Public health problems of urbanization

Developing countries have been peasant societies. The cities in traditional societies have been pilgrimage centres, seats of administration and educational centres. These cities had homogeneous relationships with the villages. Industrialization has developed modern megacities whose way of life is heterogeneous with that in the villages. Rural poverty has pushed villagers to the cities, which were never planned to accommodate immigrants. Public health and social problems have arisen lowering the quality of life. Communicable diseases among the urban poor coexist with non-communicable diseases among the comparatively affluent. Problems of pollution, crime and chronic morbidity increase. The NGOs provide relief to the poor and needy but do nothing toward creating an infrastructure for balanced development. The election of women as a result of non-discriminatory legislation provides good ground for hope.industrialization urbanization morbidity health care

The Participation Scale: measuring a key concept in public health

Purpose. To develop a scale to measure (social) participation for use in rehabilitation, stigma reduction and social integration programmes.Method. A scale development study was carried out in Nepal, India and Brazil using standard methods. The instrument was to be based on the Participation domains of the International Classification of Functioning, Disability and Health (ICF), be cross-cultural in nature and assess client-perceived participation. Respondents rated their participation in comparison with a ‘peer’, defined as ‘someone similar to the respondent in all respects except for the disease or disability’.Results. An 18-item instrument was developed in seven languages. Crohnbach's a was 0.92, intra-tester stability 0.83 and inter-tester reliability 0.80. Discrimination between controls and clients was good at a Participation Score threshold of 12. Responsiveness after a ‘life change’ was according to expectation.Conclusions. The Participation Scale is reliable and valid to measure client-perceived participation in people affected by leprosy or disability. It is expected to be valid in other (stigmatised) conditions also, but this needs confirmation. The scale allows collection of participation data and impact assessment of interventions to improve social participation. Such data may be compared between clients, interventions and programmes. The scale is suitable for use in institutions, but also at the peripheral level

Methodology in the epidemiological research of respiratory diseases and environmental pollution Metodologia na pesquisa epidemiológica de doenças respiratórias e poluição ambiental

There are complex and diverse methodological problems involved in the clinical and epidemiological study of respiratory diseases and their etiological factors. The association of urban growth, industrialization and environmental deterioration with respiratory diseases makes it necessary to pay more attention to this research area with a multidisciplinary approach. Appropriate study designs and statistical techniques to analyze and improve our understanding of the pathological events and their causes must be implemented to reduce the growing morbidity and mortality through better preventive actions and health programs. The objective of the article is to review the most common methodological problems in this research area and to present the most available statistical tools used.<br>Existem problemas metodológicos diversos e complexos envolvidos no estudo clínico e epidemiológico de doenças respiratórias e seus fatores etiológicos. A associação do crescimento urbano, da industrialização e da deterioração ambiental com as doenças respiratórias torna necessário focalizar a atenção a esse campo de estudo com uma abordagem multidisciplinar. Devem ser implementados modelos de estudo e técnicas estatísticas adequadas para analisar e melhorar o entendimento sobre os eventos patológicos e suas causas e para reduzir a crescente morbimortalidade fazendo uso de medidas preventivas e melhores programas de saúde. O objetivo do artigo é revisar os problemas metodológicos mais comuns nessa área de pesquisa e apresentar os métodos estatísticos usados de maior acesso

A hidden counter-movement? Precarity, politics, and social protection before and beyond the neoliberal era

To grasp what might exist beyond neoliberalism, we need to rethink the history of development before neoliberalism. This article makes two arguments. First, for poorer countries, processes of commodification which are highlighted as evidence of neoliberalism often predate the neoliberal era. Third World development policies tended to make social and economic life more precarious as a corollary to capital accumulation before neoliberalism as an ideology took hold. Second, the intense theoretical and discursive focus on neoliberalism has obscured a tangible shift towards de-commodification in much of the global South. The most salient examples today are state-led social assistance programs that have been implemented across the former Third World. These emerged not out of technocratic fixes from above but often out of political and social struggles from below. The rise and spread of these programs are not only in stark contrast to popular conceptions of a neoliberal reinforcement, but are also specifically targeted at social strata whose precarity commonly originated in developmental policies before the neoliberal era. Utilizing a database of 183 active flagship social assistance programs in 84 developing countries, we present macro-level quantitative evidence of the rise and spread of social protection policies over the past two decades in the global South. We then detail these programs for four middle-income countries—China, Brazil, India, and South Africa. To those who lament that the 2008 crisis has produced no Polanyian double movement, we argue that these state-driven social assistance policies are such a mechanism