Social determinants of health

To the Editor: It is becoming increasingly recognised that consumer and carer participation improves both quality and outcomes of health care.1 The Children of Parents with Mental Illness (COPMI) national initiative is a health promotion program supporting better mental health outcomes for children whose parents have a mental illness (http://www.copmi.net.au). COPMI produces and provides information ...

Lydia C Trowse · Joanne G Cook · Tyson J A Clooney

Summary Adequate health workforce alone will not ensure optimal health service access. We consider what an effective and sustainable health system for rural and remote Australia might look like in 2025, briefly describe some of the barriers to achieving this vision and propose how these challenges may be overcome. More radical change is required on at least four fronts: changing the ...

John Wakerman MTH, FAFPHM, FACRRM · John S Humphreys BA, DipEd, PhD

Humans and their environment can be seen as complex systems. It is now time to move away from “single factor” thinking, and engage with the multifaceted truth about health and disease.

Astika Kappagoda

Today, sex-based inequalities and inequities shape how individuals are disproportionately exposed to adverse determinants of health. Our sex can determine how well or ill we become, and if or how our health care needs are acknowledged and met.1 The underlying reasons for this disparity are complex and diverse, shaped by how sex and sexual customs interact within varying political and social contexts. Discriminatory values, norms ...

Izzeldin M M Abuelaish MD, MPH

The recent apology from the German Medical Association is commendable, but it fails to mention many of the victims of Nazi medicine.

George M Weisz MD, FRACS, MA

To the Editor: Weisbrot and Breen’s proposal1 for a no-fault compensation system for medical injuries should extend to all injuries in Australia, including those from motor vehicle accidents and in the workplace. It should also apply to recreational injuries that may lead to common law compensation cases. After 40 years of clinical experience in the rehabilitation of patients with severe neurological injury, I argue that such ...

David C Burke

Social injustice kills. As the Christmas season draws near, a number of contributions in the MJA examine what can, has been and needs to be done about it, both in Australia and abroad.

Ann Gregory · Ruth Armstrong

Medicare has reduced inequity in access to primary care, but inequities remain for low socioeconomic groups in rural areas, and in access to specialist, psychological and dental care.

Mark F Harris MB BS, FRACGP, MD

In a week when the presidential election was imminent, but Americans were more concerned with Hurricane Sandy and Halloween, an Australian visiting professor in New Orleans shares his observations of life and health in the United States and the ongoing recovery from Hurricane Katrina.

Charles S Guest Visiting Professor

Christmas may be a state of mind or a memory, to carry with you wherever you are“What is Christmas?” a 3-year-old boy eagerly asked his father. “Christmas, my son, is the time of the year when we celebrate the birth of Jesus Christ”, answered the father with a smile on his face. “But”, he then continued, “we also celebrate how wonderful life is by showing ...

Manda Kaled

To the Editor: Refugee health is an emerging area of clinical care. Over 200 000 humanitarian entrants have settled in Australia over the past 15 years, and the annual humanitarian intake has recently increased to 20 000 people.1 While there is (delayed) information on post-arrival refugee health screening, little is known about the longitudinal outcomes or use of health services in refugee-background Australians, and they remain invisible in existing population ...

Georgia A Paxton · Margaret P Kay · Ignacio Correa-Velez

“This regeneration process also restores the physiological respiratory function of the lungs, which is mediated by amplification of various epithelial progenitor cells and regeneration of the alveolar sacs” — Dr Bi-Sen Ding, Cornell University Visitation resumes first with the most ardent ornithologists. Loony they pierce, stride right on in, primed by the song of ocular gadgets to a once-blighted habitat that’s chalked up its comeback to a mad cheeping action poker-faced finches go ...

Kent E MacCarter MA(Lit)

To the Editor: The closet is a common lesbian response to prejudice, discrimination and stigma. Many rural lesbians choose to “pass” as heterosexual and keep their sexuality secret.1,2 Research shows that this secrecy is fuelled by the fear of violence, including harassment, ostracism and rejection,2 and it is unlikely that a lesbian will disclose her sexuality to a doctor unless she feels safe. Without full ...

Cathy Wheel

To the Editor: In June 2007 we highlighted the inconsistent application of community-accepted harm minimisation strategies, when offered to prisoners, among the various Australian jurisdictions.1 We sought information from the eight prisoner health services to assess how harm minimisation strategies were being implemented in each jurisdiction (Box). Progress has been slow, particularly in Queensland and the Northern Territory. The positive progress, however, has been the trial of condom ...

Michael H Levy · Carla Treloar

Long-term continuity of care and community engagement mean a lot to a doctor. When we pulled up in the driveway of our first rented house in Camperdown, south-west Victoria, a woman’s face appeared over the fence. “Hello”, she said, “Who are you? What are you doing here?” I explained that we were doctors and would be working in the town. “Oh, you got any family here?” ...

Ruth A Stewart MB BS, FACRRM, DRANZCOG

Global health is, by definition, an area of great breadth and depth. There is enormous diversity in health systems and health outcomes, with life expectancy at birth varying from 82–84 years in Australia and Japan to less than 55 years in more than 20 African countries. Despite this diversity and difference, communicable diseases such as HIV and severe acute respiratory syndrome, and our more recent understanding of the ...

A Rob Moodie MB BS, MPH

In the early years of transplantation, organs were retrieved from patients who were considered to have died by traditional cardiopulmonary criteria (now known as donation after cardiac death [DCD]) or from live donors. The introduction of diagnostic criteria for brain death provided a more practical and controlled pathway to organ donation. Donation after brain death (DBrD) allowed organ retrieval without prior cessation of circulation, thus minimising warm ischaemic time and enhancing organ function in the recipient.

Tim G Coulson BM, BSc · David V Pilcher MRCP, FRACP, FCICM · Shena M Graham RN, CCC, BN · Gregory I Snell MB BS, FRACP, MD · Bronwyn J Levvey RN, GradDipEpi, BEdStudies · Steve Philpot FCICM · Alvin Teo FCICM · Andrew R Davies FRACP, FCICM