The role of public health in the prevention of war: rationale and competencies.

In 2009 the American Public Health Association approved the policy statement, "The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War." Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health's ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes.

Roles and responsibilities of health care professionals in combating environmental degradation and social injustice: education and activism.

This article describes the causes and health consequences of environmental degradation and social injustice. These issues, which impact primarily on the poor and underserved (both in the United States and internationally) are rarely or inadequately covered in the curriculums of traditional health care professions. The discussion offers ways for health care professionals to promote equality and justice and uses the example of Rudolph Virchow's social activism to illustrate how one physician can lead society toward major public health gains.

Increase in obstacles to abortion: the American perspective in 2004.

This paper summarizes the barriers to abortion in the United States, including the determination of viability, cost and insurance coverage, waiting periods and parental consent laws, restrictions on medical abortion, provider unavailability, harassment, targeted regulation of abortion providers laws, refusal clauses, anti choice laws, and the fetal legal rights movement. Federally subsidized abstinence-only sex education, which has not been shown to decrease the rate of unintended pregnancy (and may increase it), has expanded and access to a full range of contraceptive options has been limited. The policies of the current and past administrations have strengthened barriers to abortion both at home and abroad.

A community-based approach to the medical humanities.

Background: This paper discusses the rationale behind, and an approach to, the development of a graduate level interdisciplinary curriculum in literature and health care that incorporates community-based learning. Such an innovative approach emerges from the recognition that professional training in both health care and humanities programmes often does not model the kinds of collaborative relationships and professional values desired by contemporary health care students, providers and patients.

Method: Recent trends in literary study and the medical humanities are described, along with the function (and benefits to students) of interdisciplinary classrooms and the role of community-based learning in higher education.

Luxury primary care, academic medical centers, and the erosion of science and professional ethics.

Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice.

Advice for young investigators: historical perspectives on scientific research.

Physicians attempting to carry out well-executed scientific investigations require an historical perspective; an awareness of our ignorance; an imagination unencumbered by scientific prejudices; originality, curiosity and imagination; patience and persistence in the face of frustration; adaptability and perseverance; a critical spirit of evaluation and willingness to question dogma; devotion to the search for truth; and an awareness of those responsibilities to individuals and to society which define the medical profession. This paper explores, through the words of famous scientists, philosophers and authors, the process of scientific investigation and discusses those qualities that investigators can develop to become more insightful and successful researchers.

Health issues of migrant and seasonal farmworkers.

This paper describes the socioeconomic conditions under which the 3 to 5 million migrant and seasonal farmworkers in the United States live. Health consequences resulting from occupational hazards and from poverty, substandard living conditions, migrancy, language and cultural barriers, and impaired access to health care are described. Specific problems include infectious diseases, chemical- and pesticide-related illnesses, dermatitis, heat stress, respiratory conditions, musculoskeletal disorders and traumatic injuries, reproductive health problems, dental diseases, cancer, poor child health, inadequate preventive care, and social and mental health problems.

Reflections of physician-authors on death: literary selections appropriate for teaching rounds.

Physicians constantly confront to death and respond in a variety of ways to the many deaths that they witness and to their own sense of mortality. Student-doctors should be exposed, prior to and during their clinical training, to these different types of responses, so that they can prepare for their encounters with the "ultimate mystery" and realize that their own reactions, uncertainties and fears are neither unique or unnatural. Writings of physician-authors provide an ideal medium for this exposure.