisation for Nuclear Research (CERN) have suggested that the failure is likely to mean that further work with the LHC will now have to wait until the spring of 2009 after the usual period of planned down-time over winter. However, they are adamant that this is not an insurmountable problem.16 Is it too much to hope that such a can-do attitude spills over into the financial sector and into those responsible for setting policies that address the health consequences of social factors?
4.
5.
6.
7.
8.
9. 10.
11. 12. 13.
14. 15. 16.
References 1. WHO Commission on Social Determinants of health, chair M.Marmot. Geneva: WHO; 2008. 2. Pust S, Mohnen SM, Schneider S. Individual and social environment influences on smoking in children and adolescents. Public Health 2008;122:1324e30. 3. Lenselink CH, Schmeink CE, Melchers WJG, Massuger LFAG, Hendriks JCM, van Hamont D, Bekkers RLM. Young adults
and acceptance of the human papillomavirus vaccine. Public Health 2008;122:1295e301. Sadoh AE, Eregie CO. Age at presentation for infant immunization in Nigeria: Implications for hepatitis B immunization. Public Health 2008;122:1318e20. Crofts JP, Gelb D, Andrews N, Delpech V, Watson JM, Abubakar I. Investigating tuberculosis trends in England. Public Health 2008;122:1302e10. Liu J, Wade T, Faught BE, Hay J. Physical inactivity in Canada: Results from the Canadian Community Health Survey Cycle 2.2 (2004-2005). Public Health 2008;122:1384e6. He Q-Q, Wong TW, Du L, Lin G-Z, Gao Y, Jiang Z-Q, Yu TI, Wu J-G, Lin L, Lin R. Nutrition and children’s respiratory health in Guangzhou, China. Public Health 2008;122: 1425e32. Mashreky SR, Rahman A, Chowdhury SM, Giashuddin S, Svanstro ¨m L, Khan TF, Cox R, Rahman F. Burn injury: economic and social impact on a family. Public Health 2008; 122:1418e24. Elsheikha HM. Safer food for pregnant women: Practices and risks. Public Health 2008;122:1407e9. Rowe RE, Magee H, Quigley MA, Heron P, Askham J, Brocklehurst P. Social and ethnic differences in attendance for antenatal care in England. Public Health 2008;122: 1363e72. Oliver MN. Racial health inequalities in the USA: The role of social class. Public Health 2008;122:1440e2. Franz GA. Price effects on the smoking behaviour of adult age groups. Public Health 2008;122:1343e8. Hansson A, Forsell Y, Hochwalder J, Hillera ˚s P. Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period. Public Health 2008;122:1392e8. Sharma BR. Road traffic injuries: A major global public health crisis. Public Health 2008;122:1399e406. O’Keefe E. Book Review: Public Health & Human Rights: Evidence-Based Approaches. Public Health 2008;122:1456e7. CERN. LHC re-start scheduled for 2009. PR10.08. Available from, http://press.web.cern.ch/press/PressReleases/Releases2008/PR10.08E.html [accessed 24.09.2008].
F. Sim P. Mackie The Royal Society for Public Health, 28 Portland Place, London W1B 1DE, UK E-mail address: [email protected] (F. Sim)
In this issue Readers will notice that this final issue of 2008 is a bigger issue than is usual, with papers from all parts of the world on a wide range of subjects. Papers on communicable disease control include topics from transmission of Salmonella, Clostridium and hepatitis B, to acceptability of the new HPV vaccine. Several papers look at health determinants and inequalities, with a focus on the so-called ‘lifestyle factors’, including child nutrition, physical (in)activity, obesity, and racial inequalities. A paper which at first glance is lighthearted, but has a serious message for those of us in the serious business of communicating about health, looks at the vast amount of jargon used in public health conference presentations. There is certainly scope for reducing the amount of jargon we use: essential if we are serious about sharing the public health agenda with the many partners who are unfamiliar with our technical language.