Evaluation of Public Health Postwar Rehabilitation Policy Evaluation of Public Health Postwar...
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Evaluation of Public Health Evaluation of Public Health Postwar Rehabilitation PolicyPostwar Rehabilitation Policy
A lesson from the United States experience in postwar Okinawa
Hidemi Todoriki, Ph.D.Hidemi Todoriki, Ph.D.
Faculty of Medicine, University of the RyukyusFaculty of Medicine, University of the Ryukyus
Okinawa, JapanOkinawa, Japan
Learning from OkinawaLearning from Okinawa Learning from the United States
experience in Okinawa can help to promote the success of current efforts in Iraq
By Alexander Cooley and Kimberly Zisk Marten at Barnard College, Columbia University. The New York Times July 30, 2003.
Policy decisions have a significant impact on public health
Life expectancy in Okinawa is the longest in the world
Simply verifying past public health policy decisions is insufficient
Currently there is no effective evaluation process
BackgroundBackground
Implications & ObjectiveImplications & Objective
“A comprehensive database must be created to enable systematic evaluation and analysis of public health decision making practices”
7,320 documents 1,917 cases
GHQ/SCAP/PHWGHQ/SCAP/PHWOkinawa DatabaseOkinawa Database
Example of MethodologyExample of Methodology
Data on Okinawan people infected with malData on Okinawan people infected with malariaaria
GHQ/Okinawa DatabaseGHQ/Okinawa Database
Findings Findings in Okinawain Okinawa
Creation of new Creation of new healthcare policies healthcare policies in U.S.in U.S.
Ability to identify and analyze changes in policy decision making over time
Numerical data support validity of analysis
Ability to compare and contrast U.S. policy decisions in Okinawa and mainland Japan
Lessons can be applied to postwar rehabilitation efforts in Iraq, Afghanistan, and regions of Africa
Significance and Applications of Significance and Applications of GHQ Okinawa DatabaseGHQ Okinawa Database
1945
1946
1947
1948
1949
1950
1951
1952
1953
Environmental Hygiene
Nourishment
Measure against infections
Social welfare
Veterinary science
Medical affairs
Medical materials
Year
Annual Transition in Annual Transition in Amount of DocumentationAmount of Documentation
Policy AssessmentPolicy Assessment
Transition of policy development Policy assessment of malaria
measures Political decisions regarding dietary
energy allowances for inhabitants of post-war countries
Weight of schoolchildren in post-war countries and analysis of nutritional transition as a result of food supply policy
Analysis of extent to which fundamental policy of 50 years ago applies today
Identification and evaluation of best common practices in past and present
Comparison with other public health programs today (e.g. MSF: Medecins Sans Frontieres ,Doctors Without Borders)
Does the U.S. previous postwar Does the U.S. previous postwar rehabilitation policy apply today?rehabilitation policy apply today?
Applications of Okinawa Model
Okinawa can be used as a case study to assist in current and future post-war rehabilitation efforts
Public policy can be adjusted according to strengths and weaknesses of the Okinawa model
Educational tools can be developed based on the Okinawa study
A comprehensive model can be developed for public health policy in post war countries
Broad Objective: Adjustment of United States Public
Health Policy
Current Undertakings: Evaluation of health care policy for
Hansen's disease Policy assessment of food nourishment
measures Political decisions regarding dietary energy
allowances for inhabitants of post-war countries Weight of schoolchildren in post-war countries and
analysis of nutritional transition as a result of food supply policy
Future Aims
Military Public Health Military Policy Decision Making (Public
Health) Personal history of Army surgeon in GHQ Personal affairs of Army surgeon in GHQ Future applications to North Korea (rice
staple as a common link with Okinawa, Japan)
Additional Areas to Investigate