200 p., For Cuba's supporters, health is the most commonly cited evidence of the socialist system's success. Even critics often concede that this is the country's saving grace. Cuba's health statistics are indeed extraordinary. This small island outperforms virtually all of its neighboring countries and all countries of the same level of economic development. Some of its health statistics rival wealthy industrialized countries. Moreover, these health outcomes have resulted against all odds. This study of the Cuban health system finds that the country possesses an unusually high level of popular participation and cooperation in the implementation of health policy. This has been achieved with the help of a longstanding government that prioritizes public health, and has enough political influence to compel the rest of the community to do the same. On the other hand, popular participation in decision-making regarding health policy is minimal, which contrasts with the image of popular participation often promoted. Political elites design and impose health policy, allowing little room for other health sector groups to meaningfully contribute to or protest official decisions. This is a problem because aspects of health care that are important to those who use the system or work within it can be neglected if they do not fit within official priorities. The country's preventive arrangements, its collective prioritization of key health areas, the improvements in public access to health services through the expansion of health facilities and the provision of free universal care are among the accomplishments that set it apart. The sustainability and progress of these achievements, however, must involve open recognition and public discussion of weaker aspects of the health system.
450 p., Examines how the development of public health, aided by the intervention of the Rockefeller Foundation, intersected with the birth of nationalism in Jamaica between 1918 and 1944. It demonstrates that a modern public health program based in western biomedicine, racial categorization and colonial modes of behavior were vital to claims of fitness for self-rule by Jamaican nationalists. In the late 1930s the demand for greater representation in government was accompanied by the scrutiny of the sexual behaviors and personal hygiene of the Afro-Jamaican masses. The author analyzes how disease and reproduction played a central role in the competing constructions of Afro-Jamaican bodies by colonial elites and ambitious middle class nationalists.
139 p., The research goal was to document differences in the epidemiology of prostate cancer among multicultural men [non-Hispanic White (NHW), Hispanic (H), non-Hispanic Black (NHB)], and Black subgroups, particularly among NHB subgroups [US-born (USB) and Caribbean-born (CBB)]. The study sample included men aged 18 and older, grouped by race/ethnicity. Among the CBB group, survey respondents were limited to the English-speaking Caribbean. Prostate cancer prevalence, by race showed a higher trend among NHB men than NHW men overall, however differences over time were not significant. CBB men reported a higher proportion of prostate cancer among cancers diagnosed than USB men overall. Among the CBB men, the number of years lived in the US did not significantly affect PSA screening behavior. When NHB men are stratified by birthplace, CBB men had a higher overall prevalence of prostate cancer diagnoses than USB men although not statistically significant. USB men were 2 to 3 times more likely to have had a PSA exam compared to CBB men, but among CBB men birthplace did not make a significant difference in screening behavior.
