Working the system: 3 ways planners can defy the odds to promote good health for all of us (2024-12-06T12:45:00+05:30)

Jennifer L. Kent, University of Sydney, Many of the chronic and costly diseases Australians face are related to how we live in cities. The speed of modern life clashes with poorly designed urban areas. As a result, health-promoting activities, such as regular physical activity, community interaction and the preparation of healthy food, become low priorities. We know better urban planning can encourage healthier behaviours. Providing infrastructure for walking and cycling is a prime example. Yet there are other, often overlooked, ways that urban planners are on the front line when it comes to promoting the health of Australians. In particular, the way cities are planned can reduce inequities in both access to health services and health outcomes. This has important implications for the health of individuals and their communities. Urban planners are well versed in the fundamentals of planning the equitable city. But planners must work within the constraints of our political systems and prevailing approaches to government. Our recent analysis of health and urban planning in Australia identified a few key ways urban planners can “work the system” to promote health equity. Why is equity so important for health? Promoting equity is important for health because there is a social gradient to the differences between people’s health. In general, the higher a person’s socio-economic position, the healthier he or she is. People from poorer social or economic circumstances have higher rates of illness and disability, and live shorter lives. Differences in life expectancies across the nation illustrate this. In 2016, a man born in remote New South Wales had a life expectancy 13 years less than a man born in the affluent suburb of Mosman in Sydney. To promote equity, we need to define what we are seeking to equalise. In this case, it is the distribution of the social determinants of health. These determinants are the conditions in which people are born, grow up, live, work and age. Factors such as income, education, employment, empowerment and social support can strengthen or undermine health and well-being. Our planners have access to the data and the grounded knowledge required to expose gaps in services. For example, a local infrastructure planner can readily identify the communities that lack internet broadband access but need it. A transport planner working for Sydney’s City Rail knows all too well which train service is unreliable, and which train station is routinely missed during the peak because of overcrowding. Planners also have the skills and insights to raise concerns about shortages of residential housing stock, before these trigger the kind of housing affordability crises we have seen recently in Australian cities. The real challenge for planners promoting equity in Australia is the need to work within the constraints of the nation’s dominant political economy. In Australia today, we have a neoliberal system, epitomised by “the subjugation of the public to the private, the state to the market, the social to the economic”, as John Clarke put it. The result of this has been a progressive withdrawal of government involvement in many areas since the latter half of the 20th century. Our recent analysis of health and urban planning in Australia provides several recommendations on how urban planners can work within this system to promote health equity. Play to emotions The first is to harness the power of human health’s emotive appeal. Relative to other planning concerns, such as environmental sustainability, health is an issue that appeals more directly to the individual. By making clear the links between good planning principles and human health, planners can leverage this emotion to promote concepts that might otherwise be ignored in developer-driven agendas. The protection of green open spaces for physical activity and community connection is a good example. By pointing out how important these things are for human health, urban planners can make a compelling and robust case for preserving these spaces. Speak the language of money A second way that planning for health can leverage space in a neoliberal system is to speak the language of the market. In 2016-17, Australia spent A$180.7 billion on health. This spending increases from year to year, outpacing growth in inflation, population or the economy. Most of this funding is dedicated to treating people once they are sick, rather than preventing illness. But prevention would produce large cost-savings. These savings can be captured in decision-making tools such as cost-benefit analysis. Planners are in a powerful position to work with public health professionals to develop a deeper understanding of the health cost savings to be made from better urban planning decisions. Enlist trusted figures Finally, health can be promoted by harnessing the power of the health fraternity. Australian research shows the voice of a well-versed and respected individual can often make the difference when it comes to preserving a piece of open space, funding a cycleway or protecting the use of land for farmers’ markets. Australians hold health professionals in high esteem. Polling company Roy Morgan conducts an Image of Professions Survey, asking Australians to rank 30 professions by characteristics such as ethics and honesty. Medical professionals, such as nurses, doctors, pharmacists and dentists, have consistently featured in the top five. These trusted professionals could be influential voices for healthy built environment agendas. Our cities can and should be places that promote good health for everyone who lives in them. Quite simply, this means the (re)prioritisation of well-being over economic growth. This is a crucial barrier to planning healthy built environments in Australia. Yet it is not insurmountable. Indeed, the key to overcoming it may well be harnessing the power of health as a significant concern for all. The ideas in this article are taken from a new book, Planning Australia’s Healthy Built Environments. Join Jennifer Kent at the Festival of Urbanism in Sydney on September 9 to explore these issues. Jennifer L. Kent, Research Fellow, Urban and Regional Planning, University of Sydney This article is republished from The Conversation under a Creative Commons license. Read the original article.

Four citizen-led campaigns promoting mental health awareness in Africa and India (2024-05-01T10:21:00+05:30)

Aisha Bubah, a Nigerian psychologist, listens attentively to a client during a counseling session. Photo provided by Aisha Bubah, used with permission. By Ebenezar Wikina: On October 10, the international community observed World Mental Health Day to highlight the importance of mental wellness to general wellbeing. The theme of this year’s observance, “Mental health is a universal human right,” aimed to improve knowledge, raise awareness and drive actions that promote and protect everyone’s mental health as a universal human right. According to a 2021 World Health Organization report, one in four people will experience mental or neurological disorders at some point in their lives. The report also showed that around 450 million people currently live with such conditions, making mental disorders among the leading causes of ill health and disability worldwide. Over the past year, four citizen-led digital campaigns have gained momentum in Nigeria, Kenya, South Africa, and India, as they seek to provide mental health care for all citizens. Here are the stories behind the citizens leading them. Aisha Bubah: Mainstreaming mental health in Nigeria’s primary healthcare system: Aisha Bubah, a 31-year-old psychologist from Nigeria's northern region, is a shining example of resilience. Despite the harrowing impact of the Boko Haram terrorist insurgency on her mental health as she has had to witness the impact of the insurgency on her home state, she has emerged stronger and founded the Idimma Initiative to empower and educate her community on the importance of mental wellbeing. Bubah’s campaign is calling on the National Primary Healthcare Development Agency (NPHCDA) to train primary healthcare workers as lay counsellors, set up mental health desks in all primary healthcare centers (PHCs), and build the capacity of medical doctors and nurses in PHCs to provide mental health services. With over 30,000 PHCs in Nigeria, Bubah’s request builds upon the Mental Health Act passed by former President Muhammadu Buhari in January 2023. This Act provides a legal framework for the protection and promotion of mental health in Nigeria, including the provision of mental health services at the primary healthcare level. John Mwangi: Protecting the rights of patients in mental health facilities in Kenya: John Mwangi, based in Nakuru, is a 30-year-old monitoring and evaluation specialist in social development who works with civil society organisations in Kenya. He was treated without dignity when he was admitted as a patient at a mental health facility in Kenya, and this terrible personal experience inspired his campaign to end human rights abuse at mental health institutions. “I was thrown in dark solitary confinement, whipped, sedated, stripped naked, neglected, verbally abused, and locked up in a flea-infested space,” Mwangi told Global Voices in an email interview. He added: If you think I’m referring to how animals are treated, you’re wrong. This is how I, a human being, was treated in the psychiatric ward of a mental health facility where I was admitted. They denied me a bed to sleep on, neither did they inform me of my diagnosis. I was made to feel unworthy of dignity and respect. Ironically, the place I had gone to seek care and healing ended up adding to my trauma.Through a petition, Mwangi is seeking the attention of the cabinet secretary of the Ministry of Health to intervene and ensure sensitization training on patients’ rights for all staff in mental health facilities. Molebogeng Tema: Psychological evaluation in South Africa’s police recruitment: Tema Molebogeng, 24, is currently working as a library assistant and tutor. She is fighting to ensure that the recruitment process of the South African Police Service (SAPS) is reviewed to ensure that police officers are within the correct mental state to carry firearms. Her campaign is calling on the Minister of Police to implement psychological evaluations as part of the SAPS recruitment process. In an email interview with Global Voices, Molebogeng said: Growing up in a community where most of our parents were members of the South African Police Service, I had a first-hand experience of how the power that comes with holding a gun has eventually corrupted officers to hurt. Since the Black Lives Matter movement the issue of “killer cops” has gained wider attention in many African countries including Nigeria and Kenya. Molebogeng’s campaign, when successful, will not only sanitise the police service in South Africa but will also save many lives. Bhavana Srirangam: Mental health support systems for Indian women: Bhavana Srirangam is a 24-year-old psychologist and social worker, living in Telangana, south-central India. Her mother walked out of 27 years of an abusive marriage. “I am taking my self-respect back,” her mother told Global Voices in an interview. For almost three decades, her mother cried for help, and demanded justice from family and the judicial system, but she was always asked to “adjust, because men put food on the table.” According to a report by the Times of India, depression and anxiety in women is twice as common as in men and affects 25 per cent of women. Two-thirds of married women in India experience domestic violence, which makes them more likely to develop mental disorders. Srirangam’s campaign is asking the Women Development & Child Welfare Department in Telangana, to create mental health support systems for women, like her mother, who had the courage to walk out of abusive households. Srirangam believes that mental health support plays a crucial role in rebuilding resilience in women. Although divided by geography, Aisha Bubah, John Mwangi, Tema Molebogeng, and Bhavana Srirangam are bound by their power and commitment as change leaders with Nguvu Collective. Nguvu Collective (“The Power Collective” in Swahili) works with new leaders from marginalised communities to make them stronger both socially and personally, so they can make a big, positive difference in society. Source: https://globalvoices.org, By: https://creativecommons.org/licenses/by/3.0/

Families USA receives $1 mln for 'successful stories' promoting Obamacare (2013-12-02T22:30:00+05:30)

.. The advocates of the US Health Care reform don’t give in and keep on working hard to promote Barack Obama Health Care bill. Families USA, a non-commercial organization has received one million dollar grant from the Robert Wood Foundation to create a database of successful stories from people who joined the Obamacare program.The Voice of Russia discussed this issue with Stan Veuger, a resident scholar at American Enterprise Institute (AEI). His academic research focuses on political economy and has been published in the Quarterly Journal of Economics. Mr. Veuger writes frequently for popular audiences on a variety of topics including policy uncertainty and Obamacare. Thank you so much for joining us, Stan. How can you comment on the creation of the so-called database of successful Obamacare stories? Can it be regarded as a desperate measure considering that Obamacare enrollment members are really quite low?  By Angela Davis. Hello, how’re you doing? I don’t think that’s a fair way to put it. Families USA is an organization, it is always backed this kind of expansion of the role of the Federal government in the provision of health care. The grant they’ve received comes from another private foundation, a private foundation that focuses on health and public health issues and they are both ideologically pretty much aligned with the Administration. I don’t think it is desperate, I think it is natural for them to follow this course of action. Are Obamacare enrollment numbers fairly low from your point of view? And they are certainly stagnantly low and it is of course a huge local problem for the administration that the numbers are so low that people are actually having their plans cancelled and that the website and the surrounding infrastructure are still not up and running but this particular grant was issued at the beginning of October when it was not clear at all yet. Now is the reason that the enrollment numbers are low is that only because the web site is not working? Its certainly doesn’t help. I think it is certainly a major factor up until now especially giving how much attention the web site have gotten, I can see how people would think “Okay, I have until mid December, I’m just going to wait until they fix their problems”, so I think if they manage to fix it, you will certainly see enrollment take up. Another problem, of course, is that for a lot of people the news policies offered are just not that attractive, especially for young and healthy people who do not receive subsidies. What in your opinion is the biggest problem with Obamacare today? The biggest and the most urgent problem today is certainly the web site and how hard it is for people to enroll, I think the bigger problem in the long run is that it is another middle class entitlement program they will inevitably expand the size of government will force taxes to be raised and will take some responsibility away from people should probably try to bear themselves. What do you think about this whole project? This Families USA that’s a non-commercial organization but they received a million dollars to create a database of successful stories. Are there any successful stories? It seems a little bit early, doesn’t it? I mean, the fewer successful stories there are the more money you need to find them, right? I can see how their work would need even more funding now than so few people have enrolled. So when are these successful Actually, these numbers are too kind. Most recent numbers show 64% want Obama-Care "Tossed into the Ash-Bin of History." To Senator Cruz, push this Bill with all your might. America is with you. Source stories supposed to appear? I think that the kind of stories they would try to find would be people who do not receive health care from their employers, who have pre existing conditions and who are relatively old or relatively poor. They would now face relatively low premiums because of community rating regulations and they all receive relatively high subsidies because they are poor. I think that’s the target group. Is Obamacare really working? Is the program working? The low number of people that are really enrolled, does it seem to be working at least somehow for, I guess, there is a target audience that doesn’t have heath care that actually got pretty high government assistance in purchasing this Obamacare. I mean is it working for some percent of Americans? I think the group for which it is working best is the group that didn’t have heath insurance before and that now qualifies for Medicaid, which is the fully funded Federal and State government program. How many people is that? I think out of the people who have enrolled so far it is a pretty big chunk. So when they first released the enrollment numbers I think it was the majority of the people enrolled. What is your personal attitude? Do you have Obamacare yourself, would you purchase it? I have employer provider insurance so I’m employed self-insured so I’m not directly affected by it. Have you looked at the plan that will be available to you in your current, if you didn’t have employer’s insurance? I have seen the plans available on the Washington DC exchange. A lot of them are very small networks of providers, there are certainly not very attractive. Also, I mean I am reasonably young and healthy, I wouldn’t qualify for subsidies, I don’t think the deal for me would be particularly good. So how much are you paying if you don’t have subsidies as a young healthy adult with no subsidies? That’s a good question. I would guess US$4,000 a year or something like that. What do people pay if we talk about private insurance? If you receive insurance through you, it is still private insurance, you would just buy it through Obamacare exchange. The thing is that a lot of people receive health insurance through the employer, get a massive tax cut in sense that employer provided health insurance is not taxed, so instead of, if your employer gives you a 100$ of health insurance, then the government takes zero dollars out of that, if the employer gives you a 100$ of salary, the Federal government will take 30$ out of that. And then with the remaining 70$ you would have to go and buy insurance for yourself. The way people receive insurance through their employers very much privileged through the existing system, so people are worse of who do not receive that and those who do not receive subsidies. When do you think Obamacare will be one year from now, two years from now or ten years from now? Would we still have it? I think a lot of it depends on the next year, so I think if the exchanges are not going to start working and the administration sees itself forced to delay the individual mandate by a year for example, I think that would be a big big blow problem for Democrats going into the Midterm elections and then after that if the Republicans win back the Senate, then it will be hard for the Administration to roll out of program as they intended. If they do that one & they keep the exchanges up but only very sick andamp; relatively old enrolled. Source Article: http://www.voiceofrussia.com, Images: brothermycroft, mshaugheysclass, daleyancy, themachoresponse, bgalrstate, randyhuntcpa, beinghappygirl, fritz-aviewfromthebeach, modernheretic3000, yastreblyansky.............................................................