Global health interdependence and the international physicians' movement

Article Abstract:

International Physicians for the Prevention of Nuclear War (IPPNW) originated in 1981 in the US and is now an international organization with a membership of 250,000 people from more than 70 nations. The group was awarded the 1985 Nobel Prize for Peace. Its focus has remained the prevention of nuclear war, by political advocacy and public education. However, current political and global trends have forced a re-evaluation of the role of international physician nongovernmental organizations (NGOs). One approach to counter the understandable opposition of government officials to IPPNW is to adopt their conceptual frameworks. These frameworks often establish 'fateful visions', ideas about how the world could be. Ten such visions are presented in tabular form. Three of these are shared by IPPNW, and that organization's goal of total disarmament should not be viewed apart from the political changes that will have to be effected before disarmament can even be realistically discussed. Physicians do not have an impact on these changes. Nor are nuclear weapons a major force in the violence that occurs in the world; rather, conventional weapons are what men, women, and children die from in modern times. Thus, the abolition of nuclear weapons as the main goal of IPPNW presents problems. What can physicians do to bring about 'desirable worlds'? As internationalism develops, leading to reduction of nationalistic fervor, offensive weapons will become less critical. IPPNW facilitates internationalism, and emerging needs for interdependence among countries will result in a broader focus for the physicians' movement. One such change is the growth of newly industrialized countries; another is the deterioration of the environment. Changing immigration patterns, the human immunodeficiency virus (associated with AIDS), and other disease outbreaks, also call for re-evaluation of the role of NGOs. Overall, physicians will be called upon to act as advocates because of their special knowledge and expertise. Much of their activity will be in the areas of public policy and should remain free of ideological constraints. In this capacity, physicians can act to promote the positive interdependence among nations essential for the survival of civilization. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Evaluation, International aspects, Medical policy, Health policy, International Physicians for the Prevention of Nuclear War

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An opportunity to oppose: physicians' role in the campaign against tobacco

Article Abstract:

Use of cigarettes and other tobacco products constitutes the largest preventable cause of illness and death in the United States. There is a direct association between cigarette smoking and illness, and recently the hazards of indirect, or passive, smoking have also become clear. Illness of smokers represents a hidden tax of $221 per person per year, or $52 billion per year in additional health costs for smokers. The author, the United States Secretary of Health and Human Services, has committed his office to the establishment of a smoke-free America by the year 2000. Because smoking is strongly entrenched behavior in American society, this will be a difficult job. The tobacco lobby has chosen to obscure the dangers of smoking, and the industry in its advertising represents smoking as glamorous. But when analyzed further, a more accurate image of smoking is not youth and good health, but disease and premature death. Recent studies have shown that the earlier an individual initiates smoking, the more likely he or she will become a long-term smoker, with a greater risk of tobacco-caused illness. Ninety percent of all smokers began the habit as adolescents; thus, passage and enforcement of laws that restrict children's access to tobacco are extremely important. The burden of tobacco-related disease falls hardest on minority groups, whose health is generally poorer than the rest of the population. Prevention campaigns and epidemiologic research, assistance to state health agencies involved with anti-smoking campaigns, and increased school health education about tobacco are included in the plans of the Department of Health and Human Services. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Smoking cessation programs, Smoking cessation, Smoking

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The need for affirmative action in medical education

Article Abstract:

In 1990, only 7.6% of first-year medical students and 5.9% of medical school graduates were black. Although this is an improvement over the 1960s, when only 3% of first-year medical students were black, much more needs to be done. The Department of Health and Human Services plans to support minority students enrolled at predominantly white institutions, help minority graduates who want to pursue doctoral degrees and assist minority faculty members who want to conduct research. The National Institute of General Medical Sciences has awarded 65 predoctoral fellowships to minority students. Colleges and universities can work with elementary and secondary schools to encourage minorities to pursue careers in science and medicine.

Planning, Affirmative action, Educational discrimination, Medical education, Discrimination in medical education

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