Correspondencia: Vicente Ortún. Centro de Investigación en Economía y Salud. Universitat Pompeu Fabra. Ramon Trias Fargas, 25. 08005 Barcelona. España.
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Centro de Investigación en Economía y Salud. Universitat Pompeu Fabra. Ramon Trias Fargas, 25. 08005 Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Public health: «politics help those who help themselves [in health services]»" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13906" "palabras" => array:8 [ 0 => "Determinantes de la salud" 1 => "Círculo vicioso pobreza/enfermedad" 2 => "Análisis coste-beneficio generalizado" 3 => "Establecimiento de prioridades" 4 => "Globalización" 5 => "Estado del Bienestar" 6 => "Salud Pública" 7 => "España" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13905" "palabras" => array:8 [ 0 => "Health determinants" 1 => "Poverty/illness vicious circle" 2 => "Generalized cost-benefit analysis" 3 => "Establishment of priorities" 4 => "Globalization" 5 => "Welfare State" 6 => "Public Health" 7 => "Spain" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La salud de los países pobres mejora aplicando conocimientos de salud pública, lo que requiere capacidad institucional y voluntad política, dos condiciones que el mero aumento de la renta no garantiza. Tanto el análisis coste-beneficio generalizado como la priorización social o compartir conocimientos mediante consenso constituyen métodos adecuados para escoger los planes de actuación. Ciertos problemas, como el aumento de la desigualdad dentro de cada país o el calentamiento global, pueden requerir cambios en nuestras «reglas de juego» al resultar muy difíciles de abordar tanto a través de mecanismos de mercado como mediante las intervenciones públicas de las actuales naciones-estado. «A la política rogando y con el mazo dando (en los servicios sanitarios)» podría ser el lema de la necesaria conciliación entre las acciones individuales y las colectivas sobre la salud. Resulta tan importante actuar sobre las diferencias de morbilidad entre individuos con parecidas exposiciones como disminuir el riesgo global de los grupos poblacionales en los que se concentran las desgracias. En un país como España la conciliación citada pasa por un Estado del Bienestar que consiga una «deseabilidad» social basada en su legitimación democrática y efectividad de actuación, que requiere la consecución de la mejor combinación de actuaciones clínicas y de salud pública.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Poor countries health improves with the application of public health knowledge, but this requires from institutional capacity and political will, not automatically guaranteed by income growth alone. Generalized cost-benefit analysis, explicit establishment of priorities and even consensus (knowledge sharing) are suitable methods to select appropriate policies. Some problems, such as the increasing inequalities among countries or the global warming, may require a change of our institutions given than both market mechanisms and traditional policy intervention by nation-states may prove insufficient. «Politics help those who help themselves (in health services)» could be the motto for the necessary conciliation between individual and collective actions on health. It has a similar importance to act upon the differences between individuals with similar exposures as diminishing the global risk of those social groups where misfortunes cluster. In a country such as Spain the aforementioned conciliation happens though a Welfare State capable of achieving social ‘desirability’ based upon democratic legitimacy and effective behavior, effectiveness that can not be obtained without the best combination of clinical and Public Health interventions.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The escape from hunger and premature death, 1700-2100" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.W. Fogel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2004" "editorial" => "Cambridge University Press" "editorialLocalizacion" => "Cambridge" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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Idioma original: Español
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