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Much of health care today involves helping patients manage conditions whose outcomes can be greatly influenced by lifestyle or behavior change. Written specifically for health care professionals, this concise book presents powerful tools to enhance communication with patients and guide them in making choices to improve their health, from weight loss, exercise, and smoking cessation, to medication adherence and safer sex practices. Engaging dialogues and vignettes bring to life the core skills of motivational interviewing (MI) and show how to incorporate this brief evidence-based approach into any health care setting. Appendices include MI training resources and publications on specific medical conditions.
This book is in the Applications of Motivational Interviewing series.

In this provocative book, Sylvia Tesh shows how "politics masquerades as science" in the debates over the causes and prevention of disease.Tesh argues that ideas about the causes of disease which dominate policy at any given time or place are rarely determined by scientific criteria alone. The more critical factors are beliefs about how much government can control industry, who should take risks when scientists are uncertain, and whether the individual or society has the ultimate responsibility for health. Tesh argues that instead of lamenting the presence of this extra-scientific reasoning, it should be brought out of hiding and welcomed. She illustrates her position by analyzing five different theories of disease causality that have vied for dominance during the nineteenth and twentieth centuries, and discusses in detail the political implications of each theory. Tesh also devotes specific chapters to the multicausal theory of disease, to health education policy in Cuba, to the 1981 air traffic controller's strike, to the debate over Agent Orange, and to an analysis of science as a belief system. Along the way she makes these prinicipal points: She criticizes as politically conservative the idea that diseases result from a multifactorial web of causes. Placing responsibility for disease prevention on "society" is ideological, she argues. In connection with the air traffic controllers she questions whether it is in a union's best interests to claim that workers' jobs are stressful. She shows why there are no entirely neutral answers to questions about the toxicity of environmental pollutants. In a final chapter, Tesh urges scientists to incorporate egalitarian values into their search for the truth, rather than pretending science can be divorced from that political ideology. Sylvia Noble Tesh, a political scientist, is on the faculty of the University of Michigan School of Public Health.

What have been the roles of charities and the state in supporting medical provision? These are issues of major relevance, as the assumptions and practices of the welfare state are increasingly thrown into doubt. This title offers a broad perspective on the relationship between charity and medicine in Western Europe, up to the advent of welfare states in the 20th century. Through detailed case studies, the authors highlight significant differences between Britain, France, Italy and Germany, and offer a critical vocabulary for grasping the issues raised. This volume reflects recent developments relating to the role of charity in medicine, particularly the revival of interest in the place of voluntary provision in contemporary social policy. It emphasizes the changing balance of "care" and "cure" as the aim of medical charity, and shows how economic and political factors influenced the various forms of charity.

`This important book reveals why the young start smoking and why, as adults, they regret having started. It is a great contribution to helping end a national epidemic' - Cheryl Healton, President/CEO, American Legacy Foundation

`This book is a must for everyone concerned about how to address the problem of tobacco use among young people. Virtually all new smokers are children. Many of them are in their early teens and one out of every three children who begin to smoke will die prematurely because of their use of tobacco. This book includes the most objective, thorough and authoritative research to date on the critical question about whether young people fully understand the consequences of their decision to smoke at the time they start and whether they are able to make rational decisions about this vitally important decision. It leaves the reader with no doubt about the value of efforts to better educate our young people and to empower them to resist the lure of tobacco marketing' - Matthew Myers, President, Campaign for Tobacco Free Kids

Smoking presents important controversial research that is based on a survey of several thousand young persons and adults, probing attitudes, beliefs, feelings, and perceptions of risk associated with smoking. The expert board of contributors point out that young smokers give little or no thought to health risks or the problems of addiction. The survey data contradicts the model of informed, rational choice and underscores the need for aggressive policies to counter tobacco firms' marketing and promotional efforts and to restrict youth access to tobacco. An excellent book for anyone studying, researching or working in the field of health.

Communicating the nature and consequences of environmental and health risks is still one of the most problematic areas of public policy in Western democracies. "Mad Cows and Mother's Milk" outlines the crucial role of risk management in dealing with public controversies and analyses risk communication practice and malpractice to provide a set of lessons for risk managers and communicators. This second edition adds new case studies on mad cow disease in North America, climate change, and genetics technologies. The first of the new case studies brings the story of the Bovine Spongiform Encephalopathy (BSE) outbreak in the United Kingdom in the 1980s up-to-date. Mad cow disease is still being discovered in UK herds and cases of mad cow disease have been found in twenty countries across the European continent and as far away as Japan with devastating consequences for the food industry. BSE has now been discovered on the North American continent in two cows born in Canada. The original cause of these two new cases is almost certainly importation of infected cattle, cattle feed, or both from Britain. Canadian government regulators and those in the cattle industry have failed to correctly assess the risks of the disease in the Canadian herd, take the precautionary measures needed to prevent the spread of disease, and communicate risks and precautionary measures to the public. The second new study deals with global warming. Not only is every aspect of this risk debate both contentious and difficult for the public to understand but the potential consequences of the risks extend all the way to global catastrophe for human civilization. A new chapter outlines the many dimensions of risk debate in the context of the need for effective and sustained dialogue by an informed public. The last new case study provides an introduction to genomic science, which is placed in the context of both the health benefits expected from genetic manipulation and some of the risk factors associated with it. One example is gene therapy, which can be used to eliminate inherited genetic diseases (i.e. cystic fibrosis), enhance human traits (i.e. athletic performance), and perhaps double life-spans. Gene technologies are relevant to some of the most fundamental human values. This new chapter suggests that we must think about the range of new risks introduced by these technologies as well as the potential benefits - and that we should do this collective thinking soon, since, given the furious pace of genomics discoveries, the possibilities will be with us sooner than we imagine. All of the case studies emphasize the need for effective communication about risks to allow effective dialogue by informed publics on health and environmental risks.

The author of the highly acclaimed Overdiagnosed describes seven widespread assumptions that encourage excessive, often ineffective, and sometimes harmful medical care.
You might think the biggest problem in medical care is that it costs too much. Or that health insurance is too expensive, too uneven, too complicated—and gives you too many forms to fill out. But the central problem is that too much medical care has too little value.

Dr. H. Gilbert Welch is worried about too much medical care. It’s not to deny that some people get too little medical care, rather that the conventional concern about “too little” needs to be balanced with a concern about “too much”: too many people being made to worry about diseases they don’t have—and are at only average risk to get; too many people being tested and exposed to the harmful effects of the testing process; too many people being subjected to treatments they don’t need—or can’t benefit from.

The American public has been sold the idea that seeking medical care is one of the most important steps to maintain wellness. Surprisingly, medical care is not, in fact, well correlated with good health. So more medicine does not equal more health; in reality the opposite may be true.

The general public harbors assumptions about medical care that encourage overuse, assumptions like it’s always better to fix the problem, sooner (or newer) is always better, or it never hurts to get more information. Less Medicine, More Health pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, Dr. Welch notes that while economics and lawyers contribute to the excesses of American medicine, the problem is essentially created when the general public clings to these powerful assumptions about the value of tests and treatments—a number of which are just plain wrong.

By telling fascinating (and occasionally amusing) stories backed by reliable data, Dr. Welch challenges patients and the health-care establishment to rethink some very fundamental practices. His provocative prescriptions hold the potential to save money and, more important, improve health outcomes for us all.

In an increasingly globalized society, a clear understanding of international healthcare systems is a fundamental step toward improving the quality of health and healthcare systems in the United States and abroad. Comparative Health Systems: Global Perspectives explores the health systems of 17 countries through comparative study. Using a consistent framework, the chapters offer an overview of each country’s history, geography, government, and economy, as well as a detailed analysis of the country’s healthcare system facilities, workforce, technology, cost, quality, and access. Current and emerging issues are also explored. The book concludes with a look at the changing U.S. healthcare system and the global challenges and opportunities for health. Ideal for courses in global health, international affairs, health administration, and public health, this innovative text challenges its readers to reflect deeply about how health care is organized and delivered. Key Features: Each chapter follows a consistent framework to allow the reader to easily compare and contrast the divergent systems of various countries. Chapter contributors are scholars and experts from countries including Canada, India, Japan, Nigeria, Germany, Australia, Mexico, the United States, and more. A forthcoming companion website will feature interactive student resources to further enhance learning as well as resources for the instructor including an Instructor's Manual, Test Bank, PowerPoint slides.

We find risks everywhere—from genetically modified crops, medical malpractice, and stem-cell therapy to intimacy, online predators, identity theft, inflation, and robbery. They arise from our own acts and they are imposed on us. In this Very Short Introduction, Baruch Fischhoff and John Kadvany draw on the sciences and humanities to explore and explain the many kinds of risk. Using simple conceptual frameworks from decision theory and behavioural research, they examine the science and practice of creating measures of risk, showing how scientists address risks by combining historical records, scientific theories, probability, and expert judgment.Risk: A Very Short Introduction describes what has been learned by cognitive scientists about how people deal with risks, applying these lessons to diverse examples, and demonstrating how understanding risk can aid choices in everyday life and public policies for health, safety, environment, finance, and many other topics. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable.

The greatest revolutions in twentieth century public health and preventive medicine have been the concepts of risk factors and healthy lifestyles as methods of preventing disease. A risk factor is anything that increases the risk of disease in an individual. Lifestyle refers to the individual's personal behaviors with regard to risk factors. Identifying risk factors and modifying them by changing lifestyles in order to prevent disease has become ubiquitous as a strategy in public health. The book examines the history and evolution of the concepts of risk factors and healthy lifestyles and their application to coronary heart disease, the major chronic disease of the twentieth century. The first part contains a history of the use of statistics in public health and medicine, and the ways in which various industries developed the concept of the risk factor. The second part describes the concept of healthy lifestyles, which was devised by municipal public health departments and life insurance companies in the early part of the century. The third and fourth parts examine how the concepts of risk factors and lifestyles were applied to the primary chronic disease of the twentieth century - coronary heart disease. The focus of the book overall is on coronary heart disease as a public health, rather than a medical, issue, and the various concepts that have been used in preventing it. William G. Rothstein is Professor of Sociology at the University of Maryland, Baltimore County.

When federal and state policy makers' efforts to enact sweeping health care reform in the mid-1990s ended in stalemate, the private sector unleashed initiatives that have affected virtually every aspect of health care. With updated essays first published in issues of the Journal of Health Politics, Policy and Law, Healthy Markets? offers the most comprehensive and critical examination yet found in a single volume of the economic, political, and social implications of this recent market transformation of health care in the United States.
With original contributions from leading social science health policy analysts, this volume addresses the full context of health system change. Believing that the analysis of health care change is too important to be left to economists alone, Mark A. Peterson has collected a mulitdisciplinary group of experts who revisit the contentious debate over the market approaches to health care and consider the disparate effects of these approaches on cost, quality, and coverage of both managed care and Medicaid and Medicare. While market enthusiasts applaud the enhanced efficiency, reduced excess capacity, and abatement of the decades-long health care cost explosion, a backlash has emerged among many providers and the public against the perceived excesses of the market: diminished access to care, commercialization of the physician-patient relationship, and exacerbated inequality. Contributors assess these varied responses while examining the impact that market-based applications are likely to have for future health policy making, the significance of the U.S. experience for policy makers abroad, and the lessons that these changes might provide for thinking sensibly about the future of our health care system.
This volume will be useful for public policy analysts, economists, social scientists, health care providers and administrators, and others interested in the future—and in understanding the past—of American health care.

Contributors. Gary S. Belkin, Lawrence D. Brown, Robert G. Evans, Martin Gaynor, Paul B. Ginsburg, Marsha Gold, Theodore R. Marmor, Cathie Jo Martin, Jonathan B. Oberlander, Mark V. Pauly, Mark A. Peterson, Thomas Rice, Deborah A. Stone, William B. Vogt, Kenneth E. Thorpe