RESUMEN

Intriguing intellectual intersections offer the promise of enriching medical geography and making it both more theoretically sophisticated and more policy relevant. Employing a socio-ecological model of health, this paper explores several of these intersections, including the incorporation of gender into our research frameworks. As a context, the complex reasons for the increased interest in women's health over the past two decades, including the persistent tensions surrounding this interest, are reviewed. Drawing not only from conventional sources but also from literature on gender relations, domestic violence and aging in the Pacific as well as recent reports on health and socioeconomic development, key issues for women's health in the Pacific Islands are addressed.

Asunto(s)

RESUMEN

This study examines areal variations in low birth weight, using the census tract as the unit of analysis. Reports from the 1980 U.S. census were used to develop summary indicators of environmental and socio-economic conditions, including poverty, employment, education and crowding, for 155 census tracts in the state of Hawaii. Maternal socio-demographic, prenatal care utilization, and medical risk indicators and low birth weight percentages for resident, single live births were extracted from the Hawaii 1979-1987 vital record live birth files and aggregated by census tract. Multiple regression analysis was used to develop a model that predicted 61% of the variation among census tracts in the percentage of low birth weight. Patterns of low birth weight were primarily associated with ethnic patterns of maternal residence and single marital status. There was no association between inadequate prenatal care and low birth weight at the census tract level.

Asunto(s)

RESUMEN

AIDS, like plagues throughout human history, has been blamed repeatedly on foreigners. This has heightened ramifications, from the personal to the geopolitical, in an era of escalating population movement and rapid international travel. By the end of 1990, the World Health Organization had estimated that the total number of AIDS cases worldwide was close to 1.3 million. Recent estimates suggest that by the year 2000, 38-100 million adults and over 10 million children will have been infected with HIV. Seventy-five to eighty-five percent of that number will be from the developing world. AIDS has rapidly become pandemic, with wide-ranging consequences for humankind. Human population movement is an important component in the natural history of AIDS. With respect to this, a central consideration is the relationship between AIDS and international travel, especially tourism. In this paper, after reviewing HIV in the Asia-Pacific region, we present the epidemiology of HIV in the Pacific Islands, discuss its impact with particular reference to population movement, and explore some of the specific challenges that the Pacific Island region faces.

Asunto(s)

RESUMEN

Inhabitants of Pacific island countries experience a wide range of levels and cause structures of mortality. Data on socioeconomic, geopolitical and demographic variables have been analysed here to identify correlates and determinants of mortality in Pacific island countries circa 1980. The mortality data used in the study were the best available for the period and are reasonably accurate; descriptive data were derived from recognised sources. Political status was a major correlate, with independence positively associated with mortality. However, the influence of political status was partly accounted for by economic and social variables. Economic indices, particularly imports per capita, were major inverse correlates of mortality. Disparities in life expectancy occurred between malarious and nonmalarious countries, and these were not explicable by other factors. Melanesians, especially women, experienced high mortality rates. Education and doctor availability were both associated with increased life expectancy. Intercorrelation and confounding need to be taken into account in the interpretation of this analysis. The results have ramifications for policy development in the Pacific island countries themselves, and for investment and aid programs from major donor nations and organisations.

Asunto(s)

RESUMEN

The 22 Pacific Island countries and territories are in a state of demographic and epidemiological transition. Mortality data for the period around 1980 were collected from various sources and are presented in this comparative study. Because death registration in many Pacific countries is deficient some data have been adjusted for underenumeration; and some mortality estimates have been calculated by indirect means, using data from censuses or surveys. Cause of death information is affected by diagnostic inaccuracy and often tabulated in broad categories only; in some Pacific countries cause of death data are only available on hospital deaths. The less developed Melanesian malarious countries and the less developed dispersed atoll nations manifest higher mortality, and higher proportional mortality from infectious disease compared with other states. The more developed US-associated states, two New Zealand-associated states, and New Caledonian Europeans all have reasonably low mortality, and relatively high proportional mortality from cardiovascular disease (CVD). Females have longer life expectancy at birth than males in all countries except Vanuatu and the Solomon Islands. The phosphate-rich island of Nauru presents an atypical picture with considerable adult male mortality from diseases associated with modernization.

PIP: The 22 Pacific Island countries and territories are in a state of demographic and epidemiological transition. Mortality data for the period around 1980 were collected from various sources and are presented in this comparative study. Because death registration in many of these countries is deficient, some data have been adjusted for underenumeration; some mortality estimates have been calculated by indirect means, using data from censuses of surveys. Cause of death information is affected by diagnostic inaccuracy and is often tabulated only in broad categories. In some Pacific countries, cause of death data are only available on hospital deaths. The less developed Melanesian malarious countries and the less developed dispersed atoll nations manifest higher mortality and higher proportional mortality from infectious disease as compared with other states. The more developed US-associated states, 2 New Zealand-associated states, and the New Caledonian Europeans all have reasonably low mortality and relatively high proportional mortality from cardiovascular disease. Females have a longer life expectancy at birth than do males in all countries except Vanuatu and the Solomon Islands. The phosphate-rich land of Nauru presents an atypical picture with considerable adult male mortality from diseases associated with modernization.

Asunto(s)

RESUMEN

Ciguatera, a form of fish poisoning with a pantropical distribution, has been a recognized health problem in the Caribbean and the Pacific for centuries (in the decade from 1973 to 1983 for the island Pacific region as a whole, reported incidence, conservatively 20% of actual incidence, was 97/100,000). Island peoples in subsistence communities have developed strategies to minimize its impact. These strategies are less effective when people move to towns, cities and wage labor. The existence of ciguatoxic fish, which are indistinguishable from those that are not, has serious implications for development in island states. Furthermore, development activities which result in disruption of the marine environment increase the potential for ciguatoxic biotopes. The distribution of this health risk in the Pacific region is presented, adaptive strategies discussed, and implications for health, nutrition, resource development and tourism explored.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)