Dr. Raphael:

This is a great presentation, thank you for posting it for wide
distribution.

The list members might be interested in 02 papers (both oral 
presentations) I presented at the annual event of the American Public 
Health Association.

I prepared these papers during courses in pursuit of a Master's in
Public Health (MPH) degree.
http://apha.confex.com/apha/134am/techprogram/paper_130490.htm
http://apha.confex.com/apha/134am/techprogram/paper_133405.htm

My presentations are available at:

Public Health Futures
http://lacal.net/files/ph/apha2006_phf.ppt
* The health of populations is determined by a variety of factors,
ranging from macrosocial factors (e.g., policies, assets) to individual
behaviors (e.g., smoking).
* As our understanding of the interrelationship between the health of
populations and the economic factors that both influence, and are
influenced by, population health, improves,  it is becoming readily
apparent that innovative public health efforts need to be considered
that can result in improved health of populations.
* Unfortunately, public health efforts in the economic arena are
frequently stymied by concerns that such efforts go beyond the
"traditional" role of public health. This paper introduces an innovative
framework that might help public health practitioners interested in
structural economic interventions.
* We propose a "Public Health Futures" funding mechanism similar to the
existing commodities futures market as an economic framework to bring
new actors to fund existing Public Health infrastructure. The proposed
framework leverages well-known financing mechanisms widely used in both
industrial and residential financial settings.
*This framework seeks to "securitize" the net present value of future
population health improvements.
* The proposed concept of Public Health Futures is designed to empower
new actors with an interest in the future earning and purchasing power
of today's youth to actively fund public health activities that have a
high probability of delivering healthy, productive citizens (and
taxpayers) in the future.
* The strengths and limitations of this approach will be discussed.

Maternal Mortgage
http://lacal.net/files/ph/apha2006_mm.ppt
Economic, social, physical, as well as emotional factors across a
woman's lifespan have a direct impact on her offspring's quality of
life. By the time an infant is born, he already inherited an assortment
of physical and emotional burdens directly related to the way his mother
lived her life, and those burdens are transferred across generations
("Maternal Mortgage"). This paper outlines a trans-generational
predictive model to measure the impact that maternal mortgages bring on
children, and the social consequences of burdening children with such
cross-generational inherited loads. Shortcomings in the availability and
quality of Maternal and Child Health services can be used as proxies to
predict the health and social well-being of the next generation. The
odds that a US resident female will become pregnant at least once in her
lifetime are around 205%, given an estimated Total Fertility Rate of
2.05 for 2005. Thus, given that pre-conceptional health care can improve
outcomes, that the early phases of conception are crucial for the
fetus's development, that any delay in ascertaining pregnancy status
could lead to a late start in taking nutritional measures, and that over
50% of pregnancies are unexpected, all females (regardless of age) must
be offered pre-conceptional services almost from birth in order to
minimize negative impacts on their children. This paper's goal is to
encourage a national dialogue on the consequences of failing to account
for this trans-generational burden.


Comments most welcome. Regards.

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