Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models. Postneoliberal reforms may provide an alternative means of reducing health inequalities and improving population health.
Informal waste recovery is a vital occupation for urban dwellers without formal economic opportunities. Despite the prevalence of informal waste pickers in urban areas, little is known about tension and conflict associated with pickers' ability to access trash at municipal waste sites. In this article, ethnographic field data are analyzed to explore themes of tension and conflict as experienced by informal waste pickers at the Managua, Nicaragua, municipal waste site. Special attention is paid to two recent events in the waste site: the announcement of a large-scale development project that will radically change municipal solid waste management practices at the site and a month-long strike carried out by waste pickers. Importantly, findings suggest that municipal waste sites should be situated in terms of historical and present-day processes, that waste must be conceptualized as a finite resource to be fought for, and that waste pickers experience tension and conflict on account of internal and external spatially-defined factors. ResumenLa recolección de basura informal es un tipo de empleo esencial para los residentes urbanos sin oportunidades de empleo formal. A pesar de la gran cantidad de recicladores informales en zonas urbanas, se sabe poco sobre la tensión y el conflicto asociado con problemas de acceso a la basura en un basurero municipal. En este articulo, analizo información de métodos etnográficos para examinar los temas de tensión y conflicto de los recicladores informales a un basurero municipal de Managua, Nicaragua. Enfoco en dos eventos recientes al basurero municipal: el anuncio de un proyecto de desarrollo que cambiara el proceso del manejo de basura en el basurero y una huelga de basura que duró un mes. De importancia son los resultados que sugieren que el basurero municipal debe ser considerado como producto de los procesos históricos y de hoy en día, que la basura debe ser conceptualizada como recurso finito y por la cual se debe luchar, y que los recicladores informales sufren tensión y conflicto a causa de los factores espaciales internos y externos. Palabras clave: recolección de basura informal, conflicto, basurero, Managua, Nicaragua
This article examines the beliefs and experiences of individuals living in underserved ethnically diverse communities in Cleveland, Ohio, regarding the influence of genetic, social, and environmental factors on health and health inequalities. Using a community-engaged methodological approach, 13 focus groups were conducted with African American, Hispanic, and White individuals residing in the Cleveland area to explore attitudes and beliefs about genetics, genetic research, and health disparities and inequalities. Results of this study highlight the range of meanings that individuals attach to genetic variation, genomic research, and gene-environment interactions, and their implications for addressing health inequalities. The majority of participants in all focus groups reported that social and environmental factors were more important than genetics in contributing to health inequalities. Most participants were unfamiliar with genetic research. These data have implications for how genetic information and research might be applied in conjunction with addressing social determinants of health to improve prevention strategies in underserved communities and ultimately reduce health inequalities.
Family health history tools rarely incorporate environmental and neighborhood factors, although the social and physical environments in which people live are recognized as major contributors to chronic diseases. This paper discusses beliefs about neighborhood influences on chronic disease risk among racially and ethnically diverse individuals in low-income communities in Cleveland, Ohio. We report findings from a qualitative study consisting of 121 interviews with White, African American, and Hispanic participants. Results are organized into four major themes: (1) social and economic environment, (2) physical environment, (3) barriers to healthy behaviors, and (4) participants' views on integrating genetic and non-genetic determinants of health to understand and address disease prevention and management. Findings suggest that integrating environmental factors into family health history assessments would better reflect lay perceptions of disease causation. Results have implications for improving patient-clinician communication and the development of strategies to prevent and manage chronic diseases.
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