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The article discusses issues related to the consequences of a possible thermonuclear attack on a major city in the United States. On one hand, the nature and magnitude of the effects of hypothetical nuclear attacks are entirely specifiable, on the other hand, these effects are completely immeasurable. This difficulty primarily occurs due to the attempt of describing an event that is without precedent. It has been suggested that in attempting to comprehend the consequences of such an attack, it is useful to consider the case of a single city and a single weapon. Hiroshima and Nagasaki in Japan do not serve as precedents for any hypothetical nuclear war scenario.

The authors discuss the publication of five articles collectively entitled "The medical consequences of thermonuclear war," which constituted the analysis by medical scientists and physicians on thermonuclear attack in the U.S. The authors say that the publication has had an impact nationally and internationally which frightened populations, physicians, and civil defence. They mention that the article was based on a hypothetical 1445-megaton attack on U.S. missile cities and based.

In this article, the author expresses his views on the failure of the U.S. health care reform debate in 2010 to discuss issues involving community health centers (CHCs). He reports that CHCs were launched by the U.S. Office of Economic Opportunity in 1965 under the administration of former U.S. President Lyndon Johnson. He also emphasizes that CHCs have been a medical home to approximately 20 million American citizens.

The article discusses the history of the Tufts Comprehensive Community Health Action Program which was proposed in 1965 to intervene in the cycle of extreme poverty, illiteracy, and unemployment in America, and it mentions the struggles of black people in places such as Bolivar County, Mississippi during the 20th century. The success of the Tufts-Delta Health Center is examined, along with comprehensive health services involving preventive medicine, pediatrics, and health education.

The U.S. Department of Health and Human Services (HHS) is committed to promoting health information technology (HIT) throughout health care. However, selection, acquisition, and implementation of HIT for quality improvement (QI) are beyond the means of many federally supported community health centers (CHCs). In the absence of federal leadership and investment, adoption of HIT will be slow, haphazard, duplicative, and wasteful. HHS should actively support HIT to improve quality in CHCs. This will maximize HIT benefits, minimize costs, and ensure that CHCs have the tools to address the needs of vulnerable populations. [ABSTRACT FROM AUTHOR]

Community health centers in the United States, first launched as a federal initiative in 1965, were rooted in models from South Africa, the American civil rights struggle, and a national commitment to address poverty. The first 2 centers, one serving a rural population in the Mississippi Delta and another a public housing project in Boston, incorporated such core principles as provision of primary care to a defined area or population; public health interventions addressing social determinants of health; emphasis on community participation; community empowerment leading to control of the new institutions; epidemiologic methods to identify problems and guide decisions; new combinations of clinical and public health personnel; and reduction of disparities in health and healthcare of the poor and minorities. The continuing relevance of these principles in today's greatly expanded health center network is reviewed. [ABSTRACT FROM AUTHOR]

Focuses on civil rights movement in the U.S. National struggles over race and ethnicity; March toward equality; Biological inferiority of a race.

This editorial looks at race and health in America and says the disparity of medical treatment in the two groups continues. A study in this issue showed that people of color in the U.S. are offered fewer medical options to treat chronic diseases. The author suggests that unconscious racism could be a contributing factor and urges every hospital to check on the care offered to whites and blacks and check and see if there is a communication problem between doctors and patients.

Opinion. Focuses on minority enrollment in medical schools in the United States. Percentage of minorities training in hospitals; Effects of the assault on affirmative action to minority enrollment; College admission rates for minorities.

The author comments on racism in relation to various public health issues in the U.S. He states that the Tuskegee Syphilis Study was only one event in a cumulative experience of several hundred years of pseudoscientific racism and pervasive discrimination in medicine, unethical and often brutal experimentation and abuse of Black people by both private institutions and government programs in health and social welfare.

Discusses the problem of racial and ethnic disparities in United States health care. Details of a specific ballot initiative in California called Proposition 54, which would eliminate the collection of health-related racial and ethnic data; Information from a report published by Physicians for Human Rights which discusses the role of racial and ethnic data collection; Efforts and roles of the government and private industries in bettering racial and ethnic disparities in US health care, such as the Closing the Health Care Gap Act of 2003; Past efforts of bettering racial and ethnic disparities in US health care; Reasons why such change in racial and ethnic disparities in US health care is needed.

Reports on the passage of an amendment in the United States Senate on May 1, 1996, protecting the principles and processes of asylum for victims of torture and persecution. Narrow margin of vote; How the anti-terrorism act would have allowed summary exclusion of asylum claimants; Widespread anti-immigrant sentiment in the US; How Senate action must now be reconciled in conference with the House of Representatives. INSET: Extracts from case-reports for two asylum claimants.

Background: The U.S. poverty rate has increased since 2000, but the depth of poverty experienced by Americans has been inadequately studied. Of particular concern is whether severe poverty is increasing, a trend that would carry important public health implications. Methods: Income-to-poverty (I/P) ratios and income deficits/surpluses were examined for the 1990–2004 period. The severely poor, moderately poor, and near-poor were classified as those with I/P ratios of less than 0.5, 0.5 to 1.0, or 1.0 to 2.0, respectively. Income deficits/surpluses were classified relative to the poverty threshold as Tier I (deficit $8000 or more), Tier II (deficit or surplus less than $8000), or Tier III (surplus more than $8000). Odds ratios for severe poverty and Tier I were also calculated. Results: Severe poverty increased between 2000 and 2004—those with I/P ratios of less than 0.5 grew by 20%, and Tier I grew by 45% to 55%—while the prevalence of higher levels of income diminished. The population in severe poverty was over-represented by children (odds ratio [OR]=1.69, confidence interval [CI]=1.63–1.75), African Americans (OR=2.84, CI=2.74–2.95), and Hispanics (OR=1.64, CI=1.58–1.71). Conclusions: From 2000 to 2004, the prevalence of severe poverty increased sharply while the proportion of Americans in higher income tiers diminished. These trends have broad societal implications. Likely health consequences include a higher prevalence of chronic illnesses, more frequent and severe disease complications, and increased demands and costs for healthcare services. Adverse effects on children warrant special concern. The growth in the number of Americans living in poverty calls for the re-examination of policies enacted in recent years to foster economic progress. [Copyright &y& Elsevier]

The U.S. Department of Health and Human Services (HHS) is committed to promoting health information technology (HIT) throughout health care. However, selection, acquisition, and implementation of HIT for quality improvement (QI) are beyond the means of many federally supported community health centers (CHCs). In the absence of federal leadership and investment, adoption of HIT will be slow, haphazard, duplicative, and wasteful. HHS should actively support HIT to improve quality in CHCs. This will maximize HIT benefits, minimize costs, and ensure that CHCs have the tools to address the needs of vulnerable populations.

Mervyn Susser's poignant reminiscence of the work of Sidney and Emily Kark in South Africa [August 1987, Vol. 17, No. 4] has a second, American, chapter. In ways that are still unfolding, and insufficiently recognized, the Karks have had a direct and profound effect on community medicine in the United States. Sidney Kark is, in a sense, the "grandfather" of the U.S. community health center network, and mentor, friend, and consultant to a generation of American community-health workers.

Tracing the complex changes that have taken place in the nation's health-care system over the last eight years, Geiger points out why opportunities are now ripe for change. If progress is to be made towards establishing a national health-care program, he argues, we must shift the terms of the debate away from fiscal and technical details and return it to the arena of public concern and social responsibility.