Health Benefits of Urban Agriculture

Health professionals increasingly recognize the value of farm-and garden-scale urban agriculture. Growing food and non-food crops in and near cities contributes to healthy communities by engaging residents in work and recreation that improves individual and public well-being. This article outlines the benefits of urban agriculture with regard to nutrition, food security, exercise, mental health, and social and physical urban environments. Potential risks are reviewed. Practical recommendations for health professionals to increase the positive benefits of urban agriculture are provided

Purchasing Organic Food in U.S. Food Systems: A Study of Attitudes and Practice

Consumers' preference for organic foods in the context of food aspects considered important in a consumption decision and socioeconomic variables has been examined in this study. The results indicate that food aspects related to naturalness, vegetarian-vegan and production location were critical enhancing regularity of organic food purchases. While the familiarity food aspect was viewed as a 'no' issue as far as organic food purchases are concerned. Results further indicate that females and young people buy organics on a regular basis. In terms of political affiliation and church attendance, the liberals and those who at least visit places worship once a month will also regularly buy organics.Consumer/Household Economics,

Gender, Nutrition, and the Human Right to Adequate Food: Toward an Inclusive Framework

The food crisis of 2008 was not an isolated incident or unique event from which the world economy and food security has re-stabilized. Rather, as Valente and Suárez Franco (2010, 455) state, [the 2008 food crisis] is not new for more than 840 million people who have constantly been subjected to hunger over the last thirty years, millions of whom died of malnutrition and associated diseases, or had their quality of life severely affected by the consequences of malnutrition. Although estimates of food insecurity differ, the geography and socio-demographic profile of the food insecure remains unaltered (FAO, WFP, IFAD 2012; HRC 2011, para. 6). Among the most food insecure population groups are food producing peasants, including small-scale and family farm holders, landless farmers surviving as tenants or agricultural workers, hunters and gatherers, pastoralists and fisherfolk, more particularly those living in higher risk environments and remote areas, as well as non-farm rural households, and the urban poor (HRC 2014, para.44; Scherr 2003, 15). Within these, women and girls face violations of their right to adequate food and nutrition at a 60:40 ratio relative to men and boys (UN ECOSOC 2007) and comprise 70 percent of the poor (HRC 2012; World Bank, FAO, IFAD 2009). Obviously, not all women everywhere are hungry and gender does not connote the last or worst basis for discrimination but is further complicated by differences of age, social status, sexuality, and dis/ability, among others. Nevertheless, available data reveal that the structural power inequalities reflected in food and nutrition insecurity according to different status of livelihood, rural-urban location, nation, ethnicity, race, and class are consistently compounded by and manifested within gender discrimination.https://scholarworks.uvm.edu/fss2015/1012/thumbnail.jp

Violence as an Under-Recognized Barrier to Women’s Realization of Their Right to Adequate Food and Nutrition: Case Studies From Georgia and South Africa

This article addresses under-acknowledged barriers of structural violence and discrimination that interfere with women’s capacity to realize their human rights generally, and their right to adequate food and nutrition in particular. Case studies from Georgia and South Africa illustrate the need for a human rights–based approach to food and nutrition security that prioritizes non-discrimination, public participation, and self-determination. These principles are frustrated by different types of structural violence that, if not seriously addressed, pose multiple barriers to women’s economic, public, and social engagement. </jats:p

Sustainable livelihood approaches for exploring smallholder agricultural programmes targeted at women - examples from South Africa

Smallholder farming can play a crucial role in contributing to food supplies and autonomy at the household and community level in rural areas, yet this has been challenging to evaluate. In South Africa, smallholder agriculture faces multiple challenges due to historical injustices regarding access to land and resources and to post-apartheid policies that failed to promote rural development. Drawing on the Sustainable Livelihoods Framework and employing a mixed methods approach, we explore through participant observation and interviews the prospects of smallholder agricultural programs for establishing sustainable livelihoods, facilitated by civil society organizations and targeted at rural black and colored South African women. Participation in these programs enabled women access to various livelihoods assets: education and capacity-building (human assets); land (natural assets); tools and infrastructure (physical assets); stipends and income from selling their produce (financial assets); and networking (social assets). Operational challenges included divergent expectations on the side of project facilitators and participants; lack of communication; participant dependency on the organizations; lack of access to markets; and programs' lack of financial sustainability. Our findings suggest that, while these programs are not yet sustainable, they stimulate an awareness of possibilities, visions, ownership, and rights that can have a long-term effect on the livelihoods of these women. In evaluating program success, especially in the initiation phases, it must be remembered that structural barriers to the improvement of rural women's livelihoods are formidable, and few South African models or alternatives are presently available to help civil society organizations formulate new opportunities

A retrospective analysis of health systems in Denmark and Kaiser Permanente

<p>Abstract</p> <p>Background</p> <p>To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy.</p> <p>Methods</p> <p>Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase comparability.</p> <p>Results</p> <p>A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100,000 individuals. KP physicians are salaried employees; in contrast, DHS primary care physicians own and run their practices, remunerated by a mixture of capitation and fee-for-service payments, while most specialists are employed at largely public hospitals. Hospitalisation rates and lengths of stay (LOS) were lower in KP, with mean acute admission LOS of 3.9 days versus 6.0 days in the DHS, and, for stroke admissions, 4.2 days versus 23 days. Screening rates also differed: 93% of KP members with diabetes received retinal screening; only 46% of patients in the DHS with diabetes did. Per capita operating expenditures were PPP$1,951 (KP) and PPP$1,845 (DHS).</p> <p>Conclusion</p> <p>Compared to the DHS, KP had a population with more documented disease and higher operating costs, while employing fewer physicians and resources like hospital beds. Observed quality measures also appear higher in KP. However, simple comparisons between health care systems may have limited value without detailed information on mechanisms underlying differences or identifying translatable care improvement strategies. We suggest items for more in-depth analyses that could improve the interpretability of findings and help identify lessons that can be transferred.</p

Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System

BACKGROUND: Self-management support is considered to be an essential part of diabetes care. However, the implementation of self-management support within healthcare settings has appeared to be challenging and there is increased interest in “real world” best practice examples to guide policy efforts. In order to explore how different approaches to diabetes care and differences in management structure influence the provision of SMS we selected two healthcare systems that have shown to be comparable in terms of budget, benefits and entitlements. We compared the extent of SMS provided and the self-management behaviors of people living with diabetes in Kaiser Permanente (KP) and the Danish Healthcare System (DHS). METHODS: Self-administered questionnaires were used to collect data from a random sample of 2,536 individuals with DM from KP and the DHS in 2006–2007 to compare the level of SMS provided in the two systems and identify disparities associated with educational attainment. The response rates were 75 % in the DHS and 56 % in KP. After adjusting for gender, age, educational level, and HbA1c level, multiple linear regression analyses determined the level of SMS provided and identified disparities associated with educational attainment. RESULTS: Receipt of SMS varied substantially between the two systems. More people with diabetes in KP reported receiving all types of SMS and use of SMS tools compared to the DHS (p < .0001). Less than half of all respondents reported taking diabetes medication as prescribed and following national guidelines for exercise. CONCLUSIONS: Despite better SMS support in KP compared to the DHS, self-management remains an under-supported area of care for people receiving care for diabetes in the two health systems. Our study thereby suggests opportunity for improvements especially within the Danish healthcare system and systems adopting similar SMS support strategies

Modeling the impact of inclusion of family planning services in Ghana\u27s National Health Insurance scheme

While access to and uptake of modern family planning (FP) in Ghana has steadily risen over the last decade, the modern Contraceptive Prevalence Rate (mCPR) among all women reached only 22% in 2019 with 30% of women still reporting unmet need. To increase FP uptake via mitigation of cost barriers among women with unmet need, the Government of Ghana is seeking to integrate claims-based FP services into the National Health Insurance Scheme benefits package. The impact of these activities has the potential to be significant with the proportion of women accessing modern FP shifting dramatically to public facilities over the past decade. The Ghana Ministry of Health, the National Health Insurance Authority, Marie Stopes International Ghana, and the Population Council launched a pilot in nine districts from 2018–20. This report uses data from pilot activity to model four scenarios involving implementation of cost removal, demand generation, and long-acting reversible contraceptives training to estimate impact on mCPR. These are input into the Health Policy Project’s ImpactNow tool to obtain estimates of health and economic benefits, intended to inform decisions regarding scale-up of these activities across the country