This article aims at contributing to the discussion on the features of public health systems consistent with the broader definition of health – broader than the strictly bio-medical one – which is currently accepted in the related literature. The questions it raises are on how social capital influences well-being, and on whether and how it can be recognized and cultivated as a basic resource for health, and integrated into the health systems. In the first part, research literature on the ways health conditions are correlated with both poverty and social capital is briefly discussed. In the second part, several cases on health prevention and rehabilitation programs are analysed in some detail, as they appear to improve the health conditions of a community by investing in its 'social capital'. The main insights are on how to combine social protection with individual agency.
Research Findings and Questions on a Modern Public Health Perspective
Ota de Leonardis
Andrew M. Courtwright
Philosophical and political discussions of health inequalities have largely focused on questions of justice. The general strategy employed by philosophers like Norman Daniels is to identify a certain state of affairs—in his case, equality of opportunity—and then argue that health disparities limiting an individual's or group's access to that condition are unjust, demanding intervention. Recent work in epidemiology, however, has highlighted the importance of socioeconomic status in creating health inequalities. I explore the ways in which theories of justice have been expanded in light of this data, suggesting that more work is required if such theories are to provide an adequate framework for addressing health disparities. I conclude by sketching an alternative possibility for thinking about health disparities outside of the context of justice.
From Ecology to Entanglement
Alex M. Nading
Medical and environmental social scientists have recently become interested in how health brings human and nonhuman animals together. is article discusses historical approaches to this question. It then explores applied disease ecology, which examines how anthropogenic landscape change leads to “disease emergence.” The article goes on to review two critical approaches to the question. Critics of bio-security concern themselves with the ways in which animal and human lives are regulated in the context of “emerging diseases” such as avian influenza and foot and mouth disease. Scholarship on human-animal “entanglement” focuses on the ways in which disease, instead of alienating humans from other life forms, brings their intimate relationships into sharper relief. The article argues that health is one terrain for developing a critical environmental analysis of the production of life, where life is the ongoing, dynamic result of human and nonhuman interactions over time.
The Case of Female Suitcase Traders
This article assesses the social factors that influence the health of female suitcase traders and the health risks related to the trade as an occupation. The findings indicate that it is imperative to study the health of small-scale traders within the framework of occupational health. Suitcase trade is widespread in both developing countries and the post-Soviet region, and recognising it as an occupation makes it possible to research related health issues. This in turn can lead to the discovery of specific patterns regarding health risks and the treatment of typical illnesses of suitcase traders, thus facilitating comparison with other occupational health research. The article examines existing barriers to health for women in Central Asia and summarises the quality and content of the treatment that is available.
Pro-activity and Well-Being
Jhan Van de Kerckhove
The current prevention policy continues to be reactive. It is even negative and demotivating. This atmosphere is destroying the working conditions we need in our new social-economic environment. Quality of work has become top of the agenda together with creativity, personal development and involvement. The human being is transformed from a potential source of disturbance into an essential success factor. A new approach to prevention policy is imposing itself in this context. Caring for safety, health and well-being of the employees at the same time means caring for the well-being and the future of the organization. The great challenge now becomes the development of the human potential. In that perspective a real proactive prevention policy is needed. Proactivity implies prevention but goes much further. Real proactivity refers to the dreams and positive objectives people wish to see realised. Well-being, participation and empowerment of all participants are important targets while the expected implications for culture are commitment, trust and open communication. This approach is very close to the conditional factors of social quality as described in the report of the European Foundation on the European Network Indicators of Social Quality.
Yagoub Yousif Al-Kandari
The rate of consanguineous marriage in Kuwait is considered to be high. Several research studies have shown that marriage among relatives is one of the major factors leading to health problems because it increases homozygosis. This article deals with both cultural and physical aspects by examining the health consequences of consanguineous marriages in Kuwait. Variables such as reproductive wastage, health problems in the offspring and infant mortality are included and measured in relation to other socio-cultural variables. Cultural variables such as the respondents' roots (Bedouin and non-Bedouin) and beliefs (Muslim Sunni and Muslim Shi'a) are also examined. The results show that there is no significant association between consanguineous and non-consanguineous marriages in the rate of abortion or the mortality of infants and children up to five years old. Finally, the data reveal significant differences between the genetic and genetic-environmental diseases in consanguineous couples' offspring and those of non-consanguineous couples. Since some of these findings contradict those of other studies, more research is needed.
For whom? By whom? For what?
Annamarie Bindenagel Šehović
English abstract: This article explores the role of health diplomacy in promoting the right to health. It first looks at the historical trajectory of the right to health as it evolves and intersects with state and human and health security. Second, it analyzes the definitions and roles of health diplomacy. It argues that health diplomacy is undergoing a cycle of (re)invention and innovation, bringing in both new and traditional actors. Yet it points out a gap in the subject of health diplomacy, asking what is the right to health, and what does its definition mean for the (changing) role of health diplomacy? It concludes by offering initial insight into what health diplomacy might be in the nearer future.
Spanish abstract: Este artículo explora el papel de la diplomacia de salud en la promoción del derecho a la salud. En primer lugar, examina la trayectoria histórica del derecho a la salud, cómo evoluciona y se cruza con la seguridad estatal, humana y sanitaria. En segundo lugar, analiza las definiciones y funciones de la diplomacia de salud. Sostiene que la diplomacia de salud está atravesando un ciclo de (re)invención e innovación, atrayendo a actores nuevos y tradicionales. Sin embargo, señala una laguna en la diplomacia de salud, al preguntarse qué es el derecho a la salud, y qué significa su definición para el papel (cambiante) de la diplomacia de salud. Concluye ofreciendo una visión inicial de lo que podría ser la diplomacia de salud en un futuro próximo.
French abstract: Cet article explore le rôle de la diplomatie de la santé dans la promotion du droit à la santé. Il examine d’abord la trajectoire historique du droit à la santé, son évolution et son intersection avec la sécurité étatique, humaine et de la santé. Il analyse ensuite les défintions et les fonctions de la diplomatie de la santé. Il soutient que la diplomatie de la santé traverse un cycle de (ré)invention et d’innovation en attirant des acteurs nouveaux et traditionnels. Cependant il signale une lacune dans la diplomatie de la santé en posant la question de ce qu’est le droit à la santé, et de ce que sa définition signifie pour le rôle (changeant) de la diplomatie de la santé. Il conclut en proposant une vision preliminaire de ce que pourrait être la diplomatie de la santé dans un futur prôche.
Migrant Experiences in the Quest for Well-Being
Anne Sigfrid Grønseth and Robin Oakley
The articles in this volume reinforce the power of ethnographic humanism, of anthropology in action. The focus is on the relationship between macro political forces and their influence on the varied experiences of health in advanced industrial capitalist contexts. Our approach views migrants as capable agents negotiating new lives for themselves and confronting the challenges they face. We strongly advocate socially informed policy that offers at minimum recognition to migrants as full fledged members of the new society that they have voluntarily or involuntarily migrated to.
Défaillances de l'aide, équité et légitimité
Mamadou Barry, Bruno Boidin and Stéphane Tizio
*Full article is in French
English abstract: The aim of this article is to study the efficiency of health aid through an analysis of recommendations made by those working in development assistance. The central focus concerns the legitimacy of these recommendations. We show that recent directions in health aid still neglect equity and sustainability issues. We also discuss how to introduce ethical considerations into health aid.
Spanish abstract: Este artículo examina las condiciones de la eficiencia de la ayuda para la salud, dadas las opciones de políticas de salud preconizadas por los actores de la ayuda al desarrollo. La pregunta sobre la legitimidad de estas preconizaciones constituye el centro de la reflexión. El artículo muestra que las recientes orientaciones en la ayuda al desarrollo en el campo de la salud dejan de lado asuntos de equidad y sostenibilidad de las políticas. En este contexto se proponen pistas que permitan introducir consideraciones éticas en la ayuda a la salud.
French abstract: Cet article s'interroge sur les conditions d'efficacité de l'aide à la santé compte tenu des options de politiques de santé préconisées par les acteurs de l'aide au développement. La question de la légitimité de ces préconisations est au cœur de notre réflexion. Nous montrons que les orientations récentes de l'aide au développement dans le domaine de la santé négligent toujours les questions d'équité et de soutenabilité des politiques. Nous proposons alors des pistes perme ant d'introduire des considérations éthiques dans l'aide à la santé.
The Role of Bodily Integrity
Mar Cabezas and Gottfried Schweiger
Our concern is with the ethical issues related to girlhood and bodily integrity—the right to be free from physical harm and harassment and to experience freedom and security in relation to the body. We defend agency, positive self-relations, and health as basic elements of bodily integrity and we advocate that this normative concept be used as a conceptual tool for the protection of the rights of girls. We assume the capability approach developed by Martha Nussbaum as an ethical framework that enables us to evaluate girls’ well-being and well-becoming in relation to the potential, and often subtle, threats they face. The capability approach can be understood as a theory of justice, and, therefore, as an ethical and political approach. An enriched concept of bodily integrity can help in the design of better policies to address gender biases against girls because it could contribute to seeing them as active agents and valid participants.