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To date, most published health literacy research has focused on assessing and improving personal skills and abilities. More recently, a better understanding has emerged of the extent to which these skills and abilities are mediated by environmental demands and situational complexities - the context in which health literacy is developed and applied. This has led to much greater attention being given to ways of reducing the situational demands and complexity in which an individual makes a health decision. This collection of papers examines current progress in understanding health literacy "in context", by improving our understanding of the mutual impact of a range of social, economic, environmental, and organisational influences on health literacy. These papers provide unique and original perspectives on the concept, distribution, and application of health literacy in very diverse populations, offering cultural insights and a clear indication of the impact of social and environmental context on health literacy. These perspectives include an examination of differing national policy responses to health literacy illustrating how policy and practice can (and should) respond to this more complete but complex understanding of health literacy. Other papers look at the application of new digital media and the creative harnessing of popular culture as routes to extend the reach and customisation of communications. These papers also illustrate good progress in the evolution of research in the contexts in which health literacy is developed and applied, as well as signaling some areas in which more research would be useful.

Social environment --- Determinants of health --- Health literacy --- Health promotion --- Social disadvantage --- Organizational change --- Health interventions --- Health education --- Culture --- Health disparities

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Extreme weather events are known to have serious consequences for human health and are predicted to increase in frequency as a result of climate change. Africa is one of the regions that risks being most seriously affected. This paper quantifies the impact of extreme rainfall and temperature events on the incidence of diarrhea, malnutrition and mortality in young children in Sub-Saharan Africa. The panel data set is constructed from Demographic and Health Surveys for 108 regions from 19 Sub-Saharan African countries between 1992 and 2001 and climate data from the Africa Rainfall and Temperature Evaluation System from 1980 to 2001. The results show that both excess rainfall and extreme temperatures significantly raise the incidence of diarrhea and weight-for-height malnutrition among children under the age of three, but have little impact on the long-term health indicators, including height-for-age malnutrition and the under-five mortality rate. The authors use the results to simulate the additional health cost as a proportion of gross domestic product caused by increased climate variability. The projected health cost of increased diarrhea attributable to climate change in 2020 is in the range of 0.2 to 0.5 percent of gross domestic product in Africa.

Aging --- Antenatal care --- Epidemiology --- Food poisoning --- Health care --- Health effects --- Health indicators --- Health interventions --- Health Monitoring and Evaluation --- Health outcomes --- Health policy --- Health services --- Health, Nutrition and Population --- Isolation --- Morbidity --- Mortality --- Nutrition --- Nutritional status --- Public health --- Vaccination --- Victims

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Public health systems in India have weakened since the 1950s, after central decisions to amalgamate the medical and public health services, and to focus public health work largely on single-issue programs - instead of on strengthening public health systems' broad capacity to reduce exposure to disease. Over time, most state health departments de-prioritized their public health systems. This paper describes how the public health system works in Tamil Nadu, a rare example of a state that chose not to amalgamate its medical and public health services. It describes the key ingredients of the system, which are a separate Directorate of Public Health - staffed by a cadre of professional public health managers with deep firsthand experience of working in both rural and urban areas, and complemented with non-medical specialists-with its own budget, and with legislative underpinning. The authors illustrate how this helps Tamil Nadu to conduct long-term planning to avert outbreaks, manage endemic diseases, prevent disease resurgence, manage disasters and emergencies, and support local bodies to protect public health in rural and urban areas. They also discuss the system's shortfalls. Tamil Nadu's public health system is replicable, offering lessons on better management of existing resources. It is also affordable: compared with the national averages, Tamil Nadu spends less per capita on health while achieving far better health outcomes. There is much that other states in India, and other developing countries, can learn from this to revitalize their public health systems and better protect their people's health.

Disasters --- Environmental health --- Family planning --- Health indicators --- Health interventions --- Health management --- Health Monitoring and Evaluation --- Health outcomes --- Health planning --- Health services --- Health, Nutrition and Population --- Hygiene --- Laws --- Medical specialists --- Medicines --- Morbidity --- Mortality --- Patient --- Primary health care --- Public Health --- Waste --- Workers

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This paper reviews the effectiveness and efficiency of key policy instruments for the achievement of the Millennium Development Goals (MDG). Based on a simple cross-country regression analysis, the paper argues that average Millennium Development Goal progress is likely to be too slow to meet education and health sector targets in a number of developing countries. The paper further shows that MDG achievement can be described by a transition path with declining rates of progress. More detailed analysis reveals that the transition toward universal primary school enrollment in poor countries with low initial enrollment has accelerated considerably in the more recent past. The main part of the paper then focuses on the role of demand versus supply-side factors in social service utilization in education and health. The review arrives at the following rules of thumb that reflect some of the key determinants of achievement of the Millennium Development Goals: First, specific single policy interventions can have a considerable impact on social service utilization and specific human development outcomes. For example, improving access to basic health services, in particular to vaccination, has been a key factor in reducing child mortality rates in a number of very poor countries. Second, demand-side policies have proved extremely effective, for example in raising school enrollment and attainment levels. However, there may be more scope for targeting the demand-side in the health sector. Third, policy effectiveness and efficiency are highly dependent on initial conditions and the specificities of the respective policy. Fourth, complementarities between MDG targets, in particular social service utilization, are likely to be very important.

Aged --- Breastfeeding --- Clinics --- Education --- Education For All --- Exercises --- Families --- Health --- Health care --- Health interventions --- Health Monitoring & Evaluation --- Health outcomes --- Health policy --- Health services --- Health Systems Development & Reform --- Immunization --- Infant health --- Intervention --- Mortality --- Nutrition --- Nutrition and Population --- Pregnancy --- Primary Education --- Primary schools --- Public health --- Social services --- Teaching and Learning --- Vaccination

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The health and wellbeing of people and the planet is currently receiving a much attention, if only because of the ongoing global crisis instigated by COVID-19. The benefits of nature for human wellbeing have been scientifically studied in multiple disciplines for over three decades. Researchers from disciplines such as ecology, sport science, psychology, tourism, medicine, forestry, environmental studies and architecture have found evidence that being in nature, interacting with nature, and feeling connected to nature are important for good health and wellbeing. In particular, physical activity in nature has been linked to wellbeing. This manuscript explores a particular type of physical activity in nature: adventure and outdoor activity. Adventure in nature is important for wellbeing, and carefully designed interventions and programs can have a profound impact. The work in this book suggests that adventure should be considered an important part of the public health offering.

Lifestyle, sport & leisure --- physical education --- national curriculum --- military personnel --- psychological wellbeing --- outdoor adventure activities --- mental health --- resilience --- mental health problems --- higher education --- outdoor adventure --- multi-variate quantitative analyses --- active components of positive change --- school children --- transitions --- primary and secondary school --- nature --- tailored outdoor education programming --- individuality --- adaptable productive functioning --- green spaces --- health and psychological well-being --- self-determination --- adventure --- armed forces --- physical activity --- recovery --- soldiers --- Nature–based health interventions --- green prescriptions --- wilderness therapy --- forest schools --- green exercise --- adherence --- compliance --- health --- outdoor and adventure activities --- outdoor therapy --- phenomenology --- therapeutic process --- embodiment --- lived-experience --- slow adventure --- time --- slowness --- wellbeing --- cognitive dissonance --- strategies of dissonance reduction --- characteristics of dissonance arousal and modes of reduction --- consonant cognitions --- attitude and behaviour change --- autophenomenology --- adventure education programming --- Ecological Dynamics --- adventure education --- representative design --- outdoor and adventure sports --- n/a --- Nature-based health interventions