Social justice in the land of Cockaigne.
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, 3000 CA, Rotterdam, The Netherlands.Journal of Epidemiology & Community Health (Impact Factor: 3.39). 02/2008; 62(1):2. DOI:10.1136/jech.2006.057877
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ABSTRACT: This essay reviews some of the sources of idealism in public health, on the basis of an intellectual journey to Kos (home to Hippocrates and his altruistic legacy), Dresden (where the Deutsches Hygiene Museum illustrates the historical connections between fascism and public health), and Utopia (exemplified by Etienne Cabet's Icarie, a fantasy of an ideal city which has nevertheless been partly realized). It is suggested that the large-scale altruism of public health has to be balanced with the value of individual autonomy, and that some degree of dreaming of a better and healthier world is indispensable for further progress in public health. The main conclusion is that the ethical foundations of public health are not always self-evident, and that critical reflection on these foundations was, is, and will always be necessary.European Journal of Epidemiology 02/2005; 20(10):817-26. · 5.12 Impact Factor
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ABSTRACT: Cardiovascular diseases and their nutritional risk factors--including overweight and obesity, elevated blood pressure, and cholesterol--are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies. BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about ID 5,000 (international dollars) and peaked at about ID 12,500 for females and ID 17,000 for males. Cholesterol's point of inflection and peak were at higher income levels than those of BMI (about ID 8,000 and ID 18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI. When considered together with evidence on shifts in income-risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol.PLoS Medicine 06/2005; 2(5):e133. · 15.25 Impact Factor
Article: HISTORY OF PUBLIC HEALTH01/1959;
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